Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In patients with ischemic heart disease (IHD) with early coronary atherosclerosis the ratio of the myocardial ischemia pain episodes (MIPE) to myocardial ischemia pain-free episodes (MIPFE) is 1:4. In IHD patients, an important role to play in the development of MIPFE has the first segmental link in the analgetic system leading to a segmental rise of the electropain sensitivity threshold. Blockade of alpha 1-adrenoreceptors with prazosinum decreases the activity of analgesic mechanisms and favours transition from MIPFE to MIPE. In patients with the initial stages of coronary atherosclerosis, prazosinum promotes a significant alleviation of both MIPFE and MIPE.
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PMID:[The role of segmental analgesic mechanisms in the development of silent myocardial ischemia in patients with initial coronary atherosclerosis]. 783 75

Between 1953 and 1993, 659 patients underwent descending thoracic aneurysm resection. The most common etiology was atherosclerosis. Pain was the main presenting symptom. Perioperative mortality fell from 24.2% between 1953 and 1964 to 14.3% between 1970 and 1993. Paraplegia occurred in 4.1% (27/659) patients overall and was little affected by time of operation or use of atriofemoral bypass. Paraparesis occurred in 5.9% (39/659) patients and was reduced by use of atriofemoral bypass. The low rate of paraparesis in the earlier experience was offset by the higher perioperative mortality from hemorrhage, attributable to the use of systemic heparin. The use of heparin-free circuits with centrifugal pumps should be considered in patients likely to have a clamp time greater than 30 minutes. The major source of perioperative morbidity and mortality was cardiac causes (48%) followed by perioperative hemorrhage (14.4%), pulmonary complications (14.4%), and rupture of another aneurysmal segment (12.0%). Late mortality occurred most commonly from cardiac causes (30.6% of deaths) and rupture of another aneurysm (16.3% of deaths). Improvement in results was due to general refinements of management in all areas rather than any single factor. These results indicate that complete preoperative assessment of the patient and the entire aorta is essential and that regular life-long follow-up is critical in order to avoid unnecessary morbidity and mortality from cardiac, cerebrovascular, or subsequent aneurysmal complications.
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PMID:Evolution of surgical techniques for aneurysms of the descending thoracic aorta: twenty-nine years experience with 659 patients. 784 45

Isolated lateral thalamic infarcts (LThl) are rare. They often produce lacunar syndromes, and their main cause is thought to be an hypertensive arteriolopathy. To verify these data, we reviewed 639 cerebral infarcts demonstrated by CT and/or MRI and included in a hospital stroke registry over a 4-year period. We identified 22 cases (3.5 p. 100) of isolated LThl (right LThl: 15; left LThl: 7). Nineteen had MRI study. There were 13 men and 9 women of mean age 65 years. None had the complete Dejerine-Roussy syndrome: sensory disturbances 21 cases, hemiparesis 7, hemiataxia 5, involuntary movements 4. They were divided in group 1 (14 cases) with prominent sensory symptomatology and group 2 (8 cases) with prominent motor symptomatology. The pulvinar and the ventral posterior thalamic nucleus were affected in both groups while adjacent nuclei such as ventral lateral or lateral posterior were more often affected in group 2. All patients but one had good recovery but 13 developed thalamic pain severely interfering with social activities in 5 cases. Several findings suggested that rather an arteriolopathy than large vessels disease or cardiogenic embolism had been a major cause in this series: 1) all patients but one (including 2 with a potential cardiac source of embolism) were hypertensive or diabetic, 2) lesions were small infarcts in the territory of perforators, 3) patients did not experience premonitory as well as subsequent cerebral events suggestive of vertebrobasilar atherosclerosis while 2 experienced deep cerebral hypertensive hemorrhage, and 4) neuro-imaging found additional asymptomatic lacunes in numerous patients. However, in the absence of angiography in most patients, these results do not preclude a potential role of artery-to-artery microembolism.
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PMID:[Lateral thalamic infarction. 22 cases]. 811 31

Peripheral obstructive arterial disease (POAD) of the lower limbs is the third main complication of atherosclerosis, after coronary artery disease and cerebrovascular disease. In 15-20% of cases POAD have an unfavourable evolution toward critical leg ischemia (CLI). This clinical condition is characterized by the onset of rest pain and/or trophic cutaneous lesions until gangrene appears. In some cases amputation is needed. The pathophysiological, clinical and therapeutic aspects of CLI were recently discussed in two Consensus Conferences held in Berlin in 1989 and in Rudesheim in 1991, with the elaboration of a final draft published on circulation. CLI appears when peripheral perfusion critically decreases due to macro and microcirculatory alterations. Atherosclerotic plaque is the primum movens, but often there are more plaques in sequence along the ilio-femoro-popliteal axis. The pathophysiological and clinical consequences are more severe if the stenosis is haemodynamically important, after a rapid progression of plaque growth or when thrombotic complications develop. The reduction in distal perfusion induces troubles in the microcirculation and an embalancement between the microvascular defense system (MDS) and the microvascular flow regulating system (MFRS) with endothelial dysfunction, platelet and leucocytes activation, worsening of blood viscosity due to the increase in fibrinogen levels and to the red cells deformability changes, activation of coagulation and impairment of fibrinolysis. So, a vicious circle appears with further worsening of distal perfusion and onset of trophic lesions. A further worsening of CLI can derive from local recurrent infections particularly frequent in diabetic patients.
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PMID:[The physiopathology of critical ischemia of the lower limbs]. 811 25

Two 11-month-old 7-kg unrelated female Beagles had clinical signs referable to the cardiovascular system. Histologic studies in both dogs revealed strikingly similar findings of sclerosis of the arteries of the sinoatrial node. Histologic changes included intimal thickening and fibrosis, with marked luminal narrowing; medial hypertrophy, fibrosis, and smooth muscle cell proliferation; and elastic fiber disruption and reduplication. Possible differential diagnoses for this condition included systemic necrotizing vasculitis (canine pain syndrome), coronary polyarteritis, and atherosclerosis.
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PMID:Sinoatrial node arteriosclerosis in two young dogs. 817 70

Fifteen patients with atherosclerosis obliterans at the lower limbs, no candidates to revascularizing surgery were submitted to ozone therapy. An improvement statistically significant was noticed in the treatment groups since amputation ratio decreased (26.7%) and the need of pain's surgery procedures (13.3%) in comparison with the control group (46.7 and 26.7% respectively). Ozone therapy is considered as a good way in the management of the atherosclerosis with obliteration in late period.
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PMID:[Ozone therapy in the advanced stages of arteriosclerosis obliterans]. 823 44

We report a 37-year-old man with cerebral infarction due to meningovascular neurosyphilis. He developed right hemiplegia and motor aphasia preceded by left retroorbital pain lasting a month. Bilateral tonic pupils were also observed. Magnetic resonance imaging (MRI) disclosed cerebral infarction in the distribution of perforating branches of the left middle cerebral artery. Abnormal enhancement was absent in the meninges on T1-weighted MRI examination. SPECT study with I-123 iodoamphetamine showed decreased perfusion in the area of the left middle cerebral artery on early phase. A delayed SPECT 4 hour later demonstrated redistribution of the cerebral blood flow in the area of its cortical branches. On cerebral angiograms, marked stenoses were disclosed at the supraclinoid segments of the bilateral internal carotid arteries as well as the M1 segment of the left middle cerebral artery. These stenoses were associated with increased collateral circulations on the left side. Atherosclerosis was not apparent, on angiography. The cerebrospinal fluid (CSF) showed pleocytosis and positive TPHA. The CSF/serum ratio of TPHA was 1/16. Oligoclonal IgG band was present in the CSF. CSF IgG index was elevated. These findings were consistent with meningovascular neurosyphilis. Causes of angiitis other than syphilis were excluded. A test for antibodies against human immunodeficiency virus was negative. The clinical course of his recovery was similar to that in patients with atherosclerotic thrombosis. The stenosis of the right internal carotid artery demonstrated by angiography could not be expected from the clinical manifestations and SPECT study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Bilateral internal carotid artery stenoses in a patient with meningovascular neurosyphilis]. 826

A sixty-six-year-old man with known severe atherosclerosis was admitted with painful feet and nonblanching purpuric lesions of his toes. He had undergone cardiac catheterization and coronary artery bypass five and three months, respectively, prior to admission. Initial treatment included: stopping the patient's lisinopril, increasing his nifedipine dose, and adding pentoxifylline 400 mg po tid. Within twenty-four hours pain was markedly decreased. Skin biopsy confirmed a diagnosis of cholesterol embolism. Pentoxifylline was stopped and intravenous heparin therapy was initiated. Within twenty-four hours, pain returned. Nitrol paste applied to the top of each foot had no effect. After forty-eight hours, pentoxifylline was restarted. Once again, pain relief was noted within twenty-four hours, and after forty-eight hours both feet were visibly improved. Heparin and analgesics were discontinued. On the ninth hospital day, the patient was able to walk and was discharged to home. The innocuous nature of the intervention combined with the prompt nature of the therapeutic response support a short trial of pentoxifylline in patients with cholesterol emboli who are not responding to other therapy.
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PMID:Pain relief and clinical improvement temporally related to the use of pentoxifylline in a patient with documented cholesterol emboli--a case report. 828 87

Pravastatin is a new lipid-lowering drug belonging to the class of 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase inhibitors. Since 1986, more than 15,000 patients have received pravastatin in sponsored clinical research trials with more than 21,000 cumulative patient-years of exposure to the drug. Analysis of long-term follow-up data from 1142 patients participating between 1986 and 1990 in six core randomized clinical trials in the United States confirms the favorable safety profile of pravastatin. Rash, gastrointestinal complaints, musculoskeletal pain, and elevations in liver transaminase levels, whether or not attributed to treatment, were the most common reasons for patients withdrawing from these trials. Ophthalmologic monitoring revealed no adverse effects on the crystalline lens. Safety assessments continue for two core trials in more than 400 patients with up to 7 years of continuous follow-up. The effects of pravastatin on serum cholesterol levels are not influenced by the age, sex, weight, or initial cholesterol level of the patient. Vitamin E, A, and D metabolism remain normal during treatment. Combination therapy with pravastatin and bile-acid-binding resins or niacin is well tolerated, with additive effects on low-density lipoprotein cholesterol. There is limited experience with the combination of pravastatin and gemfibrozil or cyclosporine. An ongoing arteriosclerosis research program with more than 21,000 patients enrolled will further define the long-term safety of pravastatin and its effects on atherosclerosis progression, as well as its role in the primary and secondary prevention of coronary heart disease.
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PMID:Long-term experience with pravastatin in clinical research trials. 845 55

A structured vascular rehabilitation program is effective in relieving pain, improving function, and promoting optimal wellness. The rehabilitation program at the Vascular Institute of Florida uses supervised in-house exercise as well as a home maintenance program with follow-up. Extensive education and information on life-style factors are provided to the patient to normalize blood fats, control high blood pressure, stabilize blood glucose levels, reduce adverse stress, prevent progression of illness, and potentially prevent the progression of atherosclerosis to the arterial periphery. Ongoing research of structured exercise therapy and atherosclerotic risk factor behavior modification practices is crucial to the continued growth of vascular nursing.
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PMID:Benefits of a structured peripheral arterial vascular rehabilitation program. 850 81


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