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)

A 35-year-old yellow-naped Amazon parrot (Amazona ochrocephala auropalliata) was presented for gradually increasing inappetence, ataxia, weakness, and lethargy. Radiographic and ultrasonographic findings were strongly suggestive of atherosclerosis. Isoxsuprine, a peripheral vasodilator demonstrated to be of benefit in humans with intermittent limb pain, weakness, and lameness secondary to occlusive vascular disease, was selected for treatment. The bird's clinical signs resolved during treatment but recurred after varying periods of time when the medication was stopped intermittently. Nearly 3 years after the initial examination, the parrot was doing well on isoxsuprine therapy, with normal prehension of food with its feet and no recurrence of clinical signs.
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PMID:Use of isoxsuprine for treatment of clinical signs associated with presumptive atherosclerosis in a yellow-naped Amazon parrot (Amazona ochrocephala auropalliata). 1808 39

Peripheral arterial disease (PAD), usually caused by atherosclerosis, is defined as an obstructive arterial disease of the lower extremities that reduces arterial flow during exercise or, in advanced stages, at rest. It affects more than 8.5 million people in the USA. PAD may appear as an asymptomatic arterial disease with abnormal noninvasive test results, or as a symptomatic disease presenting with atypical limb pain, classic intermittent claudication, or critical limb ischemia. The spectrum of PAD is not a continuum. Patients who present with critical limb ischemia may have experienced minimum symptoms. PAD results in limitation of exercise and walking ability, described as intermittent claudication. Patients with PAD are physically impaired and have a higher risk of cardiovascular events; therefore, the treatment goals are aimed at decreasing their cardiovascular risk, as well as improving exercise and daily functional performance. Apart from supervised exercise, which is a major treatment modality for patients with PAD, as of yet there have been very few significant pharmacological breakthroughs in the treatment of PAD that increases blood flow to the ischemic limb. Although percutaneous intervention has markedly improved the treatment of PAD, bypass surgery continues to play an important role. For the most part medical therapy for PAD is designed as a secondary prevention for cardiovascular risk. These include antiplatelet therapy, statins, ACE-inhibitors, smoking cessation and possibly antihypertensive therapy. Revascularization is most beneficial for patients with lifestyle limiting symptoms, acute or chronic limb ischemia with resting pain or nonhealing ulcers. In the following review article we will try to explore the clinical role of some of the latest developments in this field.
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PMID:Peripheral artery disease: therapeutic advances. 1840 43

Critical limb ischemia (CLI) represents the most advanced clinical stage of peripheral arterial disease. It is usually caused by obstructive atherosclerotic arterial disease and is associated with very high morbidity and mortality. The pathophysiology of CLI is a complex and chronic process affecting the macrovascular and microvascular circulation of the muscle and non-muscle tissues of the lower limbs. In particular, the atherosclerosis-related vascular remodelling, angiogenesis and arteriogenesis are central phenomena in the process. The most common clinical manifestations of CLI are limb pain at rest, with or without trophic skin changes or tissue loss. Diagnosis of CLI is based on physical examination, ankle-brachial index measurement, duplex-ultrasound and angiography; transcutaneous oxygen may also help. Risk factor control is recommended for all patients with CLI. Individuals with minimal or no skin breakdown or in whom comorbid conditions avoid revascularization can be treated with medical therapy (antiplatelet agents, intravenous prostanoids, rheologic agents). Treatment of infection is mandatory to decrease the metabolic demands that hamper wound healing. Therapeutic angiogenesis has been pursued with several approaches ranging from gene therapy to the use of bone marrow-derived progenitor cells, but further phase II and III trials are needed. Finally, the evaluation of the risk, benefit and optimal timing of revascularization lesions or the decision about amputation and its extension is a complex decision that requires a multidisciplinary approach.
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PMID:Critical limb ischemia. 2200 25

Exertional lower limb pain is a frequent diagnostic issue in elderly patients. Arterial claudication results from the mismatch between the oxygen requirement of, and oxygen delivery to the exercising muscles. Non-invasive vascular investigations (ultrasound imaging, plethysmography or segmental pressure) are used in routine at rest or following exercise, but none can be used during walking or to directly monitor cutaneous oxygen delivery to the limb. Here, we review the methods, tips and traps of the transcutaneous oxygen pressure measurement technique and potential applications. Transcutaneous oxygen pressure measurement is largely used in vascular medicine for patients with critical limb ischemia. It can also detect regional blood flow impairment at the proximal and distal limb simultaneously and bilaterally during exercise. Exercise-oximetry can also analyze systemic oxygen pressure changes on a reference area on the chest, to screen for occult pulmonary disease. As a surface technique, it does not directly measure muscle oxygen content but provides a reliable estimation of regional blood flow impairment. With the use of a recently reported index that is independent of the unknown transcutaneous gradient for oxygen, exercise-oximetry provides some accurate information compared to classical non-invasive vascular investigations to argue for a vascular or non-vascular origin of exertional lower limb pain during exercise. Although a time consuming technique, it is a simple test and it is progressively spreading among referral vascular centers as a useful non-invasive diagnostic tool for patients suspected of arterial claudication.
Atherosclerosis 2018 09
PMID:Clinical application of transcutaneous oxygen pressure measurements during exercise. 3026 36