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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent epidemiological studies have suggested that psoriasis represents a risk factor for thrombotic vascular diseases. In order to evaluate the possible role of hemostatic changes in the development of thrombotic episodes in psoriasis, some parameters of the hemostatic "balance" were investigated in 22 male psoriatic patients and compared to those of 22 male control subjects. Incidence of known risk factors for vascular diseases (diabetes, hypertension, smoking, dyslipidemia) was comparable in the two study groups. There were no statistically significant differences in platelet count, circulating platelet aggregates, platelet production of malondialdehyde (MDA), total plasma antithrombin and fibrinolytic activities. In patients with psoriasis the incidence of spontaneous platelet hyperaggregability and plasma levels of beta-thromboglobulin were significantly higher than in control subjects. Platelet regeneration time, measured as MDA recovery after aspirin ingestion, was significantly shorter in psoriatic patients. These data suggest that an in vivo platelet activation occurs in patients with psoriasis and could contribute to the development of thrombotic complications. The release of mitogenic and inflammatory substances by activated platelets may play a role in the histogenesis of psoriatic lesions.
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PMID:Platelet activation in psoriasis. 316 Dec 5

Many statistics demonstrate a definite improvement of myocardial infarction during hospitalization, especially a decrease in the mortality. It appears tempting to credit that improvement to the numerous modifications of the treatment of this dangerous disease in the last few decades. The study reported here indicates, however, that other factors must be taken into account. We compared the evolution of two groups of patients hospitalized for acute myocardial infection, 10 years apart: The first group (G1) of 731 patients corresponds to years 1970-1975; the second group (G2) of 729 patients, corresponds to the years 1984-85-86. During these ten years, mortality decreased by 38 p. cent, from 19.2 p. cent (G1) to 11.9 p. cent (G2). This decrease remains significant regardless of age and sex, except in two subgroups with the least number of patients, i.e. women under the age of 65 and men over 65. It should be noted that rhythm disorders occur with the same frequency in both sub-groups while atrio-ventricular blocks seem to have decreased. The difference in the mortality cannot be attributed to the patient's selection. In fact, in both groups, they are comparable regarding the men/women ratio, the age distribution and the presence of main risk factors (tobacco abuse, dyslipidemia, arterial hypertension, diabetes, heredity). The treatment results in many alterations especially concerning diuretics which seem to be used in approximately 30 p. cent of the patients in both groups. On the contrary, steroids, prescribed in 25.3 p. cent of G1 patients are abandoned; electro-systolic stimulation established in 21.2 p. cent of G1 patients, concerned only 4 p. cent of G2 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute myocardial infarction. Different treatment, different prognosis?]. 332 15

Polyarterial arteriosclerosis is a problem facing more and more clinicians because of the technical advances in exploration and revascularization methods. Epidemiologic data are rare in this field except for Framingham's study. We are reporting here the results of a French epidemiologic study regarding a representative sample of a group of 11,000 active men and women, with age ranging between 25 and 65 years. Methodologic difficulties cannot be avoided, but a minimal estimation may be expressed: polyarterial pathology represents approximately 15 p. cent of the pathology in each case. Polyarterial pathology is as prevalent as monoarterial pathology with a 10 years delay between the two sexes. Coronary diseases are the most frequent and represent the initial location in two-thirds of the cases. The same risk factors are found, but their chronology is different: more than ever, age is an essential factor since there is a ten years difference. Hyperglycaemia in men, overweight in women are major factors as important as tobacco abuse in men, arterial hypertension and dyslipidemia in both sexes. Finally the type A behavior seems to occupy an even larger role in polyarterial patients of both sexes.
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PMID:[Polyarterial pathology. Epidemiological aspects]. 336 39

Cardiovascular disease, so common in the elderly, has become an urgent public health concern. Major contributing factors include hypertension, dyslipidemia, impaired glucose tolerance, physical indolence, and cigarette smoking. Diet plays a major role in atherogenesis by its influence in blood lipids, blood pressure, and glucose tolerance, although its impact in the elderly is speculative owing to a paucity of direct evidence. But a rationale exists. Most cardiovascular risk factors are more prevalent in the elderly than in the young adult. The rise in blood pressure and blood lipids with advancing age is not inevitable. Diet may contribute to hypertension through an excess of calories, saturated fat, cholesterol, or salt and a deficiency of potassium, calcium, and magnesium. Antiatherogenic diets low in saturated fat and cholesterol, rich in fiber, and with substitution of polyunsaturated fat and restricted calories tend to normalize serum lipids and to cause lesions to involute. Emphasis on vegetable protein and fiber-rich food has merit because they provide more fiber, polyunsaturated fatty acids, magnesium, selenium, complex carbohydrate, potassium, and copper, and less cholesterol, saturated fat, and sodium. The recommended fat-modified diets are adequate in protein, vitamins, and minerals and need not be deficient in any nutrient or economically nonfeasible. The accelerating decline in cardiovascular mortality, which has included the elderly, indicates that such disease is controllable and not inevitable, even in the elderly. The decrease has occurred concurrently with reduced consumption of saturated fat and cholesterol, increased use of vegetable oils, and improved levels of cardiovascular risk factors.
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PMID:Nutritional contributors to cardiovascular disease in the elderly. 351 Feb 41

Type A represents a type of behavior manifested by an almost constant pressure of time, a deep desire of social success and a considerable underlying hostility which is largely repressed. A critical study is presented in light of the results of two prospective epidemiological surveys. The evaluation methods (interview, questionnaires) are described and seem to offer a satisfactory concordance ratio. Type A is as widespread among the french populations studied (42.2%) as among the north-american populations. It is closely related to environmental pressures. Prospective surveys have shown that this type of behavior is strongly correlated with an incidence of ischemic cardiopathies and that its predictive value is independent, and equivalent, to that of major risk factors (tobacco, arterial hypertension, dyslipidemia). This predictive value seems definite, but with more magnitude for myocardial infarction than for angina. Major implications in the prevention and the treatment of ischemic cardiopathies and the direction of research programs may be considered.
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PMID:[Ischemic cardiopathies, environment and personality. Role of type A behavior]. 359 56

Primary and secondary risk factors and prevention strategies for coronary artery disease are reviewed. Cigarette smoking, hypertension, dyslipidemia, heredity, diabetes mellitus, obesity, beta blockades, and coronary artery bypass surgery are some of the topics discussed.
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PMID:Preventive cardiology for coronary artery disease. 384 6

Risk factors for the development and progression of coronary atherosclerosis, hypertension, and cerebrovascular diseases are found in more than 10 per cent of children and adolescents in the United States. This article presents the criteria for the diagnosis of three of these risk conditions--dyslipidemia, hypertension, and obesity--and it reviews principles and specifics of their management in young people.
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PMID:Familial cardiovascular risk factors: diagnosis and management in the young. 384 7

The influence of age and other risk factors (history of hypertension and diabetes, cigarette smoking, dyslipidemia) on cerebral atherosclerosis was studied in 462 patients with RIA who had cerebral angiography. The degree of atherosclerosis was quantified using extracranial and intracranial cerebrovascular scores (ECS, ICS) based on the number and severity of the lesion in 11 extracranial and 21 intracranial arterial segments. Thirty-six percent of the patients under age 45 had a normal angiogram compared with 17% of the patients over 45. In the subgroup of patients with abnormal angiogram the mean ECS and ICS vascular scores were not significantly different in the two age groups. Cigarette smoking was the only risk factor to show a strong association with the extracranial score, and it was independent of the effect of age and other risk factors.
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PMID:Italian multicenter study on reversible cerebral ischemic attacks: III--Influence of age and risk factors on cerebrovascular atherosclerosis. 670 47

The case of a 26 year old woman who had been taking tranexamic acid to prevent uterine bleeding due to an IUD and who died from thrombosis of the left internal carotid artery is reported. The patient's father had died at age 54 of myocardial infarction. Otherwise the family history was entirely negative for thromboembolic disease. The patient was a mild smoker. She had been previously healthy and in particular, she was not affected with hypertension, diabetes, or dyslipidemia. She had carried to term 2 uncomplicated pregnancies. 40 days prior to hospital admission her gynecologist had inserted an IUD. The insertion of the IUD was followed by persistent uterine bleeding, and for this reason she began treatment with tranexamic acid (1.5 g/daily). Uterine bleeding persisted despite this treatment, and the IUD was removed. Because of persistence of a mild uterine bleeding, tranexamic acid was continued. 2 hours before admission the patient suddenly presented a left sided hemiparesis with disarthria and vomiting. On admission she was stuporous. The left side of her face drooped and the strength of the left arm and leg was markedly decreased. Both arm and leg reflexes were symmetrical. Her blood pressure was 110/70. An electroencephalogram on arrival confirmed a right sided cerebral lesion. Subsequently the patient's condition deteriorated rapidly. She developed a full left hemiplegia and became deeply comatose. A CAT scan performed 4 hours after admission showed no abnormalities. A CAT scan performed 3 days after admission showed a large cerebral infarction involving nearly the whole right cerebral hemisphere. The patient's condition remained essentially unchanged until she died 6 days after admission. Permission for autopsy was refused. Antifibrinolytic drugs competitively inhibit plasminogen activators and noncompetitively plasmin. Thromboembolic complications after the administration of antifibrinolytic drugs have long been recognized. The use of IUDs is often associated with troublesome uterine bleeding and particularly excessive menstrual bleeding. To avoid these complaints, antifibrinolytic drugs are increasingly used.
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PMID:Tranexamic acid, intrauterine contraceptive devices and fatal cerebral arterial thrombosis. Case report. 710 62

56 cerebral ischemia patients up to the age of 40 were investigated using a strict clinical and instrumental protocol in order to elicit the relative importance of the various iatrogenic factors involved. In addition to atherosclerosis risk factors (smoking, hypertension, ischemic heart disease, diabetes, dyslipidemia) other possible causes of cerebral ischemia were sought (arteritis, migraine, head injury, oral contraceptives, coagulation disorders, cardiogenic embolism, etc.). 50% of the patients examined had at least two atherosclerosis risk factors and 55% had other causes singly or in association with atherosclerosis.
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PMID:Cerebral ischemia in young adults. 733 59


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