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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with intermittent claudication were used as a clinical model to study the effects of transient episodes of ischaemia. Compared with age and sex matched controls significantly greater increases in serum lipid peroxides and urinary microalbumin occurred after exercise. These results suggest that even relatively minor ischaemic episodes, as occur with claudication, are sufficient to cause tissue damage which may be mediated by oxygen derived free radicals. There are also changes in renal permselectivity suggestive of a generalised increase in vascular permeability. These preliminary findings may have important diagnostic, aetiological and therapeutic implications for patients with vascular disease.
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PMID:Systemic effects associated with intermittent claudication. A model to study biochemical aspects of vascular disease? 325 23

Buflomedil hydrochloride is a vasoactive drug with a variety of pharmacodynamic properties. Importantly, it seems to improve nutritional blood flow in ischaemic tissue of patients with peripheral and/or cerebral vascular disease by a combination of pharmacological effects: inhibition of alpha-adrenoceptors, inhibition of platelet aggregation, improved erythrocyte deformability, nonspecific and weak calcium antagonistic effects, and oxygen sparing activity. Therapeutic trials with buflomedil in patients with peripheral vascular diseases have shown that it increases walking distances in those with intermittent claudication and heals trophic lesions and reduces rest pain in many patients with more severe vasculopathies. In open clinical trials a good to very good clinical response was achieved in 57 to 87% of those treated. In comparative studies buflomedil 600 mg/day orally was shown to be significantly superior to placebo and comparable in efficacy to pentoxifylline (oxpentifylline) and naftidrofuryl. In patients with symptoms presumed to be due to cerebrovascular insufficiencies and elderly patients with senile dementia, buflomedil 450 to 600 mg/day alleviated symptoms associated with impairment of cognitive and psychometric function and was significantly superior to placebo and slightly more effective than drugs such as cinnarizine, flunarizine and co-dergocrine mesylate. Overall, buflomedil at dosages of up to 600 mg/day has been very well tolerated and discontinuation of therapy has rarely been necessary. Thus, buflomedil would seem to be a useful adjunct to conservative treatment in patients with mild-to-moderate peripheral vascular disease and/or cerebrovascular insufficiency, and well worth a try in patients with more severe peripheral disease unable to undergo surgery. However, a few well-designed long term studies are needed to fully define its overall place in therapy.
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PMID:Buflomedil. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in peripheral and cerebral vascular diseases. 329 20

The efficacy of Trental (pentoxifylline) in the treatment of intermittent claudication was evaluated in 14 double-blind randomized studies, involving 475 patients with chronic occlusive vascular disease. In twelve studies which were performed in the USA, different countries of Europe and Australia, a placebo was used as control. Low doses of adenosine or nylidrine respectively, were given to the control groups in the other two studies. A total of 238 patients were allotted to Trental and 237 to the control groups. In most studies, the recommended dosage of Trental was 3 X 400 mg pentoxifylline in sustained release tablets. Twelve of the 14 trials had a duration between 8 and 24 weeks. The efficacy of Trental was established in a reproducible manner through the trial series under different trial designs following the requirements and guidelines from local authorities and medical societies. The number of patients with an improvement in walking distance of more than 100% was four times higher in the Trental group compared with the control group. The superiority of the Trental treatment over the control's persisted also when taking into account risk factors such as diabetes, hypertension, smoking habits and duration of the disease.
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PMID:On the assessment of the efficacy of pentoxifylline (Trental). 329 15

A cross-sectional study on the prevalence of atherosclerotic vascular disease (ASVD) and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects was carried out from 1982 to 1984 in East Finland (Kuopio) and West Finland (Turku), two areas known to differ markedly in prevalence of ASVD in the nondiabetic population. A total of 510 diabetic and 649 nondiabetic subjects aged 45-64 yr were examined in East Finland and 549 diabetic and 724 nondiabetic subjects of the same age in West Finland. In both areas and in both sexes the prevalence of coronary heart disease (CHD), stroke, and intermittent claudication was higher in diabetic than in nondiabetic subjects. Both in diabetic and nondiabetic subjects the prevalence of ASVD was higher in East Finland than in West Finland. In men, the East-West difference in the prevalence of symptomatic CHD and claudication was greater in diabetic than in nondiabetic subjects. In both areas and in both sexes the serum lipid pattern was more atherogenic and hypertension was more frequent in diabetic than in nondiabetic subjects. In both diabetic and nondiabetic subjects, serum total-cholesterol level was somewhat higher and hypertension was more frequent in East Finland than in West Finland. The East-West difference in serum total-cholesterol was greater in diabetic than in nondiabetic subjects. In multiple logistic analyses including cardiovascular risk factors, diabetes status, and area of residence, residence in East Finland was found to be, in addition to diabetes, a strong independent factor associated with CHD, particularly in men.
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PMID:Atherosclerotic vascular disease and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects in Finland. 340

To define the prevalence of large vessel disease in Ethiopian diabetic patients, the protocol of the World Health Organisation Multinational Study of Vascular disease in Diabetics was used in the Diabetic Clinic of Yekatit 12 Hospital, Addis Ababa: 221 of the possible 261 patients aged 35 to 54 years were examined during 6 months. One hundred seven were diagnosed diabetic 1 to 6 years before study, 74, 7 to 13 years and 40, 14 years or more before the study. Forty-two percent were taking insulin; 18% had retinopathy, 7% heavy albuminuria. Body mass index (BMI) of less than 18 kg/m2 was found in 13.6%; 6.4% of men had BMI more than 27 and 50% of women more than 25. Only 30 patients had ever smoked cigarettes. The plasma cholesterol was less than 6.72 mmol/l in 90% of the 221 patients. Vascular disease led to the diagnosis of diabetes in 3 patients. At study, 19.9% were hypertensive but only 5% at the time of diagnosis. Only 1 patient had had ischaemic gangrene, 1 a stroke, 4 intermittent claudication, 4 angina pectoris and 1 a myocardial infarction. Electrocardiograms, centrally Minnesota-coded in London, were interpreted as Coronary Disease Probable in only 6 patients, and Coronary Disease Possible in 25; the other 190 tracings were normal. It is concluded that macrovascular disease is uncommon in middle-aged Ethiopian diabetic patients in Addis Ababa.
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PMID:Macrovascular disease in middle-aged diabetic patients in Addis Ababa, Ethiopia. 341 58

The sensitivity and specificity of the noninvasive measurement of transcutaneous oxygen tension (PtcO2) in detecting the site of vascular disease in either the iliac or superficial femoral arteries is reported herein. Patients presenting with intermittent claudication or ischemic pain at rest were studied to determine the presence or absence of iliac or femoral occlusive disease by assessing the level of PtcO2 measurements at sites above and below the knee. PtcO2 studies were assessed against changes in the arteriogram, the "gold standard" for judging peripheral arterial insufficiency. Using our criteria, PtcO2 measurements above the knee show a sensitivity rate of 86 per cent and a specificity rate of 20 per cent to detect iliac disease. PtcO2 measurements below the knee show a sensitivity rate of 91 per cent and a specificity rate of 33 per cent to detect femoral disease. The accuracy was 69 per cent and 76 per cent, respectively. The user of the test is mainly concerned with the "predictive values" which are functions of the sensitivity, specificity and prevalence of the disease. Transcutaneous oxygen measurements above and below the knee show a very good sensitivity for detecting iliac and femoral disease, indicating that they may well serve as a quick and convenient noninvasive diagnostic procedure.
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PMID:Transcutaneous oxygen tension measurements in the detection of iliac and femoral arterial disease. 354 74

A 4-year follow-up study was carried out on the prognosis of 54 patients (36 men and 18 women) who survived their first ischaemic brain infarction which had occurred under the age of 65. Twenty patients (15 men and 5 women) already had documented atherosclerotic vascular disease other than ischaemic brain infarction at the time of the hospital admission (atherosclerotic group). When both sexes were considered together, mortality during the 4-year follow-up was significantly higher in the atherosclerotic group than in the non-atherosclerotic group (6/20 versus 3/34; p less than 0.05) and this was due to an excess of cerebrovascular mortality (4/20 versus 0/34; p less than 0.05). The incidence of recurrent fatal or non-fatal ischaemic brain infarction was significantly higher in the atherosclerotic group than in the non-atherosclerotic group (8/20 versus 3/34; p less than 0.01). Among those patients who survived the 4-year follow-up period the incidence of new non-fatal atherosclerotic vascular events (cerebrovascular accident, myocardial infarction, other heart disease or intermittent claudication) was significantly higher in the atherosclerotic group than in the non-atherosclerotic group (8/14 versus 8/31; p less than 0.05). It is concluded, that the presence of atherosclerotic vascular disease at the time of first ischaemic brain infarction in patients under the age of 65 is associated with a significantly increased risk for recurrent ischaemic brain infarction or other new atherosclerotic vascular events.
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PMID:Four-year prognosis of patients under the age of 65 surviving their first ischaemic brain infarction. 371 78

The effectiveness of drugs to improve the walking distance in intermittent claudication patients is looked into five points: pathophysiology, drugs, methodology of clinical trials, sample survey among the members of the hemodynamic section of the French College of Vascular Diseases and biometric aspects. Finally, some important points of a clinical trial in this field are presented.
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PMID:[Evaluation of the effectiveness of medical treatment of intermittent claudication]. 390 16

Premature arteriosclerosis and thromboembolic events are well-known complications of homozygous homocystinuria due to cystathionine synthase deficiency. It is unknown whether heterozygosity for homocystinuria predisposes to premature vascular disease. We explored the frequency of excessive homocysteine accumulation after standardized methionine loading in 75 patients presenting with clinical signs of ischemic disease before the age of 50:25 with occlusive peripheral arterial disease, 25 with occlusive cerebrovascular disease, and 25 with myocardial infarction. In seven patients in each of the first two groups but in none of the patients in the third group, heterozygosity for homocystinuria was established on the basis of pathological homocysteinemia after methionine loading and cystathionine synthase deficiency in skin fibroblast cultures. Because the frequency of heterozygosity for homocystinuria in the normal population is 1 in 70 at the most, we conclude that this condition predisposes to the development of premature occlusive arterial disease, causing intermittent claudication, renovascular hypertension, and ischemic cerebrovascular disease.
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PMID:Heterozygosity for homocystinuria in premature peripheral and cerebral occlusive arterial disease. 188 23

In addition to the determination of the presenting symptom of patients with peripheral vascular occlusive disease, evaluation of these patients may include the noninvasive measurements of ankle/arm pressure ratio, limb blood flow, and treadmill testing to evaluate the severity of the reduction in blood flow. We have included metabolic studies to assess the effect of this reduced blood flow in patients with stable intermittent claudication (n = 20), and with end-stage ischemia (night and rest pain) (n = 11), and in a control group without vascular disease (n = 8). No correlations were found between the resting limb blood flow, ankle/arm pressure ratios, maximum walking distance, and stated walking distance for the patients with stable claudication. Although the oxygen consumption was reduced only in the patients with end-stage ischemia, the percent oxygen extraction was increased to the same level in the patients with stable claudication and those with end-stage ischemia. Intramuscular stores of high-energy phosphates and glycogen were maintained in all groups with the lactate/pyruvate ratio increased only in the patients with end-stage ischemia. The complex interrelationships between the rate and distribution of blood flow with exercise and enzyme adaptation in patients with vascular disease make current resting hemodynamic and metabolic evaluations a poor reflection of the severity of the clinical condition within each patient group. Therefore laboratory testing may offer no advantage over clinical presentation in the overall evaluation of these patients.
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PMID:Laboratory evaluation of patients with vascular occlusive disease. 405 49


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