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

The purpose of this study was to identify criteria contributing to successful long-term prosthetic use in patients with an amputation secondary to vascular disease. All elderly patients with a unilateral below-knee amputation or an above-knee amputation, secondary to vascular disease, seen in our clinic between 1977 and 1982 were included in this telephone survey. Of those contacted, 37 of 38 below-knee amputees (BKAs) and 7 of 18 above-knee amputees (AKAs) still wore their prostheses at least part of every day (success). We used a two-tailed chi-square to compare the success of the BKAs with the success of the AKAs. The BKAs were successful more often (X2 = 24.81, df = 1, p less than .001). All AKAs also were characterized according to age, time from prescription, obesity, ambulatory status, strength, range of motion, sex, general compliance, and medical problems after prosthetic prescription. Of these criteria, only compliance and medical problems after prescription showed a significant difference between successful and nonsuccessful long-term AKA prosthetic users (X2 = 5.76, df = 1, p less than .05 for each criterion). As the demands of quality assurance and diagnostic related groupings increase, these results can assist the physical therapy clinician in setting realistic goals for the geriatric amputee and help predict if the patient will be a successful prosthetic user.
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PMID:Selective criteria for successful long-term prosthetic use. 401 80

In view of recent interest in the relationship of haematocrit and blood viscosity to hypertension and vascular disease, we have analysed retrospectively the relationship of haematocrit to blood pressure, vascular complications and other variables in 2,381 patients referred to the Glasgow Blood Pressure Clinic. Haematocrit correlated negatively with age and systolic pressure in men, and positively with age and systolic pressure in females. Positive correlations were found in both sexes between haematocrit and serum alanine aminotransferase (possibly due to mutual correlation with alcohol); and between haematocrit and overweight (Quetelet Index) but not obesity (Ponderal Index). Increased haematocrit was also associated with cigarette smoking; and with history of angina, myocardial infarction and intermittent claudication in females. No correlation was observed between haematocrit and history of stroke. These findings suggest that prospective studies of haematocrit in hypertensives may be of interest.
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PMID:Haematocrit in patients attending a hypertension clinic. 405 4

A total of 6695 diabetic men and women, aged 35 to 54 years, from 14 centres and representing 13 national groups, participated in a vascular disease prevalence survey. A random sample was drawn after stratification of each centre's diabetic base population by sex, duration of diabetes and age. A common agreed protocol, standardized examination procedures, and centralized laboratory methods were used in the investigation. Within the age range examined there was considerable variation between centres in a number of variables, including degree of obesity (measured as Body Mass Index (BMI)), proportion treated with insulin and proportion of cigarette smokers. The latter also showed considerable sex differences within centres. Subjects with age at onset below 25 years were notably few in Hong Kong, Tokyo and Oklahoma. There was also considerable variation in the apparent prevalence of both large- and small-vessel (macrovascular and microvascular) disease between centres. In pooled data, measures of large-vessel disease were significantly and independently associated with age, blood pressure and BMI in both sexes, and with diabetes duration and plasma cholesterol in men only. Within-centre analyses showed blood pressure to be the most consistently associated variable in both sexes. In pooled data, small-vessel disease of the eye was significantly and independently associated with diabetes duration, blood pressure, BMI and type of treatment in both sexes. In within-centre analyses, diabetes duration was the most consistently associated variable, followed by blood pressure. Proteinuria as an index of small-vessel disease of the kidney was, in pooled data, significantly and independently correlated with diabetes duration, blood pressure and plasma cholesterol in both sexes. In within-centre analyses, blood pressure was the most consistently associated variable, with diabetes duration and plasma cholesterol equal second - significant in 12 of the 28 centre/sex groups. Heterogeneity of large-vessel disease prevalence in diabetic subjects is confirmed by this study, and the possibility of heterogeneity in small-vessel disease prevalence and severity is suggested.
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PMID:Prevalence of small vessel and large vessel disease in diabetic patients from 14 centres. The World Health Organisation Multinational Study of Vascular Disease in Diabetics. Diabetes Drafting Group. 406 55

Disturbances of carbohydrate metabolism due to oral contraceptives appear in diabetics but also in non-diabetics, mainly those who are at high risk for diabetes mellitus (advanced age, obesity, family history, previous abnormality of glucose tolerance). Under oral contraceptives, diabetes mellitus control deteriorates in 30% of all diabetics. Atherosclerosis seems to be accelerated and can lead to serious cardiovascular complications. Reducing the doses of estrogens and progestogens as well as choosing the least diabetogenic progestogen might help to prevent these complications. We believe that micro- or macro-angiopathy is an absolute contraindication of oral contraceptives.
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PMID:[Oral contraceptives, carbohydrate metabolism and diabetes mellitus]. 632 Apr 10

Glycoregulation and insulin secretion abnormalities and micro-angiopathy were systematically investigated in 46 patients (6 men and 40 women; mean age 34.8) seeking medical attention for obesity. In all patients, a three-hour oral glucose tolerance test (OGTT) with 50 g glucose, with concomitant plasma insulin determinations, Hb A1c assay and skin biopsy (SB) at the medial aspect of the arm (optic microscopy study, PAS stain) were performed. We obtained 46 Hb A1c assays, 45 OGTT, 43 insulin determinations and 42 SB. In 40 patients, all four studies were available. We consider as abnormal blood glucose greater than 7.8 mmol at 120 mn with intermediate measurement greater than 10.1, insulin greater than 64 mcU with a maximum delayed after the 60th mn, Hb A1c greater than 6.3% and SB score greater than 10 (evaluating basement membrane thickness, endothelium swelling, aspect of pericytes, perivascular infiltration and percentage of capillaries involved). We observed 6 abnormal OGTT, 12 dysinsulinisms (DI), 5 Hb A1c greater than 6.3% and 17 SB greater than or equal to 10 with typical diabetic microangiopathy. Out of 40 fully investigated patients, 14 were normal for all criteria, 12 had only one abnormality (12 SB, 5 DI, 1 OGTT), 6 had 2 abnormalities (2 SB + DI, OGTT + DI, SB + OGTT, SB + Hb A1c, DI + Hb A1c) and 2 had 3 abnormalities (SB + DI + Hb A1c, OGTT + DI + Hb A1c).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Detection of diabetes in obese patients. Systematic study of induced hyperglycemia with assays of blood insulin, glycosylated hemoglobin A1c and cutaneous biopsy in 46 patients]. 632 Apr 20

This report describes the impulsive function of the RAAS investigated in obese and non-obese hypertensives as compared to obese and non-obese normotensives. The aim of the investigation was to clarify whether or not the hypertensive vascular disease accompanying the ponderal excess can be regarded as a well-defined pathophysiologic entity. Data obtained showed that the behavior of the RAAS in hypertensive obese patients is quite different from that of non-obese hypertensives and obese normotensives. Such a difference implies that hypertension of obese people is a biochemically distinguishable entity. This observation corroborates the concept that the clinical association of obesity-hypertension might be regarded as a syndrome with a proper nosographic dignity.
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PMID:[Differential aspects of the dynamics of the renin-angiotensin-aldosterone system in obesity with and without hypertension and in essential arterial hypertension]. 637 85

Hypertension and obesity are two disorders that have been closely related, each occurring in greater frequency with the other than in an otherwise normal population. Although a causal relationship has not been established between the two, their coincidence carries increased risk of cardiovascular morbidity and mortality. This report summarizes the pathophysiological studies from our laboratory concerning their interrelationship and offers a rational hypothesis for the mechanisms underlying this enhanced risk. Patients with hypertension demonstrate an increased total peripheral resistance that explains hemodynamically the rising arterial pressure with advancing vascular disease. In response to this increased afterload imposed upon the heart, the left ventricle adapts itself structurally through a process of concentric hypertrophy. In addition, in most patients with essential hypertension, plasma volume progressively contracts and renal vascular resistance increases in proportion to the rise in arterial pressure and total peripheral resistance. In contrast, in obesity-hypertension there is a superimposed factor of volume overload upon the hemodynamic abnormality. The result is an additional cardiac stimulus for eccentric hypertrophy due to the increased ventricular preload. This factor enhances left ventricular stroke work and its attendant myocardial oxygen demands, thereby providing a dual overload on cardiac function that can explain the increased risk of heart failure related to these associated conditions. In contrast to the compounding adverse hemodynamic effects on the heart, there does not seem to be an additive hemodynamic effect of obesity on hypertensive renal vascular disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The problem of obesity and hypertension. 662 65

Arteriosclerosis obliterans (ASO) of the lower extremities was found in 32 cases (1.9%) among 1673 Japanese diabetic patients. Comparison with age-and sex-matched control patients revealed that male sex, older age, hypertension and neglect of treatment of diabetes were positively correlated with ASO, but obesity, smoking and hyperlipidemia were not correlated with ASO. Proteinuria, cerebral vascular disease and myocardial infarction were significantly associated with ASO. The arterial pulses of the foot were examined in 451 diabetic patients. The pulse of A. dorsalis pedis was absent in 29 (6.4%) and was significantly related to the clinical signs and symptoms of ASO. The loss of the pulse of A. dorsalis pedis increased with age and was more frequent in men than in women. The results indicate a lower frequency of ASO in Japanese than in Western diabetic patients.
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PMID:Arteriosclerosis obliterans in Japanese diabetic patients. 668 May 33

The complications of cadaveric renal transplantation in a group of 10-year survivors are presented. Fifty-two (44%) of 119 graft recipients survived more than 10 years, 48 with their original allograft. The major causes of death in the others were bacterial (24%) and other (10%) infections, cerebral (12%) and myocardial (7.5%) vascular disease. Serious morbidity in the survivors included infectious episodes (55%), skin cancer (40%), vascular disease (30%), cataracts (45%) and aseptic necrosis of bone (13%). Only six (12%) patients had no complications. Although complications were frequent, 34 patients (72%) were fully rehabilitated to work or household duties. Several recipients have become parents. Prevention of the late complications of transplantation must be aimed at reducing the known risk factors early in the course of renal failure. These include hypertension, obesity, cigarette smoking and sun exposure.
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PMID:Delayed complications of renal transplantation and their prevention. 675 92

The mortality of 1564 Busselton subjects has been studied from 1966-79 to determine whether risk factors for cardiovascular disease (CVD) and coronary heart disease (CHD) showed any change in emphasis compared with the Framingham Population Study of 20 yr previously. The Busselton analysis used subjects free of probable and suspect coronary heart disease at onset. In men aged 40-59, systolic blood pressure (SBP), forced expiratory volume (FEV), and serum cholesterol levels were significant independent determining variables for CVD mortality and cholesterol for CHD mortality, with SBP being related to CVD in men aged 60-74 yr. In women, there were few indicators of future vascular risk with no significant determining variable for CVD and CHD in 40-59 yr olds, but blood glucose and FEV were significant risk factors for CVD in women aged 60-74 yr. Cholesterol was unrelated to mortality in women but showed negative relationship with cancer in 60-74 yr old men. In total mortality, smoking in men and women, and obesity in women were significant risk factors; 1 hr serum insulin had a negative relationship in men aged 40-59 yr, and a stronger positive relationship in men aged 60-74 yr, but this may have been due to the close negative association of the variable with body size (i.e. height). More studies are required to ascertain whether glucose and insulin have an aetiological role in vascular disease.
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PMID:Multiple regression analysis of risk factors for cardiovascular disease and cancer mortality in Busselton, Western Australia--13-year study. 685 63


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