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

Diabetes mellitus and arteriosclerotic vascular disease have been found to be the predisposing factors of osteomyelitis associated with peripheral vascular disease (10). A diabetic person is more susceptible to osteomyelitis because of the microangiopathy, peripheral neuropathy and decreased resistance to infection. In diabetes mellitus there can be microangiopathy which results from the proliferation of the endothelium of the intima and thickening of the basement membrane. This further contributes to a sluggish blood flow. In the patient with arteriosclerotic vascular disease, the lumens of the arterioles and arterioles are compromised by the atheromatous plaques. The anatomic structure of the blood supply to bone along with the pathologic membrane thickening, allows for slowing of blood. This slowing of blood flow causes micro-thrombi and enhances bacterial growth. In diabetes mellitus it has been shown that there is a decreased immunologic response which, along with the above, contributes to the sheltering and proliferation of bacteria in the small bones of the foot.
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PMID:Osteomyelitis associated with peripheral vascular disease secondary to diabetes mellitus. 103 Jul 28

A group of 278 patients, over the age of 60 years, and representative of geriatric and general medical admissions to the District General Hospital in Banbury, Oxforshire, was studied to correlate the prevalence of systolic murmurs to age, sex, cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripherial vascular disease and anaemia. The object was to establish the clinical significance of these murmurs and test a postulate that they could not be dismissed as benign. Seventy-five per cent of the murmurs were judged to be aortic and 12 per cent mitral in origin. The prevalence of systolic murmurs increased with age from 32 per cent at 60-64 years to 57 per cent over 85 years, and was greater in females (44 per cent) than in males (34 per cent). The presence of systolic murmurs was related to the presence of cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripheral vascular disease and anemia. Only 8 per cent of patients with systolic murmurs had none of the above-mentioned six cardiovascular abnormalities compared with 36 per cent of patients without such a murmur, while multiple cardiovascular abnormalities were also commoner in the former group. The mortality rate in hospital was similar for patients with or without a systolic murmur.
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PMID:The clinical significance of systolic murmurs in the elderly. 114 71

The results of renal transplantation in patients with juvenile-onset diabetes mellitus were compared to those of a well-matched control group of non-diabetic patients. All transplantations were performed between 1977 and 1988. In the diabetic group hypertension (72 versus 41%), coronary artery disease (17 versus 0%), and peripheral vascular disease (19 versus 0%) had been significantly more frequent pretransplantation. Fewer diabetic patients had previously been treated with dialysis therapy (69 versus 97%). Graft function measured by creatinine clearance after 1 year follow-up, and incidence of proteinuria were not significantly different. The overall graft survival was significantly worse in the diabetic group compared to the control group: 42 versus 69% after 60 months and 21 versus 62% after 90 months. This was caused by a significantly worse patient survival in the diabetic group after 105 months: 28 versus 78% in the control group. The graft survival following exclusion of the patients who died with a functioning graft did not differ significantly between the groups after 60 and 90 months: 62 and 31% in the diabetic group and 69 and 62% in the control group. The existence of any vascular disease before transplantation, especially pre-existing peripheral vascular disease, had a significant effect on mortality in diabetic patients (P = 0.0003). After transplantation, diabetic patients had significantly more cerebrovascular accidents (23 versus 3%), peripheral vascular disease (31 versus 3%), and number of infections (1.9 versus 1.2). Retransplantation was carried out in each group to the same extent, with the same success rate.
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PMID:Increased morbidity and mortality in patients with diabetes mellitus after kidney transplantation as compared with non-diabetic patients. 132 80

Cardiovascular disease is a major cause of death. There is evidence that this disease is predicted and its progression influenced by various factors (e.g. hyperlipidaemia). In this review, we consider aspects of platelet structure and function which may explain how this cell type contributes to the pathogenesis of vascular disease. The platelet also contains bioamines (serotonin, 5-HT; histamine) which are potent vasoactive substances. Studies involving patients with peripheral vascular disease (PVD) where abnormalities in platelet function (platelet aggregation and platelet shape change) and in bioamine status (vascular, platelet and plasma bioamine concentrations) are reviewed. We also discuss how platelet activation (in vitro) and plasma lipids influence intraplatelet bioamine status. Finally, we report in vitro evidence of the effect of two drugs prescribed to PVD patients: aspirin and naftidrofuryl. Aspirin is an ineffective inhibitor of 5-HT-induced whole blood platelet aggregation whereas naftidrofuryl is effective in the presence or absence of aspirin. By identifying and altering the factors which contribute to the pathogenesis of atherosclerosis we will be better equipped to prevent, reverse or retard this process.
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PMID:Serotonin, histamine and platelets in vascular disease with special reference to peripheral vascular disease. 134 86

The natural history of peripheral arterial occlusive disease is discussed. Severe limb-threatening ischemia is the most serious consequence of chronic arterial occlusive disease. Severe ischemia and amputation can be considered as an endpoint in peripheral vascular disease. Severe limb ischemia is relatively uncommon in isolated aortoiliac disease and this is more than twice in patients with either femoropopliteal or multisegmental disease. Subsequent studies have also demonstrated that both smoking and diabetes are associated with a substantial risk for sudden ischemia. A clear majority of about 50% deaths are caused by associated coronary artery disease, 15% to stroke and 10% to vascular disease in the abdomen. Ankle systolic blood pressure is one of the most significant factors in the progression of peripheral arterial occlusive disease and also for cardiovascular mortality. In the future, men need to know how therapies as exercise, during regimens would influence the most frequent complications besides severe limb ischemia, namely brain infarction and coronary artery disease.
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PMID:Natural history and evolution of peripheral obstructive arterial disease. 146 Mar 49

Podiatric physicians see great numbers of patients with vascular insufficiency of the lower extremities. Vascular disease may be the cause of their presenting complaints or may be an incidental finding recognized on routine podiatric examination. Each of these situations may require immediate attention. Vascular consultation therefore may be necessary in providing timely and appropriate medical care to podiatric patients. This manuscript discusses various surgical modalities for the treatment of peripheral vascular disease as well as complications inherent with each.
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PMID:Techniques in the surgical treatment of peripheral vascular disease and their implications on podiatric medicine. 153 40

Vitamin C (ascorbic acid) is an important anti-oxidant which may help to reduce free radical damage and atheroma formation in blood vessels. In a study in which a group of healthy volunteer subjects were followed up for 12 months and a group of patients with vascular disease taking Vitamin C supplements were followed for 23 months, we confirmed previous findings of seasonal variations in ascorbic acid and cholesterol and have shown an inverse relationship between leucocyte ascorbic acid and serum cholesterol levels. In healthy control subjects the increase in ascorbate and fall in cholesterol during the summer months was reversed when the weather changed to a more winter pattern, presumably due to dietary alterations. We found that ascorbic acid levels were lower in patients with peripheral vascular disease and that although normal ascorbic acid levels were achieved with Vitamin C supplementation, when supplements were stopped at the height of a normal summer, there was a fall in ascorbic acid and a rise in serum cholesterol to winter levels. Given these findings we suggest that patients with vascular disease should have Vitamin C supplements throughout the year.
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PMID:Seasonal and climatic variation in cholesterol and vitamin C: effect of vitamin C supplementation. 160 67

The relative importance of hypertension as a risk factor for peripheral vascular disease is of the same order as coronary artery disease. The design of drug studies in occlusive vascular disease presents several problems. First, investigations must be placebo-controlled and crossover in design. Second, since these patients are very much at risk from other vascular occlusions, length of treatment phase is critical. Third, drug doses are also critical--probably best chosen by titration to similar antihypertensive effect. Fourth, patients must be trained in treadmill procedure. Fifth, measurements of limb blood flow must be accompanied where possible by "functional" assessment, e.g., claudication distance. With respect to the specific problem of low perfusion pressure distal to the blockage of peripheral vasculature, resting blood flow may remain normal, implying compensatory reduction in tone of arteriolar resistance vessels. Thus, regional circulation distal to blockage is sensitive to changes in perfusion pressure. There is the risk of "steal" with vasodilator agents; however, conflict exists in the literature over effects of beta-blockers in this situation. In view of its peripheral hemodynamic profile, the theoretical possibilities with the beta-blocker/vasodilator carvedilol in patients with hypertension and peripheral vascular disease seem extremely rewarding, but remain to be borne out in practice.
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PMID:Antihypertensive treatment in concomitant peripheral vascular disease: current experience and the potential of carvedilol. 172 85

Lipid peroxides are thought to be formed by free radicals and may play an important role in the development of atheromatous vascular disease. We have investigated the relationship between lipids, lipoproteins, coagulation factors, and lipid peroxides (measured as thiobarbituric acid reacting species (TBARS) in Type 2 diabetic patients with macrovascular disease. Eighteen diabetic and 20 non-diabetic subjects with clinical evidence of ischaemic heart disease and/or peripheral vascular disease were investigated, together with 28 healthy subjects without evidence of vascular disease. TBARS concentrations in non-diabetic (mean 5.0 (95% Cl 4.5-5.7) mumol l-1) and diabetic groups (5.6 (5.1-6.0) mumol l-1) with macrovascular disease were not significantly different although values were higher in both groups of patients with vascular disease by comparison with control subjects (2.7 (2.4-3.1) mumol l-1, p less than 0.001). Significant univariate correlations between TBARS concentrations and measures of blood glucose control (fructosamine, blood glucose and HbA1) were found for all 66 subjects (r = 0.35-0.42, p less than 0.01-p less than 0.001), although no independent association between these parameters and TBARS was demonstrated in multiple regression analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relation of lipid peroxides to macrovascular disease in type 2 diabetes. 183 67

The effect of lower-limb ischemia on the severity of neuropathy was examined in 48 diabetic patients with peripheral vascular disease. The severity of the vascular disease, as determined by medical history, physical findings, and laboratory data, was scored for each leg. Neuropathy was rated clinically and based on the results of nerve conduction studies of the common peroneal, posterior tibial, and sural nerves. A significant correlation was found between the vascular scores and neurologic variables of the two legs, most strikingly so in electrophysiologic data, with coefficients of .6 to .7. Nondiabetic control patients showed no evidence of neuropathy, regardless of the severity of ischemia, whereas diabetic controls without limb ischemia showed symmetrical neuropathy. These findings support the hypoxic theory in the pathogenesis of diabetic neuropathy.
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PMID:Vascular insufficiency quantitatively aggravates diabetic neuropathy. 184 25


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