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Sample records for ankle-brachial pressure index

  1. Ankle-Brachial Index

    Science.gov (United States)

    ... measured at your arm. A low ankle-brachial index number can indicate narrowing or blockage of the arteries in ... tell your doctor so that he or she can continue to monitor your risk. Blockage (0.9 or less). An ankle-brachial index number less than 1.0 indicates narrowing of ...

  2. Measurement of blood pressure, ankle blood pressure and calculation of ankle brachial index in general practice

    DEFF Research Database (Denmark)

    Nexøe, Jørgen; Damsbo, Bent; Lund, Jens Otto

    2012-01-01

    BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values......BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values...

  3. Association between different measurements of blood pressure variability by ABP monitoring and ankle-brachial index

    Directory of Open Access Journals (Sweden)

    Moreira Leila B

    2010-11-01

    Full Text Available Abstract Background Blood pressure (BP variability has been associated with cardiovascular outcomes, but there is no consensus about the more effective method to measure it by ambulatory blood pressure monitoring (ABPM. We evaluated the association between three different methods to estimate BP variability by ABPM and the ankle brachial index (ABI. Methods and Results In a cross-sectional study of patients with hypertension, BP variability was estimated by the time rate index (the first derivative of SBP over time, standard deviation (SD of 24-hour SBP; and coefficient of variability of 24-hour SBP. ABI was measured with a doppler probe. The sample included 425 patients with a mean age of 57 ± 12 years, being 69.2% women, 26.1% current smokers and 22.1% diabetics. Abnormal ABI (≤ 0.90 or ≥ 1.40 was present in 58 patients. The time rate index was 0.516 ± 0.146 mmHg/min in patients with abnormal ABI versus 0.476 ± 0.124 mmHg/min in patients with normal ABI (P = 0.007. In a logistic regression model the time rate index was associated with ABI, regardless of age (OR = 6.9, 95% CI = 1.1- 42.1; P = 0.04. In a multiple linear regression model, adjusting for age, SBP and diabetes, the time rate index was strongly associated with ABI (P Conclusion Time rate index is a sensible method to measure BP variability by ABPM. Its performance for risk stratification of patients with hypertension should be explored in longitudinal studies.

  4. Arterial compliance across the spectrum of ankle-brachial index: the Multiethnic Study of Atherosclerosis.

    Science.gov (United States)

    Lilly, Scott M; Jacobs, David R; Kronmal, Richard; Bluemke, David A; Criqui, Michael; Lima, Joao; Allison, Matthew; Duprez, Daniel; Segers, Patrick; Chirinos, Julio A

    2014-04-01

    A low ankle-brachial index is associated with cardiovascular disease and reduced arterial compliance. A high ankle-brachial index is also associated with an increased risk of cardiovascular events. We tested the hypothesis that subjects with a high ankle-brachial index demonstrate a lower arterial compliance. In addition, we assessed whether pulse pressure amplification is increased among subjects with a high ankle-brachial index. We studied 6814 adults enrolled in the Multiethnic Study of Atherosclerosis who were, by definition, free of clinical cardiovascular disease at baseline. Differences in total arterial compliance (ratio of stroke volume to pulse pressure), aortic and carotid distensibility (measured with magnetic resonance imaging and duplex ultrasound, respectively) were compared across ankle-brachial index subclasses (≤0.90, 0.91-1.29; ≥1.30) with analyses adjusted for cardiovascular risk factors and subclinical atherosclerosis. Peripheral arterial disease was detected in 230 (3.4%) and high ABI in 648 (9.6%) of subjects. Those with high ankle-brachial index demonstrated greater aortic/radial pulse pressure amplification than those with a normal ankle-brachial index. In adjusted models aortic and carotid distensibility as well as total arterial compliance, were lowest among those with ankle-brachial index≤0.9 (p<0.01 vs. all), but were not reduced in subjects with an ankle-brachial index≥1.3. Lower aortic, carotid and total arterial compliance is not present in subjects free of overt cardiovascular disease and with a high ankle-brachial index. However, increased pulse pressure amplification contributes to a greater ankle-brachial index in the general population and may allow better characterization of individuals with this phenotype. Published by Elsevier Ireland Ltd.

  5. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  6. Genetic determinants of the ankle-brachial index

    DEFF Research Database (Denmark)

    Wassel, Christina L; Lamina, Claudia; Nambi, Vijay

    2012-01-01

    Candidate gene association studies for peripheral artery disease (PAD), including subclinical disease assessed with the ankle-brachial index (ABI), have been limited by the modest number of genes examined. We conducted a two stage meta-analysis of ∼50,000 SNPs across ∼2100 candidate genes to iden...

  7. Ankle-brachial pressure index estimated by laser Doppler in patients suffering from peripheral arterial obstructive disease.

    Science.gov (United States)

    Ludyga, Tomasz; Kuczmik, Waclaw B; Kazibudzki, Marek; Nowakowski, Przemyslaw; Orawczyk, Tomasz; Glanowski, Michal; Kucharzewski, Marcin; Ziaja, Damion; Szaniewski, Krzysztof; Ziaja, Krzysztof

    2007-07-01

    Ankle-brachial index (ABI) measurements are widely used for evaluating the functional state of circulation in the lower limbs. However, there is some evidence that the value of ABI does not accurately reflect the degree of walking impairment in symptomatic patients with peripheral arterial obstructive disease (PAOD). We investigated the diagnostic value of ABI estimated by means of laser Doppler flowmetry (IT) for evaluating limb ischemia. We wanted to know whether laser Doppler could be more sensitive than the Doppler method in predicting walking capacity in patients with stable intermittent claudication. We analyzed a group of 30 patients with intermittent claudication (Fontain II, II/III) who were admitted for reconstructive treatment. There were 21 men and 9 women, aged 46-74 (mean 61) years. All patients underwent the treadmill test, and pain-free walking distances were measured. In each patient, we measured ABI using the two different methods: Doppler ultrasound device (ABI-Doppler) and laser Doppler (ABI-laser Doppler). The claudication distances were 25-200 m (mean 73 +/- 50.2 m). ABI-Doppler was 0.2-0.7 (0.582 +/- 0.195). ABI-laser Doppler measurements were 0.581 (+/-0.218). A correlation was found between ABI-Doppler and claudication distance (r = 0.46, P = 0.009). Also, ABI-laser Doppler values significantly correlated with claudication distances (r = 0.536, P = 0.002). The ABI evaluated by laser Doppler correlated well with claudication distances in patients with PAOD. Comparison of Doppler and laser Doppler measurements used for determining ABI showed that both methods have similar predictive power for walking capacity; however, higher correlation was observed between claudication distances and ABI measured by laser Doppler flowmetry. ABI-laser Doppler measurements are easier, are quicker, and seem to be better suited for noncompliant patients. Further investigation should be undertaken to determine whether laser Doppler is superior to the Doppler

  8. [The ankle brachial index in type 2 diabetes].

    Science.gov (United States)

    Nussbaumerová, B; Rosolová, H; Ferda, J; Sifalda, P; Sípová, I; Sefrna, F

    2011-03-01

    The ankle brachial index (ABI), i.e. the ratio of systolic blood pressure (SBP) on the ankle and on the arm, is diagnostic for peripheral occlusive artery disease and a marker of cardiovascular (CV) risk. The association between the low ABI 101) or according to the global CV Risk Score > or = 5% (SCORE). Wilcoxon's unpaired test, chi2 test, multiple logistic regression. The ABI homocystein (17.2 +/- 7.1 micromol/L) (p or = 0.9 (age 66 +/- 9 years, CAC 234 +/- 458, total cholesterol 5.0 +/- 0.9, total homocystein 14.3 +/- 78). Many CV risk factors correlated positively with the low ABI homocystein and CAC (p < 0.05). Low ABI < 0.9 predicted ischemic stroke in subjects with T2DM and manifest CV diseases in the further 3 years. There was no correlation between the ABI and the ultrasensitive C-reactive protein. Low ABI < 0.9 was in a strong association with the CV risk. The ABI measurement is a simple, noninvasive, time-nonconsuming and inexpensive method for subclinical atherosclerosis detection; the ABI can supply standard methods for the CV risk prediction.

  9. Correlation between Changes in Leg Blood Flow and Ankle-Brachial Pressure Index: A Study Using Laser Doppler Flowmeter -The 1st Report-.

    Science.gov (United States)

    Suzuki, Kazuyoshi; Sekiguchi, Miho; Midorikawa, Hirofumi; Sato, Koichi; Akase, Kazuyoshi; Sawada, Renshi; Konno, Shin-Ichi

    2011-01-01

    The objective of this study was to use non-invasive laser Doppler flowmeter to measure changes in blood flow in peripheral vessels in the legs before and after stress induced by leg elevation stress test and investigate correlations with the ankle-brachial pressure index (ABI). Subjects included 28 patients over 20 years of age (mean, 73 years) who reported chiefly of leg symptoms such as intermittent claudication, numbness, chills, or cramps had been examined at the study institution, and agreed to participate in the study. The ABI of both legs was measured, and patients were divided into two groups: low ABI (ABI ≤0.9) and normal ABI (ABI ≥0.9). Blood flow in the big toe was measured using a box-type laser Doppler flowmeter before, during, and after leg-elevation stress. Amplitude of the recorded waveform and changes in blood flow were compared. Average ABI was 1.09 ± 0.10 in the normal ABI group (33 legs) and 0.68 ± 0.17 in the low ABI group (21 legs). Amplitude before and during stress was significantly smaller in the low ABI group than in the normal ABI group (p leg extension and elevation stress, there was a correlation between change in blood flow and amplitude, and ABI during stress. A box-type laser Doppler flowmeter may provide a means of screening for peripheral arterial disease.

  10. Ankle-brachial index by automated method and renal function

    Directory of Open Access Journals (Sweden)

    Ricardo Pereira Silva

    2017-05-01

    Full Text Available Background The Ankle-brachial index (ABI is a non-invasive method used for the diagnosis of peripheral arterial occlusive disease (PAOD. Aims To determine the clinical features of patients submitted to ABI measurement by automatic method. To investigate association between ABI and renal function. Methods The present is a cross-sectional study. The study was performed in a private clinic in the city of Fortaleza (Ce- Brazil. For ABI analysis, we utilized automatic methodology using a Microlife device. Data collection took place from March 2012 to January 2016. During this period, ABI was measured in 375 patients aged >50 years, who had a diagnosis of hypertension, diabetes or vascular disease. Results Of the 375 patients, 18 were categorized as having abnormal ABI (4.8 per cent and 357 were normal ABI (95.2 per cent. Patients with abnormal ABI showed older mean age when compared to patients with normal ABI. Among patients with normal renal function, only 0.95 per cent showed abnormal ABI; among patients with abnormal renal function, 6 per cent showed abnormal ABI. Conclusion 1 No differences were observed when comparing the groups regarding gender or the prevalence of hypertension, diabetes, dyslipidaemia or CAD. 2 Group with abnormal ABI had renal function greater impairment.

  11. The validity of Ankle- brachial Index in Free ‎Fibular Flap Surgery for Facial Reconstruction

    Directory of Open Access Journals (Sweden)

    Mahdi Yakoob Gazar

    2017-12-01

    Full Text Available Ankle brachial index test is used as a guide in maxillofacial surgery to detect any abnormalities associated with circulation in the lower extremities. This index is about 1 or 1.1 in normal conditions, if it is decreased or increased this mean that there are some abnormalities in haemodynamic such as peripheral arterial diseases. A study carried out in Al-Hilla surgical hospital including 20 patients for estimation of ankle-brachial index(volunteers to show their fitness for free flap surgery. The results were normal in 13 patients, most of them in young adult groups

  12. Cardiovascular Risk Factors and Distributions of the Ankle-Brachial Index among Type 2 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Badaruddoza Doza

    2012-01-01

    Full Text Available Background. The aim of present study is to observe the association between the levels of ankle-brachial index (ABI and cardiovascular risk factors among people with type 2 diabetes mellitus in north India. A cross-sectional study was carried out at a centre for heart and diabetic clinic in the state of Punjab on 1121 subjects (671 males and 450 females with type 2 diabetes mellitus. History of symptoms related to cardiovascular diseases was noted, and blood pressure and anthropometric measurements were recorded. Ankle-brachial index (ABI was measured using ultrasonic Doppler flow detector. Subjects with ABI ≤0.9 and ≥1.30 were classified as having low and high ABI, respectively. Females had a higher BMI and brachial-ankle pulse wave velocity (<0.001. Whereas, males had higher diastolic blood pressure and duration of type 2 diabetes mellitus. The differences of systolic blood pressure and ankle-brachial index were not found significant between the sexes. The prevalence of low ABI (<0.9 was 4.47% in men and 4.67% in women and high ABI (≥1.30 was prevalent in 14% of men and 10.45% of women. Age, BMI, baPWV, and blood pressures were significantly associated with ABI value in both sexes. The results suggested that the ABI might be used as a strong indicator for cardiovascular risk factors in type 2 diabetic subjects.

  13. Ankle brachial index, C-reactive protein, and central augmentation index to identify individuals with severe atherosclerosis

    DEFF Research Database (Denmark)

    Eldrup, Nikolaj; Sillesen, Henrik; Prescott, Eva

    2006-01-01

    We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease.......We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease....

  14. Ankle-brachial blood pressure differences in the beach-chair position of the shoulder surgery.

    Science.gov (United States)

    Choi, Jae Chan; Lee, Jong-Hyuk; Lee, Young-Don; Kim, Soon Yul; Chang, Sei-Jin

    2012-12-01

    During shoulder surgery, blood pressure is frequently measured at the ankle. Anesthetic complications may result when ankle blood pressure is higher than brachial blood pressure and anesthesiologists misinterpret ankle blood pressure as brachial blood pressure. Therefore, we investigated whether ankle blood pressure is significantly higher than brachial blood pressure before anesthesia induction, during induction, after tracheal intubation, before beach chair position, and in the beach chair position. Thirty patients requiring general anesthesia for shoulder surgery were included in this study. Ankle and brachial blood pressure were simultaneously measured before induction, during induction, after intubation, before beach chair position, and in the beach chair position. Ankle blood pressure was higher than brachial blood pressure before induction, during induction, after intubation, before beach chair position, and in the beach chair position. Ankle-brachial blood pressure differences in the beach chair condition were much higher than in four other conditions. The correlation coefficient between mean ankle-brachial blood pressure differences before the beach chair position and mean ankle-brachial blood pressure differences in the beach chair position was 0.616. Brachial systolic blood pressure could be predicted by regression equations (R(2) = 0.306-0.771). These results suggest that anesthesiologists should consider these ankle-brachial blood pressure differences when monitoring anesthesia in the beach chair position.

  15. Transcutaneous oximetry compared to ankle-brachial-index measurement in the evaluation of percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Wildgruber, Moritz; Wolf, Oliver; Weiss, Wolfgang; Berger, Hermann; Lutzenberger, Werner; Eckstein, Hans-Henning; Heider, Peter

    2007-01-01

    Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous oximetry values dropped significantly at the end of the procedure and returned close to the baseline levels at 2 and 4 weeks after angioplasty. Ankle-brachial-indices and transcutaneous oximetry were positively correlated before (r = 0.3833, p = 0.009) as well as 4 weeks after angioplasty (r = 0.4596, p = 0.001). Immediately after radiological interventions, ankle-brachial-indices and transcutaneous oximetry are not positively correlated. In patients undergoing angiography only, transcutaneous oximetry levels drop significantly immediately after angiography and remain at decreased levels even at 4 weeks after intervention. Conclusion: Transcutaneous oximetry as parameter of the microcirculation is positively correlated with ankle-brachial-index as parameter of the macrocirculation before and at 4 weeks after angioplasty. Intraarterial angiography leads to a sudden decrease in skin microcirculation without affecting macrocirculation. As indicated by a lack of recovery in transcutaneous oximetry levels after 4 weeks, angiography alone results in a prolonged impaired microcirculation which may

  16. The run-off resistance (ROR) assessed on MR angiograms may serve as a valid scoring system in patients with symptomatic peripheral arterial disease (PAD) and correlates with the ankle-brachial pressure index (ABI).

    Science.gov (United States)

    Gorny, O; Santner, W; Fraedrich, G; Jaschke, W; Greiner, A; Schocke, M F

    2012-06-01

    To investigate the correlation between the hemodynamic parameter ankle-brachial pressure index (ABI) and the run-off resistance (ROR) assessed on MR angiograms (MRA) in patients with peripheral arterial disease (PAD) Fontaine Stage I and II and its potential as reliable reporting system in clinical routine. Contrast-enhanced MRA was performed in 321 PAD patients using a 1.5T MR scanner with moving bed technique. The ROR and resting ABI were determined in each patient's leg and correlation analysis was performed using the Pearson test. A significant negative correlation (r = -.513; pROR (mean 11.03±5.42) and resting ABI (mean .81±.26) was identified. An even more pronounced correlation was found in patients younger than median age who had higher ABI values (r = -.608; pROR scoring system evaluated in this series correlates better with the ABI than previously published scoring systems and could be suggested as reporting system for routine MRA evaluation. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. The run-off resistance (ROR) assessed on MR angiograms may serve as a valid scoring system in patients with symptomatic peripheral arterial disease (PAD) and correlates with the ankle-brachial pressure index (ABI)

    International Nuclear Information System (INIS)

    Gorny, O.; Santner, W.; Fraedrich, G.; Jaschke, W.; Greiner, A.; Schocke, M.F.

    2012-01-01

    Objective: To investigate the correlation between the hemodynamic parameter ankle-brachial pressure index (ABI) and the run-off resistance (ROR) assessed on MR angiograms (MRA) in patients with peripheral arterial disease (PAD) Fontaine Stage I and II and its potential as reliable reporting system in clinical routine. Methods: Contrast-enhanced MRA was performed in 321 PAD patients using a 1.5 T MR scanner with moving bed technique. The ROR and resting ABI were determined in each patient's leg and correlation analysis was performed using the Pearson test. Results: A significant negative correlation (r = −.513; p < .001) between ROR (mean 11.03 ± 5.42) and resting ABI (mean .81 ± .26) was identified. An even more pronounced correlation was found in patients younger than median age who had higher ABI values (r = −.608; p < .001). Conclusion: The ROR scoring system evaluated in this series correlates better with the ABI than previously published scoring systems and could be suggested as reporting system for routine MRA evaluation.

  18. [Ankle-brachial index screening for peripheral artery disease in high cardiovascular risk patients. Prospective observational study of 370 asymptomatic patients at high cardiovascular risk].

    Science.gov (United States)

    Rada, C; Oummou, S; Merzouk, F; Amarir, B; Boussabnia, G; Bougrini, H; Benzaroual, D; Elkarimi, S; Elhattaoui, M

    2016-12-01

    Peripheral arterial disease is a marker of systemic atherosclerosis; it is associated with a high risk of cardiovascular disease. The aim of our study was to assess the prevalence of peripheral arterial disease by measuring the ankle-brachial pressure index in patients at high cardiovascular risk and to study the risk factors associated with this disease. This was a descriptive and analytic cross-sectional study which focused on 370 patients seen at the medical consultation for atherosclerosis prevention. The ankle-brachial index was measured with a portable Doppler (BIDOP 3) using 4 and 8Hz dual frequency probes. The standards were: normal ankle-brachial index 0.9 to 1.3; peripheral artery obstructive disease ankle-brachial index less than 0.9; poorly compressible artery (medial arterial calcification) ankle-brachial index greater than 1.3. Cardiovascular risk factors were also studied. Three hundred and seventy subjects (mean age 65.5±8.7years) were screened Cardiovascular risk factors were: sedentary lifestyle (91.5 %), hypertension (68.1 %), elevated LDL-cholesterolemia (36.3 %), diabetes (48.3 %) and tobacco smoking (33.8 %). The prevalence of peripheral artery disease was 32.4 % of which 77.5 % were asymptomatic. We found a significant correlation with smoking, diabetes, dyslipidemia and the presence of coronary artery disease or vascular cerebral disease. Screening for peripheral arterial disease (PAD) with the ankle-brachial index has increased the percentage of polyvascular patients from 6.2 to 29 %. Factors independently associated with PAD were advanced age, presence of cardiovascular disease, smoking and glycated hemoglobin. PAD is a common condition in people at high cardiovascular risk, the frequency of asymptomatic forms justifies the screening with pocket Doppler which is a simple, inexpensive and effective test to assess the overall cardiovascular risk. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Ankle-brachial index, a screening for peripheral obstructive arterial disease, and migraine - a controlled study.

    Science.gov (United States)

    Jurno, Mauro Eduardo; Chevtchouk, Liliana; Nunes, Aida Aguilar; de Rezende, Dilermando Fazito; Jevoux, Carla da Cunha; de Souza, Jano Alves; Moreira Filho, Pedro Ferreira

    2010-04-01

    Epidemiological studies support the association between migraine, especially migraine with aura, and vascular disorders. The ankle-brachial index (ABI) is largely used as a surrogate of peripheral obstructive arterial disorders (POAD). Accordingly, in this study we contrasted the ABI in individuals with migraine and in controls. We investigated 50 migraineurs and 38 controls and obtained the ABI (ratio between the systolic arterial pressure obtained in the legs and in the arms) using digital sphygmomanometry. As per validation studies, we used the cut-off of 0.9 as the normal limit for the ABI. We adjusted for gender, use of contraceptive hormones, tabagism, and other cardiovascular risk factors. We found abnormal values of ABI, suggestive of mild or moderate POAD, in 31 individuals (35.2%). Mean value was 0.96 (standard deviation = 0.10). None of our patients had ABI < 0.4, which would suggest severe POAD. Mean ABI for migraineurs was 0.94 (0.11), and for controls it was 0.99 (0.09). Difference was significant (t = 2.21 and P = .022). After adjustments, ABI remained significantly associated with migraine status (P = .024). Adjustments were reasonably effective (chi(2) of Hosmer-Lemeshow = 1.06, P = .590). Our findings suggest that decreased values of ABI are more common in migraineurs than in controls. Although causality was not assessed by us, the relationship is of importance per se. Doctors should measure the ABI in individuals with migraine as an easy way to screen for cardiovascular risk.

  20. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden: a cross sectional study using whole body magnetic resonance angiography.

    Science.gov (United States)

    Weir-McCall, Jonathan R; Khan, Faisel; Lambert, Matthew A; Adamson, Carly L; Gardner, Michael; Gandy, Stephen J; Ramkumar, Prasad Guntur; Belch, Jill J F; Struthers, Allan D; Rauchhaus, Petra; Morris, Andrew D; Houston, J Graeme

    2014-01-01

    Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). 50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated. The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005). ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is primarily due to

  1. Associations between ankle-brachial index and cognitive function: results from the Lifestyle Interventions and Independence for Elders trial

    Science.gov (United States)

    OBJECTIVE: The objective of this study was to evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function. DESIGN: Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial). SETTING: Eight US academic ce...

  2. Senam Kaki Diabetik Efektif Meningkatkan Ankle Brachial Index Pasien Diabetes Melitus Tipe 2

    Directory of Open Access Journals (Sweden)

    Aria Wahyuni

    2016-02-01

    Full Text Available AbstrakPenelitian ini bertujuan untuk mengetahui efektifitas senam kaki diabetik terhadap Ankle Brachial Index pada pasien Diabetes Melitus Tipe 2. Desain yang digunakan adalah Quasi eksperimen dengan pendekatan one-group pre-test – post-test. Populasi penelitian ini adalah pasien DM tipe 2 yang ada di salah satu wilayah kerja puskesmas yang ada di kota Payakumbuh sebanyak 77 orang. Sampel diambil menggunakan teknik purposive sampling  sebanyak 10 orang sampel yang memenuhi kriteria yaitu pasien DM tipe 2 tanpa penyakit penyerta. Rata-rata ABI sebelum dilakukan senam kaki diabetik adalah 0.62 dan rata-rata ABI setelah dilakukan senam kaki diabetik adalah 0.93. Hasil analisis statistik menunjukkan ada perbedaan nilai ABI yang signifikan antara sebelum dan setelah dilakukan senam kaki diabetik (p value = 0,005. Disimpulkan bahwa pelaksanaan senam kaki diabetik dapat meningkatkan ABI pada pasien DM tipe 2. Penelitian ini merekomendasikan bahwa pasien DM tipe 2 diharapkan untuk dapat memanfaatkan senam kaki diabetik sebagai senam alami yang praktis dalam meningkatkan perfusi ke perifer serta sebagai pencegahan komplikasi pada pasien DM tipe 2 khususnya ke daerah kaki. Rekomendasi untuk penelitian selanjutnya adalah membandingkan efektifitas senam kaki diabetik terhadap gula darah, sensitifitas kak, nilai ABI, dan waktu pengisian kapiler Kata Kunci : Ankle Brachial Index; Diabetes Melitus Tipe 2; Senam Kaki Diabetik. AbstractThis study aims to determine the effect of diabetic foot exercise on Ankle Brachial Index (ABI in patients with Diabetes Mellitus Type 2. A design used quasy experiment with one-group pre-test –post-test. The population in this study were patients DM type 2 in one of health public centre in Payakumbuh city. The sample was recruited with purposive sampling technique as many as 10 samples that satisfies the criteria of patient namely DM type 2 without comorbidities. The average ABI before diabetic foot exercise is 0.77 and

  3. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  4. Blood urea level and diabetes duration are independently associated with ankle-brachial index in type 2 diabetic patients.

    NARCIS (Netherlands)

    Bosevski, M.; Soedamah-Muthu, S.S.

    2012-01-01

    Aim

    The purpose of the study was to determine factors of ankle-brachial index (ABI) in a population of patients with type 2 diabetes and coronary artery disease.

    Material and methods

    370 patients (mean age 60.3 ± 8.3 years and diabetes duration 8.6 ± 6.2 years) with type 2

  5. Training to Perform Ankle-Brachial Index: Systematic Review and Perspectives to Improve Teaching and Learning.

    Science.gov (United States)

    Chaudru, S; de Müllenheim, P-Y; Le Faucheur, A; Kaladji, A; Jaquinandi, V; Mahé, G

    2016-02-01

    To conduct a systematic review focusing on the impact of training programs on ankle-brachial index (ABI) performance by medical students, doctors and primary care providers. Lower extremity peripheral artery disease (PAD) is a highly prevalent disease affecting ∼202 million people worldwide. ABI is an essential component of medical education because of its ability to diagnose PAD, and as it is a powerful prognostic marker for overall and cardiovascular related mortality. A systematic search was conducted (up to May 2015) using Medline, Embase, and Web of Science databases. Five studies have addressed the impact of a training program on ABI performance by either medical students, doctors or primary care providers. All were assigned a low GRADE system quality. The components of the training vary greatly either in substance (what was taught) or in form (duration of the training, and type of support which was used). No consistency was found in the outcome measures. According to this systematic review, only few studies, with a low quality rating, have addressed which training program should be performed to provide the best way of teaching how to perform ABI. Future high quality researches are required to define objectively the best training program to facilitate ABI teaching and learning. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  6. Peripheral artery questionnaire improves ankle brachial index screening in symptomatic patients with peripheral artery disease.

    Science.gov (United States)

    Kim, B-H; Cho, K-I; Spertus, J; Park, Y-H; Je, H-G; Shin, M-S; Lee, J-H; Jang, J-S

    2014-12-01

    The peripheral artery questionnaire (PAQ) is a disease-specific health status measure of patients with peripheral artery disease (PAD). Whether the PAQ scores are associated with a PAD diagnosis among patients with symptoms suspicious for PAD is unknown and could help increase the pretest probability of ankle brachial index (ABI) screening among patients with suspicious symptoms. The PAQ was completed by 567 patients evaluated for potential intermittent claudication at six tertiary centres. Demographics, medical history, physical examination findings and the PAQ domain scores were compared with ABI. A diagnostic threshold PAQ scores. The correlation between the PAQ Summary Score and ABI was also calculated. The PAQ Summary Score was significantly lower in patients with low ABI as compared with those having a normal ABI (37.6 ± 19.0 vs. 70.1 ± 22.7, p PAQ Summary Score and ABI were highly correlated (r = 0.56, p PAQ Summary Score for predicting low ABI was 50.3 (AUC = 0.86, sensitivity 80.3%, specificity 78.3%). The PAQ Summary Score was associated with an increased likelihood of PAD in patients with suspected PAD symptoms, and a low summary score (≤ 50.3) was an optimal threshold for predicting PAD among patients referred for ABI. © 2014 John Wiley & Sons Ltd.

  7. Functional MRI in peripheral arterial disease: arterial peak flow versus ankle-brachial index.

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    Bas Versluis

    Full Text Available OBJECTIVES: The purpose of this study was to compare the success rate of successful arterial peak flow (APF and ankle-brachial index (ABI measurements in patients with suspected or known peripheral arterial disease (PAD. MATERIALS AND METHODS: 183 patients with varying degrees of PAD were included. All subjects underwent ABI measurements and MR imaging of the popliteal artery to determine APF. Proportions of patients with successful APF and ABI measurements were compared and the discriminative capability was evaluated. RESULTS: APF was successfully measured in 91% of the patients, whereas the ABI could be determined in 71% of the patients (p<0.01. Success rates of APF and ABI were significantly higher in patients with intermittent claudication (95% and 80%, respectively than in patients with critical ischemia (87% and 62%, respectively. CONCLUSIONS: Compared to the assessment of PAD severity with ABI, the success rate of MRI-based APF measurements in patients with a clinical indication for MRA is 20% higher, with similar discriminatory capacity for disease severity. Therefore, APF is an especially convenient and valuable measure to assess severity in PAD patients scheduled to undergo MR angiography to obtain additional functional information concerning the vascular status.

  8. Índice tornozelo-braço em pacientes hemodialíticos Ankle-brachial index in hemodialysis patients

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    Mariane Torres Uchôa

    2012-12-01

    . The ankle-brachial index was calculated for each artery of the lower limb. It was considered normal ankle-brachial index from 0.9 to 1.3. RESULTS: We diagnosed peripheral arterial disease and poorly compressible arteries in 26.9 and 30.8% of hemodialysis patients and in 33 and 22.7% of the Control Group. In hemodialysis patients, we found abnormal ankle-brachial index in 75% of symptomatic patients (p=0.005, in 67.3% of men and 31% of women (p<0.005, in 78.6% of the elderly, 34.8% of young adults (p<0.01, and 76.9% of diabetics (p<0.005 versus nondiabetic. These patients had a higher prevalence of severe peripheral arterial disease than the Control Group. CONCLUSIONS: Abnormal ankle-brachial index was very prevalent in the groups studied; however, hemodialysis patients had more severe changes, when compared to the Control Group. Diabetes mellitus, male gender, and advanced age were important risk factors for abnormal ankle-brachial index in hemodialysis patients. The ankle-brachial index was a good method of screening for the studied changes; therefore, we suggest the routine use in the management of hemodialysis patients.

  9. Risk factors related to low ankle-brachial index measured by traditional and modified definition in hypertensive elderly patients.

    Science.gov (United States)

    Monteiro, Raphael; Marto, Renata; Neves, Mario Fritsch

    2012-01-01

    Peripheral arterial disease (PAD) increases with age and ankle-brachial index (ABI) ≤ 0.9 is a noninvasive marker of PAD. The purpose of this study was to identify risk factors related to a low ABI in the elderly using two different methods of ABI calculation (traditional and modified definition using lower instead of higher ankle pressure). A cross-sectional study was carried out with 65 hypertensive patients aged 65 years or older. PAD was present in 18% of individuals by current ABI definition and in 32% by modified method. Diabetes, cardiovascular diseases, metabolic syndrome, higher levels of systolic blood pressure and pulse pressure, elevated risk by Framingham Risk Score (FRS), and a higher number of total and antihypertensive drugs in use were associated with low ABI by both definitions. Smoking and LDL-cholesterol were associated with low ABI only by the modified definition. Low ABI by the modified definition detected 9 new cases of PAD but cardiovascular risk had not been considered high in 3 patients when calculated by FRS. In conclusion, given that a simple modification of ABI calculation would be able to identify more patients at high risk, it should be considered for cardiovascular risk prediction in all elderly hypertensive outpatients.

  10. Prognostic value of an increase in post-exercise ankle-brachial index.

    Science.gov (United States)

    Hammad, Tarek A; Hiatt, William R; Gornik, Heather L; Shishehbor, Mehdi H

    2017-06-01

    Prior studies have assessed the prognostic value of a decrease, not an increase, of the post-exercise ankle-brachial index (ABI) among patients with normal resting results. Thus, we sought to evaluate the prognostic significance of an increase in post-exercise ABI among these patients. From a single center vascular laboratory database between September 2005 and January 2010, we retrospectively identified 1437 consecutive patients with a normal resting ABI (1.00-1.40) and available post-exercise results. We classified them into group 1 (normal subjects; post-exercise ABI drop ⩽ 20%, 58%) and group 2 (post-exercise ABI increase, 42%) after excluding those with an ABI drop > 20% (peripheral artery disease) as they had known disease ( n=192). The primary outcome was to assess the risk of ischemic events, defined as a composite of unadjudicated death, stroke, or myocardial infraction (MACE). Associations between groups and outcomes were examined using multivariable Cox proportional hazard and propensity analyses. Both groups had similar prevalence of cardiovascular comorbidities. In unadjusted analysis, group 2 was more likely to have MACE ( p = 0.001). After adjusting for all baseline characteristics, an increase in post-exercise ABI compared to normal subjects was associated with a higher MACE (adjusted HR: 1.70, 95% CI: 1.14-2.53; p=0.009). This association stayed statistically significant after propensity matching (adjusted HR: 1.80, 95% CI: 1.17-2.76; p=0.007). This hypothesis-generating analysis showed that an increase in post-exercise ABI appears to identify a population with a higher risk for MACE. A prospective study of this association and mechanisms of risk should be conducted.

  11. ANNUAL FORECAST IN PATIENTS WITH ACUTE ISCHEMIC STROKE: ROLE OF PATHOLOGICAL ANKLE-BRACHIAL INDEX

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    A. N. Sumin

    2016-01-01

    Full Text Available Aim. To study the factors associated with a poor annual prognosis in patients with acute stroke and prognostic role of pathological ankle-brachial index (ABI.Material and methods. The study included 345 patients (age 63.6±7.8 years, 181 males and 164 females with ischemic stroke that were observed for 1 year. All patients were divided into 2 groups: Group 1 included patients with favorable annual outcome of stroke; Group 2 included patients that during a year had any clinical events including death. All patients underwent a standard neurological and instrumental examination including assessment of peripheral arteries status by sphygmomanometry.Results. Both groups did not differ by age and sex. The frequency of unfavorable outcomes (death, re-stroke, cardiovascular events 1 year after ischemic stroke was 29.5%. Chronic heart failure, atrial fibrillation, previous cardiovascular events, presence of peripheral atherosclerosis, overweight were identified most commonly in Group 2. Patients of Group 2 initially had a rough neurological deficit. The pathological ABI was detected in 70.7% of patients in Group 2 vs 33.8% of patients in Group 1 (p=0.000001. A strong relationship of pathological ABI with a poor outcome of stroke was found by regression analysis.Conclusions. Detection of pathological ABI in patients with ischemic stroke makes it possible to reveal peripheral atherosclerosis and to carry out the targeted preventive measures in these patients. Risk stratification can contribute to more individual and effective secondary prevention in patients with cerebrovascular disease. 

  12. A low ankle-brachial index is associated with cognitive impairment: The APAC study.

    Science.gov (United States)

    Wang, Anxin; Jiang, Ruixuan; Su, Zhaoping; Jia, Jiaokun; Zhang, Ning; Wu, Jianwei; Chen, Shengyun; Zhao, Xingquan

    2016-12-01

    Given the recognized links between atherosclerosis and cognitive impairment, the aim of this study was to examine the association between the ankle-brachial index (ABI) and cognitive impairment in a cross-sectional setting of a Chinese population. Participants (n = 3,048, aged ≥40 years, 1727 men and 1321 women) were recruited from the ongoing community-based Asymptomatic Polyvascular Abnormalities Community Study. ABI was measured and a low ABI was defined as <0.9. Cognition status was evaluated via the Mini-Mental Status Exam. Multivariate logistic regression models and linear regression models were used to assess the association between ABI and cognitive impairment. A low ABI was associated with cognitive impairment (odds ratio, OR = 1.983; 95% confidence interval, CI: 1.150-3.419), independent of the potential confounders. In addition, a decreasing ABI (per standard deviation) was significantly associated with cognitive impairment in fully adjusted models (OR = 1.156; CI: 1.013-1.319) and with a significant trend of decreasing MMSE scores (β = 0.703, 95% CI 0.189-1.218, p = 0.0074). Furthermore, the odds of a low ABI associated with cognitive impairment in participants without hypertension and participants with diabetes were 4.924 (CI: 1.860-13.035) and 6.393 (CI: 2.431-16.810), respectively. A low ABI is associated with cognitive impairment, especially in non-hypertensive and diabetic patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Perceptions of the ankle brachial index amongst podiatrists registered in Western Australia

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    Chen Pamela Y

    2012-07-01

    Full Text Available Abstract Background The ankle brachial index (ABI is an objective diagnostic tool that is widely used for the diagnosis of peripheral arterial disease. Despite its usefulness, it is evident within the literature that many practitioners forgo using this screening tool due to limiting factors such as time. There is also no recommended technique for ABI measurement. The purpose of this study is to investigate the perceptions of the use of ABI clinically among Western Australian podiatrists. Methods This study was a cross sectional survey which evaluated the perceptions of the ABI amongst registered podiatrists in Western Australia. The study sample was obtained from the register of podiatrists listed with the Podiatrists Registration Board of Western Australia. Podiatrists were contacted by telephone and invited to participate in a telephone questionnaire. Chi-square tests were performed to determine if there was a statistically significant relationship between use of the ABI and podiatrists’ profile which included: sector of employment; geographical location; and length of time in practice. Results There is a statistically significant relationship (p=0.004 between podiatrists’ profile and the use of ABI, with higher usage in the tertiary hospital setting than in private practice. Length of time spent in practice had no significant impact on ABI usage (p=0.098. Time constraints and lack of equipment were key limiting factors to performing the ABI, and no preferred technique was indicated. Conclusion Western Australian podiatrists agree that the ABI is a useful tool for lower limb vascular assessment, however, various factors influence uptake in the clinical setting. This study suggests that a podiatrists’ profile has a significant influence on the use of the ABI, which may be attributed to different patient types across the various settings. The influence of time spent in practice on ABI usage may be attributed to differences in clinical

  14. Factors affecting the validity of ankle-brachial index in the diagnosis of peripheral arterial obstructive disease.

    Science.gov (United States)

    Nam, Su Chung; Han, Seung Hwan; Lim, Sang Hyun; Hong, You Sun; Won, Je Hwan; Bae, Jae Ik; Jo, Joon

    2010-05-01

    We evaluated 158 legs from 79 consecutive patients who had undergone both ankle-brachial index (ABI) measurements and angiography for claudication symptoms between January 2007 and December 2008. The diagnosis of peripheral arterial disease (PAD) in the individual legs was established by angiography. Ankle-brachial index was considered abnormal if it was <0.9. The sensitivity and specificity of ABI was 61% and 87%, respectively. To assess the factors affecting the validity of ABI in the diagnosis of PAD, multivariate logistic regression analysis was conducted. The odds ratios (ORs) for the false negative result of ABI were 4.36 (95% confidence interval [CI] 1.36-13.92) in patients with diabetes mellitus (DM), 3.41 (95% CI 1.10-10.48) in patients with distal lesions, 3.02 (95% CI 1.07-8.49) in elderly patients, and 1.13 (95% CI 0.34-3.42) in patients with mild stenosis. Although ABI is the method of choice for the primary diagnosis of PAD, other supplementary investigations should be considered when there is clinical suspicion of PAD but an ABI <0.9.

  15. Association Between Chromosome 9p21 Variants and the Ankle-Brachial Index Identified by a Meta-Analysis of 21 Genome-Wide Association Studies

    NARCIS (Netherlands)

    Murabito, Joanne M.; White, Charles C.; Kavousi, Maryam; Sun, Yan V.; Feitosa, Mary F.; Nambi, Vijay; Lamina, Claudia; Schillert, Arne; Coassin, Stefan; Bis, Joshua C.; Broer, Linda; Crawford, Dana C.; Franceschini, Nora; Frikke-Schmidt, Ruth; Haun, Margot; Holewijn, Suzanne; Huffman, Jennifer E.; Hwang, Shih-Jen; Kiechl, Stefan; Kollerits, Barbara; Montasser, May E.; Nolte, Ilja M.; Rudock, Megan E.; Senft, Andrea; Teumer, Alexander; van der Harst, Pim; Vitart, Veronique; Waite, Lindsay L.; Wood, Andrew R.; Wassel, Christina L.; Absher, Devin M.; Allison, Matthew A.; Amin, Najaf; Arnold, Alice; Asselbergs, Folkert W.; Aulchenko, Yurii; Bandinelli, Stefania; Barbalic, Maja; Boban, Mladen; Brown-Gentry, Kristin; Couper, David J.; Criqui, Michael H.; Dehghan, Abbas; den Heijer, Martin; Dieplinger, Benjamin; Ding, Jingzhong; Doerr, Marcus; Espinola-Klein, Christine; Felix, Stephan B.; Ferrucci, Luigi; Folsom, Aaron R.; Fraedrich, Gustav; Gibson, Quince; Goodloe, Robert; Gunjaca, Grgo; Haltmayer, Meinhard; Heiss, Gerardo; Hofman, Albert; Kieback, Arne; Kiemeney, Lambertus A.; Kolcic, Ivana; Kullo, Iftikhar J.; Kritchevsky, Stephen B.; Lackner, Karl J.; Li, Xiaohui; Lieb, Wolfgang; Lohman, Kurt; Meisinger, Christa; Melzer, David; Mohler, Emile R.; Mudnic, Ivana; Mueller, Thomas; Navis, Gerjan; Oberhollenzer, Friedrich; Olin, Jeffrey W.; O'Connell, Jeff; O'Donnell, Christopher J.; Palmas, Walter; Penninx, Brenda W.; Petersmann, Astrid; Polasek, Ozren; Psaty, Bruce M.; Rantner, Barbara; Rice, Ken; Rivadeneira, Fernando; Rotter, Jerome I.; Seldenrijk, Adrie; Stadler, Marietta; Summerer, Monika; Tanaka, Toshiko; Tybjaerg-Hansen, Anne; Uitterlinden, Andre G.; van Gilst, Wiek H.; Vermeulen, Sita H.; Wild, Sarah H.; Wild, Philipp S.; Willeit, Johann; Zeller, Tanja; Zemunik, Tatijana; Zgaga, Lina; Assimes, Themistocles L.; Blankenberg, Stefan; Campbell, Harry; Boerwinkle, Eric; Cooke, John P.; de Graaf, Jacqueline; Herrington, David; Kardia, Sharon L. R.; Mitchell, Braxton D.; Murray, Anna; Muenzel, Thomas; Newman, Anne B.; Oostra, Ben A.; Rudan, Igor; Shuldiner, Alan R.; Snieder, Harold; van Duijn, Cornelia M.; Voelker, Uwe; Wright, Alan F.; Wichmann, H. -Erich; Wilson, James F.; Witteman, Jacqueline C. M.; Liu, Yongmei; Hayward, Caroline; Borecki, Ingrid B.; Ziegler, Andreas; North, Kari E.; Cupples, L. Adrienne; Kronenberg, Florian; Dorr, M.; Munzel, T.; Volker, U.

    Background-Genetic determinants of peripheral arterial disease (PAD) remain largely unknown. To identify genetic variants associated with the ankle-brachial index (ABI), a noninvasive measure of PAD, we conducted a meta-analysis of genome-wide association study data from 21 population-based cohorts.

  16. Ankle brachial index values, leg symptoms, and functional performance among community-dwelling older men and women in the lifestyle interventions and independence for elders study

    Science.gov (United States)

    The prevalence and significance of low normal and abnormal ankle brachial index (ABI) values in a community dwelling population of sedentary, older individuals is unknown. We describe the prevalence of categories of definite peripheral artery disease (PAD), borderline ABI, low-normal ABI and no PAD...

  17. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease.

    Science.gov (United States)

    Je, Hyung Gon; Kim, Bo Hyun; Cho, Kyoung Im; Jang, Jae Sik; Park, Yong Hyun; Spertus, John

    2015-05-18

    Improvement in quality of life (QoL) is a primary treatment goal for patients with peripheral arterial disease (PAD). The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ) and ankle-brachial index (ABI), and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p's PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  18. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hyung Gon Je

    2015-05-01

    Full Text Available Improvement in quality of life (QoL is a primary treatment goal for patients with peripheral arterial disease (PAD. The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ and ankle-brachial index (ABI, and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p < 0.001. PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p’s < 0.001. As expected the ABI of treated limbs showed significant improvement post-revascularization (p < 0.001. ABI after revascularization correlated with patient-reported changes in the physical function and QoL domains of the PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI < 0.15. Interestingly, poor responders reported improvement in symptoms on the PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  19. Clinical significance of an elevated ankle-brachial index differs depending on the amount of appendicular muscle mass: the J-SHIPP and Nagahama studies.

    Science.gov (United States)

    Tabara, Yasuharu; Igase, Michiya; Setoh, Kazuya; Kawaguchi, Takahisa; Okada, Yoko; Ohara, Maya; Takahashi, Yoshimitsu; Kosugi, Shinji; Ohyagi, Yasumasa; Miki, Tetsuro; Nakayama, Takeo; Kohara, Katsuhiko; Matsuda, Fumihiko

    2018-02-28

    Clinical implication of a high ankle-brachial index (ABI) is not well known. Based on our previous study, we suspected that body composition may be a determinant of a high ABI and may consequently modulate the clinical significance of a high ABI. Datasets of two studies with independent cohorts, the anti-aging study cohort (n = 1765) and the Nagahama study cohort (n = 8,039), were analyzed in this study, in which appendicular muscle mass was measured by computed tomography and bioelectrical impedance analysis, respectively. Brachial and ankle blood pressures were measured using a cuff-oscillometric method. In the anti-aging study cohort, thigh muscle area (β = 0.387, p < 0.001), but not fat area, showed a strong positive association with the ABI independent of the body mass index (p = 0.662) and other possible covariates, including systolic brachial blood pressure (p = 0.054), carotid hypertrophy (p = 0.559), and arterial stiffness (β = 0.102, p = 0.001). This positive association was replicated in the Nagahama cohort. When the subjects were subdivided by the 75th percentiles of the ABI and appendicular muscle mass, multinomial logistic regression analysis identified insulin resistance as an independent determinant of an elevated ABI in subjects with normal muscle mass (coefficient = 0.134, p = 0.010), whereas insulin resistance was inversely associated with an elevated ABI in subjects with high muscle mass (coefficient = -0.268, p = 0.001). Appendicular muscle mass was a strong determinant of the ABI. The clinical background, particularly insulin resistance, of individuals with an elevated ABI may differ based on the amount of muscle mass.

  20. Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low-Normal Ankle-Brachial Index.

    Science.gov (United States)

    AlGhatrif, Majd; Zane, Ariel; Oberdier, Matt; Canepa, Marco; Studenski, Stephanie; Simonsick, Eleanor; Spencer, Richard G; Fishbein, Kenneth; Reiter, David; Lakatta, Edward G; McDermott, Mary M; Ferrucci, Luigi

    2017-08-30

    Lower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle-brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher ABI. We hypothesized that in the absence of peripheral arterial disease, lower ABI is associated with lower mitochondrial energy production. We examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an ABI between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post-exercise phosphocreatine recovery rate constant ( k PCr) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post-exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production.The mean age of the participants was 71±12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an ABI of 1.11 to 1.40, those with an ABI of 0.90 to 1.10 had significantly lower post-exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms -1 , P =0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels ( P =0.028). Similarly, post-exercise phosphocreatine recovery rate constant was linearly associated with ABI as a continuous variable, both in the ABI ranges of 0.90 to 1.40 (standardized coefficient=0.15, P =0.003) and 1.1 to 1.4 (standardized coefficient=0.12, P =0.0405). An ABI of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an ABI of 1.11 to 1.40. These data demonstrate adverse associations of lower ABI values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal ABI. Further study is needed to determine whether interventions in persons with ABIs of 0.90 to 1.10 can prevent

  1. The reliability of the ankle-brachial index in the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS

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    Catellier Diane J

    2006-02-01

    Full Text Available Abstract Background A low ankle-brachial index (ABI is associated with increased risk of coronary heart disease, stroke, and death. Regression model parameter estimates may be biased due to measurement error when the ABI is included as a predictor in regression models, but may be corrected if the reliability coefficient, R, is known. The R for the ABI computed from DINAMAP™ readings of the ankle and brachial SBP is not known. Methods A total of 119 participants in both the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS had repeat ABIs taken within 1 year, using a common protocol, automated oscillometric blood pressure measurement devices, and technician pool. Results The estimated reliability coefficient for the ankle systolic blood pressure (SBP was 0.68 (95% CI: 0.57, 0.77 and for the brachial SBP was 0.74 (95% CI: 0.62, 0.83. The reliability for the ABI based on single ankle and arm SBPs was 0.61 (95% CI: 0.50, 0.70 and the reliability of the ABI computed as the ratio of the average of two ankle SBPs to two arm SBPs was estimated from simulated data as 0.70. Conclusion These reliability estimates may be used to obtain unbiased parameter estimates if the ABI is included in regression models. Our results suggest the need for repeated measures of the ABI in clinical practice, preferably within visits and also over time, before diagnosing peripheral artery disease and before making therapeutic decisions.

  2. Center effect on ankle-brachial index measurement when using the reference method (Doppler and manometer): results from a large cohort study.

    Science.gov (United States)

    Vierron, Emilie; Halimi, Jean-Michel; Tichet, Jean; Balkau, Beverley; Cogneau, Joel; Giraudeau, Bruno

    2009-07-01

    The ankle-brachial index (ABI) is a simple and noninvasive tool used to detect peripheral arterial disease (PAD). We aimed to assess, in a French multicenter cohort, the center effect associated with arterial pressure (AP) and ABI measurements using the reference method and using a semiautomatic device. This study included baseline and 9-year follow-up data from 3,664 volunteers of 10 health examination centers of the DESIR (Data from an Epidemiological Study on the Insulin Resistance) syndrome French cohort. Ankle and brachial AP were measured at inclusion by the reference method (a mercury sphygmomanometer coupled with a Doppler probe for ankle measurements) and at 9 years by a semiautomatic device (Omron HEM-705CP). The center effect was assessed by the intraclass correlation coefficient (ICC), ratio of the between-center variance to the total variance of the measurement. At inclusion, the sample mean age was 47.5 (s.d. 9.9) years; 49.3% were men. Although ICCs were smaller than 0.05 for brachial AP measurements, they were close to 0.18 and 0.20 for ankle systolic AP (SAP) and ABI measurements, respectively, when the reference method was used. No center effect for measures other than ankle SAP was detected. With the semiautomatic device method, all ICCs, including those for ankle SAP and ABI measurements, were between 0.005 and 0.04. We found an important center effect on ABI measured with a sphygmomanometer and a Doppler probe but not a semiautomatic device. A center effect should be taken into account when planning any multicenter study on ABI measurement.

  3. Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Rosenbaum D

    2012-04-01

    Full Text Available David Rosenbaum1,2, Sandra Rodriguez-Carranza1,3, Patrick Laroche4, Eric Bruckert1,2, Philippe Giral1,2, Xavier Girerd1,21Unité de Prévention Cardiovasculaire, Service d'Endocrinologie-Métabolisme, Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière – Université Pierre et Marie Curie, 2Dyslipoproteinemia and Atherosclerosis Research Unit, National Institute for Health and Medical Research (INSERM and Pierre et Marie Curie University (UPMC – Paris VI, Paris, France; 3Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Endocrinología y Metabolismo, Delegación Tlalpan, México Distrito Federal; 4STACTIS, Paris, FranceObjective: To evaluate the accuracy of the ankle brachial index (ABI measured with the SCVL® (“screening cardiovascular lab”; GenNov, Paris, France, an automated device with synchronized arm and ankle cuffs with an automatic ABI calculation.Methods: Patients were consecutively included in a cardiovascular prevention unit if they presented with at least two cardiovascular risk factors. ABI measurements were made using the SCVL, following a synchronized assessment of brachial and ankle systolic pressure. These values were compared to the ABI obtained with the usual Doppler-assisted method.Results: We included 157 patients. Mean age was 59.1 years, 56.8% had hypertension, 22.3% had diabetes mellitus, and 17.6% were current smokers. An abnormal ABI was observed in 17.2% with the SCVL and in 16.2% with the Doppler. The prevalence rates of an abnormal ABI by patient measured with each device, ie, 15.7% (confidence interval [CI] 0.95: [11.8; 20.4] or 14.3% (CI 0.95: [10.7; 18.9], did not differ. The coefficient of variation of Doppler and SCVL measures was 15.8% and 15.1%, respectively. The regression line between the two measurement methods was statistically significant. The value-to-value comparison also shows a difference of mean equal to 0.010 (CI 0.95: [–0

  4. Relationship between low Ankle-Brachial Index and rapid renal function decline in patients with atrial fibrillation: a prospective multicentre cohort study.

    Science.gov (United States)

    Violi, Francesco; Pastori, Daniele; Perticone, Francesco; Hiatt, William R; Sciacqua, Angela; Basili, Stefania; Proietti, Marco; Corazza, Gino R; Lip, Gregory Y H; Pignatelli, Pasquale

    2015-05-21

    To investigate the relationship between Ankle-Brachial Index (ABI) and renal function progression in patients with atrial fibrillation (AF). Observational prospective multicentre cohort study. Atherothrombosis Center of I Clinica Medica of 'Sapienza' University of Rome; Department of Medical and Surgical Sciences of University Magna Græcia of Catanzaro; Atrial Fibrillation Registry for Ankle-Brachial Index Prevalence Assessment-Collaborative Italian Study. 897 AF patients on treatment with vitamin K antagonists. The relationship between basal ABI and renal function progression, assessed by the estimated Glomerular Filtration Rate (eGFR) calculated with the CKD-EPI formula at baseline and after 2 years of follow-up. The rapid decline in eGFR, defined as a decline in eGFR >5 mL/min/1.73 m(2)/year, and incident eGFR60 mL/min/1.73 m(2), 153 (23.9%) had a reduction of the eGFR <60 mL/min/1.73 m(2). ABI ≤0.90 was also an independent predictor for incident eGFR<60 mL/min/1.73 m(2) (HR 1.851, 95% CI 1.205 to 2.845, p=0.005). In patients with AF, an ABI ≤0.90 is independently associated with a rapid decline in renal function and incident eGFR<60 mL/min/1.73 m(2). ABI measurement may help identify patients with AF at risk of renal function deterioration. NCT01161251. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. [Screening for asymptomatic peripheral arterial occlusive disease of the lower limbs by measuring the ankle-brachial index in the general population (Senegal)].

    Science.gov (United States)

    Pessinaba, S; Mbaye, A; Kane, Ad; Guene, B D; Mbaye Ndour, M; Niang, K; Jobe, M; Cazaubon, M; Mathieu, J-B S; Kane, M; Sow, D Diagne; Diack, B; Kane, A

    2012-07-01

    The purpose of this study was to investigate the prevalence of peripheral arterial disease (PAOD) and cardiovascular risk factors associated with the ankle-brachial index (ABI) in Senegalese patients aged 40 years and over. We prospectively studied a random sample of Senegalese aged 40 years and older, residing in the city of St.-Louis, Senegal. The ABI was measured with a portable doppler (DIADOP 50) using 4 and 8Hz dual frequency probes. The standards were: normal ABI 0.9 to 1.3; peripheral artery obstructive disease (PAOD) ABI less than 0.9; incompressible artery ABI greater than 1.3. Cardiovascular risk factors were also studied. Seven hundred and seventy-one subjects (mean age 57 ± 11.2 years, 559 women) were examined. Cardiovascular risk factors were: sedentary lifestyle (76.4%), hypertension (68%), obesity (32.1%), elevated LDL-cholesterolemia (27.8%), diabetes (18.3%) and tobacco smoking (6.9%). Ninety-three subjects (12.1%) had PAOD and 37 subjects (4.8%) had an incompressible artery. PAOD was significantly more common in sedentary subjects (P=0.008), in the elderly (P=0.0006) and in patients with a history of coronary artery disease (P=0.04). Smoking was not strongly associated with PAOD. PAOD is common in Senegalese and is associated with high prevalence of cardiovascular risk factors. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with Type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Ting Li

    2017-01-01

    Full Text Available The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity (BaPWV and ankle-brachial index (ABI are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group (n = 55 and a diabetes and ischemic stroke group (n = 62. We then performed ABI and BaPWV examinations for all patients. Compared with the diabetes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

  7. Ankle Brachial Index <0.9 Underestimates the Prevalence of Peripheral Artery Occlusive Disease Assessed with Whole-Body Magnetic Resonance Angiography in the Elderly

    International Nuclear Information System (INIS)

    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H.

    2008-01-01

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one ≥50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a ≥ 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population

  8. Differential identification of atypical pneumonia pathogens in aorta and internal mammary artery related to ankle brachial index and walking distance.

    Science.gov (United States)

    Iriz, Erkan; Cirak, Meltem Yalinay; Zor, Mustafa Hakan; Engin, Doruk; Oktar, Levent; Unal, Yusuf

    2013-08-01

    We studied the existence of agents in aorta biopsies, such as Chlamydia pneumoniae, cytomegalovirus, and Mycoplasma pneumoniae, that are thought to have a role in atherosclerosis etiopathogenesis role, and their association with peripheral artery disease. We examined aorta wall and internal mammarian artery (IMA) biopsies taken from two different places in 63 patients in whom coronary artery bypass was performed. In these biopsies, we evaluated the deoxyribonuclease (DNA) of these microorganisms using polymerase chain reaction. From the same patients, we recorded the ankle brachial index, road walking distance information, lipid profile, C-reactive proteins, blood parameters such as fibrinogen, and the patient's operation data. In the nine aorta biopsies taken from 63 patients, we isolated C pneumoniae DNA. In IMA biopsies taken from the same patients, we detected no microorganism DNA (P artery disease. In the development of atherosclerosis with C pneumoniae, there may be a determinant pathogen in both the aorta and the peripheral arteries. The nonexistence of C pneumoniae DNA in the IMA biopsies may indicate infectious agents because of the predominant endothelial functions in this artery, and thus its resistance to atherosclerosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. The Association of Ankle Brachial Index, Protein-Energy Wasting, and Inflammation Status with Cardiovascular Mortality in Patients on Chronic Hemodialysis

    Directory of Open Access Journals (Sweden)

    Hideki Ishii

    2017-04-01

    Full Text Available Protein-energy wasting (PEW is highly prevalent in hemodialysis (HD patients. We investigated the association of abnormal ankle brachial index (ABI, PEW, and chronic inflammation status with clinical prognosis in HD patients. A total of 973 HD patients were enrolled and were followed-up for 8 years. As a marker of the PEW, geriatric nutritional risk index (GNRI was used. Cut-off levels were 91.2 for GNRI defined from previous studies and 1.9 mg/L for C-reactive protein (CRP as median value, respectively. Abnormal ABI was seen in 332 (34.1% patients. Declined GNRI and elevated CRP levels were independently associated with abnormal ABI (odds ratio (OR 0.97, 95% confidence interval (CI 0.96–0.99, p = 0.0009 and OR 1.40, 95% CI 1.07–1.83, p = 0.013, respectively. GNRI levels were also independently correlated with CRP levels (β = −0.126, p < 0.0001. During follow-up period, 283 (29.1% patients died, including 123 (12.6% due to cardiovascular disease (CVD. Abnormal ABI (adjusted hazard ratio (HR 1.62, 95% CI 1.13–2.32, p = 0.0096, GNRI < 91.2 (adjusted HR 1.57, 95% CI 1.06–2.33, p = 0.023 and CRP > 1.9 mg/L (adjusted HR 1.89, 95% CI 1.31–2.77, p = 0.0007 independently predicted mortality due to CVD, respectively. In conclusion, abnormal ABI, GNRI, and CRP levels were closely associated with each other, and the combination of these variables increase their predictive values for the risk of mortality due to CVD and all-cause mortality in HD patients.

  10. Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos.

    Science.gov (United States)

    Tarraf, Wassim; Criqui, Michael H; Allison, Matthew A; Wright, Clinton B; Fornage, Myriam; Daviglus, Martha; Kaplan, Robert C; Davis, Sonia; Conceicao, Alan S; González, Hector M

    2018-04-01

    The Ankle-Brachial index (ABI) is a well-accepted measure of peripheral artery disease (arterial stenosis and stiffness) and has been shown to be associated with cognitive function and disorders; however, these associations have not been examined in Hispanics/Latinos. Therefore, we sought to examine relationships between ABI and cognitive function among diverse middle-age and older Hispanics/Latinos. We used cross-sectional data on n = 7991 participants aged 45-74 years, without stroke or coronary heart disease, from the Hispanic Community Health Study/Study of Latinos. Our primary outcome, global cognition (GC), was a continuous composite score of four cognitive domains (verbal learning and memory, verbal fluency, executive function, and mental status). Secondary outcomes were the individual tests representing these domains. The ABI was analyzed continuously and categorically with standard clinical cut-points. We tested associations using generalized survey regression models incrementally adjusting for confounding factors. Age, sex, hypertension, diabetes, and dyslipidemia moderations were examined through interactions with the primary exposure. In age, sex, and education adjusted models, continuous ABI had an inverse u-shape association with worse GC. We found similar associations with measures of verbal learning and memory, verbal fluency, executive function, but not with low mental status. The associations were attenuated, but not completely explained, by accounting for the confounders and not modified by age, sex, education, and vascular disease risks. In addition to being a robust indicator of arterial compromise, our study suggests that abnormal ABI readings may also be useful for early signaling of subtle cognitive deficits. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Ankle-brachial index and brachial-ankle pulse wave velocity are associated with albuminuria in community-based Han Chinese.

    Science.gov (United States)

    Xu, Xiqi; He, Jinggui; Wang, Shuxia; Zhu, Ping; Chen, Qian; Zhang, Xiujin; Tao, Tao; Wang, Hao; Liu, Jianfeng; Wang, Haijun; Li, Xiaoying

    Our study aimed to explore whether the ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were associated with albuminuria in community-based Han Chinese. Total 2127 subjects (860 men and 1267 women) aged 60 years and over were recruited in Beijing. Albuminuria was assessed by the urinary albumin-to-creatinine ratio (UACR) of ≥30 mg/g. BaPWV was divided by quartile. The logistic regression was used to determine the odds ratio (OR) and 95% confidence intervals (CIs) of ABI and baPWV with albuminuria. ABI was associated with albuminuria in the interaction model (OR 0.89, 95% CI 0.81-0.99 by every 0.1 unit increase of ABI), especially in hypertension (OR 0.82, 95% CI 0.73-0.92) and diabetes (OR 0.83, 95% CI 0.68-0.98) groups. BaPWV groups were also significantly associated with albuminuria, ORs of having albuminuria for baPWV quartile II, III, and IV were 1.02(0.65-1.52), 1.05(0.72-1.61), and 1.18(1.04-1.47) in the interaction model. For hypertension and diabetes patients, only the baPWV quartile IV group had higher OR. ABI and baPWV were associated with albuminuria after adjusting for other risk factors in Chinese community-based elderly Han population. The association of ABI with albuminuria was stronger in hypertension and diabetes patients.

  12. Ankle-brachial index (ABI), abdominal aortic calcification (AAC), and coronary artery calcification (CAC): the Jackson heart study.

    Science.gov (United States)

    Tullos, Bobby W; Sung, Jung Hye; Lee, Jae Eun; Criqui, Michael H; Mitchell, Marc E; Taylor, Herman A

    2013-04-01

    To examine the associations of peripheral atherosclerosis, assessed by the ABI at baseline with the extent of AAC and with CAC measured by MDCT at follow-up examination in the Jackson Heart Study cohort. Four categories of ABI: 1.40. Presence of CAC/AAC was defined as scoring above the 75th percentile among participants with non-zero CT calcium scores. We conducted multivariable log-binomial models for this analysis examining the relationship between ABI and the presence of CAC or AAC using normal ABI (1.0 ≤ ABI ≤ 1.39) as the reference group. We estimated prevalence ratios adjusted for age, smoking, HTN, DM, BMI, LDL, HDL, CRP, systolic and diastolic blood pressure, and use of lipid-lowering medication. There were 2,398 patients in this analysis (women: 65 %, average age 55 years). AAC scores were not significantly different between sex. CAC scores were significantly higher in males than females regardless of ABI groups. The prevalence of significant AAC was 1.7 times higher for ABI AAC prevalence did not differ between subjects with ABI > 1.40 compared to those with normal ABI. The prevalence of the significant CAC was higher for ABI 1.40 compared to those with normal ABI. Lower ABI was significantly associated with the extent of AAC and CAC in this cohort. ABI can provide clinicians with an inexpensive additional tool to assess vascular health and cardiovascular risk without exposing the patient to ionizing radiation.

  13. Resting and Post-Exercise Ankle-Brachial Index Measurements to Diagnose Asymptomatic Peripheral Arterial Disease in Middle Aged and Elderly Chronic Obstructive Pulmonary Disease Patients: A Pilot Study.

    Science.gov (United States)

    Alagiakrishnan, Kannayiram; Brokop, Michael; Cave, Andrew; Rowe, Brian H; Wong, Eric; Senthilselvan, Ambikaipakan

    2016-04-01

    Chronic obstructive pulmonary disease (COPD) patients are at risk for asymptomatic peripheral arterial disease (PAD) because smoking is a risk factor for COPD and PAD. The objectives of this study were to determine the proportion of COPD patients with asymptomatic PAD and to investigate whether the estimated risk of asymptomatic PAD in subjects with COPD differs using resting and exercise ankle-brachial index (ABI) in smokers. Using a cross-sectional study design, consecutive smokers > 50 years old were recruited over 2 months from the inpatient units and the outpatient clinics. Subjects previously diagnosed with PAD, unstable angina, recent (< 3 months) myocardial infarction or abdominal, intracranial, eye or lung surgery, and palliative care patients were excluded. Vascular risk factors, ABI (supine and post-3-minute walk supine), self-reported PAD symptoms, and spirometry were obtained. Two measurements of systolic blood pressure on all limbs were obtained using a sphygmomanometer and a Doppler ultrasound, and the ABI was calculated. Data were expressed as means ± standard deviation (SD). Dichotomous outcomes were assessed using Chi-square statistics; P-values of < 0.05 were considered significant. Thirty patients with no previous diagnosis of PAD were recruited. Mean age was 67.7 years (SD: 10.5). Overall, 21 subjects (70%) had spirometry-proven COPD. Significant ABI for PAD (< 0.9) was seen in 7/21 COPD (33.5%) and 0/9 non-COPD subjects in the supine resting position (P = 0.07), and in 9/21 COPD (42.9%) vs. 0/9 non-COPD subjects after exercise (P = 0.03). A significant proportion of patients with spirometry-proven COPD screened positive for asymptomatic PAD after exercise. Resting ABI may not be very sensitive to diagnose asymptomatic PAD in COPD subjects. ABI may be a reliable, sensitive and practical screening tool to assess cardiovascular risk in COPD patients. Future large-scale studies are required to confirm this finding.

  14. Impact of weight loss on ankle-brachial index and interartery blood pressures

    Science.gov (United States)

    Objective: To assess whether weight loss improves markers of peripheral artery disease and vascular stenosis. Methods: The Action for Health in Diabetes randomized clinical trial compared intensive lifestyle intervention (ILI) for weight loss to a control condition of diabetes support and education...

  15. Doença arterial obstrutiva periférica e índice tornozelo-braço em pacientes submetidos à angiografia coronariana Peripheral arterial occlusive disease and ankle-brachial index in patients who had coronary angiography

    Directory of Open Access Journals (Sweden)

    Sthefano Atique Gabriel

    2007-03-01

    Full Text Available OBJETIVO: Avaliar a prevalência de doença arterial obstrutiva periférica (DAOP em coronariopatas. Avaliar a relação entre Índice Tornozelo-Braço (ITB e doença coronariana, e sua correlação com fatores de risco cardiovascular. MÉTODO: ITB investigado com ultra-sonografia Doppler. Características clínicas pesquisadas: idade, sexo, diabetes mellitus, hipertensão arterial sistêmica, etilismo, tabagismo e obesidade. População: 113 pacientes submetidos à angiografia coronariana. Primeira análise: 2 grupos - ausência e presença de coronariopatia. Segunda análise: 3 grupos - Grupo 1 - ausência de lesão coronariana; Grupo 2 - estenose 70%. Terceira análise: 2 grupos - ausência e presença de DAOP. RESULTADOS: 90,76% dos coronariopatas apresentaram DAOP. Houve diferença significante quanto à faixa etária (pOBJECTIVE: To evaluate the prevalence of peripheral arterial disease (PAD in patients with coronary arterial disease. To evaluate the relation between ankle-brachial index (ABI and coronary arterial disease, and its correlation with cardiovascular risk factors. METHOD: ABI investigated with Doppler ultrasonic device. Clinical characteristics researched: age, gender, diabetes, hypertension, alcoholism, smoking and obesity. Population: 113 patients who had coronary angiography. First analyses: 2 groups - absence and presence of coronary arterial disease. Second analyses: 3 groups - Group 1 - absence of coronary lesion; Group 2 - stenosis 70%. Third analyses: 2 groups - absence and presence of PAD. RESULTS: 90.76% of patients with coronary arterial disease presented PAD. There were significant difference including age (p<0.001, hypertension (p<0.001. smoking (p<0.001, body mass index (BMI (p<0.001, systolic blood pressure (SBP (p<0.001, diastolic blood pressure (DBP (p<0.001 and pulse pressure (PP (p<0.001 and ABI (p<0.001 between patients with and without coronary lesion. There were significant difference including age (p<0

  16. Comparison of ankle-brachial index measured by an automated oscillometric apparatus with that by standard Doppler technique in vascular patients

    DEFF Research Database (Denmark)

    Korno, M.; Eldrup, N.; Sillesen, H.

    2009-01-01

    was calculated twice using both the methods on both legs. MATERIALS AND METHODS: We tested the automated oscillometric blood pressure device, CASMED 740, for measuring ankle and arm blood pressure and compared it with the current gold standard, the hand-held Doppler technique, by the Bland-Altman analysis....... RESULTS: Using the Doppler-derived ABI as the gold standard, the sensitivity and specificity of the oscillometric method for determining an ABI Udgivelsesdato: 2009/11...

  17. Predictive value of the ankle-brachial index in the evaluation of intermittent claudication Valor preditivo do índice tornozelo-braço na evolução de pacientes com claudicação intermitente

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    2000-04-01

    Full Text Available The purpose of this study was to determine whether the ankle-brachial index (ABI could be used to predict the prognosis for a patient with intermittent claudication (IC. We studied 611 patients prospectively during 28 months of follow-up. We analyzed the predictive power of using various levels of ABI - 0.30 to 0.70 at 0.05 increments - in terms of the measure's specificity (association with a favorable outcome after exercise rehabilitation therapy and sensitivity (association with a poor outcome after exercise rehabilitation therapy. We found that using an ABI of 0.30 as a cut-off value produced the lowest margin of error overall, but the predictive power was still low with respect to identifying the patients with a poor prognosis after non-aggressive therapeutic treatment. Further study is needed to perhaps identify a second factor that could increase the sensitivity of the test.O objetivo deste estudo foi determinar a evolução da distância de marcha de pacientes com claudicação intermitente relacionando com o índice tornozelo-braço (ITB e o valor deste índice como fator preditivo para o prognóstico desses pacientes. Observou-se prospectivamente a evolução de 611 pacientes durante 28 meses. Analisamos o valor preditivo do ITB inicial usando vários valores de corte - 0.30 a 0.70 em incrementos de 0.05 - em relação à especificidade (associação com uma evolução favorável após tratamento clínico e sensibilidade (associação com uma evolução desfavorável após tratamento clínico. Encontramos o ITB de 0.30 como o valor de corte produzindo a menor margem de erro, mas seu valor preditivo ainda foi baixo para identificar os pacientes com mau prognóstico para o tratamento não invasivo. Estudos adicionais são necessários para se identificar um fator adicional que possa aumentar a sensibilidade do teste.

  18. Accuracy of Physical Examination, Ankle-Brachial Index, and Ultrasonography in the Diagnosis of Arterial Injury in Patients With Penetrating Extremity Trauma: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    deSouza, Ian S; Benabbas, Roshanak; McKee, Sean; Zangbar, Bardiya; Jain, Ashika; Paladino, Lorenzo; Boudourakis, Leon; Sinert, Richard

    2017-08-01

    Penetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Timely, accurate diagnosis is essential for potential intervention in order to prevent significant morbidity. Using a systematic review/meta-analytic approach, we determined the utility of physical examination, Ankle-Brachial Index (ABI), and Ultrasonography (US) in the diagnosis of arterial injury in emergency department (ED) patients who have sustained PET. We applied a test-treatment threshold model to determine which evaluations may obviate CT Angiography (CTA). We searched PubMed, Embase, and Scopus from inception to November 2016 for studies of ED patients with PET. We included studies on adult and pediatric subjects. We defined the reference standard to include CTA, catheter angiography, or surgical exploration. When low-risk patients did not undergo the reference standard, trials must have specified that patients were observed for at least 24 hours. We used the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) to evaluate bias and applicability of the included studies. We calculated positive and negative likelihood ratios (LR+ and LR-) of physical examination ("hard signs" of vascular injury), US, and ABI. Using established CTA test characteristics (sensitivity = 96.2%, specificity = 99.2%) and applying the Pauker-Kassirer method, we developed a test-treatment threshold model (testing threshold = 0.14%, treatment threshold = 72.9%). We included eight studies (n = 2,161, arterial injury prevalence = 15.5%). Studies had variable quality with most at high risk for partial and double verification bias. Some studies investigated multiple index tests: physical examination (hard signs) in three studies (n = 1,170), ABI in five studies (n = 1,040), and US in four studies (n = 173). Due to high heterogeneity (I 2  > 75%) of the results, we could not calculate LR+ or LR- for hard signs or LR+ for ABI. The weighted

  19. Correlação entre o índice tornozelo-braço antes e após teste de deslocamento bidirecional progressivo Correlation between ankle-brachial index before and after shuttle walk test

    Directory of Open Access Journals (Sweden)

    Inácio Teixeira da Cunha-Filho

    2007-12-01

    Full Text Available CONTEXTO: A alteração de fluxo sangüíneo observada nos pacientes com doença arterial obstrutiva periférica (DAOP contribui para a redução da capacidade deambulatórida. Entretanto, ainda existe uma grande variabilidade nas correlações entre medidas inferenciais de comprometimento de fluxo e testes de deslocamento. OBJETIVO: Estabelecer o nível de correlação entre as medidas do índice tornozelo-braço (ITB, pré e pós-esforço, com um novo teste de deambulação chamado teste de deslocamento bidirecional progressivo (TDBP. MÉTODOS: Vinte e um pacientes claudicantes, com diagnóstico de DAOP, tiveram registrados o ITB antes e após a realização de um teste de caminhada no solo, com controle externo e progressivo de velocidade (TDBP. RESULTADOS: Foram registrados a distância (261,07±160,63 metros, o tempo (292,30±122,61 segundos e a velocidade (1,23±0,34 m/s obtidos no início do surgimento de sintoma claudicante, bem como durante o surgimento de sintoma limitante (369,52±157,97 metros, 377,71±104,60 segundos, 1,46±0,29 m/s, respectivamente. A média do ITB de repouso foi de 0,66±0,14, e de pós-esforço foi de 0,42±0,19. Não se observou nenhuma correlação importante entre as variáveis do teste (distância, tempo e velocidade com o ITB de repouso e nem após esforço. CONCLUSÃO: O tempo, velocidade e distância de surgimento de sintoma claudicante e de sintoma claudicante limitante durante o teste de caminhada progressiva são independentes da medida inferencial de fluxo sangüíneo através do ITB de repouso e pós-exercício.BACKGROUND: Patients with peripheral occlusive artery disease (POAD show changes in blood flow that may impair their walking ability. However, variability between inferential measurements of blood flow and walking performance is still high. OBJECTIVE: To correlate the ankle-brachial index (ABI before and after performing the shuttle walk test (SWT. METHODS: Twenty-one patients with claudication

  20. Relação entre índice tornozelo-braquial e doença aterosclerótica carotídea Association between ankle-brachial index and carotid atherosclerotic disease

    Directory of Open Access Journals (Sweden)

    Augusto Cezar Lacerda Brasileiro

    2013-05-01

    Full Text Available FUNDAMENTO: A associação do índice tornozelo-braquial (ITB com a medida do complexo médio intimal das artérias carótidas (MCMI não está amplamente estudada. OBJETIVO: Objetivamos avaliar se pacientes com ITB 0,9. MÉTODOS: No período de janeiro a dezembro de 2011, recrutamos 118 pacientes (48 homens e 70 mulheres que tiveram seus ITB e MCMI mensurados. Os pacientes foram divididos em grupo 1 (ITB 0,9. Utilizamos os testes de Mann-Whitney, qui-quadrado e Fischer para comparações entre os grupos. Para avaliar correlação entre ITB e MCMI empregamos a correlação de Pearson. RESULTADOS: A prevalência de ITB 1,5 mm de 34,7%. Não houve diferença de características clínicas entre os grupos 1 e 2: idade média (64 ± 9 vs. 62 ± 7,2 anos, p = 0,1, homens (40% vs. 41%, p = 0,9, hipertensão (74% vs. 59%, p = 0,1, diabetes melito (54% vs. 35%, p = 0,051, dislipidemia 26% vs. 24%, p = 0,8, tabagismo (57% vs. 65%, p = 0,4. A prevalência de placa carotídea foi maior no grupo 1 (48,6% vs. 28,9%, p = 0,04. A correlação de Pearson entre o ITB e a MCMI foi de - 0,235, com valor de p = 0,01. CONCLUSÕES: Pacientes com ITB BACKGROUND: The association between the ankle brachial index (ABI and the measurement of intimal medial thickness (IMT has not been fully studied. OBJECTIVE: We aimed to evaluate whether the prevalence of carotid atherosclerosis was higher in patients with ABI 0.9. METHODS: From January 2011 to December 2011, 118 patients (48 men and 70 women were enrolled. ABI and IMT Measurements were performed in all patients. Patients were divided in Group 1 (ABI 0.9 according to ABI values. Mann-Whitney, Chi-square and Fischer tests were used for comparison among the groups. Pearson's correlation was used to assess correlation between ABI and IMT. RESULTS: The prevalence of ABI 1.5 mm was 34.7 %. Clinical characteristics were similar between groups 1 and 2: mean age (64 ± 9 vs. 62 ± 7.2 years, p = 0.1, male gender (40% vs. 41%, p

  1. Hyperspectral imaging and ankle: brachial indices in peripheral arterial disease.

    Science.gov (United States)

    Jafari-Saraf, Lida; Gordon, Ian L

    2010-08-01

    To evaluate the correlation between ankle:brachial indices (ABI) and visible light reflectance spectroscopy hyperspectral imaging (HSI) determinations of oxygenated and deoxygenated hemoglobin (oxyHgb and deoxyHgb) levels in the skin of the distal lower extremity. This is a prospective, open, comparator trial which took place at the Vascular laboratory of a Veterans Administration Hospital in Long Beach, USA. Fifty-eight patients (85 limbs) were referred for routine vascular laboratory studies including ABI had concomitant HSI. Limbs with noncompressible pedal signals were excluded from the analysis. ABI was determined with continuous wave Doppler ultrasound and leg blood pressure cuffs. A commercial HSI system (Oxu-Vu(R), Hypermed, Inc.) was used to measure oxyHgb, deoxyHgb, and percent oxygenated hemoglobin (%oxyHgb) in the dorsum of the foot and ankle. HSI measurements of volar forearm skin were also obtained to normalize the lower extremity HSI measurements in a manner comparable with ABI. For purposes of comparison, data sets were divided into 3 groups: ABI > 0.9 (n = 53), 0.45 failed to show a clinically useful correlation between HSI measurements of oxyHgb levels, further evaluation of this novel technology is warranted. Published by Elsevier Inc.

  2. Use of short-radius centrifugation to augment ankle-brachial indices.

    Science.gov (United States)

    Grenon, S Marlene; Mateus, Jaime; Hsiang, York; Sidhu, Ravi; Young, Laurence; Gagnon, Joel

    2009-06-01

    Peripheral arterial disease is mainly caused by atherosclerosis and is characterized by decreased circulation, lower blood pressure, and insufficient tissue perfusion in the lower extremities. The hemodynamics of standing and altered gravity environments have been well studied relative to arm blood pressures but are less well understood for ankle pressures. Because regional blood pressure depends, in part, on the gravitational pressure gradient, we hypothesized that artificial gravity exposure on a short-arm centrifuge with the center of rotation above the head would increase blood pressure in the lower extremities. Cardiovascular parameters for 12 healthy subjects were measured during exposure to supine short-arm centrifugation at 20, 25, and 30 revolutions per minute (rpm), corresponding to centripetal accelerations of 0.94, 1.47, and 2.11 Gz at the foot level, respectively. Systolic ankle blood pressure significantly increased at all levels of centrifugation. Ankle-brachial indices (the ratio of systolic ankle to arm blood pressures) increased significantly from 1.17 +/- 0.03 to 1.58 +/- 0.03 at 0.94 Gz (P blood pressure significantly increased at 2.11 Gz, but heart rate did not change significantly. All parameters returned to normal after cessation of centrifugation. We demonstrated that short-radius centrifugation leads to an increase in ankle-brachial indices. This could have potential implications for the treatment of peripheral arterial disease.

  3. Simultaneously Measured Interarm Blood Pressure Difference and Stroke: An Individual Participants Data Meta-Analysis.

    Science.gov (United States)

    Tomiyama, Hirofumi; Ohkuma, Toshiaki; Ninomiya, Toshiharu; Mastumoto, Chisa; Kario, Kazuomi; Hoshide, Satoshi; Kita, Yoshikuni; Inoguchi, Toyoshi; Maeda, Yasutaka; Kohara, Katsuhiko; Tabara, Yasuharu; Nakamura, Motoyuki; Ohkubo, Takayoshi; Watada, Hirotaka; Munakata, Masanori; Ohishi, Mitsuru; Ito, Norihisa; Nakamura, Michinari; Shoji, Tetsuo; Vlachopoulos, Charalambos; Yamashina, Akira

    2018-04-09

    We conducted individual participant data meta-analysis to examine the validity of interarm blood pressure difference in simultaneous measurement as a marker to identify subjects with ankle-brachial pressure index blood pressure difference >5 mm Hg as being associated with a significant odds ratio for the presence of ankle-brachial pressure index blood pressure difference >15 mm Hg was associated with a significant Cox stratified adjusted hazard ratio for subsequent stroke (hazard ratio, 2.42; 95% confidence interval, 1.27-4.60; P blood pressure differences, measured simultaneously in both arms, may be associated with vascular damage in the systemic arterial tree. These differences may be useful for identifying subjects with an ankle-brachial pressure index of blood pressure in both arms at the first visit. © 2018 American Heart Association, Inc.

  4. Efeito da terapia antirretroviral e dos níveis de carga viral no complexo médio-intimal e no índice tornozelo-braço em pacientes infectados pelo HIV Antirretroviral therapy effect in the intima-medio complex and ankle-brachial index in patients infected by HIV

    Directory of Open Access Journals (Sweden)

    Emmanuelle Tenório Albuquerque Madruga Godoi

    2012-06-01

    Full Text Available OBJETIVOS: Identificar precocemente a prevalência de aterosclerose, por causa do espessamento do complexo médio-intimal das carótidas comuns e do índice tornozelo-braço. Essas medidas foram relacionadas com os fatores de risco clássicos de aterosclerose e os específicos dos infectados pelo HIV (tempo de doença, tempo de tratamento, tipo de tratamento, tipo de terapia antirretroviral utilizada, CD4 e carga viral. MÉTODOS: Setenta casos infectados com o HIV foram avaliados pela medida automática do complexo médio-intimal nas carótidas e do índice tornozelo-braço. Consideraram-se os fatores de risco clássicos de aterosclerose (idade, sexo, hipertensão arterial sistêmica, tabagismo, hipercolesterolemia, hipertrigliceridemia, obesidade e história familiar de evento cardiovascular, as medidas antropométricas e as variáveis relacionadas ao HIV. O nível de significância assumido foi de 5%. RESULTADOS: O tempo médio de diagnóstico do HIV foi de 104,9 meses e de tratamento foi de 97,9 meses. Quanto ao tipo de tratamento, 47 (67,1% fizeram uso de inibidor de protease por mais de seis meses e 36 (51,4% estão em uso atualmente. O índice tornozelo-braço estava aumentado em um único paciente (0,7% e não se evidenciou espessamento do complexo médio-intimal em nenhum indivíduo. Não existiu associação significante da medida do complexo médio-intimal da carótida comum direita com nenhuma das variáveis analisadas. CONCLUSÕES: Indivíduos jovens, sob o uso de terapia antirretroviral por cinco anos ou mais, não apresentaram espessamento do complexo médio-intimal ou aumento do índice tornozelo-braço. Não houve diferença do espessamento do complexo médio-intimal associada ao tipo de esquema antirretroviral utilizado ou nível de carga viral.OBJECTIVES: To precociously identify the prevalence of atherosclerosis caused by thickening of the intima-media complex of the common carotid arteries and of the ankle brachial index

  5. Oscillometric blood pressure measurement: a simple method in screening for peripheral arterial disease

    DEFF Research Database (Denmark)

    Mehlsen, Jesper; Wiinberg, Niels; Bruce, Christopher

    2008-01-01

    Blood pressure at the ankle level is a reliable indicator of peripheral arterial disease (PAD) and the ankle brachial index (ABI) is a useful non-invasive screening tool for the early detection of atherosclerosis. In the first part of the study, systolic blood pressures obtained by oscillometry...... and plethysmography were compared in 80 subjects referred for possible vascular disease. In the second part of the study, 31 general practitioners enrolled 1258 consecutive patients aged more than 60 years. ABI was estimated by oscillometry. Patients with an ABI lower than 0.9 were referred to the local hospital...... of PAD was sufficiently high in subjects over the age of 60 years to warrant screening. The ankle brachial index based on measurements with an oscillometric device was shown reliable in the exclusion of PAD, thereby fulfilling an important criterion for the use in screening....

  6. Exercise transcutaneous oxygen pressure measurement has good sensitivity and specificity to detect lower extremity arterial stenosis assessed by computed tomography angiography

    OpenAIRE

    Koch, Caroline; Chauve, Emmanuel; Chaudru, S?gol?ne; Le Faucheur, Alexis; Jaquinandi, Vincent; Mah?, Guillaume

    2016-01-01

    Abstract Peripheral artery disease (PAD) is a highly prevalent disease diagnosed by the use of ankle-brachial index (ABI) at rest. In some clinical conditions (diabetes, renal insufficiency, advanced age), ABI can be falsely normal and other tests are required for the PAD diagnosis (American Heart Association statement). This study was conducted to determine the accuracy of exercise transcutaneous oxygen pressure measurement (exercise-TcPo2) in detection of arterial stenosis ?50% using comput...

  7. Abnormal ankle brachial indices may predict cardiovascular disease among diabetic patients without known heart disease.

    Science.gov (United States)

    Fine, Jeffrey J; Hopkins, Christie B; Hall, Patrick Ax

    2005-07-01

    Cardiovascular disease remains the primary cause of diabetes-associated morbidity and mortality. Previous studies have failed to provide accurate, inexpensive, screening techniques to detect cardiovascular disease in diabetics. Ankle brachial indices (ABI) testing may be an effective screening technique for diabetics. The aim of this 100-subject clinical study was to determine cardiovascular disease prevalence, via perfusion stress testing, in diabetic patients having abnormal ABI (<0.90) and without known heart disease who were referred to the South Carolina Heart Center, Columbia, SC for nuclear perfusion stress testing. Study data were analyzed using frequency and descriptive statistics and 2-sample T-testing. Mean subject age was 62+/-11 years, ABI 0.76+/-13, and ejection fraction 60+/-12%. Perfusion stress testing detected 49 abnormal electrocardiograms, 36 subjects with coronary ischemia, 20 with diminished left ventricular function, and 26 subjects having significant thinning of the myocardium. There were 71 subjects who tested positive for at least one form of cardiovascular disease. The sole predictive variable reaching significance for the presence of cardiovascular disease was an ABI score <0.90 (p< or =0.0001). Cardiovascular disease may be predicted among diabetic patients via ABI scores and confirmed by nuclear perfusion testing.

  8. Ankle Brachial Index Compared With Different Lipid Ratios to Predict Coronary Events in Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Zinat Nadia Hatmi

    2014-02-01

    Multivariable adjusted relations revealed that HDL-C and #8804;34 Mg/dl significantly increased the risk of future UA, HDL-C and #8804;53 Mg/dl and sedentary life style increased the risk of MI. CONCLUSION: Multivariate adjusted relationships revealed that HDL-C and #8804;34 Mg/dl was a strong predictor of unstable angina pectoris after 15 months of follow up period. HDL-C and #8804;53 Mg/dl and physical inactivity were associated with increased risk of MI after 15 months. Of the lipid ratios the strongest predictors for developing future MI and unstable angina were TC/HDL-C and LDL-C/HDL-C. [TAF Prev Med Bull 2014; 13(1.000: 29-36

  9. Evaluation of Asymptomatic Peripheral Arterial Disease by Ankle-brachial Index in Patients with Concomitant Coronary Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hosein Vakili

    2012-12-01

    Full Text Available Background: Peripheral arterial disease is associated with adverse cardiovascular outcomes. As such, it is found that screening for peripheral arterial disease (PAD improves risk assessment. Thus, intensive risk factor modification and medical treatment in these patients are necessary. Objectives: The purpose of this study was to determine the prevalence of asymptomatic peripheral arterial disease in patients with concomitant coronary arterial disease. Methods: Asymptomatic peripheral arterial disease was investigated in 400 patients (60% males, 40% females, aged 59.7± 11.3 with a documented coronary arterial disease. Results: Among patients with documented CAD, 12% had asymptomatic PAD with the ABI ratio of less than 0.9. Conclusions: It is advisable to screen for PAD not only as a disease but also as a risk assessment method for atherosclerosis.

  10. Can augmentation index be used as an accurate tool in the diagnosis of peripheral obstructive arterial disease?

    Science.gov (United States)

    Coyle, P; Duff, G; Gavin, O; Clarke Moloney, M; Burke, P E; Kavanagh, E G; Grace, P A

    2012-09-01

    The use of radial augmentation index (rAI) as an indicator of vascular disease was investigated in the vascular imaging laboratory in a regional hospital. The aim of this study was to investigate whether a correlation exists between ankle-brachial pressure index (ABPI) and rAI in normal subjects, patients with peripheral obstructive arterial disease, and diabetic patients. A group of 46 patients and 14 controls had ABPI and rAI measured and factors affecting AI were assessed. rAI was found to have a negative correlation with ABPI (Spearman's ρ = -0.513, p peripheral obstructive vascular disease patients compared to normal (normal median 69% lower, p disease and may be a useful tool in the diagnosis of vascular pathology.

  11. Interarm differences in systolic blood pressure and mortality among US army veterans

    DEFF Research Database (Denmark)

    White, James; Mortensen, Laust Hvas; Kivimäki, Mika

    2014-01-01

    BACKGROUND: Differences between the arms in systolic blood pressure (SBP) of ≥10 mmHg have been associated with an increased risk of mortality in patients with hypertensive and chronic renal disease. For the first time, we examined these relationships in a non-clinical population. DESIGN: Cohort...... study. METHODS: Participants were 4419 men (mean age 38.37 years) from the Vietnam Experience Study. Bilateral SBP and diastolic BP (DBP), serum lipids, fasting glucose, erythrocyte sedimentation rate, metabolic syndrome, and ankle brachial index were assessed in 1986. RESULTS: Ten per cent of men had....... CONCLUSIONS: In this non-clinical cohort study, interarm differences in SBP were not associated with mortality after accounting for traditional CVD risk factors. Interarm differences might not be valuable as an additional risk factor for mortality in populations with a low risk of CVD....

  12. Rejection index for pressure tubes

    International Nuclear Information System (INIS)

    Mitchell, A.B.; Meneley, D.

    1989-10-01

    The objective of the present study was to establish a set of criteria (or Rejection Index) which could be used to decide whether a zirconium-2 1/2 w/o niobium pressure tube in a CANDU reactor should be removed from service due to in-service degradation. A critique of key issues associated with establishing a realistic rejection index was prepared. Areas of uncertainty in available information were identified and recommendations for further analysis and laboratory testing made. A Rejection Index based on the following limits has been recommended: 1) Limits related to design intent and normal operation: any garter spring must remain within the tolerance band specified for its design location; the annulus gas system must normally be operated in a circulating mode with a procedure in place for purging to prevent accumulation of deuterium. It must remain sensitive to leaks into any part of the systems; and pressure tube dimensions and distortions must be limited to maintain the fuel channels within the original design intent; 2) Limits related to defect tolerance: adequate time margins between occurrence of a leaking crack and unstable failure must be demonstrated for all fuel channels; long lap-type flaws are unacceptable; crack-like defects of any size are unacceptable; and score marks, frat marks and other defects with contoured profiles must fall below certain depth, length and stress intensity limits; and 3) Limits related to property degradation: at operating temperature each pressure tube must be demonstrated to have a critical length in excess of a stipulated value; the maximum equivalent hydrogen level in any pressure tube should not exceed a limit which should be defined taking into account the known history of that tube; the maximum equivalent hydrogen level in any rolled joint should not exceed a limit which is presently recommended as 200 ppm equivalent hydrogen; and the maximum diametral creep strain should be limited to less than 5%

  13. Index Driven Price Pressure in Corporate Bonds

    DEFF Research Database (Denmark)

    Dick-Nielsen, Jens

    of 356.2 bps (T-stat 2.82). Liquidity provision at exclusions is more profitable than at inclusions because index trackers follow a sampling strategy and returns also increase when liquidity provision becomes more expensive. Furthermore, price reactions following index changes are reversed shortly after...... the event date which indicate temporary price pressure....

  14. Association Between Chromosome 9p21 Variants and the Ankle-Brachial Index Identified by a Meta-Analysis of 21 Genome-Wide Association Studies

    DEFF Research Database (Denmark)

    Murabito, Joanne M; White, Charles C; Kavousi, Maryam

    2012-01-01

    meta-analysis, rs10757269 on chromosome 9 near CDKN2B had the strongest association with ABI (ß= -0.006, p=2.46x10(-8)). We sought replication of the 6 strongest SNP associations in 5 population-based studies and 3 clinical samples (n=16,717). The association for rs10757269 strengthened in the combined...... discovery and replication analysis (p=2.65x10(-9)). No other SNP associations for ABI or PAD achieved genome-wide significance. However, two previously reported candidate genes for PAD and one SNP associated with coronary artery disease (CAD) were associated with ABI: DAB21P (rs13290547, p=3.6x10(-5)); CYBA...... (rs3794624, p=6.3x10(-5)); and rs1122608 (LDLR, p=0.0026). CONCLUSIONS: -GWAS in more than 40,000 individuals identified one genome-wide significant association on chromosome 9p21 with ABI. Two candidate genes for PAD and 1 SNP for CAD are associated with ABI....

  15. Effect of patient positioning on toe pressure measurement using noninvasive vascular testing.

    Science.gov (United States)

    Sansosti, Laura E; Berger, Michael D; Gerrity, Michael A; Kelly, Patrick; Meyr, Andrew J

    2015-09-01

    Interpretation of digital pressure in the assessment of healing potential for diabetic foot disease has become common because of the potential for false elevation with the ankle-brachial index. However, the specific testing protocol for segmental Doppler examinations and photoplethysmography require patients to be in the supine position, with the lower limbs at heart level, in order to minimise the effect of hydrostatic pressure. This may be difficult in many patients with lower extremity pathology, particularly those who are nonambulatory, with painful wounds, or with orthopnea. In these situations, the noninvasive vascular test may be performed with the patient in a more comfortable position, which may include sitting in a wheelchair with the leg in a dependent position. The objective of this investigation was to evaluate the effect of patient positioning on measurement of the digital pressure. Hallux pressures were measured in 20 healthy volunteers in 3 variable positions of limb dependency. The mean±standard deviation of digital pressure for subjects while lying supine with the limb at heart level was 103.5±26.0 mmHg (the recommended position for performance of the test), while sitting upright with the limb level on the table was 130.6±27.9 mmHg (+26.2%, pposition was 169.8±30.8 mmHg (+64.1%, ppositioning has a significant effect on measurement of digital pressure.

  16. Prevalence of subclinical Cardiovascular Disease in healthy HIV ...

    African Journals Online (AJOL)

    ESEM

    hypertension, diabetes and smoking). Clinical data included blood pressure, weight and height. Laboratory data included CD4 counts, serum creatinine, total cholesterol and triglycerides. We tested for subclinical CVD using 3 tools: Ankle Brachial Index.

  17. Peripheral and central arterial pressure and its relationship to vascular target organ damage in carotid artery, retina and arterial stiffness. Development and validation of a tool. The Vaso risk study

    Directory of Open Access Journals (Sweden)

    Patino-Alonso Maria C

    2011-04-01

    Full Text Available Abstract Background Ambulatory blood pressure monitoring (ABPM shows a better correlation to target organ damage and cardiovascular morbidity-mortality than office blood pressure. A loss of arterial elasticity and an increase in carotid artery intima-media thickness (IMT has been associated with increased cardiovascular morbidity-mortality. Tools have been developed that allow estimation of the retinal arteriovenous index but not all studies coincide and there are contradictory results in relation to the evolution of the arteriosclerotic lesions and the caliber of the retinal vessels. The purpose of this study is to analyze the relationship between peripheral and central arterial pressure (clinic and ambulatory and vascular structure and function as evaluated by the carotid artery intima-media thickness, retina arteriovenous index, pulse wave velocity (PWV and ankle-brachial index in patients with and without type 2 diabetes. In turn, software is developed and validated for measuring retinal vessel thickness and automatically estimating the arteriovenous index. Methods/Design A cross-sectional study involving a control group will be made, with a posterior 4-year follow-up period in primary care. The study patients will be type 2 diabetics, with a control group of non-diabetic individuals. Consecutive sampling will be used to include 300 patients between 34-75 years of age and no previous cardiovascular disease, one-half being assigned to each group. Main measurements: age, gender, height, weight and abdominal circumference. Lipids, creatinine, microalbuminuria, blood glucose, HbA1c, blood insulin, high sensitivity C-reactive protein and endothelial dysfunction markers. Clinic and ambulatory blood pressure monitoring. Carotid ultrasound to evaluate IMT, and retinography to evaluate the arteriovenous index. ECG to assess left ventricle hypertrophy, ankle-brachial index, and pulse wave analysis (PWA and pulse wave velocity (PWV with the Sphigmocor

  18. Differing Pattern of Ambulatory Blood Pressure in Very Elderly Men Expresses Dynamics in Atherosclerotic Load in the Senescence

    Directory of Open Access Journals (Sweden)

    Arkadiusz Siennicki-Lantz

    2012-01-01

    Full Text Available To assess an impact of vascular risk factors on ambulatory blood pressure measurement (ABPM in the elderly, we followed up a population-based cohort of men from 68 until 82 years, when 104 survivors underwent ABPM. Results. At age 68, hypertension and high clinic blood pressure (CBP did not predict ABPM level. Smoking and low ankle-brachial index (ABI predicted higher ABPM variability and pulse pressure (PP, but not absolute ABPM values. At age 82, hypertension, high or increasing CBP, strongly positively correlated with all variables of ABPM. Carotid stenosis, low or declining ABI during followup, correlated with higher nocturnal ABPM and PP. Concluding. Hypertension and vascular risk factors in a cohort of 68-year-old men do not result in higher ABPM at age 82, possibly due to inflection point in their pressure development. Higher ABPM reflects instead an increasing CBP and aggravating atherosclerosis during the preceding decade in that part of the cohort with previously favorable risk factor status.

  19. Relationship between blood pressure, body mass index and health ...

    African Journals Online (AJOL)

    Objective: Globally, studies have shown that the trend of overweight and obesity has increased astronomically and there is a close link between body mass index and blood pressure. This study determined the link between the body mass index (BMI), blood pressure and health promoting practices of women in rural and ...

  20. Index Driven Price Pressure in Corporate Bonds

    DEFF Research Database (Denmark)

    Dick-Nielsen, Jens

    Inclusion and exclusion of bonds from major indices are information-free, monthly events. At these events, liquidity providers get a significant abnormal return by trading against index trackers. The return is highest for bonds that are excluded because of a recent downgrade with a one-day return...

  1. A Novel Index Using Ankle Hemodynamic Parameters to Assess the Severity of Peripheral Arterial Disease: A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Jun Tanno

    Full Text Available In peripheral arterial disease (PAD of the lower extremities, the presence of flow-limiting stenoses can be objectively detected by the ankle-brachial index (ABI. However, the severity of ischemic symptoms is not necessarily associated with the ABI value. Atherosclerotic plaque in lower extremity PAD induces ankle arterial stiffness and reduces ankle vascular resistance, which may decrease ankle blood flow and cause ischemic symptoms. We hypothesized that the ankle hemodynamic index (AHI, defined as the ratio of ankle arterial stiffness to ankle vascular resistance, could be used to assess the blood supply deficiency in a diseased lower limb in patients with PAD. The 85 consecutive patients with PAD who were retrospectively analyzed in this study had Rutherford grade 1 to grade 6 ischemia diagnosed as PAD and significant stenotic lesions (>50% diameter stenosis of the lower extremity on contrast angiography. The AHI was calculated as the product of the ankle pulse pressure and the ratio of heart rate to ankle mean arterial pressure (ankle pulse pressure × heart rate/ankle mean arterial pressure. The Rutherford grade was significantly correlated with the AHI (r = 0.50, P < 0.001, but not with the ABI (r = 0.07, P = 0.52. Multiple ordinal regression analysis showed that anemia (odds ratio 0.66, P = 0.002 and AHI (odds ratio 1.04, P = 0.02 were independently associated with Rutherford grade. Our study shows that AHI, a novel parameter based on the ABI measurement, is well correlated with ischemic symptoms, and may be a useful means to assess the arterial blood supply of the lower extremities of patients with PAD.

  2. Physical activity, body mass index and blood pressure in primary ...

    African Journals Online (AJOL)

    Working Group on high blood pressure in children and adolescents: Fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and ad- olescents. Paediatrics 2004; 114: 555 – 566. 21. Owa JA, Adejuyigbe O. Fat mass, fat mass percentage, body mass index and upper mid arm circumference ...

  3. Assessment of Body Mass Index and Blood Pressure among ...

    African Journals Online (AJOL)

    Body Mass Index (BMI) has been described as a significant predictor of Blood Pressure (B.P) but few studies have demonstrated this association in our environment. The study aims to determine the pattern of relationship between BMI and blood pressure in our environment Two thousand and ninety six (2096) students in ...

  4. Evaluation of skin perfusion pressure to assess refractory foot ulcers.

    Science.gov (United States)

    Kawai, M; Mihara, S; Takahagi, S; Iwamoto, K; Hiragun, T; Hide, M

    2017-05-02

    The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. This study aimed to validate the use of SPP in cases of foot gangrene and ulcers in patients with and without diabetes mellitus (DM) and infection. Clinical symptoms, ankle-brachial pressure index (ABPI) and SPP were assessed to evaluate the condition of each foot ulcer. Every foot ulcer was treated as independent, even if a participant had multiple ulcers. All ulcers for which we measured SPP were subject to the analysis. All ulcers were purely ischaemic in nature and were exclusively located on the foot or toes. Data were collected from 117 foot ulcers on 91 toes and feet from 65 patients. Almost all SPP values in healed cases were > 27 mmHg. There were three patients whose ulcers failed to heal by conservative treatments were complicated with severe infection. However, no effect of DM on the relationship between SPP values and prognosis was observed. Logistic regression analysis of all ulcers except for the 5 cases complicated with infection revealed that those with 30 mmHg or lower SPP values are likely to heal by conservative treatment with 23% or lower probability, whereas any ulcer with more than 50 mmHg SPP value and without severe infection may heal without the need for further operations with 80% or higher probability. The combination of SPP and careful evaluation of infection may be a good parameter to decide the appropriate treatment for ischaemic skin ulcers, regardless of the complication of DM.

  5. Physical activity, body mass index and blood pressure in primary ...

    African Journals Online (AJOL)

    Background: Lack of physical activity contributes to overweight and obesity. It is recommended that children accumulate at least one hour of moderate to vigorous intensity physical activity daily. Objective: The level of physical activity, body mass index (BMI) and blood pressure (BP) were evaluated in pupils attending private ...

  6. Original Research Article Body Mass Index and Blood Pressure ...

    African Journals Online (AJOL)

    Erah

    for all University students is also recommended. Keywords: Body mass index; Blood pressure; Obesity;. University students; Nigeria. Kenneth E Oghagbon1. Valentine U Odili2*. Eze K Nwangwa3. Kevin E Pender3. 1Department of. Chemical. Pathology, Faculty of Clinical. Medicine, College of Health. Sciences, Delta State ...

  7. Phenomenon of declining blood pressure in elderly - high systolic levels are undervalued with Korotkoff method

    Directory of Open Access Journals (Sweden)

    Elmståhl Sölve

    2011-10-01

    Full Text Available Abstract Background Systolic blood pressure (SBP decline has been reported in octogenarians. The aim was to study if it could be observed while measuring SBP with two methods: Korotkoff (K-BP and Strain-Gauge-Finger-Pletysmography (SG-BP, and which of them were more reliable in expressing vascular burden. Methods A cohort of 703 men from a population of Malmö, Sweden, were included in "Men born in 1914-study" and followed-up at ages: 68 and 81 years. 176 survivors were examined with K-BP and SG-BP at both ages, and 104 of them with Ambulatory Blood Pressure at age 81/82. Ankle Brachial Index (ABI was measured on both occasions, and Carotid Ultrasound at age 81. Results From age 68 to 81, mean K-BP decreased in the cohort with mean 8.3 mmHg, while SG-BP increased with 13.4 mmHg. K-BP decreased in 55% and SG-BP in 31% of the subjects. At age 81, K-BP was lower than SG-BP in 72% of subjects, and correlated to high K-BP at age 68 (r = --.22; p Conclusion In contrast to K-BP, values of SG-BP in octogenarians strongly correlated with Ambulatory Blood Pressure. The SG-BP decline in the last decade was rare, and increasing SG-BP better than K-BP reflected advanced atherosclerosis. It should be aware, that K-BP underdetected 46% of subjects with SG-BP equal/higher than 140 mmHg at age 81, which may lead to biased associations with risk factors due to differential misclassification by age.

  8. Response of fish communities to multiple pressures: Development of a total anthropogenic pressure intensity index.

    Science.gov (United States)

    Poikane, Sandra; Ritterbusch, David; Argillier, Christine; Białokoz, Witold; Blabolil, Petr; Breine, Jan; Jaarsma, Nicolaas G; Krause, Teet; Kubečka, Jan; Lauridsen, Torben L; Nõges, Peeter; Peirson, Graeme; Virbickas, Tomas

    2017-05-15

    Lakes in Europe are subject to multiple anthropogenic pressures, such as eutrophication, habitat degradation and introduction of alien species, which are frequently inter-related. Therefore, effective assessment methods addressing multiple pressures are needed. In addition, these systems have to be harmonised (i.e. intercalibrated) to achieve common management objectives across Europe. Assessments of fish communities inform environmental policies on ecological conditions integrating the impacts of multiple pressures. However, the challenge is to ensure consistency in ecological assessments through time, across ecosystem types and across jurisdictional boundaries. To overcome the serious comparability issues between national assessment systems in Europe, a total anthropogenic pressure intensity (TAPI) index was developed as a weighted combination of the most common pressures in European lakes that is validated against 10 national fish-based water quality assessment systems using data from 556 lakes. Multi-pressure indices showed significantly higher correlations with fish indices than single-pressure indices. The best-performing index combines eutrophication, hydromorphological alterations and human use intensity of lakes. For specific lake types also biological pressures may constitute an important additional pressure. The best-performing index showed a strong correlation with eight national fish-based assessment systems. This index can be used in lake management for assessing total anthropogenic pressure on lake ecosystems and creates a benchmark for comparison of fish assessments independent of fish community composition, size structure and fishing-gear. We argue that fish-based multiple-pressure assessment tools should be seen as complementary to single-pressure tools offering the major advantage of integrating direct and indirect effects of multiple pressures over large scales of space and time. Copyright © 2017 The Authors. Published by Elsevier B.V. All

  9. Pulse pressure and michigan neuropathy screening instrument are independently associated with asymptomatic peripheral arterial disease among type 2 diabetes community residents: A community-based screening program in Taiwan

    Directory of Open Access Journals (Sweden)

    Li-Chi Fan

    2013-12-01

    Full Text Available Background: Peripheral arterial disease (PAD is one of the major manifestations of systemic atherosclerosis and plays an important role in low-extremity amputation in type 2 diabetic patients. The aim of this study was to explore the prevalence and risk factors for asymptomatic PAD in type 2 diabetic community residents. Methods: This cross-sectional study enrolled 552 type 2 diabetic adults (232 men and 320 women without subjective symptoms of intermittent claudication. We defined the PAD group as an ankle-brachial index (ABI ≤ 0.90, and the normal group as an ABI 0.91-1.30. Their clinical characteristics, Michigan Neuropathy Screening Instrument (MNSI scores and blood pressure were compared. Results: We discovered that 51 patients have asymptomatic PAD. Univariate logistic regression analysis revealed that age, history of stroke, longer duration of diabetes (> 10 years, unemployment or retirement, pulse pressure, systolic blood pressure, and high MNSI score (> 2 were risk factors for PAD. By multivariate logistic regression analysis, pulse pressure, high MNSI score, age, and history of stroke were independent risk factors with odds ratios (95% confidence intervals, CI of 1.032 (1.012-1.053, 2.359 (1.274-4.370, 1.050 (1.010-1.091, and 5.152 (1.985-13.368, respectively. Furthermore, the prevalence of PAD increased significantly with increment in the pulse pressure and MNSI. Conclusions: In summary, the overall prevalence of asymptomatic PAD in the type 2 diabetic adults was 9.2%. Age, history of stroke, pulse pressure and MNSI score may provide important clinical information. Primary care physicians should be aware of asymptomatic patients with high pulse pressure and MNSI scores.

  10. ORIGINAL ARTICLES

    African Journals Online (AJOL)

    Gender, body mass index (BMI), blood pressure, capillary blood glucose and smoking status were determined. The ankle-brachial pressure index (ABPI) was measured by. Doppler ultrasound, and PAD was defined as a ratio less than. 0.9. Peripheral arterial disease (PAD) is a condition in which the arteries that carry blood ...

  11. The Association of Four-Limb Blood Pressure with History of Stroke in Chinese Adults: A Cross-Sectional Study.

    Science.gov (United States)

    Guo, Hong; Sun, Fengyu; Dong, Lihang; Chang, Huiying; Gu, Xingbo; Zhang, Haiyu; Sheng, Lijiang; Tian, Ye

    2015-01-01

    We investigated the association of ankle-brachial blood pressure index (ABI), interarm blood pressure (BP) difference and interankle BP difference, obtained by simultaneous four-limb BP measurement, with history of stroke in a Chinese adult population. This cross-sectional study included 1485 participants aged ≥35 years in the framework of the China Hypertension Survey. We performed simultaneous four-limb BP measurement using oscillometric devices with the participants in the supine position and calculated ABI and interarm/interankle BP differences between the 4 limbs. Logistic regression analysis was used to estimate the association of these BP parameters and other factors with a history of stroke. In univariate analyses, participants with ABI stroke than those without (p stroke after adjustment for interarm BP difference ≥15 mmHg, interankle BP difference ≥10 mmHg, and traditional risk factors for stroke (p = 0.001). An interankle BP difference ≥10 mmHg was associated with prior stroke after the two variables of hypertension and ABI were removed from the logistic regression model (p = 0.0142). Net reclassification improvement analysis showed that inclusion of interankle BP difference ≥10 mmHg to the independent risk factors (age, family history of stroke, hypertension, and ABI) improved net reclassification by 11.92%. ABI stroke prevalence in Chinese adults and it just detected a small propotion of paticipants. The addition of interankle BP difference ≥10 mmHg to the independent risk factors for stroke may improve the prediction of stroke.

  12. Body mass index and blood pressure measurement during pregnancy.

    LENUS (Irish Health Repository)

    Hogan, Jennifer L

    2012-02-01

    OBJECTIVE: The accurate measurement of blood pressure requires the use of a large cuff in subjects with a high mid-arm circumference (MAC). This prospective study examined the need for a large cuff during pregnancy and its correlation with maternal obesity. METHODS: Maternal body mass index (BMI), fat mass, and MAC were measured. RESULTS: Of 179 women studied, 15.6% were obese. With a BMI of level 1 obesity, 44% needed a large cuff and with a BMI of level 2 obesity 100% needed a large cuff. CONCLUSION: All women booking for antenatal care should have their MAC measured to avoid the overdiagnosis of pregnancy hypertension.

  13. A Proposed New Index for Clinical Evaluation of Interproximal Soft Tissues: The Interdental Pressure Index

    Directory of Open Access Journals (Sweden)

    Checchi Luigi

    2014-01-01

    Full Text Available The interdental pressure index (IPI is introduced to specifically evaluate clinical interproximal-tissue conditions and assess the effect of interproximal hygiene stimulation. This index scores clinical responses of periodontal tissues to the apical pressure of a horizontally placed periodontal probe. It is negative when gingival tissues are firm, bleeding-free, and slightly ischemic by the stimulation; otherwise it is positive. The clinical validation showed high intraoperator agreement (0.92; 95% CI: 0.82–0.96; P=0.0001 and excellent interoperator agreement (0.76; 95% CI: 0.14–1.38; P=0.02. High internal consistency with bleeding on probing (κ=0.88 and gingival index (Cronbach’s α=0.81 was obtained. Histological validation obtained high sensitivity (100% and specificity (80% for IPI+ toward inflammatory active form. The same results were recorded for IPI− toward chronic inactive form. IPI results as a simple and noninvasive method with low error probability and good reflection of histological condition that can be applied for oral hygiene motivation. Patient compliance to oral hygiene instructions is essential in periodontal therapy and IPI index can be a practical and intuitive tool to check and reinforce this important aspect.

  14. A proposed new index for clinical evaluation of interproximal soft tissues: the interdental pressure index.

    Science.gov (United States)

    Checchi, Luigi; Luigi, Checchi; Montevecchi, Marco; Marco, Montevecchi; Marucci, Gianluca; Gianluca, Marucci; Checchi, Vittorio; Vittorio, Checchi

    2014-01-01

    The interdental pressure index (IPI) is introduced to specifically evaluate clinical interproximal-tissue conditions and assess the effect of interproximal hygiene stimulation. This index scores clinical responses of periodontal tissues to the apical pressure of a horizontally placed periodontal probe. It is negative when gingival tissues are firm, bleeding-free, and slightly ischemic by the stimulation; otherwise it is positive. The clinical validation showed high intraoperator agreement (0.92; 95% CI: 0.82-0.96; P = 0.0001) and excellent interoperator agreement (0.76; 95% CI: 0.14-1.38; P = 0.02). High internal consistency with bleeding on probing (κ = 0.88) and gingival index (Cronbach's α = 0.81) was obtained. Histological validation obtained high sensitivity (100%) and specificity (80%) for IPI+ toward inflammatory active form. The same results were recorded for IPI- toward chronic inactive form. IPI results as a simple and noninvasive method with low error probability and good reflection of histological condition that can be applied for oral hygiene motivation. Patient compliance to oral hygiene instructions is essential in periodontal therapy and IPI index can be a practical and intuitive tool to check and reinforce this important aspect.

  15. Multivariate Modeling of Body Mass Index, Pulse Pressure, Systolic and Diastolic Blood Pressure in Chinese Twins

    DEFF Research Database (Denmark)

    Wu, Yili; Zhang, Dongfeng; Pang, Zengchang

    2015-01-01

    Systolic and diastolic blood pressure, pulse pressure (PP), and body mass index (BMI) are heritable traits in human metabolic health but their common genetic and environmental backgrounds are not well investigated. The aim of this article was to explore the phenotypic and genetic associations among...... PP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. The studied sample contained 615 twin pairs (17-84 years) collected in the Qingdao municipality. Univariate and multivariate structural equation models were fitted for assessing the genetic and environmental contributions....... The AE model combining additive genetic (A) and unique environmental (E) factors produced the best fit for each four phenotypes. Heritability estimated in univariate analysis ranged from 0.42 to 0.74 with the highest for BMI (95% CI 0.70-0.78), and the lowest for PP (95% CI 0.34-0.49). The multivariate...

  16. Maximal Inspiratory Pressure: A Lost Point Trying to Explain a S-Index Function Line Index

    Directory of Open Access Journals (Sweden)

    Paulo Eugênio Silva, João Luiz Quaglioti Durigan, Gerson Cipriano

    2015-12-01

    Full Text Available Minahan et al. (2015 recently published a study that examined respiratory strength using a new device, POWERbreathe K5, before and after a strenuous exercise, in comparison with an well-established maneuver to evaluate the maximum inspiratory pressure (MIP. In this study, authors have compared a dynamic evaluation of the inspiratory muscles (S-Index with a quasi-isometric evaluation (MIP including a scientific rational about an isokinetic and isometric limb muscles evaluation, even considering that the S-index is not an isokinetic parameter. The authors did not find respiratory muscle fatigue evaluated by these two different parameters before and after whole body exercise protocol. However, the present results may have been influenced by two confounders: 1 The exercise protocol used to induce respiratory muscle fatigue and 2 The learning effect of the test.

  17. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G

    1995-01-01

    A consecutive series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. A naturally occurring optimal vein diameter was discovered. It was significantly correlated with higher postoperative ankle-brachial pres......-brachial pressure index (ABI) and lesser early postoperative thrombosis. A significant linear regression was found between the pre and postoperative vein diameter....

  18. Percutane subintimale angioplastiek bij een oude vaatpatiënte met kritieke ischemie en een niet-genezend arterieel ulcus aan de voet

    NARCIS (Netherlands)

    Reekers, J. A.

    2007-01-01

    A 92-year-old female patient developed an intractable ulcer on the upper side of her right foot after she had dropped a pan on the foot. Non-invasive examination of the vessels revealed severe arterial disease with considerable lowering of the ankle-brachial blood pressure index, the arterial

  19. Prediction of Cerebral Hyperperfusion Syndrome with Velocity Blood Pressure Index

    Directory of Open Access Journals (Sweden)

    Zhi-Chao Lai

    2015-01-01

    Full Text Available Background: Cerebral hyperperfusion syndrome is an important complication of carotid endarterectomy (CEA. An >100% increase in middle cerebral artery velocity (MCAV after CEA is used to predict the cerebral hyperperfusion syndrome (CHS development, but the accuracy is limited. The increase in blood pressure (BP after surgery is a risk factor of CHS, but no study uses it to predict CHS. This study was to create a more precise parameter for prediction of CHS by combined the increase of MCAV and BP after CEA. Methods: Systolic MCAV measured by transcranial Doppler and systematic BP were recorded preoperatively; 30 min postoperatively. The new parameter velocity BP index (VBI was calculated from the postoperative increase ratios of MCAV and BP. The prediction powers of VBI and the increase ratio of MCAV (velocity ratio [VR] were compared for predicting CHS occurrence. Results: Totally, 6/185 cases suffered CHS. The best-fit cut-off point of 2.0 for VBI was identified, which had 83.3% sensitivity, 98.3% specificity, 62.5% positive predictive value and 99.4% negative predictive value for CHS development. This result is significantly better than VR (33.3%, 97.2%, 28.6% and 97.8%. The area under the curve (AUC of receiver operating characteristic: AUC VBI = 0.981, 95% confidence interval [CI] 0.949-0.995; AUC VR = 0.935, 95% CI 0.890-0.966, P = 0.02. Conclusions: The new parameter VBI can more accurately predict patients at risk of CHS after CEA. This observation needs to be validated by larger studies.

  20. Associations between body mass index, ambulatory blood pressure findings, and changes in cardiac structure: relevance of pulse and nighttime pressures.

    NARCIS (Netherlands)

    Fedecostante, M.; Spannella, F.; Giulietti, F.; Espinosa, E.; Dessi-Fulgheri, P.; Sarzani, R.

    2015-01-01

    Ambulatory blood pressure monitoring (ABPM) is central in the management of hypertension. Factors related to BP, such as body mass index (BMI), may differently affect particular aspects of 24-hour ABPM profiles. However, the relevance of BMI, the most used index of adiposity, has been

  1. Indian monsoon variability in relation to Regional Pressure Index

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    trough which is known to affect the Indian mon- soon adversely. For the construction of these indices we have taken monthly mean sea level pressure data from the web site http:// tao.atmos.Washington. edu/data-sets/. Monthly mean sea level pressure data across 40◦N and 20◦N, along 70◦E,75◦E,80◦E and 85◦E, have been ...

  2. Gastroesophageal pressure gradients in gastroesophageal reflux disease: relations with hiatal hernia, body mass index, and esophageal acid exposure

    NARCIS (Netherlands)

    de Vries, Durk R.; van Herwaarden, Margot A.; Smout, André J. P. M.; Samsom, Melvin

    2008-01-01

    OBJECTIVES: The roles of intragastric pressure (IGP), intraesophageal pressure (IEP), gastroesophageal pressure gradient (GEPG), and body mass index (BMI) in the pathophysiology of gastroesophageal reflux disease (GERD) and hiatal hernia (HH) are only partly understood. METHODS: In total, 149 GERD

  3. Central blood pressure and pulse wave velocity: relationship to target organ damage and cardiovascular morbidity-mortality in diabetic patients or metabolic syndrome. An observational prospective study. LOD-DIABETES study protocol.

    Science.gov (United States)

    Gómez-Marcos, Manuel A; Recio-Rodríguez, José I; Rodríguez-Sánchez, Emiliano; Castaño-Sánchez, Yolanda; de Cabo-Laso, Angela; Sánchez-Salgado, Benigna; Rodríguez-Martín, Carmela; Castaño-Sánchez, Carmen; Gómez-Sánchez, Leticia; García-Ortiz, Luis

    2010-03-18

    Diabetic patients show an increased prevalence of non-dipping arterial pressure pattern, target organ damage and elevated arterial stiffness. These alterations are associated with increased cardiovascular risk.The objectives of this study are the following: to evaluate the prognostic value of central arterial pressure and pulse wave velocity in relation to the incidence and outcome of target organ damage and the appearance of cardiovascular episodes (cardiovascular mortality, myocardial infarction, chest pain and stroke) in patients with type 2 diabetes mellitus or metabolic syndrome. This is an observational prospective study with 5 years duration, of which the first year corresponds to patient inclusion and initial evaluation, and the remaining four years to follow-up. The study will be carried out in the urban primary care setting. Consecutive sampling will be used to include patients diagnosed with type 2 diabetes between 20-80 years of age. A total of 110 patients meeting all the inclusion criteria and none of the exclusion criteria will be included. Patient age and sex, family and personal history of cardiovascular disease, and cardiovascular risk factors. Height, weight, heart rate and abdominal circumference. Laboratory tests: hemoglobin, lipid profile, creatinine, microalbuminuria, glomerular filtration rate, blood glucose, glycosylated hemoglobin, blood insulin, fibrinogen and high sensitivity C-reactive protein. Clinical and 24-hour ambulatory (home) blood pressure monitoring and self-measured blood pressure. Common carotid artery ultrasound for the determination of mean carotid intima-media thickness. Electrocardiogram for assessing left ventricular hypertrophy. Ankle-brachial index. Retinal vascular study based on funduscopy with non-mydriatic retinography and evaluation of pulse wave morphology and pulse wave velocity using the SphygmoCor system. The medication used for diabetes, arterial hypertension and hyperlipidemia will be registered, together

  4. Cerebral Pulsatility Index Is Elevated in Patients with Elevated Right Atrial Pressure.

    Science.gov (United States)

    Lahiri, Shouri; Schlick, Konrad H; Padrick, Matthew M; Rinsky, Brenda; Gonzalez, Nestor; Jones, Heather; Mayer, Stephan A; Lyden, Patrick D

    2018-01-01

    Extracerebral venous congestion can precipitate intracranial hypertension due to obstruction of cerebral blood outflow. Conditions that increase right atrial pressure, such as hypervolemia, are thought to increase resistance to jugular venous outflow and contribute to cerebro-venous congestion. Cerebral pulsatility index (CPI) is considered a surrogate marker of distal cerebrovascular resistance and is elevated with intracranial hypertension. Thus, we sought to test the hypothesis that elevated right atrial pressure is associated with increased CPI compared to normal right atrial pressure. We retrospectively reviewed 61 consecutive patients with subarachnoid hemorrhage. We calculated CPI from transcranial Doppler studies and correlated these with echocardiographic measures of right atrial pressure. CPIs were compared from patients with elevated and normal right atrial pressure. There was a significant difference between CPI obtained from all patients with elevated right atrial pressure compared to those with normal right atrial pressure (P right and left hemispheric CPI from patients with both elevated and normal right atrial pressure. Patients with elevated right atrial pressure had significantly higher CPI compared to patients with normal right atrial pressure. These findings suggest that cerebro-venous congestion due to impaired jugular venous outflow may increase distal cerebrovascular resistance as measured by CPI. Since elevated CPI is associated with poor outcome in numerous neurological conditions, future studies are needed to elucidate the significance of these results in other populations. Copyright © 2017 by the American Society of Neuroimaging.

  5. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Fuglsang, S; Bendtsen, F; Christensen, E

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40....../PP on one side and age, sex, body weight, portal pressure, systemic hemodynamics, biochemical variables, and severity of disease on the other. In the multiple-regression analysis, sex, age, mean arterial blood pressure, systemic vascular resistance, and biochemical variables were significant independent...

  6. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Fuglsang, S; Bendtsen, F; Christensen, E

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40%...... predictors of SV/PP (P abnormalities in the arterial compliance of these patients....

  7. A Comparison of Blood Pressure, Body Mass Index, and Acanthosis Nigricans in School-Age Children

    Science.gov (United States)

    Otto, Debra E.; Wang, Xiaohui; Tijerina, Sandra L.; Reyna, Maria Elena; Farooqi, Mohammad I.; Shelton, Margarette L.

    2010-01-01

    The purpose of this retrospective quantitative study was to examine the relationships among acanthosis nigricans (AN), body mass index (BMI), blood pressure (BP), school grade, and gender in children attending elementary school located in South West Texas. Data were collected by attending school district nurses. Researchers reviewed 7,026…

  8. Pressure dependence of the refractive index of diamond, cubic silicon carbide and cubic boron nitride

    Science.gov (United States)

    Balzaretti, N. M.; da Jornada, J. A. H.

    1996-09-01

    The pressure dependence of the refractive index of diamond, cubic boron nitride and cubic silicon carbide, was measured up to 9 GPa by an interferometric method using the diamond anvil cell. A least-square fit yields the following values for ( {1}/{n}) ( {dn }/{dP }): - 3.6 × 10 -4GPa -1 for diamond, -3.2 × 10 -4GPa -1 for c-BN and, for 3CSiC, -8.3 × 10 -4GPa -1. These results were used to investigate, for the first time under pressure, general empirical relationships between refractive index and energy gap found in the literature. The volume dependence of the electronic polarizability, α, of these compounds was determined through the Lorentz-Lorenz approach. The obtained linear behavior of α for the three cases was correlated to previous results for the pressure dependence of the transverse effective charge, e T∗.

  9. Prevalence, Progression and Associated Risk Factors of ...

    African Journals Online (AJOL)

    early intervention and reducing their increased risk of cardiovascular-related mortality (1,9,10). The primary non-invasive screening test for PAD is the. Ankle Brachial Index (ABI), an accurate, reliable and easily assessable, though poorly utilised tool in general practice (11,12). Ankle Brachial Index (ABI) detects peripheral ...

  10. Maximum inspiratory pressure and rapid shallow breathing index as predictors of successful ventilator weaning

    OpenAIRE

    Bien, Umilson dos Santos; Souza, Gerson Fonseca; Campos, Elisangela Siqueira; Farah de Carvalho, Etiene; Fernandes, Matheus Guedes; Santoro, Ilka; Costa, Dirceu; Arena, Ross; Sampaio, Luciana Maria Malos?

    2015-01-01

    [Purpose] To investigate the predictive value of maximum inspiratory pressure (MIP) and the rapid shallow breathing index (RSBI) in a ventilator weaning protocol and to evaluate the differences between clinical and surgical patients in the intensive care unit. [Subjects and Methods] Patients aged ?15?years who underwent orotracheal intubation for mechanical ventilation and who met the criteria of the weaning protocol were included in the study. Receiver operating characteristic (ROC) curves w...

  11. Can the Foot Posture Index or their individual criteria predict dynamic plantar pressures?

    Science.gov (United States)

    Sánchez-Rodríguez, Raquel; Martínez-Nova, Alfonso; Escamilla-Martínez, Elena; Pedrera-Zamorano, Juan Diego

    2012-07-01

    The Foot Posture Index (FPI) quantifies foot posture through the evaluation of six individual criteria. The objective of the present study was then to establish the plantar pressure differences between types of feet, and to study the capacity of the whole FPI value and the six individual criteria to predict the pattern of plantar pressures. In a sample of 400 healthy subjects (201 men and 199 women), the FPI was evaluated and plantar pressures were measured in 10 zones using the Footscan(®) platform. Five plantar pressures measurements were made for each foot, using for the study the mean of these measurements for each subject's left foot. The hallux and the lesser toes had lower pressure indices in highly supinated feet, with the values increasing progressively toward the highly pronated feet (pfeet, and decreased in the highly pronated feet (pfeet--pronated, neutral, and supinated. Its individual criteria predict moderate or low plantar pressures variability, with the talonavicular prominence being the most influential criterion. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. An environmental pressure index proposal for urban development planning based on the analytic network process

    International Nuclear Information System (INIS)

    Gomez-Navarro, Tomas; Garcia-Melon, Monica; Acuna-Dutra, Silvia; Diaz-Martin, Diego

    2009-01-01

    This paper introduces a new approach to prioritize urban planning projects according to their environmental pressure in an efficient and reliable way. It is based on the combination of three procedures: (i) the use of environmental pressure indicators, (ii) the aggregation of the indicators in an Environmental Pressure Index by means of the Analytic Network Process method (ANP) and (iii) the interpretation of the information obtained from the experts during the decision-making process. The method has been applied to a proposal for urban development of La Carlota airport in Caracas (Venezuela). There are three options which are currently under evaluation. They include a Health Club, a Residential Area and a Theme Park. After a selection process the experts chose the following environmental pressure indicators as ANP criteria for the project life cycle: used land area, population density, energy consumption, water consumption and waste generation. By using goal-oriented questionnaires designed by the authors, the experts determined the importance of the criteria, the relationships among criteria, and the relationships between the criteria and the urban development alternatives. The resulting data showed that water consumption is the most important environmental pressure factor, and the Theme Park project is by far the urban development alternative which exerts the least environmental pressure on the area. The participating experts coincided in appreciating the technique proposed in this paper is useful and, for ranking ordering these alternatives, an improvement from traditional techniques such as environmental impact studies, life-cycle analysis, etc.

  13. VenUS II : a randomised controlled trial of larval therapy in the management of leg ulcers

    OpenAIRE

    Dumville, J. C.; Worthy, G.; Soares, M. O.; Bland, J. M.; Cullum, N.; Dowson, C.; Iglesias, C.; McCaughan, D.; Mitchell, J. L.; Nelson, E. A.; Torgerson, D. J.

    2009-01-01

    Objectives: To compare the clinical effectiveness and cost-effectiveness of larval therapy with a standard debridement technique (hydrogel). Design: A pragmatic, three-arm, randomised controlled trial with an economic evaluation. Setting: Community nursing services, community leg ulcer clinics and hospital outpatient leg ulcer clinics. A range of urban and rural settings. Participants: Patients with venous or mixed venous/arterial ulcers (minimum ankle brachial pressure index of 0.6) where a ...

  14. Plantar Pressure as a Risk Assessment Tool for Diabetic Foot Ulceration in Egyptian Patients with Diabetes

    Directory of Open Access Journals (Sweden)

    Olfat A. Fawzy

    2014-01-01

    Full Text Available Background Diabetic foot ulceration is a preventable long-term complication of diabetes. In the present study, peak plantar pressures (PPP and other characteristics were assessed in a group of 100 Egyptian patients with diabetes with or without neuropathy and foot ulcers. The aim was to study the relationship between plantar pressure (PP and neuropathy with or without ulceration and trying to clarify the utility of pedobarography as an ulceration risk assessment tool in patients with diabetes. Subjects and Methods A total of 100 patients having diabetes were selected. All patients had a comprehensive foot evaluation, including assessment for neuropathy using modified neuropathy disability score (MNDS, for peripheral vascular disease using ankle brachial index, and for dynamic foot pressures using the MAT system (Tekscan. The studied patients were grouped into: (1 diabetic control group (DC, which included 37 patients who had diabetes without neuropathy or ulceration and MNDS ≤ 2; (2 diabetic neuropathy group (DN, which included 33 patients who had diabetes with neuropathy and MNDS >2, without current or a history of ulceration; and (3 diabetic ulcer group (DU, which included 30 patients who had diabetes and current ulceration, seven of those patients also gave a history of ulceration. Results PP parameters were significantly different between the studied groups, namely, forefoot peak plantar pressure (FFPPP, rearfoot peak plantar pressure (RFPPP, forefoot/rearfoot ratio (F/R, forefoot peak pressure gradient (FFPPG rearfoot peak pressure gradient (RFPPG, and forefoot peak pressure gradient/rearfoot peak pressure gradient (FFPPG/RFPPG ( P 0.05. FFPPP, F/R ratio, FFPPG, and FFPPG/RFPPG correlated significantly with the severity of neuropathy according to MNDS ( P < 0.05. These same variables as well as MNDS were also significantly higher in patients with foot deformity compared to those without deformity ( P < 0.05. Using the receiver operating

  15. The impact of hydraulic flow unit & reservoir quality index on pressure profile and productivity index in multi-segments reservoirs

    Directory of Open Access Journals (Sweden)

    Salam Al-Rbeawi

    2017-12-01

    Full Text Available The objective of this paper is studying the impact of the hydraulic flow unit and reservoir quality index (RQI on pressure profile and productivity index of horizontal wells acting in finite reservoirs. Several mathematical models have been developed to investigate this impact. These models have been built based on the pressure distribution in porous media, depleted by a horizontal well, consist of multi hydraulic flow units and different reservoir quality index. The porous media are assumed to be finite rectangular reservoirs having different configurations and the wellbores may have different lengths. Several analytical models describing flow regimes have been derived wherein hydraulic flow units and reservoir quality index have been included in addition to rock and fluid properties. The impact of these two parameters on reservoir performance has also been studied using steady state productivity index.It has been found that both pressure responses and flow regimes are highly affected by the existence of multiple hydraulic flow units in the porous media and the change in reservoir quality index for these units. Positive change in the RQI could lead to positive change in both pressure drop required for reservoir fluids to move towards the wellbore and hence the productivity index.

  16. The effect of baseline pressure errors on an intracranial pressure-derived index: results of a prospective observational study

    Science.gov (United States)

    2014-01-01

    Background In order to characterize the intracranial pressure-volume reserve capacity, the correlation coefficient (R) between the ICP wave amplitude (A) and the mean ICP level (P), the RAP index, has been used to improve the diagnostic value of ICP monitoring. Baseline pressure errors (BPEs), caused by spontaneous shifts or drifts in baseline pressure, cause erroneous readings of mean ICP. Consequently, BPEs could also affect ICP indices such as the RAP where in the mean ICP is incorporated. Methods A prospective, observational study was carried out on patients with aneurysmal subarachnoid hemorrhage (aSAH) undergoing ICP monitoring as part of their surveillance. Via the same burr hole in the scull, two separate ICP sensors were placed close to each other. For each consecutive 6-sec time window, the dynamic mean ICP wave amplitude (MWA; measure of the amplitude of the single pressure waves) and the static mean ICP, were computed. The RAP index was computed as the Pearson correlation coefficient between the MWA and the mean ICP for 40 6-sec time windows, i.e. every subsequent 4-min period (method 1). We compared this approach with a method of calculating RAP using a 4-min moving window updated every 6 seconds (method 2). Results The study included 16 aSAH patients. We compared 43,653 4-min RAP observations of signals 1 and 2 (method 1), and 1,727,000 6-sec RAP observations (method 2). The two methods of calculating RAP produced similar results. Differences in RAP ≥0.4 in at least 7% of observations were seen in 5/16 (31%) patients. Moreover, the combination of a RAP of ≥0.6 in one signal and 0.2 was significantly associated with the frequency of BPEs (5 mmHg ≤ BPE <10 mmHg). Conclusions Simultaneous monitoring from two separate, close-by ICP sensors reveals significant differences in RAP that correspond to the occurrence of BPEs. As differences in RAP are of magnitudes that may alter patient management, we do not advocate the use of RAP in the management of

  17. Is cardiovascular disease in patients with diabetes associated with serum levels of MMP-2, LOX, and the elastin degradation products ELM and ELM-2?

    DEFF Research Database (Denmark)

    Rørdam Preil, Simone; Faarvang Thorsen, Anne-Sofie; Christiansen, Anne Lindegaard

    2017-01-01

    RNA-expression in diabetic patients, namely matrix metalloproteinase 2 (MMP-2), lysyl oxidase (LOX) and elastin itself. In this study we investigate whether the serum concentrations of elastin-related proteins correlate to signs of CVD in patients with T2DM. METHODS: Blood samples from 302 type 2 diabetic patients were...... analysed for MMP-2, LOX, and the elastin degradation products ELM and ELM2. The results were investigated for correlations to signs of CVD in different vascular territories, as determined by myocardial perfusion scintigraphy, carotid artery thickness and ankle-brachial blood pressure index. RESULTS: T2DM...... patients with peripheral arterial disease (low ankle-brachial index) (PAD) display higher levels of MMP-2 and ELM compared to patients without PAD. However, none of the proteins or degradation products correlated with myocardial ischemia or a combined measure of CVD-signs, including myocardial ischemia...

  18. Pulmonary acute respiratory distress syndrome: positive end-expiratory pressure titration needs stress index.

    Science.gov (United States)

    Huang, Yingzi; Yang, Yi; Chen, Qiuhua; Liu, Songqiao; Liu, Ling; Pan, Chun; Yang, Congshan; Qiu, Haibo

    2013-11-01

    The heterogeneity of lung injury in pulmonary acute respiratory distress syndrome (ARDS) may have contributed to the greater response of hyperinflated area with positive end-expiratory pressure (PEEP). PEEP titrated by stress index can reduce the risk of alveolar hyperinflation in patients with pulmonary ARDS. The authors sought to investigate the effects of PEEP titrated by stress index on lung recruitment and protection after recruitment maneuver (RM) in pulmonary ARDS patients. Thirty patients with pulmonary ARDS were enrolled. After RM, PEEP was randomly set according to stress index, oxygenation, static pulmonary compliance (Cst), or lower inflection point (LIP) + 2 cmH2O strategies. Recruitment volume, gas exchange, respiratory mechanics, and hemodynamic parameters were collected. PEEP titrated by stress index (15.1 ± 1.8 cmH2O) was similar to the levels titrated by oxygenation (14.5 ± 2.9 cmH2O), higher than that titrated by Cst (11.3 ± 2.5 cmH2O) and LIP (12.9 ± 1.6 cmH2O) (P stress index and oxygenation but higher than that titrated by Cst and LIP. Compared with baseline, lung compliance increased significantly when PEEP determined by Cst, but there was no difference of Cst in these four strategies. There was no influence of PEEP titration with the four strategies on hemodynamic parameters. PEEP titration by stress index might be more beneficial for pulmonary ARDS patients after RM. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Concurrent validity of an automated algorithm for computing the center of pressure excursion index (CPEI).

    Science.gov (United States)

    Diaz, Michelle A; Gibbons, Mandi W; Song, Jinsup; Hillstrom, Howard J; Choe, Kersti H; Pasquale, Maria R

    2018-01-01

    Center of Pressure Excursion Index (CPEI), a parameter computed from the distribution of plantar pressures during stance phase of barefoot walking, has been used to assess dynamic foot function. The original custom program developed to calculate CPEI required the oversight of a user who could manually correct for certain exceptions to the computational rules. A new fully automatic program has been developed to calculate CPEI with an algorithm that accounts for these exceptions. The purpose of this paper is to compare resulting CPEI values computed by these two programs on plantar pressure data from both asymptomatic and pathologic subjects. If comparable, the new program offers significant benefits-reduced potential for variability due to rater discretion and faster CPEI calculation. CPEI values were calculated from barefoot plantar pressure distributions during comfortable paced walking on 61 healthy asymptomatic adults, 19 diabetic adults with moderate hallux valgus, and 13 adults with mild hallux valgus. Right foot data for each subject was analyzed with linear regression and a Bland-Altman plot. The automated algorithm yielded CPEI values that were linearly related to the original program (R 2 =0.99; Pcomputation methods. Results of this analysis suggest that the new automated algorithm may be used to calculate CPEI on both healthy and pathologic feet. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Study of blood pressure and blood sugar levels in adolescence and comparison with body mass index.

    Science.gov (United States)

    Borade, Ashwin; Kadam, Gauri Shashank; Bhide, Gayatri; Dhongade, Ram

    2011-07-01

    Worldwide prevalence of overweight and obesity is increasing and its consequences prompted the WHO to designate obesity as a global epidemic in 2002. Being overweight is a risk factor for significant illness, especially diabetes and hypertension in adult life. To study the blood pressure and blood sugar levels and lifestyle parameters in adolescence and comparison with body mass index. In a prospective case control study, out of the 1000 screened, a total of 200 adolescents were considered out of which 100 were with high body mass index (BMI) and the other 100 were with normal BMI. Height, weight, BMI, waist hip ratio (WHR), blood pressure (BP), BSL, and associated risk factors like physical activity, fast food consumption, and computer/television watching were measured and screened. 109 (54.5%) males and 91 (45.5%) females were included. Maximum number [90 (45%)] of adolescents screened were in the age group of 17-19 years, while 54 (27%) and 56 (28%) adolescents were in the age group of 10-13 years and 14-16 years, respectively. According to CDC charts 2000, prevalence of overweight was 24% which was double when compared to WHO charts 2007. There was significant difference in prevalence of obesity; according to CDC chart it was 26%, whereas according to WHO chart it was 39%. The difference in blood pressures between cases and controls as per both CDC and WHO charts was found to be statistically significant (P 0.05) with BMI. The adolescents seem to have become heavier owing to environmental influences on growth patterns. So, a consideration should be given to shift the cut-offs for overweight and obesity to higher BMI percentiles if recent growth charts are to be followed. Adolescents with a BMI above the 95 th percentile (obese) are most likely to have obesity-related health risks.

  1. Investigation of a pressure-dependent refractive index of germanium film with an optical fiber film sensor.

    Science.gov (United States)

    Yuan, Dongxu; Gao, Hongyun; Chen, Hao; Li, Min

    2018-02-01

    The refractive index of Ge is found in decline with applied pressure at a specific wavelength in the absorption region below 1900 nm, where the absorption coefficient rises dramatically with decreased wavelength. In this paper, we use a Ge-coated fiber optic probe to demonstrate quantitatively that the downward trend in the refractive index to increasing pressure matches the theoretically simulated optical properties of Ge with a measurement error of 1.03×10 -3 in the refractive index, which is further calculated within the framework of density functional theory with local density approximation. For the first time, to the best of our knowledge, both theoretical and experimental results prove that the refractive index reduces linearly with a gradient of -3.30×10 -4 /MPa as the pressure increases from 0 to 20 MPa.

  2. A PRESSURE ULCER AND FALL RATE QUALITY COMPOSITE INDEX FOR ACUTE CARE UNITS: A MEASURE DEVELOPMENT STUDY

    Science.gov (United States)

    Jayawardhana, Ananda; Burman, Mary E.; Dunton, Nancy E.; Staggs, Vincent S.; Bergquist-Beringer, Sandra; Gajewski, Byron J.

    2016-01-01

    Background Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. Objective The study objective was to develop a unit-level inpatient composite nursing care quality performance index – the Pressure Ulcer and Fall Rate Quality Composite Index. Design Two-phase measure development study. Settings 5,144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013. Methods The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. Results The Pressure Ulcer and Fall Rate Quality Composite Index = 100 − PUR − FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of

  3. Nonlinear intersubband absorption and refractive index changes in square and graded quantum well modulated by temperature and Hydrostatic pressure

    International Nuclear Information System (INIS)

    Ozturk, Emine; Sokmen, Ismail

    2013-01-01

    In this study, the effects of hydrostatic pressure and temperature on the linear and nonlinear intersubband transitions and the refractive index changes in the conduction band of square and graded quantum well (QW) are theoretically calculated within the framework of effective mass approximation. Results obtained show that the energy levels in different QWs and intersubband properties can be modified and controlled by the hydrostatic pressure and temperature. The modulation of the absorption coefficients and the refractive index changes which can be suitable for good performance optical modulators and various infrared optical device applications can be easily obtained by tuning the temperature and the hydrostatic pressure. - Highlights: ► Linear and nonlinear optical processes can be changed by pressure and temperature. ► Magnitude and energy of absorption peaks decrease as pressure increases. ► Refractive index changes in magnitude and energy decrease by increasing pressure. ► Energy differences are dependent on pressure, temperature and QW shapes. ► By increasing pressure we can obtain redshift in the optical transitions. ► For SQW, the absorption spectrum shows blueshift as the temperature increases. ► For GQW, the absorption spectrum shows redshift by temperature.

  4. Maximum inspiratory pressure and rapid shallow breathing index as predictors of successful ventilator weaning.

    Science.gov (United States)

    Bien, Umilson Dos Santos; Souza, Gerson Fonseca; Campos, Elisangela Siqueira; Farah de Carvalho, Etiene; Fernandes, Matheus Guedes; Santoro, Ilka; Costa, Dirceu; Arena, Ross; Sampaio, Luciana Maria Malosá

    2015-12-01

    [Purpose] To investigate the predictive value of maximum inspiratory pressure (MIP) and the rapid shallow breathing index (RSBI) in a ventilator weaning protocol and to evaluate the differences between clinical and surgical patients in the intensive care unit. [Subjects and Methods] Patients aged ≥15 years who underwent orotracheal intubation for mechanical ventilation and who met the criteria of the weaning protocol were included in the study. Receiver operating characteristic (ROC) curves were calculated for the analysis of each index. [Results] Logistic regression analysis was also performed. MIP showed greater sensitivity and specificity [area under the curve (AUC): 0.95 vs. 0.89] and likelihood ratios (LR) (positive(+): 20.85 vs. 9.45; negative(-): 0.07 vs. 0.17) than RSBI in the overall sample (OS) as well as in clinical patients (CP) (AUC: 0.99 vs. 0.90; LR+: 24.66 vs. 7.22; LR-: 0.01 vs. 0.15) and surgical patients (SP) (AUC: 0.99 vs. 0.87; LR+: 9.33 vs. 5.86; LR-: 0.07 vs. 0.14). The logistic regression analysis revealed that both parameters were significantly associated with the weaning success. The MIP showed greater accuracy than the RSBI (OS: 0.93 vs. 0.85; CP: 0.98 vs. 0.87; SP: 0.93 vs. 0.87). [Conclusion] Both parameters are good predictors of successful ventilator weaning.

  5. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  6. The correlation between body mass index and intraocular pressure in children

    Directory of Open Access Journals (Sweden)

    Luciano Lira de Albuquerque

    2013-02-01

    Full Text Available PURPOSE: There is evidence from some studies that support an association between obesity in adults and higher intraocular pressure (IOP. However, this association has not been completely studied in children. Our aim is to evaluate the association between child body mass index (BMI and IOP. METHODS: Ninety-six children attending the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP in Brazil were studied. Thirty-three were overweight/obese with a mean BMI of 29.7 ± 5.2 and 63 with a mean BMI of 20.8 ± 3.3. IOP was measured using the Goldmann applanation tonometer and was corrected for corneal thickness. The coefficient of correlation between BMI and IOP was calculated. RESULTS: There was no significant difference in the IOP of children with or without overweight/obesity. The mean IOP was 13.5 and 13.0 mmHg for the right eye and 13.1 and 12.9 mmHg for left eye, respectively (p=0.38 and p=0.71. The results remained the same after correction by pachymetry; 13.0 and 13.1 mmHg for the right eye and 12.4 and 12.9 mmHg for the left eye, respectively (p=0.88 and p=0.41. The coefficient of correlation between BMI and IOP was 0.070 (p=0.496. CONCLUSION: These results do not show a correlation between body mass index and IOP in children. Further studies are warranted to clarify the association between BMI and IOP in children.

  7. Intramuscular pressure and electromyography as indexes of force during isokinetic exercise

    Science.gov (United States)

    Aratow, M.; Ballard, R. E.; Grenshaw, A. G.; Styf, J.; Watenpaugh, D. E.; Kahan, N. J.; Hargens, A. R.

    1993-01-01

    A direct method for measuring force production of specific muscles during dynamic exercise is presently unavailable. Previous studies indicate that both intramuscular pressure (IMP) and electromyography (EMG) correlate linearly with muscle contraction force during isometric exercise. The objective of this study was to compare IMP and EMG as linear assessors of muscle contraction force during dynamic exercise. IMP and surface EMG activity were recorded during concentric and eccentric isokinetic plantarflexion and dorsiflexion of the ankle joint from the tibialis anterior (TA) and soleus (SOL) muscles of nine male volunteers. Ankle torque was measured using a dynamometer, and IMP was measured via catheterization. IMP exhibited better linear correlation than EMG with ankle joint torque during concentric contractions of the SOL and the TA, as well as during eccentric contractions. IMP provides a better index of muscle contraction force than EMG during concentric and eccentric exercise through the entire range of torque. IMP reflects intrinsic mechanical properties of individual muscles, such as length-tension relationships, which EMG is unable to assess.

  8. Blood pressure, body mass index and risk of cardiovascular disease in Chinese men and women

    Directory of Open Access Journals (Sweden)

    Huang Jianfeng

    2010-04-01

    Full Text Available Abstract Background It is still uncertain whether increased blood pressure (BP has a stronger effect on the risk of cardiovascular disease (CVD in lean persons than in obese persons. We tested it using a data set collected from a large cohort of Chinese adults. Methods Systolic and diastolic BP, body mass index (BMI and other variables were measured in 169,871 Chinese men and women ≥ 40 years of age in 1991 using standard protocols. Follow-up evaluation was conducted in 1999-2000, with a response rate of 93.4%. Data were analyzed with Cox proportional hazards models. Results After adjusted for age, sex, cigarette smoking, alcohol consumption, high school education, physical inactivity, geographic region, and urbanization, we found that the effects of systolic or diastolic BP on risk of CVD generally increased with the increasing BMI levels (underweight, normal, overweight, and obese. For example, hazard ratios (HRs and 95% confidence interval (CI per 1- standard deviation (SD increase in systolic BP within corresponding BMI levels were 1.27(1.21-1.33, 1.45(1.41-1.48, 1.52 (1.45-1.59 and 1.63 (1.51-1.76, respectively. Statistically significant interactions (P Conclusion Our study suggests that the magnitude of the association between BP and CVD generally increase with increasing BMI. Hypertension should not be regarded as a less serious risk factor in obese than in lean or normal-weight persons in Chinese adults.

  9. A predictive model for pressure ulcer outcome: the Wound Healing Index.

    Science.gov (United States)

    Horn, Susan D; Barrett, Ryan S; Fife, Caroline E; Thomson, Brett

    2015-12-01

    The purpose of this learning activity is to provide information regarding the creation of a risk-stratification system to predict the likelihood of the healing of body and heel pressure ulcers (PrUs). This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Explain the need for a PrU risk stratification tool.2. Describe the purpose and methodology of the study.3. Delineate the results of the study and development of the Wound Healing Index. : To create a validated system to predict the healing likelihood of patients with body and heel pressure ulcers (PrUs), incorporating only patient- and wound-specific variables. The US Wound Registry data were examined retrospectively and assigned a clear outcome (healed, amputated, and so on). Significant variables were identified with bivariate analyses. Multivariable logistic regression models were created based on significant factors (P wound clinics in 24 states : A total of 7973 body PrUs and 2350 heel PrUs were eligible for analysis. Not applicable : Healed PrU MAIN RESULTS:: Because of missing data elements, the logistic regression development model included 6640 body PrUs, of which 4300 healed (64.8%), and the 10% validation sample included 709 PrUs, of which 477 healed (67.3%). For heel PrUs, the logistic regression development model included 1909 heel PrUs, of which 1240 healed (65.0%), and the 10% validation sample included 203 PrUs, of which 133 healed (65.5%). Variables significantly predicting healing were PrU size, PrU age, number of concurrent wounds of any etiology, PrU Stage III or IV, evidence of bioburden/infection, patient age, being nonambulatory, having renal transplant, paralysis, malnutrition, and/or patient hospitalization for any reason. Body and heel PrU Wound Healing Indices are comprehensive, user-friendly, and validated predictive models for

  10. Blood pressure levels and body mass index in Brazilian adults with Down syndrome

    Directory of Open Access Journals (Sweden)

    Felipe Pucci

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Increased life expectancy among people with Down syndrome (DS has introduced new environmental factors that may affect blood pressure (BP and/or lead to obesity in this population. The aim here was to investigate BP levels and body mass index (BMI in adults with DS, correlating these data with the patients' sex and age. DESIGN AND SETTING: Analytical cross-sectional observational study conducted in special schools in Curitiba (PR, Brazil. METHODS: 97 adult patients were included. BP was measured in accordance with the established guidelines. BMI was calculated by dividing the weight by the height squared (kg/m2. RESULTS: Sex had no influence on BMI; nor did systolic BP (SBP or diastolic BP (DBP. The age range was from 18 to 56 years. No correlation was observed between increasing age and greater BMI or BP. Eighty-six individuals (88.7% presented normal BP, eleven (11.3% prehypertension and none hypertension. Twenty patients (20.4% presented BP lower than 90 × 60 mmHg. BMI ranged from 18 to 48 kg/m2 (mean of 28.8 ± 3.92 kg/m2: 21.9% had normal weight; 40.7% were overweight; and 25.3% had obesity class I, 9.9% class II and 2.2% class III. Higher BMI was associated with significantly greater SBP and DBP (P = 0.0175 and P = 0.0015. CONCLUSION: Sex and age did not influence SBP, DBP or BMI in Brazilian adults with DS. Higher BMI was associated with greater BP (both systolic and diastolic.

  11. Longitudinal relationship of parental hypertension with body mass index, blood pressure, and cardiovascular reactivity in children.

    Science.gov (United States)

    Li, Rongling; Alpert, Bruce S; Walker, Sammie S; Somes, Grant W

    2007-05-01

    To investigate whether parental hypertension (HTN) affects children's body mass index (BMI) and cardiovascular reactivity (CVR) over time. A longitudinal study of 315 students (black: 23 females, 19 males; white: 142 females, 131 males) was conducted in the public schools of Obion County, Tennessee, between 1987 and 1992. BMI and BMI z scores were calculated. The CVR task was a series of video games (taking approximately 10 minutes to play) given to the same students in their third-, fourth-, fifth-, seventh-, and eighth-grade years. CVR was defined as the change in blood pressure (delta_BP) or heart rate (delta_HR) between before playing and while playing the video game. Positive parental history of HTN (27.6%) was defined as at least 1 parent with HTN. Multivariable regression analyses were performed to estimate the effects of parental HTN on children's BMI and CVR over time. Children with parental HTN had significant higher BMI, BMI z score, and R_BP than did children without parental HTN (BMI: 21.6 vs 19.9, P = .001; BMI z score: 1.6 vs 1.1, P = .003; R_SBP: 112.6 vs 110.4 mm Hg, P = .01; R_DBP 62.7 vs 60.6 mm Hg, P = .003) after adjustment for covariates. Increased CVR was observed in children with parental HTN compared with children without parental HTN but was statistically significant only for SBP (delta_SBP: 17.2 vs 14.9 mm Hg; P = .01) after adjustment for covariates. Parental HTN independently predicted children's BMI, BMI z score, resting BP, and BP reactivity.

  12. Impact of body mass index on high blood pressure among obese children in the western region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulmoein E. Al-Agha

    2018-01-01

    Full Text Available Objectives: To evaluate the impact of body mass index (BMI on high blood pressure among obese children and adolescents in western region, Saudi Arabia. Methods: Cross-sectional data were obtained from 306 (female: 140, male: 166 child, between August 2016 and March 2017. A questioner was filled by health professionals at ambulatory pediatric clinic followed by waist-hip circumference, height, weight, and blood pressure measurement. Diastolic blood pressure (DBP and systolic blood pressure (SBP were adjusted to gender, height, and age. World Health Organization growth standards were used to calculate BMI z-scores. Results: The mean age of subjects was 10.1 years. Body mass index increased SBP by 1.722 mmHg (p=0.001, and DBP by 0.901 mmHg (p=0.006 in boys, and 0.969 mmHg (p=0.036, and DBP by 0.704 mmHg (p=0.045 in girls. Waist hip ratio showed significant difference p=0.041, (p=0.0001 between male and female. Of the baseline characteristics, age greater than 11 years showed significant difference. Symptomatic manifestation of high blood pressure, family history of hypertension, level of activity, income level and post-secondary education in parents, did not show any significant results. Conclusion: Elevated BMI is associated with significantly increased diastolic and systolic blood pressure in obese children, especially in children older than 11 years.

  13. Impact of body mass index on high blood pressure among obese children in the western region of Saudi Arabia.

    Science.gov (United States)

    Al-Agha, Abdulmoein E; Mahjoub, Areej O

    2018-01-01

    To evaluate the impact of body mass index (BMI) on high blood pressure among obese children and adolescents in western region, Saudi Arabia.  Methods: Cross-sectional data were obtained from 306 (female: 140, male: 166) child, between August 2016 and March 2017. A questioner was filled by health professionals at ambulatory pediatric clinic followed by waist-hip circumference, height, weight, and blood pressure measurement. Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were adjusted to gender, height, and age. World Health Organization growth standards were used to calculate BMI z-scores. Results: The mean age of subjects was 10.1 years. Body mass index increased SBP by 1.722 mmHg (p=0.001), and DBP by 0.901 mmHg (p=0.006) in boys, and 0.969 mmHg (p=0.036), and DBP by 0.704 mmHg (p=0.045) in girls. Waist hip ratio showed significant difference p=0.041, (p=0.0001) between male and female. Of the baseline characteristics, age greater than 11 years showed significant difference. Symptomatic manifestation of high blood pressure, family history of hypertension, level of activity, income level and post-secondary education in parents, did not show any significant results. Conclusion: Elevated BMI is associated with significantly increased diastolic and systolic blood pressure in obese children, especially in children older than 11 years.

  14. [The evaluation of the end-ejection pressure-length relation as an index of regional contractility].

    Science.gov (United States)

    Perlini, S; Meyer, T E; Bernardi, L; Soldà, P L; Calciati, A; Finardi, G; Foëx, P

    1992-08-01

    Although end-systolic pressure-length relationship (ESPLR) is now widely used as a regional substitute for the end-systolic pressure-volume relationship, there are some reservations about its use as an index of systolic performance. This study aimed at assessing whether by using end-ejection (zero aortic flow) as a definition of end-systole, ESPLR can be used to characterize myocardial performance independent of load, and if the choice of the region where to implant the sonomicrometers is critical. Ten anaesthetized dogs (16 +/- 2 kg) were instrumented with a left ventricular (LV) pressure micromanometer and an aortic flow probe. Sonomicrometers were implanted in the apical (L1) and the mid-ventricular (L2) regions of the anterior LV wall, and in the basal region of the lateral wall (L3). End-systolic pressure-length relationships were obtained during acute preload reduction induced by the inflation of a vena caval balloon. This evaluation was repeated after increasing end-diastolic pressure to 14-18 mmHg (delta PL), after increasing systolic pressure by 15 (delta P-I) and 25 mmHg (delta P-II) with graded descending aorta occlusion, and during dobutamine infusions at 2.5 (Db 2.5) and 5 micrograms/kg/min (Db5). End-systolic pressure-length relationships (r > 0.97; pressure range: 70-100 mmHg) were characterized by their slopes (Ees), the extrapolated intercept at zero pressure (L0) and the values of segment length at a pressure of 75 (L75) and 100 mmHg (L100). In all the myocardial regions studied by sonomicrometry, the increments in preload and afterload did not significantly shift ESPLR.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Automated method to compute Evans index for diagnosis of idiopathic normal pressure hydrocephalus on brain CT images

    Science.gov (United States)

    Takahashi, Noriyuki; Kinoshita, Toshibumi; Ohmura, Tomomi; Matsuyama, Eri; Toyoshima, Hideto

    2017-03-01

    The early diagnosis of idiopathic normal pressure hydrocephalus (iNPH) considered as a treatable dementia is important. The iNPH causes enlargement of lateral ventricles (LVs). The degree of the enlargement of the LVs on CT or MR images is evaluated by using a diagnostic imaging criterion, Evans index. Evans index is defined as the ratio of the maximal width of frontal horns (FH) of the LVs to the maximal width of the inner skull (IS). Evans index is the most commonly used parameter for the evaluation of ventricular enlargement. However, manual measurement of Evans index is a time-consuming process. In this study, we present an automated method to compute Evans index on brain CT images. The algorithm of the method consisted of five major steps: standardization of CT data to an atlas, extraction of FH and IS regions, the search for the outmost points of bilateral FH regions, determination of the maximal widths of both the FH and the IS, and calculation of Evans index. The standardization to the atlas was performed by using linear affine transformation and non-linear wrapping techniques. The FH regions were segmented by using a three dimensional region growing technique. This scheme was applied to CT scans from 44 subjects, including 13 iNPH patients. The average difference in Evans index between the proposed method and manual measurement was 0.01 (1.6%), and the correlation coefficient of these data for the Evans index was 0.98. Therefore, this computerized method may have the potential to accurately compute Evans index for the diagnosis of iNPH on CT images.

  16. Design and methodology for calculating the environmental pressure index as a tool for environmental land planning: the case of Cundinamarca

    International Nuclear Information System (INIS)

    Camacho O, Juana; Burgos S, Javier Dario

    2006-01-01

    The aim of this work is to provide a practical tool to carry out environmental planning and management processes regarding the use of space, in a complex way including not only biophysical but socioeconomic criteria. In the context of river basin management the Environmental Social Pressure Index was created. This paper presents an Environmental Planning and Management definition, based on the Ecological Supporting Structure, as well as one of sustainability, worked out of several authors. This work offers the methodological sequence to design and calculate a customized Environmental Social Pressure Index according to the specific features of any given territory, using the conceptual framework developed earlier and the multivariate analysis and power laws tools. Finally we present an exercise to illustrate this process, developed for Cundinamarca for 1995

  17. Sudden cerebral depression detected by bispectral index monitoring in cryptococcal meningitis with elevated near-fatal cerebrospinal fluid pressure.

    Science.gov (United States)

    Matsumoto, Hironori; Annen, Suguru; Umakoshi, Kensuke; Takeba, Jun; Kikuchi, Satoshi; Nakabayashi, Yuki; Moriyama, Naoki; Ohshita, Muneaki; Aibiki, Mayuki

    2017-07-01

    An increase in cerebrospinal fluid pressure (CSFP) is usually prominent in cryptococcal meningitis, which has a high mortality rate, so aggressive management to control CSFP is crucial. In this case, a 40-year-old-man survived cryptococcal meningitis treated with continuous spinal drainage under bispectral index (BIS) monitoring. He unexpectedly showed hypertension, went into a coma, and even loss his light reflexes due to CSFP elevation. His BIS values had abruptly dropped before developing these symptoms, but dramatically recovered after lumbar puncture drainage, suggesting that BIS monitoring could reflect cerebral function changes due to CSFP alternations. Inducing continuous spinal drainage to control CSFP provided stable control of blood pressure and brain activity, which was continuously monitored by BIS, enabling us to provide prompt treatment. Cerebral depressions due to elevated CSFP may suddenly develop, so continuous spinal drainage is needed for preventing catastrophic events. Bispectral index could be useful for detecting early changes from CSFP elevation in meningitis cases with intracranial hypertension.

  18. Quantitative Doppler ultrasound evaluation of occlusive arterial disease in the lower limb

    DEFF Research Database (Denmark)

    Bagi, P; Sillesen, H; Hansen, H J

    1988-01-01

    Forty consecutive patients with lower limb arterial disease were evaluated using a multi-gated pulsed Doppler system. Doppler signals were sampled at 4 sites in each limb, and following spectral analysis, the pulse rise time (PRT) was measured. The value obtained at the location giving the longest...... duration of PRT was used for comparison with ankle/brachial pressure index (A/B index) and angiography. A highly significant correlation was found between PRT and A/B index (r = -0.75, P less than 0.001). Based on receiver operating characteristic curves an overall diagnostic accuracy of 90% in diagnosing...

  19. The B2 stress index as a function of internal pressure, bend angle, loading type and material

    International Nuclear Information System (INIS)

    Matzen, V.C.; Xi Yuan

    2003-01-01

    The current ASME Boiler and Pressure Vessel Code equation for the B2 stress index, which is used in the design equation for primary stresses in piping components, is widely considered to be overly conservative. In recent years, various researchers have investigated the behavior of piping components, primarily elbows, to determine the effect of parameters such as internal pressure, bend angle, location of adjacent flanges, loading type, etc. on the inelastic response of elbows. This paper contains a detailed evaluation of the effects of elbow size and schedule, loading type, internal pressure and material type on the collapse moments of straight pipes and elbows using nonlinear finite element analysis, and then uses these data to construct B2 stress indices for the various combinations of parameters. Using these results, various equations for the stress index as a function of the pipe bend characteristic parameter, the bend angle, internal pressure and material type are investigated and an optimal form of one of the equations is recommended for use. (author)

  20. Change in pulse pressure/stroke index in response to sustained blood pressure reduction and its impact on left ventricular mass and geometry changes: the life study

    DEFF Research Database (Denmark)

    Palmieri, V.; Bella, J.N.; Gerdts, E.

    2008-01-01

    in hypertension (LIFE) study, we evaluated the impact of antihypertensive treatment on change of PP/SVi as raw indicator of systemic arterial stiffness, and further explored the impact of the change in PP/SVi on the change in LV mass and RWT. RESULTS: Compared to baseline, mean PP/SVi reduction was -13% at year 1......BACKGROUND: In cross-sectional data in hypertensive subjects, brachial pulse pressure (PP)/Doppler stroke index (SVi), (PP/SVi) correlates weakly but significantly with left ventricular (LV) mass and relative wall thickness (RWT). METHODS: In the Losartan Intervention For End-point reduction...

  1. Correlation of intraocular pressure with blood pressure and body mass index in offsprings of diabetic patients: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Shailaja Patil, Anita Herur, Shashikala GV, Surekharani Chinagudi, Manjula R, Roopa Ankad, Sukanya Badami, Brid SV

    2014-07-01

    Full Text Available Background: Raised intraocular pressure (IOP has been associated with risk factors like hypertension, diabetes mellitus (DM, obesity, body mass index (BMI and sex, increasing the risk of glaucoma causing visual impairment and blindness. Since familial inheritance is known with glaucoma and DM, the aim was to study the IOP and its correlation with BMI and blood pressure (BP in offsprings of DM and also to predict the future/early onset of glaucoma in them. Methods: This was an observational study done in medical undergraduate students. 25 students were included in the study group (offsprings of diabetic parents-cases and 23 students in the control group (offsprings without diabetic history in parents. Height, weight, blood pressure and intraocular pressure were recorded in both the groups and these were compared. Statistical analysis was done by student’s t test and Pearson’s correlation. Results: Cases exhibited a lower IOP, BMI, mean arterial pressure (MAP and diastolic blood pressure (DBP, but not SBP, as compared to controls. These differences, however, were not statistically significant except DBP. There was a negative correlation found between IOP and BMI and also between IOP and MAP in cases, whereas in controls, there was a positive correlation found between BMI and IOP and no correlation between IOP and MAP. Conclusion: Offsprings of diabetic patients may be less prone for primary open angle glaucoma. Limitations: The limitations of the present study include a smaller sample size, study of the results in relation to paternal or maternal diabetic status and also of grandparents, so that the inheritance of diabetes and also of IOP can be studied.

  2. Central aortic blood pressure and augmentation index: comparison between Vasotens® and SphygmoCor® technology

    Directory of Open Access Journals (Sweden)

    Rogoza AN

    2012-05-01

    Full Text Available Anatoliy N Rogoza,1 Aleksandr A Kuznetsov21Cardiology Research Complex, Moscow, Russian Federation; 2Therapy Research Institute, Siberian branch of Russian Academy of Medical Science, Novosibirsk, Russian FederationIntroduction: The aim of this study is the comparison of Vasotens® technology as used in a device with an oscillometric method of blood pressure measurement (BPLab, Petr Telegin Ltd, Nizhny Novgorod, Russian Federation against the validated tonometric system (SphygmoCor®, AtCor Medical Pty Ltd, West Ryde, Australia.Methods: The examinations were carried out in two medical centers. Exclusion criteria included atrial fibrillation, severe cardiac anomalies, heart failure, arrhythmia, decompensated diabetes, the presence of an artificial pacemaker, pregnancy, and BMI > 30. Overall, 160 patients and healthy volunteers were examined. Central aortic systolic blood pressure (aSBP and augmentation index (aAIx were obtained by means of applanation tonometry and the oscillometric method was compared.Results: aSBP and aAIx measured using the BPLab device equates significantly with the same parameters measured by SphygmoCor.Conclusion: This finding allows the recommendation of Vasotens technology, which can be used with the 24-hour BPLab monitoring system for wide clinical use.Keywords: central aortic blood pressure, augmentation index, validation, Vasotens®, BPLab®

  3. Stress index development for piping with trunnion attachment under pressure and moment loading

    International Nuclear Information System (INIS)

    Lee, D. H.; Kim, J. M.; Park, S. H.

    1997-01-01

    A finite element analysis of a trunnion pipe anchor is presented. The structure is analyzed for the case of internal pressure and moment loadings. The stress results are categorized into the average (membrane) stress, the linearly varying (bending) stress and the peak stress through the thickness. The resulting stresses are interpreted per section III of the ASME boiler and pressure vessel code from which the Primary (B 1 ), Secondary (C 1 ) and Peak (K 1 ) stress indices for pressure, the Primary (B 2 ), Secondary (C 2 ) and Peak (K 2 ) stress indices for moment are developed. Based on the comparison between stress value by stress indices derived in this paper and stress value represented by the ASME Code Case N-391-1, the empirical equations for stress indices are effectively used in the piping stress analysis. Therefore, the use of empirical equations can simplify the procedure of evaluating the local stress in the piping design stage. (author)

  4. The impact of exercise on derived measures of central pressure and augmentation index obtained from the SphygmoCor device.

    Science.gov (United States)

    Dawson, Ellen A; Black, Mark A; Pybis, Jennifer; Cable, N Timothy; Green, Daniel J

    2009-06-01

    The purpose of this study was to investigate whether measures derived from the SphygmoCor device and its associated transfer function are influenced by exercise-induced alterations in vascular tone. Measurements were taken from either the exercised or the contralateral nonexercised limb during repeated and identical incremental hand-grip protocols. Eight male subjects performed three 3-min bouts of hand-grip exercise on two occasions. The exercise intensities were set at 3 kg, 5 kg, with a final 1.5-kg bout performed during cuff ischemia (1.5Isch). Blood pressure waveforms were recorded from the radial artery of either the exercised or nonexercised limb using applanation tonometry (SphygmoCor) during a 90-s rest period immediately after each exercise bout. Central blood pressures and augmentation indexes (AIx), an index of arterial stiffness, were derived using the peripheral waveform and the inbuilt SphygmoCor transfer function (TF). AIx was consistently approximately 10% higher in the exercised arm during all trials compared with the nonexercised limb. Similarly, there was a consistent and significant difference ( approximately 3 mmHg; P < 0.05) between exercised and nonexercised arms for the derived central systolic and mean arterial blood pressures. Despite identical bouts of exercise, AIx and central systolic and mean arterial blood pressures derived from applanation tonometry at the peripheral radial artery were statistically different when assessed at the exercising arm vs. the nonexercising arm. Changes in vascular tone with exercise may modify the intrinsic characteristics of the vessel wall and could compromise the assumptions underlying transfer functions used to derive central measures using applanation tonometry.

  5. Yearly evolution of organ damage markers in diabetes or metabolic syndrome: data from the LOD-DIABETES study

    Directory of Open Access Journals (Sweden)

    Rodriguez-Sanchez Emiliano

    2011-10-01

    Full Text Available Abstract Background Cardiovascular disease morbidity-mortality is greater in people with type 2 diabetes mellitus or metabolic syndrome. The purpose of this study was to evaluate the yearly evolution of organ damage markers in diabetes or metabolic syndrome, and to analyze the associated factors. Methods An observational prospective study was carried out in the primary care setting, involving 112 patients: 68 diabetics and 44 subjects with metabolic syndrome, subjected to 12 months of follow-up. Measurements: traditional cardiovascular risk factors (blood pressure, blood glucose, lipids, smoking, body mass index (BMI and and non-traditional risk factors (waist circumference, hsC Reactive Protein and fibrinogen; subclinical vascular (carotid intima-media thickness, pulse wave velocity and ankle/brachial index, cardiac (Cornell voltage-duration product, renal organ damage (creatinine, glomerular filtration and albumin/creatinine index, and antihypertensive and lipid-lowering drugs. Results At baseline, the diabetics presented a mean age of 59.9 years, versus 55.2 years in the subjects with metabolic syndrome (p = 0.03. Diastolic blood pressure, total cholesterol and HDL-cholesterol were lower among the patients with diabetes, while blood glucose and HbA1c, as well as antihypertensive and lipid-lowering drug use, were greater. At evaluation after one year, the diabetics showed a decrease in BMI (-0.39, diastolic blood pressure (-3.59, and an increase in fibrinogen (30.23 mg/dL, ankle/brachial index (0.07 and the number of patients with ankle/brachial index pathologic decreased in 6. In turn, the patients with metabolic syndrome showed an increase in HDL-cholesterol (1-91 mg/dL, fibrinogen (25.54 mg/dL, Cornell voltage-duration product (184.22 mm/ms, ankle/brachial index (0.05 and the use of antihypertensive and lipid-lowering drugs, and a reduction in serum glucose (3.74 mg/dL, HOMA, systolic (-6.76 mmHg, diastolic blood pressure (-3.29 mmHg, and

  6. Central aortic blood pressure, augmentation index, and reflected wave transit time: reproducibility and repeatability of data obtained by oscillometry

    Directory of Open Access Journals (Sweden)

    Ageenkova O

    2011-11-01

    Full Text Available Olga A Ageenkova, Marina A Purygina Department of Therapy, Functional and Ultrasound Diagnostics, Postgraduate Training Faculty of Smolensk State Medical Academy, Smolensk, Russian Federation Background: The evidence suggests that arterial stiffness acts as an independent predictor of general as well as cardiovascular mortality, strokes in patients with arterial hypertension, type 2 diabetes mellitus in the elderly, and in the general population. The oscillometric method measures parameters of arterial stiffness by applying special methods of processing oscillograms. This is a study of the reproducibility and repeatability of central aortic systolic blood pressure (SBP, augmentation index, and reflected wave transit time measured by Vasotens® technology. Methods: Anthropometric and hemodynamic measurements for 90 volunteers were made by two observers using the 24-hour blood pressure monitoring system, BPLab®, with Vasotens technology in "office" mode, over a period of two days and always at the same time in the morning. Initialization of the device was performed prior to each measurement cycle for each participant. Results: Analysis of short-term repeatability and reproducibility data for central aortic systolic blood pressure, reflected wave transit time, and augmentation index did not reveal any statistically significant differences. For observer A, SBP was 0.11 ± 7.53 mmHg and aortic SBP was 0.26 ± 6.11 mmHg; for observer B, SBP was 0.14 ± 8.42 and aortic SBP was 0.2 ± 7.25 mmHg. Short-term reproducibility for the different observers with averaging of both measurements was 0.36 ± 5.69 mmHg for SBP and 0.37 ± 6.7 mmHg for aortic SBP; the next day, repeatability for observer A was 0.52 ± 10.7 mmHg for SBP and 0.73 ± 8.98 mmHg for aortic SBP. Conclusion: BPLab with Vasotens technology has good reproducibility and repeatability, and can be recommended for clinical vascular risk estimation. Keywords: arterial stiffness, central aortic

  7. Validity of the Edinburgh claudication questionnaire for diagnosis of peripheral artery disease in patients with type 2 diabetes.

    Science.gov (United States)

    Pita-Fernández, Salvador; Modroño-Freire, María José; Pértega-Díaz, Sonia; Herrera-Díaz, Lizbeth; Seoane-Pillado, Teresa; Paz-Solís, Adriana; Varela Modroño, José Luis

    2017-11-01

    To assess the prevalence of peripheral artery disease and the validity of clinical signs for its diagnosis in patients with type 2 diabetes. Setting: Health center (Mariñamansa,Orense). January 2011-January 2013. Patients with type 2 diabetes, informed consent. Age, sex, diabetes duration, body mass index, Charlson index, blood pressure, ankle-brachial index (ABI), cholesterol levels, smoking. Cardiovascular risk (UKPDS). Edinburgh Claudication Questionnaire. n=323 (± 5.5% accuracy, 95% confidence). multivariate logistic regression analysis. Sensitivity, specificity, predictive values, and agreement were estimated. Informed consent and ethics committee approval were obtained (2010/278). Mean patient age was 71.56±12.73 years, and mean diabetes duration 12.38±9.96 years. Symptoms of intermittent claudication were reported by 26,4% of patients, ABI was normal (0.9-1.1) in 37.2% of patients, less than 0.9 in 26,5%, and higher than 1.10 in 36.2% of patients. The kappa index of agreement of peripheral artery disease according to the Edinburgh Claudication Questionnaire and the ankle-brachial index was 0.33). The questionnaire showed a sensitivity of 50.7% for predicting the diagnosis of peripheral artery disease (ABI <0.9) with a specificity of 82.6%, with positive and negative predictive values of 48.6% and 83.8% respectively. One-fourth of patients with type 2 diabetes had peripheral artery disease. There was a low level of agreement between the evaluation of symptoms of intermittent claudication and the results of the ankle-brachial index. Presence or absence of symptoms of claudication did not allow for confirming or ruling out peripheral artery disease. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Cardiovascular Risk Factors in Cluster Headache.

    Science.gov (United States)

    Lasaosa, S Santos; Diago, E Bellosta; Calzada, J Navarro; Benito, A Velázquez

    2017-06-01

     Patients with cluster headache tend to have a dysregulation of systemic blood pressure such as increased blood pressure variability and decreased nocturnal dipping. This pattern of nocturnal nondipping is associated with end-organ damage and increased risk of cardiovascular disease.  To determine if cluster headache is associated with a higher risk of cardiovascular disease.  Cross-sectional study of 33 cluster headache patients without evidence of cardiovascular disease and 30 age- and gender-matched healthy controls. Ambulatory blood pressure monitoring was performed in all subjects. We evaluate anthropometric, hematologic, and structural parameters (carotid intima-media thickness and ankle-brachial index).  Of the 33 cluster headache patients, 16 (48.5%) were nondippers, a higher percentage than expected. Most of the cluster headache patients (69.7%) also presented a pathological ankle-brachial index. In terms of the carotid intima-media thickness values, 58.3% of the patients were in the 75th percentile, 25% were in the 90th percentile, and 20% were in the 95th percentile. In the control group, only five of the 30 subjects (16.7%) had a nondipper pattern ( P  =   0.004), with 4.54% in the 90th and 95th percentiles ( P  =   0.012 and 0.015).  Compared with healthy controls, patients with cluster headache presented a high incidence (48.5%) of nondipper pattern, pathological ankle-brachial index (69.7%), and intima-media thickness values above the 75th percentile. These findings support the hypothesis that patients with cluster headache present increased risk of cardiovascular disease. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Time Course of Changes in Extravascular Lung Water Index, Intracranial and Cerebral Perfusion Pressures in Acute Cerebral Circulatory Disorders

    Directory of Open Access Journals (Sweden)

    Yu. A. Churlyaev

    2009-01-01

    Full Text Available Objective: to study the time course of changes in extravascular lung water index (ELWI and intracranial and cerebral perfusion pressures (ICP and CPP and to determine their possible relationships in acute cerebral circulatory disorders (ACCD. Subject and methods. ELWI, pulmonary vascular permeability index (PVPI, ICP, CPP, and central hemodynamics were studied by transpulmonary thermodilution and current X-ray studies were conducted in 18 patients on days 1, 3, 5, and 7 of ACCD. Results. Examinations revealed a supratentorial dislocation of the brain in 6 persons; its subtento-rial dislocation was found in 1 case; supra- and subtentorial dislocations were seen in 6. In patients, ELWI and PVPI increased from days 1 and 5, respectively. The high baseline ICP increased over time. CPP remained unchanged. Preserved left ventricular contractility, enhanced myocardial one, a significant direct correlation between ELWI and PVPI, as well as their increase confirmed that the noncardiogenic genesis was responsible for increased ELWI. A direct significant correlation was found between ICP and ELWI, ICP and PVPI. Against this background, acute respiratory distress syndrome developed in 14 patients with pneumonia evolving in its presence in 7 patients. Conclusion. In ACCD, ELWI increases in the first 24 hours of the acute period. One of its causes is, along with others, primary and/or secondary damage to the brainstem structures with elevated ICP and progressive brain dislocation. The determination of ICP, unlike CPP, is crucial in the diagnosis and treatment of primary/secondary brain injuries and in prognosis. Key words: acute cerebral circulatory disorder, extravascular lung fluid, pulmonary vascular permeability, intracranial pressure, cerebral perfusion pressure, acute respiratory distress syndrome.

  10. Decrease in blood pressure, body mass index and glycemia after aerobic training in elderly women with type 2 diabetes.

    Science.gov (United States)

    Monteiro, Luciana Zaranza; Fiani, Cássio Ricardo Vaz; Freitas, Maria Cristina Foss de; Zanetti, Maria Lúcia; Foss, Milton César

    2010-10-01

    The aging process is associated with the development of several diseases, which can be attenuated by the practice of physical activities. Aerobic training is an effective method to maintain and improve cardiovascular function. Additionally, it has a crucial role in the prevention and treatment of several chronic-degenerative diseases, especially diabetes mellitus. } To verify the effect of a 13-week aerobic training program on blood pressure (BP), body mass index (BMI) and glycemia levels in elderly women with type-2 diabetes mellitus (DM2). Eleven sedentary elderly women with DM2, aged 61.0 ± 9.1 years, were submitted a 13-week aerobic training program, constituting group G2. Eleven controlled elderly women (aged 60.2 ± 6.8 years) were not submitted to the aerobic training, constituting the control group (G1). G1 attended educational lectures once a week, whereas G2 walked three times a week. Both groups presented a significant decrease in glycemia and diastolic blood pressure levels. No significant decreases in BMI were observed after the aerobic training in either group. The 13-week aerobic training program was enough to promote significant decrease in the diastolic blood pressure and glycemia levels; therefore, this type of exercise training decreases the risk factors for cardiovascular and metabolic diseases.

  11. Diode laser heterodyne interferometry for refractive index measurement of small-scale plasmas in high pressure gases

    Science.gov (United States)

    Urabe, Keiichiro; Muneoka, Hitoshi; Stauss, Sven; Terashima, Kazuo

    2013-09-01

    The electron density is one of the most important plasma parameters; however, the behavior of the electron density in high-pressure small-scale plasmas (so-called microplasmas) is still not well understood. We have studied the electron density in direct-current microplasmas operated at atmospheric pressure by using laser heterodyne interferometry and reported some results using CO2 laser as a light source. By measuring the temporal evolutions of the refractive index of the plasmas by the interferometer, the temporal changes of the electron and gas number densities can be derived. Because of its shorter wavelength, using near-infrared diode laser (890 nm) as a light source allows improving the spatial resolution of the measurement over that obtained using a CO2 laser (10.6 μm). Furthermore, by replacing a lock-in amplifier used in our previous CO2-laser interferometry by a custom-made phase detecting module, the response time and temporal resolution of the measurements could be improved. Finally, we discuss potentials of the diode laser interferometry for the measurement of electron and gas number densities with the measurement results of pulsed microplasmas operated in atmospheric and higher pressure gases. This work was supported financially in part by a Grant-in-Aid for Scientific Research on Innovative Areas (No. 21110002) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

  12. Contrasting effects of prenatal life stress on blood pressure and body mass index in young adults.

    Science.gov (United States)

    Bhat, Sunil K; Beilin, Lawrence J; Robinson, Monique; Burrows, Sally; Mori, Trevor A

    2015-04-01

    Various environmental stressors in pregnancy have been reported to affect high blood pressure (BP) in adult offspring. However, few studies have examined the effect of prenatal maternal psychological stress on offspring BP and BMI in early adulthood. In 957 Raine cohort participants, regression analyses were used to examine the association between the count of maternal life stress events experienced during pregnancy and offspring BP and BMI at age 20. Prenatal life stress associated positively with offspring BMI but inversely with SBP. After adjustment for confounders each additional prenatal life stress event reduced offspring SBP by 0.66  mmHg (P = 0.013) in those with an average BMI and lowered the odds of systolic (pre)hypertension by 17% (odds ratio = 0.83; P = 0.008). The inverse relationship between prenatal life stress and adult SBP was stronger in offspring with higher BMI. On the contrary, each unit increase in prenatal life stress score predicted a BMI increase of 0.37  kg/m (P = 0.022). Longitudinal analysis showed similar effects of prenatal life stress for offspring BMI from age 8 and SBP from age 14. This study has shown that maternal stress in pregnancy significantly associated with BMI from early childhood, but contrary to our hypothesis predicted lower resting SBP and lower odds of systolic (pre)hypertension in young adult offspring. The effect of prenatal life stress on BP was accentuated by a higher BMI. Fetal programming events as a result of prenatal stress may underpin some of these relationships.

  13. Interaction between body mass index and serum uric acid in relation to blood pressure in community-dwelling Japanese men.

    Science.gov (United States)

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Senzaki, Kensuke; Kumagi, Teru

    2018-01-01

    Few data is available on the association between body mass index (BMI), serum uric acid (SUA) levels and blood pressure (BP) categories in the disease continuum, when efforts for its prevention may be applicable. We performed a cross-sectional study to examine the association between BMI, SUA and BP in a community-dwelling sample of Japanese men. Individuals not on antihypertensive and uric acid lowering medications, and aged 50 to 90 years [817men aged 66 ± 9 (mean ± standard deviation) years] were recruited for the survey during a community based annual medical check-up. The main outcome was the presence of prehypertension [systolic BP (SBP) 120-139 mmHg and/or diastolic BP (DBP) 80-89 mmHg] and hypertension [SBP ≥ 140 and /or DBP ≥ 90]. In participants with a BMI of dwelling men.

  14. Higher body mass index is associated with more adverse changes in calf muscle characteristics in peripheral arterial disease.

    Science.gov (United States)

    Raval, Zankhana; Liu, Kiang; Tian, Lu; Ferrucci, Luigi; Guralnik, Jack M; Liao, Yihua; Criqui, Michael H; McDermott, Mary M

    2012-04-01

    This study investigated whether higher body mass index (BMI) is associated with more adverse lower extremity muscle characteristics at baseline and more adverse changes in muscle over time among participants with lower extremity peripheral arterial disease (PAD). This was a longitudinal, observational study of 425 men and women with PAD and 261 without PAD. Computed tomography was used to measure calf muscle characteristics at baseline and every 2 years. Knee extension isometric strength, power, and 6-minute walk distance were measured at baseline and annually. Baseline BMI (kg/m(2)) categories were ideal (20-25), overweight (>25-30), and obese (>30). Analyses adjust for age, race, sex, ankle brachial index, comorbidities, and other covariates. At baseline, higher BMI among participants with PAD was associated with greater calf muscle area (ideal BMI: 5181 mm(2); overweight: 5513 mm(2); obese: 5695 mm(2); P = .0009 for trend), higher calf muscle percentage of fat (6.38%, 10.28%, 17.44%, respectively, P calf muscle density (P calf muscle area (P = .030 for trend) and greater increases in calf muscle percentage of fat (P = .023 for trend). Among participants without PAD, there were no significant associations of baseline BMI with changes in lower extremity muscle outcomes over time. Among PAD participants, higher BMI is associated with greater calf muscle area at baseline. However, higher BMI is associated with more adverse calf muscle density and calf muscle percentage of fat at baseline and greater declines in calf muscle area over time. Copyright © 2012 Society for Vascular Surgery. All rights reserved.

  15. Blood pressure-independent effect of candesartan on cardio-ankle vascular index in hypertensive patients with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Kanako Bokuda

    2010-07-01

    Full Text Available Kanako Bokuda1, Atsuhiro Ichihara1,2, Mariyo Sakoda1, Asako Mito1, Kenichiro Kinouchi1, Hiroshi Itoh11Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Endocrinology and Anti-Aging Medicine, Keio University School of Medicine, Tokyo, JapanAbstract: Angiotensin receptor blockers (ARBs are known to reduce the cardiovascular risk in hypertensive patients. This study was designed to examine the effect of an ARB candesartan on subclinical atherosclerosis assessed by cardio-ankle vascular index (CAVI in comparison with calcium channel blockers (CCBs alone in hypertensive patients with metabolic syndrome (MetS. A total of 53 consecutive hypertensive patients with MetS were randomly assigned to the candesartan group, in which candesartan was added on, or the CCBs group, in which CCBs were added on. Clinical and biological parameters were obtained before and after the 12-month treatment period. The primary measure of efficacy was the %change in CAVI. When treated with candesartan, but not CCBs, CAVI significantly decreased from 8.7 to 7.7 by 11%. Blood pressure (BP significantly decreased with both treatments, but the differences between groups were not significant. The changes in other parameters remained unchanged in both the groups. Analysis of covariance found that both the BP reduction and the therapy difference contributed to the decrease in CAVI, but the BP reduction was not involved in the decrease in CAVI caused by the difference in the therapy. Candesartan may be a better antihypertensive drug than CCBs to that subclinical atherosclerosis of patients with MetS.Keywords: albuminuria, ambulatory blood pressure, calcium channel blockers, carotid ­intima-media thickness

  16. Investigation of Peak Pressure Index Parameters for People with Spinal Cord Injury Using Wheelchair Tilt-in-Space and Recline: Methodology and Preliminary Report

    Science.gov (United States)

    Lung, Chi-Wen; Yang, Tim D.; Crane, Barbara A.; Elliott, Jeannette; Dicianno, Brad E.; Jan, Yih-Kuen

    2014-01-01

    The purpose of this study was to determine the effect of the sensel window's location and size when calculating the peak pressure index (PPI) of pressure mapping with varying degrees of wheelchair tilt-in-space (tilt) and recline in people with spinal cord injury (SCI). Thirteen power wheelchair users were recruited into this study. Six combinations of wheelchair tilt (15°, 25°, and 35°) and recline (10° and 30°) were used by the participants in random order. Displacements of peak pressure and center of pressure were extracted from the left side of the mapping system. Normalized PPI was computed for three sensel window dimensions (3 sensels × 3 sensels, 5 × 5, and 7 × 7). At least 3.33 cm of Euclidean displacement of peak pressures was observed in the tilt and recline. For every tilt angle, peak pressure displacement was not significantly different between 10° and 30° recline, while center of pressure displacement was significantly different (P < .05). For each recline angle, peak pressure displacement was not significantly different between pairs of 15°, 25°, and 35° tilt, while center of pressure displacement was significantly different between 15° versus 35° and 25° versus 35°. Our study showed that peak pressure displacement occurs in response to wheelchair tilt and recline, suggesting that the selected sensel window locations used to calculate PPI should be adjusted during changes in wheelchair configuration. PMID:25057491

  17. Investigation of Peak Pressure Index Parameters for People with Spinal Cord Injury Using Wheelchair Tilt-in-Space and Recline: Methodology and Preliminary Report

    Directory of Open Access Journals (Sweden)

    Chi-Wen Lung

    2014-01-01

    Full Text Available The purpose of this study was to determine the effect of the sensel window’s location and size when calculating the peak pressure index (PPI of pressure mapping with varying degrees of wheelchair tilt-in-space (tilt and recline in people with spinal cord injury (SCI. Thirteen power wheelchair users were recruited into this study. Six combinations of wheelchair tilt (15°, 25°, and 35° and recline (10° and 30° were used by the participants in random order. Displacements of peak pressure and center of pressure were extracted from the left side of the mapping system. Normalized PPI was computed for three sensel window dimensions (3 sensels × 3 sensels, 5 × 5, and 7 × 7. At least 3.33 cm of Euclidean displacement of peak pressures was observed in the tilt and recline. For every tilt angle, peak pressure displacement was not significantly different between 10° and 30° recline, while center of pressure displacement was significantly different (P<.05. For each recline angle, peak pressure displacement was not significantly different between pairs of 15°, 25°, and 35° tilt, while center of pressure displacement was significantly different between 15° versus 35° and 25° versus 35°. Our study showed that peak pressure displacement occurs in response to wheelchair tilt and recline, suggesting that the selected sensel window locations used to calculate PPI should be adjusted during changes in wheelchair configuration.

  18. Infrared thermography as option for evaluating the treatment effect of percutaneous transluminal angioplasty by patients with peripheral arterial disease.

    Science.gov (United States)

    Staffa, Erik; Bernard, Vladan; Kubicek, Lubos; Vlachovsky, Robert; Vlk, Daniel; Mornstein, Vojtech; Bourek, Ales; Staffa, Robert

    2017-02-01

    Aim of this study was to evaluate the possible use of infrared thermography as a supplementary method to the ankle-brachial index used in assessing the treatment effect of percutaneous transluminal angioplasty. The study included 21 patients, mean age was 60.22 years. Healthy control group included 20 persons, mean age was 55.60 years. Patients with symptomatic peripheral arterial disease (Fontaine stages I-III) were admitted for endovascular treatment by percutaneous transluminal angioplasty. Thermal images and ankle-brachial index values were obtained before and after treatment by percutaneous transluminal angioplasty. Median temperature change in the treated limb was 0.4℃, for non-treated limb was -0.5℃. The median value of ankle-brachial index in the treated limb increased by 0.17 from 0.81 after the procedure. The median value of ankle-brachial index in the non-treated limb decreased by 0.03 from the value of 1.01. Significant difference between treated limb and non-treated limb in change of ankle-brachial index was found with p value = .0035. The surface temperature obtained by the infrared thermography correlates with ankle-brachial index. We present data showing that the increase of ankle-brachial index is associated with increase of skin temperature in the case of limbs treated by percutaneous transluminal angioplasty. Our results also suggest potential of the use of infrared thermography for monitoring foot temperature as a means of early detection of onset of foot ischemic disorders.

  19. Maternal Prepregnancy Body Mass Index and Their Children's Blood Pressure and Resting Cardiac Autonomic Balance at Age 5 to 6 Years

    NARCIS (Netherlands)

    Gademan, M.G.J.; van Eijsden, M.; Roseboom, T.J.; van der Post, J.A.M.; Stronks, K.; Vrijkotte, T.G.M.

    2013-01-01

    Adverse intrauterine conditions can program hypertension. Because one of the underlying mechanisms is thought to be cardiac autonomic balance, we investigated the association between prepregnancy body mass index (BMI) and blood pressure and indicators of the autonomic balance in the child at age 5

  20. [Medical assessments and measurements in ELSA-Brasil].

    Science.gov (United States)

    Mill, Jose Geraldo; Pinto, Karina; Griep, Rosane Härter; Goulart, Alessandra; Foppa, Murilo; Lotufo, Paulo A; Maestri, Marcelo K; Ribeiro, Antonio Luiz; Andreão, Rodrigo Varejão; Dantas, Eduardo Miranda; Oliveira, Ilka; Fuchs, Sandra C; Cunha, Roberto de Sá; Bensenor, Isabela M

    2013-06-01

    The article describes assessments and measurements performed in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). Some assessments including anthropometric assessment, casual blood pressure measurement, and ankle-brachial index have an established clinical application while others including pulse wave velocity, heart rate variability, and carotid intima-media thickness have no established application and do not have reference values for healthy Brazilian population but may be important predictors of cardiovascular outcomes. Blood pressure measurement following postural change maneuver was included in the ELSA-Brasil because it has not been much tested in epidemiological studies. Innovative approaches were developed for assessing the ankle-brachial index using an automatic device instead of the mercury column to measure blood pressure and for assessing the anterior-posterior diameter of the right lobe of the liver by ultrasound for quantitative assessment of nonalcoholic fatty liver disease. All ELSA-Brasil subjects were younger (35 years or more) than those included in other cohorts studying subclinical atherosclerosis. The inclusion of younger individuals and a variety of assessments make the ELSA-Brasil a relevant epidemiology study nationwide and worldwide.

  1. Real-time feedback of dynamic foot pressure index for gait training of toe-walking children with spastic diplegia.

    Science.gov (United States)

    Pu, Fang; Ren, Weiyan; Fan, Xiaoya; Chen, Wei; Li, Shuyu; Li, Deyu; Wang, Yu; Fan, Yubo

    2017-09-01

    The aim of this study was to determine whether and how real-time feedback of dynamic foot pressure index (DFPI) could be used to correct toe-walking gait in spastic diplegic children with dynamic equinus. Thirteen spastic diplegic children with dynamic equinus were asked to wear a monitoring device to record their ambulation during daily gait, conventional training gait, and feedback training gait. Parameters based on their DFPI and stride duration were compared among the three test conditions. The results with feedback training were significantly better for all DFPI parameters in comparison to patients' daily gait and showed significant improvements in DFPI for toe-walking gait and percentage of normal gait in comparison to conventional training methods. Moreover, stride duration under two training gaits was longer than patient's daily gait, but there was no significant difference between the two training gaits. Although the stride duration for the two training gaits was similar, gait training with real-time feedback of DFPI did produce noticeably superior results by increasing heel-loading impulse of toe-walking gait and percentage of normal gait in comparison to convention training methods. However, its effectiveness was still impacted by the motion limitations of diplegic children. Implications for Rehabilitation The DFPI-based gait training feedback system introduced in this study was shown to be more effective at toe-walking gait rehabilitation training over conventional training methods. The feedback system accomplished superior improvement in correcting toe-walking gait, but its effectiveness in an increasing heel-loading impulse in normal gait was still limited by the motion limitations of diplegic children. Stride duration of normal gait and toe-walking gait was similar under conventional and feedback gait training.

  2. Differential effects of angiotensin II receptor blocker and losartan/hydrochlorothiazide combination on central blood pressure and augmentation index.

    Science.gov (United States)

    Metoki, Hirohito; Obara, Taku; Asayama, Kei; Satoh, Michihiro; Hosaka, Miki; Elnagar, Noha; Miyawaki, Yoshinori; Kojima, Iwao; Ohkubo, Takayoshi; Imai, Yutaka

    2015-01-01

    Central systolic blood pressure (CSBP) may be a better predictor of cardiovascular risk than clinic brachial (B)SBP. The effects of dose increment from medium dose of angiotensin II receptor blockers (ARBs) to the maximum dose of ARBs (maximum) and changing from medium dose of ARBs to losartan 50 mg/hydrochlorothiazide 12.5 mg combination (combination) were compared in hypertensive patients in whom monotherapy with a medium ARB dose did not achieve goal home SBP (135 mmHg). Four weeks after treatment with a medium ARB dose monotherapy, those whose home SBP level was above 135 mmHg were randomized to receive the maximum ARB dose (n = 101) or the combination (n = 99) once daily for 8 weeks. Both regimens significantly decreased BSBP and CSBP, while a decrease in BSBP and CSBP was greater with combination. The maximum significantly decreased augmentation index (AIx), while the combination did not. The rate of a decrease in reflection to decrease in CSBP was greater in the maximum than in the combination. In the elderly subgroup, the combination more effectively lowered BSBP than the maximum, and only the combination decreased CSBP. However, in the young subgroup, the maximum decreased AIx more than combination, while both regimens lowered CSBP and BSBP to a similar extent. It is explained in part that the maximum may affect pulse wave reflection more predominantly than the combination, especially in young subjects. A weak effect on pulse wave reflection and, thus, on CSBP, of the combination may be overcome by the potent antihypertensive effect of this regimen.

  3. Use of a dynamic foot pressure index to monitor the effects of treatment for equinus gait in children with cerebral palsy.

    Science.gov (United States)

    Bennett, Damien; Walsh, Mike; O'Sullivan, Rory; Gallagher, Joseph; O'Brien, Tim; Newman, Christopher John

    2007-01-01

    The purpose of this study is to introduce and describe a newly developed index using foot pressure analysis to quantify the degree of equinus gait in children with cerebral palsy before and after injection with botulinum toxin. Data were captured preinjection and 12 weeks postinjection. Ten children aged 2(1/2) to 6(1/2) years took part (5 boys and 5 girls). Three of them had a diagnosis of spastic diplegia and 7 of congenital hemiplegia. In total, 13 limbs were analyzed. After orientation and segmentation of raw pedobarographic data, we determined a dynamic foot pressure index graded 0 to 100 that quantified the relative degree of heel and forefoot contact during stance. These data were correlated (Pearson correlation) with clinical measurements of dorsiflexion at the ankle (on a slow and fast stretch) and video observation (using the Observational Gait Scale). Pedobarograph data were strongly correlated with both the Observational Gait Scale scores (R = 0.79, P spasticity (R = 0.70, P spasticity and good correlation with video observations seems to indicate this technique's potential validity. When manipulated and segmented appropriately, and with the development of a simple ordinal index, we found that foot pressure data provided a useful tool in tracking changes in patients with spastic equinus.

  4. The association of physical activity, body mass index and the blood pressure levels among urban poor youth in Accra, Ghana

    NARCIS (Netherlands)

    Afrifa-Anane, Ernest; Agyemang, Charles; Codjoe, Samuel Nii Ardey; Ogedegbe, Gbenga; de-Graft Aikins, Ama

    2015-01-01

    Globally, there is an increasing prevalence of high blood pressure (HBP) among adults and youth. However, the mechanisms of how the risk factors (physical inactivity and obesity) relate with blood pressure (BP) are not well known especially among the urban poor youth in low and middle income

  5. Oxygen cost of breathing and diaphragmatic pressure-time index. Measurement in patients with COPD during weaning with pressure support ventilation.

    Science.gov (United States)

    Annat, G J; Viale, J P; Dereymez, C P; Bouffard, Y M; Delafosse, B X; Motin, J P

    1990-08-01

    The oxygen cost of breathing and the time integral of the transdiaphragmatic pressure were measured at the onset of the weaning period in eight patients with chronic obstructive pulmonary disease requiring mechanical ventilation. Measurements were achieved during continuous positive airway pressure ventilation and during 15 cmH2O pressure support ventilation. For both periods, the O2COB was estimated as the difference between oxygen uptake of the period and that during controlled ventilation. During CPAP ventilation, the O2COB was 16.9 +/- 1.5 percent. During PSV, it was only 6.3 +/- 1.3 percent, and PTdi decreased by 73 percent compared to the CPAP period. Both effects illustrate the ability of PSV to facilitate spontaneous breathing during weaning from mechanical ventilation. However, we found these measurements to be of no help in predicting the duration of the weaning process.

  6. Male sex, height, weight, and body mass index can increase external pressure to calf region using knee-crutch-type leg holder system in lithotomy position

    Directory of Open Access Journals (Sweden)

    Mizuno J

    2016-02-01

    Full Text Available Ju Mizuno,1 Toru Takahashi2 1Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, 2Faculty of Health and Welfare Science, Okayama Prefectural University, Soja-shi, Okayama, Japan Background: Well-leg compartment syndrome (WLCS is one of the catastrophic complications related to prolonged surgical procedures performed in the lithotomy position, using a knee-crutch-type leg holder (KCLH system, to support the popliteal fossae and calf regions. Obesity has been implicated as a risk factor in the lithotomy position-related WLCS during surgery. In the present study, we investigated the relationship between the external pressure (EP applied to the calf region using a KCLH system in the lithotomy position and selected physical characteristics. Methods: Twenty-one young, healthy volunteers (21.4±0.5 years of age, eleven males and ten females participated in this study. The KCLH system used was Knee Crutch®. We assessed four types of EPs applied to the calf region: box pressure, peak box pressure, contact pressure, and peak contact pressure, using pressure-distribution measurement system (BIG-MAT®. Relationships between these four EPs to the calf regions of both lower legs and a series of physical characteristics (sex, height, weight, and body mass index [BMI] were analyzed. Results: All four EPs applied to the bilateral calf regions were higher in males than in females. For all subjects, significant positive correlations were observed between all four EPs and height, weight, and BMI. Conclusion: EP applied to the calf region is higher in males than in females when the subject is supported by a KCLH system in the lithotomy position. In addition, EP increases with the increase in height, weight, and BMI. Therefore, male sex, height, weight, and BMI may contribute to the risk of inducing WLCS. Keywords: well-leg compartment syndrome, pressure-distribution measurement system, peak contact pressure

  7. The effects of intermittent negative pressure on the lower extremities' peripheral circulation and wound healing in four patients with lower limb ischemia and hard-to-heal leg ulcers: a case report.

    Science.gov (United States)

    Sundby, Øyvind H; Høiseth, Lars Ø; Mathiesen, Iacob; Jørgensen, Jørgen J; Sundhagen, Jon O; Hisdal, Jonny

    2016-10-01

    Peripheral circulation is severely compromised in the advanced stages of peripheral arterial disease. Recently, it was shown that the application of -40 mmHg intermittent negative pressure (INP) to the lower leg and foot enhances macro- and microcirculation in healthy volunteers. In this case report, we describe the effects of INP treatment on four patients with lower limb ischemia and hard-to-heal leg and foot ulcers. We hypothesized that INP therapy may have beneficial hemodynamic and clinical effects in the patients. Four patients (age range: 61-79 years) with hard-to-heal leg and foot ulcers (6-24 months) and ankle-brachial pressure indices of ≤0.60 on the affected side were included. They were treated with an 8-week intervention period of -40 mmHg INP (10 sec negative pressure and 7 sec atmospheric pressure) on the lower limbs. A custom-made vacuum chamber was used to apply INP to the affected lower leg and foot for 2 h per day. After 8 weeks of INP therapy, one ulcer healed completely, while the other three ulcers were almost completely healed. These cases suggest that INP may facilitate wound healing. The theoretical foundation is that INP assists wound healing by improving blood flow to the small blood vessels in the affected limb, increasing the flow of oxygen and nutrients to the cells. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  8. [Prevalence of high blood pressure and their association with body mass index in children between 5 and 11 years of Nahbalam, Yucatan].

    Science.gov (United States)

    Saury-Paredes, Leonel Alejandro

    To determine the prevalence of high blood pressure in children aged between 5-11 years in the community of Nahbalam, Yucatan, and its association with the body mass index. A transversal study with children of the primary school "Lazaro Cardenas del Rio" was performed, measuring blood pressure, height, and weight of 259 girls and boys; systolic and/or diastolic blood pressure equal or greater than percentile 95 for gender, age, and height at three measures was considered as hypertension; prehypertension was considered as blood pressure equal or greater than percentile 90 but lower than percentile 95. A prevalence of 11.9% prehypertension and 6.1% hypertension was found. There is an association between hypertension and overweight and obesity (p ≤ 0.001). The prevalence of high blood pressure in children of the community of Nahbalam, Yucatan, is 18%. The children with overweight and obesity have an almost tenfold greater risk of hypertension than the eutrophic children (OR: 9.896; 95% CI: 2.738-35.764).

  9. Limited accuracy of the hyperbaric index, ambulatory blood pressure and sphygmomanometry measurements in predicting gestational hypertension and preeclampsia

    NARCIS (Netherlands)

    Vollebregt, Karlijn Corien; Gisolf, Janneke; Guelen, Ilja; Boer, Kees; van Montfrans, Gert; Wolf, Hans

    2010-01-01

    Objective The aim of this study was to validate the hyperbaric index (HBI) for first trimester prediction of preeclampsia and gestational hypertension. Methods Participants were low-risk and high-risk nulliparous women and high-risk multiparous women, and were recruited between April 2004 and June

  10. Potential usefulness of solubility index for prediction of the skin permeation rate of 5-ISMN from pressure-sensitive adhesive tape.

    Science.gov (United States)

    Sato, K; Mitsui, N; Hasegawa, T; Sugibayashi, K; Morimoto, Y

    2001-06-15

    Skin permeation of 5-ISMN from pressure sensitive adhesive (PSA) tape was evaluated using thermodynamic activity of the drug in PSA. Three acrylic adhesives (Gelva 737, Gelva 1430 and Gelva 1753) were used as PSA. Since the drug activity in PSA is difficult to determine, however, a solubility index was defined. Several PSA tapes containing different amounts of 5-ISMN were prepared, and heat of fusion at the dissolution of 5-ISMN in each PSA was determined by DSC. No exothermic peak was found when the drug concentration was less than the solubility in PSA, whereas the heat of fusion increased proportionally with amount of solid drug in the PSA when the drug concentration was above the solubility. The bending point in the profile of heat of fusion versus 5-ISMN content in PSA was defined as the solubility index. In vitro skin permeation was determined using excised hairless rat skin from 5-ISMN-saturated PSA tapes. The obtained skin permeation of the drug decreased with increases in the solubility index. These profiles were confirmed by a theoretical approach using the differential equation corresponding to Fick's second law of diffusion. These results suggested that the solubility index can be utilized for prediction of the skin permeability of drugs from PSA tape.

  11. Male sex, height, weight, and body mass index can increase external pressure to calf region using knee-crutch-type leg holder system in lithotomy position.

    Science.gov (United States)

    Mizuno, Ju; Takahashi, Toru

    2016-01-01

    Well-leg compartment syndrome (WLCS) is one of the catastrophic complications related to prolonged surgical procedures performed in the lithotomy position, using a knee-crutch-type leg holder (KCLH) system, to support the popliteal fossae and calf regions. Obesity has been implicated as a risk factor in the lithotomy position-related WLCS during surgery. In the present study, we investigated the relationship between the external pressure (EP) applied to the calf region using a KCLH system in the lithotomy position and selected physical characteristics. Twenty-one young, healthy volunteers (21.4±0.5 years of age, eleven males and ten females) participated in this study. The KCLH system used was Knee Crutch(®). We assessed four types of EPs applied to the calf region: box pressure, peak box pressure, contact pressure, and peak contact pressure, using pressure-distribution measurement system (BIG-MAT(®)). Relationships between these four EPs to the calf regions of both lower legs and a series of physical characteristics (sex, height, weight, and body mass index [BMI]) were analyzed. All four EPs applied to the bilateral calf regions were higher in males than in females. For all subjects, significant positive correlations were observed between all four EPs and height, weight, and BMI. EP applied to the calf region is higher in males than in females when the subject is supported by a KCLH system in the lithotomy position. In addition, EP increases with the increase in height, weight, and BMI. Therefore, male sex, height, weight, and BMI may contribute to the risk of inducing WLCS.

  12. Left atrium volume index is influenced by aortic stiffness and central pulse pressure in type 2 diabetes mellitus patients: a hemodynamic and echocardiographic study.

    Science.gov (United States)

    Zapolski, Tomasz; Wysokiński, Andrzej

    2013-03-04

    Left atrial volume index (LAVI) has recently emerged as a useful biomarker for risk stratification and risk monitoring in many clinical settings. Many hemodynamic factors such as preload and afterload have an effect on evaluating left atrium function. This study was performed to investigate the relationship between LAVI and aortic stiffness index (ASI) and selected markers characterizing hemodynamic state in patients with type 2 diabetes mellitus (DM2). The study population consisted of 100 patients (56 men, 44 women), 67.2 (±10.9) years old DM2, scheduled for routine coronary angiography. Standard transthoracic echocardiography was used to measure parameters needed for calculation of LAVI and ASI. During invasive procedures, central pulse pressure (CPP) in the ascendens aorta and left ventricle end-diastolic pressure (LVEDP) were recorded. Selected laboratory parameters were obtained, including lipidogram, serum uric acid, hs-CRP, fibrinogen, cTnT, myoglobin, BNP, HbA1C, creatinine, and GFR. Both LAVI and ASI were greater and CPP and LVEDP were markedly elevated in DM2 patients compared to controls. The independent predictors of LAVI were ASI (ß=0.331; p=0.011), CPP (ß=0.312; p=0.020), LVEDP (ß=0.381; p=0.006), HbA1C (ß=0.379; p=0.008), and BNP (ß=0,423; pDM2 patients.

  13. Indexes of hemodynamics in a dosage of physical activity in girls against the background of low systolic blood pressure

    Directory of Open Access Journals (Sweden)

    Levchenko V. A.

    2015-02-01

    Full Text Available Purpose: to examine the state of hemodynamics, blood oxygenation levels in girls with hypotensive type neurodystonia in a dosed physical load. Material : The study involved 59 women with hypotensive type neurodystonia aged 18-19 years and 14 healthy women the same age. Results : It was found that the girls on the background of low systolic blood pressure observed early hemodynamic response from the very first steps (25-50 W bicycle stress test in the form of increased heart rate, stroke volume, pulse pressure. At the height of the stress test in 76.27 % of girls showed a reduction in blood oxygenation indices and lengthening of the period of recovery. Conclusions : The dose of girls in physical activity with hypotension, place high demands on the cardiovascular system, the restructuring of which is accompanied by inadequate oxygen supply systems in operation, adjustment disorder, low capacity for work that requires a non-drug methods of rehabilitation in the form of regular dose of physical activity, breathing exercises .

  14. Kan Doppler-ultralyd erstatte strain gauge til måling af systolisk ankelblodtryk?

    DEFF Research Database (Denmark)

    Sørensen, T L; Perner, A; Hansen, L

    1992-01-01

    Traditionally, strain gauge technique is used in Denmark to measure ankle blood pressure, a method requiring both time and well-trained personnel. In a study involving 90 limbs in 45 patients, this method was compared with ultrasonic technique using a portable 5 MHz Doppler. The reproducibility...... of Doppler ankle pressure measurement was similar to that found in strain gauge based studies. Two consecutive measurements may differ by 20 mmHg or in terms of ankle-brachial index by 0.15 before this is considered significant. No systematic variation was found between the two methods. Increasing...... difficulties were encountered with the Doppler technique at pressures below 50 mmHg. It is concluded that Doppler is a good alternative to strain gauge for measurement of ankle blood pressure....

  15. [Multiparameter analysis of the ergometric test. Significance of the failure of systolic blood pressure to decrease during recovery phase as an index of coronary disease].

    Science.gov (United States)

    Doria, G; Scaccianoce, G; Artale, S; Francaviglia, B; Platania, F; Circo, A

    1990-10-01

    Ergometric tests were performed in 27 patients who had previously undergone coronarography following instrumental findings and/or symptoms which seemed highly indicative of ischemic cardiopathy. The aim of the study was to assess the diagnostic importance of the failure of systolic blood pressure to decrease during the third minute of the recovery phase of the test as an index of coronary disease. In particular, as reported by other studies, the ratio between systolic blood pressure at the third minute of recovery and maximum systolic blood pressure during the test was also assessed values above 0.7 were considered pathological. Sixteen out the 27 patients examined showed lesions which were hemodynamically significant, whereas 11 patients were free of lesions and 9 had previous myocardial necrosis. The level of the above ratio in subjects without significant coronary lesions was 0.66 +/- 0.05, whereas it was 0.85 +/- 0.04 (p less than 0.01) in patients with coronary disease. Sensitivity, specificity, and positive and negative prognostic values were respectively 91.6%, 62%, 64.7% and 90.9%. In patients with lesions to the three main arteries both the sensitivity and the specificity were 100%. In the same patients, the ST criteria were 85.7%, 50%, 81.8% and 74.3%.

  16. Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol

    Directory of Open Access Journals (Sweden)

    Nicolás Eguskiñe

    2010-05-01

    Full Text Available Abstract Background Healthy lifestyles may help to delay arterial aging. The purpose of this study is to analyze the relationship of physical activity and dietary pattern to the circadian pattern of blood pressure, central and peripheral blood pressure, pulse wave velocity, carotid intima-media thickness and biological markers of endothelial dysfunction in active and sedentary individuals without arteriosclerotic disease. Methods/Design Design: A cross-sectional multicenter study with six research groups. Subjects: From subjects of the PEPAF project cohort, in which 1,163 who were sedentary became active, 1,942 were sedentary and 2,346 were active. By stratified random sampling, 1,500 subjects will be included, 250 in each group. Primary measurements: We will evaluate height, weight, abdominal circumference, clinical and ambulatory blood pressure with the Radial Pulse Wave Acquisition Device (BPro, central blood pressure and augmentation index with Pulse Wave Application Software (A-Pulse and SphymgoCor System Px (Pulse Wave Analysis, pulse wave velocity (PWV with SphymgoCor System Px (Pulse Wave Velocity, nutritional pattern with a food intake frequency questionnaire, physical activity with the 7-day PAR questionnaire and accelerometer (Actigraph GT3X, physical fitness with the cycle ergometer (PWC-170, carotid intima-media thickness by ultrasound (Micromax, and endothelial dysfunction biological markers (endoglin and osteoprotegerin. Discussion Determining that sustained physical activity and the change from sedentary to active as well as a healthy diet improve circadian pattern, arterial elasticity and carotid intima-media thickness may help to propose lifestyle intervention programs. These interventions could improve the cardiovascular risk profile in some parameters not routinely assessed with traditional risk scales. From the results of this study, interventional approaches could be obtained to delay vascular aging that combine physical

  17. Dietary modification, Body Mass Index (BMI), Blood Pressure (BP) and cardiovascular risk in medical students of a government medical college of Karachi

    International Nuclear Information System (INIS)

    Raza, S.; Sheikh, M.A.; Hussain, M.F.A.; Siddiqui, S.E.; Muhammad, R.; Aziz, S.; Qamar, S.; Saleem, M.A.; Waki, N.; Faruqi, H.; Zia, A.

    2010-01-01

    Objective: To determine the prevalence of major risk factors including dietary modification, Body Mass Index (BMI), Blood Pressure (BP) and physical activity in medical students of government teaching hospitals of Karachi. Methods: A cross sectional study was conducted on students of Dow Medical College, Karachi, Pakistan through a structured pre-tested questionnaire. Non-probability purposive sampling was used. Smoking, hypertension, family history of cardiovascular disease (CVD), overweight and low physical activity levels are risk factors the presence of which can lead to development of CVD. Prevalence of these risk factors was determined by asking appropriate questions and through measurement of BMI and blood pressure for overweight and hypertension respectively. Awareness of risk factors was determined through knowledge of the effect of various food substances on development of CVD and of adoption of dietary changes keeping in mind the risk of developing CVD. SPSS 16.0 was used for statistical analysis. Results: A total of 132 medical students were included in the study of which 57 (43.2%) and 75 (56.8%) were male and female respectively with mean age of 20.85 +- 1.21 years. About 15.9% of students had elevated blood pressure i.e. > 140/90 mmHg. Twenty eight percent of the total students were found to be underweight and 17.4% were overweight, 5% had some history of CVD, 56.8% had family history of CVD, 9.4% were smokers and 29.5% had high physical activity level. About 87.1% had modified their diet for preventing CVD. Most of the students had adequate knowledge about the cardiovascular risk factors Conclusion: Majority of students were not overweight. A high prevalence of cardiovascular risk factors; family history and elevated blood pressure was present. Awareness in terms of knowledge was satisfactory but implementation in terms of diet modification and adequate physical activity was lacking. (author)

  18. Impact of childhood experience of famine on late life health.

    Science.gov (United States)

    Woo, J; Leung, J C S; Wong, S Y S

    2010-02-01

    This study examines whether experience of famine during late childhood affect late life health. Cross sectional cohort survey carried out from 2001-2004. Community in Hong Kong. 1,906 men and 1,826 women aged >or= 65 years living in the community. We examined the impact of experience of famine during late childhood, defined as caloric restriction for at least one year, on body mass index, body composition using DEXA, grip strength, walking speed and stride length, blood pressure, and ankle-brachial index,using logistic regression adjusting for various co-variates (age, lifestyle, socioeconomic factors). Participants who had been exposed to a period of undernutrition in late childhood were shorter, had higher body mass index (BMI) and appendicular lean mass/height2, higher prevalence of recurrent falls, higher prevalence of myocardial infarct, arthritis and back pain. Late childhood undernutrition has some adverse impact on late life health and functional outcomes.

  19. The influence of puberty onset, body mass index, and pressure to be thin on disordered eating behaviors in children and adolescents.

    Science.gov (United States)

    Tremblay, Line; Lariviere, Michel

    2009-04-01

    The main objective of this study is to verify the hypothesis that pubertal development, obesity, body satisfaction, as well as family and peer influences predict unhealthy eating habits in children and adolescents. A randomized stratified sample of young Quebecers aged 9, 13, and 16 years on March 31, 1999 [608 children aged of 9 years (325 girls and 283 boys) and 662 adolescents aged of 13 and 16 years (349 girls and 313 boys)] were used. Children's weight, height, and Body Mass Index (BMI) were recorded. Questionnaires were administered to children and a parent (usually the mother). Among 9-year-old children, this study found that weight loss or weight control behaviors were predicted mainly by the onset of puberty, lower maternal abusive control, and the level of peer pressure. Among adolescents, mother's BMI, income, peer pressure, and negative comments about the child's weight most strongly predicted behaviors to control weight, strategies to lose weight and the frequency of such behaviors. The findings suggest that both parents and children need to understand the impact of comments on a child's behavior.

  20. Phenotypic and genetic correlation of blood pressure and body mass index with retinal vascular caliber in children and adolescents: the Guangzhou twin eye study.

    Science.gov (United States)

    Zheng, Yingfeng; Huang, Wenyong; Zhang, Jian; He, Mingguang

    2013-01-17

    To examine the phenotypic and genetic associations of blood pressure and body mass index (BMI) with retinal vascular caliber. A total of 657 monozygotic and 378 dizygotic twin pairs aged 7 to 19 years were recruited from the Guangzhou Twin Registry. All twins underwent digital retinal photography and measurement of retinal vascular caliber. The genetic correlations between the traits were estimated by applying a multivariate Cholesky model. In traditional regression analyses, participants with a higher mean arterial pressure (MAP) and a higher BMI were significantly more likely to have narrower retinal arterioles, whereas participants with a higher BMI level were more likely to have a wider retinal venule (all P < 0.001). In multivariate Cholesky models, only 1% to 2% of the phenotypic variation in retinal arteriole was shared with those in MAP and BMI, although the majority of these phenotypic variations were explained by shared genetic components. The phenotypic variation in retinal venule was not shared with those in MAP and BMI. Retinal vascular caliber is significantly but weakly associated with MAP and BMI in children and young adolescents. These phenotypic correlations are mainly attributable to genetic components.

  1. The association of birth order with later body mass index and blood pressure: a comparison between prospective cohort studies from the United Kingdom and Brazil.

    Science.gov (United States)

    Howe, L D; Hallal, P C; Matijasevich, A; Wells, J C; Santos, I S; Barros, A J D; Lawlor, D A; Victora, C G; Smith, G D

    2014-07-01

    Previous studies have found greater adiposity and cardiovascular risk in first born children. The causality of this association is not clear. Examining the association in diverse populations may lead to improved insight. We examine the association between birth order and body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP) in the 2004 Pelotas cohort from southern Brazil and the Avon Longitudinal Study of Parents and Children (ALSPAC) from Bristol, south-west England, restricting analysis to families with two children in order to remove confounding by family size. No consistent differences in BMI, SBP or DBP were observed comparing first and second born children. Within the Pelotas 2004 cohort, first born females were thinner, with lower SBP and DBP; for example, mean difference in SBP comparing first with second born was -0.979 (95% confidence interval -2.901 to 0.943). In ALSPAC, first born females had higher BMI, SBP and DBP. In both cohorts, associations tended to be in the opposite direction in males, although no statistical evidence for gender interactions was found. The findings do not support an association between birth order and BMI or blood pressure. Differences to previous studies may be explained by differences in populations and/or confounding by family size in previous studies.

  2. Intersubband optical absorption coefficients and refractive index changes in a graded quantum well under intense laser field: Effects of hydrostatic pressure, temperature and electric field

    International Nuclear Information System (INIS)

    Ungan, F.; Restrepo, R.L.; Mora-Ramos, M.E.; Morales, A.L.; Duque, C.A.

    2014-01-01

    The effects of hydrostatic pressure, temperature, and electric field on the optical absorption coefficients and refractive index changes associated with intersubband transition in a typical GaAs/Ga 0.7 Al 0.3 As graded quantum well under intense laser field have been investigated theoretically. The electron energy eigenvalues and the corresponding eigenfunctions of the graded quantum well are calculated within the effective mass approximation and envelope wave function approach. The analytical expressions of the optical properties are obtained using the compact density-matrix approach and the iterative method. The numerical results show that the linear and nonlinear optical properties depend strongly on the intense laser field and electric field but weakly on the hydrostatic pressure and temperature. Additionally, it has been found that the electronic and optical properties in a GaAs/Ga 0.7 Al 0.3 As graded quantum well under the intense laser field can be tuned by changing these external inputs. Thus, these results give a new degree of freedom in the devices applications

  3. Systolic Sac Pressure Index for the Prediction of Persistent Type II Endoleak for 12 Months After Endovascular Abdominal Aortic Aneurysm Repair

    Energy Technology Data Exchange (ETDEWEB)

    Ikoma, Akira, E-mail: yfb04322@nifty.com; Nakai, Motoki, E-mail: momonga@wakayama-med.ac.jp; Sato, Morio, E-mail: morisato@wakayama-med.ac.jp; Sato, Hirotatsu, E-mail: kuppa1220@yahoo.co.jp; Minamiguchi, Hiroki, E-mail: hiromina4@hotmail.com; Sonomura, Tetsuo, E-mail: sonomura@wakayama-med.ac.jp [Wakayama Medical University, Departments of Radiology (Japan); Nishimura, Yoshiharu, E-mail: nishim-y@wakayama-med.ac.jp; Okamura, Yoshitaka, E-mail: y-ok@wakayama-med.ac.jp [Wakayama Medical University, Thoracic and Cardiovascular Surgery (Japan)

    2016-04-15

    PurposeTo assess the relationship between the systolic sac pressure index (SPI) and the presence of endoleaks 12 months after endovascular abdominal aortic aneurysm repair (EVAR).Materials and MethodsWe performed a single-center prospective trial of consecutively treated patients. SPI (calculated as systolic sac pressure/systolic aortic pressure) was measured by catheterization immediately after EVAR. Contrast-enhanced computed tomography was scheduled 12 months after EVAR to detect possible endoleaks.ResultsData were available for 34 patients who underwent EVAR for an AAA. Persisting type II endoleak was found in 8 patients (endoleak-positive group) but not in the other 26 patients (endoleak-negative group). The mean ± standard deviation SPI was significantly greater in the endoleak-positive group than in the endoleak-negative group (0.692 ± 0.048 vs. 0.505 ± 0.081, respectively; P = .001). Receiver-operating characteristic curve analysis revealed that an SPI of 0.638 was the optimum cutoff value for predicting a persistent endoleak at 12 months with high accuracy (0.971; 33/34), sensitivity (1.00), and specificity (0.962) values. The mean change in AAA diameter was −4.28 ± 5.03 mm and 2.22 ± 4.54 mm in patients with SPI of <0.638 or ≥0.638, respectively (P = .002).ConclusionPatients with an SPI of ≥0.638 immediately after EVAR were more likely to have a persistent type II endoleak at 12 months with an accuracy of 0.971, and showed increases in aneurysm sac diameter compared with patients with an SPI of <0.638.

  4. Perceived spatial stigma, body mass index and blood pressure: a global positioning system study among low-income housing residents in New York City

    Directory of Open Access Journals (Sweden)

    Dustin T. Duncan

    2016-05-01

    Full Text Available Previous research has highlighted the salience of spatial stigma on the lives of low-income residents, but has been theoretical in nature and/or has predominantly utilised qualitative methods with limited generalisability and ability to draw associations between spatial stigma and measured cardiovascular health outcomes. The primary objective of this study was to evaluate relationships between perceived spatial stigma, body mass index (BMI, and blood pressure among a sample of low-income housing residents in New York City (NYC. Data come from the community-based NYC Low-income Housing, Neighborhoods and Health Study. We completed a crosssectional analysis with survey data, which included the four items on spatial stigma, as well objectively measured BMI and blood pressure data (analytic n=116; 96.7% of the total sample. Global positioning systems (GPS tracking of the sample was conducted for a week. In multivariable models (controlling for individual-level age, gender, race/ethnicity, education level, employment status, total household income, neighborhood percent non-Hispanic Black and neighborhood median household income we found that participants who reported living in an area with a bad neighborhood reputation had higher BMI (B=4.2, 95%CI: -0.01, 8.3, P=0.051, as well as higher systolic blood pressure (B=13.2, 95%CI: 3.2, 23.1, P=0.01 and diastolic blood pressure (B=8.5, 95%CI: 2.8, 14.3, P=0.004. In addition, participants who reported living in an area with a bad neighborhood reputation had increased risk of obesity/overweight [relative risk (RR=1.32, 95%CI: 1.1, 1.4, P=0.02 and hypertension/pre-hypertension (RR=1.66, 95%CI: 1.2, 2.4, P=0.007. However, we found no differences in spatial mobility (based GPS data among participants who reported living in neighborhoods with and without spatial stigma (P>0.05. Further research is needed to investigate how placebased stigma may be associated with impaired cardiovascular health among individuals

  5. Non-invasive markers of atherosclerosis and their correlation with ...

    African Journals Online (AJOL)

    McRoy

    2014-07-26

    Jul 26, 2014 ... [11,12]. Today, non-invasive methods are on the forefront for accurate assessment of atherosclerosis. cIMT and markers of vascular dysfunction in peripheral circulation (measured by oscillometric methods) namely, pulse wave velocity (PWV), arterial stiffness index. (ASI) and ankle brachial index (ABI) can.

  6. Assessment of lower extremity ischemia using smartphone thermographic imaging

    Directory of Open Access Journals (Sweden)

    Peter H. Lin, MD

    2017-12-01

    Full Text Available Conventional diagnostic modalities for assessing arterial circulation or tissue perfusion include blood pressure measurement, ultrasound evaluation, and contrast-based angiographic assessment. An infrared thermal camera can detect infrared radiation energy from the human body, which generates a thermographic image to allow tissue perfusion analysis. We describe a smartphone-based miniature thermal imaging system that can be used as an adjunctive imaging modality to assess tissue perfusion. This smartphone-based camera device is noninvasive, simple to use, and cost-effective in assessing patients with lower extremity tissue perfusion. Assessment of patients with lower extremity arterial ischemia can be performed by a variety of diagnostic modalities, including ankle-brachial index, absolute systolic ankle or toe pressure, transcutaneous oximetry, arterial Doppler waveform, arterial duplex ultrasound, computed tomography scan, arterial angiography, and thermal imaging. We herein describe a noninvasive imaging modality using smartphone-based infrared thermography.

  7. Lower limb ischaemia in patients with diabetic foot ulcers and gangrene: recognition, anatomic patterns and revascularization strategies.

    Science.gov (United States)

    Mills, Joseph L

    2016-01-01

    The confluence of several chronic conditions--in particular ageing, peripheral artery disease, diabetes, and chronic kidney disease--has created a global wave of lower limbs at risk for major amputation. While frequently asymptomatic or not lifestyle limiting, at least 1% of the population has peripheral artery disease of sufficient severity to be limb threatening. To avoid the critical error of failing to diagnose ischaemia, all patients with diabetic foot ulcers and gangrene should routinely undergo physiologic evaluation of foot perfusion. Ankle brachial index is useful when measurable, but may be falsely elevated or not obtainable in as many as 30% of patients with diabetic foot ulcers primarily because of medial calcinosis. Toe pressures and skin perfusion pressures are applicable to such patients. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Assessing peripheral arteries in South African black women with ...

    African Journals Online (AJOL)

    Assessing peripheral arteries in South African black women with type 2 diabetes mellitus. ... Palpation of the pedal pulses, Doppler derived ankle brachial systolic blood pressure indices, photo plethysmographic-derived toe brachial systolic blood pressure indices and antero-posterior radiographs of both feet. Results.

  9. Body mass index, blood pressure, and glucose and lipid metabolism among permanent and fixed-term workers in the manufacturing industry: a cross-sectional study.

    Science.gov (United States)

    Inoue, Mariko; Minami, Masahide; Yano, Eiji

    2014-02-27

    Temporary employment, a precarious form of employment, is recognized as social determinant of poor health. However, evidence supporting precarious employment as a risk factor for health is mainly obtained from subjective data. Studies using objective clinical measurement data in the assessment of health status are limited. This study compared body mass index (BMI), lipid and glucose metabolism, and health-related lifestyle factors between permanent workers and fixed-term workers employed in the manufacturing industry. Data of 1,701 male manufacturing industry workers 4.0%), whereas the overweight population (BMI ≥ 25.0) was greater among permanent workers (21.4%) compared with fixed-term workers (18.1%). Although fixed-term workers tended not to be overweight, regression analysis adjusted for age and lifestyle factors suggested that fixed-term employment was significantly associated with higher blood pressure (systolic β = 2.120, diastolic β = 2.793), triglyceride (β = 11.147), fasting blood glucose (β = 2.218), and HbA1c (β = 0.107) compared with permanent workers (all p < 0.01). Fixed-term workers showed more health risks, such as poorer blood pressure and lipid and glucose metabolism, even when adjusted for age and lifestyle variables, although BMI of fixed-term workers were lower than permanent workers. Precarious work might contribute to a deteriorating health status even among less overweight populations.

  10. Effort-reward imbalance at work and 5-year changes in blood pressure: the mediating effect of changes in body mass index among 1400 white-collar workers.

    Science.gov (United States)

    Trudel, Xavier; Brisson, Chantal; Milot, Alain; Masse, Benoit; Vézina, Michel

    2016-11-01

    A number of prospective studies have documented the effect of adverse psychosocial work factors (work stress) on high blood pressure (BP). Weight gain could be an important pathway by which work stress exerts its effect on BP. No previous prospective study has examined this mediating effect. The aim of the present study was to examine the mediating effect of body mass index (BMI) in the association between psychosocial work factors from Siegrist's effort-reward imbalance model (ERI) and ambulatory BP (ABP). A prospective study was conducted among 1436 white-collar workers. Data were collected three times during a 5-year period. ERI was measured using validated scales, at each time. BMI was measured by a trained assistant. ABP was measured every 15 min during a working day. ERI exposure onset over 3 years was indirectly associated with ABP changes (0.49 mmHg; 95 % CI 0.05, 1.22), through BMI changes, in women with baseline BMI ≥25 kg/m 2 . An effect of similar magnitude and of borderline significance was observed for ERI chronic exposure. No mediating effect was observed among men, and using ERI exposure over 5 years. The mediating effect of BMI was of small magnitude and observed in certain subgroups and time frame only. Subgroup-specific mediating pathways might be involved to explain the effect of work stress on cardiovascular diseases risk.

  11. Body mass index-modified relationship of chronic mental stress with resting blood pressure during 5 years in Japanese middle-aged male workers.

    Science.gov (United States)

    Toyoshima, Hideaki; Otsuka, Rei; Hashimoto, Shuji; Tamakoshi, Koji; Yatsuya, Hiroshi

    2014-01-01

    Chronic mental stress has been reported to be directly or inversely proportional to blood pressure (BP). To explain this inconsistent relationship, we assumed effect-modification by body mass index (BMI). We examined 1,673 Japanese male local government employees who were not taking antihypertensive drugs or had no history of cardiovascular disease. BP and BMI were recorded at yearly health checkups. Exposure to mental stress, smoking, drinking, exercising, and salty taste were checked by questionnaire in 1997 and 2002. The main effect and interaction of stress and BMI on the averages and changes of resting systolic and diastolic BPs over the 5 years were assessed by a general linear model by adjusting for confounders. Obesity (BMI ≥25kg/m(2)) was significantly related with higher average systolic and diastolic BPs (Pstress was not, showing a significantly different relationship dependent on BMI (P for interaction =0.002, 0.004): a significant and directly proportional association with systolic and diastolic BPs (P=0.001, 0.001) in the obese, but borderline significant and inversely proportional association (P=0.07, 0.08) in the lean. Only BMI was significantly related to the degree of BP change. Whereas BMI was proportionally associated with BP, BMI was a modifier which, depending on its level, inverted the direction of the association between chronic mental stress and resting BP.

  12. Impact of Speed-Eating Habit on Subsequent Body Mass Index and Blood Pressure Among Schoolchildren - The Ibaraki Children's Cohort Study (IBACHIL).

    Science.gov (United States)

    Yamagishi, Kazumasa; Sairenchi, Toshimi; Sawada, Nobuyuki; Sunou, Keiko; Sata, Mizuki; Murai, Utako; Takizawa, Nobue; Irie, Fujiko; Watanabe, Hiroshi; Iso, Hiroyasu; Ota, Hitoshi

    2018-01-25

    Habitual speed eating is a risk factor of obesity but evidence of this in children is limited. We examined the association between speed-eating habit and subsequent body mass index (BMI) and blood pressure (BP) among Japanese children.Methods and Results:The community-based study comprised 1,490 Japanese boys and girls who were born in 1989, involved in the Ibaraki Children's Cohort Study at age 3 years, and had returned questionnaires at both ages 6 and 12 years. In a subsample, we measured BP (n=263). Speed-eating habit was categorized into 4 groups: Never, Quit, Newly, and Continuous. Sex-specific mean values of questionnaire-based BMI and measured BPs at age 12 were examined according to speed-eating habit. Children with continuous speed eating had a higher BMI at age 12 than those who had never had a speed-eating habit (20.0 vs. 17.9 kg/m 2 for boys (Peating than in those without (117 vs. 110 mmHg, P=0.01), but such a difference was not observed in girls (112 vs. 111 mmHg, P=0.95). Habitualspeed eating was positively associated with subsequent BMI among boys and girls as well as with systolic BP among boys.

  13. Blood pressure, body mass index, heart rate and levels of blood cholesterol and glucose of volunteers during National Heart Weeks, 1995-1997.

    Science.gov (United States)

    Khoo, K L; Tan, H; Liew, Y M; Sambhi, J S; Aljafri, A M; Hatijah, A

    2000-12-01

    The paper presents the results of a health screening programme conducted in 10 major centers in Malaysia--Kuala Lumpur, Penang, Ipoh, Johor Bahru, Alor Star, Kuala Terengganu, Malacca, Kota Bahru, Kuching and Kota Kinabalu during the National Heart Weeks, 1995-1997. There were 6,858 participants of both sexes aged between 6 years to 81 years old. The parameters involved in the screening programme were body mass index, blood pressure, heart rate, cholesterol and glucose. The following are the results of the study:- 1. The mean and standard deviation for the body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), total cholesterol (TC) and non fasting (random) blood glucose (GL) of the volunteers studied were 24.3 +/- 4.0 kg/m2, 128.3 +/- 21.1 mmHg, 79.6 +/- 11.9 mmHg, 77.2 +/- 12.1 bpm, 5.33 +/- 1.37 mmol/l and 5.11 +/- 1.97 mmol/l respectively. 2. There was a rising trend for BMI, SBP, DBP, TC and GL with age. The HR was higher in the younger age group of those below 20 years. Males tended to have higher mean values than females except for HR which was similar in both sexes. 3. The Malays, Chinese and Indians seemed to have closely similar mean values for SBP, DBP and HR but the Indians possessed the highest BMI (25.62 +/- 3.90 kg/m2), TC (5.61 +/- 1.48 mmol/l) and GL (5.41 +/- 2.43 mmol/l) among the three major ethnic groups. While the Ibans had highest TC (6.07 + 1.09 mmol/l), their GL level was the lowest (4.76 +/- 1.15 mmol/l). The Kadazans had the lowest TC level (4.94 +/- 1.39 mmol/l) among all the ethnic groups. 4. Among the participants screened, 31.9% were overweight (BMI > or = 25), 7.6% were obese (BMI > or = 30); 26.8% had raised SBP (> or = 140 mmHg) and 19.3% had raised DBP (> or = 90 mmHg); 13.6% of the participants had increased HR (> or = 90 bpm), 22% had raised TC (> or = 6.20 mmol/l) and 2% had raised GL (> or = 11.00 mmol/l). There was a higher prevalence for abnormal values with increasing age

  14. Coronary, Carotid, and Lower-extremity Atherosclerosis and Their Interrelationship in Danish Patients with Systemic Lupus Erythematosus

    DEFF Research Database (Denmark)

    Kay, Susan Due; Poulsen, Mikael Kjaer; Diederichsen, Axel Cosmus Pyndt

    2015-01-01

    OBJECTIVE: Atherosclerosis is highly prevalent among patients with systemic lupus erythematosus (SLE), but has been demonstrated predominantly in non-European SLE cohorts and few investigations have included more than 1 imaging modality. We aimed to investigate the prevalence of atherosclerosis......-media thickening and plaque, and abnormal ankle-brachial index by means of cardiac computed tomography, ultrasound of the carotid arteries, and ankle systolic blood pressure. RESULTS: In patients with SLE, the prevalence of atherosclerosis in any vascular territory was 41%. The distribution of the atherosclerotic...... manifestations showed an overlap with 45% of the patients having involvement in more than 1 vascular territory. However, more than one-third of the patients with SLE with coronary, carotid, or lower-extremity atherosclerosis exclusively demonstrated this particular manifestation. Based on a multiple logistic...

  15. Use of hydrocapillary dressing in the management of highly exuding ulcers

    DEFF Research Database (Denmark)

    Norkus, A.; Dargis, V.; Thomsen, J.K.

    2005-01-01

    was conducted on 97 patients with an ankle brachial pressure index > or = 0.8 and a highly exuding leg ulcer. Ulcer duration was at least four weeks.Treatment continued until healing or for a maximum of 12 months. RESULTS: There was no statistically significant difference in healing time or wound area reduction...... between the two treatment protocols. The test dressing (Alione Hydrocapillary) had better absorption capacity and was more comfortable for the patients than the comparator dressings (Tielle/Tielle Plus) and adhered less to the wound bed.Also, more patients preferred the test dressing to their previous...... treatment. Although severe leakage and maceration were observed more frequently in the comparator group compared with the test group, this was not statistically significant. CONCLUSION: Both treatment protocols were safe and effective in treating highly exuding chronic venous leg ulcers. The test dressing...

  16. Continuous crossover femoropopliteal bypass in a 68-year-old gentleman with rest pain.

    LENUS (Irish Health Repository)

    Smith, F M

    2012-02-03

    Patients who have had multiple previous attempts at limb salvaging surgery frequently go on to have an amputation. This, however, results both in psychological perturbation for the patient and high rehabilitation costs for the community. Successful limb salvage surgery therefore has an important role in vascular surgery. We describe the management of a patient with critical limb ischemia that had previously undergone multiple limb salvage procedures and whose limb was saved by the use of a continuous femoropopliteal crossover bypass graft. The patient, who may have been deemed by some as a candidate for amputation, has full use of his limb 6 months after surgery with ankle brachial pressure index readings of 0.6. Continuous femoropopliteal crossover bypass grafting is a poorly described surgical technique that may be appropriate in a subgroup of patients and may allow salvage of a limb that otherwise may have been deemed fit for amputation.

  17. Identification of International Classification of Functioning, Disability and Health categories for patients with peripheral arterial disease.

    Science.gov (United States)

    Vyskocil, Erich; Gruther, Wolfgang; Steiner, Irene; Schuhfried, Othmar

    2014-07-01

    Disease-specific categories of the International Classification of Functioning, Disability and Health have not yet been described for patients with chronic peripheral arterial obstructive disease (PAD). The authors examined the relationship between the categories of the Brief Core Sets for ischemic heart diseases with the Peripheral Artery Questionnaire and the ankle-brachial index to determine which International Classification of Functioning, Disability and Health categories are most relevant for patients with PAD. This is a retrospective cohort study including 77 patients with verified PAD. Statistical analyses of the relationship between International Classification of Functioning, Disability and Health categories as independent variables and the endpoints Peripheral Artery Questionnaire or ankle-brachial index were carried out by simple and stepwise linear regression models adjusting for age, sex, and leg (left vs. right). The stepwise linear regression model with the ankle-brachial index as dependent variable revealed a significant effect of the variables blood vessel functions and muscle endurance functions. Calculating a stepwise linear regression model with the Peripheral Artery Questionnaire as dependent variable, a significant effect of age, emotional functions, energy and drive functions, carrying out daily routine, as well as walking could be observed. This study identifies International Classification of Functioning, Disability and Health categories in the Brief Core Sets for ischemic heart diseases that show a significant effect on the ankle-brachial index and the Peripheral Artery Questionnaire score in patients with PAD. These categories provide fundamental information on functioning of patients with PAD and patient-centered outcomes for rehabilitation interventions.

  18. Peripheral artery disease (PAD) screening in the asymptomatic population

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Falk, Erling

    2011-01-01

    Measurement of ankle-brachial index (ABI) was developed to assess peripheral artery disease (PAD) in patients with symptoms of peripheral ischemia being present at rest or only functionally dependent (intermittent claudication). Reduced ABI is caused by arterial obstruction between the aortic arch...

  19. Comparative analysis of different modalities of assessment of lower ...

    African Journals Online (AJOL)

    LEAD was assessed in all the patients using: 1. History of intermittent claudication using the Edinburgh Claudication Questionnaire. 2. Palpation of pedal pulses for diminished or absent dorsalis pedis and/or posterior tibial artery pulsations. 3. Ankle Brachial Index <0.9 in either leg, using hand-held Doppler ultrasonography

  20. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

  1. Prevalence of subclinical Cardiovascular Disease in healthy HIV ...

    African Journals Online (AJOL)

    We tested for subclinical CVD using 3 tools: Ankle Brachial Index (ABI) to measure for the presence of peripheral artery disease, 12 lead Electrocardiogram (ECG) for electrical abnormalities and transthoracic Echocardiography (ECHO), to measure abnormalities in cardiac structure and function. At analysis, patients where ...

  2. A study on the physical fitness index, heart rate and blood pressure in different phases of lunar month on male human subjects.

    Science.gov (United States)

    Chakraborty, Ujjwal; Ghosh, Tusharkanti

    2013-09-01

    The gravitational pull of the moon on the earth is not the same in all phases of the lunar month, i.e. new moon (NM), first quarter (FQ), full moon (FM) and third quarter (TQ), and as a result the amplitude of tide differs in different phases. The gravitational pull of the moon may have effects on the fluid compartments of the human body and hence the cardiovascular system may be affected differentially in the different phases of the lunar month. In the present study resting heart rate (HR) and blood pressure (BP), physical fitness index (PFI), peak HR and BP immediately after step test, and recovery HR and BP after step test were measured during different phases of the lunar month in 76 male university students (age 23.7 ± 1.7 years). At rest, both systolic and mean arterial BP were ∼5 mmHg lower in NM and FM compared to FQ and TQ, but resting HR was not significantly different between phases. Further, peak HR and peak systolic BP after step test were lower (∼4 beat/min and ∼5 mmHg, respectively) in NM and FM compared to FQ and TQ. PFI was also higher (∼5) in NM and FM compared to FQ and TQ. Recovery of HR after step test was quicker in NM and FM compared to that of FQ and TQ. It appears from this study that gravitational pull of the moon may affect the cardiovascular functions of the human body. Moreover, the physical efficiency of humans is increased in NM and FM due to these altered cardiovascular regulations.

  3. Relationship between Body Mass Index, Blood Pressure, and Visual Acuity in Residents of Esan West Local Government Area of Edo State, Nigeria

    Directory of Open Access Journals (Sweden)

    I. O. Ernest-Nwoke

    2014-01-01

    Full Text Available Aim. To study the relationship between body mass index (BMI and blood pressure (BP on visual acuity among apparently healthy residents of Ekpoma, Esan West Local Government Area of Edo State, Nigeria. Methodology. This is a cross-sectional descriptive study among 225 subjects (ages of 18–35 years from whom BP, body weight, and height were collected. Visual acuity was measured using the Snellen chart following standard procedures of number of letters seen at 6-metre distance. The data were then analyzed using SPSS version 17. Results. The sampled population consists of 112 male and 113 female (mean age 31.72±14.2 years. Majority (180 of the respondents had normal visual acuity. However, compared with the respondents with normal BMI (R19.61±1.5; L19.67±1.70, visual acuity of underweight (R18.53±2.30; L18.53±2.70 and obese (R15.68±4.79; L17.73±1.70 were more deviated. Similarly, compared with respondent with normal BP (120–125/80–85 mmHg; R18.00±2.53; L18.07±3.11, hypotensive (R15.5±7.35; L15.00±10.20, and hypertensive (R15.01±21.25; L15.00±11.91 respondents had deviated visual acuity. Conclusion. Abnormal body weight (underweight and obese and BP (hypotension and hypertension have potential negative impacts on visual acuity. Based on the observed relationship between weights, BP, and visual acuity, eye examinations can be included as regular screening exercise for abnormal BMI and BP conditions.

  4. Age-period-cohort analysis of trends in blood pressure and body mass index in children and adolescents in Hong Kong.

    Science.gov (United States)

    Kwok, Man Ki; Tu, Yu Kang; Kawachi, Ichiro; Schooling, C Mary

    2017-12-01

    The declining or fluctuating trend in blood pressure (BP) despite the rising trend in body mass index (BMI) during childhood and adolescence is unexplained. We decomposed trends in BP and BMI to identify the relevance of early-life and contemporaneous factors. We assessed the relative contribution of age, period and cohort to secular trends in BP in children and adolescents (9-18 years) from 1999 to 2014 and BMI (6-18 years) from 1996 to 2014 in Hong Kong, China. After accounting for age, period effects contributed more than cohort effects to the overall fluctuating BP trend and the rising BMI trend observed in this Chinese population. For both sexes, BP fell from the start of period to a low point in 2003-2005 but then rose. BMI rose strongly across the period before levelling off in 2009-2010. Earlier cohorts (born in 1983-1984) had higher BP and BMI than later cohorts. With globalisation and associated lifestyle changes, successive generations of children and adolescents in a recently developed Chinese setting had lower BP and BMI, but this fall was offset until recently by population-wide increase in BMI. School-based health promotion efforts could have partly mitigated the population-wide rise in child and adolescent BMI, while socioeconomic transition or other factors could be relevant to changes in BP between generations. Explaining these trends will help identify early-life factors that may contribute to a healthier start as well as contemporaneous factors that may protect against rising trends in adiposity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Time trends in blood pressure, body mass index and smoking in the Vietnamese population: a meta-analysis from multiple cross-sectional surveys.

    Directory of Open Access Journals (Sweden)

    Quang Ngoc Nguyen

    Full Text Available INTRODUCTION: Data for trends in cardiovascular disease (CVD risk factors are needed to set priorities and evaluate intervention programmes in the community. We estimated time trends in blood pressure (BP, anthropometric variables and smoking in the Vietnamese population and highlighted the differences between men and women or between rural and urban areas. METHODS: A dataset of 23,563 adults aged 25-74 from 5 cross-sectional surveys undertaken within Vietnam from 2001 to 2009 by the Vietnam National Heart Institute was used to estimate mean BP, weight, waist circumference (WC, body mass index (BMI, the prevalence of hypertension, adiposity or smoking, which were standardised to the national age structure of 2009. Multilevel mixed linear models were used to estimate annual changes in the variables of interest, adjusted by age, sex, residential area, with random variations for age and surveyed provinces. FINDINGS: Among the adult population, the age-standardised mean systolic and diastolic BP increased by 0.8 and 0.3 mmHg in women, 1.1 and 0.4 mmHg in men, while the mean BMI increased by 0.1 kgm(-2 in women, 0.2 kgm(-2 in men per year. Consequently, the prevalence of hypertension and adiposity increased by 0.9 and 0.3% in women, 1.1 and 0.9% in men with similar time trends in both rural and urban areas, while smoking prevalence only increased in women by 0.3% per year. A U-shaped association was found between age-adjusted BP and BMI in both sexes and in both areas. CONCLUSIONS: From 2001 to 2009, mean BP, weight and WC significantly increased in the Vietnamese population, leading to an increased prevalence of hypertension and adiposity, suggesting the need for the development of multi-sectoral cost-effective population-based interventions to improve CVD management and prevention. The U-shaped relationship between BP and BMI highlighted the hypertension burden in the underweight population, which is usually neglected in CVD interventions.

  6. Hypocaloric diet supplemented with probiotic cheese improves body mass index and blood pressure indices of obese hypertensive patients - a randomized double-blind placebo-controlled pilot study

    Science.gov (United States)

    2013-01-01

    Background Gut lactobacilli can affect the metabolic functions of healthy humans. We tested whether a 1500 kcal/d diet supplemented with cheese containing the probiotic Lactobacillus plantarum TENSIA (Deutsche Sammlung für Mikroorganismen, DSM 21380) could reduce some symptoms of metabolic syndrome in Russian adults with obesity and hypertension. Methods In this 3-week, randomized, double-blind, placebo-controlled, parallel pilot study, 25 subjects ingested probiotic cheese and 15 ingested control cheese. Fifty grams of each cheese provided 175 kcal of energy. Blood pressure (BP), anthropometric characteristics, markers of liver and kidney function, metabolic indices (plasma glucose, lipids, and cholesterol), and urine polyamines were measured. Counts of fecal lactobacilli and L. plantarum TENSIA were evaluated using molecular methods. The data were analyzed by t-test for independent samples and Spearman’s partial correlation analysis. Results The probiotic L. plantarum TENSIA was present in variable amounts (529.6 ± 232.5 gene copies) in 16/25 (64%) study subjects. Body mass index (BMI) was significantly reduced (p = 0.031) in the probiotic cheese group versus the control cheese group. The changes in BMI were closely associated with the water content of the body (r = 0.570, p = 0.0007) when adjusted for sex and age. Higher values of intestinal lactobacilli after probiotic cheese consumption were associated with higher BMI (r = 0.383, p = 0.0305) and urinary putrescine content (r = 0.475, p = 0.006). In patients simultaneously treated with BP-lowering drugs, similar reductions of BP were observed in both groups. A positive association was detected between TENSIA colonization and the extent of change of morning diastolic BP (r = 0.617, p = 0.0248) and a trend toward lower values of morning systolic BP (r = −0.527, p = 0.0640) at the end of the study after adjusting for BMI, age, and sex. Conclusion In a pilot study of obese hypertensive patients, a hypocaloric

  7. The prevalence of peripheral arterial disease in diabetic subjects in south-west Nigeria

    Directory of Open Access Journals (Sweden)

    Bolaji O. Oyelade

    2012-02-01

    Full Text Available Background: Peripheral arterial disease (PAD is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index, a simple and reliable test. Objectives: To determine the prevalence of PAD in diabetic subjects aged 50–89 years and the value of ankle-brachial index measurement in the detection of PAD.Method: A cross-sectional descriptive study of 219 diabetic subjects aged 50–89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI was done. The ankle-brachial index < 0.90 was considered equivalent to peripheral arterial disease.Results: The overall prevalence of PAD was 52.5%. The prevalence of symptomatic PAD was 28.7% whilst that of asymptomatic PAD was 71.3%. There were a number of associations with PAD which included, age (p < 0.05, sex (p < 0.05, and marital status (p < 0.05. The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses.Conclusion: The prevalence of PAD is relatively high in diabetic subjects in the southwestern region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses.

  8. The prevalence of peripheral arterial disease in diabetic subjects in south-west Nigeria

    Directory of Open Access Journals (Sweden)

    Bolaji O. Oyelade

    2012-10-01

    Full Text Available Background: Peripheral arterial disease (PAD is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index, a simple and reliable test. Objectives: To determine the prevalence of PAD in diabetic subjects aged 50–89 years and the value of ankle-brachial index measurement in the detection of PAD. Method: A cross-sectional descriptive study of 219 diabetic subjects aged 50–89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI was done. The ankle-brachial index < 0.90 was considered equivalent to peripheral arterial disease. Results: The overall prevalence of PAD was 52.5%. The prevalence of symptomatic PAD was 28.7% whilst that of asymptomatic PAD was 71.3%. There were a number of associations with PAD which included, age (p < 0.05, sex (p < 0.05, and marital status (p < 0.05. The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses. Conclusion: The prevalence of PAD is relatively high in diabetic subjects in the southwestern region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses.

  9. A computational analysis of the long-term regulation of arterial pressure [v2; ref status: indexed, http://f1000r.es/2hm

    Directory of Open Access Journals (Sweden)

    Daniel A. Beard

    2013-12-01

    Full Text Available The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production—the acute pressure-diuresis and pressure-natriuresis curves—physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the “Guyton-Coleman model”, no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. representing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  10. A computational analysis of the long-term regulation of arterial pressure [v1; ref status: indexed, http://f1000r.es/1xq

    Directory of Open Access Journals (Sweden)

    Daniel A. Beard

    2013-10-01

    Full Text Available The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production—the acute pressure-diuresis and pressure-natriuresis curves—physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the “Guyton-Coleman model”, no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. capturing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  11. Browse Title Index

    African Journals Online (AJOL)

    Items 251 - 300 of 2005 ... Issue, Title. Vol 92, No 4 (2015), Blood Pressure and Obesity Index Assessment in a Typical Urban Slum in Enugu, Nigeria, Abstract. GI Ahaneku, CU Osuji, OC Oguejiofor, BC Anisiuba, VO Ikeh, JE Ahaneku. Vol 80, No 10 (2003):, Blood pressure control in a population where antihypertensives are ...

  12. Heart rate index

    DEFF Research Database (Denmark)

    Haedersdal, C; Pedersen, F H; Svendsen, J H

    1992-01-01

    after the myocardial infarction. A significant correlation (Spearman's correlation coefficient rs, p less than 0.05) was found between LVEF at rest and the following variables assessed at exercise test: 1) the heart rate at rest, 2) rise in heart rate, 3) ratio between maximal heart rate and heart rate...... at rest, 4) rise in systolic blood pressure, 5) rate pressure product at rest, 6) rise in rate pressure product, 7) ratio (rHR) between maximal rate pressure product and rate pressure product at rest, 8) total exercise time. The heart rate was corrected for effects caused by age (heart index (HR...

  13. Stroke volume variation compared with pulse pressure variation and cardiac index changes for prediction of fluid responsiveness in mechanically ventilated patients

    Directory of Open Access Journals (Sweden)

    Randa Aly Soliman

    2015-04-01

    Conclusions: Baseline stroke volume variation ⩾8.15% predicted fluid responsiveness in mechanically ventilated patients with acute circulatory failure. The study also confirmed the ability of pulse pressure variation to predict fluid responsiveness.

  14. A meta-analysis of the effect of angiotensin receptor blockers and calcium channel blockers on blood pressure, glycemia and the HOMA-IR index in non-diabetic patients.

    Science.gov (United States)

    Yang, Yue; Wei, Ri-bao; Xing, Yue; Tang, Lu; Zheng, Xiao-yong; Wang, Zi-cheng; Gao, Yu-wei; Li, Min-xia; Chen, Xiang-mei

    2013-12-01

    This study compared the efficacy of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) in the effect of insulin resistance (IR) as assessed using the homeostasis model assessment of insulin resistance (HOMA-IR) in non-diabetic patients. The MEDLINE, EMBASE, and Cochrane Library databases were searched to identify studies published before December 2012 that investigated the use of ARBs and CCBs to determine the effect on the HOMA-IR index in non-diabetics. Parameters on IR and blood pressure were collected. Review Manager 5.2 and Stata 12.0 were used to perform the meta-analysis. Fixed and random effects models were applied to various aspects of the meta-analysis, which assessed the therapeutic effects of the two types of drug using the HOMA-IR index in non-diabetic patients. The meta-analysis included five clinical trials. Patient comparisons before and after treatment with ARBs and CCBs revealed that ARBs reduced the HOMA-IR index (weighted mean difference (WMD) -0.65, 95% confidence interval (CI) -0.93 to -0.38) and fasting plasma insulin (FPI) (WMD -2.01, 95% CI -3.27 to -0.74) significantly more than CCBs. No significant differences in the therapeutic effects of these two types of drug on blood pressure were observed. Given that there are no significant differences in the therapeutic effects of ARBs and CCBs on blood pressure, as ARBs are superior to CCBs in their effect on the HOMA-IR index in non-diabetics, they might be a better choice in hypertension patients without diabetes. © 2013.

  15. A critical appraisal of the rate pressure product as index of myocardial oxygen consumption for the study of metabolic coronary flow regulation

    NARCIS (Netherlands)

    Kal, J. E.; van Wezel, H. B.; Vergroesen, I.

    1999-01-01

    For the assessment of metabolic coronary vasodilatation, changes in systolic rate pressure product (RPP) are frequently used to estimate the pacing- or exercise induced changes in myocardial oxygen consumption (MVO2). The present study was designed to test whether this is justified in patients with

  16. Resource Endowments and Responses to Regulatory Pressure: Publications of Economics, Management, and Political Science Departments of Turkish Universities in Indexed Journals, 2000-2008

    Science.gov (United States)

    Onder, Cetin; Kasapoglu-Onder, Rana

    2011-01-01

    This paper investigates how differences in resource endowments of universities shape variation in their response to regulatory pressures. Earlier research on higher education institutions tends to conceive regulatory rules as the primary basis of action and does not attend to differences in the salient characteristics of universities. This paper…

  17. The Effect of HIV and the Modifying Effect of Anti-Retroviral Therapy (ART) on Body Mass Index (BMI) and Blood Pressure Levels in Rural South Africa.

    Science.gov (United States)

    Feigl, Andrea B; Bloom, David E; Danaei, Goodarz; Pillay, Deenan; Salomon, Joshua A; Tanser, Frank; Bärnighausen, Till W

    2016-01-01

    High BMI and blood pressure are leading chronic disease risk factors in South Africa. Longterm effects of HIV and ART on adiposity and blood pressure are poorly understood, and direct comparisons of risk factor trajectories in HIV- versus HIV+ populations are rare. In 2003 and 2010, height, weight, and blood pressure were recorded in a study population (n = 505) in KwaZulu-Natal, South Africa (30% adult HIV prevalence). We modeled change in BMI and BP longitudinally in HIV- individuals (n = 315), seroconverters (n = 32), HIV+ patients not on ART (HIV+ART-; n = 52), HIV+ patients on ART for 0-ART0-ART for 2-5 years (HIV+ART2-5yrs; n = 44), and a subgroup with unknown HIV status (n = 44). Difference-in-differences were assessed in reference to the HIV- population. Between 2003 and 2010, BMI increased significantly in the HIV- group, by 0.874 (95% CI 0.339, 1.41; p = 0.001), to 30.4. BMI drop was significantly greater in HIV+ART0-ART2-5yrs (p = 0.005). DID in BMI in HIV+ART0-ART2-5yrs versus reference was -1.35 (95% CI -2.89, 0.189; p = 0.086). DID in SBP in HIV+ART-vs HIV- DID was -7.55 mmHg (95% CI -13.2 to -1.90; p = 0.009). Short-term ART (0-ART or long-term ART. Once on ART for 2+ years, individuals 'caught up' on weight gain with the HIV- population. Our results showcase the importance of health system readiness to address the burgeoning double burden of disease in South Africa.

  18. An Altimetry-Derived Index of the Offshore Forcing on the "Pressure Point" of the West Florida Shelf: Anomalous Upwelling and Its Influence on Harmful Algal Blooms

    Science.gov (United States)

    Liu, Y.; Weisberg, R. H.; Lenes, J. M.; Zheng, L.; Hubbard, K.; Walsh, J. J.

    2017-12-01

    Gulf of Mexico Loop Current (LC) interactions with the West Florida Shelf (WFS) slope play an important role in shelf ecology through the upwelling of new inorganic nutrients across the shelf break. This is particularly the case when the LC impinges upon the shelf slope in the southwest portion of the WFS near the Dry Tortugas. By contacting shallow water isobaths at this "pressure point" the LC forcing sets the entire shelf into motion. Characteristic patterns of LC interactions with the WFS and their occurrences are identified from altimetry data using unsupervised neural network, self-organizing map. The duration of the occurrences of such LC patterns is used as an indicator of offshore forcing of anomalous upwelling. Consistency is found between the altimetry-derived offshore forcing and the occurrence and severity of WFS coastal blooms of the toxic dinoflagellate, Karenia brevis: years without major blooms tend to have prolonged LC contact at the "pressure point," whereas years with major blooms tend not to have prolonged offshore forcing. Resetting the nutrient state of the shelf by the coastal ocean circulation in response to deep-ocean forcing demonstrates the importance of physical oceanography in shelf ecology. A satellite altimetry-derived seasonal predictor for major K. brevis blooms is also proposed.

  19. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 245 of 245 ... Vol 13, No 2 (2014), Sewage disposal methods in a sub-urban community in Edo state, Nigeria, Abstract PDF. AR Isara, AQ Aigbokhaode. Vol 16, No 1 (2017), Sleep deprivation and coffee consumption induced changes in blood pressure, body mass index and blood glucose in male Wistar albino rats ...

  20. Evaluation of the apnea-hypopnea index determined by the S8 auto-CPAP, a continuous positive airway pressure device, in patients with obstructive sleep apnea-hypopnea syndrome.

    Science.gov (United States)

    Ueno, Kanako; Kasai, Takatoshi; Brewer, Gregory; Takaya, Hisashi; Maeno, Ken-ichi; Kasagi, Satoshi; Kawana, Fusae; Ishiwata, Sugao; Narui, Koji

    2010-04-15

    Continuous positive airway pressure (CPAP) has been established as an effective treatment for obstructive sleep apnea-hypopnea syndrome (OSAHS). Recently, several auto-CPAP devices that can detect upper airway obstructive events and provide information about residual events while patients are on CPAP have come into clinical use. The purpose of this study was to compare the apnea-hypopnea index (AHI) determined by the S8 auto-CPAP device with the AHI derived by polysomnography in patients with OSAHS. Consecutive patients with OSAHS titrated on S8 auto-CPAP were included. The correlation between AHI determined by manual scoring (AHI-PSG) and by S8 (AHIS8) during an overnight in-hospital polysomnogram with the patient on CPAP was assessed. Furthermore, the apnea index (Al) and the hypopnea index (HI) were evaluated separately. Seventy patients with OSAHS (94% men) were enrolled. The mean AHI on the diagnostic study was 51.9 +/- 2.4. During the titration, this device markedly suppressed the respiratory events (AHI-PSG, 4.2 +/- 0.4; AI, 1.9 +/- 0.3; HI, 2.3 +/- 0.3). On the other hand, the AHI-S8 was 9.9 +/- 0.6 (AI-S8, 2.4 +/- 0.3; HI-S8, 7.5 +/- 0.4). There was a strong correlation between the overall AHI-PSG and the AHI-S8 (r = 0.85, p S8 (r = 0.93, p S8 (r = 0.67, p S8 was observed. However, the correlation was weakened when the analysis was limited to the HI.

  1. Village distance from urban centre as the prime modernization variable in differences in blood pressure and body mass index of adults of the Purari delta of the Gulf Province, Papua New Guinea.

    Science.gov (United States)

    Ulijaszek, Stanley J; Koziel, Slawomir; Hermanussen, Michael

    2005-01-01

    The study examined the extent to which the geographical proximity of villages to an urban centre and other modernization variables are associated with variation in blood pressure and body mass index (BMI) of adults of the Purari delta of the Gulf Province, Papua New Guinea (PNG). Mean BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 292 adults surveyed in 1995-1997 in the Purari delta, PNG, are reported by village of residence, and related to modernization variables, including village of residence, urban life, urban connectedness, economic status and education. Mean BMI, SBP and DBP differ according to village of residence, there being a gradient in mean blood pressure from highest in the village closest to the urban centre, Baimuru, and lowest in the village most distant from it. The gradients in these variables across the three villages are not due to differences in age structures between the villages. Place of residence, which represents the distance from town, has the greatest impact on the BMI of males, while among the females, the number of relatives living in urban centres had a significant effect on BMI. For both males and females, place of residence has the strongest effect on SBP. While for the males, place of residence is the only significant factor associated with SBP, for the females, SBP is also associated with BMI, level of income and to a lesser extent with age. Very similar results were obtained for DBP. Distance to urban centre appears to have a strong effect, relative to other modernization variables, on BMI and blood pressure, this effect being far stronger for males than for females. In large part, this effect operates by way of differences in number of sources of income as well as number of close relatives of women who are resident in an urban centre. Reasons for the male-female differences observed may include gender differences in degree of mobility, and possibly greater physical sensitivity of males to the

  2. Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Martín-Madrazo Carmen

    2011-04-01

    Full Text Available Abstract Background Individual health education is considered to be essential in the overall care of patients with type 2 diabetes (DM2, although there is some uncertainty regarding its metabolic control benefits. There have been very few randomized studies on the effects of individual education on normal care in DM2 patients with a control group, and none of these have assessed the long-term results. Therefore, this study aims to use this design to assess the effectiveness of the PRECEDE (Predisposing, Reinforcing, Enabling, Causes in Educational Diagnosis, and Evaluation education model in the metabolic control and the reduction of cardiovascular risk factors, in patients with type 2 diabetes. Methods An open community effectiveness study was carried out in 8 urban community health centers in the North-East Madrid Urban Area (Spain. Six hundred patients with DM2 were randomized in two groups: PRECEDE or conventional model for health promotion education. The main outcome measures were glycated hemoglobin A1c, body mass index (BMI, blood pressure, lipids and control criteria during the 2-year follow-up period. Results Glycated hemoglobin A1c and systolic blood pressure (SBP levels decreased significantly in the PRECEDE group (multivariate analysis of covariance, with baseline glycated hemoglobin A1c, SBP, and variables showing statistically significant differences between groups at baseline visits. The decrease levels in diastolic blood pressure (DBP, triglycerides and LDL cholesterol were nonsignificant. PRECEDE increased compliance in all control criteria, except for LDL cholesterol. BMI did not change during the study in either of the two models analyzed. Conclusions PRECEDE health education model is a useful method in the overall treatment in patients with type 2 diabetes, which contributes to decrease glycated hemoglobin A1c and SBP levels and increase the compliance in all the control criteria, except for LDL cholesterol. Trial

  3. Afghanistan Index

    DEFF Research Database (Denmark)

    Linnet, Poul Martin

    2007-01-01

    The Afghanistan index is a compilation of quantitative and qualitative data on the reconstruction and security effort in Afghanistan. The index aims at providing data for benchmarking of the international performance and thus provides the reader with a quick possibility to retrieve valid...... information on progress or lack of progress in the reconstruction of the post Taliban Afghanistan. The index is mainly based on information collected on the internet in order to provide quick access to the original source. The index is under development and thus new information will be added on a continuous...

  4. AP Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

  5. Ambulatory arterial stiffness indices and target organ damage in hypertension

    Directory of Open Access Journals (Sweden)

    Gómez-Marcos Manuel

    2012-01-01

    Full Text Available Abstract Background The present study was designed to evaluate which arterial stiffness parameter - AASI or the home arterial stiffness index (HASI - correlates best with vascular, cardiac and renal damage in hypertensive individuals. Methods A cross-sectional study was carried out involving 258 hypertensive patients. AASI and HASI were defined as the 1-regression slope of diastolic over systolic blood pressure readings obtained from 24-hour recordings and home blood pressure over 6 days. Renal damage was evaluated by glomerular filtration rate (GFR and microalbuminuria; vascular damage by carotid intima-media thickness (IMT, pulse wave velocity (PWV and ankle/brachial index (ABI; and left ventricular hypertrophy by the Cornell voltage-duration product (VDP and the Novacode index. Results AASI and HASI were not correlated with microalbuminuria, however AASI and HASI- blood pressure variability ratio (BPVR showed negative correlation with GRF. The Cornell PDV was positively correlated with AASI- BPVR-Sleep (r = 0.15, p Conclusions After adjusting for age, gender and 24-hour heart, the variables that best associated with the variability of IMT, PWV and ABI were AASI and Awake-AASI, and with GFR was HASI-BPVR.

  6. Serum Interleukin-23 in Polish Patients with Systemic Lupus Erythematosus: Association with Lupus Nephritis, Obesity, and Peripheral Vascular Disease

    OpenAIRE

    Fischer, Katarzyna; Przepiera-Będzak, Hanna; Sawicki, Marcin; Walecka, Anna; Brzosko, Iwona; Brzosko, Marek

    2017-01-01

    Objectives. To analyze the correlation between the serum concentration of interleukin- (IL-) 23 and atherosclerotic changes, traditional atherosclerotic risk factors, the autoantibody profile, and involvement of selected organs in systemic lupus erythematosus (SLE) patients. Patients and Methods. We studied 94 SLE patients and 27 controls. We analyzed the IL-23 serum concentration, autoantibodies, carotid intima-media thickness and atherosclerotic plaque, the ankle-brachial index, atheroscler...

  7. Prevalencia de calcificación arterial y factores de riesgo cardiovascular asociados: Estudio multicéntrico poblacional ARTPER Prevalence of arterial calcification and related risk factors: The multicenter population-based ARTPER study

    Directory of Open Access Journals (Sweden)

    María Teresa Alzamora

    2012-02-01

    Full Text Available Objetivos: Estudiar la prevalencia de calcificación arterial (índice tobillo-brazo >1,4 y de factores de riesgo cardiovascular asociados en población general >49 años de edad. Métodos: Estudio transversal, 3786 sujetos seleccionados aleatoriamente en 28 centros. Para el cálculo de la prevalencia se usó toda la muestra, excluyendo los sujetos con arteriopatía periférica (índice tobillo-brazo Objective: To determine the prevalence of arterial calcification (ankle-brachial index >1.4 and its related factors among the general population aged >49 years. Methods: We performed a cross-sectional study of 3,786 people randomly selected from 28 centers. To assess the factors associated with arterial calcification using a multivariate logistic model, the whole sample was used to compute prevalence, excluding persons with peripheral arterial disease (ankle-brachial index <0.9. Results: Arterial calcification was found in 235 persons (prevalen 6.2%; 95% CI: 5.6-7.0, and was twice as frequent in men as in women. Patients with arterial calcification were older, had more previous cardiovascular events, diabetes and obesity, and were less able to perform physical activity than persons with a healthy ankle-brachial index. Conclusions: We recommend measurement of the ankle-brachial index in primary care centers to detect arterial calcification among men, persons with diabetes, overweight, obesity or difficulty in performing physical activity, and in those with left ventricular hypertrophy.

  8. Antioxidant Enzymes Activity in Patients with Peripheral Vascular Disease, with and without Presence of Diabetes Mellitus

    OpenAIRE

    Jandrić-Balen, Marica; Božikov, Veljko; Bistrović, Dragica; Jandrić, Ivan; Božikov, Jadranka; Romić, Željo; Balen, Ivan

    2003-01-01

    The study evaluated antioxidant status in patients with peripheral vascular disease (PVD), with and without concomitant diabetes mellitus (DM). 211 participants were divided into standardized 4 groups: patients with PVD and DM (PVD+DM+), patients with PVD without DM (PVD+DM-), patients without PVD with DM (PVD-DM+) and patients without PVD and DM (PVD-DM-). The diagnosis of PVD was established by Doppler sonography analysis, including determination of the ankle brachial index (...

  9. AA Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The geomagnetic aa index provides a long climatology of global geomagnetic activity using 2 antipodal observatories at Greenwich and Melbourne- IAGA Bulletin 37,...

  10. Diversity Index

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — This map service summarizes racial and ethnic diversity in the United States in 2012.The Diversity Index shows the likelihood that two persons chosen at random from...

  11. Walkability Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of...

  12. Density, refractive index, interfacial tension, and viscosity of ionic liquids [EMIM][EtSO4], [EMIM][NTf2], [EMIM][N(CN)2], and [OMA][NTf2] in dependence on temperature at atmospheric pressure.

    Science.gov (United States)

    Fröba, Andreas P; Kremer, Heiko; Leipertz, Alfred

    2008-10-02

    The density, refractive index, interfacial tension, and viscosity of ionic liquids (ILs) [EMIM][EtSO 4] (1-ethyl-3-methylimidazolium ethylsulfate), [EMIM][NTf 2] (1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide), [EMIM][N(CN) 2] (1-ethyl-3-methylimidazolium dicyanimide), and [OMA][NTf 2] (trioctylmethylammonium bis(trifluoromethylsulfonyl)imide) were studied in dependence on temperature at atmospheric pressure both by conventional techniques and by surface light scattering (SLS). A vibrating tube densimeter was used for the measurement of density at temperatures from (273.15 to 363.15) K and the results have an expanded uncertainty ( k = 2) of +/-0.02%. Using an Abbe refractometer, the refractive index was measured for temperatures between (283.15 and 313.15) K with an expanded uncertainty ( k = 2) of about +/-0.0005. The interfacial tension was obtained from the pendant drop technique at a temperature of 293.15 K with an expanded uncertainty ( k = 2) of +/-1%. For higher and lower temperatures, the interfacial tension was estimated by an adequate prediction scheme based on the datum at 293.15 K and the temperature dependence of density. For the ILs studied within this work, at a first order approximation, the quantity directly accessible by the SLS technique was the ratio of surface tension to dynamic viscosity. By combining the experimental results of the SLS technique with density and interfacial tension from conventional techniques, the dynamic viscosity could be obtained for temperatures between (273.15 and 333.15) K with an estimated expanded uncertainty ( k = 2) of less than +/-3%. The measured density, refractive index, and viscosity are represented by interpolating expressions with differences between the experimental and calculated values that are comparable with but always smaller than the expanded uncertainties ( k = 2). Besides a comparison with the literature, the influence of structural variations on the thermophysical properties of the

  13. Intelligent indexing

    International Nuclear Information System (INIS)

    Farkas, J.

    1992-01-01

    In this paper we discuss the relevance of artificial intelligence to the automatic indexing of natural language text. We describe the use of domain-specific semantically-based thesauruses and address the problem of creating adequate knowledge bases for intelligent indexing systems. We also discuss the relevance of the Hilbert space ι 2 to the compact representation of documents and to the definition of the similarity of natural language texts. (author). 17 refs., 2 figs

  14. Indexing mechanisms

    International Nuclear Information System (INIS)

    Wood, A.G.; Parker, G.E.; Berry, R.

    1976-01-01

    It is stated that the indexing mechanism described can be used in a nuclear reactor fuel element inspection rig. It comprises a tubular body adapted to house a canister containing a number of fuel elements located longtitudinally, and has two chucks spaced apart for displacing the fuel elements longitudinally in a stepwise manner, together with a plunger mechanism for displacing them successively into the chucks. A measuring unit is located between the chucks for measuring the diameter of the fuel elements at intervals about their circumferences, and a secondary indexing mechanism is provided for rotating the measuring unit in a stepwise manner. (U.K.)

  15. Elevated Extravascular Lung Water Index (ELWI) as a Predictor of Failure of Continuous Positive Airway Pressure Via Helmet (Helmet-CPAP) in Patients With Acute Respiratory Failure After Major Surgery.

    Science.gov (United States)

    Redondo Calvo, Francisco Javier; Bejarano Ramirez, Natalia; Uña Orejon, Rafael; Villazala Garcia, Ruben; Yuste Peña, Ana Sofia; Belda, Francisco Javier

    2015-11-01

    NIV is increasingly used for prevention and treatment of respiratory complications and failure. Some of them are admitted to the PACU with advanced hemodynamic monitors which allow quantification of Extravascular Lung Water (EVLW) by transpulmonary thermodilution technique (TPTD) and Pulmonary Vascular Permeability (PVP) providing information on lung edema. The objective of this study was to ascertain if EVLW Index and PVP Index may predict failure (intubation) or success (non-intubation) in patients developing acute respiratory failure (ARF) in the postoperative period following major abdominal surgery, where the first line of treatment was non-invasive continuous positive airway pressure via a helmet. Hemodynamic variables, EVLWI and PVPI were monitored with a transpulmonary thermodilution hemodynamic monitor device (PiCCO™) before and after the application of CPAP. Avoidance of intubation was observed in 66% of patients with Helmet-CPAP. In these patients after the first hour of application of CPAP, PaO2/FiO2 ratio significantly increased (303.33±65.2 vs. 141.6±14.6, P<.01). Before starting Helmet-CPAP values of EVLWI and PVPI were significantly lower in non-intubated patients (EVLWI 8.6±1.08 vs. 11.8±0.99ml/kg IBW, P<.01 and PVPI 1.7±0.56 vs. 3.0±0.88, P<.01). An optimal cut-off value for EVLWI was established at 9.5, and at 2.45 for PVPI (sensitivity of 0.7; specificity of 0.9, P<.01). In this type of patient the physiological parameters that predict the failure of Helmet-CPAP with the greatest accuracy were the value of the EVLWI and PVPI before Helmet-CPAP institution and the PaO2/FiO2 ratio and the respiratory rate after one hour of CPAP. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  16. Author Index

    Indian Academy of Sciences (India)

    Author Index. Alshaary, A. A. see Sharaf, M. A., 9. Banajh, M. A. see Sharaf, M. A., 9. Burbidge Geoffrey see Narlikar Jayant, V., 67. Chen, H. D. see Li, K. J., 147. Chen, Y. Q. see Huang, C., 139. Cui Wenyuan Evolution of the Distribution of Neutron Exposures in the Galaxy. Disc: An Analytical Model, 55. Dhurde Samir see ...

  17. Author Index

    Indian Academy of Sciences (India)

    Author Index. Alecian, E. see Samadhi, R., 171; see Goupil, M.-J., 249. Antia, H. M. Helioseismology, 161. Ashoka, B. N. see Seetha, S., 301. Baudin, F. see Samadhi, R., 171. Boehm, T. see Goupil, M.-J., 249. Catala, C. see Goupil, M.-J., 249. Cunha Margarida S. Asteroseismic Theory of Rapidly Oscillating Ap Stars, 213.

  18. SUBJECT INDEX

    Indian Academy of Sciences (India)

    Unknown

    SUBJECT INDEX. Absorption. Effect of NaCl on the spectral and kinetic properties of cresyl violet (CV)-sodium dodecyl sulphate (SDS) complex. 299. Acid catalysts. Temperature-programmed desorption of water and ammonia on sulphated zirconia catalysts for measuring their strong acidity and acidity distribution. 281.

  19. Author Index

    Indian Academy of Sciences (India)

    J. Astrophys. Astr. (2008) 29, 405–409. Author Index. Aggarwal Malini see Jain Rajmal, 125; X-ray Emission Characteristics of Flares. Associated with CMEs, 195. Alyana Radharani see Rathod Jatin, 293; see Reddy Chandrasekhar, A., 313. Ambastha Ashok Helioseismic Effects of Energetic Transients, 93; see Maurya.

  20. SUBJECT INDEX

    Indian Academy of Sciences (India)

    Unknown

    SUBJECT INDEX. Ab initio calculations. Basis set effects on energy and hardness profiles of the hydrogen fluoride dimer. 549. Activation by calcinations. Highly active and reusable catalyst from Fe-Mg- hydrotalcite anionic clay for Friedel–Crafts type benzyla- tion reactions. 635. Adsorption. Adsorption studies of iron(III) on ...

  1. Author Index

    Indian Academy of Sciences (India)

    Author Index. Aggarwal Malini see Jain Rajmal, 155. Aghaee, A. Determination of the Mean Hi Absorption of the Intergalactic. Medium, 59. Agrawal, S. P. see Singh Ambika, 89. Biesiada Marek Could the Optical Transient SCP 06F6 be due to Micro- lensing?, 213. C¸ aliskan, S . see Küçük, ˙I., 135. Evans Lloyd, T. Carbon ...

  2. Author Index

    Indian Academy of Sciences (India)

    Author Index. Ahmad Farooq see Iqbal Naseer, 373. Ali Syed Salman Study of a Large Helical Eruptive Prominence Associated with. Double CME on 21 April 2001, 347; see Uddin Wahab, 267. Ali, A. Chemistry of Carbon Rich Star IRAS 15194–5115, 399. Ambastha Ashok Photospheric, Chromospheric and Helioseismic ...

  3. Subject Index

    Indian Academy of Sciences (India)

    J. Astrophys. Astr. (2006) 27, 469–472. Subject Index. Astrophysical Processes. Spatial Damping of Linear Compressional Magnetoacoustic Waves in Quiescent. Prominences (K. A. P. Singh), 321. Report on the Dynamical Evolution of an Axially Symmetric Quasar Model. (N. J. Papadopoulos & N. D. Caranicolas), 389.

  4. SUBJECT INDEX

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    SUBJECT INDEX. 1D inversion. A direct inversion scheme for deep resistivity sound- ing data using artificial neural networks. 49. 40. Ar-. 39. Ar thermochronology. Tectono-thermal evolution of the India-Asia colli- sion zone based on. 40. Ar-. 39. Ar thermochronology in. Ladakh, India. 737. ANN. Artificial neural network ...

  5. Index Fossils

    Indian Academy of Sciences (India)

    stricted geologic time range, easily preservable, of short species duration and found in multiple environment. Index fossils are used by geologists and palaeontologists as significant aids to determine the correlation and age of rock sequences [2]. Geologists use both large fossils or 'macrofossils' and microscopic fossils or ...

  6. Author Index

    Indian Academy of Sciences (India)

    user1

    Yan, X. L. see Deng, L. H., 221. Phase Relationship Between Sunspot Number, Flare Index and Solar Radio. Flux, 387. ZANINETTI, L. Revisiting the Cosmological Principle in a Cellular Framework, 399. ZHAO XIAN-FENG. Constraints on the Moment of Inertia of a Proto Neutron Star from the Hyperon Coupling Constants, ...

  7. Index Fossils

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 11; Issue 10. Index Fossils - Evidences from Plant Sources. Dipanjan Ghosh. General Article ... Author Affiliations. Dipanjan Ghosh1. Biological Science Department Kirnahar Shib Chandra High School Kirnahar, Birbhum 731302, West Bengal, India.

  8. Ptolemaic indexing

    Directory of Open Access Journals (Sweden)

    Magnus Lie Hetland

    2015-07-01

    Full Text Available This paper discusses a new family of bounds for use in similarity search, related to those used in metric indexing, but based on Ptolemy's inequality, rather than the metric axioms. Ptolemy's inequality holds for the well-known Euclidean distance, but is also shown here to hold for quadratic form metrics in general, with Mahalanobis distance as an important special case. The inequality is examined empirically on both synthetic and real-world data sets and is also found to hold approximately, with a very low degree of error, for important distances such as the angular pseudometric and several Lp norms. Indexing experiments are performed on several data sets, demonstrating a highly increased filtering power when using certain forms of Ptolemaic filtering, compared to existing, triangular methods. It is also shown that combining the Ptolemaic and triangular filtering can lead to better results than using either approach on its own.

  9. Comparison of characteristics and healing course of diabetic foot ulcers by etiological classification: neuropathic, ischemic, and neuro-ischemic type.

    Science.gov (United States)

    Yotsu, Rie Roselyne; Pham, Ngoc Minh; Oe, Makoto; Nagase, Takeshi; Sanada, Hiromi; Hara, Hisao; Fukuda, Shoji; Fujitani, Junko; Yamamoto-Honda, Ritsuko; Kajio, Hiroshi; Noda, Mitsuhiko; Tamaki, Takeshi

    2014-01-01

    To identify differences in the characteristics of patients with diabetic foot ulcers (DFUs) according to their etiological classification and to compare their healing time. Over a 4.5-year period, 73 patients with DFUs were recruited. DFUs were etiologically classified as being of neuropathic, ischemic, or neuro-ischemic origin. Descriptive analyses were performed to characterize study subjects, foot-related factors, and healing outcome and time. Duration of healing was assessed using the Kaplan-Meier method. Healing time among the three types was compared using the log rank test. The number of patients manifesting neuropathic, ischemic, and neuro-ischemic ulcers was 30, 20, and 14, respectively. Differences were identified for age, diabetes duration, body mass index, hypertension, and estimated glomerular filtration rate. Patients with neuro-ischemic ulcers had better ankle-brachial index, skin perfusion pressure (SPP), and transcutaneous oxygen pressure values compared to those with ischemic ulcers. The average time in which 50% of patients had healed wounds was 70, 113, and 233 days for neuropathic, neuro-ischemic, and ischemic ulcers, respectively. Main factors associated with healing were age and SPP values. Based on the etiological ulcer type, DFU healing course and several patient factors differed. Failure to consider the differences in DFU etiology may have led to heterogeneity of results in previous studies on DFUs. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Statin ameliorates endothelial dysfunction and insulin resistance in Tibet women with polycystic ovary syndrome.

    Science.gov (United States)

    Yang, B; Sun, Z-J; Chen, B; Zhang, J; Zhao, H; Li, C-W; Cao, Y-K; Cao, F

    2016-01-01

    Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. In Tibet population, little is known about the correlation between PCOS and endothelial function and insulin resistance. In this study, we investigated the efficacy of simvastatin on ameliorating endothelial dysfunction and insulin resistance in Tibet patients with PCOS. A group of 21 PCOS women was compared with 21 age-paired controls for blood pressure, body mass index (BMI), lipids, glucose and insulin levels. Plasma ET-1 was quantitated using a commercially available ELISA kits. The invasive vascular endothelial function was evaluated through the measurement of brachial artery flow-mediated dilation (FMD) in the fasting state using high-resolution B-mode ultrasound and ankle-brachial index (ABI) by using a blood pressure cuff and a Doppler instrument. PCOS women had higher BMI (p Tibet PCOS patients present a clustering of atherosclerosis risk factors (obesity, adverse lipid profile, hypertension and hyperglycemia) and more prevalent in insulin resistance and endothelial dysfunction than non-PCOS women. The endothelial function and insulin resistance of PCOS patients were ameliorated The endothelial function and insulin resistance of PCOS patients were ameliorated after statin administration.

  11. A comparative research on obesity hypertension by the comparisons and associations between waist circumference, body mass index with systolic and diastolic blood pressure, and the clinical laboratory data between four special Chinese adult groups.

    Science.gov (United States)

    Wu, Ou; Leng, Jian-Hang; Yang, Fen-Fang; Yang, Hai-Ming; Zhang, Hu; Li, Zeng-Fang; Zhang, Xing-Yu; Yuan, Cheng-Da; Li, Jia-Jia; Pan, Qi; Liu, Wei; Ren, Yan-Jun; Liu, Bing; Liu, Qing-Min; Cao, Cheng-Jian

    2018-01-01

    The obesity-hypertension pathogenesis is complex. From the phenotype to molecular mechanism, there is a long way to clarify the mechanism. To explore the association between obesity and hypertension, we correlate the phenotypes such as the waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), and diastolic blood pressure (DB) with the clinical laboratory data between four specific Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group), and the results may show something. To explore the mechanisms from obesity to hypertension by analyzing the correlations and differences between WC, BMI, SB, DB, and other clinical laboratory data indices in four specific Chinese adult physical examination groups. This cross-sectional study was conducted from September 2012 to July 2014, and 153 adult subjects, 34 women and 119 men, from 21 to 69 years, were taken from four characteristic Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group). The study was approved by the ethics committee of Hangzhou Center for Disease Control and Prevention. WC, BMI, SB, DB, and other clinical laboratory data were collected and analyzed by SPSS. Serum levels of albumin (ALB),alanine aminotransferase (ALT), low density lipoprotein cholesterol (LDLC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), alkaline phosphatase (ALP), uric acid (Ua), and TC/HDLC (odds ratio) were statistically significantly different between the four groups. WC statistically significantly positively correlated with BMI, ALT, Ua, and serum levels of glucose (GLU), and TC/HDLC, and negatively with ALB, HDLC, and serum levels of conjugated bilirubin (CB). BMI

  12. Hypocaloric diet supplemented with probiotic cheese improves body mass index and blood pressure indices of obese hypertensive patients--a randomized double-blind placebo-controlled pilot study.

    Science.gov (United States)

    Sharafedtinov, Khaider K; Plotnikova, Oksana A; Alexeeva, Ravilay I; Sentsova, Tatjana B; Songisepp, Epp; Stsepetova, Jelena; Smidt, Imbi; Mikelsaar, Marika

    2013-10-12

    Gut lactobacilli can affect the metabolic functions of healthy humans. We tested whether a 1500 kcal/d diet supplemented with cheese containing the probiotic Lactobacillus plantarum TENSIA (Deutsche Sammlung für Mikroorganismen, DSM 21380) could reduce some symptoms of metabolic syndrome in Russian adults with obesity and hypertension. In this 3-week, randomized, double-blind, placebo-controlled, parallel pilot study, 25 subjects ingested probiotic cheese and 15 ingested control cheese. Fifty grams of each cheese provided 175 kcal of energy. Blood pressure (BP), anthropometric characteristics, markers of liver and kidney function, metabolic indices (plasma glucose, lipids, and cholesterol), and urine polyamines were measured. Counts of fecal lactobacilli and L. plantarum TENSIA were evaluated using molecular methods. The data were analyzed by t-test for independent samples and Spearman's partial correlation analysis. The probiotic L. plantarum TENSIA was present in variable amounts (529.6 ± 232.5 gene copies) in 16/25 (64%) study subjects. Body mass index (BMI) was significantly reduced (p = 0.031) in the probiotic cheese group versus the control cheese group. The changes in BMI were closely associated with the water content of the body (r = 0.570, p = 0.0007) when adjusted for sex and age. Higher values of intestinal lactobacilli after probiotic cheese consumption were associated with higher BMI (r = 0.383, p = 0.0305) and urinary putrescine content (r = 0.475, p = 0.006). In patients simultaneously treated with BP-lowering drugs, similar reductions of BP were observed in both groups. A positive association was detected between TENSIA colonization and the extent of change of morning diastolic BP (r = 0.617, p = 0.0248) and a trend toward lower values of morning systolic BP (r = -0.527, p = 0.0640) at the end of the study after adjusting for BMI, age, and sex. In a pilot study of obese hypertensive patients, a hypocaloric diet supplemented with a probiotic cheese

  13. Peripheral arterial disease: an underestimated aetiology of exercise intolerance in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Castagna, Olivier; Boussuges, Alain; Nussbaum, Eric; Marqueste, Louis; Brisswalter, Jeanick

    2008-06-01

    To assess the prevalence of peripheral arterial disease and its implications for exercise limitation in chronic obstructive pulmonary disease (COPD) patients. One hundred and fifty-one moderate-to-severe COPD patients (forced expiratory volume in 1 s: 37+/-6 SD% predicted) and 73 healthy age-matched control individuals (divided into 31 smokers and 42 nonsmokers) participated in this study. All COPD patients were either exsmokers or current smokers and their tobacco-smoking history was similar to that of healthy smokers. To evaluate the existence of arterial disease, lower limb perfusion pressure impairment was assessed using the ankle brachial index, whereas arterial stiffness was assessed by the pulse wave velocity (PWV). The definition of peripheral arterial disease required an ankle brachial index value of 0.90 or less, whereas the PWV increment was considered to be a direct witness of arterial stiffness increase. A 6-min walk test was performed to assess physical exercise capacity. Prevalence of peripheral arterial disease was higher in COPD patients than in healthy participants (81+/-3 SD; 49+/-5 SD and 9+/-2 SD%, respectively, in COPD, healthy smokers and nonsmokers). PWV mean values were significantly higher in COPD patients compared with healthy smokers and nonsmokers (10.3+/-2.1 SD m/s; 9.2+/-1.3 SD m/s and 8.7+/-2.2 SD m/s, respectively). The distance covered during the 6-min-walk test was associated positively with the degree of peripheral arterial disease (r=0.78; P=0.05) and negatively with the PWV values (r=-0.74; P=0.05). Not only tobacco-smoking history but also COPD severity was shown to influence these associations. The effect of peripheral arterial disease on exercise intolerance in COPD seems to be considerable. Therefore, COPD patients participating in a pulmonary rehabilitation programme should profit from a systematic search for arterial disease. Arterial dysfunction has to be taken into account in the multidisciplinary treatment of these

  14. Storm pulse chemographs of saturation index and carbon dioxide pressure: implications for shifting recharge sources during storm events in the karst aquifer at Fort Campbell, Kentucky/Tennessee, USA

    Science.gov (United States)

    Vesper, Dorothy J.; White, William B.

    Continuous records of discharge, specific conductance, and temperature were collected through a series of storm pulses on two limestone springs at Fort Campbell, western Kentucky/Tennessee, USA. Water samples, collected at short time intervals across the same storm pulses, were analyzed for calcium, magnesium, bicarbonate, total organic carbon, and pH. Chemographs of calcium, calcite saturation index, and carbon dioxide partial pressure were superimposed on the storm hydrographs. Calcium concentration and specific conductance track together and dip to a minimum either coincident with the peak of the hydrograph or lag slightly behind it. The CO2 pressure continues to rise on the recession limb of the hydrograph and, as a result, the saturation index decreases on the recession limb of the hydrograph. These results are interpreted as being due to dispersed infiltration through CO2-rich soils lagging the arrival of quickflow from sinkhole recharge in the transport of storm flow to the springs. Karst spring hydrographs reflect not only the changing mix of base flow and storm flow but also a shift in source of recharge water over the course of the storm. L'enregistrement en continu du débit, de la conductivité et de la température de l'eau a été réalisé au cours d'une série de crues à deux sources émergeant de calcaires, à Fort Campbell (Kentucky occidental, Tennessee, États-Unis). Des échantillons d'eau, prélevés à de courts pas de temps lors de ces crues, ont été analysés pour le calcium, le magnésium, les bicarbonates, le carbone organique total et le pH. Les chimiogrammes de calcium, d'indice de saturation de la calcite et de la pression partielle en CO2 ont été superposés aux hydrogrammes de crue. La concentration en calcium et la conductivité de l'eau se suivent bien et passent par un minimum correspondant au pic de l'hydrogramme ou légèrement retardé. La pression partielle en CO2 continue de croître au cours de la récession de l

  15. Dynamic analysis with a fractional-order chaotic system for estimation of peripheral arterial disease in diabetic foot

    Science.gov (United States)

    Li, Chien-Ming; Du, Yi-Chun; Wu, Jian-Xing; Lin, Chia-Hung; Ho, Yueh-Ren; Chen, Tainsong

    2013-08-01

    Lower-extremity peripheral arterial disease (PAD) is caused by narrowing or occlusion of vessels in patients like type 2 diabetes mellitus, the elderly and smokers. Patients with PAD are mostly asymptomatic; typical early symptoms of this limb-threatening disorder are intermittent claudication and leg pain, suggesting the necessity for accurate diagnosis by invasive angiography and ankle-brachial pressure index. This index acts as a gold standard reference for PAD diagnosis and categorizes its severity into normal, low-grade and high-grade, with respective cut-off points of ≥0.9, 0.9-0.5 and diabetics and 11 healthy adults, with analysis of dynamic errors based on various butterfly motion patterns, and color relational analysis as classifier for pattern recognition. The results show that the classification of PAD severity among these testees was achieved with high accuracy and efficiency. This noninvasive methodology potentially provides timing and accessible feedback to patients with asymptomatic PAD and their physicians for further invasive diagnosis or strict management of risk factors to intervene in the disease progression.

  16. Dynamic analysis with a fractional-order chaotic system for estimation of peripheral arterial disease in diabetic foot

    International Nuclear Information System (INIS)

    Li, Chien-Ming; Wu, Jian-Xing; Chen, Tainsong; Du, Yi-Chun; Lin, Chia-Hung; Ho, Yueh-Ren

    2013-01-01

    Lower-extremity peripheral arterial disease (PAD) is caused by narrowing or occlusion of vessels in patients like type 2 diabetes mellitus, the elderly and smokers. Patients with PAD are mostly asymptomatic; typical early symptoms of this limb-threatening disorder are intermittent claudication and leg pain, suggesting the necessity for accurate diagnosis by invasive angiography and ankle-brachial pressure index. This index acts as a gold standard reference for PAD diagnosis and categorizes its severity into normal, low-grade and high-grade, with respective cut-off points of ≥0.9, 0.9–0.5 and <0.5. PAD can be assessed using photoplethysmography as a diagnostic screening tool, displaying changes in pulse transit time and shape, and dissimilarities of these changes between lower limbs. The present report proposed photoplethysmogram with fractional-order chaotic system to assess PAD in 14 diabetics and 11 healthy adults, with analysis of dynamic errors based on various butterfly motion patterns, and color relational analysis as classifier for pattern recognition. The results show that the classification of PAD severity among these testees was achieved with high accuracy and efficiency. This noninvasive methodology potentially provides timing and accessible feedback to patients with asymptomatic PAD and their physicians for further invasive diagnosis or strict management of risk factors to intervene in the disease progression. (paper)

  17. Influence of controlled vascular training on the pain free walking distance and plasmaviscosity in patients suffering from peripheral arterial occlusive disease.

    Science.gov (United States)

    Häfner, Hans-Martin; Jünger, Irmgard; Geyer, Annette; Jünger, Michael; Strölin, Anke

    2009-01-01

    Does controlled vascular training influence plasmaviscosity and the pain free walking distance in patients with peripheral arterial occlusive disease (paod) Fontaine stage II?37 patients, 24 men and 13 women with a mean age of 64.5 years SD 8.5 took part in ambulant vascular training over a period of 12 months.Before, after 6 months and after 12 months, pain free (pfwd) and maximum walking distance (mwd) was measured using a standardized treadmill program. Also ankle-brachials systolic pressure index (a-bspi), transcutaneous oxygen tension (tcPO2) and plasmaviscosity (pv) were measured.Pfwd increased from 212 SD 143 m to 371 SD 249 m (ptraining, but without statistically significance. A-bspi increased between the first 6 months of training statistically significant. Before training pv was 1.31 mPa s SD 0.10, after training period of 6 months it was 1.27 mPa s SD 0.11 (p=0.06) and 12 months later it was 1.28 SD 0.11 mPa s (p=0.35). The improvement of pfwd and the decrease of pv correlates (r=-0.39, p=0.05).In most patients, arterial vascular training improves pfwd and mwd. Simultaneously to the increase of the walking distances plasmaviscosity decreases and crurobrachial indexes increases. We found a coupling between improvement of pfwd and pv. Pv seems to participate in improvement of leg hemodynamics in patients with paod.

  18. Elevated serum alkaline phosphatase and peripheral arterial disease in the United States National Health and Nutrition Examination Survey 1999-2004.

    Science.gov (United States)

    Cheung, Bernard M Y; Ong, Kwok Leung; Wong, Louisa Y F

    2009-06-26

    Alkaline phosphatase (ALP) is elevated in peripheral arterial disease (PAD). We therefore examined the relationship of PAD with ALP and other liver enzymes in the United States National Health and Nutrition Examination Survey 1999-2004. The analysis included 5995 men and non-pregnant women aged >or=40 years with no missing data in variables of interest. PAD was defined as ankle-brachial blood pressure index (ABI) alkaline phosphatase (ALP) level was associated significantly with lower ABI after adjustment for confounding factors (p=0.019). No significant association of ABI with other liver enzymes was found. Serum ALP level increased with increasing age, body mass index, C-reactive protein, monocyte count, serum uric acid, lead, cadmium, and prevalence of hypercholesterolemia, diabetes, smoking, non-alcohol drinking, and cardiovascular diseases after adjusting for age, sex, race/ethnicity, and survey years (p90 ml/min/1.73 m(2)), the odds ratio increased to 4.22 (95% CI 1.45-12.35) (p=0.010). Elevated serum ALP is correlated with PAD, independent of other traditional cardiovascular risk factors.

  19. Investigation on Cardiovascular Risk Prediction Using Physiological Parameters

    Directory of Open Access Journals (Sweden)

    Wan-Hua Lin

    2013-01-01

    Full Text Available Cardiovascular disease (CVD is the leading cause of death worldwide. Early prediction of CVD is urgently important for timely prevention and treatment. Incorporation or modification of new risk factors that have an additional independent prognostic value of existing prediction models is widely used for improving the performance of the prediction models. This paper is to investigate the physiological parameters that are used as risk factors for the prediction of cardiovascular events, as well as summarizing the current status on the medical devices for physiological tests and discuss the potential implications for promoting CVD prevention and treatment in the future. The results show that measures extracted from blood pressure, electrocardiogram, arterial stiffness, ankle-brachial blood pressure index (ABI, and blood glucose carry valuable information for the prediction of both long-term and near-term cardiovascular risk. However, the predictive values should be further validated by more comprehensive measures. Meanwhile, advancing unobtrusive technologies and wireless communication technologies allow on-site detection of the physiological information remotely in an out-of-hospital setting in real-time. In addition with computer modeling technologies and information fusion. It may allow for personalized, quantitative, and real-time assessment of sudden CVD events.

  20. The AMC Linear Disability Score (ALDS: a cross-sectional study with a new generic instrument to measure disability applied to patients with peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Legemate Dink A

    2009-10-01

    Full Text Available Abstract Background The AMC Linear Disability Score (ALDS is a calibrated generic itembank to measure the level of physical disability in patients with chronic diseases. The ALDS has already been validated in different patient populations suffering from chronic diseases. The aim of this study was to assess the clinimetric properties of the ALDS in patients with peripheral arterial disease. Methods Patients with intermittent claudication (IC and critical limb ischemia (CLI presenting from January 2007 through November 2007 were included. Risk factors for atherosclerosis, ankle/brachial index and toe pressure, the Vascular Quality of Life Questionnaire (VascuQol, and the ALDS were recorded. To compare ALDS and VascuQol scores between the two patient groups, an unpaired t-test was used. Correlations were determined between VascuQol, ALDS and pressure measurements. Results Sixty-two patients were included (44 male, mean ± sd age was 68 ± 11 years with IC (n = 26 and CLI (n = 36. The average ALDS was significantly higher in patients with IC (80, ± 10 compared to patients with CLI (64, ± 18. Internal reliability consistency of the ALDS expressed as Cronbach's α coefficient was excellent (α > 0.90. There was a strong convergent correlation between the ALDS and the disability related Activity domain of the VascuQol (r = 0.64. Conclusion The ALDS is a promising clinimetric instrument to measure disability in patients with various stages of peripheral arterial disease.

  1. Sarpogrelate hydrochloride, a selective 5-hydroxytryptamine(2A) antagonist, augments autologous bone marrow mononuclear cell implantation-induced improvement in endothelium-dependent vasodilation in patients with critical limb ischemia.

    Science.gov (United States)

    Higashi, Yukihito; Miyazaki, Masanori; Goto, Chikara; Sanada, Hiroaki; Sueda, Taijiro; Chayama, Kazuaki

    2010-01-01

    The purpose of this study was to determine the effect of a combination of bone marrow mononuclear cell (BM-MNC) implantation and sarpogrelate, a selective 5-HT(2A) antagonist, on endothelial function in patients with critical limb ischemia (CLI). We evaluated the leg blood flow (LBF) responses to acetylcholine (ACh) and sodium nitroprusside before and after BM-MNC implantation in 16 patients with CLI. We divided patients with CLI into 2 groups: those cotreated with sarpogrelate orally for 12 weeks (sarpogrelate group, n = 8) and those who remained on conventional therapy (control group, n = 8). LBF was measured by strain gauge plethysmography. BM-MNC implantation improved ankle brachial pressure index, transcutaneous oxygen pressure, and pain-free walking time. There was no significant difference in these parameters between the 2 groups. Before BM-MNC implantation, LBF responses to ACh were similar in the sarpogrelate group and control group. Twelve weeks of BM-MNC implantation enhanced LBF responses to ACh in the sarpogrelate and control groups. After 12 weeks of BM-MNC implantation, LBF response to ACh was significantly greater in the sarpogrelate group than in the control group. BM-MNC implantation did not alter the LBF responses to sodium nitroprusside in either group. These findings suggest that BM-MNC implantation improved not only limb ischemic symptoms but also endothelium-dependent vasodilation in patients with CLI. A combination of BM-MNC implantation and sarpogrelate had a more beneficial effect on vascular function in these patients.

  2. Endovascular repair of aortic isthmus coarctation with a self-expanding covered stent.

    Science.gov (United States)

    Oberhuber, Alexander; Muehling, Bernd M; Orend, Karl-Heinz; Schelzig, Hubert

    2012-05-01

    Coarctation is one of the most often seen congenital aortal defects. In the majority, diagnosis will be made in newborns. Endovascular repair is critical in children owing to their growth, but in adult patients, it is an interesting alternative. A 31-year-old man presenting with hypertension of upper extremities and pulseless lower extremities was admitted to our hospital. Systolic blood pressure was 190 mm Hg, although a triple antihypertensive medication was administered. Computed tomographic angiography showed a nearly total occlusion of the aortic isthmus. Coarctation was treated by an endovascular approach with a self-expanding covered stent-graft (Medtronic Talent; Medtronic World Medical, Sunrise, FL) after predilatation with a Reliant balloon (Medtronic World Medical, Sunrise, FL). After a follow-up of 40 months, the patient is normotensive and antihypertensive medication could be reduced. Lower extremities showed normal pulses and normal ankle-brachial index. Computed tomographic scans showed unchanged stent-graft position, with constant slight waist. Endovascular repair of atresia or coarctation of the thoracic aorta is a minimal invasive debatable option. Not only reduction of blood pressure but also reduction of left ventricular mass and prolongation of life expectancy can be achieved by endovascular treatment. Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  3. Imaging of vascular dynamics within the foot using dynamic diffuse optical tomography to diagnose peripheral arterial disease

    Science.gov (United States)

    Khalil, M. A.; Kim, H. K.; Hoi, J. W.; Kim, I.; Dayal, R.; Shrikande, G.; Hielscher, A. H.

    2013-03-01

    Peripheral Arterial Disease (PAD) is the narrowing of the functional area of the artery generally due to atherosclerosis. It affects between 8-12 million people in the United States and if untreated this can lead to ulceration, gangrene and ultimately amputation. The current diagnostic method for PAD is the ankle-brachial index (ABI). The ABI is a ratio of the patient's systolic blood pressure in the foot to that of the brachial artery in the arm, a ratio below 0.9 is indicative of affected vasculature. However, this method is ineffective in patients with calcified arteries (diabetic and end-stage renal failure patients), which falsely elevates the ABI recording resulting in a false negative reading. In this paper we present our results in a pilot study to deduce optical tomography's ability to detect poor blood perfusion in the foot. We performed an IRB approved 30 patient study, where we imaged the feet of the enrolled patients during a five stage dynamic imaging sequence. The patients were split up into three groups: 10 healthy subjects, 10 PAD patients and 10 PAD patients with diabetes and they were imaged while applying a pressure cuff to their thigh. Differences in the magnitude of blood pooling in the foot and rate at which the blood pools in the foot are all indicative of arterial disease.

  4. The study on risk factor of metabolic diseases in pancreatic steatosis

    International Nuclear Information System (INIS)

    Cho, Jin Young; Ye, Soo Young; Kim, Dong Hyun

    2016-01-01

    The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDLcholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease

  5. An integrated care pathway to save the critically ischaemic diabetic foot.

    Science.gov (United States)

    El Sakka, K; Fassiadis, N; Gambhir, R P S; Halawa, M; Zayed, H; Doxford, M; Greensitt, C; Edmonds, M; Rashid, H

    2006-06-01

    This prospective study describes and evaluates the efficacy of an integrated care pathway for the management of the critically ischaemic diabetic foot patients by a multidisciplinary team. A weekly joint diabetes/vascular/podiatry ward round and outpatient clinic was established where patients were assessed within 7 days of referral by clinical examination, ankle-brachial-index-pressures, duplex angiogram and transcutaneous oxygen pressures. An angiogram +/- angioplasty or alternatively a magnetic resonance angiography prior to surgical revascularisation was performed in patients deemed not suitable for angioplasty based on the above vascular assessment. Between January 2002 and June 2003(18 months), 128 diabetic patients with lower limb ischaemia were seen. Thirty-four (26.6%) patients received medical treatment alone, and 18 (14.1%) were deemed 'palliative' due to their significant co-morbidities. The remaining 76 (59.4%) patients underwent either angioplasty (n = 56), surgical reconstruction (n = 18), primary major amputation (n = 2) or secondary amputation after surgical revascularisation (n = 1). Minor toe amputations were required in 35 patients. The mortality in the intervention group was 14% (11/76). This integrated multidisciplinary approach offers a consistent and equitable service to diabetic patients with critically ischaemic feet and appears to have a beneficial major/minor amputation ratio.

  6. The study on risk factor of metabolic diseases in pancreatic steatosis

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jin Young; Ye, Soo Young; Kim, Dong Hyun [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2016-03-15

    The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDLcholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease.

  7. Sovereign debt crises in Latin America : A market pressure approach

    NARCIS (Netherlands)

    Boonman, T.M.; Jacobs, J.P.A.M.; Kuper, G.H.

    2013-01-01

    We construct a continuous sovereign debt crisis index for four large Latin American countries for the period 1870-2012. Our sovereign debt crisis index is similar to the Exchange Market Pressure Index for currency crises, and the Money Market Pressure Index for banking crises. To obtain the optimal

  8. Atmospheric stability index using radio occultation refractivity profiles

    Indian Academy of Sciences (India)

    A new stability index based on atmospheric refractivity at ∼500 hPa level and surface measurements of temperature, pressure and humidity is formulated. The new index named here as refractivity based lifted index (RLI) is designed to give similar results as traditionally used lifted index derived from radiosonde profiles of ...

  9. The Index of Refraction of Seawater

    Science.gov (United States)

    1976-01-01

    the three temper- atures. By integrating these linear gradients, we recovered the index of refrection dependence on pressure, at each of the three...U.S. DEPARTMENT OF COMMERCE National Technical Information Service AD-A024 800 The Index of Refraction of Seawater Scripps Institution of...or Government Reports NTIS reports are distributed in the SAIM Announcements and Index categories, or to program. You will receive a notice in your the

  10. Exposure to secondhand smoke and risk of peripheral arterial disease in southern Chinese non-smokers: The Guangzhou Biobank Cohort Study-Cardiovascular Disease Sub-cohort.

    Science.gov (United States)

    Lu, Liya; Jiang, Chaoqiang; Mackay, Danny F; Pell, Jill P; Cheng, Kar Keung; Lam, Tai Hing; Thomas, G Neil

    2017-06-01

    Objectives We studied the association between secondhand smoke (SHS) exposure and peripheral arterial disease (PAD) in Chinese non-smokers. Methods We conducted a cross-sectional study using baseline data from the Guangzhou Biobank Cohort Study: Cardiovascular Disease Sub-cohort Study (GBCS-CVD). Guangzhou residents aged ≥ 50 years were recruited between 2003 and 2008. Baseline data included measurement of ankle brachial pressure index (ABPI) and self-reported smoking status and SHS exposure. Univariate and multivariate logistic regression analyses were used to analyze the association between SHS and PAD (defined as ABPI Exposure to SHS at home of ≥25 h per week was reported by 16.7% of PAD cases compared with 3.8% of those without PAD (χ2 test, p = 0.003). After adjustment for potential confounders, exposure to ≥25 h per week at home was still associated with PAD (adjusted OR 7.86, 95% CI 2.00-30.95, p = 0.003), with suggestion of a dose-response relationship. Conclusions Our results extend the US Surgeon General's 2006 report that SHS exposure is an independent risk factor for PAD. National smoke-free legislation is needed to protect all people from exposure.

  11. The contribution of arterial calcification to peripheral arterial disease in pseudoxanthoma elasticum.

    Directory of Open Access Journals (Sweden)

    Georges Leftheriotis

    Full Text Available The contribution of arterial calcification (AC in peripheral arterial disease (PAD and arterial wall compressibility is a matter of debate. Pseudoxanthoma elasticum (PXE, an inherited metabolic disease due to ABCC6 gene mutations, combines elastic fiber fragmentation and calcification in various soft tissues including the arterial wall. Since AC is associated with PAD, a frequent complication of PXE, we sought to determine the role of AC in PAD and arterial wall compressibility in this group of patients.Arterial compressibility and patency were determined by ankle-brachial pressure index (ABI in a cohort of 71 PXE patients (mean age 48 ± SD 14 yrs, 45 women and compared to 30 controls without PAD. Lower limb arterial calcification (LLAC was determined by non-contrast enhanced helicoidal CT-scan. A calcification score (Ca-score was computed for the femoral, popliteal and sub-popliteal artery segments of both legs. Forty patients with PXE had an ABI1.40. LLAC increased with age, significantly more in PXE subjects than controls. A negative association was found between LLAC and ABI (r = -0.363, p = 0.002. The LLAC was independently associated with PXE and age, and ABI was not linked to cardiovascular risk factors.The presence of AC was associated with PAD and PXE without affecting arterial compressibility. PAD in PXE patients is probably due to proximal obstructive lesions developing independently from cardiovascular risk factors.

  12. The contribution of arterial calcification to peripheral arterial disease in pseudoxanthoma elasticum.

    Science.gov (United States)

    Leftheriotis, Georges; Kauffenstein, Gilles; Hamel, Jean François; Abraham, Pierre; Le Saux, Olivier; Willoteaux, Serge; Henrion, Daniel; Martin, Ludovic

    2014-01-01

    The contribution of arterial calcification (AC) in peripheral arterial disease (PAD) and arterial wall compressibility is a matter of debate. Pseudoxanthoma elasticum (PXE), an inherited metabolic disease due to ABCC6 gene mutations, combines elastic fiber fragmentation and calcification in various soft tissues including the arterial wall. Since AC is associated with PAD, a frequent complication of PXE, we sought to determine the role of AC in PAD and arterial wall compressibility in this group of patients. Arterial compressibility and patency were determined by ankle-brachial pressure index (ABI) in a cohort of 71 PXE patients (mean age 48 ± SD 14 yrs, 45 women) and compared to 30 controls without PAD. Lower limb arterial calcification (LLAC) was determined by non-contrast enhanced helicoidal CT-scan. A calcification score (Ca-score) was computed for the femoral, popliteal and sub-popliteal artery segments of both legs. Forty patients with PXE had an ABI1.40. LLAC increased with age, significantly more in PXE subjects than controls. A negative association was found between LLAC and ABI (r = -0.363, p = 0.002). The LLAC was independently associated with PXE and age, and ABI was not linked to cardiovascular risk factors. The presence of AC was associated with PAD and PXE without affecting arterial compressibility. PAD in PXE patients is probably due to proximal obstructive lesions developing independently from cardiovascular risk factors.

  13. Association of depressive symptoms, trait anxiety, and perceived stress with subclinical atherosclerosis: results from the Chicago Healthy Aging Study (CHAS).

    Science.gov (United States)

    Hernandez, Rosalba; Allen, Norrina Bai; Liu, Kiang; Stamler, Jeremiah; Reid, Kathryn Jean; Zee, Phyllis C; Wu, Donghong; Kang, Joseph; Garside, Daniel B; Daviglus, Martha L

    2014-04-01

    Examine the association between multiple psychological factors (depressive symptoms, trait anxiety, perceived stress) and subclinical atherosclerosis in older age. This cross-sectional study included 1101 adults ages 65-84 from the Chicago Healthy Aging Study (CHAS - 2007-2010). Previously validated self-report instruments were used to assess psychological factors. Non-invasive methods were used to assess subclinical atherosclerosis in two regions of the body, i.e., ankle-brachial blood pressure index (ABI) and coronary artery calcification (CAC). Multivariate logistic regression was used to examine the association between each psychological measure and subclinical atherosclerosis, after the adjustment for socio-demographic factors, sleep quality, young adulthood/early middle age and late-life CVD risk status, and psychological ill-being as appropriate. The burden of major cardiovascular disease risk factors did not significantly differ across tertiles of psychological factors. In multivariate adjusted models, trait anxiety was associated with calcification: those in the second tertile were significantly more likely to have CAC >0 compared to those in the lowest anxiety tertile [OR=1.68; 95% CI=1.09-2.58], but no significant difference was observed for Tertile III of trait anxiety [OR=1.31; 95% CI=0.75-2.27]. No association was seen between psychological measures and ABI. Of several psychological factors, only trait anxiety was significantly associated with CAC. Copyright © 2014. Published by Elsevier Inc.

  14. Rationale and protocol of a trial for prevention of diabetic atherosclerosis by using antiplatelet drugs: study of Diabetic Atherosclerosis Prevention by Cilostazol (DAPC study

    Directory of Open Access Journals (Sweden)

    Kawamori Ryuzo

    2006-08-01

    Full Text Available Abstract Background Secondary treatment of arteriosclerosis may be applicable for the primary prevention of atherosclerosis in diabetic patients. This prospective, 2-year follow-up study was designed to determine the efficacy and safety of antiplatelet therapy in the prevention of atherosclerosis of diabetic subjects. Methods Patients with type 2 diabetes and arteriosclerosis obliterans from the Eastern Asian countries were registered online and randomly assigned either to the aspirin group (81–100 mg/day or the cilostazol group (100–200 mg/day in this international, 2-year, prospective follow-up interventional study. Results The primary study endpoint was changes in right and left maximum intima-media thickness of the common carotid artery. Secondary endpoints include changes in right and left maximum intima-media thickness of the internal carotid artery; semiquantitative evaluation of cerebral infarction by magnetic resonance imaging; cardiovascular events including sudden death, stroke, transient cerebral ischemic attacks, acute myocardial infarction, angina, and progression of arteriosclerosis obliterans; overall death; withdrawal; and change in ankle-brachial pressure index. Conclusion This is the first study to use an online system that was developed in Asian countries for pooling data from an international clinical trial. These findings are expected to help in the prevention of diabetic atherosclerosis and subsequent cardiovascular and cerebrovascular disease.

  15. Outcome of 'Kissing Stents' for Aortoiliac Atherosclerotic Disease, Including the Effect on the Non-diseased Contralateral Iliac Limb

    International Nuclear Information System (INIS)

    Mohamed, Faheez; Sarkar, B.; Timmons, G.; Mudawi, A.; Ashour, H.; Uberoi, R.

    2002-01-01

    Purpose: To assess outcomes following 'kissing stents' for aortoiliac atherosclerotic disease,particularly in the non-diseased/non-symptomatic limb. Methods: Twenty-four patients underwent kissing stenting over 36 months. There were 36 symptomatic and 12 non-symptomatic/non-diseased limbs. Patients were prospectively followed with 3-monthly clinical assessment as well as duplex ultrasound. Results: At 23.5 months follow-up (range 3-36 months), 75% of patients had improvement in symptoms, 20% no change and 5% had deterioration. Sixty-one percent of limbs maintained an increase in ankle-brachial pressure index of >0.1. There were 15 reinterventions in nine patients, including three in non-symptomatic/non-diseased limbs. Primary patency at 6, 12 and 24 months was 94%, 81% and 58%, respectively. Primary assisted and secondary patency rates were 96%, 84% and 84% respectively for diseased limbs, and 92% and 100% for non-symptomatic/non-diseased limbs. Although reinterventions were required, there were no long-term occlusions in the non-diseased/non-symptomatic limb. Conclusion: Kissing stents offer an invaluable alternative to surgery. There were no long-term occlusions following kissing stents in a previously non-symptomatic/non-diseased limb

  16. Clinical Evaluation of Human Umbilical Cord Mesenchymal Stem Cell Transplantation After Angioplasty for Diabetic Foot.

    Science.gov (United States)

    Qin, H L; Zhu, X H; Zhang, B; Zhou, L; Wang, W Y

    2016-09-01

    Aims: The multilineage differentiation potential of human umbilical cord mesenchymal stem cells (HUCMSCs) holds therapeutic promise for non-healing ulcers and tissue regeneration. The present study evaluated the effects of HUCMSC transplantation after angioplasty for treatment of diabetic foot. Methods: Included in the study were 53 patients (72 limbs) with severe symptoms of Fontaine II-IV diabetic foot accompanied by varying degrees of lower extremity arterial disease. The patients were randomly apportioned to a control group (25 patients; 38 limbs) or an experimental group (28 patients; 34 limbs). Patients of both groups received interventional treatment with angioplasty; those in the experimental group also received HUCMSCs by endovascular infusion and injection around the foot ulcer. Results: Within the 3-month follow-up, relative to patients in the control group, those in the experimental group experienced significantly greater and more stable improvements in skin temperature, ankle-brachial pressure index, transcutaneous oxygen tension, and claudication distance. Notably, 3 months after treatment a significant increase in neovessels, accompanied by complete or gradual ulcer healing, was shown in the experimental group. In addition, no serious complications or adverse reactions were associated with the treatment. Conclusion: Therefore, our results indicate that HUCMSC transplantation after angioplasty is a safe and effective clinical therapy for severe diabetic foot. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Sulodexide as Adjunctive Therapy in Diabetic Foot Patients With Critical Limb Ischemia Treated With Percutaneous Transluminal Angioplasty.

    Science.gov (United States)

    Piaggesi, Alberto; Abbruzzese, Lorenza; Mattaliano, Chiara; Bargellini, Irene; Cicorelli, Antonello; Iacopi, Elisabetta; Lunardi, Alessandro; Coppelli, Alberto; Goretti, Chiara; Cioni, Roberto

    2014-06-01

    We evaluated the safety and efficacy of sulodexide, a biocompound of glycosamin-glicans, as adjunct medical therapy to percutaneous transluminal angioplasty (PTA) in diabetes mellitus (DM) patients with critical limb ischemia (CLI). We studied 27 consecutive DM patients with CLI successfully subjected to PTA who, on top of standard antiplatelet therapy, received sulodexide 25 mg bid, and were followed-up for 24 weeks, monitoring adverse events, transcutaneous oxygen tension (TcPO 2 ), ankle-brachial pressure index, pain, and ulcer dimension. At the end of follow-up, ulcer healing, amputation rates, and cardiovascular risk profile of patients were evaluated. Patients were compared with a historical superimposable control group that was treated for the same indications in the same way as the study group, except for sulodexide inception. No differences in ulcer healing and amputation rates were found at the end of follow-up between the groups. In the study group, TcPO 2 was significantly (P < .05) higher at the end of follow-up, and pain intensity was reduced more rapidly. Plasma fibrinogen and plasma creatinine concentration were significantly (P < .05) reduced in study group at the end of follow-up. No differences in adverse events were observed between the groups during follow-up. Our data suggest that sulodexide administration after PTA, on top of antiplatelet therapy, may improve the outcome of PTA in DM patients with CLI by improving microcirculatory function. © The Author(s) 2014.

  18. Safety and Effectiveness of Bone Marrow Cell Concentrate in the Treatment of Chronic Critical Limb Ischemia Utilizing a Rapid Point-of-Care System

    Directory of Open Access Journals (Sweden)

    Venkatesh Ponemone

    2017-01-01

    Full Text Available Critical limb ischemia (CLI is the end stage of lower extremity peripheral vascular disease (PVD in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17 no-option CLI patients with ischemic rest pain were enrolled in the study. Single dose of aBMC, prepared utilizing an intraoperative point-of-care device, the Res-Q™ 60 BMC system, was injected intramuscularly into the afflicted limb and patients were followed up at regular intervals for 12 months. A statistically significant improvement in Ankle Brachial Index (ABI, Transcutaneous Oxygen Pressure (TcPO2, mean rest pain and intermittent claudication pain scores, wound/ ulcer healing, and 6-minute walking distance was observed following aBMC treatment. Major amputation-free survival (mAFS rate and amputation-free rates (AFR at 12 months were 70.6% and 82.3%, respectively. In conclusion, aBMC injections were well tolerated with improved tissue perfusion, confirming the safety, feasibility, and preliminary effectiveness of aBMC treatment in CLI patients.

  19. Umbilical Cord-Derived Mesenchymal Stem Cells Relieve Hindlimb Ischemia through Enhancing Angiogenesis in Tree Shrews

    Directory of Open Access Journals (Sweden)

    Cunping Yin

    2016-01-01

    Full Text Available Hindlimb ischemia is still a clinical problem with high morbidity and mortality. Patients suffer from consequent rest pain, ulcers, cool limbs, and even amputation. Angiogenesis is a promising target for the treatment of ischemic limbs, providing extra blood for the ischemic region. In the present study, we investigated the role of umbilical cord-derived mesenchymal stem cells (UC-MSCs in regulating angiogenesis and relieving hindlimb ischemia. UC-MSCs were isolated from the umbilical cord of tree shrews. Angiography results showed that UC-MSCs injection significantly promoted angiogenesis in tree shrews. Moreover, the ankle brachial index, transcutaneous oxygen pressure, blood perfusion, and capillary/muscle fiber ratio were all markedly increased by the application of UC-MSCs. In addition, the conditioned culture of human umbilical vein endothelial cells using medium collected from UC-MSCs showed higher expression of angiogenic markers and improved migration ability. In short, the isolated UC-MSCs notably contributed to restoring blood supply and alleviating the symptoms of limb ischemia through enhancing angiogenesis.

  20. Umbilical Cord-Derived Mesenchymal Stem Cells Relieve Hindlimb Ischemia through Enhancing Angiogenesis in Tree Shrews.

    Science.gov (United States)

    Yin, Cunping; Liang, Yuan; Zhang, Jian; Ruan, Guangping; Li, Zian; Pang, Rongqing; Pan, Xinghua

    2016-01-01

    Hindlimb ischemia is still a clinical problem with high morbidity and mortality. Patients suffer from consequent rest pain, ulcers, cool limbs, and even amputation. Angiogenesis is a promising target for the treatment of ischemic limbs, providing extra blood for the ischemic region. In the present study, we investigated the role of umbilical cord-derived mesenchymal stem cells (UC-MSCs) in regulating angiogenesis and relieving hindlimb ischemia. UC-MSCs were isolated from the umbilical cord of tree shrews. Angiography results showed that UC-MSCs injection significantly promoted angiogenesis in tree shrews. Moreover, the ankle brachial index, transcutaneous oxygen pressure, blood perfusion, and capillary/muscle fiber ratio were all markedly increased by the application of UC-MSCs. In addition, the conditioned culture of human umbilical vein endothelial cells using medium collected from UC-MSCs showed higher expression of angiogenic markers and improved migration ability. In short, the isolated UC-MSCs notably contributed to restoring blood supply and alleviating the symptoms of limb ischemia through enhancing angiogenesis.

  1. Changes in flow-mediated dilatation in patients with femoropopliteal occlusion receiving conservative and invasive treatment.

    Science.gov (United States)

    Pawlaczyk, Katarzyna; Gabriel, Marcin; Urbanek, Tomasz; Dzieciuchowicz, Łukasz; Begier-Krasińska, Beata; Stanisić, Michał; Wachal, Krzysztof; Zieliński, Maciej

    2016-01-01

    Although the beneficial effect of revascularisation on reduction of local clinical ischaemic symptoms has been well established, its effect on systemic vascular endothelial function has not been fully explained yet. To determine changes in endothelium-dependent flow-mediated dilatation in patients with unilateral femoropopliteal occlusion receiving medical and surgical treatment. Seventy-nine patients with symptomatic atherosclerotic ischaemia of lower extremities, treated with endovascular procedures, with femoropopliteal graft, or receiving conservative treatment (21-day controlled treadmill training) were enrolled in the study. Ankle brachial pressure index (ABPI), skin blood flow on the feet, and flow-mediated dilatation (FMD) of brachial arteries were measured in each patient at baseline and after 90 days of follow-up. The ABPI, vasomotion in the myogenic frequency band, and FMD increased significantly in surgical patients. In patients after femoropopliteal bypass a significant increase of vasomotion in the endothelial frequency band was also observed. In patients receiving conservative treatment (treadmill training), vasomotion in the myogenic frequency band increased whereas the FMD remained unchanged. It seems that surgical treatment may contribute to reducing the risk of cardiovascular complications in patients with advanced peripheral artery disease, as a result of improving the systemic vascular endothelial function. Limiting treatment to just treadmill training increases pain-free walking distance but does not improve systemic vascular endothelial function.

  2. Indoxyl Sulfate Impairs Endothelial Progenitor Cells and Might Contribute to Vascular Dysfunction in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Cheng-Jui Lin

    2016-12-01

    Full Text Available Background/Aims: Indoxyl sulfate (IS is a protein-bound uremic toxin that accumulates in patients with chronic kidney disease (CKD. We explored the effect of IS on human early endothelial progenitor cells (EPCs and analyzed the correlation between serum IS levels and parameters of vascular function, including endothelial function in a CKD-based cohort. Methods: A cross-sectional study with 128 stable CKD patients was conducted. Flow-mediated dilation (FMD, pulse wave velocity (PWV, ankle brachial index, serum IS and other biochemical parameters were measured and analyzed. In parallel, the activity of early EPCs was also evaluated after exposure to IS. Results: In human EPCs, a concentration-dependent inhibitory effect of IS on chemotactic motility and colony formation was observed. Additionally, serum IS levels were significantly correlated with CKD stages. The total IS (T-IS and free IS (F-IS were strongly associated with age, hypertension, cardiovascular disease, blood pressure, PWV, blood urea nitrogen, creatine and phosphate but negatively correlated with FMD, the estimated glomerular filtration rate (eGFR, hemoglobin, hematocrit, and calcium. A multivariate linear regression analysis also showed that FMD was significantly associated with IS after adjusting for other confounding factors. Conclusions: In humans, IS impairs early EPCs and was strongly correlated with vascular dysfunction. Thus, we speculate that this adverse effect of IS may partly result from the inhibition of early EPCs.

  3. Oscillometric blood pressure measurements: differences between measured and calculated mean arterial pressure.

    NARCIS (Netherlands)

    Kiers, H.D.; Hofstra, J.M.; Wetzels, J.F.M.

    2008-01-01

    Mean arterial pressure (MAP) is often used as an index of overall blood pressure. In recent years, the use of automated oscillometric blood pressure measurement devices is increasing. These devices directly measure and display MAP; however, MAP is often calculated from systolic blood pressure (SBP)

  4. The effect of a trunk release maneuver on Peak Pressure Index, trunk displacement and perceived discomfort in older adults seated in a high Fowler’s position: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Best Krista L

    2012-11-01

    Full Text Available Abstract Background Pressure ulcers pose significant negative individual consequences and financial burden on the healthcare system. Prolonged sitting in High Fowler’s position (HF is common clinical practice for older adults who spend extended periods of time in bed. While HF aids in digestion and respiration, being placed in a HF may increase perceived discomfort and risk of pressure ulcers due to increased pressure magnitude at the sacral and gluteal regions. It is likely that shearing forces could also contribute to risk of pressure ulcers in HF. The purpose of this study was to evaluate the effect of a low-tech and time-efficient Trunk Release Manuever (TRM on sacral and gluteal pressure, trunk displacement and perceived discomfort in ambulatory older adults. Method A randomized controlled trial was used. We recruited community-living adults who were 60 years of age and older using posters, newspaper advertisements and word-of-mouth. Participants were randomly allocated to either the intervention or control group. The intervention group (n = 59 received the TRM, while the control group (n = 58 maintained the standard HF position. Results The TRM group had significantly lower mean (SD PPI values post-intervention compared to the control group, 59.6 (30.7 mmHg and 79.9 (36.5 mmHg respectively (p = 0.002. There was also a significant difference in trunk displacement between the TRM and control groups, +3.2 mm and −5.8 mm respectively (p = 0.005. There were no significant differences in perceived discomfort between the groups. Conclusion The TRM was effective for reducing pressure in the sacral and gluteal regions and for releasing the trunk at the point of contact between the skin and the support surface, but did not have an effect on perceived discomfort. The TRM is a simple method of repositioning which may have important clinical application for the prevention of pressure ulcers that may occur as a result of HF.

  5. Clinical examination and non-invasive screening tests in the diagnosis of peripheral artery disease in people with diabetes-related foot ulceration.

    Science.gov (United States)

    Vriens, B; D'Abate, F; Ozdemir, B A; Fenner, C; Maynard, W; Budge, J; Carradice, D; Hinchliffe, R J

    2018-04-06

    Peripheral artery disease is common in people with diabetes-related foot ulceration and is a risk factor for amputation. The best method for the detection or exclusion of peripheral artery disease is unknown. This study investigated the utility of clinical examination and non-invasive bedside tests in screening for peripheral artery disease in diabetes-related foot ulceration. Some 60 people presenting with new-onset ulceration participated. Accuracy of pulses, ankle pressure, toe pressure, toe-brachial index (TBI), ankle-brachial pressure index (ABPI), pole test at ankle, transcutaneous oxygen pressure and distal tibial waveform on ultrasound were examined. The gold standard diagnostic test used was > 50% stenosis in any artery or monophasic flow distal to calcification in any ipsilateral vessel on duplex ultrasound. The negative and positive likelihood ratios of pedal pulse assessment (0.75, 1.38) and the other clinical assessment tools were poor. The negative and positive likelihood ratios of ABPI (0.53, 1.69), transcutaneous oxygen pressure (1.10, 0.81) and ankle pressure (0.67, 2.25) were unsatisfactory. The lowest negative likelihood ratios were for tibial waveform assessment (0.15) and TBI (0.24). The highest positive likelihood ratios were for toe pressure (17.55) and pole test at the ankle (10.29) but the negative likelihood ratios were poor at 0.56 and 0.74. Pulse assessment and ABPI have limited utility in the detection of peripheral artery disease in people with diabetes foot ulceration. TBI and distal tibial waveforms are useful for selecting those needing diagnostic testing. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Pressure Sores

    Science.gov (United States)

    Pressure sores are areas of damaged skin caused by staying in one position for too long. They ... wheelchair, or are unable to change your position. Pressure sores can cause serious infections, some of which ...

  7. Pressure Controller

    Science.gov (United States)

    1981-01-01

    EPIC is Electronic Pressure Indicating Controller produced by North American Manufacturing Company. It is a high-sensitivity device for improving combustion efficiency in industrial furnaces that interprets a signal from a pressure transducer on a furnace and regulates furnace pressure accordingly. A controller can provide savings of from five to 25 percent of an industrial user's annual furnace fuel bill.

  8. Intracranial Pressure

    DEFF Research Database (Denmark)

    Hvedstrup, Jeppe; Radojicic, Aleksandra; Moudrous, Walid

    2018-01-01

    OBJECTIVE: To compare a new method of noninvasive intracranial pressure (nICP) measurement with conventional lumbar puncture (LP) opening pressure. METHODS: In a prospective multicenter study, patients undergoing LP for diagnostic purposes underwent intracranial pressure measurements with HeadSen...

  9. EJSCREEN Indexes 2015 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eight EJ Indexes in EJSCREEN reflecting the 8 environmental indicators. The EJ Index names are:...

  10. EJSCREEN Indexes 2016 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There is an EJ Index for each environmental indicator. There are eleven EJ Indexes in EJSCREEN reflecting the 11 environmental indicators. The EJ Index names are:...

  11. Experimental and predicted volumetric and refractive index properties of ternary mixtures of iodoethane with toluene and alcohols at temperature 298.15K and pressure 101kPa

    International Nuclear Information System (INIS)

    Atik, Zadjia

    2006-01-01

    Excess molar volumes V m E and change in refractive indices Δ mix n of the binary mixtures of (toluene+methanol) (toluene+ethanol) (toluene+1-propanol) (toluene+iodoethane) (methanol+iodoethane) (ethanol+iodoethane) (1-propanol+iodoethane), and the ternary mixtures of (toluene+methanol+iodoethane) (toluene+ethanol+iodoethane), and (toluene+1-propanol+iodoethane) were measured with vibrating-tube densimeters and an Abbe-type refractometer at the temperature 298.15K and the pressure 101kPa. The experimental V m E and Δ mix n values of the ternary systems were predicted by empirical equations using binary solution data

  12. Zero-Flow Pressure Measured Immediately After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Provides the Best Invasive Index for Predicting the Extent of Myocardial Infarction at 6 Months: An OxAMI Study (Oxford Acute Myocardial Infarction).

    Science.gov (United States)

    Patel, Niket; Petraco, Ricardo; Dall'Armellina, Erica; Kassimis, George; De Maria, Giovanni Luigi; Dawkins, Sam; Lee, Regent; Prendergast, Bernard D; Choudhury, Robin P; Forfar, John C; Channon, Keith M; Davies, Justin; Banning, Adrian P; Kharbanda, Rajesh K

    2015-09-01

    The aim of this study was to define which measure of microvascular best predicts the extent of left ventricular (LV) infarction. Microvascular injury after ST-segment elevation myocardial infarction (STEMI) is an important determinant of outcome. Several invasive measures of the microcirculation at primary percutaneous coronary intervention (PPCI) have been described. One such measure is zero-flow pressure (Pzf), the calculated pressure at which coronary flow would cease. In 34 STEMI patients, Pzf, hyperemic microvascular resistance (hMR), and index of microcirculatory resistance (IMR) were derived using thermodilution flow/pressure and Doppler flow/pressure wire assessment of the infarct-related artery following PPCI. The extent of infarction was determined by blinded late gadolinium enhancement on cardiac magnetic resonance at 6 months post-PPCI. Infarction of ≥24% total LV mass was used as a categorical cutoff in receiver-operating characteristic curve analysis. Pzf was superior to both hMR and IMR for predicting ≥24% infarction area under the curve: 0.94 for Pzf versus 0.74 for hMR (p = 0.04) and 0.54 for IMR (p = 0.003). Pzf ≥42 mm Hg was the optimal cutoff value, offering 100% sensitivity and 73% specificity. Patients with Pzf ≥42 mm Hg also had a lower salvage index (61.3 ± 8.1 vs. 44.4 ± 16.8, p = 0.006) and 6-month ejection fraction (62.4 ± 3.6 vs. 49.9 ± 9.6, p = 0.002). In addition, there were significant direct relationships between Pzf and troponin area under the curve (rho = 0.55, p = 0.002), final infarct mass (rho = 0.75, p infarction and percent transmurality of infarction (rho = 0.77 and 0.74, respectively, p myocardial salvage index (rho = -0.53, p = 0.01) and 6-month ejection fraction (rho = -0.73, p = 0.0001). Pzf measured at the time of PPCI is a better predictor of the extent of myocardial infarction than hMR or IMR. Pzf may provide important prognostic information at the time of PPCI and merits further

  13. [Journal selection and indexing for Index Medicus and Chinese periodicals indexed in Index Medicus].

    Science.gov (United States)

    Zhou, Qing-Hui; Ling, Chang-Quan; Bai, Yu-Jin; Yin, Hui-Xia

    2005-01-01

    Index Medicus/MEDLINE/PubMed published by U. S. National Library of Medicine (NLM) is the most important and commonly used biomedical literature retrieval system in the world. According to the"List of Journals Indexed in Index Medicus (2004)", 4,098 journals are indexed for Index Medicus, including 70 journals from mainland China and Hong Kong and 9 journals from Taiwan. Journal of Chinese Integrative Medicine established in May, 2003 is indexed in Index Medicus in 2004. This article outlines the critical elements of journal selection for Index Medicus/MEDLINE and the journal selection process for indexing at NLM, and introduces some measures for the Journal of Chinese Integrative Medicine being indexed in Index Medicus/MEDLINE.

  14. In 6- to 8-year-old children, hair cortisol is associated with body mass index and somatic complaints, but not with stress, health-related quality of life, blood pressure, retinal vessel diameters, and cardiorespiratory fitness.

    Science.gov (United States)

    Gerber, Markus; Endes, Katharina; Brand, Serge; Herrmann, Christian; Colledge, Flora; Donath, Lars; Faude, Oliver; Pühse, Uwe; Hanssen, Henner; Zahner, Lukas

    2017-02-01

    Hair cortisol measurement has become an increasingly accepted approach in endocrinology and biopsychology. However, while in adult research hair cortisol has been proposed as a relevant biomarker for chronic stress (and its adverse consequences), studies with children are scarce. Therefore, the goal of the present exploratory study was to examine the associations between hair cortisol concentrations (HCCs), stress, and a series of health-related outcomes in a sample of Swiss first grade schoolchildren. The sample consisted of 318 children (53% girls, M age =7.26, SD=0.35). Hair strands were taken near the scalp from a posterior vertex position, and HCCs were tested for the first 3-cm hair segment. Parents provided information about their children's age, gender, parental education, children's stress (recent critical life events, daily hassles), health-related quality of life, and psychosomatic complaints. Body composition, blood pressure, retinal vessel diameters, and cardiorespiratory fitness were measured with established methods. In multiple regression analyses, higher HCCs were weakly associated with increased BMI in girls (β=0.22, phealth-related quality of life, blood pressure, retinal vessel diameters, and cardiorespiratory fitness. Although small significant relationships were found between HCCs, BMI and somatic complaints, the findings of this exploratory study challenge the view that HCCs can be used as a reliable biomarker of recent critical life events, daily hassles, health-related quality of life, and cardiovascular health indicators in non-clinical young children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Pressure ulcers.

    Science.gov (United States)

    Reddy, Madhuri

    2011-04-28

    Unrelieved pressure or friction of the skin, particularly over bony prominences, can lead to pressure ulcers in up to one third of people in hospitals or community care, and one fifth of nursing home residents. Pressure ulcers are more likely in people with reduced mobility and poor skin condition, such as older people or those with vascular disease. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of preventive interventions in people at risk of developing pressure ulcers? What are the effects of treatments in people with pressure ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 64 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: air-filled vinyl boots, air-fluidised supports, alternating-pressure surfaces (including mattresses), alternative foam mattresses, constant low-pressure supports, debridement, electric profiling beds, electrotherapy, hydrocellular heel supports, low-air-loss beds (including hydrotherapy beds), low-level laser therapy, low-tech constant-low-pressure supports, medical sheepskin overlays, nutritional supplements, orthopaedic wool padding, pressure-relieving overlays on operating tables, pressure-relieving surfaces, repositioning (regular "turning"), seat cushions, standard beds, standard care, standard foam mattresses, standard tables, surgery, therapeutic ultrasound, topical lotions and

  16. Evaluation of hydration indexes in kale leaves

    OpenAIRE

    Calbo, Adonai G.; Ferreira, Marcos D.

    2011-01-01

    Hydration indexes are practical variables for quantifying plant water stress and can be useful for agronomic purposes. Three adapted hydration indexes based on relative water content, volumetric hydration, and leaf turgor pressure were evaluated in kale (Brassica oleracea var. acephala) leaf segments. Relative water content and volumetric hydration were measured in leaf segments after a water infiltration procedure with the aim of filling its large intercellular volumes (@18%v/v). The infiltr...

  17. To Index or Not To Index.

    Science.gov (United States)

    Veenema, Fred

    1996-01-01

    Describes an experiment comparing the performance of an automatic full-text indexing software for personal computers (i.e., the Quick-Finder facility in WordPerfect 6.1 for Windows) with the human intellectual assignment of indexing terms to each document in a collection. Results are discussed in terms of ease of use, the time factor, and recall…

  18. Influência do índice de massa corporal e da circunferência abdominal na pressão arterial sistêmica de crianças Influence of body mass index and abdominal circumference on children's systemic blood pressure

    Directory of Open Access Journals (Sweden)

    Marcelo Nunes Iampolsky

    2010-06-01

    Full Text Available OBJETIVO: Avaliar os níveis pressóricos em crianças e relacioná-los ao índice de massa corporal e à circunferência abdominal. MÉTODOS: Por meio de estudo prospectivo e transversal, avaliaram-se 1.408 escolares com idade entre cinco anos e dez anos e 11 meses, matriculados em escolas públicas do Município de Santo André. Foram coletados: peso ao nascer; peso e estatura, expressos como escore Z do índice de massa corporal (ZIMC e estatura para idade (ZEI. A pressão arterial (medida única foi aferida pelo mesmo examinador. Considerou-se: desnutrição quando ZIMC+2, baixa estatura se ZEIP90 para sexo e idade e pressão arterial elevada quando superior ao percentil 90 para sexo, idade e estatura. A análise estatística incluiu o teste do qui-quadrado e o cálculo da Odds Ratio, adotando-se como significante o valor de pOBJECTIVE: To evaluate blood pressure levels in children, relating them to body mass index and abdominal circumference. METHODS: This cross-sectional prospective study enrolled 1.408 school children, aged between five and ten years and 11 months, in the municipality of Santo Andre, São Paulo, Brazil. The following variables were evaluated: birth weight, weight and height, expressed as body mass index Z score (ZBMI and height to age Z score (ZH, and waist circumference (WC. Blood pressure was measured once by the same physician. Malnutrition was considered when ZBMI +2, short stature when ZH P90 for age and gender, and increased blood pressure when >P90 for age, gender and height. Statistical analysis included chi-square test and Odds Ratio, being significant p<0.05. RESULTS: Mean age was seven years old, and 51% were females. High systolic blood pressure levels were observed in 19% and elevated diastolic blood pressure in 12%. Short stature, malnutrition, obesity and increased abdominal circumference were diagnosed in 2.6%, 3.1%, 7.3% and 13.4%, respectively, of the studied population. The presence of obesity was

  19. Total Contact Cast Use in Patients With Peripheral Arterial Disease: A Case Series and Systematic Review.

    Science.gov (United States)

    Tickner, Anthony; Klinghard, Cheri; Arnold, Jonathan F; Marmolejo, Valerie

    2018-02-01

    As the majority of diabetic foot ulcerations (DFUs) occur on the plantar foot, excessive pressure is a major contributing factor to delayed healing. The gold standard for offloading is the total contact cast (TCC); yet, TCC use is contraindicated in patients with ischemia. Lower extremity ischemia typically presents in the more severe end stages of peripheral arterial disease (PAD). As PAD exists on a severity spectrum from mild to severe, designation of a clear cutoff where TCC use is an absolute contraindication would assist those who treat DFUs on a daily basis. The aim of this study is to determine if a potential cutoff value for PAD where TCC use would be an absolute contraindication could be ascertained from a retrospective case series and a systematic literature review of patients with PAD in which treatment included TCC use. A retrospective cases series and systematic review of patients with mild to moderate PAD treated with a TCC was performed. All reports of TCC use in patients with PAD and a neuropathic ulceration that included results of noninvasive vascular studies were included. Results suggested that TCC use is a viable treatment modality for pressure-related DFUs in patients with an ankle pressure ≥ 80 mm Hg, a toe pressure ≥ 74 mm Hg, an ankle-brachial index ≥ 0.55, or a toe-brachial index ≥ 0.55. Vascular evaluation, individual risk/benefit analysis, close follow-up, and patient education are essential components of TCC use in these patients. Repeat vascular evaluation is recommended if the wound fails to progress towards resolution with TCC use.

  20. Analysis in indexing

    DEFF Research Database (Denmark)

    Mai, Jens Erik

    2005-01-01

    The paper discusses the notion of steps in indexing and reveals that the document-centered approach to indexing is prevalent and argues that the document-centered approach is problematic because it blocks out context-dependent factors in the indexing process. A domain-centered approach to indexing...... is presented as an alternative and the paper discusses how this approach includes a broader range of analyses and how it requires a new set of actions from using this approach; analysis of the domain, users and indexers. The paper concludes that the two-step procedure to indexing is insufficient to explain...

  1. Supersymmetry and index theory

    International Nuclear Information System (INIS)

    Alvarez-Gaume, L.

    1985-01-01

    The author presents information mainly concerned with the fact that many of the ingredients and results in index theory have very simple analogs in supersymmetric quantum mechanical systems so that using elementary quantum mechanics one can obtain new proofs of the Atiyah-Singer index theorem and related results. Simple ideas on index theorems and characteristic classes are reviewed; simple results on fermion functional integrals are outlined; supersymmetric quantum mechanical systems which appear naturally in dealing with index problems are analyzed; proof of the classical index theorem is presented; the character valued index theorem is derived; and applications of the methods developed here for the computation of anomalies are presented

  2. Pressure Drop

    Science.gov (United States)

    Lawson, Mike

    2010-01-01

    Mike Lawson briefly discussed pressure drop for aerospace applications and presented short stories about adventures experienced while working at NASA and General Dynamics, including exposure to technologies like the Crew and Equipment Translation Aid (CETA) cart and the SWME.

  3. Macro- and microperfusion during application of a new compression system, designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease.

    Science.gov (United States)

    Jünger, Michael; Haase, Hermann; Schwenke, Linda; Bichel, Jens; Schuren, Jan; Ladwig, Andrea

    2013-01-01

    To investigate macro- and microperfusion during 14 days of treatment with a new 2-layer compression system (3M™ Coban™ 2 Lite), designed for patients with leg ulcer and concomitant peripheral arterial occlusive disease. A single-centre, open-label, prospective pilot study was performed with 15 subjects suffering from peripheral arterial occlusive disease with an ankle brachial pressure index (ABPI) of 0.5-0.8, who volunteered to have their 'study leg' bandaged with the new system. Coincident leg ulcer or chronic venous disease was not mandatory. All subjects received the new compression system, which stayed in place from 1 up to 4 days according to scheduled study visits. The system was reapplied by study personnel at each clinical visit (days 1, 2, 3, 4, 7, 10 and 14). The study participation stopped after 14 days. At each clinical visit safety assessments were performed: measurement of acral pulsation to capture macroperfusion; laser Doppler fluxmetry to capture microperfusion; clinical signs of pressure related skin damage, hypoxia-related pain and sub-bandage pressure measurement. In addition, the leg volume was measured and a comfort questionnaire was completed. An average sub-bandage pressure in standing position of approximately 30 mmHg was measured at the B1 location immediately after bandage application. Laser Doppler fluxmetry demonstrated positive effects on microcirculation regarding vasomotion and respiratory reflux. No change of the cardiac signal appeared. For acrale pulsations a high intraindividual variability was found with no clear interference to the bandage application. No pressure-related skin damage or hypoxia-related pain was detected. After application of the new compression system in subjects with moderate PAOD, laser Doppler fluxmetry indicated significant improvements of the microcirculation. High variability and lack of correlation to clinical symptoms was found for the acral pulsation. The new compression system revealed a high

  4. Immediate arterial hemostasis after cardiac catheterization: initial experience with a new puncture closure device.

    Science.gov (United States)

    Aker, U T; Kensey, K R; Heuser, R R; Sandza, J G; Kussmaul, W G

    1994-03-01

    A novel device for obtaining arterial hemostasis after invasive procedures was tested in 30 patients undergoing diagnostic catheterization (26 patients) or coronary angioplasty (4 patients). The device is deployed through an arterial sheath and forms a positive mechanical seal both inside and outside the defect in the arterial wall. The components are all bioabsorbable. Thirteen patients received a heparin bolus during the catheterization procedure. The activated clotting time recorded in 15 patients just prior to device deployment averaged 264 sec. 29 of 32 attempted device deployments were successful (91%); and the remaining 3 devices pulled completely out as called for by design in the event of incomplete deployment. Twenty-nine patients ultimately achieved successful hemostasis using the device, with the other patient receiving manual hemostasis. Of these 29, hemostasis was immediate and complete in 19 patients. Light digital pressure was required in another 8 patients for less than 5 min. There was minor delayed bleeding requiring supplemental light pressure in several cases. A total of 11 patients required supplemental pressure in addition to the hemostasis device. The use of bolus heparin was significantly (P = 0.05, Fisher's exact test) related to the requirement for supplemental pressure. Three patients developed hematomas, one of which was present prior to device deployment. The other two patients had received bolus heparin. No patient required transfusion or surgical repair. There was no change in the ankle/brachial systolic blood pressure index after device deployment or at late (30-60 day) follow-up. Ultrasound studies revealed no significant pathology relative to the device.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Western Alaska ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  6. IndexCat

    Data.gov (United States)

    U.S. Department of Health & Human Services — IndexCat provides access to the digitized version of the printed Index-Catalogue of the Library of the Surgeon General's Office; eTK for medieval Latin texts; and...

  7. Body Mass Index Table

    Science.gov (United States)

    ... Families ( We Can! ) Health Professional Resources Body Mass Index Table 1 for BMI greater than 35, go ... Health Information Email Alerts Jobs and Careers Site Index About NHLBI National Institute of Health Department of ...

  8. Human Use Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  9. Master Veteran Index (MVI)

    Data.gov (United States)

    Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

  10. Human Use Index (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the...

  11. Associations between bone mineral density and subclinical atherosclerosis: a cross-sectional study of a Chinese population.

    Science.gov (United States)

    Liang, Dong-Ke; Bai, Xiao-Juan; Wu, Bing; Han, Lu-Lu; Wang, Xiao-Nan; Yang, Jun; Chen, Xiang-Mei

    2014-02-01

    The significance of associations between bone mineral density (BMD) and atherosclerosis in the Asian population is less clear. The aim of this study was to explore the population-level associations between BMD and subclinical atherosclerosis. This was a community-based cross-sectional study conducted in Shenyang, China. A total of 385 Chinese women and men aged 37-87 years were studied. The BMD was measured at the total hip and lumbar spine using dual-energy x-ray absorptiometry. The ankle-brachial index (ABI), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) were measured to assess atherosclerosis. Multiple regression analysis was applied to study the associations. Multicolinearity was examined using the variance inflation factor, condition index, and variance proportions. Factor analysis and principal component regression were used to remove the problem of multicolinearity. The differences of ABI, PWV, and CIMT among the normal BMD, osteopenia, and osteoporosis groups were not found. Total hip BMD was correlated with ABI in women after adjustment for age (r = 0.156). Sex-specific regression models included adjustment for age, body mass index, cigarette smoking, alcohol consumption, menopausal status (women), systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, serum uric acid, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and fibrinogen. Total hip BMD was associated with ABI in women after adjustment for age (per SD decrease in ABI: -0.130 g/cm(2), P = .022), but the association was borderline significant after full adjustment (P = .045). Total hip BMD and lumbar spine BMD were not associated with ABI, PWV, and CIMT after full adjustment in participants without a fracture history. The risk of osteoporosis was not associated with ABI, PWV, and CIMT. Low BMD is not associated with

  12. Relationship between Serum Uric Acid and Vascular Function and Structure Markers and Gender Difference in a Real-World Population of China-From Beijing Vascular Disease Patients Evaluation Study (BEST) Study.

    Science.gov (United States)

    Liu, Huan; Liu, Jinbo; Zhao, Hongwei; Zhou, Yingyan; Li, Lihong; Wang, Hongyu

    2018-03-01

    The study was done to establish the relationship between serum uric acid (UA) and vascular function and structure parameters including carotid femoral pulse wave velocity (CF-PWV), carotid radial pulse wave velocity (CR-PWV), cardio ankle vascular index (CAVI), ankle brachial index (ABI), and carotid intima-media thickness (CIMT), and the gender difference in a real-world population from China. A total of 979 subjects were enrolled (aged 60.86±11.03 years, male 416 and female 563). Value of UA was divided by 100 (UA/100) for analysis. Body mass index (BMI), diastolic blood pressure (DBP), fasting plasma glucose (FPG), UA, and UA/100 were significantly higher in males compared with females (all p<0.05); pulse pressure (PP), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were lower in males than females (all p<0.05). All vascular parameters including CF-PWV, CR-PWV, CAVI, ABI, and CIMT were higher in males than females (all p<0.05). Multiple linear regression analysis showed that UA/100 was independently positively linearly correlated with CAVI (B=0.143, p=0.001) and negatively correlated with ABI in the male population (B=-0.012, p=0.020). In people with higher UA, the risk of higher CF-PWV was 1.593 (p<0.05). 1. All vascular parameters were higher in males than females. There was no gender difference in the relationship between UA and vascular markers except in ABI. 2. UA was independently linearly correlated with CAVI. 3. In people with higher UA level, the risk of higher CF-PWV increased. Therefore, higher UA may influence the vascular function mainly instead of vascular structure.

  13. Indexing Executive Compensation Contracts

    NARCIS (Netherlands)

    I. Dittmann (Ingolf); E.G. Maug (Ernst); O.G. Spalt (Oliver)

    2013-01-01

    textabstractWe analyze the efficiency of indexing executive pay by calibrating the standard model of executive compensation to a large sample of US CEOs. The benefits from linking the strike price of stock options to an index are small and fully indexing all options would increase compensation costs

  14. The Europe 2020 Index

    Science.gov (United States)

    Pasimeni, Paolo

    2013-01-01

    This paper presents a new index to quantify, measure and monitor the progress towards the objectives of the Europe 2020 strategy. This index is based on a set of relevant, accepted, credible, easy to monitor and robust indicators presented by the European Commission at the time the strategy was launched. The internal analysis of the index shows…

  15. Serum lipoprotein(a) levels in patients with atherosclerotic peripheral vascular disease in Hospital Kuala Lumpur.

    Science.gov (United States)

    Hakim, N A; Hafizan, M T; Baizurah, M H; Zainal, A A

    2008-01-01

    The objective of this study was to determine the proportion of patients with atherosclerotic peripheral vascular disease (PVD) who had elevated lipoprotein(a) [Lp(a)] levels, as well as to determine the latter's significance as a risk factor for PVD in the local population. This case-controlled study was conducted between June and October 2004 in the Department of Surgery, Kuala Lumpur Hospital. A total of 100 patients were recruited and divided into control and PVD groups. Patients were defined as having PVD if they were symptomatic, with ankle-brachial systolic index population.

  16. Pressure Ulcer Prevention

    Science.gov (United States)

    2009-01-01

    23.4) 13.1–25.7 (3100) All health care settings 26 (25.2–26.8) 13.1–53.3 (7774) * CI indicates confidence interval. † Nonacute care included sub-acute care, chronic care, complex continuing care, long-term care, and nursing home care. ‡ Mixed health care includes a mixture of acute, nonacute, and/or community care health care delivery settings. Pressure ulcers have a considerable economic impact on health care systems. In Australia, the cost of treating a single stage IV ulcer has been estimated to be greater than $61,000 (AUD) (approximately $54,000 CDN), (3) while in the United Kingdom the total cost of pressure ulcers has been estimated at £1.4–£2.1 billion annually or 4% of the National Health Service expenditure. (4) Because of the high physical and economic burden of pressure ulcers, this review was undertaken to determine which interventions are effective at preventing the development of pressure ulcers in an at-risk population. Review Strategy The main objective of this systematic review is to determine the effectiveness of pressure ulcer preventive interventions including Risk Assessment, Distribution Devices, Nutritional Supplementation, Repositioning, and Incontinence Management. A comprehensive literature search was completed for each of the above 5 preventive interventions. The electronic databases searched included MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. As well, the bibliographic references of selected studies were searched. All studies meeting explicit inclusion and exclusion criteria for each systematic review section were retained and the quality of the body of evidence was determined using the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) system. (5) Where appropriate, a meta-analysis was undertaken to determine the overall estimate of effect of the preventive intervention under review

  17. Cardiovascular responses of peripheral artery disease patients during resistance exercise

    Directory of Open Access Journals (Sweden)

    Ana Patrícia Ferreira Gomes

    2015-03-01

    Full Text Available BACKGROUND: Resistance training has been used for the treatment of patients with peripheral artery disease (PAD. However, cardiovascular responses during this type of exercise have not been fully elucidated in these patients. OBJECTIVES: To analyze the cardiovascular responses during resistance exercise and to verify whether there are any correlations between these responses and disease severity or blood pressure levels in patients with PAD. METHODS: Seventeen PAD patients performed one set of 10 repetitions of knee extension exercise with an intensity of 50% of one repetition maximum. The responses of systolic blood pressure (SBP, diastolic blood pressure (DBP and heart rate (HR were continuously monitored using the finger photoplethysmography technique. The rate-pressure product (RPP was obtained by multiplication of SBP and HR. RESULTS: During the resistance exercises there were significant increases in SBP (126 ± 14 vs. 184 ± 20 mmHg, p<0.001, DBP (68 ± 8 vs. 104 ± 14 mmHg, p<0.001, HR (76 ± 18 vs. 104 ± 30 bpm, p<0.001 and RPP (9523 ± 2115 vs. 19103 ± 6098 mmHg x bpm, p<0.001. A negative correlation was observed between relative change (Δ in SBP and SBP at rest (r =-0.549, p=0.022. On the other hand, there was no relationship between Δ SBP and the ankle-brachial index (r=0.076, p=0.771. CONCLUSION: Increases in cardiovascular variables were observed during resistance exercise in PAD patients. The highest increases occurred in patients with lower SBP levels at resting.

  18. Systolic Blood Pressure Accuracy Enhancement in the Electronic Palpation Method Using Pulse Waveform

    National Research Council Canada - National Science Library

    Sorvoja, H

    2001-01-01

    .... Systolic pressure errors were defined and correlations with other specific values, like pressure rise time, pulse wave velocity, systolic pressure, augmentation, arm circumference and body mass index were calculated...

  19. Glycemic index, insulinemic index, and satiety index of kefir.

    Science.gov (United States)

    Kong, Kai Ling; Hendrich, Suzanne

    2012-08-01

    To determine glycemic, insulinemic, and satiety indices of 3 types of kefir. This study was divided into 3 phases. In phase 1, 50 g of available carbohydrate from low-fat strawberry kefir or orange kefir was tested, and in phase 2, low-fat plain kefir containing 25 g of available carbohydrates was tested for glycemic index (GI), in both cases compared with an equivalent amount of glucose. In phase 3, 1000-kJ portions of all 3 types of kefirs were compared with white bread with the same energy content to determine the insulinemic index (II) and satiety index (SI) of all 3 kefirs. In all phases, a single-meal, randomized crossover design was performed in which the test meals were given to healthy adults, 5 men and 5 women. The total incremental plasma glucose area under the curve (iAUC) for strawberry, orange, and plain kefirs was significantly lower compared with the respective high-GI control food, which was glucose solution. However, the IIs and SIs of kefir did not differ significantly from the white bread. Kefir is a low- to moderate-GI food; however, its II was high. Although kefir had higher water content, the SI of kefir was not significantly different from white bread.

  20. Coal swelling and thermoplasticity under high pressure

    Energy Technology Data Exchange (ETDEWEB)

    Ndaji, F.E.; Butterfield, I.M.; Thomas, K.M. (Newcastle upon Tyne University, Newcastle upon Tyne (United Kingdom). Northern Carbon Research Labs., Dept. of Chemistry)

    1992-01-01

    The literature on the following topics is reviewed: swelling and agglomeration of coal; measurements of swelling index and dilatometric and plastometric properties at high pressures; and the effects of oxidation, tar addition and minerals on high-pressure thermoplastic properties. 34 refs., 6 figs.

  1. Improving interMediAte Risk management. MARK study

    Directory of Open Access Journals (Sweden)

    Garcia-Gil Maria

    2011-10-01

    Full Text Available Abstract Background Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI, measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018 from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years. We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country

  2. Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition

    Science.gov (United States)

    Miner, Brienne; Tinetti, Mary E.; Van Ness, Peter H.; Han, Ling; Leo-Summers, Linda; Newman, Anne B.; Lee, Patty J.; Fragoso, Carlos A. Vaz

    2016-01-01

    Objectives The evaluation of dyspnea in older persons is traditionally focused on cardiorespiratory diseases, rather than systematically evaluating the multiple impairments that often occur with advancing age and which may also contribute to dyspnea. Accordingly, we have evaluated the associations between a broad array of cardiorespiratory and non-cardiorespiratory impairments and dyspnea in older persons. Design Cross-sectional. Setting Cardiovascular Health Study. Participants 4,413 community-dwelling persons; mean age was 72.6, 57.1% were female, 4.5% were African-American, 27.2% had less than a high school education, and 54.7% were ever-smokers. Measurements Dyspnea severity (American Thoracic Society grade ≥2 defined moderate-to-severe) and several impairments, including those established by: spirometry (forced expiratory volume in 1-second [FEV1]), maximal inspiratory pressure (respiratory muscle strength), echocardiography, ankle-brachial index, blood pressure, whole-body muscle mass (bioelectrical impedance), single chair stand (lower extremity function), grip strength, serum hemoglobin and creatinine, Center for Epidemiologic Studies Depression Scale (CES-D), Mini Mental State Examination, medication use, and body mass index (BMI). Results In a multivariable logistic regression model, impairments having strong associations with moderate-to-severe dyspnea included: FEV1 dyspnea included respiratory muscle weakness, diastolic cardiac dysfunction, grip weakness, anxiety symptoms, and use of cardiovascular and psychoactive medications (adjORs ranged from 1.31-1.71). Conclusion In community-dwelling older persons, several cardiorespiratory and non-cardiorespiratory impairments were significantly associated with moderate-to-severe dyspnea, akin to a multifactorial geriatric health condition. PMID:27549914

  3. Does the metabolic syndrome predict subclinical atherosclerotic damage in an asymptomatic population at intermediate cardiovascular risk?

    Science.gov (United States)

    Zocchi, L; Perego, F; Casella, F; Arquati, M; Renesto, E; Casazza, G; D'Ambrosio, A; Cortellaro, M

    2013-09-01

    It is not clear whether the metabolic syndrome (MetS) is a distinct entity or a combination of risk factors. Several studies showed the association between MetS and cardiovascular disease (CVD). Subclinical target organ damage (TOD) is a recognized marker of atherosclerosis and predictor of cardiovascular events. Increased burden of subclinical atherosclerosis was detected in individuals with MetS. We thus aimed to examine the association between MetS and cumulative or specific TOD and to assess whether MetS predicts TOD better than the risk factors included in current definitions. We recorded TOD in 979 patients at intermediate cardiovascular risk with and without MetS according to IDF and NCEP criteria. We measured common carotid intima-media thickness, left ventricular mass index (LVMI), urine albumin to creatinine ratio (UACR), and ankle-brachial index. We found no correlation between having at least one TOD and being positive for MetS. A high UACR was associated with MetS using both IDF and NCEP criteria, while only NCEP identified individuals with increased LVMI. Using a multivariate logistic regression model including MetS, age, sex, waist circumference, triglycerides, HDL cholesterol, blood pressure and blood glucose levels we found no correlations between the presence of MetS and at least one TOD. The associations with high UACR and LVMI disappeared when age, blood pressure and glycemia were counted in. Although MetS showed some relation with subclinical renal and cardiac damage, it does not predict TOD any better than the risk factors specified in the definitions. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Hemoglobin A1c and arterial and ventricular stiffness in older adults.

    Directory of Open Access Journals (Sweden)

    Susan J Zieman

    Full Text Available Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE are implicated in this stiffening pathophysiology. We examined the association between HbA(1c, an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes.Baseline HbA(1c was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥ 65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA(1c and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG with like measures.HbA(1c was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both and positively associated with greater body-mass index and black race. In adjusted models, HbA(1c was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP, carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM. FG levels were positively associated with systolic, diastolic and PP and LVM.In this sample of older adults without diabetes, HbA(1c was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.

  5. Effects of rosiglitazone on metabolic parameters and large artery sclerosis in nondiabetic patients with metabolic sydrome

    International Nuclear Information System (INIS)

    Shen Zhenhai; Lu Yun; Feng Yinbo; Jin Xian

    2010-01-01

    Objective: To observe the effects of rosiglitazone on metabolic parameters, carotid intimamedia thickness (IMT), brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) in nondiabetic patients with metabolic syndrome. Methods: Seventy-nine nondiabetic patients with metabolic syndrome were randomly divided into treatment group (n = 41) and control group (n = 38). The patients in treatment group were treated with rosiglitazone on the basis of life-style intervention, those in control group were treated with life-style intervention for 9 months. All patients were followed up every 3 months. Body mass index (BMI) ,waist circumference(WC), systolic blood pressure (SBP), diastolic blood pressure(DBP), fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), highdendity lipoprotein (HDL-C), Low-density lipoprotein (LDL), high sensitivity C-reactive protein (hsCRP), HbA 1 C, fasting insulin (FIns), HOMA-IR, IMT, baPWV and ABI were measured in both groups before treatment and at the 6th, 9th month after treatment. Results: (1) After treatment with rosiglitazone for 6 months, FPG, TG, HDL-C, hsC RP, HbA 1 C, Fins and HOMA-IR in treatment group were improved (P 1 C, Fins and HOMA-IR got further improvement at the 9th month after treatment (P 1 C, Fins and HOMA-IR were changed significantly in treatment group compared to those in control group (P 1 C and HOMA-IR was independently related to the improvement of ABI by multivarient analysis. Conclusion: In nondiabetic patients with metabolic syndrome, rosiglitazone can significantly improve insulin resistance, correct metabolic disorders, has anti-inflammatory effect and retard atherosclerosis at some extent. (authors)

  6. Decadal variability of the NAO: Introducing an augmented NAO index

    Science.gov (United States)

    Wang, Y.-H.; Magnusdottir, Gudrun; Stern, H.; Tian, X.; Yu, Y.

    2012-11-01

    The wintertime NAO is traditionally defined as the first Empirical Orthogonal Function of monthly sea level pressure (SLP) anomalies for all winters and therefore remains fixed in space. The associated NAO index represents the projection of SLP onto the fixed NAO pattern. The NAO index is positive when the pressure contrast between the two centers of action is particularly strong; it is negative when the contrast is weak. This index represents an incomplete description of the wintertime NAO as the pattern is found to shift location on decadal timescales. This study investigates the movement of the centers of action (or nodes) of the NAO for winter in 20-yr running windows starting in 1871. A new climate index, the Angle index, is introduced. It is a measure of the asymmetry in location of the two nodes of the NAO defined in the partially overlapping 20-yr windows. The Angle index has a value of zero only when both nodes are located on the same meridian. It increases in positive value as the curve connecting the nodes tilts more to the northeast; it becomes negative when the tilt is to the northwest. The Angle index complements the smooth NAO index, which is the traditional NAO index averaged over the 20-yr window, especially when the Angle index is strongly negative as occurred during the Arctic warming of the early to mid 20th century. Regression analysis shows that the Angle index provides additional information about climate variability beyond that provided by the smooth NAO index.

  7. Supplement: Commodity Index Report

    Data.gov (United States)

    Commodity Futures Trading Commission — Shows index traders in selected agricultural markets. These traders are drawn from the noncommercial and commercial categories. The noncommercial category includes...

  8. All-optical pressure sensor

    DEFF Research Database (Denmark)

    2014-01-01

    The present invention relates to an all-optical pressure sensor comprising a waveguide accommodating a distributed Bragg reflector. Pressure sensing can then be provided by utilizing effective index modulation of the waveguide and detection of a wavelength shift of light reflected from the Bragg...... reflector. Sound sensing may also be provided thereby having an all-optical microphone. One embodiment of the invention relates to an optical pressure sensor comprising at least one outer membrane and a waveguide, the waveguide comprising at least one core for confining and guiding light,at least one...... distributed Bragg reflector located in said at least one core, and at least one inner deflecting element forming at least a part of the core,wherein the pressure sensor is configured such that the geometry and/or dimension of the at least one core is changed when the at least one outer membrane is submitted...

  9. EJSCREEN Supplementary Indexes 2015 Public

    Data.gov (United States)

    U.S. Environmental Protection Agency — There are 40 supplementary EJSCREEN indexes that are divided into 5 categories: EJ Index with supplementary demographic index, Supplementary EJ Index 1 with...

  10. Global Ecosystem Restoration Index

    DEFF Research Database (Denmark)

    Fernandez, Miguel; Garcia, Monica; Fernandez, Nestor

    2015-01-01

    The Global ecosystem restoration index (GERI) is a composite index that integrates structural and functional aspects of the ecosystem restoration process. These elements are evaluated through a window that looks into a baseline for degraded ecosystems with the objective to assess restoration...

  11. Rethinking image indexing?

    DEFF Research Database (Denmark)

    Christensen, Hans Dam

    2017-01-01

    Hans Dam Christensen, ”Rethinking image indexing?”, in: Journal of the Association for Information Science and Technology, vol. 68, no. 7, 2017, 1782-1785......Hans Dam Christensen, ”Rethinking image indexing?”, in: Journal of the Association for Information Science and Technology, vol. 68, no. 7, 2017, 1782-1785...

  12. Browse Title Index

    African Journals Online (AJOL)

    Browse Title Index. Journal Home > Advanced Search > Browse Title Index. Log in or Register to get access to full text downloads. ... Vol 2, No 1 (1978), Weakly Nonlinear Waves with Slowly-Varying Speed, Abstract PDF. SC Chikwendu. Vol 33, No 2 (2014), Web Portal Usability among Nigerian University Students: A Case ...

  13. Indian monsoon variability in relation to Regional Pressure Index

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    spatial scale. On the decadal and climatological scale, winter and spring time RPI show a significant inverse relationship with the rainfall over the regions Peninsular India (PI) and North West India. (NWI), while the ... spatial and temporal scales, for developing the LRF models. .... ability in Indian summer monsoon rainfall on.

  14. Blood Pressure and Obesity Index Assessment in a Typical Urban ...

    African Journals Online (AJOL)

    Background: Rapid transition from rural to urban lifestyle in Africa has been associated with increasing cardiovascular disease burden and thus, the need for continuous reevaluation of cardiovascular risk factors in African slums which have been shown to harbor 40 to 80% of urban residents cannot be over emphasized.

  15. Blood Pressure Test

    Science.gov (United States)

    ... pressure monitors may have some limitations. Tracking your blood pressure readings It can be helpful in diagnosing or ... more Stage 2 high blood pressure (hypertension) Elevated blood pressure and stages 1 and 2 high blood pressure ( ...

  16. ParkIndex

    DEFF Research Database (Denmark)

    Kaczynski, Andrew T; Schipperijn, Jasper; Hipp, J Aaron

    2016-01-01

    , planners, and citizens to evaluate the potential for park use for a given area. Data used for developing ParkIndex were collected in 2010 in Kansas City, Missouri (KCMO). Adult study participants (n=891) reported whether they used a park within the past month, and all parks in KCMO were mapped and audited...... using ArcGIS 9.3 and the Community Park Audit Tool. Four park summary variables - distance to nearest park, and the number of parks, amount of park space, and average park quality index within 1 mile were analyzed in relation to park use using logistic regression. Coefficients for significant park...... summary variables were used to create a raster surface (ParkIndex) representing the probability of park use for all 100m×100m cells in KCMO. Two park summary variables were positively associated with park use - the number of parks and the average park quality index within 1 mile. The ParkIndex probability...

  17. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 1011 ... Vol 36, No 2 (2017), Analysis of pressure variation of fluid in bounded circular reservoirs under the constant pressure outer boundary condition, Abstract PDF ... Vol 24, No 1 (2005), Analysis of the Environmental and Socio-Economic Impact of Noise Pollution in Eleme Petrochemical Company Limited ...

  18. Association of Serum Uric Acid Levels with Leg Ischemia in Patients with Peripheral Arterial Disease after Treatment.

    Science.gov (United States)

    Sotoda, Yoko; Hirooka, Shigeki; Orita, Hiroyuki; Wakabayashi, Ichiro

    2017-07-01

    We investigated the relationships of serum uric acid levels with the progression of atherosclerosis in patients with peripheral arterial disease (PAD) after treatment. Subjects were male patients diagnosed with PAD. Atherosclerosis at the common carotid artery was evaluated based on its intima-media thickness (IMT). Leg arterial flow was evaluated by measuring ankle-brachial index (ABI) and exercise-induced decrease in ABI. Among various risk factors including age, blood pressure, adiposity, estimated glomerular filtration rate, and blood lipid, blood glucose, uric acid, fibrinogen and C-reactive protein levels, only uric acid levels showed significant correlations with ABI [Pearson's correlation coefficient, -0.292 (p<0.01)] and leg exercise-induced decrease in ABI [Pearson's correlation coefficient, 0.236 (p< 0.05)]. However, there was no significant correlation between uric acid levels and maximum or mean IMT. Odds ratios of subjects with the 3rd tertile versus subjects with the 1st tertile for uric acid levels were significantly higher than the reference level of 1.00 for low ABI [4.44 (95% confidence interval, 1.45-13.65, p<0.01)] and for high % decrease in ABI after exercise [4.31 (95% confidence interval, 1.34-13.82, p<0.05)]. The associations of uric acid levels with the indicators of leg ischemia were also found after adjustment for age, history of revascularization therapy, diabetes, smoking, alcohol consumption, body mass index, triglyceride levels, and renal function. Uric acid levels are associated with the degree of leg ischemia in patients with PAD. Further interventional studies are needed to determine whether the correction of uric acid levels is effective in preventing the progression of PAD.

  19. Intelligence in early adulthood and subclinical atherosclerosis in middle-aged men: the Vietnam Experience Study.

    Science.gov (United States)

    Gale, Catharine R; Deary, Ian J; Fowkes, F Gerald; Batty, G David

    2012-07-01

    People with higher intelligence in early life have a lower subsequent risk of coronary heart disease events, but the explanation for these observations is unclear. To examine whether intelligence in early adulthood is associated with risk of subclinical atherosclerosis in mid-life, as indicated by the ankle brachial index (ABI), and investigate its potential mediating role in the association between intelligence and mortality. Participants were 4286 male US veterans whose intelligence was measured on enlistment into military service at a mean age of 20.4 years and whose ABI was measured by Doppler as part of a detailed medical examination at a mean age of 38.3 years. Higher intelligence in early adulthood was associated with a higher ABI in mid-life. For an SD increase in intelligence, after adjusting for age, ABI (× 10) rose by 0.05 (0.02, 0.07), and the OR (95% CI) for having a low ABI (≤ 0.90) was 0.84 (0.72 to 0.98). Further adjustment for smoking, serum cholesterol, triglycerides and glucose concentrations, blood pressure, erythrocyte sedimentation rate, body mass index, alcohol intake, education and measures of socioeconomic position had little or no attenuating effect on these associations. Lower ABI was associated with increased mortality from all causes and cardiovascular disease but it did not account for the associations between IQ and mortality from these causes. Men of lower intelligence may be more susceptible to atherogenesis, though this mechanism does not appear to explain their increased risk of earlier death.

  20. [Prevalence of abdominal aortic aneurysm in a rural population of 65-80 year-old males].

    Science.gov (United States)

    Salcedo Jódar, L; Alcázar Carmona, P; Tenías Burillo, J M; García Tejada, R

    2014-01-01

    The prevalence of aortic aneurysm (AAA) is reported to be 3.55%-4% in men over 65. But it is not known if this prevalence, resulting from ultrasound measurements made by Family Physicians, can be extrapolated to a rural population. To estimate the prevalence of AAA in a rural population of males aged 65-80 years, using abdominal ultrasound by family physicians, and to identify its association with different cardiovascular risk factors. A cross sectional study was conducted that included males of 65-80 years (n=320) in a rural population of the province of Ciudad Real, Spain. The dependent variable was the presence or not of AAA using ultrasound measurements of the aorta. Those with a diameter greater than or equal to 3cm were considered positive. Explanatory variables were measured; ankle/brachial index (ABI), body mass index (BMI), medical history of high blood pressure (hypertension), diabetes mellitus (DM), dyslipidaemia (DLP), ischemic heart disease, cerebrovascular accidents (CVA), and smoking habits. A bivariate and multivariate analysis of the prevalences was performed, as well as a study of the agreement between observers. The prevalence of AAA in the population was 3.3% (95% CI: 1.1-5.5%. DM and DLP were significantly associated with AAA. The agreement between observers was 0.96 (95% CI; 0.91-0.98). The high prevalence of different cardiovascular risk factors (CVRF) was particularly noteworthy. The prevalence of AAA in 65-80 year-old males in a rural population is similar to that found in the literature. Due to the cross-sectional nature of the study, CVRFs such as hypertension or CVA were not associated with the AAA. A screening program for the early detection of AAA could be introduced into Primary Health Care by family physicians. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  1. Plasma cathepsin S and cystatin C levels and risk of abdominal aortic aneurysm: a randomized population-based study.

    Directory of Open Access Journals (Sweden)

    Bing-Jie Lv

    Full Text Available BACKGROUND: Human abdominal aortic aneurysm (AAA lesions contain high levels of cathepsin S (CatS, but are deficient in its inhibitor, cystatin C. Whether plasma CatS and cystatin C levels are also altered in AAA patients remains unknown. METHODS AND RESULTS: Plasma samples were collected from 476 male AAA patients and 200 age-matched male controls to determine CatS and cystatin C levels by ELISA. Student's t test demonstrated higher plasma levels of total, active, and pro-CatS in AAA patients than in controls (P<0.001. ROC curve analysis confirmed higher plasma total, active, and pro-CatS levels in AAA patients than in controls (P<0.001. Logistic regression suggested that plasma total (odds ratio [OR] = 1.332, active (OR = 1.21, and pro-CatS (OR = 1.25 levels were independent AAA risk factors that associated positively with AAA (P<0.001. Plasma cystatin C levels associated significantly, but negatively, with AAA (OR = 0.356, P<0.001. Univariate correlation demonstrated that plasma total and active CatS levels correlated positively with body-mass index, diastolic blood pressure, and aortic diameter, but negatively with the lowest ankle-brachial index (ABI. Plasma cystatin C levels also correlated negatively with the lowest ABI. Multivariate linear regression showed that plasma total, active, and pro-CatS levels correlated positively with aortic diameter and negatively with the lowest ABI, whereas plasma cystatin C levels correlated negatively with aortic diameter and the lowest ABI, after adjusting for common AAA risk factors. CONCLUSIONS: Correlation of plasma CatS and cystatin C with aortic diameter and the lowest ABI suggest these serological parameters as biomarkers for human peripheral arterial diseases and AAA.

  2. Sex differences in correlates of intermediate phenotypes and prevalent cardiovascular disease in the general population

    Directory of Open Access Journals (Sweden)

    Renate B. Schnabel

    2015-04-01

    Full Text Available Background-There are marked sex differences in cardiovascular disease [CVD] manifestation. It is largely unknown how the distribution of CVD risk factors or intermediate phenotypes explain sex-specific differences.Methods and Results-In 5000 individuals of the population-based Gutenberg Health Study, mean age 55±11 years, 51% males, we examined sex-specific associations of classical CVD risk factors with intima-media thickness, ankle-brachial index, flow-mediated dilation, peripheral arterial tonometry, echocardiographic and electrocardiographic variables. Intermediate cardiovascular phenotypes were related to prevalent CVD (coronary artery disease, heart failure, stroke, myocardial infarction, lower extremity artery disease [LEAD] N=561.We observed differential distributions of CVD risk factors with a higher risk factor burden in men. Manifest coronary artery disease, stroke, myocardial infarction and LEAD were more frequent in men; the proportion of heart failure was higher in women. Intermediate phenotypes showed clear sex differences with more beneficial values in women. Fairly linear changes towards less beneficial values with age were observed in both sexes. In multivariable-adjusted regression analyses age, systolic blood pressure and body mass index were consistently associated with intermediate phenotypes in both sexes with different ranking according to random forests, maximum model R² 0.43. Risk factor-adjusted associations with prevalent CVD showed some differences by sex. No interactions by menopausal status were observed. Conclusions-In a population-based cohort we observed sex differences in risk factors and a broad range of intermediate phenotypes of noninvasive cardiovascular structure and function. Their relation to prevalent CVD differed markedly. Our results indicate the need of future investigations to understand sex differences in CVD manifestation.

  3. Recalcitrant Venous Leg Ulcers May Heal by Outpatient Treatment of Venous Disease Even in the Presence of Concomitant Arterial Occlusive Disease.

    Science.gov (United States)

    Mosti, G; Cavezzi, A; Massimetti, G; Partsch, H

    2016-09-01

    Peripheral arterial occlusive disease (PAOD) is reported in about 15-20% of patients with venous leg ulcers (VLU). In such cases arterial recanalization is often recommended, and compression therapy is considered a contraindication when the ankle brachial pressure index (ABPI) is venous recalcitrant leg ulcer" [pvRLU]) and with associated PAOD ("mixed arterial and venous recalcitrant leg ulcer" [mavRLU]), by treating only the venous disease. The records of 180 outpatients with recalcitrant ulcers treated between January 2011 and July 2014 were reviewed retrospectively. In total, 109 were affected by pvRLU and 71 by mavRLU, with moderate PAOD defined by an ABPI between 0.5 and 0.8. In addition to the same local wound dressing, the patients received ultrasound guided foam sclerotherapy of the refluxing superficial veins and a modified inelastic compression with a pressure ≤ 40 mmHg. No patient was referred for arterial revascularization. The patients were followed until ulcer healing. Patients with pvRLU and mavRLU showed comparable demographic characteristics. Twenty-five patients were lost to follow up and the outcomes were analyzed in 93 patients with pVLU (85.4%) and in 62 patients with mavRLU (87.4%). The maximum time to complete healing was 48 weeks in the pvRLU group and 52 weeks in the mavRLU group (p = .009), The median healing time was 23 (pvRLU) versus 25.5 weeks (mavRLU) (p = .030). Deep venous incompetence (p ulcer surface area (p ulcer duration (p ulcers by treating venous incompetence by foam sclerotherapy and modified compression is successful, even if underlying moderate PAOD is not actively treated. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  4. The contribution of cardiovascular risk factors to peripheral arterial disease in South Asians and Blacks: a sub-study to the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) study.

    Science.gov (United States)

    Bennett, P C; Lip, G Y H; Silverman, S; Blann, A D; Gill, P S

    2010-09-01

    To determine whether differences exist in prevalence of peripheral arterial disease (PAD) between South Asians (people originating from India, Pakistan and Bangladesh) and Blacks (Black Caribbean and Black African), the two largest minority ethnic groups in the UK. To determine if associations with cardiovascular risk factors and this disease differ between these two ethnic groups. We recruited 572 patients (356 South Asian and 216 Blacks) > or = 45 years as a sub-study to a community screening project, the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) study. All subjects completed an interviewer-led questionnaire, anthropometric measurements and blood sampling. Ankle brachial pressure index (ABPI) was calculated and intermittent claudication was assessed using the Edinburgh Claudication Questionnaire. The presence of PAD was defined as ABPI South Asians and 10.2% (95% CI 6.2-14.2) in Blacks with no significant difference between the two ethnic groups. The prevalence of PAD was higher in South Asian women than Black women (16.3 vs. 6.1%; P = 0.011). No difference in prevalence was found in men (11 vs. 14% P = 0.47, in South Asians and Blacks, respectively). The prevalence of intermittent claudication was 0.9% (95% CI 0.11-1.63). On multivariate logistic regression, mean systolic blood pressure, diabetes, smoking and male sex were independently associated with PAD in South Asians (P = 0.016, 0.022, 0.037 and 0.008, respectively). In Blacks, only age remained independently associated with PAD on multivariate logistic regression (P = 0.003). The prevalence of PAD is similar in South Asians and Blacks, and similar to levels reported in pre-dominantly White populations. South Asian women had a higher prevalence of PAD than Black women, which is not explained by traditional cardiovascular risk factors.

  5. The Viborg vascular (VIVA screening trial of 65-74 year old men in the central region of Denmark: study protocol

    Directory of Open Access Journals (Sweden)

    Henneberg Eskild W

    2010-05-01

    Full Text Available Abstract Background Screening for abdominal aortic aneurysm (AAA of men aged 65-74 years reduces the AAA-related mortality and is generally considered cost effective. Despite of this only a few national health care services have implemented permanent programs. Around 10% of men in this group have peripheral arterial disease (PAD defined by an ankle brachial systolic blood pressure index (ABI below 0.9 resulting in an increased mortality-rate of 25-30%. In addition well-documented health benefits may be achieved through primary prophylaxis by initiating systematic cholesterol-lowering, smoking cessation, low-dose acetylsalicylic acid (aspirins, exercise, a healthy diet and blood-pressure control altogether reducing the increased risks for cardiovascular disease by at least 20-25%. The benefits of combining screening for AAA and PAD seem evident; yet they remain to be established. The objective of this study is to assess the efficacy and the cost-effectiveness of a combined screening program for AAA, PAD and hypertension. Methods The Viborg Vascular (VIVA screening trial is a randomized, clinically controlled study designed to evaluate the benefits of vascular screening and modern vascular prophylaxis in a population of 50,000 men aged 65-74 years. Enrolment started October 2008 and is expected to stop in October 2010. The primary outcome is all-cause mortality. The secondary outcomes are cardiovascular mortality, AAA-related mortality, hospital services related to cardiovascular conditions, prevalence of AAA, PAD and potentially undiagnosed hypertension, health-related quality of life and cost effectiveness. Data analysis by intention to treat. Results Major follow-up will be performed at 3, 5 and 10 years and final study result after 15 years. Trial registration ClinicalTrials.gov NCT00662480

  6. Pesticide Use Site Index

    Science.gov (United States)

    The Pesticide Use Site Index will help a company (or other applicant) identify which data requirements are needed to register a pesticide product. It provides information on pesticide use sites and pesticide major use patterns.

  7. Palmer Drought Severity Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — PDSI from the Dai dataset. The Palmer Drought Severity Index (PDSI) is devised by Palmer (1965) to represent the severity of dry and wet spells over the U.S. based...

  8. VT Nitrate Leaching Index

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) Nitrate Leaching Index data for the state of Vermont. This is a derivative product based on the SSURGO soils data for all counties except Essex...

  9. National Death Index

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Death Index (NDI) is a centralized database of death record information on file in state vital statistics offices. Working with these state offices, the...

  10. Regional Snowfall Index (RSI)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA's National Climatic Data Center is now producing the Regional Snowfall Index (RSI) for significant snowstorms that impact the eastern two thirds of the U.S. The...

  11. TOMS Absorbing Aerosol Index

    Data.gov (United States)

    Washington University St Louis — TOMS_AI_G is an aerosol related dataset derived from the Total Ozone Monitoring Satellite (TOMS) Sensor. The TOMS aerosol index arises from absorbing aerosols such...

  12. Indexing for summary queries

    DEFF Research Database (Denmark)

    Yi, Ke; Wang, Lu; Wei, Zhewei

    2014-01-01

    returned by reporting queries. In this article, we design indexing techniques that allow for extracting a statistical summary of all the records in the query. The summaries we support include frequent items, quantiles, and various sketches, all of which are of central importance in massive data analysis....... Our indexes require linear space and extract a summary with the optimal or near-optimal query cost. We illustrate the efficiency and usefulness of our designs through extensive experiments and a system demonstration....

  13. NURSING REMUNERATION INDEX

    OpenAIRE

    Suprajitno Suprajitno

    2017-01-01

    Introduction: Nurses have some variables, which can be used as basic of the remuneration. The aim of the study was to develop nursing remuneration index in the hospital of Ngudi Waluyo Wlingi using statistics approach. Methods: Research design was descriptive, study that is divided into two levels. The fi rst level was surveying and focus group discussion and the second level was assessing the remuneration index formula by simulation. The subject for surveying was the whole nurses who have st...

  14. Silt density index and modified fouling index relation, and effect of pressure, temperature and membrane resistance

    NARCIS (Netherlands)

    Al-Hadidi, A.M.M.; Alhadidi, A.; Kemperman, Antonius J.B.; Blankert, B.; Blankert, B.; Schippers, J.C.; Wessling, Matthias; van der Meer, Walterus Gijsbertus Joseph

    2011-01-01

    Particulate matter present in feed water of reverse osmosis and nanofiltration membrane elements tends to deposit on the membrane surface and spacers. This type of fouling results in permeate flux decline, loss of product quality and membrane damage. To characterize the fouling potential of RO feed

  15. Browse Title Index

    African Journals Online (AJOL)

    , Abstract PDF ... Vol 29, No 2 (2017), Prescription pattern of antihypertensive medications and blood pressure control among hypertensive outpatients at the University of Benin Teaching Hospital in Benin City, Nigeria ...

  16. Relationship between anthropometric and hemodynamic indexes in school children

    Directory of Open Access Journals (Sweden)

    Ana Paula de Oliveira Azambuja

    2014-03-01

    Cardiovascular diseases are the main cause of death in world population. Current analysis with 1074 schoolchildren in municipal schools of Cruzeiro do Oeste, Paraná State, Brazil, evaluated anthropometric indexes and blood pressure levels of schoolchildren and verified the relationship between Body Mass Index (BMI and Waist Circumference (WC with blood pressure (BP. Evaluations comprised weight and height for the calculation of BMI, waist circumference and arterial pressure. Chi-square test and Cramer’s coefficient verified whether the variables were associated. High percentage of weight excess was reported, or rather, 16.6% of children were overweight; 9.8% were obese; 30.6% had high WC and 38.3% had high blood pressure. BMI and WC were associated with high BP. Overweight schoolchildren with central adiposity had a great trend of having high blood pressure.

  17. Ruby fluorescence pressure scale: Revisited

    International Nuclear Information System (INIS)

    Liu Lei; Bi Yan; Xu Ji-An

    2013-01-01

    Effect of non-hydrostatic stress on X-ray diffraction in a diamond anvil cell (DAC) is studied. The pressure gradient in the sample chamber leads to the broadening of the diffraction peaks, which increase with the hkl index of the crystal. It is found that the difference between the determined d-spacing compressive ratio d/d 0 and the real d-spacing compressive ratio d r /d 0 is determined by the yield stress of the pressure transmitting media (if used) and the shear modulus of the sample. On the basis of the corrected experiment data of Mao et al. (MXB86), which was used to calibrate the most widely used ruby fluorescence scale, a new relationship of ruby fluorescence pressure scale is corrected, i.e., P = (1904/9.827)[(1 + Δλ/λ 0 ) 9.827 −1]. (condensed matter: structural, mechanical, and thermal properties)

  18. Normal Pressure Hydrocephalus (NPH)

    Science.gov (United States)

    ... local chapter Join our online community Normal Pressure Hydrocephalus (NPH) Normal pressure hydrocephalus is a brain disorder ... Symptoms Diagnosis Causes & risks Treatments About Normal Pressure Hydrocephalus Normal pressure hydrocephalus occurs when excess cerebrospinal fluid ...

  19. Detection of peripheral arterial disease with an improved automated device: comparison of a new oscillometric device and the standard Doppler method

    Directory of Open Access Journals (Sweden)

    Špan M

    2016-07-01

    Full Text Available Matjaž Špan,1 Gregor Geršak,2 Sandrine C Millasseau,3 Marko Meža,4 Andrej Košir4 1Cardiovascular Department, Izola General Hospital, Izola, 2Laboratory of Metrology and Quality, Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia; 3Pulse Wave Consulting, Saint Leu La Foret, France; 4Faculty of Electrical Engineering, User-adapted Communication and Ambient Intelligence Lab, University of Ljubljana, Ljubljana, Slovenia Abstract: In occidental countries, peripheral arterial disease (PAD is an important health issue; however, most subjects are asymptomatic (~50% and therefore undiagnosed and untreated. Current guidelines recommend screening for PAD in primary care setting using ankle brachial index (ABI in all patients with cardiovascular risks. This is, however, not performed strictly because the standard Doppler method is cumbersome and time-consuming. Here, we evaluate the accuracy and reproducibility of ABI measurements obtained by an improved automated oscillometric device, the MESI ABPI MD® device, and the standard Doppler method. ABI was measured in random order in a general practice with Doppler probes by two operators separately (ABI_dop and twice with the MESI ABPI MD device (ABI_mesi. ABI_dop was calculated dividing the highest systolic blood pressure from both tibial and dorsalis pedis arteries by the highest systolic blood pressure of both brachial arteries. ABI_mesi was obtained automatically with simultaneous measurements on three extremities. According to ABI_dop, PAD was present in 10% of the 136 screened subjects (68.2±7.4 years. Interoperator coefficient of variation was 5.5% for ABI_dop, while the intrasubject coefficient of variation for ABI_mesi was 3.0%. ABI_mesi was correlated with ABI_dop (R=0.61, P<0.0001. The difference between the two techniques was 0.06±0.14 with ABI_mesi providing slightly higher values (P<0.0001 and negligible bias across the range (R=0.19, P<0.0001. Therefore, ABI

  20. Oral buflomedil in the prevention of cardiovascular events in patients with peripheral arterial obstructive disease: a randomized, placebo-controlled, 4-year study.

    Science.gov (United States)

    Leizorovicz, A; Becker, F

    2008-02-12

    Cardiovascular-related morbidity and mortality in patients with peripheral arterial obstructive disease remain high. We performed an international, multicenter, randomized, double-blind, placebo-controlled trial to investigate whether long-term administration of oral buflomedil could reduce the rate of cardiovascular events in patients with intermittent claudication. Patients >40 years of age with documented peripheral arterial obstructive disease, intermittent claudication, and an ankle-brachial index between 0.30 and 0.80 were eligible for inclusion and were randomized to receive orally either buflomedil or placebo for 2 to 4 years. Aspirin was recommended for all patients (unless they were receiving other antithrombotic treatments at inclusion). The primary efficacy outcome was critical cardiovascular events, defined as the composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, symptomatic deterioration of peripheral arterial obstructive disease, or leg amputation. A total of 2078 patients were recruited. Mean treatment duration was 33 months. The rate of critical cardiovascular events was significantly lower in buflomedil-randomized patients than in placebo-randomized patients (9.1% versus 12.4%; hazard ratio, 0.742; 95% confidence interval, 0.603 to 0.915; P=0.0163). Ankle-brachial index increased by 9.2% in buflomedil-randomized patients and decreased by 3.6% in placebo-randomized patients (Pperipheral arterial disease. The use of buflomedil should be considered in addition to an antiplatelet agent in patients with peripheral arterial obstructive disease and intermittent claudication.

  1. Common polymorphisms in CYP2C9, subclinical atherosclerosis and risk of ischemic vascular disease in 52 000 individuals

    DEFF Research Database (Denmark)

    Kaur-Knudsen, D.; Bojesen, S.E.; Nordestgaard, Børge

    2009-01-01

    Cytochrome P450 2C9 (CYP2C9) enzymes metabolize warfarin and arachidonic acid. We hypothesized that the CYP2C9*2 (rs. 1799853) and CYP2C9*3 (rs. 1057910) polymorphisms with decreased enzyme activity affect risk of subclinical atherosclerosis (reduced ankle brachial index and increased C-reactive ......Cytochrome P450 2C9 (CYP2C9) enzymes metabolize warfarin and arachidonic acid. We hypothesized that the CYP2C9*2 (rs. 1799853) and CYP2C9*3 (rs. 1057910) polymorphisms with decreased enzyme activity affect risk of subclinical atherosclerosis (reduced ankle brachial index and increased C...... of follow-up; the Copenhagen General Population Study, a cross-sectional study including 21 629 participants; and the Copenhagen Ischemic Heart Disease Study, a case-control study including 5082 cases and 14 904 controls. CYP2C9 carriers versus noncarriers did not associate with subclinical atherosclerosis......% power. In conclusion, in three independent studies totaling more than 52 000 individuals, we found no association between CYP2C9*2 and CYP2C9*3 polymorphisms and risk of subclinical atherosclerosis, ischemic vascular disease or death after ischemic heart disease. The Pharmacogenomics Journal (2009) 9...

  2. Racial differences in functional decline in peripheral artery disease and associations with socioeconomic status and education.

    Science.gov (United States)

    McDermott, Mary M; Polonsky, Tamar S; Kibbe, Melina R; Tian, Lu; Zhao, Lihui; Pearce, William H; Gao, Ying; Guralnik, Jack M

    2017-09-01

    The objective of this study was to determine whether blacks with lower extremity peripheral artery disease (PAD) have faster functional decline than whites with PAD. Participants with ankle-brachial index sex, ankle-brachial index, comorbidities, and other confounders (hazard ratio, 1.45; 95% confidence interval, 1.05-1.99; P = .022). This association was attenuated after adjustment for income and education (P = .229). Among 844 participants without baseline mobility impairment, black participants had a higher rate of mobility loss (64/209 [30.6%] vs 164/635 [25.8%]; log-rank, P = .009). Black race was associated with increased mobility loss, adjusting for potential confounders (hazard ratio, 1.42; 95% confidence interval, 1.04-1.94; P = .028). This association was attenuated after additional adjustment for income and education (P = .392) and physical activity (P = .113). There were no racial differences in average annual declines in 6-minute walk, usual-paced 4-meter walking velocity, or fast-paced 4-meter walking velocity. Black PAD patients have higher rates of mobility loss and becoming unable to walk for 6 minutes continuously. These differences appear related to racial differences in socioeconomic status and physical activity. Copyright © 2017 Society for Vascular Surgery. All rights reserved.

  3. Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion.

    Science.gov (United States)

    Zhu, Yue-Qi; Zhao, Jun-Gong; Li, Ming-Hua; Liu, Fang; Wang, Jian-Bo; Cheng, Ying-Sheng; Wang, Jue; Li, Jie

    2010-12-01

    To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry following unsuccessful subintimal angioplasty for arterial occlusion below the ankle. TDP or TPD retrograde intraluminal re-entry angioplasty was attempted in 8 limbs of 8 diabetic patients (5 men; mean age 74.5 ± 7.76 years, range 62-81) with chronic below-the-ankle arterial occlusive disease when standard transtibial subintimal angioplasty failed. The clinical symptoms, dorsal or plantar arterial pulse volume scores, and ankle-brachial indexes (ABI) were compared before and after the procedures. At follow-up, pain relief, wound healing, limb salvage, and the presence of any restenosis of the target vessels were evaluated. TDP or TPD retrograde intraluminal re-entry angioplasty was performed successfully in 5 (62.5%) patients; foot pain improved, with median pulse volume scores and ankle-brachial indexes increasing from 0.60 ± 0.55 and 0.32 ± 0.20 before to 2.40 ± 0.55 and 0.75 ± 0.12, respectively, after the procedure (pfoot ischemia in diabetic patients when standard below-the-ankle angioplasty has failed.

  4. Femoro-Supragenicular Popliteal Bypass with a Bridging Stent Graft in a Diffusely Diseased Distal Target Popliteal Artery: Alternative to Below-Knee Popliteal Polytetrafluoroethylene Bypass

    Directory of Open Access Journals (Sweden)

    Joung Hun Byun

    2017-10-01

    Full Text Available Background: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. Methods: Between April 2012 and October 2015, 16 patients (18 limbs with lifestyle- limiting claudication (n=12 or chronic critical limb ischemia (n=6 underwent femoral–above-knee (AK polytetrafluoroethylene (PTFE bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. Results: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months, and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55 significantly increased to 0.8 (range, 0.5 to 1.0 at 12 months (p<0.01. The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. Conclusion: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.

  5. Low-level laser therapy and Calendula officinalis in repairing diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Ana Flávia Machado de Carvalho

    Full Text Available Abstract OBJECTIVE To evaluate the effects of low-level laser therapy isolated and associated with Calendula officinalis oil in treating diabetic foot ulcers. METHOD An experimental, randomized, controlled, prospective, interventional clinical case study using a quantitative approach. The sample consisted of 32 diabetic patients of both genders. Participants were randomly divided into four groups. Doppler Ultrasound evaluation of the Ankle-Brachial Index, brief pain inventory and analog pain scale were performed at baseline and after 30 days. RESULTS Reduced pain was observed in the Low-level laser therapy and Low-level laser therapy associated with Essential Fatty Acids groups (p<0.01. Regarding the Ankle-Brachial Index and Doppler Ultrasound, all groups remained stable. By analyzing lesion area reduction, Low-level laser therapy associated with Essential fatty acids group showed a significance of p=0.0032, and the Low-level laser therapy group showed p=0.0428. CONCLUSION Low-level laser therapy, performed alone or associated with the Calendula officinalis oil was effective in relieving pain and accelerating the tissue repair process of diabetic foot.

  6. Sustainability index for Taipei

    International Nuclear Information System (INIS)

    Lee, Y.-J.; Huang Chingming

    2007-01-01

    Sustainability indicators are an effective means of determining whether a city is moving towards sustainable development (SD). After considering the characteristics of Taipei, Taiwan, discussions with experts, scholars and government departments and an exhaustive literature review, this study selected 51 sustainability indicators corresponding to the socio-economic characteristic of Taipei City. Such indicators should be regarded as a basis for assessing SD in Taipei City. The 51 indicators are classified into economic, social, environmental and institutional dimensions. Furthermore, statistical data is adopted to identify the trend of SD from 1994 to 2004. Moreover, the sustainability index is calculated for the four dimensions and for Taipei as a whole. Analysis results demonstrate that social and environmental indicators are moving towards SD, while economic and institutional dimensions are performing relatively poorly. However, since 2002, the economic sustainability index has gradually moved towards SD. Overall, the Taipei sustainability index indicates a gradual trend towards sustainable development during the past 11 years

  7. Calculate Your Body Mass Index

    Science.gov (United States)

    ... Can! ) Health Professional Resources Calculate Your Body Mass Index Body mass index (BMI) is a measure of body fat based ... Health Information Email Alerts Jobs and Careers Site Index About NHLBI National Institute of Health Department of ...

  8. 2005 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2005 Environmental Sustainability Index (ESI) is a measure of overall progress towards environmental sustainability, developed for 146 countries. The index...

  9. Bibliography on vapour pressure isotope effects

    International Nuclear Information System (INIS)

    Illy, H.; Jancso, G.

    1976-03-01

    The bibliography of research on vapour pressure isotope effects from 1919 to December 1975 is presented in chronological order. Within each year the references are listed alphabetically according to the name of the first author of each work. The bibliography is followed by a Compound Index containing the names o compounds, but the type of isotopic substituation is not shown. The Author Index includes all authors of the papers. (Sz.N.Z.)

  10. Redução da pressão arterial, da IMC e da glicose após treinamento aeróbico em idosas com diabete tipo 2 Decrease in blood pressure, body mass index and glycemia after aerobic training in elderly women with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Luciana Zaranza Monteiro

    2010-10-01

    Full Text Available FUNDAMENTO: O processo de envelhecimento associa-se ao desenvolvimento de várias doenças, que podem ser amenizadas pela prática de atividades físicas. O treinamento aeróbico é um meio efetivo para manter e melhorar as funções cardiovasculares. Além disso, desempenha um papel fundamental na prevenção e tratamento de diversas doenças crônico-degenerativas, em especial o diabete melito. OBJETIVO: Verificar os efeitos de 13 semanas de treinamento aeróbico sobre a pressão arterial, o índice de massa corpórea e a glicemia em idosas com diabete tipo 2. MÉTODOS: Onze mulheres idosas diabéticas (61,0 ± 9,1 anos de idade, sedentárias, realizaram 13 semanas de treinamento aeróbico, compondo o grupo G2. Onze idosas (60,2 ± 6,8 anos de idade controladas não realizaram exercícios físicos durante a pesquisa, constituindo o grupo-controle (G1. O grupo G1 foi submetido somente a orientações educativas uma vez na semana, e o grupo G2, a caminhadas três vezes na semana. RESULTADOS: Houve redução significativa da glicemia e da pressão arterial diastólica nos dois grupos. Não foram encontradas reduções significativas no IMC após o treinamento aeróbico em ambos os grupos. CONCLUSÃO: Treze semanas de treinamento aeróbico foi suficiente para promover reduções significativas na pressão arterial diastólica e glicemia, portanto, esse tipo de exercício reduz os fatores de risco para doenças cardiovasculares e metabólicas.BACKGROUND: The aging process is associated with the development of several diseases, which can be attenuated by the practice of physical activities. Aerobic training is an effective method to maintain and improve cardiovascular function. Additionally, it has a crucial role in the prevention and treatment of several chronic-degenerative diseases, especially diabetes mellitus. }OBJECTIVE: To verify the effect of a 13-week aerobic training program on blood pressure (BP, body mass index (BMI and glycemia levels

  11. Inflammation and infection do not promote arterial aging and cardiovascular disease risk factors among lean horticulturalists.

    Directory of Open Access Journals (Sweden)

    Michael Gurven

    2009-08-01

    Full Text Available Arterial aging is well characterized in industrial populations, but scantly described in populations with little access to modern medicine. Here we characterize health and aging among the Tsimane, Amazonian forager-horticulturalists with short life expectancy, high infectious loads and inflammation, but low adiposity and robust physical fitness. Inflammation has been implicated in all stages of arterial aging, atherogenesis and hypertension, and so we test whether greater inflammation associates with atherosclerosis and CVD risk. In contrast, moderate to vigorous daily activity, minimal obesity, and low fat intake predict minimal CVD risk among older Tsimane.Peripheral arterial disease (PAD, based on the Ankle-Brachial Index (ABI, and hypertension were measured in Tsimane adults, and compared with rates from industrialized populations. No cases of PAD were found among Tsimane and hypertension was comparatively low (prevalence: 3.5%, 40+; 23%, 70+. Markers of infection and inflammation were much higher among Tsimane than among U.S. adults, whereas HDL was substantially lower. Regression models examine associations of ABI and BP with biomarkers of energy balance and metabolism and of inflammation and infection. Among Tsimane, obesity, blood lipids, and disease history were not significantly associated with ABI. Unlike the Tsimane case, higher cholesterol, C-reactive protein, leukocytes, cigarette smoking and systolic pressure among North Americans are all significantly associated with lower ABI.Inflammation may not always be a risk factor for arterial degeneration and CVD, but instead may be offset by other factors: healthy metabolism, active lifestyle, favorable body mass, lean diet, low blood lipids and cardiorespiratory health. Other possibilities, including genetic susceptibility and the role of helminth infections, are discussed. The absence of PAD and CVD among Tsimane parallels anecdotal reports from other small-scale subsistence

  12. Cardiac troponin T predicts occult coronary artery stenosis in patients with chronic kidney disease at the start of renal replacement therapy.

    Science.gov (United States)

    Hayashi, Terumasa; Obi, Yoshitsugu; Kimura, Tomonori; Iio, Ken-Ichiro; Sumitsuji, Satoru; Takeda, Yoshihiro; Nagai, Yoshiyuki; Imai, Enyu

    2008-09-01

    The high prevalence of asymptomatic coronary artery stenosis (CAS) in chronic kidney disease (CKD) has emerged as an important predictor of outcome. However, diagnostic tools that can identify asymptomatic CAS have not yet been established. We investigated whether asymptomatic patients at the initiation of renal replacement therapy (RRT) could be screened using cardiac troponin T (cTnT) and atherosclerotic surrogate markers such as ankle-brachial blood pressure index (ABPI) and intima-media thickness (IMT). Among 142 patients who were about to start RRT, 60 who were asymptomatic underwent coronary evaluation by multi-slice computed tomography (MSCT) and/or coronary angiography (CAG). CAG diagnosed 35 patients (43.8%) as CAS positive and 27 of them had multi-vessel disease. Factors associated with CAS were smoking, elevated cTnT, low ABPI and high IMT. Moreover, the severity of CAS was associated with smoking, cTnT and ABPI. Stepwise logistic regression analyses revealed that cTnT was a powerful predictor of asymptomatic multi-vessel CAS. Receiver operating characteristic analysis documented the usefulness of cTnT as a screening tool with a cut-off point 0.05 ng/ml. The optimal screening tool for multi-vessel CAS was cTnT (sensitivity, 92.6%; 95% CI, 82.7-99.9; specificity, 63.6%; 95% CI, 47.2-80.0). We concluded that cTnT should be measured as part of a strategy for detecting asymptomatic CAS, especially multi-vessel disease in patients with CKD at the start of RRT.

  13. Peripheral arterial disease among adult diabetic patients attending a large outpatient diabetic clinic at a national referral hospital in Uganda: a descriptive cross sectional study.

    Directory of Open Access Journals (Sweden)

    Raymond Mbayo Mwebaze

    Full Text Available BACKGROUND: Peripheral arterial disease (PAD is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda. METHODS: In this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 5-10 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without. RESULTS: The mean age/standard deviation of the study participants was 53.9/12.4 years with a male predominance (75, 51.4%. PAD was prevalent in 57 (39% study participants. Of these, 34 (59.6% had symptomatic PAD. The noted clinical factors associated with PAD in this study population were presence of symptoms of intermittent claudication and microalbuminuria. CONCLUSIONS: This study documents a high prevalence of PAD among adult ambulatory Ugandan diabetic patients. Aggressive screening for PAD using ABI measurement in adult diabetic patients should be emphasised in Uganda especially in the presence of symptoms of intermittent claudication and microalbuminuria.

  14. Evaluation of hyperspectral imaging technology in patients with peripheral vascular disease.

    Science.gov (United States)

    Chiang, Nathaniel; Jain, Jitendra K; Sleigh, Jamie; Vasudevan, Thodur

    2017-10-01

    Hyperspectral imaging technology is a novel method of using transcutaneous measurement of oxyhemoglobin (HT-Oxy) and deoxyhemoglobin (HT-Deoxy) concentrations to create a two-dimensional, color-coded "oxygen map." The aims of this study were to compare the use of a hyperspectral imaging device with the transcutaneous oxygen measurement (TCOM), ankle-brachial index (ABI), and severity of peripheral vascular disease (PVD) and to assess their correlations. This prospective study recruited 294 participants divided into three distinct groups composed of healthy volunteers and patients with PVD. Patients underwent measurements of lower limbs at a standardized point over the head of the first metatarsal on the plantar aspect using the hyperspectral imaging device, generating four outputs including HT-Oxy, HT-Deoxy, oxygen saturation (HT-Sat), and skin temperature, and the TCOM system, generating transcutaneous partial pressure of oxygen (TcpO 2 ) and carbon dioxide (TcpCO 2 ). Demographic data, severity of PVD, ABI, and other pertinent information were obtained from both the participants and medical records. Interoperator reliability ranged from 86% to 94% across the four hyperspectral imaging device outputs, whereas intraoperator reliability ranged from 92% to 94%. The HT-Oxy, HT-Sat, TcpCO 2 , and ABI of the diseased limb correlated significantly with the severity of PVD. HT-Sat significantly correlated with TcpO 2 (R = 0.19), TcpCO 2 (R = -0.26), ABI (R = 0.42), and skin temperature (R = 0.56). HT-Deoxy also correlated with TcpCO 2 (R = 0.27). This study demonstrates the reliability of hyperspectral imaging in comparison to TCOM, ABI, skin temperature, and severity of PVD in a series of patients. Its correlation to other established modalities and low interoperator and intraoperator variability could enable this modality to be a useful screening tool in PVD. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  15. Premature vascular deterioration in young patients affected by Wilson’s disease: a pilot study

    Directory of Open Access Journals (Sweden)

    Georgios Kouvelas

    2017-07-01

    Full Text Available Introduction: Wilson’s disease (WD is a genetically inherited pathology which leads to an excessive deposition of copper in the human tissues, most of all in those of liver and brain. Even the cardiovascular system may be involved, although heart and vessels in those suffering from WD were fleetingly studied. This research aimed at evaluating the autonomic control of blood pressure (BP and the endothelial function in a sample of young WD subjects.Methods: Eleven WD individuals were recruited in the study (54% females; mean age and age at diagnosis: 16.3 ± 5.0 and 8.3 ± 4.0 years, respectively. BP was measured at the right arm (supine and upright after 3 minutes of standing and ankle-brachial index (ABI was evaluated as well. WD findings were compared with those of healthy peers (controls.Results: In those with WD, systolic BP in the upright position raised when compared to the value in the supine position (128 ± 2 vs 112 ± 3 mmHg, p < 0.002, while declined in the controls. ABI was significantly lower in WD group (0.9 ± 0.2 vs 1.1 ± 0.1 in the control group, p < 0.05 and an inverse correlation was found between the disease duration and ABI as well (r = -0.66, p < 0.03.Conclusions: These preliminary results suggest an early vascular de­terioration in WD patients, notwithstanding their very young age and concomitant copper-chelating treatment. Although the heart and vessels are not the main target of WD, the detection of this unique population, potentially predisposed to cardiovascular accidents, suggests to enhance strategies of primary prevention.

  16. Efficacy of Cellular Therapy for Diabetic Foot Ulcer: A Meta-Analysis of Randomized Controlled Clinical Trials.

    Science.gov (United States)

    Zhang, Ye; Deng, Hong; Tang, Zhouping

    2017-12-01

    Diabetes mellitus is a widely spread chronic disease with growing incidence worldwide, and diabetic foot ulcer is one of the most serious complications of diabetes. Cellular therapy has shown promise in the management of diabetic foot ulcer in many preclinical experiments and clinical researches. Here, we performed a meta-analysis to evaluate the efficacy and safety of cellular therapy in the management of diabetic foot ulcer. We systematically searched PubMed, MEDLINE, EMBASE, and Cochrane Library databases from inception to May 2017 for randomized controlled trials assessing the efficacy of cellular therapy in diabetic foot ulcer, and a meta-analysis was conducted. A total of 6 randomized controlled clinical trials involving 241 individuals were included in this meta-analysis. The results suggested that cellular therapy could help accelerating the healing of diabetic foot ulcer, presented as higher ankle-brachial index (mean difference = 0.17, 95% confidence interval [CI] = 0.11 to 0.23), higher transcutaneous oxygen pressure (standardized mean difference [SMD] = 1.43; 95% CI, 1.09- to 1.78), higher ulcer healing rate (relative risk [RR] = 1.78; 95% CI, 1.41 to 2.25), higher amputation-free survival (RR = 1.25; 95% CI, 1.11 to 1.40), and lower scale of pain (SMD = -1.69; 95% CI, -2.05 to -1.33). Furthermore, cellular therapy seemed to be safe, with no serious complications and low risk of short-term slight complications. Cellular therapy could accelerate the rate of diabetic foot ulcer healing and may be more efficient than standard therapy for diabetic foot treatment.

  17. Scoping study into wound management nurse practitioner models of practice.

    Science.gov (United States)

    Gibb, Michelle A; Edwards, Helen E; Gardner, Glenn E

    2015-04-01

    The primary objective of this research was to investigate wound management nurse practitioner (WMNP) models of service for the purposes of identifying parameters of practice and how patient outcomes are measured. A scoping study was conducted with all authorised WMNPs in Australia from October to December 2012 using survey methodology. A questionnaire was developed to obtain data on the role and practice parameters of authorised WMNPs in Australia. The tool comprised seven sections and included a total of 59 questions. The questionnaire was distributed to all members of the WMNP Online Peer Review Group, to which it was anticipated the majority of WMNPs belonged. Twenty-one WMNPs responded (response rate 87%), with the results based on a subset of respondents who stated that, at the time of the questionnaire, they were employed as a WMNP, therefore yielding a response rate of 71% (n=15). Most respondents (93%; n=14) were employed in the public sector, with an average of 64 occasions of service per month. The typical length of a new case consultation was 60 min, with 32 min for follow ups. The most frequently performed activity was wound photography (83%; n=12), patient, family or carer education (75%; n=12), Doppler ankle-brachial pressure index assessment (58%; n=12), conservative sharp wound debridement (58%; n=12) and counselling (50%; n=12). The most routinely prescribed medications were local anaesthetics (25%; n=12) and oral antibiotics (25%; n=12). Data were routinely collected by 91% of respondents on service-related and wound-related parameters to monitor patient outcomes, to justify and improve health services provided. This study yielded important baseline information on this professional group, including data on patient problems managed, the types of interventions implemented, the resources used to accomplish outcomes and how outcomes are measured.

  18. Endovascular treatment of diabetic foot syndrome: results from a single center prospective registry using mixed coronary and peripheral techniques and equipment.

    Science.gov (United States)

    Cardaioli, Paolo; Rigatelli, Gianluca; Dell'avvocata, Fabio; Giordan, Massimo; Lisato, Giovanna; Mollo, Francesco; Vassilev, Dobrin; Nanjundappa, Aravinda

    2011-12-01

    To assess the long-term results of interventional treatment of diabetic foot using mixed coronary and peripheral equipments and techniques. The interventional diabetic foot syndrome treatment is rapidly becoming the therapy of choice in such patients, but proper materials and techniques are still debated. From January 2006 to December 2010, we prospectively enrolled 220 diabetic patients (78.5 ± 15.8 years, 107 females, all with Fontaine III or IV class), referred to our center for diabetic foot syndrome and severe limb ischemia. Mixed coronary and peripheral guidewires and balloons techniques were used. Doppler ultrasonography and foot transcutaneous oxygen pressure (TCPO2) before and after the procedure were calculated as well as the amputation rate. The preferred approach was ipsilateral femoral antegrade in 170/220 patients (77.7%), contralateral cross-over in 40/220 patients (18.8%), and popliteal retrograde + femoral antegrade in 10/220 patients (4.5%). The techniques included combined use of coronary and dedicated peripheral guidewires and coronary and peripheral dedicated balloons. Balloon angioplasty was performed in 252 legs (32 patients with bilateral disease): the procedure was successful in 239/252 legs with an immediate success rate of 94.8% and a significant improvement in TCPO2 and ankle-brachial index with ulcer healing in 233/252 legs (92.4%). The freedom from major amputation was 82.8% at a mean follow-up of 3.1 ± 1.8 years (range 1 to 5 years). The endovascular diabetic foot syndrome treatment using mixed coronary and peripheral materials and techniques seems to lead to high immediate success and limb salvage rates compared to historical series. ©2011, Wiley Periodicals, Inc.

  19. Reclaiming Autologous Amputated Tissue for Limb Salvage of a Diabetic Foot Burn with Underlying Critical Limb Ischemia.

    Science.gov (United States)

    Tchanque-Fossuo, Catherine N; Wishy, Andrew M; West, Kaitlyn I M; Dawson, David L; Dahle, Sara E; Carson, John G

    2018-01-01

    Diabetes mellitus is a worldwide pandemic that impacts more than 387 million people, with 29 million individuals affected in the United States alone. Diabetic patients have a 25% lifetime risk of developing a diabetic foot ulcer (DFU). Having a DFU is associated with a risk of recurrence approaching 70%. In addition, 1 in 6 patients with DFU will have a lower-limb amputation, with an associated increase in mortality ranging from 47% to 70%. Therefore, limb salvage is critical in patients with DFU. This article describes the case of a 70-year-old man with diabetes mellitus, end-stage renal disease, and peripheral arterial occlusive disease who presented with a 1.5% total-body-surface-area, third-degree burn to the left hallux with dry gangrene extending to the midfoot. Ankle brachial indexes were 0.66 on the left and 0.64 on the right. Toe pressures on the left were absent because of extensive dry gangrene. His right foot had a prior transmetatarsal amputation. Using a retrograde pedal approach, a chronic total occlusion of the left posterior tibial artery was recanalized with balloon angioplasty. He then underwent a transmetatarsal amputation with closure, except that the plantar medial side could not be closed without tension. Therefore, an autologous full-thickness skin graft, from the amputation specimen, was used to bridge the defect. At 32-week follow-up, the wound was healed, the graft had fully incorporated, and the patient was ambulating well using custom orthotic footwear. The creative use of amputated tissue to assist with wound coverage has not been well described in the literature.

  20. Inflammation and infection do not promote arterial aging and cardiovascular disease risk factors among lean horticulturalists.

    Science.gov (United States)

    Gurven, Michael; Kaplan, Hillard; Winking, Jeffrey; Eid Rodriguez, Daniel; Vasunilashorn, Sarinnapha; Kim, Jung Ki; Finch, Caleb; Crimmins, Eileen

    2009-08-11

    Arterial aging is well characterized in industrial populations, but scantly described in populations with little access to modern medicine. Here we characterize health and aging among the Tsimane, Amazonian forager-horticulturalists with short life expectancy, high infectious loads and inflammation, but low adiposity and robust physical fitness. Inflammation has been implicated in all stages of arterial aging, atherogenesis and hypertension, and so we test whether greater inflammation associates with atherosclerosis and CVD risk. In contrast, moderate to vigorous daily activity, minimal obesity, and low fat intake predict minimal CVD risk among older Tsimane. Peripheral arterial disease (PAD), based on the Ankle-Brachial Index (ABI), and hypertension were measured in Tsimane adults, and compared with rates from industrialized populations. No cases of PAD were found among Tsimane and hypertension was comparatively low (prevalence: 3.5%, 40+; 23%, 70+). Markers of infection and inflammation were much higher among Tsimane than among U.S. adults, whereas HDL was substantially lower. Regression models examine associations of ABI and BP with biomarkers of energy balance and metabolism and of inflammation and infection. Among Tsimane, obesity, blood lipids, and disease history were not significantly associated with ABI. Unlike the Tsimane case, higher cholesterol, C-reactive protein, leukocytes, cigarette smoking and systolic pressure among North Americans are all significantly associated with lower ABI. Inflammation may not always be a risk factor for arterial degeneration and CVD, but instead may be offset by other factors: healthy metabolism, active lifestyle, favorable body mass, lean diet, low blood lipids and cardiorespiratory health. Other possibilities, including genetic susceptibility and the role of helminth infections, are discussed. The absence of PAD and CVD among Tsimane parallels anecdotal reports from other small-scale subsistence populations and suggests

  1. Evolution and degree of control of cardiovascular risk factors after 5 years of follow-up and their relationship with the incidence of peripheral arterial disease: ARTPER cohort.

    Science.gov (United States)

    Forés, Rosa; Alzamora, María Teresa; Pera, Guillem; Valverde, Marta; Angla, Maria; Baena-Díez, José Miguel; Mundet-Tuduri, Xavier

    2017-02-09

    Although cardiovascular risk factors (CVRF) are well known, their degree of control is not optimal. The aim of this study is to assess the evolution and control of CVRFs after 5 years of monitoring a population-based cohort and their association with the incidence of peripheral arterial disease (PAD). Prospective cohort study recruited between 2006-2008. Second phase between 2011-2012. An ankle brachial index was determined for all participants in both phases. Demographic variables, CVRF and previous cardiovascular events, blood pressure, total cholesterol and its fractions (HDL, LDL), triglycerides, glucose and glycosylated hemoglobin levels in diabetic patients and the cardiovascular risk score according to the REGICOR table were recorded. A total of 2,125 individuals were analyzed. We observed an increase in the prevalence of hypertension (HT) (15.4%), diabetes (DM) (8.2%) and hypercholesterolemia (20.4%), with no changes in obesity and smoking. The cardiovascular risk determined on the basis of the REGICOR table remained at around 5.5%. We observed an increased control of CVRF throughout the follow-up period, except in the case of DM and obesity. In the multivariate analysis, uncontrolled HT 2-folded the risk of onset of PAD (odds ratio [OR] 2.3; 95% confidence interval [95% CI] 1.3-4.1), whereas smoking 5-folded this risk (OR 5.0; 95% CI 2.5-10.2). Smoking and uncontrolled HT increase the risk of onset of PAD in this population. Despite the increase in drug treatments, the control of CVRFs continues to be suboptimal. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. Saphenofemoral ligation as a safe and effective alternative for the treatment of chronic venous leg ulcer

    International Nuclear Information System (INIS)

    El-Hafez, Emad A.; Seleem, Mohamed I.

    2004-01-01

    To evaluate the effectiveness and safety of isolated saphenofemoral junction ligation for the treatment of chronic venous leg ulcer in comparison to traditional stripping procedure. 36 patients (28 men and 8 women) with mean age of 42.3+-8.7, presented with a venous leg ulcer. After taking the full history, they underwent examination for presence of edema, cellulitis or local ulcer infection. The site and size of ulceration were recorded and ankle-brachial pressure index (ABPI) was measured, Venous valvular incompetence was assessed using Valsalva testand calf compression. Patients were divided into 2 groups. Group I, (n=10) assigned for long saphenous stripping, while group II (n=26) assigned for saphenofemoral ligationan and divided combined with ligation of major tributaries under local infiltration anesthesia. Mean operative time, postoperative complications and hospital stay were recorded. The study was carried out in Benha University Hospital, Egypt and Armed Forces Hospital, Southern Region, Khamis Mushayt, Sadi Arabia between January 2000 and December 2001. The mean operative time and the hospital stay were significantly (p<0.05) reduced in group II compared to group I. The postoperative complications were signficantly (x=7.5, p<0.05) reduced in group II. Ulcer healing started after 3 months in group II and six months in group I, but by 12 month, group II had significant (x=6.7, p<0.05) number of healed ulcers (n=22, 84.6%), compared to group I (n=7, 70%). The isolated ligation of of saphenofemoral junction is a minimally invasive, safe and effective modality for treatment of chronic leg ulcer, and being easily performed under local anesthesia and considerd to be a satisfactory procedure for treatment of leg ulcer in patients who are unfit for general anesthesia. (author)

  3. Characterization of patients with diabetic foot disease presenting to an Irish Podiatry Centre: profiling suitability for entry to a clinical trial of advanced wound therapeutics.

    Science.gov (United States)

    Mahon, A M; MacGilchrist, C; McIntosh, C; O'Brien, T

    2017-08-01

    Diabetes mellitus, coined the 'Black Death of the Twenty-First Century', is associated with complications, including foot ulceration with potential loss of limb. There is a need for development of new wound therapies through completion of robust clinical trials. To profile demographics and wound characteristics of an Irish cohort with diabetes, forecast eligibility for entry to a clinical trial of advanced wound therapeutics, and adjust criteria to optimize eligibility for enrolment. A cross-sectional study of out-patients attending a Podiatry centre over 12 weeks was conducted. Information was collected through clinical assessment, including Neuropathy Disability Score and Ankle-Brachial Pressure Index. Ulcers were characterised as 'healing' or 'non-healing'; a 'healing' wound decreased by 30 % over the previous month, accomplished by retrospective analysis of files. Statistics, including binomial logistic regression and column analysis for eligibility assessment, were conducted. Seventy-four participants were identified with a mean age of 67 (± 8.79) years. Non-healing DFU status correlated significantly with larger wound area (P = 0.013), infection (P = 0.009), and greater degrees of ischaemia (P = 0.015). The eligibility criteria were modelled after those proposed by the EU consortium project REDDSTAR. In this Irish population, these criteria limit eligibility to 1.4 %. This research found an eligibility criterion of wound area 2-10 cm 2 for enrolment in a clinical trial of mesenchymal stromal cell therapy too restrictive. Extension of wound area to 1-10 cm 2 and the inclusion of neuro-ischaemic ulcers increased eligibility for enrolment from 1.4 to 20 %.

  4. The effects of Crenotherapy and exercise in peripheral arterial occlusive disease. A comparison with simple exercise training.

    Science.gov (United States)

    Quarto, Gennaro; Amato, Bruno; Serra, Raffaele; Benassai, Giacomo; Monti, Maria G; Salzano, Andrea; D'Assante, Roberta; Furino, Ermenegildo

    2017-01-01

    Conservative therapies for patients affected by Peripheral Arterial Occlusive Disease (PAOD) aim first to correct the risk factors and to slow down the disease progression. Among these, exercise has positive effects on blood flow, muscle metabolism and well demonstrated systemic effects. These include reduction of chronic inflammation markers, improvement of walking mechanics and heart function. Controlled physical training increases the ability to perform the daily activities improving life expectancy of these patients. The aim of this study is to evaluate the effects and the effectiveness of physical training performed in thermal water compared to traditional treadmill walking exercise. 98 patients affected by IIb stage PAOD, according to Leriche-Fontaine classification, were enrolled. Patients were randomized into two groups: the first arm carried out an intensive training program under medical supervision (group A); the second one carried out a rehabilitative exercise associated with crenotherapy (group B). The following parameters were detected: Ankle-Brachial pressure index (ABI), actual claudication distance (ACD), maximum walking distance (MWD), flow mediated dilatation (FMD) and the intima-media thickness (IMT). All patients underwent Doppler echocardiography and complete biochemical assay. In both groups, there was a statistically significant improvement of lipidaemia compared to baseline. When compared with each other, the two groups did not show statistically significant differences. There were no significant differences between the two groups regarding echocardiographic findings. Vascular reactivity study showed a statistically significant improvement of FMD after 3 months of exercise in both groups. In crenotherapy group (B) FMD values were significantly higher than the treadmill ones (A). In both groups a statistically significant improvement in ACD was observed CONCLUSIONS: Our experience shows that crenotherapy has similar effects compared to

  5. Copenhagen comorbidity in HIV infection (COCOMO) study: a study protocol for a longitudinal, non-interventional assessment of non-AIDS comorbidity in HIV infection in Denmark.

    Science.gov (United States)

    Ronit, Andreas; Haissman, Judith; Kirkegaard-Klitbo, Ditte Marie; Kristensen, Thomas Skårup; Lebech, Anne-Mette; Benfield, Thomas; Gerstoft, Jan; Ullum, Henrik; Køber, Lars; Kjær, Andreas; Kofoed, Klaus; Vestbo, Jørgen; Nordestgaard, Børge; Lundgren, Jens; Nielsen, Susanne Dam

    2016-11-26

    Modern combination antiretroviral therapy (cART) has improved survival for people living with HIV (PLWHIV). Non-AIDS comorbidities have replaced opportunistic infections as leading causes of mortality and morbidity, and are becoming a key health concern as this population continues to age. The aim of this study is to estimate the prevalence and incidence of non-AIDS comorbidity among PLWHIV in Denmark in the cART era and to determine risk factors contributing to the pathogenesis. The study primarily targets cardiovascular, respiratory, and hepatic non-AIDS comorbidity. The Copenhagen comorbidity in HIV-infection (COCOMO) study is an observational, longitudinal cohort study. The study was initiated in 2015 and recruitment is ongoing with the aim of including 1500 PLWHIV from the Copenhagen area. Follow-up examinations after 2 and 10 years are planned. Uninfected controls are derived from the Copenhagen General Population Study (CGPS), a cohort study including 100,000 uninfected participants from the same geographical region. Physiological and biological measures including blood pressure, ankle-brachial index, electrocardiogram, spirometry, exhaled nitric oxide, transient elastography of the liver, computed tomography (CT) angiography of the heart, unenhanced CT of the chest and upper abdomen, and a number of routine biochemical analysis are uniformly collected in participants from the COCOMO study and the CGPS. Plasma, serum, buffy coat, peripheral blood mononuclear cells (PBMC), urine, and stool samples are collected in a biobank for future studies. Data will be updated through periodical linking to national databases. As life expectancy for PLWHIV improves, it is essential to study long-term impact of HIV and cART. We anticipate that findings from this cohort study will increase knowledge on non-AIDS comorbidity in PLWHIV and identify targets for future interventional trials. Recognizing the demographic, clinical and pathophysiological characteristics of

  6. Climatological and statistical characteristics of the Haines Index for North America

    Science.gov (United States)

    Julie A. Winkler; Brian E. Potter; Dwight F. Wilhelm; Ryan P. Shadbolt; Krerk Piromsopa; Xindi Bian

    2007-01-01

    The Haines Index is an operational tool for evaluating the potential contribution of dry, unstable air to the development of large or erratic plume-dominated wildfires. The index has three variants related to surface elevation, and is calculated from temperature and humidity measurements at atmospheric pressure levels. To effectively use the Haines Index, fire...

  7. Browse Title Index

    African Journals Online (AJOL)

    Items 301 - 312 of 312 ... Vol 30, No 1-2 (2015), Vitamin C Prevents Sleep Deprivation-induced Elevation in Cortisol and Lipid Peroxidation in the Rat Plasma, Abstract PDF. Olayaki L A, Sulaiman S O, Anoba N B. Vol 25, No 2 (2010), Waist circumference, waist to hip ratio, and body mass index in the diagnosis of metabolic ...

  8. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 1463 ... Vol 14, No 4 (2014), Association between mean platelet volume levels and inflammation in SLE patients presented with arthritis, Abstract PDF ... Vol 10, No 3 (2010), Atherogenic index of plasma as useful predictor of cardiovascular risk among postmenopausal women in Enugu, Nigeria, Abstract ...

  9. Indexes to Volume 56

    Indian Academy of Sciences (India)

    Subject Index. Unsharp spin observables, non-locality and Fry, Walther and Li experiment. Sisir Roy. 189–198. Backward causation, hidden variables and the meaning of completeness. Huw Price. 199–210. An experiment to distinguish between de Broglie-Bohm and standard quan- tum mechanics. Partha Ghose. 211–216.

  10. Refractive index based measurements

    DEFF Research Database (Denmark)

    2014-01-01

    In a method for performing a refractive index based measurement of a property of a fluid such as chemical composition or temperature by observing an apparent angular shift in an interference fringe pattern produced by back or forward scattering interferometry, ambiguities in the measurement caused...

  11. Refractive index based measurements

    DEFF Research Database (Denmark)

    2014-01-01

    In a method for performing a refractive index based measurement of a property of a fluid such as chemical composition or temperature, a chirp in the local spatial frequency of interference fringes of an interference pattern is reduced by mathematical manipulation of the recorded light intensity...

  12. Refractive index based measurements

    DEFF Research Database (Denmark)

    2014-01-01

    A refractive index based measurement of a property of a fluid is measured in an apparatus comprising a variable wavelength coherent light source (16), a sample chamber (12), a wavelength controller (24), a light sensor (20), a data recorder (26) and a computation apparatus (28), by - directing...

  13. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 379 ... Vol 52, No 1 (2016), Effects of adherence to antiretroviral therapy on body mass index, immunological and virological status of Nigerians living with HIV/AIDS ... Vol 51, No 2 (2015), Efficacy of biofeedback-assisted pelvic floor muscle training in females with pelvic floor dysfunction, Abstract PDF.

  14. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 183 ... Vol 10, No 1 (2005), Influence Of Specialized Mathematical Language On Secondary School Students Mathematical Achievement In Kenya, Abstract ... Vol 6, No 1 (2001), Maternal education, age and household head gender associated with weight for age index of preschool children in Imo state ...

  15. Nitrate leaching index

    Science.gov (United States)

    The Nitrate Leaching Index is a rapid assessment tool that evaluates nitrate (NO3) leaching potential based on basic soil and climate information. It is the basis for many nutrient management planning efforts, but it has considerable limitations because of : 1) an oversimplification of the processes...

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 301 - 350 of 577 ... Vol 25, No 2 (2008), Maternal Serum Triglycerides at Midpregnancy and Term Neonate Weight in Non-Diabetic Women with Normal Body Mass Index, Abstract PDF. L Sekhavat, F Zare. Vol 25, No 1 (2008), MDGs & SOGON: Mortality, The Media & Corporate Nigeria - The Third Olusola Adewole Ojo ...

  17. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 68 of 68 ... Vol 11, No 2 (2013), Some Haematological Parameters in Posttraumatic Stress Disorder Patients in Nassarawa Gwom Following the 2010 Jos Crisis ... Vol 10, No 2 (2012), The comparative study of the body mass index of Hausa and Yoruba children aged 2-5 in Jos, Plateau state, Nigeria, Abstract.

  18. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 338 ... Vol 17, No 2 (2005), A successful cognitive-behavioural intervention that failed: a case study of adolescent conduct disorder at a school for the disadvantaged, Abstract. E Mashalaba, D Edwards. Vol 27, No 3 (2015), A validational study of the Ironson–Woods Spirituality/ Religiousness Index in Nigerian ...

  19. Browse Title Index

    African Journals Online (AJOL)

    Items 851 - 900 of 1255 ... Vol 10, No 4 (2004), Occurrence of Parasites in Pseudotolithus elongatus and Cynoglossus seneglensis in Cross River Estuary, Nigeria, Abstract PDF. JT Abraham, PA ... P C Chikezie. Vol 9, No 1 (2003), Parasitic contamination of leafy vegetables: a function of the leaf area index (lai), Abstract PDF.

  20. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 775 ... Vol 9, No 2 (2016), Biosynthesis, characterization and antimicrobial study of silver nanoparticles (agNPs), Abstract PDF. Aminu A. Hamisu, Maryam Abdullahi, U. Abubakar, S. Bilal, A.J. Abbas. Vol 2, No 2 (2009), Body mass index variations among adolescents from Kano Metropolis, Nigeria, Abstract ...

  1. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 100 of 242 ... ... No 2 (2008), Effect of Body Mass Index (BMI) On Degree of Angular Knee Deformity in Children with Blount\\'s Disease. Abstract. A Bafor, AO Ogbemudia, PFA Umebese. Vol 11, No 2 (2012), Efficacy of Six Weeks Skin Traction in the Management of Chronic Pain from Lumber Spondylosis, Abstract.

  2. Indexes to Volume 77

    Indian Academy of Sciences (India)

    2015-11-27

    Proceedings of the International Workshop/Conference on Computational Condensed Matter Physics and Materials Science (IWCCMP-2015). Posted on November 27, 2015. Guest Editors: Anurag Srivastava, C. S. Praveen, H. S. Tewari. © 2015 Indian Academy of Sciences, Bengaluru. Contact | Site index.

  3. Life quality index revisited

    DEFF Research Database (Denmark)

    Ditlevsen, Ove Dalager

    2004-01-01

    The derivation of the life quality index (LQI) is revisited for a revision. This revision takes into account the unpaid but necessary work time needed to stay alive in clean and healthy conditions to be fit for effective wealth producing work and to enjoyable free time. Dimension analysis consist...

  4. Browse Title Index

    African Journals Online (AJOL)

    Items 251 - 300 of 1011 ... Issue, Title. Vol 31, No 2 (2012), Design and Development of a Soap Stamping and Tableting Machine for Small Scale Soap Manufacturer, Abstract PDF. BN Nwankwojike. Vol 36, No 3 (2017), DESIGN AND FABRICATION OF A DISCOMFORT INDEX METER FOR DETERMINATION OF STRESS IN ...

  5. A Tourism Conditions Index

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); H-K. Hsu (Hui-Kuang); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ This paper uses monthly data from April 2005 to August 2013 for Taiwan to propose a novel tourism indicator, namely the Tourism Conditions Index (TCI). TCI accounts for the spillover weights based on the Granger causality test and estimates of the multivariate BEKK

  6. Indexical Hybrid Tense Logic

    DEFF Research Database (Denmark)

    Blackburn, Patrick Rowan; Jørgensen, Klaus Frovin

    2012-01-01

    In this paper we explore the logic of now, yesterday, today and tomorrow by combining the semantic approach to indexicality pioneered by Hans Kamp [9] and refined by David Kaplan [10] with hybrid tense logic. We first introduce a special now nominal (our @now corresponds to Kamp’s original now...

  7. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 162 of 162 ... Issue, Title. Vol 2, No 2 (2003), The Significance Of Adaptive Changes In Rat Haemoglobin Micro-environment And Electophoretic Fractions During Barocamera Hypoxia, Abstract. BO Ekpo. Vol 5, No 1 (2006), The study of conicity index and waist hip ratio in Nigerian children and adolescents, Abstract.

  8. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 708 ... Vol 37, No 1 (2012), A comparative assessment of the health status of feral populations of Clarias gariepinus from three dams in the Limpopo and Olifants river systems, Limpopo province, South Africa, using the fish health assessment index protocol, Abstract. GN Madanire-Moyo, WJ Luus-Powell, ...

  9. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 100 of 273 ... AMS Nyomora. Vol 38, No 2 (2012), Distribution and Potential Impact of Feral Cotton on the Reintroduction of Cotton in the Southern Highlands, Tanzania, Abstract PDF. O Shilla, TP Hauser, FI Tibazarwa. Vol 31 (2005):, Distribution of hourly variability index of sky clearness, Abstract PDF. A Madhlopa.

  10. Indexing Moving Points

    DEFF Research Database (Denmark)

    Agarwal, Pankaj K.; Arge, Lars Allan; Erickson, Jeff

    2003-01-01

    We propose three indexing schemes for storing a set S of N points in the plane, each moving along a linear trajectory, so that any query of the following form can be answered quickly: Given a rectangle R and a real value t, report all K points of S that lie inside R at time t. We first present an...

  11. Montessori Index. Third Edition.

    Science.gov (United States)

    Fleege, Virginia B.; And Others

    This volume, the result of 2 years of work, is an index to 24 volumes on Montessori theory and practice. The books were read and analyzed a minimum of six times. Sixteen of the volumes are authored by Maria Montessori. (DR)

  12. Browse Title Index

    African Journals Online (AJOL)

    Items 401 - 450 of 483 ... Vol 41, No 2 (2014), Serum zinc levels in HIV infected children attending the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. ... Vol 43, No 1 (2016), Subacute combined degeneration of the spinal cord in a Nigerian child: a need for a high index of suspicion, Abstract PDF.

  13. Automated Water Extraction Index

    DEFF Research Database (Denmark)

    Feyisa, Gudina Legese; Meilby, Henrik; Fensholt, Rasmus

    2014-01-01

    of various sorts of environmental noise and at the same time offers a stable threshold value. Thus we introduced a new Automated Water Extraction Index (AWEI) improving classification accuracy in areas that include shadow and dark surfaces that other classification methods often fail to classify correctly...

  14. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 250 of 661 ... Journal Home > Advanced Search > Browse Title Index. Log in or Register to get access to full text downloads. .... A El-Mahdy, B Bolduc, J Upadhyay, R Shoukr, A Khoury. Vol 19, No 1 (2013), Factors affecting lower calyceal stone clearance after Extracorporeal shock wave lithotripsy, Abstract PDF.

  15. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 985 ... Journal Home > Advanced Search > Browse Title Index ... Vol 17 (2010), Alternating Direction Implicit Finite Difference Time Domain Acoustic Wave Algorithm, Abstract. E Ikata .... Vol 17 (2010), Analytic derivation of the wave profile and phase speed of sixth order Stokes waves in deep water, Abstract.

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 229 ... Journal Home > Advanced Search > Browse Title Index. Log in or Register to get ... KM Lawal, MN Umego, SB Ojo. Vol 17, No 1 (2005), Obtaining the green's function for electromagnetic waves propagating in layered in-homogeneous thin film media of spherical particles on a substrate, Abstract.

  17. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 48 of 48 ... Journal Home > Advanced Search > Browse Title Index. Log in or Register to get access to full text ... Vol 1 (2000), Measurement of Ground Electrical Conductivity for Planning Medium Wave Radio Broadcast Stations in South Western Nigeria, Abstract PDF. Moses Oludare Ajewole, Adeseye Muyiwa ...

  18. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 45 of 45 ... Vol 7, No 1 (2015), On The Relationship between Illiquidity, Aggregate Market Return and Conditional Volatility of the NIFTY Index, Abstract PDF. Som Sankar Sen. Vol 2, No 2 (2009), Opportunities for Micro and Small Scale Businesses in the Tourism Sector: The Case of The Kenya Coast1, Abstract PDF.

  19. Browse Title Index

    African Journals Online (AJOL)

    Vol 6, No 4 (2000), Solar energy as a viable pathway toward ecologically sustainable, Details ... Vol 18, No 3-4 (2012), Source Apportionment and distribution of Polycyclic Aromatic Hydrocarbons in Imo River Sediments near Afam Power Station, S.E. Nigeria: Molecular index and Multi-Variate Approaches, Abstract PDF.

  20. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 58 ... Vol 6, No 10 (2009), An Analysis of Alternative Weighting System on the National Price Index in Tanzania: The Implication to Poverty Analysis, Abstract PDF. AF Mkenda, W ... Vol 5, No 7 (2008), Exchange Rate Volatility, Currency Substitution and Monetary Policy in Nigeria, Abstract. DO Yinusa, AE Akinlo.

  1. Browse Title Index

    African Journals Online (AJOL)

    Items 251 - 300 of 390 ... Vol 46, No 3 (2005), Pattern of fertility and perception of population concerns in Kwara State, Nigeria, Abstract. MO Araoye .... Vol 54, No 3 (2013), Prevalence of obesity among adolescents in Ile‑Ife, Osun state, Nigeria using body mass index and waist hip ratio: A comparative study, Abstract. Adedayo ...

  2. Browse Title Index

    African Journals Online (AJOL)

    Items 951 - 1000 of 1329 ... ... Physicochemical Characteristics of Soil from Selected Solid Waste Dump Sites in Port Harcourt, Rivers State, Nigeria, Abstract PDF. FU Obianefo, IO Agbagwa, F.B.G. Tanee. Vol 19, No 3 (2015), Physico-Chemical Characterization and Pollution Index Determination of Leachates from Warri Waste ...

  3. Spinal Cord Injury and Pressure Ulcer Prevention: Using Functional Activity in Pressure Relief

    Directory of Open Access Journals (Sweden)

    May Stinson

    2013-01-01

    Full Text Available Background. People with spinal cord injury (SCI are at increased risk of pressure ulcers due to prolonged periods of sitting. Concordance with pressure relieving movements is poor amongst this population, and one potential alternative to improve this would be to integrate pressure relieving movements into everyday functional activities. Objectives. To investigate both the current pressure relieving behaviours of SCI individuals during computer use and the application of an ergonomically adapted computer-based activity to reduce interface pressure. Design. Observational and repeated measures design. Setting. Regional Spinal Cord Injury Unit. Participants. Fourteen subjects diagnosed with SCI (12 male, 2 female. Intervention.Comparing normal sitting to seated movements and induced forward reaching positions. Main Outcome Measures. Interface pressure measurements: dispersion index (DI, peak pressure index (PPI, and total contact area (CA. The angle of trunk tilt was also measured. Results. The majority of movements yielded less than 25% reduction in interface pressure compared to normal sitting. Reaching forward by 150% of arm length during an adapted computer activity significantly reduced DI (P<0.05, angle of trunk tilt (p<0.05, and PPI for both ischial tuberosity regions (P<0.001 compared to normal sitting. Conclusion. Reaching forward significantly redistributed pressure at the seating interface, as evidenced by the change in interface pressures compared to upright sitting.

  4. Interface pressure mapping pilot study to select surfaces that effectively redistribute pediatric occipital pressure.

    Science.gov (United States)

    Higer, Samantha; James, Thomas

    2016-02-01

    The aim of this pilot study was to better inform clinical decisions to prevent pediatric occipital pressure ulcers with quantitative data to choose an appropriate reactive support surface. A commercially available capacitive pressure mapping system (XSENSOR, X3 Medical Seat System, Calgary, Canada) was used to evaluate a standard pediatric mattress and four commercially available pressure-redistributing support surfaces. The pressure mapping system was validated for use in the pediatric population through studies on sensitivity, accuracy, creep, and repeatability. Then, a pilot pressure mapping study on healthy children under 6 years old (n = 22) was performed to determine interface pressure and pressure distribution between the occipital region of the skull and each surface: standard mattress, gel, foam, air and fluidized. The sensor was adequate to measure pressure generated by pediatric occipital loading, with 0.5-9% error in accuracy in the 25-95 mmHg range. The air surface had the lowest mean interface pressure (p pressure index (PPI), defined as the peak pressure averaged over four sensels, (p pressure for mattress, foam, fluidized, gel, and air materials were 24.8 ± 4.42, 24.1 ± 1.89, 19.4 ± 3.25, 17.9 ± 3.10, and 14.2 ± 1.41 mmHg, respectively. The air surface also had the most homogenous pressure distribution, with the highest mean to PPI ratio (p surfaces (p surface was the most effective pressure-redistributing material for pediatric occipital pressure as it had the lowest interface pressure and a homogeneous pressure distribution. This implies effective envelopment of the bony prominence of the occiput and increasing contact area to decrease peak pressure points. Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  5. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 242 ... Vol 3, No 1 (2004), Pressure ulcers in spinal cord injury patients in Gombe, Nigeria, Abstract. II Onche, SJ Yiltok, SK Obiano. Vol 8, No 2 (2009), Prevalence and Risk Factors of Low Back Pain among Nurses in Africa: Nigerian and Ethiopian specialized Hospitals survey. Abstract. L Sikiru, H Shmaila, ...

  6. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 312 ... Vol 30, No 1-2 (2015), Honey Attenuates the Detrimental Effects of Nicotine on Testicular Functions in Nicotine Treated Wistar Rats, Abstract PDF. Kolawole T A, Oyeyemi W A, Adigwe C, Leko B, Udeh C, Dapper D V. Vol 22, No 1-2 (2007), Hypertension, and blood pressure response to graded ...

  7. Browse Title Index

    African Journals Online (AJOL)

    Items 901 - 950 of 1463 ... Vol 14, No 3 (2014), Normative ultrasound values of renal parenchymal thickness among adults in Enugu, South-East Nigeria. ... Vol 15, No 1 (2015), Obstructive sleep apnea syndrome and erectile dysfunction: does long term continuous positive airway pressure therapy improve erections?

  8. Browse Title Index

    African Journals Online (AJOL)

    Items 601 - 650 of 1329 ... Vol 20, No 3 (2016), Evaluation of the levels of phthalate ester plasticizers in surface water of Ethiope River System, Delta State, Nigeria, Abstract PDF. O Edjere, I.G. Asibor, S.E. Otolo. Vol 20, No 4 (2016), Evaluation of the levels of renal indices and blood pressure in Type 2 diabetes mellitus, ...

  9. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 100 of 184 ... Vol 18, No 2 (2013), Determining ethnic-, gender-, and age-specific waist circumference cut-off points to predict metabolic syndrome: the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study, Abstract PDF. S Hoebel, JH De Ridder. Vol 21, No 2 (2016), Diabetes distress and ...

  10. Indexes to Volume 54

    Indian Academy of Sciences (India)

    model. J D Anand, N Chandrika Devi, V K Gupta and S Singh. 737–749. General Relativity and Gravitation. Static charged spheres with anisotropic pressure in general relativity. J Krishna Rao, M Annapurna and M M Trivedi. 215–225. Collapse of a charged radiating star with shear. S D Maharaj and M Govender. 715–727.

  11. Browse Title Index

    African Journals Online (AJOL)

    Items 201 - 250 of 277 ... Vol 22, No 1 (2014), Role of prophylactic use of timolol maleate (0.5%) in preventing rise of intraocular pressure (iop) post Neodymium: Yttrium Aluminum Garnet (Nd: Yag) capsulotomy, Abstract PDF ... Vol 8, No 1 (2000), Sickle Cell Eye Disease in Nigerias: A study of 90 patients in Abuja, Details PDF.

  12. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 463 ... Vol 2, No 9 (2010), Controlled temperature grinding under modified atmosphere for Almond (Prunus Dulcis) paste production, Abstract PDF. G Aiello, G La Scalia, L Cannizzaro. Vol 3, No 4 (2011), Correlation between pipe bend geometry and allowable pressure in pipe bends using artificial neural ...

  13. Indexes to Volume 59

    Indian Academy of Sciences (India)

    electrode atmospheric pressure arc plasma system. S Ghorui,. S N Sahasrabudhe, P S S Murthy, A K Das and N Venkatramani. 143–150. Relativistic longitudinal non-Abelian oscillations in quark–antiquark plasma. Vishnu M Bannur. 671–677. Condensed Matter Physics. Self-assembled growth of nanostructural Ge islands ...

  14. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 220 ... Kenneth L.L. Sube, Oromo F. Seriano, Salvador Jajaa, Rose P. Gore, Richard L.L. Loro, Emmanuel Oryem, Opiaka A. Seriano, Ayuel D.A. Nula, Jurel ... South Sudan: A retrospective cohort study of single blood pressure readings among potential blood donors at Juba Teaching Hospital 2010-2012 ...

  15. Browse Title Index

    African Journals Online (AJOL)

    Items 151 - 200 of 1011 ... Vol 34, No 1 (2015), Cloud Computing in Nigeria: The Cloud Ecosystem Perspective, Abstract PDF. FM Dahunsi, TM Owoseni. Vol 32, No 3 (2013), CO2 Uptake on Activated Carbon: A Comparison at Low and High Pressures, Abstract. CP Ogbuka, TS Farrow, O Benson, RE Njoku. Vol 30, No 1 (2011) ...

  16. Browse Title Index

    African Journals Online (AJOL)

    Items 601 - 650 of 745 ... Vol 6, No 3 (1996), Selected lifestyles and blood pressure in a rural Nigerian community, Abstract. A Osibogun. Vol 24, No 2 (2014), Self reported adherence to .... F A Oredugba, O O Orenuga. Vol 13, No 3-4 (2003), Telemedicine: Definition, Benefits and Limitation, Abstract. C N Okoromah, B B Afolabi.

  17. Response of fish communities to multiple pressures: Development of a total anthropogenic pressure intensity index

    Czech Academy of Sciences Publication Activity Database

    Poikane, S.; Ritterbusch, D.; Argillier, C.; Bialokoz, W.; Blabolil, Petr; Breine, J.; Jaarsma, N.G.; Krause, T.; Kubečka, Jan; Lauridsen, T. L.; Noges, P.; Peirson, G.; Virbickas, T.

    2017-01-01

    Roč. 586, MAY (2017), s. 502-511 ISSN 0048-9697 R&D Projects: GA MŠk(CZ) EE2.3.20.0204; GA ČR(CZ) GA15-01625S Institutional support: RVO:60077344 Keywords : aquatic ecosystems * bioassessment * fish assemblages * fish-based assessment system * lakes Subject RIV: EH - Ecology, Behaviour OBOR OECD: Marine biology, freshwater biology, limnology Impact factor: 4.900, year: 2016

  18. Scientific Journal Indexing

    Directory of Open Access Journals (Sweden)

    Getulio Teixeira Batista

    2007-08-01

    Full Text Available It is quite impressive the visibility of online publishing compared to offline. Lawrence (2001 computed the percentage increase across 1,494 venues containing at least five offline and five online articles. Results shown an average of 336% more citations to online articles compared to offline articles published in the same venue. If articles published in the same venue are of similar quality, then they concluded that online articles are more highly cited because of their easier access. Thomson Scientific, traditionally concerned with printed journals, announced on November 28, 2005, the launch of Web Citation Index™, the multidisciplinary citation index of scholarly content from institutional and subject-based repositories (http://scientific.thomson. com/press/2005/8298416/. The Web Citation Index from the abstracting and indexing (A&I connects together pre-print articles, institutional repositories and open access (OA journals (Chillingworth, 2005. Basically all research funds are government granted funds, tax payer’s supported and therefore, results should be made freely available to the community. Free online availability facilitates access to research findings, maximizes interaction among research groups, and optimizes efforts and research funds efficiency. Therefore, Ambi-Água is committed to provide free access to its articles. An important aspect of Ambi-Água is the publication and management system of this journal. It uses the Electronic System for Journal Publishing (SEER - http://www.ibict.br/secao.php?cat=SEER. This system was translated and customized by the Brazilian Institute for Science and Technology Information (IBICT based on the software developed by the Public Knowledge Project (Open Journal Systems of the British Columbia University (http://pkp.sfu.ca/ojs/. The big advantage of using this system is that it is compatible with the OAI-PMH protocol for metadata harvesting what greatly promotes published articles

  19. Site index comparisons among hardwoods

    Science.gov (United States)

    Richard M. Godman

    1992-01-01

    Site index is one of the more easily measured indicators of the productive capacity of an area for a given species. In mixed stands, the site index of one species can be used to predict the site index of another. Site index also illustrates growth differences among species.

  20. Low pressure support changes the rapid shallow breathing index (RSBI in critically ill patients on mechanical ventilation Baixos níveis de pressão de suporte alteram o índice de respiração rápida e superficial (IRRS em pacientes graves sob ventilação mecânica

    Directory of Open Access Journals (Sweden)

    Elaine C. Gonçalves

    2012-10-01

    Full Text Available BACKGROUND: The rapid shallow breathing index (RSBI is the most widely used index within intensive care units as a predictor of the outcome of weaning, but differences in measurement techniques have generated doubts about its predictive value. OBJECTIVE: To investigate the influence of low levels of pressure support (PS on the RSBI value of ill patients. METHOD: Prospective study including 30 patients on mechanical ventilation (MV for 72 hours or more, ready for extubation. Prior to extubation, the RSBI was measured with the patient connected to the ventilator (DragerTM Evita XL and receiving pressure support ventilation (PSV and 5 cmH2O of positive end expiratory pressure or PEEP (RSBI_MIN and then disconnected from the VM and connected to a Wright spirometer in which respiratory rate and exhaled tidal volume were recorded for 1 min (RSBI_ESP. Patients were divided into groups according to the outcome: successful extubation group (SG and failed extubation group (FG. RESULTS: Of the 30 patients, 11 (37% failed the extubation process. In the within-group comparison (RSBI_MIN versus RSBI_ESP, the values for RSBI_MIN were lower in both groups: SG (34.79±4.67 and 60.95±24.64 and FG (38.64±12.31 and 80.09±20.71; pCONTEXTUALIZAÇÃO: O índice de respiração rápida e superficial (IRRS tem sido o mais utilizado dentro das unidades de terapia intensiva (UTIs como preditor do resultado do desmame, porém diferenças no método de obtenção têm gerado dúvidas quanto a seu valor preditivo. OBJETIVO: Verificar a influência de baixos níveis de pressão de suporte (PS no valor do IRRS em pacientes graves. MÉTODO: Estudo prospectivo, incluindo 30 pacientes sob ventilação mecânica (VM por 72 horas ou mais, prontos para extubação. Anteriormente à extubação, o IRRS foi obtido com o paciente conectado ao ventilador Evita-XL da DragerTM recebendo pressão de suporte ventilatório (PSV e PEEP=5 cmH2O (IRRS_MIN e, logo após, desconectado da VM e

  1. Biodiversity intactness index

    CSIR Research Space (South Africa)

    Scholes, RJ

    2005-03-03

    Full Text Available range from complete protection to extreme trans- formation, such as urbanization. All activities are expressed on the basis of the area affected. The index is aggregated by weighting by the area subject to each activity and the number of species... pastures and fallow, or recently abandoned cultivated areas. Orchards and vineyards. SADC Landcover Data set36, filled with GLC2000 (ref. 37) for Namibia and Botswana. Plantation Natural land cover permanently replaced by dense plantations of trees...

  2. Browse Title Index

    African Journals Online (AJOL)

    Vol 9, No 2S (2017): Special Issue, Water quality assessment of the rivers in bauxite mining area at Kuantan Pahang, Abstract PDF. N Yaakub, M.N.A. Raoff, M.N. Haris, A.A.A. Halim, M.K.A. Kamarudin. Vol 9, No 2S (2017): Special Issue, Water quality index assesment around industrial area in Kuantan, Pahang, Abstract ...

  3. Comparison of ambulatory blood pressure monitoring and office blood pressure measurements in obese children and adolescents.

    Science.gov (United States)

    Renda, Rahime

    2018-04-01

    Obesity in adults has been related to hypertension and abnormal nocturnal dipping of blood pressure, which are associated with poor cardiovascular and renal outcomes. Here, we aimed to resolve the relationship between the degree of obesity, the severity of hypertension and dipping status on ambulatory blood pressure in obese children. A total 72 patients with primary obesity aged 7 to 18 years (mean: 13.48 ± 3.25) were selected. Patients were divided into three groups based on body mass index (BMİ) Z-score. Diagnosis and staging of ambulatory hypertension based on 24-h blood pressure measurements, obtained from ambulatory blood pressure monitoring. Based on our ambulatory blood pressure data, 35 patients (48.6%) had hypertension, 7 (20%) had ambulatory prehypertension, 21 (60%) had hypertension, and 7 patients (20%) had severe ambulatory hypertension. There was a significant relationship between severity of hypertension and the degree of obesity (p lood pressure results and loads were similar between groups. Diastolic and mean arterial blood pressure levels during the night, diastolic blood pressure loads, and heart rate during the day were significantly higher in Group 3 (p lood pressure at night, mean arterial pressure at night, diastolic blood pressure loads and heart rate at day. Increase in BMI Z-score does not a significant impact on daytime blood pressure and nocturnal dipping status.

  4. Intracranial pressure monitoring

    Science.gov (United States)

    ICP monitoring; CSF pressure monitoring ... There are 3 ways to monitor pressure in the skull (intracranial pressure). INTRAVENTRICULAR CATHETER The intraventricular catheter is the most accurate monitoring method. To insert an intraventricular catheter, a ...

  5. Intracranial pressure monitoring (image)

    Science.gov (United States)

    Intracranial pressure monitoring is performed by inserting a catheter into the head with a sensing device to monitor the pressure around the brain. An increase in intracranial pressure can cause a decrease in blood flow to ...

  6. High Blood Pressure Facts

    Science.gov (United States)

    ... Stroke Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN High Blood Pressure Facts Recommend on Facebook Tweet Share Compartir On ... Top of Page CDC Fact Sheets Related to High Blood Pressure High Blood Pressure Pulmonary Hypertension Heart Disease Signs ...

  7. High Blood Pressure

    Science.gov (United States)

    ... normal blood pressure 140/90 or higher is high blood pressure Between 120 and 139 for the top number, ... prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High ...

  8. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has high ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  9. Relationships between blood lead, blood pressure, serum ...

    African Journals Online (AJOL)

    Study examined the associations between blood – Pb, serum cholesterol, diastolic and, systolic blood pressures, hematocrit, body weight, age and body mass index in 528 study subjects comprising 50% cigarette smoking and 50% non-smoking male residents of Abeokuta, Nigeria, aged from 15 to 80 years. Blood Pb was ...

  10. Renal Resistive Index: not only kidney.

    Science.gov (United States)

    Di Nicolò, Pierpaolo; Granata, Antonio

    2017-06-01

    From growing data from the literature emerges that so-called ecoDoppler "Renal" Resistive Indexes (RRI) are not only specific markers of kidney damage and indicators of renal functional prognosis but they always express more clearly a strong link with the systemic circulation. In fact, some cardiovascular parameters such as aortic pulse pressure, aortic stiffness, abdominal aortic calcifications and clinical settings for instance heart failure progression have shown a great association with RRI. Relationships between renal and inflammatory indexes in hypertensive patients have been found and data from the literature on kidney transplants underline the capability of the graft RRI to change according to host hemodynamic features. The purpose of this article is to explain the emerging pathophysiological aspects of this relationship between renal microcirculation and cardiovascular system by emphasizing the importance for the ultrasonographer and for the nephrologist of not overlooking a global vision of the patient before interpreting the RRI.

  11. Impact coverage of the success-index

    OpenAIRE

    EGGHE, Leo

    2014-01-01

    We show mathematically that the success-index can be any of the following impact indices, dependent on the value of the threshold used in the definition of the success-index: Hirsch-index (h-index), g-index, generalized Wu- and Kosmulski-indices, the average. success-index; Hirsch-index; h-Index; g-Index; Wu-index; Kosmulski-index

  12. Candesartan cilexetil/hydrochlorothiazide combination treatment versus high-dose candesartan cilexetil monotherapy in patients with mild to moderate cardiovascular risk (CHILI Triple T)

    Science.gov (United States)

    Bönner, Gerd; Landers, Bernhard; Bramlage, Peter

    2011-01-01

    Background: Candesartan cilexetil has been shown to effectively reduce blood pressure and cardiovascular risk. Whether it is advantageous to combine candesartan cilexetil with low-dose hydrochlorothiazide (HCTZ) or uptitrate it in cases of insufficient blood pressure control has not been fully investigated under routine clinical conditions. Methods: CHILI Triple T is a prospective, noninterventional, observational study. Patients with uncontrolled hypertension and added cardiovascular risk received a fixed-dose combination of candesartan cilexetil 16 mg and HCTZ 12.5 mg (combination therapy group) or high-dose monotherapy with candesartan cilexetil 32 mg (high-dose monotherapy group). Results: A total of 4600 patients with a mean age of 63.1 ± 11.0 years, of which 44.7% were female, was included. The combination therapy group had 3337 patients, and the high-dose monotherapy group 1263 patients. Patients in both treatment groups were comparable with respect to age and gender, but patients receiving high-dose monotherapy had a slightly higher mean systolic blood pressure, more prior revascularizations, renal insufficiency, diabetic nephropathy, peripheral artery disease, and a lower ankle brachial index. The use of combination therapy resulted in a blood pressure reduction of −28.5 ± 13.8/−14.2 ± 9.4 mm Hg (P < 0.001 vs 160.2 ± 13.3/94.5 ± 8.2 mm Hg at baseline). The use of high-dose monotherapy reduced blood pressure by −29.73 ±15.3/−14.1 ± 9.6 mm Hg (P < 0.001 vs 162.4 ± 14.7/94.7 ±8.7 mm Hg at baseline). Differences in subgroups of patients defined by age, gender, body mass index, dyslipidemia, waist circumference, smoking, prior cardiovascular event, glomerular filtration rate, and microalbuminuria were minor, although partially significant. Tolerability was excellent, with only 28 out of 3358 patients (0.8%) in the combination therapy group and 15 out of 1273 patients (1.2%) in the high-dose monotherapy group experiencing any adverse event, of

  13. Plastic Deformation of Pressured Metallic Glass

    Directory of Open Access Journals (Sweden)

    Yun Cheng

    2017-11-01

    Full Text Available Although pressured metallic glass (MG has been reported in the literature; there are few studies focusing on pressure effects on the structure; dynamics and its plastic deformation. In this paper; we report on and characterize; via molecular dynamics simulation, the structure and dynamics heterogeneity of pressured MGs, and explore a causal link between local structures and plastic deformation mechanism of pressured glass. The results exhibit that the dynamical heterogeneity of metallic liquid is more pronounced at high pressure, while the MGs were less fragile after the release of external pressure, reflected by the non-Gaussian parameter (NGP. High pressure glass shows better plastic deformation; and the local strain zone distributed more uniformly than of in normal glass. Further research indicates that although the number of icosahedrons in pressured glass was much larger than that in normal glass, while the interpenetrating connections of icosahedra (ICOI exhibited spatial correlations were rather poor; In addition, the number of ‘fast’ atoms indexed by the atoms’ moving distance is larger than that in normal glass; leading to the sharp decreasing in number of icosahedrons during deformation. An uniform distribution of ‘fast’ atoms also contributed to better plastic deformation ability in the pressured glass. These findings may suggest a link between the deformation and destruction of icosahedra with short-range order.

  14. Water density and polarizability deduced from the refractive index determined by interferometric measurements up to 250 MPa.

    Science.gov (United States)

    Weiss, L; Tazibt, A; Tidu, A; Aillerie, M

    2012-03-28

    The refractive index of water is precisely determined in the visible light range as a function of the pressure until 250 MPa by means of a new measurement device that uses a special pipe tee included in an interferometer set. This technique allows revisiting the Bradley-Tait and Sellmeier equations to make them dependent on the wavelength and the pressure, respectively. The Bradley-Tait equation for the pressure dependence of the water refractive index is completed by a wavelength-dependent factor. Also, in the considered pressure and wavelength ranges, it is shown that the Sellmeier coefficients can be straightforwardly linked to the pressure, allowing the determination of the refractive index of water for either any wavelength or pressure. A new simple model allows the determination of the density of water as a function of the measured refractive index. Finally, the polarizability of water as function of pressure and wavelength is calculated by means of the Lorentz-Lorenz equation.

  15. Repositioning for treating pressure ulcers.

    Science.gov (United States)

    Moore, Zena E H; Cowman, Seamus

    2015-01-05

    Pressure, from lying or sitting on a particular part of the body results in reduced oxygen and nutrient supply, impaired drainage of waste products and damage to cells. If a patient with an existing pressure ulcer continues to lie or bear weight on the affected area, the tissues become depleted of blood flow and there is no oxygen or nutrient supply to the wound, and no removal of waste products from the wound, all of which are necessary for healing. Patients who cannot reposition themselves require assistance. International best practice advocates the use of repositioning as an integral component of a pressure ulcer management strategy. This review has been conducted to clarify the role of repositioning in the management of patients with pressure ulcers. To assess the effects of repositioning patients on the healing rates of pressure ulcers. For this third update we searched the Cochrane Wounds Group Specialised Register (searched 28 August 2014); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 7); Ovid MEDLINE (2013 to August Week 3 2014); Ovid MEDLINE (In-Process & Other Non-Indexed Citations 29 August, 2014); Ovid EMBASE (2012 to 29 August, 2014); and EBSCO CINAHL (2012 to 27 August 2014). We considered randomised controlled trials (RCTs) comparing repositioning with no repositioning, or RCTs comparing different repositioning techniques, or RCTs comparing different repositioning frequencies for the review. Controlled clinical trials (CCTs) were only to be considered in the absence of RCTs. Two authors independently assessed titles and, where available, abstracts of the studies identified by the search strategy for their eligibility. We obtained full versions of potentially relevant studies and two authors independently screened these against the inclusion criteria. We identified no studies that met the inclusion criteria. Despite the widespread use of repositioning as a component of the management plan for

  16. 2001 Environmental Sustainability Index (ESI)

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2001 Environmental Sustainability Index (ESI) utilizes a refined methodology based on the 2000 Pilot ESI effort, to construct an index covering 122 countries...

  17. 2016 Traffic Safety Culture Index

    Science.gov (United States)

    ... SEARCH Driver Behavior & Performance 2016 Traffic Safety Culture Index This report presents the results of our annual Traffic Safety Culture Index survey, providing data on the attitudes and behaviors ...

  18. Blood pressure to height ratio as a screening tool for ...

    African Journals Online (AJOL)

    2015-12-03

    Dec 3, 2015 ... diagnosis of pediatric high blood pressure have been proposed. The blood pressure height ratio (BPHR) was first proposed as a simple, accurate, and nonage dependent screening index for adolescent hypertension by Lu et al.[6] in. China. Subsequently, there have been efforts to validate this tool among ...

  19. Anthropometry and Blood Pressure in Nigerian Children – Egbuna ...

    African Journals Online (AJOL)

    For boys, weight correlated (r=0.3205) more than height (r=o.2585) with systolic blood pressures. These values were nonetheless statistically significant. For their diastolic blood pressures, it was observed that all the variables showed weak correlation; weight (r=0.1785), height (r=0.1504), Quetelet's index (r=0.0828)

  20. Ambulatory blood pressure profiles in familial dysautonomia.

    Science.gov (United States)

    Goldberg, Lior; Bar-Aluma, Bat-El; Krauthammer, Alex; Efrati, Ori; Sharabi, Yehonatan

    2018-02-12

    Familial dysautonomia (FD) is a rare genetic disease that involves extreme blood pressure fluctuations secondary to afferent baroreflex failure. The diurnal blood pressure profile, including the average, variability, and day-night difference, may have implications for long-term end organ damage. The purpose of this study was to describe the circadian pattern of blood pressure in the FD population and relationships with renal and pulmonary function, use of medications, and overall disability. We analyzed 24-h ambulatory blood pressure monitoring recordings in 22 patients with FD. Information about medications, disease severity, renal function (estimated glomerular filtration, eGFR), pulmonary function (forced expiratory volume in 1 s, FEV1) and an index of blood pressure variability (standard deviation of systolic pressure) were analyzed. The mean (± SEM) 24-h blood pressure was 115 ± 5.6/72 ± 2.0 mmHg. The diurnal blood pressure variability was high (daytime systolic pressure standard deviation 22.4 ± 1.5 mmHg, nighttime 17.2 ± 1.6), with a high frequency of a non-dipping pattern (16 patients, 73%). eGFR, use of medications, FEV1, and disability scores were unrelated to the degree of blood pressure variability or to dipping status. This FD cohort had normal average 24-h blood pressure, fluctuating blood pressure, and a high frequency of non-dippers. Although there was evidence of renal dysfunction based on eGFR and proteinuria, the ABPM profile was unrelated to the measures of end organ dysfunction or to reported disability.

  1. Relationship Between Glycated Haemoglobin and Body Mass Index ...

    African Journals Online (AJOL)

    Blood pressure, Height, Weight were all measured and body mass index (BMI) calculated as weight (in kilograms) divided by height (in meters squared). Glycated haemoglobin was estimated using the ion exchange chromatography method. Result: A total of 100 healthy subjects, 50 males and 50 females, ages ranging ...

  2. Upwelling Index, 57N 137W, 6-hourly

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Upwelling index computed from 1-degree FNMOC sea level pressure for 15 locations off the North American West Coast at each 3 degrees of latitude from 21N to 60N. The...

  3. Upwelling Index, 21N 107W, 6-hourly

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Upwelling index computed from 1-degree FNMOC sea level pressure for 15 locations off the North American West Coast at each 3 degrees of latitude from 21N to 60N. The...

  4. Reproducibility of the ambulatory arterial stiffness index in hypertensive patients

    DEFF Research Database (Denmark)

    Dechering, D.G.; Steen, M.S. van der; Adiyaman, A.

    2008-01-01

    BACKGROUND: We studied the repeatability of the ambulatory arterial stiffness index (AASI), which can be computed from 24-h blood pressure (BP) recordings as unity minus the regression slope of diastolic on systolic BP. METHODS: One hundred and fifty-two hypertensive outpatients recruited in Nijm...

  5. correlation of the undrained shear strength and plasticity index

    African Journals Online (AJOL)

    Dr Obe

    Ko, = coefficient of lateral earth pressure at rest. LI = Liquidity Index. LL = liquid limit. P = total mean stress (= (σ ... quantity of seepage through an earth dam or beneath a concrete dam or into an excavation; the force on a .... of hollow cylindrical cutters attached to boring rods. These samples were then trimmed to cylindrical ...

  6. Reproducibility of the ambulatory arterial stiffness index in hypertensive patients

    DEFF Research Database (Denmark)

    Dechering, D.G.; Steen, M.S. van der; Adiyaman, A.

    2008-01-01

    BACKGROUND: We studied the repeatability of the ambulatory arterial stiffness index (AASI), which can be computed from 24-h blood pressure (BP) recordings as unity minus the regression slope of diastolic on systolic BP. METHODS: One hundred and fifty-two hypertensive outpatients recruited...

  7. Upwelling Index, 60N 149W, 6-hourly

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Upwelling index computed from 1-degree FNMOC sea level pressure for 15 locations off the North American West Coast at each 3 degrees of latitude from 21N to 60N. The...

  8. Upwelling Index, 33N 119W, 6-hourly

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Upwelling index computed from 1-degree FNMOC sea level pressure for 15 locations off the North American West Coast at each 3 degrees of latitude from 21N to 60N. The...

  9. Pattern of body mass index (BMI) among adult hypertensive ...

    African Journals Online (AJOL)

    In recent times Asaba – the capital of Delta State, Nigeria – is witnessing a rapid growth in urbanization and fast food eateries. Several studies have shown that Blood Pressure (BP) is directly associated with Body Mass Index (BMI) in populations worldwide. However, some variations exist in the pattern of the association ...

  10. Indexing contamination surveys

    International Nuclear Information System (INIS)

    Brown, R.L.

    1998-01-01

    The responsibility for safely managing the Tank Farms at Hanford belongs to Lockheed Martin Hanford Corporation which is part of the six company Project Hanford Management Team led by Fluor Daniel Hanford, Inc.. These Tank Farm Facilities contain numerous outdoor contamination areas which are surveyed at a periodicity consistent with the potential radiological conditions, occupancy, and risk of changes in radiological conditions. This document describes the survey documentation and data tracking method devised to track the results of contamination surveys this process is referred to as indexing. The indexing process takes a representative data set as an indicator for the contamination status of the facility. The data are further manipulated into a single value that can be tracked and trended using standard statistical methodology. To report meaningful data, the routine contamination surveys must be performed in a manner that allows the survey method and the data collection process to be recreated. Three key criteria are necessary to accomplish this goal: Accurate maps, consistent documentation, and consistent consolidation of data meeting these criteria provides data of sufficient quality to be tracked. Tracking of survey data is accomplished by converting the individual survey results into a weighted value, corrected for the actual number of survey points. This information can be compared over time using standard statistical analysis to identify trends. At the Tank Farms, the need to track and trend the facility's radiological status presents unique challenges. Many of these Tank Farm facilities date back to the second world war. The Tank Farm Facilities are exposed to weather extremes, plant and animal intrusion, as well as all of the normal challenges associated with handling radiological waste streams. Routine radiological surveys did not provide a radiological status adequate for continuing comparisons

  11. Review of Cohesion in Indexing

    Directory of Open Access Journals (Sweden)

    Hasan Ashrafi Rizi

    2007-07-01

    Full Text Available Indexers often disagree on judging terms that best reflect the content of a document. Difference of opinion highlights one of the characteristics of indexing which is indexing cohesion. Also known as consistency, little study of the subject matter has been undertaken in the past few years. However, its importance has been recently acknowledged in effective information retrieval and expansion of access points to the document content. The present paper investigates cohesion in indexing. In addition of presenting the definitions offered by experts, it takes note of the factors influencing indexing cohesion. Methods for measuring cohesion are offered.

  12. Advances in high pressure science and technology: proceedings of the fourth national conference on high pressure science and technology

    International Nuclear Information System (INIS)

    Yousuf, Mohammad; Subramanian, N.; Govinda Rajan, K.

    1997-09-01

    The proceedings of the fourth National Conference on High Pressure Science and Technology covers a wide area of research and development activities in the field of high pressure science and technology, broadly classified into the following themes: mechanical behaviour of materials; instrumentation and methods in high pressure research; pressure calibration, standards and safety aspects; phase transitions; shock induced reactions; mineral science, geophysics, geochemistry and planetary sciences; optical, electronic and transport properties; synthesis of materials; soft condensed matter physics and liquid crystals; computational methods in high pressure research. Papers relevant to INIS are indexed separately

  13. Do maternal and intrauterine factors influence blood pressure in childhood?

    OpenAIRE

    Whincup, P H; Cook, D G; Papacosta, O

    1992-01-01

    It has been proposed that maternal health and nutrition may be important in the development of adult cardiovascular risk, and that blood pressure may be an important intermediate step in this process. To examine the relevance of this hypothesis in contemporary British children, the relationships of several maternal factors to blood pressure were studied in 3360 children of European origin aged 5-7 years. Maternal age, height, and body mass index were all positively related to blood pressure i...

  14. Transient productivity index for numerical well test simulations

    Energy Technology Data Exchange (ETDEWEB)

    Blanc, G.; Ding, D.Y.; Ene, A. [Institut Francais du Petrole, Pau (France)] [and others

    1997-08-01

    The most difficult aspect of numerical simulation of well tests is the treatment of the Bottom Hole Flowing (BHF) Pressure. In full field simulations, this pressure is derived from the Well-block Pressure (WBP) using a numerical productivity index which accounts for the grid size and permeability, and for the well completion. This productivity index is calculated assuming a pseudo-steady state flow regime in the vicinity of the well and is therefore constant during the well production period. Such a pseudo-steady state assumption is no longer valid for the early time of a well test simulation as long as the pressure perturbation has not reached several grid-blocks around the well. This paper offers two different solutions to this problem: (1) The first one is based on the derivation of a Numerical Transient Productivity Index (NTPI) to be applied to Cartesian grids; (2) The second one is based on the use of a Corrected Transmissibility and Accumulation Term (CTAT) in the flow equation. The representation of the pressure behavior given by both solutions is far more accurate than the conventional one as shown by several validation examples which are presented in the following pages.

  15. Refractive index of K9 Glass under Shock Loading

    Science.gov (United States)

    Hu, Changming; Wang, Xiang; Cai, Lingcang; Liu, Cangli

    2013-06-01

    We study K9 glass refraction index under shock loading conducted on powder gun,all experimental tests are plate impact loading. The impact veceloty range from 300m/s to 1200m/s, and the measure method is laser interferometer Photon Doppler Velocimetry(PDV) to measure the particle velocity both at the impact interface and free surface, The shock pressure from 2 GPa to 8 GPa, values for refraction are found from velocity corrections that must be made to account for refraction-index changes in the K9 glass due to shock wave motion. Experiment results show that refraction-index of K9 glass changes with the shock pressure in line relations, it can be as measure window to study the interesting materials under 10 GPa during the shock loading.

  16. Solar index generation and delivery

    Energy Technology Data Exchange (ETDEWEB)

    Lantz, L.J.

    1980-01-01

    The Solar Index, or, more completely defined as the Service Hot Water Solar Index, was conceptualized during the spring of 1978. The purpose was to enhance public awareness to solar energy usability. Basically, the Solar Index represents the percentage of energy that solar would provide in order to heat an 80 gallon service hot water load for a given location and day. The Index is computed by utilizing SOLCOST, a computer program, which also has applications to space heating, cooling, and heat pump systems and which supplies economic analyses for such solar energy systems. The Index is generated for approximately 68 geographic locations in the country on a daily basis. The definition of the Index, how the project came to be, what it is at the present time and a plan for the future are described. Also presented are the models used for the generation of the Index, a discussion of the primary tool of implementation (the SOLCOST program) and future efforts.

  17. Association of plasma uric acid with ischaemic heart disease and blood pressure

    DEFF Research Database (Denmark)

    Palmer, Tom M; Nordestgaard, Børge G; Benn, Marianne

    2013-01-01

    To assess the associations between both uric acid levels and hyperuricaemia, with ischaemic heart disease and blood pressure, and to explore the potentially confounding role of body mass index.......To assess the associations between both uric acid levels and hyperuricaemia, with ischaemic heart disease and blood pressure, and to explore the potentially confounding role of body mass index....

  18. Complexity of intracranial pressure correlates with outcome after traumatic brain injury

    Science.gov (United States)

    Lu, Cheng-Wei; Czosnyka, Marek; Shieh, Jiann-Shing; Smielewska, Anna; Pickard, John D.

    2012-01-01

    This study applied multiscale entropy analysis to investigate the correlation between the complexity of intracranial pressure waveform and outcome after traumatic brain injury. Intracranial pressure and arterial blood pressure waveforms were low-pass filtered to remove the respiratory and pulse components and then processed using a multiscale entropy algorithm to produce a complexity index. We identified significant differences across groups classified by the Glasgow Outcome Scale in intracranial pressure, pressure-reactivity index and complexity index of intracranial pressure (P intracranial pressure achieved the strongest statistical significance (F = 28.7; P intracranial pressure assessed by multiscale entropy was significantly associated with outcome in patients with brain injury. PMID:22734128

  19. SUBJECT AND AUTHOR INDEXS

    Directory of Open Access Journals (Sweden)

    IJBE Volume 1

    2015-09-01

    Full Text Available SUBJECT INDEX IJBE VOLUME 1EPA, 1Agrotourism, 148AHP, 148balance scorecard, 63batik tulis Rolla Junior, 23Broiler, 90business model canvas, 137business performance,32capital structure, 81cashew industry,158CHAID,106CLI,42coal transportation service,63company’s characteristics, 81competitive advantage, 12competitive strategy, 127consumer satisfaction, 51CSI, 42customer loyalty, 42customer satisfaction,42decision of visitors, 72development strategy, 23development,158entrepreneurship, 32Feasibility studies, 90FEM, 81gap analysis, 1Indonesia Stock Exchange, 177Indosat, 137investor,177Kawah Putih, 72kedai sop durian lodaya (KSDL,51klassen typology, 96leading sector, 96less cash society, 137liquidity ratio, 165location quotient, 96logistic regression, 115market, 177marketing development strategy, 148Marketing mix, 72mobile payment, 137modern and Traditional cage, 90multiple regression analyse,165multiple regression, 177net working capital, 165organic tofu product, 115Padang, 106paired comparison, 63partnership, 1, 32Pecking Order Theory, 81PLS, 81Portfolio, 96power, 32product quality, 51profitability ratio, 165Prol Tape Primadona, 127purchase decision, 115purchase intention, 51purchasing interest,115QSPM, 23, 127refilled drinking water, 106seed,1segmentation, 106SEM, 42, 51service quality, 51SMEs, 96specialty coffee, 12stock,177strategic diagnosis,137strategy, 158Sukorambi Botanic Garden, 148SWOT, 23, 127, 148, 158SWOT-AHP, 12tourists,72UD. Primadona, 127value chain, 12VRIO,12 AUTHOR INDEX IJBE VOLUME 1Adiningsih, Kartika Puspitasari,42Aknesia, Vharessa,12Amalia, Firda Rachma,90Andati, Trias, 177Anggraeni, Lukytawati,23Asriani,158Daryanto, Arief,12, 90Djamaludin, MD., 42Djohar, Setiadi,96Fachrodji, Achmad,72Fahmi, Idqan,1, 63, 127Fasyni, Awisal,106Hubeis, Musa,148Iskandar, Dodi,51Juanda, Bambang, 165Kirbrandoko, 12, 106, 115Lumbantoruan, Dewi Margareth,96Maulana, TB Nur Ahmad,81Muksin, 148Mukti Soleh, Cecep,63Najib, Mukhamad,106Noor, Tajudin,81

  20. Echocardiographic evaluation of right ventricular stroke work index in advanced heart failure: a new index?

    Science.gov (United States)

    Frea, Simone; Bovolo, Virginia; Bergerone, Serena; D'Ascenzo, Fabrizio; Antolini, Marina; Capriolo, Michele; Canavosio, Federico Giovanni; Morello, Mara; Gaita, Fiorenzo

    2012-12-01

    Right ventricular (RV) function plays a pivotal role in advanced heart failure patients, especially for screening those who may benefit from left ventricular assist device (LVAD) implantation. We introduce RV contraction pressure index (RVCPI) as a new echo-Doppler parameter of RV function. The accuracy of RVCPI in detecting RV failure was compared with the criterion standard, the RV stroke work index (RVSWI) obtained through right heart catheterization in advanced heart failure patients referred for heart transplantation or LVAD implantation. Right heart catheterization and echo-Doppler were simultaneously performed in 94 consecutive patients referred to our center for advanced heart failure (ejection fraction (EF) 24 ± 8.8%, 40% NYHA functional class IV). RV stroke volume and invasive pulmonary pressures were used to obtain RVSWI. Simplified RVCPI (sRVCPI) was derived as TAPSE × (RV - right atrial pressure gradient). Close positive correlation between sRVCPI and RVSWI was found (r = 0.68; P rights reserved.

  1. 2012 Environmental Performance Index and Pilot Trend Environmental Performance Index

    Data.gov (United States)

    National Aeronautics and Space Administration — The 2012 Environmental Performance Index (EPI) ranks 132 countries on 22 performance indicators in the following 10 policy categories: environmental burden of...

  2. Pressure-driven flow of a Herschel-Bulkley fluid with pressure-dependent rheological parameters

    Science.gov (United States)

    Panaseti, Pandelitsa; Damianou, Yiolanda; Georgiou, Georgios C.; Housiadas, Kostas D.

    2018-03-01

    The lubrication flow of a Herschel-Bulkley fluid in a symmetric long channel of varying width, 2h(x), is modeled extending the approach proposed by Fusi et al. ["Pressure-driven lubrication flow of a Bingham fluid in a channel: A novel approach," J. Non-Newtonian Fluid Mech. 221, 66-75 (2015)] for a Bingham plastic. Moreover, both the consistency index and the yield stress are assumed to be pressure-dependent. Under the lubrication approximation, the pressure at zero order depends only on x and the semi-width of the unyielded core is found to be given by σ(x) = -(1 + 1/n)h(x) + C, where n is the power-law exponent and the constant C depends on the Bingham number and the consistency-index and yield-stress growth numbers. Hence, in a channel of constant width, the width of the unyielded core is also constant, despite the pressure dependence of the yield stress, and the pressure distribution is not affected by the yield-stress function. With the present model, the pressure is calculated numerically solving an integro-differential equation and then the position of the yield surface and the two velocity components are computed using analytical expressions. Some analytical solutions are also derived for channels of constant and linearly varying widths. The lubrication solutions for other geometries are calculated numerically. The implications of the pressure-dependence of the material parameters and the limitations of the method are discussed.

  3. Pulse pressure and diabetes treatments: Blood pressure and pulse pressure difference among glucose lowering modality groups in type 2 diabetes.

    Science.gov (United States)

    Alemi, Hamid; Khaloo, Pegah; Mansournia, Mohammad Ali; Rabizadeh, Soghra; Salehi, Salome Sadat; Mirmiranpour, Hossein; Meftah, Neda; Esteghamati, Alireza; Nakhjavani, Manouchehr

    2018-02-01

    Type 2 diabetes is associated with higher pulse pressure. In this study, we assessed and compared effects of classic diabetes treatments on pulse pressure (PP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) in patients with type 2 diabetes.In a retrospective cohort study, 718 non-hypertensive patients with type 2 diabetes were selected and divided into 4 groups including metformin, insulin, glibenclamide+metformin, and metformin+insulin. They were followed for 4 consecutive visits lasting about 45.5 months. Effects of drug regimens on pulse and blood pressure over time were assessed separately and compared in regression models with generalized estimating equation method and were adjusted for age, duration of diabetes, sex, smoking, and body mass index (BMI).Studied groups had no significant change in PP, SBP, and DBP over time. No significant difference in PP and DBP among studied groups was observed (PP:P = 0.090; DBP:P = 0.063). Pairwise comparisons of PP, SBP, and DBP showed no statistically significant contrast between any 2 studied groups. Interactions of time and treatment were not different among groups.Our results demonstrate patients using metformin got higher PP and SBP over time. Averagely, pulse and blood pressure among groups were not different. Trends of variation in pulse and blood pressure were not different among studied diabetes treatments.

  4. SUBJECT AND AUTHOR INDEXS

    Directory of Open Access Journals (Sweden)

    IJBE Volume 2

    2016-09-01

    Full Text Available SUBJECT INDEX IJBE VOLUME 2access credit, 93acquisition, 177AHP, 61, 82, 165arena simulation,43BMC, 69Bojonegoro, 69brand choice, 208brand image, 208brand positioning, 208bullwhip effect, 43burger buns, 1business synergy and financial reports, 177capital structure, 130cluster, 151coal reserves, 130coffee plantation, 93competitiveness, 82consumer behaviour, 33consumer complaint behavior, 101cooking spices, 1crackers, 1cross sectional analytical, 139crosstab, 101CSI, 12direct selling, 122discriminant analysis, 33economic value added, 130, 187employee motivation, 112employee performance, 112employees, 139EOQ, 23farmer decisions, 93farmer group, 52financial performance evaluation, 187financial performance, 52, 177financial ratio, 187financial report, 187fiva food, 23food crops, 151horticulture, 151imports, 151improved capital structure, 177IPA, 12leading sector, 151life insurance, 165LotteMart, 43main product, 61marketing mix, 33, 165matrix SWOT, 69MPE, 61multiple linear regression, 122muslim clothing, 197Ogun, 139Pangasius fillet, 82Pati, 93pearson correlation, 101perceived value, 208performance suppy chain, 23PLS, 208POQ, 23portfolio analyzing, 1product, 101PT SKP, 122pulp and papers, 187purchase decision, 165purchase intention, 33remuneration, 112re-purchasing decisions, 197sales performance, 122sawmill, 52SCOR, 23sekolah peternakan rakyat, 69SEM, 112SERVQUAL, 12Sido Makmur farmer groups, 93SI-PUHH Online, 12small and medium industries (IKM, 61socio-demographic, 139sport drink, 208stress, 139supply chain, 43SWOT, 82the mix marketing, 197Tobin’s Q, 130trade partnership, 52uleg chili sauce, 1 AUTHOR INDEX IJBE VOLUME 2Achsani, Noer Azam, 177Andati, Trias, 52, 177Andihka, Galih, 208Arkeman, Yandra, 43Baga, Lukman M, 69Cahyanugroho, Aldi, 112Daryanto, Arief, 12David, Ajibade, 139Djoni, 122Fahmi, Idqan, 1Fattah, Muhammad Unggul Abdul, 61Hakim, Dedi Budiman, 187Harianto, 93Hartoyo, 101Homisah, 1Hubeis, Musa, 112Hutagaol, M. Parulian, 93Jaya, Stevana

  5. Low blood pressure

    Science.gov (United States)

    ... Low blood pressure can usually be treated with success. Possible Complications Falls due to low blood pressure ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  6. Atmospheric Pressure Indicator.

    Science.gov (United States)

    Salzsieder, John C.

    1995-01-01

    Discusses observable phenomena related to air pressure. Describes a simple, unobtrusive, semiquantitative device to monitor the changes in air pressure that are associated with altitude, using a soft-drink bottle and a balloon. (JRH)

  7. Pressure vessel design manual

    CERN Document Server

    Moss, Dennis R

    2013-01-01

    Pressure vessels are closed containers designed to hold gases or liquids at a pressure substantially different from the ambient pressure. They have a variety of applications in industry, including in oil refineries, nuclear reactors, vehicle airbrake reservoirs, and more. The pressure differential with such vessels is dangerous, and due to the risk of accident and fatality around their use, the design, manufacture, operation and inspection of pressure vessels is regulated by engineering authorities and guided by legal codes and standards. Pressure Vessel Design Manual is a solutions-focused guide to the many problems and technical challenges involved in the design of pressure vessels to match stringent standards and codes. It brings together otherwise scattered information and explanations into one easy-to-use resource to minimize research and take readers from problem to solution in the most direct manner possible. * Covers almost all problems that a working pressure vessel designer can expect to face, with ...

  8. Pressure surge attenuator

    Science.gov (United States)

    Christie, Alan M.; Snyder, Kurt I.

    1985-01-01

    A pressure surge attenuation system for pipes having a fluted region opposite crushable metal foam. As adapted for nuclear reactor vessels and heads, crushable metal foam is disposed to attenuate pressure surges.

  9. Preventing Pressure Sores

    Medline Plus

    Full Text Available ... increased? play_arrow What do family members and caregivers need to know about pressure sores? play_arrow What do family members and caregivers need to do to prevent pressure sores? play_ ...

  10. High blood pressure medications

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007484.htm High blood pressure medicines To use the sharing features on this page, please enable JavaScript. Treating high blood pressure will help prevent problems such as heart disease, ...

  11. High blood pressure - children

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007696.htm High blood pressure - children To use the sharing features on this page, please enable JavaScript. High blood pressure (hypertension) is an increase in the force of ...

  12. High Blood Pressure

    Science.gov (United States)

    ... Immunosuppressant medicines Anxiety, depression and mental health Kidney rejection Lifestyle changes Donate a kidney Being a living ... take a blood pressure medicine. There are many types of blood pressure medicine and you may need to take ...

  13. Preventing Pressure Sores

    Medline Plus

    Full Text Available ... Injury Medical Expert Videos Topics menu Topics Preventing Pressure Sores Adult Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

  14. Preventing Pressure Sores

    Medline Plus

    Full Text Available ... L Sarah Harrison, OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury ... do to prevent pressure sores? play_arrow What role does diet and hydration play in preventing pressure ...

  15. Preventing Pressure Sores

    Medline Plus

    Full Text Available ... to prevent pressure sores? play_arrow What is “skin tolerance” and how can it be ... play_arrow What role does diet and hydration play in preventing pressure sores among ...

  16. Preventing High Blood Pressure

    Science.gov (United States)

    ... Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN Preventing High Blood Pressure: Healthy Living Habits Recommend on Facebook Tweet Share ... meal and snack options can help you avoid high blood pressure and its complications. Be sure to eat plenty ...

  17. High blood pressure - infants

    Science.gov (United States)

    Hypertension - infants ... and blood vessels The health of the kidneys High blood pressure in infants may be due to kidney or ... blood vessel of the kidney) In newborn babies, high blood pressure is often caused by a blood clot in ...

  18. Understanding Blood Pressure Readings

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Understanding Blood Pressure Readings Updated:Feb 19,2018 What do your ... this chart: English | Spanish | Traditional Chinese Enter Your Blood Pressure Systolic mm Hg (upper #) Diastolic mm Hg (lower #) ...

  19. Equiseparability on Terminal Wiener Index

    DEFF Research Database (Denmark)

    Deng, Xiaotie; Zhang, Jie

    2012-01-01

    The aim of this work is to explore the properties of the terminal Wiener index, which was recently proposed by Gutman et al. (2004) [3], and to show the fact that there exist pairs of trees and chemical trees which cannot be distinguished by using it. We give some general methods for constructing...... equiseparable pairs and compare the methods with the case for the Wiener index. More specifically, we show that the terminal Wiener index is degenerate to some extent....

  20. Asset pricing with index investing

    OpenAIRE

    Georgy Chabakauri; Oleg Rytchkov

    2014-01-01

    We provide a novel theoretical analysis of how index investing affects capital market equilibrium. We consider a dynamic exchange economy with heterogeneous investors and two Lucas trees and find that indexing can either increase or decrease the correlation between stock returns and in general increases (decreases) volatilities and betas of stocks with larger (smaller) market capitalizations. Indexing also decreases market volatility and interest rates, although those effects are weak. The im...