WorldWideScience

Sample records for sub-clinical vascular disease

  1. Dietary inflammatory index in relation to sub-clinical atherosclerosis and atherosclerotic vascular disease mortality in older women.

    Science.gov (United States)

    Bondonno, Nicola P; Lewis, Joshua R; Blekkenhorst, Lauren C; Shivappa, Nitin; Woodman, Richard J; Bondonno, Catherine P; Ward, Natalie C; Hébert, James R; Thompson, Peter L; Prince, Richard L; Hodgson, Jonathan M

    2017-06-01

    Arterial wall thickening, stimulated by low-grade systemic inflammation, underlies many cardiovascular events. As diet is a significant moderator of systemic inflammation, the dietary inflammatory index (DIITM) has recently been devised to assess the overall inflammatory potential of an individual's diet. The primary objective of this study was to assess the association of the DII with common carotid artery-intima-media thickness (CCA-IMT) and carotid plaques. To substantiate the clinical importance of these findings we assessed the relationship of DII score with atherosclerotic vascular disease (ASVD)-related mortality, ischaemic cerebrovascular disease (CVA)-related mortality and ischaemic heart disease (IHD)-related mortality more. The study was conducted in Western Australian women aged over 70 years (n 1304). Dietary data derived from a validated FFQ (completed at baseline) were used to calculate a DII score for each individual. In multivariable-adjusted models, DII scores were associated with sub-clinical atherosclerosis: a 1 sd (2·13 units) higher DII score was associated with a 0·013-mm higher mean CCA-IMT (P=0·016) and a 0·016-mm higher maximum CCA-IMT (P=0·008), measured at 36 months. No relationship was seen between DII score and carotid plaque severity. There were 269 deaths during follow-up. High DII scores were positively associated with ASVD-related death (per sd, hazard ratio (HR): 1·36; 95 % CI 1·15, 1·60), CVA-related death (per sd, HR: 1·30; 95 % CI 1·00, 1·69) and IHD-related death (per sd, HR: 1·40; 95 % CI 1·13, 1·75). These results support the hypothesis that a pro-inflammatory diet increases systemic inflammation leading to development and progression of atherosclerosis and eventual ASVD-related death.

  2. Sub-clinical Addison′s disease

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    Manash P Baruah

    2012-01-01

    Full Text Available As autoimmune adrenalitis is fast replacing tuberculosis as the most common etiology cause of adrenal insufficiency, subtler forms of the same are being recognised as subclinical addison′s disease. In this article, we review what is known about this entity till date.

  3. What Is Vascular Disease?

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    ... Policy What Is Vascular Disease? What Is Vascular Disease? Vascular disease is any abnormal condition of the blood ... Privacy Policy × Your ticket for the: What Is Vascular Disease? Title What Is Vascular Disease? USD Close Print

  4. Collagen vascular disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001223.htm Collagen vascular disease To use the sharing features on this page, ... previously said to have "connective tissue" or "collagen vascular" disease. We now have names for many specific conditions ...

  5. Vascular disease burden in Indian subjects with vascular dementia.

    Science.gov (United States)

    Chandra, Mina; Anand, Kuljeet Singh

    2015-01-01

    Vascular disease factors like hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease contribute to the development of vascular dementia. As comorbidity of vascular disease factors in vascular dementia is common, we investigated the vascular disease burden in subjects with vascular dementia. To investigate the vascular disease burden due to four vascular disease factors: hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease in Indian subjects with vascular dementia. In this study, 159 subjects with probable vascular dementia (as per NINDS-AIREN criteria) attending the memory clinic at a tertiary care hospital were assessed for the presence of hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease using standardised operational definitions and for severity of dementia on the Clinical Dementia Rating (CDR) scale. The data obtained was subjected to appropriate statistical analysis. Dyslipidaemia (79.25 per cent) was the most common vascular disease factor followed by hypertension (73.58 per cent), ischaemic heart disease (58.49 per cent), and diabetes mellitus (40.80 per cent). Most subjects (81.1 per cent) had two or more vascular disease factors. Subjects with more severe dementia had more vascular disease factors (sig 0.001). People with moderate to severe dementia have a significantly higher vascular disease burden; therefore, higher vascular disease burden may be considered as a poor prognostic marker in vascular dementia. Subjects with vascular dementia and their caregivers must manage cognitive impairment and ADL alongside managing serious comorbid vascular diseases that may worsen the dementia.

  6. Spinal Cord Vascular Disease

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    Abdoreza Ghoreishi

    2017-02-01

    Full Text Available The spinal cord is subject to many of the same vascular diseases that involve the brain, but its anatomy and embryology render it susceptible to some syndromes that do not have intracranial counterparts.The embryonic arterial supply to the spinal cord derives from intradural vessels that enter at each spinal level and divide to follow the dorsal and ventral roots. SPINAL CORD ISCHEMIA: The midthoracic levels of the spinal cord are traditionally considered to be the most vulnerable to compromise from hypoperfusion, but more recent evidence suggests that the lower thoracic cord is at greater risk . The actual prevalence of spinal cord infarction is unknown, but is generally cited as representing 1% to 2% of all central neurovascular events and 5% to 8% of all acute myelopathies. Weakness (100%, sensory loss (89%, back pain at onset (82%, and urinary complaints requiring catheterization (75% were the most common symptoms of cord ischemia at the time of presentation . Weakness most commonly affects both legs. Examination typically reveals flaccid paresis accompanied by diminished superficial and tendon reflexes below the level of the lesion. Preservation of strength and reflexes suggests the rare syndrome of posterior spinal artery territory infarction. Weakness most commonly affects both legs. Examination typically reveals flaccid paresis accompanied by diminished superficial and tendon reflexes below the level of the lesion. Preservation of strength and reflexes suggests the rare syndrome of posterior spinal artery territory infarction.   Aortic pathologies with regional hemodynamic compromise are the most common cause of spinal cord infarction, accounting for 30% to 40% of cases.                                                                                 The medical management of spinal cord ischemia is generally supportive and focused on reducing risk for

  7. Imaging of peripheral vascular disease

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    Mo Al-Qaisi

    2009-03-01

    Full Text Available Mo Al-Qaisi1, David M Nott1, David H King1, Sam Kaddoura2, Mo Hamady31Charing Cross Hospital, London, UK; 2Royal Brompton Hospital, London, UK; 3St. Mary’s Hospital, London, UKAbstract: This illustrated review article gives an evidence-based update on the different modalities used for imaging peripheral vascular disease (duplex ultrasound, computed tomography angiography, magnetic resonance angiography, and digital subtraction angiography. After discussing the latest technological developments for each modality, their limitations are also highlighted. The evidence is presented for the various modalities’ roles in the imaging of peripheral vascular disease, including problem-solving applications. The strengths and weaknesses of each modality are therefore critically appraised, including the salient technological, clinical, and financial aspects. This review allows the general and specialist practitioner to make an informed decision on how best to deploy imaging tests in peripheral vascular disease as part of an evidence-based approach. The article concludes with a rational imaging algorithm for the investigation of peripheral vascular disease.Keywords: imaging, peripheral, vascular, duplex, angiography, arterial 

  8. [Alzheimer's disease and vascular dementia].

    Science.gov (United States)

    Nagata, Ken

    2014-04-01

    Alzheimer's disease (AD) and vascular dementia (VaD) are the two major forms of dementia in the elderly, and they had been separated categorically on the basis of pathogenetic mechanisms and clinical operationalized criteria. However, it was claimed that this strict separation might steered toward the overdiagnosis of vascular dementia, this dichotomy has been reevaluated in the light of recent epidemiological and neuropathological knowledge. Cerebrovascular disease (CVD) is now considered as one of the vascular risk factors to the onset and evolution of Alzheimer's disease. Futhermore, the term "AD with CVD" has been used to classify patients fulfilling the clinical criteria for possible AD and who also present clinical or brain imaging evidence of relevant CVD.

  9. The Vascular Depression Hypothesis: Mechanisms Linking Vascular Disease with Depression

    Science.gov (United States)

    Taylor, Warren D.; Aizenstein, Howard J.; Alexopoulos, George S.

    2013-01-01

    The ‘Vascular Depression’ hypothesis posits that cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between late-life depression, vascular risk factors, and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in late-life depression, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression but also provide guidance on the potential repurposing of pharmacological agents that may improve late-life depression outcomes. PMID:23439482

  10. [Menopause: Hypertension and vascular disease].

    Science.gov (United States)

    Zilberman, J M

    2018-01-28

    Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Protecting against vascular disease in brain

    Science.gov (United States)

    2011-01-01

    Endothelial cells exert an enormous influence on blood vessels throughout the circulation, but their impact is particularly pronounced in the brain. New concepts have emerged recently regarding the role of this cell type and mechanisms that contribute to endothelial dysfunction and vascular disease. Activation of the renin-angiotensin system plays a prominent role in producing these abnormalities. Both oxidative stress and local inflammation are key mechanisms that underlie vascular disease of diverse etiology. Endogenous mechanisms of vascular protection are also present, including antioxidants, anti-inflammatory molecules, and peroxisome proliferator-activated receptor-γ. Despite their clear importance, studies of mechanisms that underlie cerebrovascular disease continue to lag behind studies of vascular biology in general. Identification of endogenous molecules and pathways that protect the vasculature may result in targeted approaches to prevent or slow the progression of vascular disease that causes stroke and contributes to the vascular component of dementia and Alzheimer's disease. PMID:21335467

  12. Vascular manifestations of Behcet's disease

    Directory of Open Access Journals (Sweden)

    Regina Georgiyeva Goloeva

    2010-01-01

    Conclusion. Vascular disorders in BD were diagnosed in one fourth of the patients, mainly in young male patients. Severe thromboses with the development of chronic venous insignificance, Budd-Chiari syndrome, pulmonary and iliac artery aneurysms, and arterial thromboses were observed in male patients only. Vascular events were associated with erythema nodosum and epididymitis; in these concomitances, the vascular risk was substantially increased. Vascular death rates were 2,2%.

  13. Dental infection and vascular disease.

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    Zoellner, Hans

    2011-04-01

    Periodontitis is a chronic inflammatory response to bacterial plaque in which the anchoring bone and soft tissues supporting teeth are destroyed, resulting in tooth mobility and loss. Dental caries involves the spread of infection from the dentine to the vascular dental pulp and periapical bony tissues, before involvement of adjacent soft tissues and spreading sepsis. Several case-controlled, cross-sectional, and cohort studies report correlation between periodontitis and increased cardiovascular, cerebrovascular, and peripheral artery disease, as determined by clinical disease, angiography, ultrasonography, and reduced flow-mediated dilation. Some studies report a similar relationship of atherosclerosis with periapical infection and potentially also with coronal caries, and this review identifies the need to investigate these associations further. Smoking and cadmium exposure are epidemiologically confounding environmental risk factors shared by atherosclerosis and periodontitis. Further complicating epidemiological studies are the risk factors for both atherosclerosis and periodontitis, with which periodontitis appears to have separate positive feedback relationships. These include diabetes, increased plasma lipid levels, hypertension, and white blood cell count. Animal and human intervention studies provide some direct support of a causal role for periodontitis in atherosclerosis, and possible mechanisms include bacterial invasion of arteries, specific atherogenic properties of oral bacteria, the acute phase response, and cytokine polymorphisms. © Thieme Medical Publishers.

  14. Headache as Risk Factor for Vascular Disease

    OpenAIRE

    J Gordon Millichap

    2010-01-01

    The association of severe or recurrent headache or migraine with vascular disease in childhood or adolescence was examined by a National Health and Nutrition Survey at the National Institute of Neurological Disease and Stroke and of Mental Health, Bethesda, MD.

  15. Cardiopulmonary Manifestations of Collagen Vascular Diseases.

    Science.gov (United States)

    Jawad, Hamza; McWilliams, Sebastian R; Bhalla, Sanjeev

    2017-10-09

    The study aimed to illustrate the cardiopulmonary findings of the following collagen vascular diseases on cross-sectional imaging: rheumatoid arthritis, scleroderma (progressive systemic sclerosis), systemic lupus erythematosus, the inflammatory myopathies (polymyositis/dermatomyositis), and Sjögren's syndrome. Although collagen vascular diseases can affect any part of the body, interstitial lung disease and pulmonary hypertension are the two most important cardiopulmonary complications and are responsible for the majority of morbidity and mortality in this patient population. Interstitial pneumonia with autoimmune features (IPAF) is a newly described entity that encompasses interstitial lung disease in patients with clinical, serologic, or morphologic features suggestive of but not diagnostic of collagen vascular disease; these patients are thought to have better outcomes than idiopathic interstitial pneumonias. Interstitial lung disease and pulmonary hypertension determine the prognosis in collagen vascular disease patients. IPAF is a new term to label patients with possible collagen vascular disease-related interstitial lung disease. Collagen vascular disease patients are at increased risk for various malignancies.

  16. Differential patterns of planning impairments in Parkinson's disease and sub-clinical signs of dementia? A latent-class model-based approach.

    Science.gov (United States)

    Köstering, Lena; McKinlay, Audrey; Stahl, Christoph; Kaller, Christoph P

    2012-01-01

    Planning impairments mark a well-documented consequence of neurodegenerative diseases such as Parkinson's disease (PD). Recently, using the Tower of London task we demonstrated that, rather than being generally impaired, PD patients selectively fail when planning requires flexible in-breadth search strategies. For a better understanding of the interindividual patterns underlying specific planning impairments, here we performed an explorative re-analysis of the original data using a latent-class model-based approach. Data-driven classification according to subjects' performance was based on a multinomial processing tree (MPT) model accommodating the impact of increased breadth versus depth of looking ahead during planning. In order to assess interindividual variability in coping with these different task demands, an extension of MPT models was used in which sample-immanent heterogeneity is accounted for by identifying different latent classes of individuals. Two latent classes were identified that differed considerably in performance for problems placing high demands on the depth of anticipatory search processes. In addition, these impairments were independent of PD diagnosis. However, latent-class mediated search depth-related deficits in planning performance were associated with poorer outcomes in dementia screenings, albeit sub-clinical. PD patients exhibited additional deficits related to the breadth of searching ahead. Taken together, results revealed dissociable impairments in specific planning processes within a single task of visuospatial problem solving. Present analyses put forward the hypothesis that cognitive sequelae of PD and sub-clinical signs of dementia may be related to differential patterns of planning impairments.

  17. Subclinical atherosclerotic vascular disease in chronic obstructive pulmonary disease: Prospective hospital-based case control study

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    Sandip Chindhi

    2015-01-01

    Full Text Available Introduction: Chronic obstructive pulmonary disease (COPD is an important non-communicable disease worldwide with a rising global incidence. COPD is associated with multiple co-morbidities. Patients with COPD are at increased risk of atherosclerosis and other cardiovascular events. Cardiovascular diseases are an important cause of morbidity and mortality in COPD. The present case-control study was designed to assess the relationship between sub-clinical atherosclerotic vascular diseases with COPD. Methods: It was a prospective case-control blinded observational study. There were 142 COPD patients and 124 age-and sex-matched controls without COPD and cardiovascular diseases. Frequency of sub-clinical atherosclerosis was assessed by the carotid B-mode duplex ultrasonography assessment of carotid wall intima medial thickness (IMT. Plaque was defined as IMT of more than 1.2 mm. Results: Prevalence of carotid plaqing was significantly higher amongst patients of COPD (38.7% compared to controls (13.7% , odds ratio 3.9, P < 0.0001. Multinomial logistic regression analysis revealed COPD as an independent predictor of carotid plaqing (r = 0.85, P < 0.023. Conclusion: The frequency of carotid plaqing is high in COPD patients. Carotid plaqing may be due to shared risk factors or the presence of low-grade systemic inflammation. Presence of increased CIMT and carotid plaqing in COPD patients identifies early atherosclerotic changes and future cardiovascular risk. Hence screening of CIMT should be a part of cardiovascular assessment in patients with COPD.

  18. Adiposity, adipocytokines & microvesicles in the etiology of vascular disease

    NARCIS (Netherlands)

    Kanhai, D.A.N.I.S.

    2013-01-01

    Vascular disease, in this thesis the terms vascular and cardiovascular are used interchangeably, is the number 1 cause of death worldwide. In 2008, 30% of all mortality had a vascular origin. Vascular mortality rates after a first manifestation of vascular disease are decreasing in Western society,

  19. Hypertensive organ damage in patients with vascular disease

    NARCIS (Netherlands)

    Vlek, A.L.M.

    2009-01-01

    Hypertension is one of the most common vascular risk factors, and is an important cause of development of different vascular diseases. The main aim of this thesis was to determine the burden of hypertension-associated vascular diseases and end-organ damage in patients with manifest vascular disease.

  20. Vascular complications in kidney disease

    NARCIS (Netherlands)

    Ocak, Gürbey

    2015-01-01

    The main objectives of this thesis were to investigate the association between kidney disease and venous and arterial thrombosis and to provide insight in the mechanism of the association between kidney disease and thrombosis. Furthermore, the mortality risks for hemodialysis patients with catheter,

  1. Alzheimer and vascular brain disease: Senile dementia

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    Eliasz Engelhardt

    Full Text Available Alois Alzheimer is best known for his description of a novel disease, subsequently named after him. However, his wide range of interests also included vascular brain diseases. He described Senile dementia, a highly heterogeneous condition, and was able not only to distinguish it from syphilitic brain disease, but also to discriminate two clinicopathological subtypes, that may be labeled a "arteriosclerotic subtype", comparable to the present clinicopathological continuum of "Vascular cognitive impairment", and another as a "neurodegenerative subtype", characterized by primary [cortical] ganglion cell [nerve cells] degeneration, possibly foreshadowing a peculiar presenile disease that he was to describe some years later and would carry his name. He also considered the possibility of a senile presentation of this disease subtype, which was described by Oskar Fischer a short time later. Considering the clinicopathological overlapping features of the "arteriosclerotic subtype" of Senile dementia with Arteriosclerotic atrophy of the brain, it might be possible to consider that both represent a single condition.

  2. Alzheimer and vascular brain disease: Senile dementia.

    Science.gov (United States)

    Engelhardt, Eliasz; Grinberg, Lea T

    2015-01-01

    Alois Alzheimer is best known for his description of a novel disease, subsequently named after him. However, his wide range of interests also included vascular brain diseases. He described Senile dementia, a highly heterogeneous condition, and was able not only to distinguish it from syphilitic brain disease, but also to discriminate two clinicopathological subtypes, that may be labeled a "arteriosclerotic subtype", comparable to the present clinicopathological continuum of "Vascular cognitive impairment", and another as a "neurodegenerative subtype", characterized by primary [cortical] ganglion cell [nerve cells] degeneration, possibly foreshadowing a peculiar presenile disease that he was to describe some years later and would carry his name. He also considered the possibility of a senile presentation of this disease subtype, which was described by Oskar Fischer a short time later. Considering the clinicopathological overlapping features of the "arteriosclerotic subtype" of Senile dementia with Arteriosclerotic atrophy of the brain, it might be possible to consider that both represent a single condition.

  3. Adiposity, adipocytokines & microvesicles in the etiology of vascular disease

    OpenAIRE

    Kanhai, D.A.N.I.S.

    2013-01-01

    Vascular disease, in this thesis the terms vascular and cardiovascular are used interchangeably, is the number 1 cause of death worldwide. In 2008, 30% of all mortality had a vascular origin. Vascular mortality rates after a first manifestation of vascular disease are decreasing in Western society, which is attributable to better disease awareness, better preventive strategies and better healthcare systems. As mortality rates are decreasing, the number of patients surviving their first vascul...

  4. Homocysteine, vitamins, and prevention of vascular disease.

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    McCully, Kilmer S

    2004-04-01

    Within the past four decades, the efforts of investigators worldwide have established the amino acid homocysteine as an important factor in arteriosclerosis and diseases of aging. After its discovery in 1932, homocysteine was demonstrated to be an important intermediate in the metabolism of amino acids. However, little was known about the broader biomedical significance of homocysteine until 1962, when children with mental retardation, accelerated growth, dislocated ocular lenses, and frequent vascular thrombosis were found to excrete homocysteine in the urine. My study of two patients with homocystinuria caused by different inherited enzymatic disorders in 1968 disclosed advanced widespread arteriosclerotic plaques in both cases. This discovery led to the conclusion that homocysteine causes vascular disease by a direct effect on the cells and tissues of the arteries. This interpretation suggests that homocysteine is important in the pathogenesis of arteriosclerosis in persons with hereditary, dietary, environmental, hormonal, metabolic, and other factors predisposing them to hyperhomocysteinemia. Within the past decade, many major clinical and epidemiological studies have proven that hyperhomocysteinemia is a potent independent risk factor for vascular disease. According to the homocysteine theory of arteriosclerosis, insufficient dietary intake of the B vitamins, folic acid and pyridoxine, caused by losses of these nutrients during processing of foods, leads to elevation of blood homocysteine and vascular disease in the general population. The dramatic decline in cardiovascular mortality since the 1960s in the United States is attributed to fortification of the food supply by synthetic pyridoxine and folic acid. The recent Swiss Heart Study showed that B vitamins slowed restenosis in patients with coronary arteriosclerosis treated with angioplasty. Currently, more than 20 prospective, worldwide, interventional trials involving at least 100,000 participants are

  5. Visfatin and cardio-cerebro-vascular disease.

    Science.gov (United States)

    Wang, Pei; Vanhoutte, Paul M; Miao, Chao-Yu

    2012-01-01

    Nicotinamide phosphoribosyltransferase is the rate-limiting enzyme that catalyzes the first step in the biosynthesis of nicotinamide adenine dinucleotide from nicotinamide. This protein was originally cloned as a putative pre-B cell colony-enhancing factor and also found to be a visceral fat-derived adipokine (visfatin). As a multifunctional protein, visfatin plays an important role in immunity, metabolism, aging, inflammation, and responses to stress. Visfatin also participates in several pathophysiological processes contributing to cardio-cerebro-vascular diseases, including hypertension, atherosclerosis, ischemic heart disease, and ischemic stroke. However, whether visfatin is a friend or a foe in these diseases remains uncertain. This brief review focuses on the current understanding of the complex role of visfatin in the cardio-cerebro-vascular system under normal and pathophysiological conditions.

  6. [Cell biology of intraocular vascular diseases].

    Science.gov (United States)

    Ishibashi, T

    1999-12-01

    Diabetic retinopathy (DR) still remains the leading cause of blindness in the working population of Japan and western world, though therapies such as retinal photocoagulation and vitrectomy can be remarkably effective when administered at an appropriate stage in the disease process. Consequently, there is a need for further investigation of the pathogenesis of DR to develop better therapy. DR is characterized by gradually progressive alterations in the retinal microvasculature, leading to three fundamental morbidities: 1. vascular hyperpermeability, 2. vascular occlusion, and 3. neovascularization. Recent studies have revealed that hyperglycemia causes several metabolic disorders which cause DR directly or indirectly through the abnormal expression of cytokines including vascular endothelial growth factor (VEGF). In this study, we performed precise tests of the correlation between intraocular VEGF and the three fundamental changes in the diabetic retina mentioned above. Ultrastructural study of the human retina revealed that two major pathways are responsible for hyperpermeability of diabetic retinal vessels, i.e., intercellular or paracellular transport (opening of the tight junctions) and intracellular or transcellular transport (caveolae, intracytoplasmic vesicles, and fenestration). All these pathways were induced by intravitreal injection of VEGF. The major trigger of VEGF overexpression is tissue ischemia caused by vascular occlusion. However, the retinas from the eyes with background DR revealed increased expression of VEGF without apparent incidence of vascular occlusion. We have identified accumulation of advanced glycation end products (AGEs) in these retinas, and found that AGEs are a major stimulus for VEGF overexpression in background DR. Retinal vascular occlusion was caused by thrombus formation primarily in the capillary vessels. Thrombi mainly consisted of fibrin, platelets, and leucocytes in the early stage of their formation, and glial cells and

  7. Patterns of peripheral vascular diseases at Muhimbili National hospital

    African Journals Online (AJOL)

    Background: Vascular diseases are emerging as a major health burden worldwide and vascular surgery is the major treatment of choice for these diseases. The treatment results in cosmetic and functional improvement. Purpose of the report is to show the commonly seen peripheral vascular disorders and treatment options ...

  8. Cytokines in Alzheimer's disease and vascular dementia.

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    Angelopoulos, P; Agouridaki, H; Vaiopoulos, H; Siskou, E; Doutsou, K; Costa, V; Baloyiannis, S I

    2008-12-01

    The levels of interleukin 1beta, interleukin 6, and interleukin 10 were elevated in the serum of patients with dementia. No statistically significant correlation was recorded in the interleukin levels among patients with Alzheimer's disease and vascular dementia. Also, no significant correlation was observed in the interleukin levels in the serum and the severity of dementia. However, a significant correlation was found between IL-6 and tumor necrosis factor-alpha (TNF-alpha) levels and age. The levels of IL-1beta and IL-6 were positively correlated with hypertension, and IL-2 levels were negatively correlated. No correlation was found between depressive symptoms and levels of cytokines in the serum.

  9. Vascular disease and stroke risk in atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y.H.; Lane, Deirdre A

    2012-01-01

    Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial fibri...... fibrillation and whether adding vascular disease improves Congestive heart failure, Hypertension, Age 75 years, Diabetes, previous Stroke (CHADS(2)) risk stratification....

  10. Rheumatic diseases and autoimmune vascular dementia.

    Science.gov (United States)

    Atzeni, Fabiola; Pipitone, Nicolò; Iaccarino, Luca; Masala, Ignazio Francesco; Weiss, Ronen; Alciati, Alessandra; Doria, Andrea; Chapmanand, Joab; Sarzi-Puttini, Piercarlo

    2017-10-13

    Vascular dementia (VD) comes second after Alzheimer's disease (AD) as a cause of impaired cognition. VD is not a specific nosological entity, but rather a syndrome encompassing a number of diseases caused by impaired supply of blood to the brain. Systemic autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis and antiphospholipid syndrome (APS) can be associated with dementia. VD is often related to the presence of traditional cardiovascular risk factors, but it may also be associated with a host of disorders affecting the brain blood vessels, neuronal cells, or both. It is important to entertain in the differential diagnosis of VD, to recognize and to cure them accurately in order to preserve life's quality of our patients. Copyright © 2017. Published by Elsevier B.V.

  11. Uric Acid, Hyperuricemia and Vascular Diseases

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    Jin, Ming; Yang, Fan; Yang, Irene; Yin, Ying; Luo, Jin Jun; Wang, Hong; Yang, Xiao-Feng

    2011-01-01

    Uric acid is the product of purine metabolism. It is known that hyperuricemia, defined as high levels of blood uric acid, is the major etiological factor of gout. A number of epidemiological reports have increasingly linked hyperuricemia with cardiovascular and neurological diseases. Studies highlighting the pathogenic mechanisms of uric acid point to an inflammatory response as the primary mechanism for inducing gout and possibly contributing to uric acid's vascular effects. Monosodium urate (MSU) crystals induce an inflammatory reaction, which are recognized by Toll-like receptors (TLRs). These TLRs then activate NALP3 inflammasome. MSU also triggers neutrophil activation and further produces immune mediators, which lead to a proinflammatory response. In addition, soluble uric acid can also mediate the generation of free radicals and function as a pro-oxidant. This review summarizes the epidemiological studies of hyperuricemia and cardiovascular disease, takes a brief look at hyperuricemia and its role in neurological diseases, and highlights the studies of the advanced pathological mechanisms of uric acid and inflammation. PMID:22201767

  12. Atrial fibrillation and vascular disease-a bad combination

    DEFF Research Database (Denmark)

    Bjerring Olesen, Jonas; Gislason, Gunnar Hilmar; Torp-Pedersen, Christian

    2012-01-01

    This article provides an overview of (i) the risk of stroke associated with vascular disease (acute coronary syndromes and peripheral artery disease) in patients with atrial fibrillation, (ii) the frequent coexistence of vascular disease in patients with atrial fibrillation and, (iii......) the cardiovascular risk associated with the coexisting of the two diseases. The literature on this topic is relatively sparse, and we discuss results from both clinical trials and observational studies. There is a clear indication of an increased stroke risk associated with vascular disease in patients with atrial...... fibrillation. Indeed, patients with atrial fibrillation often had coexisting vascular disease (around 18%), and the combination of the two diseases substantially increases the risk of future cardiovascular events. The increased risk associated with peripheral artery disease in atrial fibrillation is even more...

  13. Elevated Plasma Homocysteine Level in Vascular Dementia Reflects the Vascular Disease Process

    OpenAIRE

    Karin Nilsson; Lars Gustafson; Björn Hultberg

    2013-01-01

    Background: Patients with vascular dementia (VaD) exhibit particularly elevated levels of plasma total homocysteine (tHcy) compared to patients with other psychogeriatric diseases. Methods: We investigated the main determinants (age, renal impairment, cobalamin/folate status and presence of extracerebral vascular disease) of plasma tHcy in 525 patients with VaD. Furthermore, 270 patients with depression were used as a reference group to reveal the potential specificity of elevated plasma tHcy...

  14. Vascular cognitive impairments in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    I. V. Rogova

    2015-01-01

    Full Text Available Objective: to study the specific features of development of cognitive impairments (CIs, the role of traditional cardiovascular risk factors and renal failure-induced factors in patients with Stages I–IV chronic kidney disease (CKD and to assess an association of CIs with the signs of vascular wall remodeling in them. Patients and methods. Fifty-one patients aged 53±10 years with CKD were examined. Among them, there were 20 patients with Stages I–II CKD: a glomerular filtration rate (GFR of і60 ml/min/1.73 m2, signs of renal lesion; 20 with Stages III CKD: a GFR of <60–30 ml/min/1.73 m2, and 11 with Stages VI CKD: a GFR of <30–15 ml/min/1.73 m2. Results and discussion. CIs were more common in the patients with Stages III–IV than in those with Stages I–II, as shown by the scores of the mini-mental state examination (p<0.001, the frontal assessment battery (p=0.001, and the regulatory function test (p<0.001. These tests showed that the magnitude of CIs increased with the higher stage of CKD. Stages III–IV CKD is an independent predictor of CIs in persons with predialysis-stage kidney lesion. CIs were found to be related to hyperhomocysteinemia, anemia, abdominal obesity, left ventricular hypertrophy, and patient age. The signs of atherosclerotic lesion of the common carotid arteries and the indicators of arterial stiffness were also associated with the incidence and magnitude of CIs in CKD. The detection of CIs in patients with early CKD allows one to timely initiate adequate therapy aimed particularly at improving cerebral circulation, eliminating the impact of risk factors, and slowing down the vascular remodeling. The management tactics for patients with CKD must involve the identification and correction of cardiovascular risk factors, and duplex scanning of the wall of the common carotid arteries may be used as a noninvasive method to assess the risk of the development and progression of CIs in predialysis CKD. 

  15. Is Pseudoexfoliation Syndrome a Risk Factor for Cerebro Vascular Disease?

    Science.gov (United States)

    Kan, Emrah; Yılmaz, Ahmet; Demirağ, Mehmet Derya; Çalık, Murat

    2017-01-01

    To determine the relationship between cerebro vascular disease and pseudoexfoliation syndrome. This cross-sectional case control study consisted of 50 patients with ischemic-type cerebro vascular disease and 50 control subjects. All subjects were investigated for diabetes mellitus and hypertension status and underwent a detailed ophthalmic examination. A diagnosis of pseudoexfoliation syndrome was made if characteristic greyish particulate matter was found on the anterior lens capsule after pupillary dilatation by slit-lamp examination. All subjects were compared in terms of pseudoexfoliation syndrome, diabetes mellitus, and hypertension. Pearson Chi Square and Student's t test were used for statistical analysis. Logistic regression analyses of the risk factors between groups were also made. The presence of pseudoexfoliation syndrome was significantly higher in patients with cerebro vascular disease when compared to the control subjects (p = 0.02). The frequency of diabetes mellitus was similar between the two groups. Arterial hypertension was significantly more frequent in the patient group when compared to the control subjects (p cerebro vascular disease. In the present study, we found that pseudoexfoliation syndrome frequency was found to be higher in patients with cerebro vascular disease than in control subjects. A slit-lamp examination of the eye could be an important marker that indicates the risk of cerebro vascular disease. We recommend an evaluation of all subjects with pseudoexfoliation syndrome for the presence of cerebro vascular disease. Longitudinal studies with larger populations are needed to confirm this relationship.

  16. Neuropsychological profiles of vascular disease and risk of dementia: implications for defining vascular cognitive impairment no dementia (VCI-ND)

    OpenAIRE

    Stephan, BCM; Minett, T.; Muniz-Terrera, G.; Harrison, SL; Matthews, FE; Brayne, C.

    2017-01-01

    $\\textbf{Background}$ vascular cognitive impairment no dementia (VCI-ND) defines a preclinical phase of cognitive decline associated with vascular disorders. The neuropsychological profile of VCI-ND may vary according to different vascular conditions. $\\textbf{Objective}$ to determine the neuropsychological profile of individuals with no dementia and vascular disorders, including hypertension, peripheral vascular disease (PVD), coronary heart disease (CHD), diabetes and stroke. Ri...

  17. Diagnosis and Management of Lymphatic Vascular Disease

    National Research Council Canada - National Science Library

    Rockson, Stanley G

    2008-01-01

    ... it. The most readily recognizable attribute of lymphatic vascular incompetence is the presence of the characteristic swelling of tissues, called lymphedema, which arises as a consequence of insufficient lymph transport...

  18. Sleep apnoea, hypertension and vascular disease: where are we now?

    Directory of Open Access Journals (Sweden)

    B. Buyse

    2007-12-01

    Full Text Available The objective of the present article was to explore the relationship between obstructive sleep apnoea (OSA and hypertension (HT and/or arterial vascular disease (VD, including stroke and ischaemic coronary disease. Epidemiological and interventional studies on these relationships provide compelling evidence that OSA is causally related to HT. The causal relationship between OSA and VD other than HT has not been firmly established. A number of pathophysiological mechanisms that could potentially provide a causal link between obstructive sleep apnoea and hypertension, as well as vascular disease, have been identified. Available data on such mechanisms include sustained daytime sympathetic activation, oxidative stress, promotion of vascular inflammation and endothelial dysfunction.

  19. Assessment of risk of peripheral vascular disease and vascular care capacity in Ghana

    Science.gov (United States)

    Gyedu, Adam; Stewart, Barclay T; Nakua, Emmanuel; Quansah, Robert; Donkor, Peter; Mock, Charles; Hardy, Mark A; Yangni-Angate, Koffi Herve

    2015-01-01

    Introduction This study aimed to describe national peripheral vascular disease (PVD) risk and health burden and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in a low- and middle-income country (LMIC) is defined and capacity improvement priorities identified. Methods Data to estimate PVD risk factor burden were obtained from: i) World Health Organization’s Study on Global Ageing and Health (SAGE), Ghana; and ii) Institute of Health Metrics and Evaluation Global Burden of Disease database (IHME GBD). In addition, a novel nationwide assessment of vascular care capacity was performed, with 20 vascular care items assessed at 40 hospitals in Ghana. Factors contributing to specific item deficiency were also described. Results From the SAGE database, there were 4,305 respondents aged at least 50 years with data to estimate PVD risk. Out of these 57% were at moderate to high PVD risk with ≥3 risk factors, thus giving 1,654,557 persons when extrapolated nationally. Using IHME GBD data, the estimated disability-adjusted life years incurred from PVD increased 5-fold from 1990 to 2010 (1.3 to 3.2 per 100,000 persons, respectively). Vascular care capacity assessment demonstrated marked deficiencies in items for diagnosis, perioperative and vascular surgical care. Deficiencies were most often due to absence of equipment, lack of training and technology breakage. Conclusion Risk factor reduction and management as well as optimization of current resources are paramount to avoid the large burden of peripheral vascular disease falling on healthcare systems in low- and middle-income countries that are not well equipped to handle vascular surgical care, and for which rapid development of such capacity would be difficult and expensive. PMID:26560502

  20. Major lipids, apolipoproteins, and risk of vascular disease

    DEFF Research Database (Denmark)

    Collaboration, Emerging Risk Factors; Di Angelantonio, Emanuele; Sarwar, Nadeem

    2009-01-01

    CONTEXT: Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified. OBJECTIVE: To assess major lipids and apolipoproteins in vascular risk. DESIGN, SETTING, AND PARTICIPANTS: Individual records were supplied on 302,430 people without...... initial vascular disease from 68 long-term prospective studies, mostly in Europe and North America. During 2.79 million person-years of follow-up, there were 8857 nonfatal myocardial infarctions, 3928 coronary heart disease [CHD] deaths, 2534 ischemic strokes, 513 hemorrhagic strokes, and 2536...... assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride....

  1. Diabetes and microvascular disease in Vascular Cognitive Impairment

    NARCIS (Netherlands)

    Brundel, M.|info:eu-repo/dai/nl/38048854X

    2014-01-01

    The contribution of cerebrovascular disease in the development of cognitive dysfunction and dementia is increasingly recognized. Cerebrovascular damage is heterogeneous, ranging from a clinical stroke to more insidious brain changes. The term vascular cognitive impairment (VCI) has been introduced,

  2. Homocysteine metabolism, hyperhomocysteinaemia and vascular disease: an overview.

    NARCIS (Netherlands)

    Castro, R.; Rivera, I.; Blom, H.J.; Jakobs, C.; Almeida, I.T. de

    2006-01-01

    Hyperhomocysteinaemia has been regarded as a new modifiable risk factor for atherosclerosis and vascular disease. Homocysteine is a branch-point intermediate of methionine metabolism, which can be further metabolised via two alternative pathways: degraded irreversibly through the transsulphuration

  3. T cells in vascular inflammatory diseases

    NARCIS (Netherlands)

    Lintermans, Lucas L.; Stegeman, Coen A.; Heeringa, Peter; Abdulahad, Wayel H.

    2014-01-01

    Inflammation of the human vasculature is a manifestation of many different diseases ranging from systemic autoimmune diseases to chronic inflammatory diseases, in which multiple types of immune cells are involved. For both autoimmune diseases and chronic inflammatory diseases several observations

  4. Oscillation of Angiogenesis and Vascular Dropout in Progressive Human Vascular Disease. [Vascular Pattern as Useful Read-Out of Complex Molecular Signaling

    Science.gov (United States)

    Parsons-Wingerter, Patricia

    2010-01-01

    When analyzed by VESsel GENeration Analysis (VESGEN) software, vascular patterns provide useful integrative read-outs of complex, interacting molecular signaling pathways. Using VESGEN, we recently discovered and published our innovative, surprising findings that angiogenesis oscillated with vascular dropout throughout progression of diabetic retinopathy, a blinding vascular disease. Our findings provide a potential paradigm shift in the current prevailing view on progression and treatment of this disease, and a new early-stage window of regenerative therapeutic opportunities. The findings also suggest that angiogenesis may oscillate with vascular disease in a homeostatic-like manner during early stages of other inflammatory progressive diseases such as cancer and coronary vascular disease.

  5. Impaired vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Tetzner, Fabian; Scholze, Alexandra; Wittstock, Antje

    2008-01-01

    Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics.......Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics....

  6. Elevated Plasma Homocysteine Level in Vascular Dementia Reflects the Vascular Disease Process

    Directory of Open Access Journals (Sweden)

    Karin Nilsson

    2013-02-01

    Full Text Available Background: Patients with vascular dementia (VaD exhibit particularly elevated levels of plasma total homocysteine (tHcy compared to patients with other psychogeriatric diseases. Methods: We investigated the main determinants (age, renal impairment, cobalamin/folate status and presence of extracerebral vascular disease of plasma tHcy in 525 patients with VaD. Furthermore, 270 patients with depression were used as a reference group to reveal the potential specificity of elevated plasma tHcy in patients with VaD. Results: Elevated plasma tHcy levels in patients with VaD could only partly be attributed to cobalamin/folate deficiency or renal impairment. Plasma tHcy might also be related to the vascular disease process since patients with depression and vascular disease exhibited similar plasma tHcy levels to patients with VaD. Conclusion: Our findings suggest that elevated plasma tHcy might be a sensitive marker for the vascular disease process in patients with VaD and that the level also is a reflection of changes in the other main determinants of plasma tHcy.

  7. Vascular lesions in mixed dementia, vascular dementia, and Alzheimer disease with cerebrovascular disease: the Kurihara Project.

    Science.gov (United States)

    Meguro, Kenichi; Tanaka, Naofumi; Nakatsuka, Masahiro; Nakamura, Kei; Satoh, Masayuki

    2012-11-15

    The concept and diagnosis for mixed dementia is not simple, since it is difficult to identify the type and regions of cerebrovascular disease (CVD) responsible for causing dementia. An investigation is needed to confirm the presence of mixed dementia, those who met the criteria for Alzheimer's disease (AD) and those for vascular dementia (VaD). According to the community-based stroke, dementia, and bed-confinement prevention in Kurihara, northern Japan (Kurihara Project), the prevalence of dementia and dementing diseases was surveyed in 2008-2010. Five hundred and ninety people finally agreed to participate (47.0%), and 73 (12.4%) people were diagnosed with dementia according to the DSM-IV. Using MRI, intensive evaluations on CVDs were performed for the 49 dementia patients associated with CVDs (mixed dementia, VaD, and AD with CVD). For the mixed dementia group, all had left subcortical strategic CVDs. These included the caudate head and thalamus. For the VaD group, all patients had at least cortical CVDs or subcortical strategic CVDs. The AD with CVD group had non-strategic CVDs in cortical, subcortical, or other areas in 5 or 6 patients each. Two extreme concepts regarding CVD and dementia are possible. One is that there is no concept for mixed dementia or VaD. An alternative is that the vascular factor should be considered as primary. Our data showed an importance of cortical and subcortical "strategic" areas, the latter included thalamus and caudate head. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Circulating Progenitor Cells in Diabetic Vascular Disease

    NARCIS (Netherlands)

    van Oostrom, O.

    2009-01-01

    Patients with diabetes have altered levels and function of (bone marrow-derived) vascular progenitor cells (endothelial progenitor cells-EPC, smooth muscle progenitor cells-SPC) which may contribute to their accelerated atherosclerosis. The results from clinical and experimental studies in this

  9. Genetically elevated C-reactive protein and ischemic vascular disease

    DEFF Research Database (Denmark)

    Zacho, J.; Tybjaerg-Hansen, A.; Jensen, J.S.

    2008-01-01

    in CRP levels of up to 64%, resulting in a theoretically predicted increased risk of up to 32% for ischemic heart disease and up to 25% for ischemic cerebrovascular disease. However, these genotype combinations were not associated with an increased risk of ischemic vascular disease. In contrast......, apolipoprotein E genotypes were associated with both elevated cholesterol levels and an increased risk of ischemic heart disease. Conclusions: Polymorphisms in the CRP gene are associated with marked increases in CRP levels and thus with a theoretically predicted increase in the risk of ischemic vascular disease....... However, these polymorphisms are not in themselves associated with an increased risk of ischemic vascular disease Udgivelsesdato: 2008/10/30...

  10. Renal vascular changes in renal disease independent of hypertension

    NARCIS (Netherlands)

    Bos, W. J.; Demircan, M. M.; Weening, J. J.; Krediet, R. T.; van der Wal, A. C.

    2001-01-01

    INTRODUCTION: Cardiovascular disease is common in patients with renal disease, but little is known about the effect of renal disease and loss of renal function on vascular morphology. Intima proliferation of small renal arteries, which correlates with atherosclerosis in the aorta, is sometimes

  11. BMP signaling in vascular and heterotopic bone diseases

    NARCIS (Netherlands)

    Cai, Jie

    2016-01-01

    Bone morphogenetic proteins (BMPs) are multifunctional regulators in embryonic development and tissue homeostasis. Disruptions in BMP signaling lead to various diseases, such as skeletal diseases, vascular diseases and cancer. Studies in this thesis mainly focused on the role of BMP signaling in

  12. [Gorham's disease and intra-osseous vascular abnormalities].

    Science.gov (United States)

    Héritier, Sébastien; Donadieu, Jean

    2012-05-01

    Gorham's disease is a rare condition of unknown etiology, which is characterized by intra-osseous vascular abnormalities leading to osteolysis and sometimes, extension to adjacent tissues. Although there is no histological evidence of malignancy, the lesions display an aggressive potential responsible of osteolysis with pathological fractures and respiratory failure. The extension of the disease varies from one location to multiple bone lesions throughout the skeleton and the clinical presentations depend on the sites of involvement. In the ISSVA (International Society for the Study of Vascular Abnormalities) classification, its affiliation to the group of vascular tumors or vascular malformations is still debated. To date, there is no standard treatment defined for this disease. The proposed treatments are inhibitors of bone resorption (bisphosphonates) and interferon alpha therapy or anti-angiogenic molecules. Radiation therapy and surgery may also have a place in the therapeutic strategy.

  13. Blood flow and stem cells in vascular disease.

    Science.gov (United States)

    Zhang, Cheng; Zeng, Lingfang; Emanueli, Costanza; Xu, Qingbo

    2013-07-15

    It is well known that the altered blood flow is related to vascular diseases, including atherosclerosis, restenosis, and arteriosclerosis, which preferentially located at areas with the disturbed blood flow, suggesting that altered biomechanical stress may exert their effect on the vascular disease. Recent evidence indicated the presence of abundant stem/progenitor cells in the vessel wall, in which laminar shear stress can stimulate these cells to differentiate towards endothelial lineage, while cyclic strain results in smooth muscle differentiation. In line with this, it was evidenced that altered biomechanical stress in stented vessels may lead to 'wrong' direction of vascular stem cell differentiation resulting in restenosis. However, the underlying mechanisms are not well understood. In this article, we will give an overview of the effect of the local flow pattern on stem/progenitor cell differentiation and the possible mechanism on how the blood flow influences stem cell behaviours in the development of vascular diseases.

  14. Vascular and Biochemical Effects of Moderate Alcohol Consumption: Mechanisms of Protection Against Cardiovascular Disease

    NARCIS (Netherlands)

    Sierksma, A.; Grobbee, D.E.; Hendriks, H.F.J.

    2004-01-01

    This chapter focuses on the vascular and biochemical effects of moderate alcohol consumption and the mechanisms of protection against cardiovascular disease. Cardiovascular disease (CVD), including coronary heart disease, cerebrovascular disease, and peripheral vascular disease, is the leading cause

  15. Asymmetric dimethylarginine: a possible link between vascular disease and dementia.

    Science.gov (United States)

    Asif, Muhammad; Soiza, Roy Louis; McEvoy, Mark; Mangoni, Arduino A

    2013-05-01

    There is good epidemiological evidence that vascular disease predisposes to cognitive decline and dementia. The impact of vascular disease on dementia is likely to increase further because of the poor diagnosis and management of vascular risk factors, the increase in life expectancy, and the improved survival following major cardiovascular events, e.g. acute stroke. It is estimated that the adequate management of vascular risk factors, with pharmacological and/or nonpharmacological interventions, might result in a 50% reduction in the forecasted dementia prevalence. The exact mechanisms by which vascular risk factors and vascular disease adversely affect brain function remain unclear, but it is hypothesized that endothelial dysfunction plays an important role. Reduced synthesis and availability of endothelial nitric oxide (NO) may contribute to the development of dementia by at least two mechanisms: (1) favoring the onset and progression of atherosclerosis, vasoconstriction, and impaired cerebral blood flow regulation; and (2) reduced neuroprotection.Several studies have shown that asymmetric dimethylarginine (ADMA), an endogenous methylated form of the amino acid L-arginine, inhibits NO synthesis and favors oxidative stress and vascular damage. Unlike NO, ADMA concentrations are relatively stable and can be accurately measured in plasma. There is good evidence that higher plasma ADMA concentrations favor atherosclerosis and independently predict adverse cardiovascular and cerebrovascular outcomes in several patient groups. ADMA might represent a unifying pathophysiological pathway linking the presence of vascular risk factors with the onset and progression of cognitive decline and dementia. This review discusses the biological role of ADMA, its potential contribution to the onset and progression of dementia through vascular disease and atherosclerosis, the available evidence linking ADMA with cognitive impairment and dementia, and the strategies to characterize

  16. Imaging and CFD in the analysis of vascular disease progression

    Science.gov (United States)

    Saloner, David; Acevedo-Bolton, Gabriel; Rayz, Vitaliy; Wintermark, Max; Martin, Alastair; Dispensa, Brad; Young, William; Lawton, Michael; Rapp, Joseph; Jou, Liang-Der

    2006-03-01

    Conventional evaluation of the significance of vascular disease has focused on estimates of geometric factors. There is now substantial interest in investigating whether the onset and progression of vascular pathology can be related to hemodynamic factors. Current imaging modalities have excellent capabilities in delineating the geometric boundaries of the vascular lumen. Advanced non-invasive imaging modalities such as Multi Detector CT and MRI are also able to define the extent of disease within the vessel wall and to provide information on the composition of thrombotic and atherosclerotic components. Finally, it is also possible to use imaging techniques to measure flow velocities across the lumen of vessels of interest, and to determine the pulsatile variation of these velocities through the cardiac cycle. Despite these advanced capabilities, imaging alone is unable to determine important features of the vascular hemodynamics such as wall shear stress or pressure distributions. However, the information on lumenal geometry and the inlet and outlet flow conditions can be used as input into numerical simulation models that are able to predict those quantities. These Computational Fluid Dynamics models can be used to predict hemodynamic parameters on a patient-specific basis. It is therefore possible to use non-invasive imaging methods to follow the progression of vascular disease over time, and to relate changes in lumenal and wall structure to calculated hemodynamic descriptors. This approach can be used not only to understand the natural progression of vascular disease, but as a tool to predict the likely outcome of a surgical intervention.

  17. Perivascular fat, AMP-activated protein kinase and vascular diseases.

    Science.gov (United States)

    Almabrouk, T A M; Ewart, M A; Salt, I P; Kennedy, S

    2014-02-01

    Perivascular adipose tissue (PVAT) is an active endocrine and paracrine organ that modulates vascular function, with implications for the pathophysiology of cardiovascular disease (CVD). Adipocytes and stromal cells contained within PVAT produce mediators (adipokines, cytokines, reactive oxygen species and gaseous compounds) with a range of paracrine effects modulating vascular smooth muscle cell contraction, proliferation and migration. However, the modulatory effect of PVAT on the vascular system in diseases, such as obesity, hypertension and atherosclerosis, remains poorly characterized. AMP-activated protein kinase (AMPK) regulates adipocyte metabolism, adipose biology and vascular function, and hence may be a potential therapeutic target for metabolic disorders such as type 2 diabetes mellitus (T2DM) and the vascular complications associated with obesity and T2DM. The role of AMPK in PVAT or the actions of PVAT have yet to be established, however. Activation of AMPK by pharmacological agents, such as metformin and thiazolidinediones, may modulate the activity of PVAT surrounding blood vessels and thereby contribute to their beneficial effect in cardiometabolic diseases. This review will provide a current perspective on how PVAT may influence vascular function via AMPK. We will also attempt to demonstrate how modulating AMPK activity using pharmacological agents could be exploited therapeutically to treat cardiometabolic diseases. © 2013 The British Pharmacological Society.

  18. Vascular pathology: Cause or effect in Alzheimer disease?

    Science.gov (United States)

    Rius-Pérez, S; Tormos, A M; Pérez, S; Taléns-Visconti, R

    2015-09-15

    Alzheimer disease (AD) is the main cortical neurodegenerative disease. The incidence of this disease increases with age, causing significant medical, social and economic problems, especially in countries with ageing populations. This review aims to highlight existing evidence of how vascular dysfunction may contribute to cognitive impairment in AD, as well as the therapeutic possibilities that might arise from this evidence. The vascular hypothesis emerged as an alternative to the amyloid cascade hypothesis as an explanation for the pathophysiology of AD. This hypothesis locates blood vessels as the origin for a variety of pathogenic pathways that lead to neuronal damage and dementia. Destruction of the organisation of the blood brain barrier, decreased cerebral blood flow, and the establishment of an inflammatory context would thus be responsible for any subsequent neuronal damage since these factors promote aggregation of β-amyloid peptide in the brain. The link between neurodegeneration and vascular dysfunction pathways has provided new drug targets and therapeutic approaches that will add to the treatments for AD. It is difficult to determine whether the vascular component in AD is the cause or the effect of the disease, but there is no doubt that vascular pathology has an important relationship with AD. Vascular dysfunction is likely to act synergistically with neurodegenerative changes in a cycle that exacerbates the cognitive impairment found in AD. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  19. [Vascular risk in endocrine diseases other than diabetes].

    Science.gov (United States)

    Antequera, Isabel; Cuende, José I; Nieto López-Guerrero, Jerónimo; Valdivielso, Pedro

    2016-01-01

    Endocrinological diseases directly affect the cardiovascular system. The deleterious effects on cardiovascular function can be direct, and linked to the increase or reduction of circulating hormones. Equally, the adverse effects may be indirect; for example following the rise in blood pressure, increase or redistribution of lean mass, or increased plasma lipoproteins. The best health care and the increasing availability of biochemical tests lead to the diagnosis of many endocrine diseases before the onset of clinical signs. This review will focus on presenting evidence of cardiovascular functional or structural impairment in cases of primary hyperparathyroidism, Cushing's syndrome, and hypothyroidism in their sub-clinical forms, as well as the reversibility of complications after appropriate treatment. Copyright © 2015 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Possible role of vascular risk factors in Alzheimer's disease and vascular dementia.

    Science.gov (United States)

    Hasnain, Mehrul; Vieweg, W Victor R

    2014-01-01

    The contribution of vascular risk factors to Alzheimer-vascular spectrum dementias is increasingly being recognized. We provide an overview of recent literature on this subject. Overweight and obesity as well as underweight during midlife predict cognitive decline and dementia later in life. Hypertension during midlife is also associated with dementia later in life and the association is stronger for untreated hypertension. Calcium channel blockers, angiotensin converting enzyme inhibitors, and angiotensin-1 receptor-blockers may be particularly beneficial in diminishing the risk of dementia associated with hypertension. Studies have fairly consistently shown that type 2 diabetes is a risk factor for dementia. Episodes of hypoglycemia add to this risk. Regular physical exercise during any point in the lifespan protects against cognitive decline and dementia. Most benefit is realized with physical exercise during early and midlife. Dyslipidemia also increases the risk of dementia but the findings are less consistent. Findings on the possible benefit of lipid-lowering agents (statins) are conflicting. Earlier studies identified smoking as protective of dementia but recent better designed studies have consistently shown that smoking increases the risk of dementia. The association of vascular risk factors with dementia is more robust for vascular dementia than Alzheimer's disease. Heterogeneity of studies and lack of trials specifically designed to assess cognition as an endpoint make firm conclusions difficult. But considering the expected global burden of dementia and projected attributable risk of vascular risk factors to it, there is sufficient evidence to promote vascular risk factor reduction strategies as dementia prevention interventions.

  1. Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for Alzheimer's disease.

    Science.gov (United States)

    Kalaria, Raj N

    2016-05-01

    Vascular dementia (VaD) is recognised as a neurocognitive disorder, which is explained by numerous vascular causes in the general absence of other pathologies. The heterogeneity of cerebrovascular disease makes it challenging to elucidate the neuropathological substrates and mechanisms of VaD as well as vascular cognitive impairment (VCI). Consensus and accurate diagnosis of VaD relies on wide-ranging clinical, neuropsychometric and neuroimaging measures with subsequent pathological confirmation. Pathological diagnosis of suspected clinical VaD requires adequate postmortem brain sampling and rigorous assessment methods to identify important substrates. Factors that define the subtypes of VaD include the nature and extent of vascular pathologies, degree of involvement of extra and intracranial vessels and the anatomical location of tissue changes. Atherosclerotic and cardioembolic diseases appear the most common substrates of vascular brain injury or infarction. Small vessel disease characterised by arteriolosclerosis and lacunar infarcts also causes cortical and subcortical microinfarcts, which appear to be the most robust substrates of cognitive impairment. Diffuse WM changes with loss of myelin and axonal abnormalities are common to almost all subtypes of VaD. Medial temporal lobe and hippocampal atrophy accompanied by variable hippocampal sclerosis are also features of VaD as they are of Alzheimer's disease. Recent observations suggest that there is a vascular basis for neuronal atrophy in both the temporal and frontal lobes in VaD that is entirely independent of any Alzheimer pathology. Further knowledge on specific neuronal and dendro-synaptic changes in key regions resulting in executive dysfunction and other cognitive deficits, which define VCI and VaD, needs to be gathered. Hereditary arteriopathies such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy or CADASIL have provided insights into the mechanisms of

  2. Adiponectin as a potential biomarker of vascular disease.

    Science.gov (United States)

    Ebrahimi-Mamaeghani, Mehrangiz; Mohammadi, Somayeh; Arefhosseini, Seyed Rafie; Fallah, Parviz; Bazi, Zahra

    2015-01-01

    The increasing prevalence of diabetes and its complications heralds an alarming situation worldwide. Obesity-associated changes in circulating adiponectin concentrations have the capacity to predict insulin sensitivity and are a link between obesity and a number of vascular diseases. One obvious consequence of obesity is a decrease in circulating levels of adiponectin, which are associated with cardiovascular disorders and associated vascular comorbidities. Human and animal studies have demonstrated decreased adiponectin to be an independent risk factor for cardiovascular disease. However, in animal studies, increased circulating adiponectin alleviates obesity-induced endothelial dysfunction and hypertension, and also prevents atherosclerosis, myocardial infarction, and diabetic cardiac tissue disorders. Further, metabolism of a number of foods and medications are affected by induction of adiponectin. Adiponectin has beneficial effects on cardiovascular cells via its antidiabetic, anti-inflammatory, antioxidant, antiapoptotic, antiatherogenic, vasodilatory, and antithrombotic activity, and consequently has a favorable effect on cardiac and vascular health. Understanding the molecular mechanisms underlying the regulation of adiponectin secretion and signaling is critical for designing new therapeutic strategies. This review summarizes the recent evidence for the physiological role and clinical significance of adiponectin in vascular health, identification of the receptor and post-receptor signaling events related to the protective effects of the adiponectin system on vascular compartments, and its potential use as a target for therapeutic intervention in vascular disease.

  3. The metabolic syndrome and vascular disease

    NARCIS (Netherlands)

    Olijhoek, Jobien Karen

    2006-01-01

    In the Western population cardiovascular diseases are the most common cause of mortality and morbidity. There are several important risk factors for cardiovascular diseases, among them hypertension, hypercholesterolemia, diabetes and obesity. The clustering of cardiovascular risk factors associated

  4. Statin usage, vascular diagnosis and vascular risk factors in Parkinson's disease.

    Science.gov (United States)

    Cheng, Kelvin Kw; Swallow, Diane Ma; Grosset, Katherine A; Grosset, Donald G

    2017-08-01

    Background and aims Vascular disease is a common comorbidity in Parkinson's disease patients. Statins are potentially neuroprotective for Parkinson's disease through non-vascular mechanisms. We investigated prevailing statin use in a Parkinson's disease cohort. Methods and results Data on diagnostic indication for statins, anti-Parkinson therapy, vascular risk factors, and statin prescription, were obtained from electronic medical record review for consecutive Parkinson's disease patients. The ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network system was used to calculate future cardiovascular risk and identify those warranting statin use. Of 441 patients included, 59.9% were male, with a mean age of 68.9 years (standard deviation 10.3). One hundred and seventy-four (39.5%) patients had at least one diagnostic indication for statin use, of whom 136 (78.2%) were prescribed a statin. In the 267 (60.5%) cases without a diagnostic indication, 54 (20.2%) were excluded owing to age limitations defined in ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network. Of the remaining 213, 62 (29.1%) had an ASsessing cardiac risk using Scottish Intercollegiate Guidelines Network score in the recommended range for statin therapy, of whom 15 (24.1%) were prescribed statins. Conclusion There is suboptimal implementation of statin therapy in Parkinson's disease patients. Given the possible neuroprotective effects of statins in Parkinson's disease in addition to reducing cardiovascular risk, reasons for suboptimal implementation warrant further investigation.

  5. Clinical Application of Vascular Regenerative Therapy for Peripheral Artery Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Suzuki

    2013-01-01

    Full Text Available Prognosis of peripheral artery disease (PAD, especially critical limb ischemia, is very poor despite the development of endovascular therapy and bypass surgery. Many patients result in leg amputation and, therefore, vascular regenerative therapy is expected in this field. Gene therapy using vascular endothelial growth factor is the first step of vascular regenerative therapy, but did not confirm effectiveness in a large-scale randomized comparative study. Based on animal experiments, bone marrow mononuclear cells (MNCs, peripheral blood MNCs were used as the cell source for regenerative therapy. Those cells were confirmed to be effective to decrease rest pain and ulcer size, but its effect was not fully satisfied. Mesenchymal stem cells (MSCs are expected as an effective cell source for vascular regeneration and clinical studies are ongoing, because the cells are able to differentiate into various cell types and produce a significant amount of vascular growth factors. Of vascular regeneration therapy, peripheral MNCs and bone marrow MNCs were recognized as advanced medical technology but do not attain to the standard therapy. However, clinical use of MSCs have already started, and induced pluripotent stem cells are surely promising tool for vascular regeneration therapy although further basic studies are required for clinical application.

  6. Early Detection System of Vascular Disease and Its Application Prospect

    Directory of Open Access Journals (Sweden)

    Huan Liu

    2016-01-01

    Full Text Available Markers of imaging, structure, and function reflecting vascular damage, integrating a long time accumulation effect of traditional and unrecognized cardiovascular risk factors, can be regarded as surrogate endpoints of target organ damage before the occurrence of clinical events. Prevention of cardiovascular disease requires risk stratification and treatment of traditional risk factors, such as smoking, hypertension, hyperlipidemia, and diabetes. However, traditional risk stratification is not sufficient to provide accurate assessment of future cardiovascular events. Therefore, vascular injury related parameters obtained by ultrasound or other noninvasive devices, as a surrogate parameter of subclinical cardiovascular disease, can improve cardiovascular risk assessment and optimize the preventive treatment strategy. Thus, we will summarize the research progress and clinical application of early assessment technology of vascular diseases in the present review.

  7. Alzheimer and vascular brain diseases: Focal and diffuse subforms

    Directory of Open Access Journals (Sweden)

    Eliasz Engelhardt

    Full Text Available Alois Alzheimer is best known for his description of the pre-senile neurodegenerative disease named after him. However, his previous interest in vascular brain diseases, underlying cognitive and behavioral changes, was very strong. Besides describing the Arteriosclerotic atrophy of the brain and the arteriosclerotic subtype of Senile dementia which he viewed as main forms of vascular brain diseases, he also identified and described a series of conditions he considered subforms. These may be divided, as suggested by the authors of the present paper, into 3 groups: gliosis and sclerosis, subcortical atrophies, and apoplectic. The subforms of the three groups present characteristic neuropathological features and clinical, cognitive and behavioral manifestations. These provide the basis, together with part of the main forms, for the contemporary condition known as Vascular Cognitive Impairment.

  8. Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

    DEFF Research Database (Denmark)

    Bowman, Louise; Hopewell, Jemma C; Chen, Fang

    2017-01-01

    BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol...... vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per...... was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin...

  9. Adiponectin as a potential biomarker of vascular disease

    Directory of Open Access Journals (Sweden)

    Ebrahimi-Mamaeghani M

    2015-01-01

    Full Text Available Mehrangiz Ebrahimi-Mamaeghani,1 Somayeh Mohammadi,2 Seyed Rafie Arefhosseini,3 Parviz Fallah,4 Zahra Bazi5 1Nutrition Research Center, 2Department of Nutrition, 3Department of Food Technology, Faculty of Nutrition Sciences, Tabriz University of Medical Sciences, Tabriz, 4Department of Molecular Biology and Genetic Engineering, Stem Cell Technology Research Center, Tehran, 5Department of Biotechnology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranAbstract: The increasing prevalence of diabetes and its complications heralds an alarming situation worldwide. Obesity-associated changes in circulating adiponectin concentrations have the capacity to predict insulin sensitivity and are a link between obesity and a number of vascular diseases. One obvious consequence of obesity is a decrease in circulating levels of adiponectin, which are associated with cardiovascular disorders and associated vascular comorbidities. Human and animal studies have demonstrated decreased adiponectin to be an independent risk factor for cardiovascular disease. However, in animal studies, increased circulating adiponectin alleviates obesity-induced endothelial dysfunction and hypertension, and also prevents atherosclerosis, myocardial infarction, and diabetic cardiac tissue disorders. Further, metabolism of a number of foods and medications are affected by induction of adiponectin. Adiponectin has beneficial effects on cardiovascular cells via its antidiabetic, anti-inflammatory, antioxidant, antiapoptotic, antiatherogenic, vasodilatory, and antithrombotic activity, and consequently has a favorable effect on cardiac and vascular health. Understanding the molecular mechanisms underlying the regulation of adiponectin secretion and signaling is critical for designing new therapeutic strategies. This review summarizes the recent evidence for the physiological role and clinical significance of adiponectin in vascular health, identification of

  10. Diabetic Retinopathy: Vascular and Inflammatory Disease

    Science.gov (United States)

    Semeraro, F.; Cancarini, A.; dell'Omo, R.; Rezzola, S.; Romano, M. R.; Costagliola, C.

    2015-01-01

    Diabetic retinopathy (DR) is the leading cause of visual impairment in the working-age population of the Western world. The pathogenesis of DR is complex and several vascular, inflammatory, and neuronal mechanisms are involved. Inflammation mediates structural and molecular alterations associated with DR. However, the molecular mechanisms underlying the inflammatory pathways associated with DR are not completely characterized. Previous studies indicate that tissue hypoxia and dysregulation of immune responses associated with diabetes mellitus can induce increased expression of numerous vitreous mediators responsible for DR development. Thus, analysis of vitreous humor obtained from diabetic patients has made it possible to identify some of the mediators (cytokines, chemokines, and other factors) responsible for DR pathogenesis. Further studies are needed to better understand the relationship between inflammation and DR. Herein the main vitreous-related factors triggering the occurrence of retinal complication in diabetes are highlighted. PMID:26137497

  11. Protein Kinase C Inhibitors as Modulators of Vascular Function and Their Application in Vascular Disease

    Directory of Open Access Journals (Sweden)

    Raouf A. Khalil

    2013-03-01

    Full Text Available Blood pressure (BP is regulated by multiple neuronal, hormonal, renal and vascular control mechanisms. Changes in signaling mechanisms in the endothelium, vascular smooth muscle (VSM and extracellular matrix cause alterations in vascular tone and blood vessel remodeling and may lead to persistent increases in vascular resistance and hypertension (HTN. In VSM, activation of surface receptors by vasoconstrictor stimuli causes an increase in intracellular free Ca2+ concentration ([Ca2+]i, which forms a complex with calmodulin, activates myosin light chain (MLC kinase and leads to MLC phosphorylation, actin-myosin interaction and VSM contraction. Vasoconstrictor agonists could also increase the production of diacylglycerol which activates protein kinase C (PKC. PKC is a family of Ca2+-dependent and Ca2+-independent isozymes that have different distributions in various blood vessels, and undergo translocation from the cytosol to the plasma membrane, cytoskeleton or the nucleus during cell activation. In VSM, PKC translocation to the cell surface may trigger a cascade of biochemical events leading to activation of mitogen-activated protein kinase (MAPK and MAPK kinase (MEK, a pathway that ultimately increases the myofilament force sensitivity to [Ca2+]i, and enhances actin-myosin interaction and VSM contraction. PKC translocation to the nucleus may induce transactivation of various genes and promote VSM growth and proliferation. PKC could also affect endothelium-derived relaxing and contracting factors as well as matrix metalloproteinases (MMPs in the extracellular matrix further affecting vascular reactivity and remodeling. In addition to vasoactive factors, reactive oxygen species, inflammatory cytokines and other metabolic factors could affect PKC activity. Increased PKC expression and activity have been observed in vascular disease and in certain forms of experimental and human HTN. Targeting of vascular PKC using PKC inhibitors may function in

  12. Applications of Doppler ultrasound in clinical vascular disease

    Science.gov (United States)

    Barnes, R. W.; Hokanson, D. E.; Sumner, D. S.; Strandness, D. E., Jr.

    1975-01-01

    Doppler ultrasound has become the most useful and versatile noninvasive technique for objective evaluation of clinical vascular disease. Commercially available continuous-wave instruments provide qualitative and quantitative assessment of venous and arterial disease. Pulsed Doppler ultrasound was developed to provide longitudinal and transverse cross-sectional images of the arterial lumen with a resolution approaching that of conventional X-ray techniques. Application of Doppler ultrasound in venous, peripheral arterial, and cerebrovascular diseases is reviewed.

  13. Technetium-99m thyroid scan; does it have a diagnostic aid in sub-clinical auto-immune thyroid disease in systemic lupus erythematosus patients?

    Science.gov (United States)

    Amin, A; Alkemary, A; Abdo, M; Salama, M

    2016-02-01

    Technetium-99m (Tc-99m) thyroid scintigraphy is a well known diagnostic tool that shows the entire gland in a single image. We aimed to evaluate its additive diagnostic value in subclinical autoimmune thyroid disease (S-AITD) in systemic lupus erythematosus (SLE) patients. We investigated 100 systemic lupus erythematosus (SLE) patients without overt thyroid involvement (eight men and 92 women; mean age 40±6.5 years) and 50 age and sex matched controls. All were subjected to thyroid evaluation using anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies; hormones (FT3; FT4 and TSH) and Tc-99m thyroid scintigraphy. 14/100 (14%) and none (0%) were positive for S-AITD in SLE and control groups, respectively (P = 0.0001). They were classified by thyroid scintigraphy and hormonal profile into 2/14 Hashimoto; 10/14 atrophic thyroiditis and 2/14 Graves' disease. Anti-TPO was elevated in 12 SLE cases, while anti-TG was elevated in only 2/14 (P = 0.0001). Thyroid scintigraphy showed statistically significant associations with FT4, TSH and anti-TPO. Tc-99m thyroid scintigraphy may have an additional diagnostic role in S-AITD among SLE patients, with an impact on patient management. This potential needs to be further evaluated in a larger series on a multicenter basis. © The Author(s) 2015.

  14. PET/MR Imaging in Vascular Disease

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten; Pedersen, Sune Folke; Kjær, Andreas

    2016-01-01

    For imaging of atherosclerotic disease, lumenography using computed tomography, ultrasonography, or invasive angiography is still the backbone of evaluation. However, these methods are less effective to predict the likelihood of future thromboembolic events caused by vulnerability of plaques. PET...

  15. Vascular remodeling in coronary artery disease

    NARCIS (Netherlands)

    C. di Mario (Carlo); P.N. Ruygrok (Peter); P.W.J.C. Serruys (Patrick)

    1994-01-01

    textabstractTraditionally, the diagnosis of significant coronary atherosclerotic disease has relied on angiographic techniques. Both histologic analyses and, more recently, intravascular ultrasonography techniques have revealed that a significant atherosclerotic plaque load may be present in

  16. Liver involvement in children with collagen vascular diseases.

    Science.gov (United States)

    Pawłowska, Joanna; Naorniakowska, Magdalena; Liber, Anna

    2015-11-01

    Liver injury such as hepatomegaly, splenomegaly and various degrees of biochemical abnormalities are quite common in children with collagen vascular diseases. They may be primary or secondary, particularly due to drug therapy (drug toxicity, fatty infiltration), superadded infections, diabetes or overlap with autoimmune hepatitis.

  17. HIV-occlusive vascular disease | Van Marle | South African Journal ...

    African Journals Online (AJOL)

    Objectives. To evaluate peripheral arterial occlusive disease in HIV-infected patients regarding clinical presentation and outcome of surgical intervention. Design. Prospective clinical survey. Patients and methods. Routine voluntary testing for HIV/AIDS was performed in all patients presenting to our vascular unit.

  18. Vascular targeting of nanoparticles for molecular imaging of diseased endothelium.

    Science.gov (United States)

    Atukorale, Prabhani U; Covarrubias, Gil; Bauer, Lisa; Karathanasis, Efstathios

    2017-04-01

    This review seeks to highlight the enormous potential of targeted nanoparticles for molecular imaging applications. Being the closest point-of-contact, circulating nanoparticles can gain direct access to targetable molecular markers of disease that appear on the endothelium. Further, nanoparticles are ideally suitable to vascular targeting due to geometrically enhanced multivalent attachment on the vascular target. This natural synergy between nanoparticles, vascular targeting and molecular imaging can provide new avenues for diagnosis and prognosis of disease with quantitative precision. In addition to the obvious applications of targeting molecular signatures of vascular diseases (e.g., atherosclerosis), deep-tissue diseases often manifest themselves by continuously altering and remodeling their neighboring blood vessels (e.g., cancer). Thus, the remodeled endothelium provides a wide range of targets for nanoparticles and molecular imaging. To demonstrate the potential of molecular imaging, we present a variety of nanoparticles designed for molecular imaging of cancer or atherosclerosis using different imaging modalities. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Language Impairment in Alzheimer's Disease and Vascular Dementia.

    Science.gov (United States)

    Lempinen, Maire; And Others

    A study of 21 patients with Alzheimer's Disease and 25 with vascular dementia, the two most common forms of dementia, investigated language impairments in the dementia syndrome to see if analysis of language disturbances is helpful in differential diagnosis. Diagnostic assessment included a neurological examination, detailed medical history,…

  20. Adaptive cognitive testing in cerebrovascular disease and vascular dementia

    NARCIS (Netherlands)

    Wouters, H.; de Koning, I.; Zwinderman, A.H.; van Gool, W.A.; Schmand, B.; Buiter, M.; Lindeboom, R.

    2009-01-01

    Background/Aims: To examine whether brevity can be combined with precision in measuring global cognitive ability in patients with cerebrovascular disease (CVD) or vascular dementia (VaD). Longer tests (e.g. the CAMCOG) are precise but inefficient, whereas brief tests (e.g. the MMSE) are efficient

  1. Acute type II cryoglobulinaemic vasculitis mimicking atherosclerotic peripheral vascular disease.

    LENUS (Irish Health Repository)

    Saeed, A

    2012-01-31

    Atherosclerotic peripheral vascular disease is a common presenting cause for digital ischaemia in life long smokers. Acute severe Type II Cryoglobulinaemic vasculitis is a rare yet important cause, which may present with similar clinical features and which if undiagnosed may be rapidly fatal. Following the instigation of therapy with intravenous methylprednisolone and cyclophosphamide this patient made an excellent recovery.

  2. Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review

    Science.gov (United States)

    Aziz, Muhammad; Ali, Shozab S.; Das, Sankalp; Younus, Adnan; Malik, Rehan; Latif, Muhammad A.; Humayun, Choudhry; Anugula, Dixitha; Abbas, Ghulam; Salami, Joseph; Elizondo, Javier Valero; Veledar, Emir

    2017-01-01

    Aim: Abnormal daily sleep duration and quality have been linked to hypertension, diabetes, stroke, and overall cardiovascular disease (CVD) morbidity & mortality. However, the relationship between daily sleep duration and quality with subclinical measures of CVD remain less well studied. This systematic review evaluated how daily sleep duration and quality affect burden of subclinical CVD in subjects free of symptomatic CVD. Methods: Literature search was done via MEDLINE, EMBASE, Web of Science until June 2016 and 32 studies met the inclusion criteria. Sleep duration and quality were measured either via subjective methods, as self-reported questionnaires or Pittsburg Sleep Quality Index (PSQI) or via objective methods, as actigraphy or polysomnography or by both. Among subclinical CVD measures, coronary artery calcium (CAC) was measured by electron beam computed tomography, Carotid intima-media thickness (CIMT) measured by high-resolution B-mode ultrasound on carotid arteries, endothelial/microvascular function measured by flow mediated dilation (FMD) or peripheral arterial tone (PAT) or iontophoresis or nailfold capillaroscopy, and arterial stiffness measured by pulse wave velocity (PWV) or ankle brachial index (ABI). Results: Subjective short sleep duration was associated with CAC and CIMT, but variably associated with endothelial dysfunction (ED) and arterial stiffness; however, subjective long sleep duration was associated with CAC, CIMT and arterial stiffness, but variably associated with ED. Objective short sleep duration was positively associated with CIMT and variably with CAC but not associated with ED. Objective long sleep duration was variably associated with CAC and CIMT but not associated with ED. Poor subjective sleep quality was significantly associated with ED and arterial stiffness but variably associated with CAC and CIMT. Poor objective sleep quality was significantly associated with CIMT, and ED but variably associated with CAC. Conclusions

  3. Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review.

    Science.gov (United States)

    Aziz, Muhammad; Ali, Shozab S; Das, Sankalp; Younus, Adnan; Malik, Rehan; Latif, Muhammad A; Humayun, Choudhry; Anugula, Dixitha; Abbas, Ghulam; Salami, Joseph; Elizondo, Javier Valero; Veledar, Emir; Nasir, Khurram

    2017-03-01

    Abnormal daily sleep duration and quality have been linked to hypertension, diabetes, stroke, and overall cardiovascular disease (CVD) morbidity& mortality. However, the relationship between daily sleep duration and quality with subclinical measures of CVD remains less well studied. This systematic review evaluated how daily sleep duration and quality affect burden of subclinical CVD in subjects free of symptomatic CVD. Literature search was done via MEDLINE, EMBASE, Web of Science until June 2016 and 32 studies met the inclusion criteria. Sleep duration and quality were measured either via subjective methods, as self-reported questionnaires or Pittsburg Sleep Quality Index (PSQI) or via objective methods, as actigraphy or polysomnography or by both. Among subclinical CVD measures, coronary artery calcium (CAC) was measured by electron beam computed tomography, Carotid intima-media thickness (CIMT) measured by high-resolution B-mode ultrasound on carotid arteries, endothelial/microvascular function measured by flow mediated dilation (FMD) or peripheral arterial tone (PAT) or iontophoresis or nailfold capillaroscopy, and arterial stiffness measured by pulse wave velocity (PWV) or ankle brachial index (ABI). Subjective short sleep duration was associated with CAC and CIMT, but variably associated with endothelial dysfunction (ED) and arterial stiffness; however, subjective long sleep duration was associated with CAC, CIMT and arterial stiffness, but variably associated with ED. Objective short sleep duration was positively associated with CIMT and variably with CAC but not associated with ED. Objective long sleep duration was variably associated with CAC and CIMT but not associated with ED. Poor subjective sleep quality was significantly associated with ED and arterial stiffness but variably associated with CAC and CIMT. Poor objective sleep quality was significantly associated with CIMT, and ED but variably associated with CAC. Overall, our review provided mixed

  4. Genetics of hyperhomocysteinemia in vascular disease

    NARCIS (Netherlands)

    Lievers, Caroline Joan Antoinette

    2002-01-01

    Homocysteine is an amino acid that plays a pivotal role in methionine metabolism. Moderately elevated plasma homocysteine concentrations are considered to be a risk factor for cardiovascular diseases (CVD). Plasma homocysteine concentrations are influenced by environmental factors, such as diet and

  5. [Rare vascular diseases, building dedicated multidisciplinary specialized center].

    Science.gov (United States)

    Krieger, Caroline; Baud, David; Bouchardy, Judith; Christen-Zaech, Stephanie; De Buys, Anthony; Deglise, Sebastien; El Ezzi, Oumama; Fresa, Marco; Hofer, Michael; Hohl, Daniel; Kirsch, Matthias; Lazor, Romain; Michel, Patrick; Monney, Pierre; Munier, Francis; Qanadli, Salah Dine; Raffoul, Wassim; Aubry Rozier, Berangere; Saucy, François; Schoepfer, Alain; Saliou, Guillaume; Sekarski, Nicole; Superti-Furga, Andrea; Wuerzner, Gregoire; Wasserfallen, Jean-Blaise; Mazzolai, Lucia

    2017-12-06

    Rare Vascular Diseases (RVD) encompass different types of vessel involvement. Some cause a dilation, others a weakening or tortuosity of the arterial wall, others an obstruction or excessive calcification of arterial walls. Clinical pathway of patients with RVD to diagnosis is often long and complex. Thus, in order to allow early diagnosis and coordinated multidisciplinary management and follow-up, a specialized RVD centre has been set-up at the CHUV, following the framework of the national concept of rare diseases.

  6. Bile pigments in pulmonary and vascular disease

    Directory of Open Access Journals (Sweden)

    Stefan W. Ryter

    2012-03-01

    Full Text Available The bile pigments, biliverdin and bilirubin, are endogenously-derived substances generated during enzymatic heme degradation. These compounds have been shown to act as chemical antioxidants in vitro. Bilirubin formed in tissues circulates in the serum, prior to undergoing hepatic conjugation and biliary excretion. The excess production of bilirubin has been associated with neurotoxicity, in particular to the newborn. Nevertheless, clinical evidence suggests that mild states of hyperbilirubinemia may be beneficial in protecting against cardiovascular disease in adults. Pharmacological application of either bilirubin and/or its biological precursor biliverdin, can provide therapeutic benefit in several animal models of cardiovascular and pulmonary disease. Furthermore, biliverdin and bilirubin can confer protection against ischemia/reperfusion injury and graft rejection secondary to organ transplantation in animal models. Several possible mechanisms for these effects have been proposed, including direct antioxidant and scavenging effects, and modulation of signaling pathways regulating inflammation, apoptosis, cell proliferation, and immune responses. The practicality and therapeutic-effectiveness of bile pigment application to humans remains unclear.

  7. Cardio-Vascular Disease and Cancer

    Directory of Open Access Journals (Sweden)

    K. Mitchell-Fearon DrPh

    2015-11-01

    Full Text Available Objective: To report the level of utilization of clinical preventive services by older adults in Jamaica and to identify independent factors associated with utilization. Method: A nationally representative, community-based survey of 2,943 older adults was undertaken. Utilization frequency for six preventive, cardiovascular or cancer-related services was calculated. Logistic regression models were used to determine the independent factors associated with each service. Results: A dichotomy in annual utilization rates exists with cardiovascular services having much higher uptake than those for cancer (83.1% for blood pressure, 76.7% blood glucose, 68.1% cholesterol, 35.1% prostate, 11.3% mammograms, and 9.6% papanicolaou smears. Age, source of routine care, and having a chronic disease were most frequently associated with uptake. Discussion: Education of providers and patients on the need for utilizing preventive services in older adults is important. Improved access to services in the public sector may also help increase uptake of services.

  8. Antiplatelet therapy and vascular disease: an update.

    Science.gov (United States)

    Buch, Mamta H; Prendergast, Bernard D; Storey, Robert F

    2010-08-01

    Atherosclerosis is a diffuse, systemic disorder of the large and medium-sized arterial vessels, affecting the coronary, cerebral and peripheral circulation. Chronic inflammatory processes are the central pathophysiological mechanism largely driven by lipid accumulation, and provide the substrate for occlusive thrombus formation. The clinical sequelae of acute arterial thrombosis, heart attack and stroke, are the most common causes of morbidity and mortality in the industrialized world. Such acute events are characterized by rupture or erosion of the atherosclerotic plaque leading to acute thrombosis. The atherosclerotic process and associated thrombotic complications are collectively termed atherothrombosis. The platelet is a pivotal mediator of various endothelial, immune, thrombotic and inflammatory responses and therefore a key player in the initiation and progression of atherothrombosis. A robust evidence base supports the clear clinical benefits of antiplatelet agents in the primary and secondary therapy of atherothrombotic disorders. Percutaneous coronary and peripheral interventions have an established central role in the management of atherothrombotic disease and demand a greater understanding of platelet biology. In this article, we provide a clinically orientated overview of the pathophysiology of arterial thrombosis and the evidence supporting the use of the various established antiplatelet therapies, and discuss new and future agents.

  9. Extracellular vesicles as mediators of vascular inflammation in kidney disease.

    Science.gov (United States)

    Helmke, Alexandra; von Vietinghoff, Sibylle

    2016-03-06

    Vascular inflammation is a common cause of renal impairment and a major cause of morbidity and mortality of patients with kidney disease. Current studies consistently show an increase of extracellular vesicles (EVs) in acute vasculitis and in patients with atherosclerosis. Recent research has elucidated mechanisms that mediate vascular wall leukocyte accumulation and differentiation. This review addresses the role of EVs in this process. Part one of this review addresses functional roles of EVs in renal vasculitis. Most published data address anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis and indicate that the number of EVs, mostly of platelet origin, is increased in active disease. EVs generated from neutrophils by activation by ANCA can contribute to vessel damage. While EVs are also elevated in other types of autoimmune vasculitis with renal involvement such as systemic lupus erythematodes, functional consequences beyond intravascular thrombosis remain to be established. In typical hemolytic uremic syndrome secondary to infection with shiga toxin producing Escherichia coli, EV numbers are elevated and contribute to toxin distribution into the vascular wall. Part two addresses mechanisms how EVs modulate vascular inflammation in atherosclerosis, a process that is aggravated in uremia. Elevated numbers of circulating endothelial EVs were associated with atherosclerotic complications in a number of studies in patients with and without kidney disease. Uremic endothelial EVs are defective in induction of vascular relaxation. Neutrophil adhesion and transmigration and intravascular thrombus formation are critically modulated by EVs, a process that is amenable to therapeutic interventions. EVs can enhance monocyte adhesion to the endothelium and modulate macrophage differentiation and cytokine production with major influence on the local inflammatory milieu in the plaque. They significantly influence lipid phagocytosis and antigen presentation by

  10. Impact of inflammation on vascular disease in hypertension.

    Science.gov (United States)

    Virdis, Agostino; Dell'Agnello, Umberto; Taddei, Stefano

    2014-07-01

    Low grade inflammation exerts a crucial pathogenic role in hypertension and cardiovascular disease. A large body of evidence indicates that innate and adaptive immune systems, and in particular T cells, are involved. A balance between T-effector lymphocytes and Treg lymphocytes represents a crucial regulatory mechanism that, when altered, favours blood pressure elevation and organ damage development. Of note, Treg lymphocytes exert important anti-inflammatory properties, whose activities guarantees vascular homeostasis and protects the vessel wall from the development of atherosclerosis. In humans, most of evidence ascertaining essential hypertension as a condition of chronic low-grade inflammatory status revealed a strict and independent association between CRP, TNF-α, IL-6 or adhesion molecules and vascular changes in essential hypertensive patients. Evidence of involvement of the immune system in vasculature from patients with hypertension or cardiovascular disease starts to appear in literature. Further investigation on immunity, including the role of T-lymphocytes, will help develop of new therapeutic targets that may improve outcomes in hypertension and cardiovascular disease and discover novel approaches in the treatment of hypertension and vascular disease. Copyright © 2014. Published by Elsevier Ireland Ltd.

  11. Intravascular brachytherapy for peripheral vascular disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2008-09-01

    Full Text Available Scientific background: Percutaneous transluminal angioplasties (PTA through balloon dilatation with or without stenting, i.e. vessel expansion through balloons with or without of implantation of small tubes, called stents, are used in the treatment of peripheral artery occlusive disease (PAOD. The intravascular vessel irradiation, called intravascular brachytherapy, promises a reduction in the rate of repeated stenosis (rate of restenosis after PTA. Research questions: The evaluation addresses questions on medical efficacy, cost-effectiveness as well as ethic, social and legal implications in the use of brachytherapy in PAOD patients. Methods: A systematic literature search was conducted in August 2007 in the most important medical electronic databases for publications beginning from 2002. The medical evaluation included randomized controlled trials (RCT. The information synthesis was performed using meta-analysis. Health economic modeling was performed with clinical assumptions derived from the meta-analysis and economical assumptions derived from the German Diagnosis Related Groups (G-DRG-2007. Results: Medical evaluation: Twelve publications about seven RCT on brachytherapy vs. no brachytherapy were included in the medical evaluation. Two RCT showed a significant reduction in the rate of restenosis at six and/or twelve months for brachytherapy vs. no brachytherapy after successful balloon dilatation, the relative risk in the meta-analysis was 0.62 (95% CI: 0.46 to 0.84. At five years, time to recurrence of restenosis was significantly delayed after brachytherapy. One RCT showed a significant reduction in the rate of restenosis at six months for brachytherapy vs. no brachytherapy after PTA with optional stenting, the relative risk in the meta-analysis was 0.76 (95% CI: 0.61 to 0.95. One RCT observed a significantly higher rate of late thrombotic occlusions after brachytherapy in the subgroup of stented patients. A single RCT for brachytherapy

  12. Neuropsychological assessment and cerebral vascular disease: the new standards.

    Science.gov (United States)

    Godefroy, O; Leclercq, C; Bugnicourt, J-M; Roussel, M; Moroni, C; Quaglino, V; Beaunieux, H; Taillia, H; Nédélec-Ciceri, C; Bonnin, C; Thomas-Anterion, C; Varvat, J; Aboulafia-Brakha, T; Assal, F

    2013-10-01

    Vascular cognitive impairment (VCI) includes vascular dementia (VaD), vascular mild cognitive impairment (VaMCI) and mixed dementia. In clinical practice, VCI concerns patients referred for clinical stroke or cognitive complaint. To improve the characterization of VCI and to refine its diagnostic criteria, an international group has elaborated a new standardized evaluation battery of clinical, cognitive, behavioral and neuroradiological data which now constitutes the reference battery. The adaption of the battery for French-speaking subjects is reported as well as preliminary results of the on-going validation study of the GRECOG-VASC group [Clinical Trial NCT01339195]. The diagnostic accuracy of various screening tests is reviewed and showed an overall sub-optimal sensitivity (dementia. In addition to the well known NINDS-AIREN criteria of VaD, criteria of VCI have been recently proposed which are based on the demonstration of a cognitive disorder by neuropsychological testing and either history of clinical stroke or presence of vascular lesion by neuroimaging suggestive of a link between cognitive impairment and vascular disease. A memory deficit is no longer required for the diagnosis of VaD as it is based on the cognitive decline concerning two or more domains that affect activities of daily living. Both VaMCI and VaD are classified as probable or possible. These new criteria have yet to be validated. Considerable uncertainties remain regarding the determinant of VCI, and especially the lesion amount inducing VCI and VaD. The interaction between lesion amount and its location is currently re-examined using recent techniques for the analysis of MRI data. The high frequency of associated Alzheimer pathology is now assessable in vivo using amyloid imaging. The first studies showed that about a third of patients with VaD due to small vessel disease or with poststroke dementia have amyloid PET imaging suggestive of AD. These new techniques will examine the

  13. Disruption of vascular homeostasis in patients with Kawasaki disease: Involvement of vascular endothelial growth factor and angiopoietins

    NARCIS (Netherlands)

    Breunis, Willemijn B.; Davila, Sonia; Shimizu, Chisato; Oharaseki, Toshiaki; Takahashi, Kei; van Houdt, Michel; Khor, Chiea Chuen; Wright, Victoria J.; Levin, Michael; Burns, Jane C.; Burgner, David; Hibberd, Martin L.; Kuijpers, Taco W.; Odam, Miranda; Christiansen, Frank; Witt, Campbell; Goldwater, Paul; Curtis, Nigel; Palasanthiran, Pamela; Ziegler, John; Nissan, Michael; Nourse, Clare; Kuipers, Irene M.; Ottenkamp, Jaap J.; Geissler, Judy; Tacke, Carline C. E.; Ng, Sarah B.; Li, Yi; Bonnard, Carine; Ling, Ling; Brogan, Paul; Klein, Nigel; Shah, Vanita; Dillon, Michael; Booy, Robert; Shingadia, Delane; Bose, Anu; Mukasa, Thomas; Tulloh, Robert; Michie, Colin; Shike, Hiroko; Nievergelt, Caroline M.; Schork, Nicholas J.; Newburger, Jane W.; Baker, Annette L.; Sundel, Robert P.; Rowley, Anne H.; Shulman, Stanford T.

    2012-01-01

    Objective In Kawasaki disease (KD), a pediatric vasculitis of medium-sized arteries, the coronary arteries are most commonly affected. Angiopoietins and vascular endothelial growth factor (VEGF) play an important role in maintaining vascular homeostasis. Recently, we identified ANGPT1 and VEGFA as

  14. Role of pyrophosphate in vascular calcification in chronic kidney disease.

    Science.gov (United States)

    Azpiazu, Daniel; Gonzalo, Sergio; González-Parra, Emilio; Egido, Jesús; Villa-Bellosta, Ricardo

    2017-11-11

    Vascular calcification is a pathology characterized by the deposition of calcium-phosphate in cardiovascular structures, mainly in the form of hydroxyapatite crystals, resulting in ectopic calcification. It is correlated with increased risk of cardiovascular disease and myocardial infarction in diabetic patients and in those with chronic kidney disease (CKD). Vascular smooth muscle cells are sensitive to changes in inorganic phosphate (Pi) levels. They are able to adapt and modify some of their functions and promote changes which trigger calcification. Pi is regulated by parathyroid hormone and 1,25-dihydroxyvitamin D. Changes in the transport of Pi are the primary factor responsible for the regulation of Pi homeostasis and the calcification process. Synthesis of calcification inhibitors is the main mechanism by which cells are able to prevent vascular calcification. Extracellular pyrophosphate (PPi) is a potent endogenous inhibitor of calcium-phosphate deposition both in vivo and in vitro. Patients with CKD show lower levels of PPi and increased activity of the enzyme alkaline phosphatase. Numerous enzymes implicated in the metabolism of PPi have been associated with vascular calcifications. PPi is synthesized from extracellular ATP by nucleotide pyrophosphatase/phosphodiesterase from extracellular ATP hydrolysis. PPi is hydrolyzed into Pi by tissue-nonspecific alkaline phosphatase. ATP can be hydrolyzed to Pi via the ectonucleoside triphosphate diphosphohydrolase family. All these enzymes must be in balance, thereby preventing calcifications. However, diseases like CKD or diabetes induce alterations in their levels. Administration of PPi could open up new treatment options for these patients. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Relationship between vascular endothelium and periodontal disease in atherosclerotic lesions: Review article

    National Research Council Canada - National Science Library

    Marco Aurélio Lumertz Saffi Mariana Vargas Furtado Carisi Anne Polanczyk Márlon Munhoz Montenegro Ingrid Webb Josephson Ribeiro Cassio Kampits Alex Nogueira Haas Cassiano Kuchenbecker R?sing Eneida Rejane Rabelo-Silva

    2015-01-01

    .... Recent studies suggest that periodontal infection and the ensuing increase in the levels of inflammatory markers may be associated with myocardial infarction, peripheral vascular disease and cerebrovascular disease...

  16. Vascular Aging: Implications for Cardiovascular Disease and Therapy

    Science.gov (United States)

    Ghebre, Yohannes T; Yakubov, Eduard; Wong, Wing Tak; Krishnamurthy, Prasanna; Sayed, Nazish; Sikora, Andrew G; Bonnen, Mark D

    2017-01-01

    The incidence and prevalence of cardiovascular disease is highest among the elderly, in part, due to deleterious effects of advancing age on the heart and blood vessels. Aging, a known cardiovascular risk factor, is progressively associated with structural and functional changes to the vasculature including hemodynamic disturbance due to increased oxidative stress, premature cellular senescence and impairments in synthesis and/or secretion of endothelium-derived vasoactive molecules. These molecular and physiological changes lead to vessel wall stiffening and thickening, as well as other vascular complications that culminate to loss of vascular tone regulation and endothelial function. Intriguingly, the vessel wall, a biochemically active structure composed of collagen, connective tissue, smooth muscle and endothelial cells, is adversely affected by processes involved in premature or normal aging. Notably, the inner most layer of the vessel wall, the endothelium, becomes senescent and dysfunctional with advancing age. As a result, its ability to release vasoactive molecules such as acetylcholine (ACh), prostacyclin (PGI2), endothelium-derived hyperpolarizing factor (EDHF), and nitric oxide (NO) is reduced and the cellular response to these molecules is also impaired. By contrast, the vascular endothelium increases its generation and release of reactive oxygen (ROS) and nitrogen (RNS) species, vasoconstrictors such as endothelin (ET) and angiotensin (AT), and endogenous inhibitors of NO synthases (NOSs) to block NO. This skews the balance of the endothelium in favor of the release of highly tissue reactive and harmful molecules that promote DNA damage, telomere erosion, senescence, as well as stiffened and hardened vessel wall that is prone to the development of hypertension, diabetes, atherosclerosis and other cardiovascular risk factors. This Review discusses the impact of advancing age on cardiovascular health, and highlights the cellular and molecular mechanisms

  17. The design and rationale of the Beijing Vascular Disease Patients Evaluation Study (BEST study

    Directory of Open Access Journals (Sweden)

    Huan Liu

    2017-09-01

    Conclusions: 2858 subjects were enrolled into our present study at baseline, and this present study will provide important information on the metabolic related traditional and new risk factors, establish a new vascular disease early detection system and scoring systems based on comprehensive vascular disease risk factors and vascular function and structure evaluation indexes.

  18. VASCULAR DEMENTIA

    Directory of Open Access Journals (Sweden)

    Maria Alekseyevna Cherdak

    2010-01-01

    vascular cognitive disorders and vascular dementia (VD. The heterogeneity of vascular cognitive disorders, concurrence of vascular and neurodegenerative diseases are discussed. Data from studies of specific therapy for VD are given.

  19. Exercise, vascular wall and cardiovascular diseases: an update (Part 1).

    Science.gov (United States)

    Leung, Fung Ping; Yung, Lai Ming; Laher, Ismail; Yao, Xiaoqiang; Chen, Zhen Yu; Huang, Yu

    2008-01-01

    Cardiovascular disease (CVD) remains the leading cause of morbidity and premature mortality in both women and men in most industrialized countries, and has for some time also established a prominent role in developing nations. In fact, obesity, diabetes mellitus and hypertension are now commonplace even in children and youths. Regular exercise is rapidly gaining widespread advocacy as a preventative measure in schools, medical circles and in the popular media. There is overwhelming evidence garnered from a number of sources, including epidemiological, prospective cohort and intervention studies, suggesting that CVD is largely a disease associated with physical inactivity. A rapidly advancing body of human and animal data confirms an important beneficial role for exercise in the prevention and treatment of CVD. In Part 1 of this review we discuss the impact of exercise on CVD, and we highlight the effects of exercise on (i) endothelial function by regulation of endothelial genes mediating oxidative metabolism, inflammation, apoptosis, cellular growth and proliferation, increased superoxide dismutase (SOD)-1, down-regulation of p67phox, changes in intracellular calcium level, increased vascular endothelial nitric oxide synthase (eNOS), expression and eNOS Ser-1177 phosphorylation; (ii) vascular smooth muscle function by either an increased affinity of the Ca2+ extrusion mechanism or an augmented Ca2+ buffering system by the superficial sarcoplasmic reticulum to increase Ca2+ sequestration, increase in K+ channel activity and/or expression, and increase in L-type Ca2+ current density; (iii) antioxidant systems by elevation of Mn-SOD, Cu/Zn-SOD and catalase, increases in glutathione peroxidase activity and activation of vascular nicotinamide adenine dinucleotide phosphate [(NAD(P)H] oxidase and p22phox expression; (iv) heat shock protein (HSP) expression by stimulating HSP70 expression in myocardium, skeletal muscle and even in human leucocytes, probably through heat

  20. N-acetylcysteine improves arterial vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Wittstock, Antje; Burkert, Magdalena; Zidek, Walter

    2009-01-01

    Patients with stage 5 chronic kidney disease show increased cardiovascular morbidity and mortality that are partly related to impaired arterial vascular reactivity. We investigated whether intravenous administration of the antioxidant acetylcysteine improves arterial vascular reactivity...

  1. Depressive symptoms, vascular risk factors, and Alzheimer's disease.

    Science.gov (United States)

    Luchsinger, José A; Honig, Lawrence S; Tang, Ming-Xin; Devanand, Devangere P

    2008-09-01

    Depressive symptoms in the elderly are associated with an increased Alzheimer's disease (AD) risk. We sought to determine whether the association between depressive symptoms and AD is explained by a history of vascular risk factors and stroke. Five hundred and twenty-six elderly persons from New York City without dementia at baseline were followed for a mean of 5 years. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAM). Incident AD was ascertained using standard criteria. Diabetes, hypertension, heart disease, current smoking and stroke were ascertained by self-report. Proportional hazards regression was used to relate HAM scores to incident AD. HAM scores were higher in persons with hypertension, heart disease, and stroke, which in turn were related to higher AD risk. AD risk increased with increasing HAM scores as a continuous logarithmically transformed variable (HR for one point increase=1.4; 95% CI=1.1,1.8) and as a categorical variable (HR for HAM >or= 10=3.4; 95% CI=1.5,8.1; p for trend=0.004 with HAM=0 as the reference). These results were virtually unchanged after adjustment for vascular risk factors and stroke, individually (HR for HAM >or= 10=3.4; 95% CI=1.5,8.1; p for trend = 0.004), and in a composite measure (HR for HAM >or= 10=3.0; 95% CI=1.2,7.8; p for trend=0.02). The prospective relation between depressive symptoms and AD is not explained by a history of vascular risk factors and stroke, suggesting that other mechanisms may account for this association.

  2. Mesoglycan: Clinical Evidences for Use in Vascular Diseases

    Directory of Open Access Journals (Sweden)

    Antonella Tufano

    2010-01-01

    Full Text Available Vascular glycosaminoglycans (GAG are essential components of the endothelium and vessel wall and have been shown to be involved in several biologic functions. Mesoglycan, a natural GAG preparation, is a polysaccharide complex rich in sulphur radicals with strong negative electric charge. It is extracted from porcine intestinal mucosa and is composed of heparan sulfate, dermatan sulfate, electrophoretically slow-moving heparin, and variable and minimal quantities of chondroitin sulfate. Data on antithrombotic and profibrinolytic activities of the drug show that mesoglycan, although not indicated in the treatment of acute arterial or venous thrombosis because of the low antithrombotic effect, may be useful in the management of vascular diseases, when combined with antithrombotics in the case of disease of cerebral vasculature, and with antithrombotics and vasodilator drugs in the case of chronic peripheral arterial disease. The protective effect of mesoglycan in patients with venous thrombosis and the absence of side effects, support the use of GAG in patients with chronic venous insufficiency and persistent venous ulcers, in association with compression therapy (zinc bandages, multiple layer bandages, etc., elastic compression stockings, and local care, and in the prevention of recurrences in patients with previous DVT following the standard course of oral anticoagulation treatment.

  3. Diffuse and vascular hepatic diseases; Diffuse und vaskulaere Lebererkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Kreimeyer, S.; Grenacher, L. [Universitaetsklinikum Heidelberg, Abteilung Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

    2011-08-15

    In addition to focal liver lesions, diffuse and vascular disorders of the liver represent a wide spectrum of liver diseases which are from the radiological point of view often difficult or nearly impossible to diagnose. Classical diagnostic methods are computed tomography and magnetic resonance imaging in addition to ultrasound. Diffuse parenchymal damage caused by diseases of various etiologies is therefore difficult to evaluate because it often lacks characteristic morphological features. For hepatic steatosis, hemochromatosis/siderosis as an example of a diffuse storage disease and sarcoidosis and candidiasis as infectious/inflammatory diseases, an image-based diagnosis is appropriate in some cases. For most diffuse liver diseases, however only nonspecific changes are visualized. Vascular pathologies of the liver, such as the Budd-Chiari syndrome and portal vein thrombosis, however, can usually be diagnosed very clearly using radiology and there is also a very effective interventional radiological treatment. Chronic diseases very often culminate in liver cirrhosis which is highly associated with an increased risk of liver cancer. (orig.) [German] Neben den fokalen Leberlaesionen stellen diffuse und vaskulaere Lebererkrankungen ein weites Spektrum an Erkrankungen der Leber dar, die radiologisch oft schwer oder gar nicht diagnostizierbar sind. Klassische diagnostische Verfahren sind dabei neben dem Ultraschall die Computertomographie und die Magnetresonanztomographie. Diffuse Parenchymschaeden, bedingt durch Erkrankungen unterschiedlichster Aetiologie, sind deshalb schwierig evaluierbar, weil haeufig charakteristische bildmorphologische Merkmale fehlen. Die Steatosis hepatis, die Haemochromatose/Siderose als Beispiel der Speicherkrankheiten sowie die Sarkoidose und die Candidose als infektioes-entzuendliche Erkrankungen sind einer bildbasierten Diagnosestellung z. T. zugaenglich, bei den meisten diffusen Lebererkrankungen jedoch zeigen sich lediglich unspezifische

  4. The management of combined coronary artery disease and peripheral vascular disease

    NARCIS (Netherlands)

    A. Cassar (Andrew); D. Poldermans (Don); C.S. Rihal (Charanjit); B.J. Gersh (Bernard)

    2010-01-01

    textabstractCoronary artery disease (CAD) and peripheral vascular disease (PVD) remain highly prevalent in the population due to population ageing, smoking, diabetes, unhealthy lifestyles, and the epidemic of obesity, and frequently coexist. The management of combined CAD and PVD is a common

  5. Blink Reflex May Help Discriminate Alzheimer Disease From Vascular Dementia.

    Science.gov (United States)

    Mohammadian, Fatemeh; Noroozian, Maryam; Nafissi, Shahriar; Fatehi, Farzad

    2015-12-01

    Dementia has several different etiologies, and vascular dementia (VaD) is considered the second leading cause of dementia after Alzheimer disease (AD). Various studies used blink reflex in different spectrum of neurological diseases as a complementary diagnostic test. We performed blink test in AD, VaD, and mixed dementia to investigate different usefulness of blink reflex in differentiating these types of dementia. Blink reflex was performed for patients with AD (n = 18), VaD (n = 17), mixed dementia (n = 19), and normal subjects (n = 20). The absolute latency of R1, R2, and contralateral R2 (R2c) was determined and then compared with normal values. We used ROC curve to determine the screening cut-off value for R2 and R2c to discriminate dementia with vascular component and AD. The mean age ± SD of patients was 71.61 ± 8.23, 66.71 ± 11.48, 75.26 ± 8.32, and 66.60 ± 3.91 years in 4 groups of AD, VaD, mixed dementia, and normal, respectively. R2 and R2c were recorded in fewer number of subjects with VaD or mixed dementia than AD and normal subjects. For mean R2 latency higher than 45 milliseconds, the sensitivity and specificity were 42% and 100%, respectively, and for latency higher than 45 milliseconds, the sensitivity and specificity were 72% and 89%, respectively. R2 and R2c components of blink reflex could specifically discriminate between Alzheimer and dementia with vascular component. The interruption of descending corticoreticular pathways by small infarcts could explain it.

  6. Cancer linked to Alzheimer disease but not vascular dementia

    Science.gov (United States)

    Roe, C M.; Fitzpatrick, A L.; Xiong, C; Sieh, W; Kuller, L; Miller, J P.; Williams, M M.; Kopan, R; Behrens, M I.; Morris, J C.

    2010-01-01

    Objective: To investigate whether cancer is associated with Alzheimer disease (AD) and vascular dementia (VaD). Methods: Cox proportional hazards models were used to test associations between prevalent dementia and risk of future cancer hospitalization, and associations between prevalent cancer and risk of subsequent dementia. Participants in the Cardiovascular Health Study–Cognition Substudy, a prospective cohort study, aged 65 years or older (n = 3,020) were followed a mean of 5.4 years for dementia and 8.3 years for cancer. Results: The presence of any AD (pure AD + mixed AD/VaD; hazard ratio [HR] = 0.41, 95% confidence interval [CI] = 0.20–0.84) and pure AD (HR = 0.31, 95% CI = 0.12–0.86) was associated with a reduced risk of future cancer hospitalization, adjusted for demographic factors, smoking, obesity, and physical activity. No significant associations were found between dementia at baseline and rate of cancer hospitalizations for participants with diagnoses of VaD. Prevalent cancer was associated with reduced risk of any AD (HR = 0.72; 95% CI = 0.52–0.997) and pure AD (HR = 0.57; 95% CI = 0.36–0.90) among white subjects after adjustment for demographics, number of APOE ε4 alleles, hypertension, diabetes, and coronary heart disease; the opposite association was found among minorities, but the sample size was too small to provide stable estimates. No significant association was found between cancer and subsequent development of VaD. Conclusions: In white older adults, prevalent Alzheimer disease (AD) was longitudinally associated with a reduced risk of cancer, and a history of cancer was associated with a reduced risk of AD. Together with other work showing associations between cancer and Parkinson disease, these findings suggest the possibility that cancer is linked to neurodegeneration. GLOSSARY 3MSE = modified Mini-Mental State Examination; AD = Alzheimer disease; ADDTC = Alzheimer Disease Diagnostic and Treatment Centers; CHD = coronary heart

  7. Neuropsychological profiles of vascular disease and risk of dementia: implications for defining vascular cognitive impairment no dementia (VCI-ND).

    Science.gov (United States)

    Stephan, Blossom Christa Maree; Minett, Thais; Muniz-Terrera, Graciela; Harrison, Stephanie L; Matthews, Fiona E; Brayne, Carol

    2017-09-01

    vascular cognitive impairment no dementia (VCI-ND) defines a preclinical phase of cognitive decline associated with vascular disorders. The neuropsychological profile of VCI-ND may vary according to different vascular conditions. to determine the neuropsychological profile of individuals with no dementia and vascular disorders, including hypertension, peripheral vascular disease (PVD), coronary heart disease (CHD), diabetes and stroke. Risk of 2-year incident dementia in individuals with disease and cognitive impairment was also tested. participants were from the Cognitive Function and Ageing Study. At baseline, 13,004 individuals aged ≥65 years were enrolled into the study. Individuals were grouped by baseline disorder status (present, absent) for each condition. Cognitive performance was assessed using the Mini Mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG). Dementia was assessed at 2 years. in the cross-sectional analysis, hypertension, PVD and CHD were not associated with cognitive impairment. Stroke was associated with impaired global (MMSE) and CAMCOG sub-scale (including memory and non-memory) scores. Diabetes was associated with impairments in global cognitive function (MMSE) and abstract thinking. In the longitudinal analysis, cognitive impairments were associated with incident dementia in all groups. the neuropsychological profile in individuals with vascular disorders depends on the specific condition investigated. In all conditions cognitive impairment is a risk factor for dementia. A better understanding of which cognitive domains are affected in different disease groups could help improve operationalisation of the neuropsychological criteria for VCI-ND and could also aid with the development of dementia risk prediction models in persons with vascular disease.

  8. Family history of neurodegenerative and vascular diseases in ALS: a population-based study

    NARCIS (Netherlands)

    Huisman, M.H.; Jong, S.W. de; Verwijs, M.C.; Schelhaas, H.J.; Kooi, A.J. van der; Visser, M. de; Veldink, J.H.; Berg, L.H. van den

    2011-01-01

    OBJECTIVE: To determine whether the frequency of Parkinson disease (PD), dementia, and vascular diseases in relatives of patients with amyotrophic lateral sclerosis (ALS) differs from the frequency of those diseases in relatives of controls, providing further information about the association

  9. Vascular aging: chronic oxidative stress and impairment of redox signaling-consequences for vascular homeostasis and disease.

    Science.gov (United States)

    Bachschmid, Markus M; Schildknecht, Stefan; Matsui, Reiko; Zee, Rebecca; Haeussler, Dagmar; Cohen, Richard A; Pimental, David; Loo, Bernd van der

    2013-02-01

    Characteristic morphological and molecular alterations such as vessel wall thickening and reduction of nitric oxide occur in the aging vasculature leading to the gradual loss of vascular homeostasis. Consequently, the risk of developing acute and chronic cardiovascular diseases increases with age. Current research of the underlying molecular mechanisms of endothelial function demonstrates a duality of reactive oxygen and nitrogen species in contributing to vascular homeostasis or leading to detrimental effects when formed in excess. Furthermore, changes in function and redox status of vascular smooth muscle cells contribute to age-related vascular remodeling. The age-dependent increase in free radical formation causes deterioration of the nitric oxide signaling cascade, alters and activates prostaglandin metabolism, and promotes novel oxidative posttranslational protein modifications that interfere with vascular and cell signaling pathways. As a result, vascular dysfunction manifests. Compensatory mechanisms are initially activated to cope with age-induced oxidative stress, but become futile, which results in irreversible oxidative modifications of biological macromolecules. These findings support the 'free radical theory of aging' but also show that reactive oxygen and nitrogen species are essential signaling molecules, regulating vascular homeostasis.

  10. Dietary vitamin K and therapeutic warfarin alter susceptibility to vascular calcification in experimental chronic kidney disease

    Science.gov (United States)

    The leading cause of death in patients with chronic kidney disease (CKD) is cardiovascular disease (CVD), with vascular calcification (VC) being a key modifier of disease progression. A local regulator of vascular calcification is vitamin K. This gamma-glutamyl carboxylase substrate is an essential ...

  11. Mouse strain-specific differences in vascular wall gene expression and their relationship to vascular disease.

    Science.gov (United States)

    Tabibiazar, Raymond; Wagner, Roger A; Spin, Joshua M; Ashley, Euan A; Narasimhan, Balasubramanian; Rubin, Edward M; Efron, Bradley; Tsao, Phil S; Tibshirani, Robert; Quertermous, Thomas

    2005-02-01

    Different strains of inbred mice exhibit different susceptibility to the development of atherosclerosis. The C3H/HeJ and C57Bl/6 mice have been used in several studies aimed at understanding the genetic basis of atherosclerosis. Under controlled environmental conditions, variations in susceptibility to atherosclerosis reflect differences in genetic makeup, and these differences must be reflected in gene expression patterns that are temporally related to the development of disease. In this study, we sought to identify the genetic pathways that are differentially activated in the aortas of these mice. We performed genome-wide transcriptional profiling of aortas from C3H/HeJ and C57Bl/6 mice. Differences in gene expression were identified at baseline as well as during normal aging and longitudinal exposure to high-fat diet. The significance of these genes to the development of atherosclerosis was evaluated by observing their temporal pattern of expression in the well-studied apolipoprotein E model of atherosclerosis. Gene expression differences between the 2 strains suggest that aortas of C57Bl/6 mice have a higher genetic propensity to develop inflammation in response to appropriate atherogenic stimuli. This study expands the repertoire of factors in known disease-related signaling pathways and identifies novel candidate genes for future study. To gain insights into the molecular pathways that are differentially activated in strains of mice with varied susceptibility to atherosclerosis, we performed comprehensive transcriptional profiling of their vascular wall. Genes identified through these studies expand the repertoire of factors in disease-related signaling pathways and identify novel candidate genes in atherosclerosis.

  12. Blood glucose fluctuation aggravates lower extremity vascular disease in type 2 diabetes.

    Science.gov (United States)

    Jiao, X-M; Zhang, X-G; Xu, X U-P; Yi, C; Bin, C; Cheng, Q-P; Gong, Q-Q; Lv, X-F

    2014-01-01

    Lower-extremity vascular diseases are important complication of diabetes. In the present study, we investigated the influence of blood glucose fluctuation in type 2 diabetes-associated lower-extremity vascular diseases, and explore the possible mechanism. Patients with type 2 diabetes was assigned to Group B (without lower-extremity vascular disease) and group C (with lower-extremity vascular disease). Healthy subjects (Group A) served as normal controls. All patients received dynamic blood glucose monitoring for 72 h. The mean amplitude of glycemic excursion (MAGE) and the largest amplitude of glycemic excursion (LAGE) were estimated. The levels of von Willebrand factor (vWF), ischemia-modified albumin (IMA), glycosylated hemoglobin (HbA1c), and biochemical indices were examined, and the lower-extremity vascular diseases were scored in patients from group C. Groups B and C have higher systolic blood pressure (SBP), total cholesterol (TC) level, high-density lipoprotein cholesterol (HDL-C) level, HbA1c level, and vWF level and lower IMA level than those in Group A (p lower-extremity vascular diseases was associated with MAGE, LAGE, SBP, LDL-C, vWF, HbA1c, and IMA (p lower-extremity vascular diseases were involved with MAGE, IMA, and vWF. Enhanced fluctuation in patients with type 2 diabetes may promote the occurrence and development of lower-extremity vascular diseases through aggravating vascular endothelial injury.

  13. Innate immunity in CKD-associated vascular diseases.

    Science.gov (United States)

    Zewinger, Stephen; Schumann, Timo; Fliser, Danilo; Speer, Thimoteus

    2016-11-01

    Chronic kidney disease (CKD) is associated with an increased risk for cardiovascular events. Therefore, the activation of the innate immune system plays an important role. In contrast to the adaptive immunity, unspecific recognition of conserved endogenous and exogenous structures by pattern recognition receptors (PRRs) represents a key feature of the innate immunity. Of these PRRs, Toll-like receptors (TLRs) as well as the inflammasome complex have been documented to be involved in the pathogenesis of cardiovascular diseases (CVDs). They are not only expressed in leukocytes but also in a variety of cell types such as endothelial cells or fibroblasts. While activation of TLRs on the cell surface leads to nuclear factor κB-dependent expression of pro-inflammatory mediators, the inflammasome is a cytosolic multimeric protein complex, which cleaves cytokines such as interleukin-1β into their biologically active forms. Several endogenous ligands for these PRRs have been identified as contributing to the development of a CKD-specific pro-inflammatory microenvironment. Notably, activation of TLRs as well as the inflammasome is associated with arterial hypertension, formation of atherosclerotic vascular lesions and vascular calcification. However, detailed molecular mechanisms on how the innate immune system contributes to CKD-associated CVDs are as yet poorly understood. Currently, several agents modulating the activation of the innate immune system are the focus of cardiovascular research. Large clinical studies will provide further information on the therapeutic applicability of these substances to reduce cardiovascular morbidity and mortality in the general population. Further trials including patients with CKD will be necessary to assess their effects on CKD-associated CVD. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  14. Descriptive study of relationship between cardio-ankle vascular index and biomarkers in vascular-related diseases.

    Science.gov (United States)

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

    2017-01-01

    Cardio-ankle vascular index (CAVI) was supposed to be an independent predictor for vascular-related events. Biomarkers such as homocysteine (Hcy), N-terminal pro-brain natriuretic peptide (NT-proBNP), and urine albumin(microalbumin) (UAE) have involved the pathophysiological development of arteriosclerosis. The present study was to investigate relationship between CAVI and biomarkers in vascular-related diseases. A total of 656 subjects (M/F 272/384) from department of Vascular Medicine were enrolled into our study. They were divided into four groups according to the numbers of suffered diseases, healthy group (group 0: subjects without diseases of hypertension, diabetes mellitus (DM), coronary heart disease (CHD); n = 186), group 1 (with one of diseases of hypertension, CHD, DM; n = 237), group 2 (with two of diseases of hypertension, CHD, DM; n = 174), and group 3 (with all diseases of hypertension, CHD, DM; n = 59). CAVI was measured by VS-1000 apparatus. CAVI was increasing with increasing numbers of suffered vascular-related diseases. Similar results were found in the parameters of biomarkers such as Hcy, log NT-ProBNP, and log UAE. There were positive correlation between log NT-proBNP, Hcy, log UAE, and CAVI in the entire study group and nonhealthy group. Positive correlation between log UAE and CAVI were found in the entire study group after adjusting for age, body mass index (BMI), blood pressure, uric acid, and lipids. Multivariate analysis showed that log UAE was an independent associating factor of CAVI in all subjects. CAVI was significantly higher in subjects with hypertension, CHD, and DM. There was correlation between arterial stiffness and biomarkers such as NT-proBNP, Hcy, and UAE.

  15. Vascular care in patients with Alzheimer disease with cerebrovascular lesions slows progression of white matter lesions on MRI: the evaluation of vascular care in Alzheimer's disease (EVA) study.

    Science.gov (United States)

    Richard, Edo; Gouw, Alida A; Scheltens, Philip; van Gool, Willem A

    2010-03-01

    White matter lesions (WMLs) and cerebral infarcts are common findings in Alzheimer disease and may contribute to dementia severity. WMLs and lacunar infarcts may provide a potential target for intervention strategies. This study assessed whether multicomponent vascular care in patients with Alzheimer disease with cerebrovascular lesions slows progression of WMLs and prevents occurrence of new infarcts. A randomized controlled clinical trial, including 123 subjects, compared vascular care with standard care in patients with Alzheimer disease with cerebrovascular lesions on MRI. Progression of WMLs, lacunes, medial temporal lobe atrophy, and global cortical atrophy were semiquantitatively scored after 2-year follow-up. Sixty-five subjects (36 vascular care, 29 standard care) had a baseline and a follow-up MRI and in 58 subjects, a follow-up scan could not be obtained due to advanced dementia or death. Subjects in the vascular care group had less progression of WMLs as measured with the WML change score (1.4 versus 2.3, P=0.03). There was no difference in the number of new lacunes or change in global cortical atrophy or medial temporal lobe atrophy between the 2 groups. Vascular care in patients with Alzheimer disease with cerebrovascular lesions slows progression of WMLs. Treatment aimed at vascular risk factors in patients with early Alzheimer disease may be beneficial, possibly in an even earlier stage of the disease.

  16. Vascular diseases await translation of blood vessels engineered from stem cells.

    Science.gov (United States)

    Samuel, Rekha; Duda, Dan G; Fukumura, Dai; Jain, Rakesh K

    2015-10-14

    The discovery of human induced pluripotent stem cells (hiPSCs) might pave the way toward a long-sought solution for obtaining sufficient numbers of autologous cells for tissue engineering. Several methods exist for generating endothelial cells or perivascular cells from hiPSCs in vitro for use in the building of vascular tissue. We discuss current developments in the generation of vascular progenitor cells from hiPSCs and the assessment of their functional capacity in vivo, opportunities and challenges for the clinical translation of engineered vascular tissue, and modeling of vascular diseases using hiPSC-derived vascular progenitor cells. Copyright © 2015, American Association for the Advancement of Science.

  17. C-reactive protein and microalbuminuria differ in their associations with various domains of vascular disease

    NARCIS (Netherlands)

    Stuveling, EM; Hillege, HL; Bakker, SJL; Asselbergs, FW; de Jong, PE; Gans, ROB; de Zeeuw, D

    C-reactive protein (CRP) and microalbuminuria (MA) have been identified as risk markers for cardiovascular disease (CVD). We questioned whether CRP and MA are similar markers of vascular disease in different regions of the vascular tree like the heart, kidneys and extremities or if they differ in

  18. Distinguishing between vascular dementia and Alzheimer's disease by means of the WAIS: A meta-analysis

    NARCIS (Netherlands)

    Scherder, E.J A; Oosterman, J

    2006-01-01

    This study was intended to, meta-analytically, review whether the subtests of the Wechsler Adult Intelligence Scale are useful in differentiating between vascular dementia and Alzheimer's disease. We expected the Alzheimer's disease group to outperform the vascular dementia group on those subtests

  19. Distinguishing between vascular dementia and alzheimer's disease by means of the WAIS: a meta-analysis.

    NARCIS (Netherlands)

    Oosterman, J.M.; Scherder, E.J.A.

    2006-01-01

    This study was intended to, meta-analytically, review whether the subtests of the Wechsler Adult Intelligence Scale are useful in differentiating between vascular dementia and Alzheimer's disease. We expected the Alzheimer's disease group to outperform the vascular dementia group on those subtests

  20. Distinguishing between vascular dementia and Alzheimer's disease by means of the WAIS : A meta-analysis

    NARCIS (Netherlands)

    Scherder, Erik J. A.; Oosterman, J

    2006-01-01

    This study was intended to, meta-analytically, review whether the subtests of the Wechsler Adult Intelligence Scale are useful in differentiating between vascular dementia and Alzheimer's disease. We expected the Alzheimer's disease group to outperform the vascular dementia group on those subtests

  1. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter

    2011-01-01

    To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population.......To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population....

  2. Familial hyperhomocysteinemia, age and peripheral vascular diseases - an Italian study

    Directory of Open Access Journals (Sweden)

    Sandro Michelini

    2013-01-01

    Full Text Available Hyperhomocysteinemia is a widely recognized, although not yet entirely understood, risk factor for cardiovascular disease. Particularly, the complex relationships between age, hyperhomocysteinemia, predisposing genetic factors and peripheral vascular diseases have not been fully evaluated. Our contribution to this issue is a retrospective analysis of a large series of patients with peripheral arterial, venous and lymphatic disease, and of their blood relatives, with special reference to homocysteine plasma levels, age and methylenetetrahydrofolate reductase (MTHFR polymorphisms. Serum homocysteine was measured in 477 patients (286 males, 191 females, age range 19-78 years with various vascular clinical conditions: postphlebitic syndrome (46 recurrent venous ulcers (78, arterial diseases (101 primary lymphoedema (87, secondary lymphoedema (161 and outlet thoracic syndrome (4, and in 50 normal controls. A MTHFR study for polymorphisms was carried on in the subjects with homocysteine values exceeding 15 mol/L. Serum homocysteine determination and MTHFR polymorphism studies were performed also in 1430 healthy blood related relatives (mainly siblings, descendents and sibling descendents of the subjects with hyperhomocysteinemia and MTHFR polymorphisms. We found MTHFR polymorphisms in 20% of controls and in 69.3%, 69.5% and 53.8% of hyperhomocysteinemic subjects with arterial diseases, postphlebitic syndrome and venous ulcers, respectively. As expected, the percentage of hyperhomocysteinemia in patients with secondary lymphoedema and with thoracic outlet syndrome did not show significant differences compared to the control group. A MTHFR polymorphism was found in 116 out of the 214 hyperhomocysteinemic patients, i.e., in the 54% of the overall patient population with hyperhomocysteinemia (214 patients. Interestingly 750 (52% out of the 1430 blood relatives of the 116 patients with hyperhomocysteinemia and MTHFR polymorphisms showed at least one

  3. Loss-of-Function Mutations in APOC3 and Risk of Ischemic Vascular Disease

    DEFF Research Database (Denmark)

    Jørgensen, Anders Berg; Frikke-Schmidt, Ruth; Nordestgaard, Børge G

    2014-01-01

    of ischemic cardiovascular disease in the general population is unknown. METHODS: Using data from 75,725 participants in two general-population studies, we first tested whether low levels of nonfasting triglycerides were associated with reduced risks of ischemic vascular disease and ischemic heart disease....... Second, we tested whether loss-of-function mutations in APOC3, which were associated with reduced levels of nonfasting triglycerides, were also associated with reduced risks of ischemic vascular disease and ischemic heart disease. During follow-up, ischemic vascular disease developed in 10...... (350 mg per deciliter) or more (hazard ratio for ischemic vascular disease, 0.43; 95% confidence interval [CI], 0.35 to 0.54; hazard ratio for ischemic heart disease, 0.40; 95% CI, 0.31 to 0.52). Heterozygosity for loss-of-function mutations in APOC3, as compared with no APOC3 mutations, was associated...

  4. Impact of vascular diseases on the progression of mild cognitive impairment to Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Marta Nesteruk

    2015-04-01

    Full Text Available Introduction: Mild cognitive impairment does not meet the criteria for the diagnosis of dementia, but reaching this diagnosis raises concern about the future state of a patient due to the possibility of the conversion to Alzheimer’s disease. Although the aetiology of Alzheimer’s disease is neurodegenerative, the impact of vascular diseases is also taken into consideration. The aim of this study was to assess the impact of vascular diseases in patients diagnosed with mild cognitive impairment on the conversion to Alzheimer’s disease. Material and methods: In each of 101 patients with a diagnosis of mild cognitive impairment, a detailed medical history was taken, taking into account: hypertension, ischaemic heart disease, arrhythmias, myocardial infarction, stroke, diabetes as well as thyroid diseases, head injuries, alcohol abuse, smoking, exposure to toxic substances, surgery under general anaesthesia and the family character of dementia. Clinical follow-ups were scheduled after 6, 12 and 24 months. Results: Amongst 101 patients with mild cognitive impairment, 17 (16.8% converted to Alzheimer’s disease within two years of observation. The analysis of the distribution of independence tests showed that the conversion is significant for two variables: ischaemic heart disease and myocardial infarction.

  5. Heterozygosity for R1141X in ABCC6 and risk of ischemic vascular disease

    DEFF Research Database (Denmark)

    Hornstrup, Louise S; Tybjærg-Hansen, Anne; Haase, Christiane L

    2011-01-01

    Pseudoxanthoma elasticum (PXE) is an autosomal recessive disease caused by loss-of-function mutations in ABCC6 and characterized by elastic calcification leading to dermal, ocular, and ischemic vascular disease. We tested the hypothesis that heterozygosity for R1141X, the most frequent PXE......-causing mutation in Caucasians, associated with risk of ischemic vascular disease, as previous studies suggested 4- to 11-fold risk of ischemic heart disease (IHD) in heterozygotes....

  6. Evaluation of computer tomography in cerebro-vascular disease (Strokes)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Sik; Baek, Seung Yon; Rhee, Chung Sik; Kim, Hee Seup [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    Most of cerebrovascular disease are composed of vascular occulusive changes and hemorrhage. Now a day, the computed tomography is the best way for evaluation of cerebrovascular disease including detection of nature, location, and associated changes. This study includes evaluation of computed tomography of 70 patients with cerebrovascular disease during the period of 10 months from April. 1983 to Feb. 1984 in Department of Radiology, Ewha Womans University Hospital. The results were as follows: 1. Age distribution of the total 70 patients was broad ranging from 25 years to 79 years. 78.6% of patients were over the age of 50. The male and female sex ratio was 1.4:1. 2. 4 out of 70 patients were normal and 66 patients revealed abnormal on C.T. findings; those were intracranial hemorrhage (28 patients), cerebral infarction (34 patients) and brain atrophy (4 patients). 3. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (28 cases), and next was basal ganglia (2 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. 4. In cases of intracranial hemorrhage, the basal ganglia was most common site of lesion (15 cases). The next common site was cerebral hemisphere (9 cases). 6 patients of all intracranial hemorrhage were combined with intraventricular hemorrhage. Ratio of right and left was 2:3. 5. In patients with motor weakness or hemiparesis, more common findings on CT scan were cerebral infarction. In case with hemiplegia, more common CT findings were intracerebral hemorrhage. 6. Of the 40 cases thought to be cerebral infarction initially by clinical findings and spinal tap. 8 cases (20.0%) were proved to be cerebral hemorrhage by the CT scan. However, of the 22 cases thought to be cerebral hemorrhage, initially, only two cases (9.0%) were cerebral infarction.

  7. Microparticle subpopulations are potential markers of disease progression and vascular dysfunction across a spectrum of connective tissue disease

    Directory of Open Access Journals (Sweden)

    E.M. McCarthy

    2017-06-01

    The association between circulating MP levels and objective assessment of macro- and microvascular dysfunction within these disease areas suggests that MPs might have a useful role as novel circulating biomarkers of vascular disease within the CTDs.

  8. Primitive reflexes distinguish vascular parkinsonism from Parkinson's disease.

    Science.gov (United States)

    Okuda, Bungo; Kawabata, Keita; Tachibana, Hisao; Kamogawa, Kenji; Okamoto, Kensho

    2008-06-01

    Although vascular parkinsonism (VP) occurs frequently in the elderly, its clinical features have not been investigated in detail, particularly in comparison with Parkinson's disease (PD). The goal of this study is to clarify the diagnostic value of pathological reflexes in differentiating between VP and PD. In 132 patients with PD and 55 with VP, pathological reflexes, including snout reflex (SR), palmomental reflex (PMR), corneomandibular reflex (CMR), jaw reflex (JR), Hoffmann reflex (HR), and extensor plantar response (EPR), were evaluated. The percentage of each pathological reflex elicited in two groups (VP:PD) was as follows: SR (78:30), PMR (53:26), CMR (9:6), JR (33:12), HR (29:11), and EPR (25:8). The prevalence of pathological reflexes, except for CMR, was significantly higher in the VP patients than in the PD patients. In particular, SR and PMR were more frequent than upper motor neuron signs in the VP patients. The sensitivity and specificity of either SR or PMR for VP were 84% and 82%. Snout and palmomental reflexes are useful tools in the differentiation between VP and PD.

  9. Pharmacogenetics of Vascular Risk Factors in Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Ramón Cacabelos

    2018-01-01

    Full Text Available Alzheimer’s disease (AD is a polygenic/complex disorder in which genomic, epigenomic, cerebrovascular, metabolic, and environmental factors converge to define a progressive neurodegenerative phenotype. Pharmacogenetics is a major determinant of therapeutic outcome in AD. Different categories of genes are potentially involved in the pharmacogenetic network responsible for drug efficacy and safety, including pathogenic, mechanistic, metabolic, transporter, and pleiotropic genes. However, most drugs exert pleiotropic effects that are promiscuously regulated for different gene products. Only 20% of the Caucasian population are extensive metabolizers for tetragenic haplotypes integrating CYP2D6-CYP2C19-CYP2C9-CYP3A4/5 variants. Patients harboring CYP-related poor (PM and/or ultra-rapid (UM geno-phenotypes display more irregular profiles in drug metabolism than extensive (EM or intermediate (IM metabolizers. Among 111 pentagenic (APOE-APOB-APOC3-CETP-LPL haplotypes associated with lipid metabolism, carriers of the H26 haplotype (23-TT-CG-AG-CC exhibit the lowest cholesterol levels, and patients with the H104 haplotype (44-CC-CC-AA-CC are severely hypercholesterolemic. Furthermore, APOE, NOS3, ACE, AGT, and CYP variants influence the therapeutic response to hypotensive drugs in AD patients with hypertension. Consequently, the implementation of pharmacogenetic procedures may optimize therapeutics in AD patients under polypharmacy regimes for the treatment of concomitant vascular disorders.

  10. Sex differences in sub-clinical psychosis--results from a community study over 30 years.

    Science.gov (United States)

    Rössler, Wulf; Hengartner, Michael P; Ajdacic-Gross, Vladeta; Haker, Helene; Angst, Jules

    2012-08-01

    Sex differences in schizophrenia have long been reported. They are found within almost all aspects of the disease, from incidence and prevalence, age of onset, symptomatology, and course to its psycho-social outcome. Many sex-related hypotheses have been developed about the biology, psychology, or sociology of that disease. A further approach to study sex differences would be to examine such differences in sub-clinical psychotic states as well. If factors related to full-blown psychosis were equally meaningful over the entire psychosis continuum, we should expect that "true" sex differences could also be identified in sub-clinical psychosis. Here, we studied sex differences in sub-clinical psychosis within a community cohort in Zurich, Switzerland. This population was followed for over 30 years and included males and females between the ages of 20/21 and 49/50. We applied two different measures of sub-clinical psychosis representing schizotypal signs and schizophrenia nuclear symptoms. Using cross-sectional and longitudinal analyses, we found no significant sex differences in sub-clinical psychosis over time with respect to age of onset, symptomatology, course, or psycho-social outcome. Thus it appears that sex differences in psychosis manifest themselves at the high end of the continuum (full-blown schizophrenia) rather than within the sub-threshold range. Possibly males and females have separate thresholds for certain symptoms because they are differently vulnerable or exposed to various risk factors. Copyright © 2012. Published by Elsevier B.V.

  11. Pulmonary manifestations in collagen vascular diseases; Pulmonale Manifestationen bei Kollagenosen

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    Vogel, M.N.A. [Thoraxklinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Kreuter, M. [Thoraxklinik, Universitaetsklinikum Heidelberg, Zentrum fuer interstitielle und seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Kauczor, H.U. [Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany); Heussel, C.P. [Thoraxklinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Heidelberg (Germany); Radiologische Klinik, Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaetsklinikum Heidelberg, Translational Lung Research Center (TLRC), Heidelberg (Germany)

    2016-10-15

    Pulmonary complications are frequent in patients with collagen vascular diseases (CVD). Frequent causes are a direct manifestation of the underlying disease, side effects of specific medications and lung infections. The standard radiological procedure for the work-up of pulmonary pathologies in patients with CVD is multidetector computed tomography (MDCT) with thin-slice high-resolution reconstruction. The accuracy of thin-slice CT for the identification of particular disease patterns is very high. The pattern of usual interstitial pneumonia (UIP) representing the direct pulmonary manifestation of rheumatoid arthritis (RA) can be identified with a sensitivity of 45 % and a specificity of 96 %. Both direct pulmonary manifestations, drug-induced toxicity and certain infections can have a similar appearance in thin-slice MDCT in various forms of CVD. Knowledge of the patterns and causes contributes to the diagnostic certainty. At first diagnosis of a CVD and associated pulmonary symptoms thin-slice MDCT is recommended. Clinical, lung function and imaging follow-up examinations should be performed every 6-12 months depending on the results of the MDCT. In every case the individual CT morphological patterns of pulmonary involvement must be identified. The combination of information on the anamnesis, clinical and imaging results is a prerequisite for an appropriate disease management. (orig.) [German] Pulmonale Komplikationen sind bei Patienten mit Kollagenosen keine Seltenheit. Haeufig sind eine direkte Manifestation der Grunderkrankung, eine Nebenwirkung der medikamentoesen Therapie oder eine Lungeninfektion die Ursachen. Das radiologische Standardverfahren zur Klaerung pulmonaler Pathologien bei Patienten mit Kollagenosen ist die Multidetektorcomputertomographie mit duennschichtigen Rekonstruktionen (Duennschicht-MDCT). Die Treffsicherheit der Duennschicht-MDCT ist fuer die Identifikation eines Erkrankungsmusters sehr hoch. So kann beispielsweise das Muster einer

  12. Antithrombotic treatment in patients with heart failure and associated atrial fibrillation and vascular disease

    DEFF Research Database (Denmark)

    Lamberts, Morten; Lip, Gregory Y. H.; Ruwald, Martin H.

    2014-01-01

    OBJECTIVES: The aim of this study was to investigate the impact of atrial fibrillation (AF) and antithrombotic treatment on the prognosis in patients with heart failure (HF) as well as vascular disease. BACKGROUND: HF, vascular disease, and AF are pathophysiologically related, and understanding...... antithrombotic treatment for these conditions is crucial. METHODS: In hospitalized patients with HF and coexisting vascular disease (coronary artery disease or peripheral arterial disease) followed from 1997 to 2009, AF status was categorized as prevalent AF, incident AF, or no AF. Risk of thromboembolism (TE...... differences were seen between antithrombotic therapies in TE or MI risk, whereas bleeding risk was significantly increased for VKA with and without single-antiplatelet therapy. CONCLUSIONS: In AF patients with coexisting HF and vascular disease, adding single-antiplatelet therapy to VKA therapy...

  13. Axon-glial disruption: the link between vascular disease and Alzheimer's disease?

    Science.gov (United States)

    Horsburgh, Karen; Reimer, Michell M; Holland, Philip; Chen, Guiquan; Scullion, Gillian; Fowler, Jill H

    2011-08-01

    Vascular risk factors play a critical role in the development of cognitive decline and AD (Alzheimer's disease), during aging, and often result in chronic cerebral hypoperfusion. The neurobiological link between hypoperfusion and cognitive decline is not yet defined, but is proposed to involve damage to the brain's white matter. In a newly developed mouse model, hypoperfusion, in isolation, produces a slowly developing and diffuse damage to myelinated axons, which is widespread in the brain, and is associated with a selective impairment in working memory. Cerebral hypoperfusion, an early event in AD, has also been shown to be associated with white matter damage and notably an accumulation of amyloid. The present review highlights some of the published data linking white matter disruption to aging and AD as a result of vascular dysfunction. A model is proposed by which chronic cerebral hypoperfusion, as a result of vascular factors, results in both the generation and accumulation of amyloid and injury to white matter integrity, resulting in cognitive impairment. The generation of amyloid and accumulation in the vasculature may act to perpetuate further vascular dysfunction and accelerate white matter pathology, and as a consequence grey matter pathology and cognitive decline.

  14. The vascular phenotype in pseudoxanthoma elasticum and related disorders: Contribution of a genetic disease to the understanding of vascular calcification.

    Directory of Open Access Journals (Sweden)

    Georges eLeftheriotis

    2013-02-01

    Full Text Available Vascular calcification is a complex and dynamic process occurring in various physiological conditions such as aging and exercise or in acquired metabolic disorders like diabetes or chronic renal insufficiency. Arterial calcifications are also observed in several genetic diseases revealing the important role of unbalanced or defective anti- or pro-calcifying factors. Pseudoxanthoma elasticum (PXE is an inherited disease (OMIM 264800 characterized by elastic fiber fragmentation and calcification in various soft conjunctive tissues including the skin, eyes and arterial media. The PXE disease results from mutations in the ABCC6 gene, encoding an ATP-binding cassette transporter primarily expressed in the liver, kidneys suggesting that it is a prototypic metabolic soft-tissue calcifying disease of genetic origin. The clinical expression of the PXE arterial disease is characterized by an increased risk for coronary (myocardial infarction, cerebral (aneurysm and stroke and lower limb peripheral artery disease. However, the structural and functional changes in the arterial wall induced by PXE are still unexplained. The use of a recombinant mouse model inactivated for the Abcc6 gene is an important tool for the understanding of the PXE pathophysiology although the vascular impact in this model remains limited to date. Overlapping of the PXE phenotype with other inherited calcifying diseases could bring important informations to our comprehension of the PXE disease.

  15. Alois Alzheimer and vascular brain disease: Arteriosclerotic atrophy of the brain

    Directory of Open Access Journals (Sweden)

    Eliasz Engelhardt

    Full Text Available Alois Alzheimer is best known for his description of neurofibrillary changes in brain neurons of a demented patient, identifying a novel disease, soon named after him by Kraepelin. However, the range of his studies was broad, including vascular brain diseases, published between 1894 and 1902. Alzheimer described the clinical picture of Arteriosclerotic atrophy of the brain, differentiating it from other similar disorders. He stated that autopsy allowed pathological distinction between arteriosclerosis and syphilis, thereby achieving some of his objectives of segregating disorders and separating them from syphilis. His studies contributed greatly to establishing the key information on vascular brain diseases, predating the present state of knowledge on the issue, while providing early descriptions of what would be later regarded as the dimensional presentation of the now called "Vascular cognitive impairment", constituted by a spectrum that includes a stage of "Vascular cognitive impairment not dementia" and another of "Vascular dementia".

  16. The role of Hippo/yes-associated protein signalling in vascular remodelling associated with cardiovascular disease.

    Science.gov (United States)

    He, Jinlong; Bao, Qiankun; Yan, Meng; Liang, Jing; Zhu, Yi; Wang, Chunjiong; Ai, Ding

    2017-04-03

    Vascular remodelling is a vital process of a wide range of cardiovascular diseases and represents the altered structure and arrangement of blood vessels. The Hippo pathway controls organ size by regulating cell survival, proliferation and apoptosis. Yes-associated protein (YAP), a transcription coactivator, is a downstream effector of the Hippo pathway. There is growing evidence for the importance of the Hippo/YAP pathway in vascular-remodelling and related cardiovascular diseases. The Hippo/YAP pathway alters extracellular matrix production or degradation and the growth, death and migration of vascular smooth muscle cells and endothelial cells, which contributes to vascular remodelling in cardiovascular diseases such as pulmonary hypertension, atherosclerosis, restenosis, aortic aneurysms and angiogenesis. In this review, we summarize and discuss recent findings about the roles and mechanisms of Hippo/YAP signalling in vascular remodelling and related conditions. © 2017 The British Pharmacological Society.

  17. Metabolic syndrome and incidence of type 2 diabetes in patients with manifest vascular disease

    NARCIS (Netherlands)

    Wassink, A.M.J.; Graaf, van der Y.; Soedamah-Muthu, S.S.; Spiering, W.; Visseren, F.L.J.

    2008-01-01

    Risk reduction in patients with clinically manifest vascular disease focuses on preventing new vascular events and not on prevention of type 2 diabetes. However, given the common pathophysiological pathways involved in the development of atherosclerosis and type 2 diabetes, it is probable that

  18. Clinical correlation of mesenteric vascular disease in older patients.

    Science.gov (United States)

    Cardin, Fabrizio; Fratta, Stefania; Perissinotto, Egle; Casarrubea, Giuseppe; Inelmen, Emine Meral; Terranova, Claudio; Sergi, Giuseppe; Militello, Carmelo

    2012-06-01

    Mesenteric vascular obstruction is difficult to characterize, since it may produce differing acute or chronic clinical pictures and various organic symptoms, such as ischemic colitis and abdominal angina. The diagnosis of chronic mesenteric ischemia (CMI) is thus still mainly based on historic diagnostic criteria drawn up before non-invasive radiological imaging of the mesenteric vessels became widespread, and before the current demographic developments leading to a rise in the number of older patients with multiple pathologies. With this premise, we studied the clinical condition of 85 patients aged over 65 years of age, submitted to angio-CT scan for reasons other than neoplastic and general pathologies which may cause alterations in mesenteric blood flow, and without the typical symptoms of acute intestinal ischemia. Of these, 34 patients presented occlusion of at least one mesenteric vessel and 13 were affected by multivessel injury. Compared with controls, patients with mesenteric artery disease had lower BMI (24.9+/-3.3 vs 26.8+/-4.5) and longer hospital stays (14 vs 6 days), and were more frequently affected by vasculopathies in other districts (97.1% vs 80.4%), but the only bowel symptom present was diarrhea (21.2% vs 5.9%). These patients also took more benzodiazepines and acetylsalicylic acid. The results of stepwise logistic analysis of length of hospital stay, vasculopathies, diarrhea, and use of benzodiazepines yielded a predictive model with an AUC (area under the curve) of 0.81. Our data show that some features characterizing CMI in the geriatric population differ from those of the general population.

  19. Reactive oxygen species and angiotensin II signaling in vascular cells: implications in cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Touyz R.M.

    2004-01-01

    Full Text Available Diseases such as hypertension, atherosclerosis, hyperlipidemia, and diabetes are associated with vascular functional and structural changes including endothelial dysfunction, altered contractility and vascular remodeling. Cellular events underlying these processes involve changes in vascular smooth muscle cell (VSMC growth, apoptosis/anoikis, cell migration, inflammation, and fibrosis. Many factors influence cellular changes, of which angiotensin II (Ang II appears to be amongst the most important. The physiological and pathophysiological actions of Ang II are mediated primarily via the Ang II type 1 receptor. Growing evidence indicates that Ang II induces its pleiotropic vascular effects through NADPH-driven generation of reactive oxygen species (ROS. ROS function as important intracellular and intercellular second messengers to modulate many downstream signaling molecules, such as protein tyrosine phosphatases, protein tyrosine kinases, transcription factors, mitogen-activated protein kinases, and ion channels. Induction of these signaling cascades leads to VSMC growth and migration, regulation of endothelial function, expression of pro-inflammatory mediators, and modification of extracellular matrix. In addition, ROS increase intracellular free Ca2+ concentration ([Ca2+]i, a major determinant of vascular reactivity. ROS influence signaling molecules by altering the intracellular redox state and by oxidative modification of proteins. In physiological conditions, these events play an important role in maintaining vascular function and integrity. Under pathological conditions ROS contribute to vascular dysfunction and remodeling through oxidative damage. The present review focuses on the biology of ROS in Ang II signaling in vascular cells and discusses how oxidative stress contributes to vascular damage in cardiovascular disease.

  20. Human perivascular adipose tissue dysfunction as a cause of vascular disease: Focus on vascular tone and wall remodeling.

    Science.gov (United States)

    Ozen, Gulsev; Daci, Armond; Norel, Xavier; Topal, Gokce

    2015-11-05

    Obesity is one of the major risk factors for the development of cardiovascular diseases. It is characterized by excessive or abnormal accumulation of adipose tissue, including depots which surround the blood vessels named perivascular adipose tissue (PVAT). PVAT plays endocrine and paracrine roles by producing large numbers of metabolically vasoactive adipokines. The present review outlines our current understanding of the beneficial roles of PVAT in vascular tone and remodeling in healthy subjects supported by clinical studies, highlighting different factors or mechanisms that could mediate protective effects of PVAT on vascular function. Most studies in humans show that adiponectin is the best candidate for the advantageous effect of PVAT. However, in pathological conditions especially obesity-related cardiovascular diseases, the beneficial effects of PVAT on vascular functions are impaired and transform into detrimental roles. This change is defined as PVAT dysfunction. In the current review, the contribution of PVAT dysfunction to obesity-related cardiovascular diseases has been discussed with a focus on possible mechanisms including an imbalance between beneficial and detrimental adipokines (commonly described as decreased levels of adiponectin and increased levels of leptin or tumor necrosis factor-alpha (TNFα)), increased quantity of adipose tissue, inflammation, cell proliferation and endothelial dysfunction. Finally, novel pharmacotherapeutic targets for the treatment of cardiovascular and metabolic disorders are addressed. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Microorganisms associated with sub-Clinical mastitis and their ...

    African Journals Online (AJOL)

    Camels are adapted to the arid and semi arid lands (ASAL), but their full milking potential is affected by udder infection especially sub-clinical mastitis. The purpose of this study was to identify the most common pathogens responsible for sub-clinical mastitis in camels kept under ranch conditions in Northern Kenya. A total of ...

  2. Neuropsychiatric symptoms in patients with Alzheimer's disease with a vascular component.

    Science.gov (United States)

    Bidzan, Mariola; Bidzan, Leszek; Pachalska, Maria

    2014-01-01

    Vascular changes are observed in most cases of Alzheimer's disease (AD). Observations of AD and vascular disease (VD) allow us to surmise that vascular changes may not only affect cognitive impairment in AD but may also have a negative influence on the neuropsychiatric symptoms which often occur in the course of the disease. The aim of the study was to evaluate the impact of vascular factors on the neuropsychiatric symptoms in Alzheimer's Disease. The study included 48 people with a preliminary diagnosis of Alzheimer's Disease on the basis of NINCDS/ADRDA criteria. The evaluation of impairments in cognitive functioning was carried out by means of the Alzheimer Disease Assessment Scale - the cognitive part (ADAS - cog), whereas the behavioural and psychological symptoms were evaluated by means of the Neuropsychiatric Inventory - the version adapted for residents of nursing homes for the elderly (Neuropsychiatric Inventory - Nursing Home Version) (NPI - NH). The score on the Hachinski scale was the basis for dividing the study participants into two groups - those with a mild vascular component (0-1 points on the Hachinski scale) and those with a severe vascular component (2-4 points). The analyzed groups did not differ with respect to the intensity of cognitive impairments (ADAS-cog) or age of the participants. Scores obtained on the NPI - NH scale as well as some of its elements (depression/dysphoria and anxiety) had a discriminating value. Studies show that vascular factors are a serious risk factor for neuropsychiatric symptoms in AD. Vascular factors in Alzheimer's Disease influence the presence of neuropsychiatric symptoms. In the course of angiogenic dementia a greater frequency in depressive disorders was shown. The most visible differences between individuals with a greater and lesser burden of vascular factors was in the realm of depressive and dysphoric disorders.

  3. Neuropsychiatric symptoms in patients with Alzheimer’s disease with a vascular component

    Directory of Open Access Journals (Sweden)

    Mariola Bidzan

    2014-06-01

    Full Text Available objective. Vascular changes are observed in most cases of Alzheimer’s disease (AD. Observations of AD and vascular disease (VD allow us to surmise that vascular changes may not only affect cognitive impairment in AD but may also have a negative influence on the neuropsychiatric symptoms which often occur in the course of the disease. The aim of the study was to evaluate the impact of vascular factors on the neuropsychiatric symptoms in Alzheimer’s Disease. material and methods. The study included 48 people with a preliminary diagnosis of Alzheimer’s Disease on the basis of NINCDS/ADRDA criteria. The evaluation of impairments in cognitive functioning was carried out by means of the Alzheimer Disease Assessment Scale – the cognitive part (ADAS – cog, whereas the behavioural and psychological symptoms were evaluated by means of the Neuropsychiatric Inventory – the version adapted for residents of nursing homes for the elderly (Neuropsychiatric Inventory – Nursing Home Version (NPI – NH. The score on the Hachinski scale was the basis for dividing the study participants into two groups – those with a mild vascular component (0–1 points on the Hachinski scale and those with a severe vascular component (2–4 points. results. The analyzed groups did not differ with respect to the intensity of cognitive impairments (ADAS-cog or age of the participants. Scores obtained on the NPI – NH scale as well as some of its elements (depression/dysphoria and anxiety had a discriminating value. Studies show that vascular factors are a serious risk factor for neuropsychiatric symptoms in AD. conclusions. Vascular factors in Alzheimer’s Disease influence the presence of neuropsychiatric symptoms. In the course of angiogenic dementia a greater frequency in depressive disorders was shown. The most visible differences between individuals with a greater and lesser burden of vascular factors was in the realm of depressive and dysphoric disorders.

  4. Genetic variation in the cholesterol transporter NPC1L1, ischaemic vascular disease, and gallstone disease

    DEFF Research Database (Denmark)

    Lauridsen, Bo Kobberø; Stender, Stefan; Frikke-Schmidt, Ruth

    2015-01-01

    variation in NPC1L1, mimicking the effect of ezetimibe, was associated with reduced risk of ischaemic vascular disease (IVD) and with increased risk of symptomatic gallstone disease. METHODS AND RESULTS: We included 67 385 individuals from the general population. Of these, 5255 and 3886 individuals...... developed IVD or symptomatic gallstone disease, respectively, during follow-up from 1977 to 2013. We genotyped four common NPC1L1 variants, previously associated with reduced LDL cholesterol levels, thus mimicking the effect of ezetimibe, and calculated a weighted genotype score. With increasing genotype...... score, LDL cholesterol decreased stepwise up to 3.5% (0.12 mmol/L) and total cholesterol up to 1.9% (0.11 mmol/L) (P-trend: 2 × 10(-12) and 2 × 10(-9)). The cumulative incidence by age of IVD decreased, while that of symptomatic gallstone disease increased as a function of increasing genotype score (P...

  5. Predictors of the Progression of Dementia Severity in Brazilian Patients with Alzheimer's Disease and Vascular Dementia

    Directory of Open Access Journals (Sweden)

    Márcia L. Chaves

    2010-01-01

    Full Text Available Introduction. This study evaluates the progression of dementia and identifies prognostic risk factors for dementia. Methods. A group of 80 Brazilian community residents with dementia (34 with Alzheimer's disease and 46 with vascular dementia was assessed over the course of 2 years. Data were analyzed with Cox regression survival analysis. Results. The data showed that education predicted cognitive decline (HR=1.2; P<.05 when analyzed without controlling for vascular risk factors. After the inclusion of vascular risk factors, education (HR=1.32; P<.05 and hypertension were predictive for cognitive decline (HR=38; P<.05, and Alzheimer's disease diagnosis was borderline predictive (P=.055. Conclusion. Vascular risk factors interacted with the diagnosis of vascular dementia. Education was a strong predictor of decline.

  6. Effect of sub-clinical mastitis on milk yield and composition of dairy ...

    African Journals Online (AJOL)

    Production of dairy goats is on the increase in East African countries. As in cows, prevalence of mastitis in dairy goats appears to be high but studies on the influence of this disease on milk yield and composition are scarce. This study was, therefore, carried out to determine the effect of sub-clinical mastitis on milk yield and ...

  7. Vascular care in patients with Alzheimer's disease with cerebrovascular lesions-a randomized clinical trial

    NARCIS (Netherlands)

    Richard, Edo; Kuiper, Roy; Dijkgraaf, Marcel G. W.; van Gool, Willem A.

    2009-01-01

    OBJECTIVES: To investigate whether vascular care slows dementia progression in patients with Alzheimer's disease with cerebrovascular lesions on neuroimaging. DESIGN: Multicenter randomized controlled clinical trial with 2-year follow-up. SETTING: Neurological and geriatric outpatient clinics in 10

  8. Nanoparticles as magnetic resonance imaging contrast agents for vascular and cardiac diseases

    NARCIS (Netherlands)

    Chen, Wei; Cormode, David P.; Fayad, Zahi A.; Mulder, Willem J. M.

    2011-01-01

    Advances in nanoparticle contrast agents for molecular imaging have made magnetic resonance imaging a promising modality for noninvasive visualization and assessment of vascular and cardiac disease processes. This review provides a description of the various nanoparticles exploited for imaging

  9. Contribution of vascular risk factors to disease progression in Alzheimer’s Disease

    Science.gov (United States)

    Helzner, Elizabeth P.; Luchsinger, José A.; Scarmeas, Nikolaos; Cosentino, Stephanie; Brickman, Adam M.; Glymour, M. Maria; Stern, Yaakov

    2010-01-01

    Objective To determine whether pre-diagnosis vascular risk factors are associated with Alzheimer’s disease progression. Design Inception cohort followed longitudinally for a mean of 3.5 (up to 10.2) years. Setting Washington Heights Inwood Columbia Aging Project, New York City Participants 156 incident AD patients (mean age 83 years at diagnosis) Predictor variables Vascular factors including medical history (heart disease, stroke, diabetes, hypertension), smoking, and pre-diagnosis blood lipid measurements (total cholesterol, High density lipoproteins (HDL-C), Low density lipoproteins (LDL-C) and triglycerides). Main Outcome Measure Change in a composite score of cognitive ability from diagnosis on. Results In Generalized Estimating Equation (GEE) models (adjusted for age, race/ethnicity and education), higher cholesterol (total and LDL-C), and diabetes history were associated with faster cognitive decline. Each 10-unit increase in cholesterol and LDL-C was associated with a 10% of a standard deviation decrease in cognitive score per year of follow-up (p<0.001 for total cholesterol, p=0.001 for LDL-C). HDL and triglycerides were not associated with rate of decline. Diabetes history was associated with an additional 50% of a standard deviation decrease in cognitive score per year (p=0.05). History of heart disease and stroke were associated with cognitive decline among APOE-ε4 carriers only. In a final GEE model that included HDL-C, LDL-C and diabetes, only higher LDL-C was independently associated with faster cognitive decline. Conclusions Higher pre-diagnosis total cholesterol, LDL-C, and diabetes were associated with faster cognitive decline among incident AD patients, providing further evidence for the role of vascular risk factors in Alzheimer’s disease course. PMID:19273753

  10. Aspects of Subcortical Ischaemic Vascular Disease : Early clinical manifestations and associations with Type 2 diabetes mellitus

    OpenAIRE

    Harten, van, B.

    2006-01-01

    Summary Subcortical ischaemic vascular disease (SIVD) is an important cause of cognitive impairment in elderly patients. Screening and diagnostic tests are needed to identify these patients. The HIV dementia scale (HDS) is a reliable and quantitative scale for identifying HIV dementia1. The cognitive profile of HIV dementia has subcortical features that resemble subcortical ischaemic vascular disease (SIVD). The clinical syndrome is characterized by early impairment of attention and executive...

  11. Vascular endothelial growth factor in children with cyanotic and acyanotic and congenital heart disease

    OpenAIRE

    Baghdady, Yasser; Hussein, Yasser; Shehata, Mohamed

    2010-01-01

    Introduction Vascular endothelial growth factor is a potent stimulator of angiogenesis. Children with cyanotic congenital heart disease often experience the development of widespread formation of collateral blood vessels, which may represent a form of abnormal angiogenesis resulting in increased morbidity and mortality. We undertook the present study to determine whether children with cyanotic congenital heart disease have elevated serum levels of vascular endothelial growth factor compared t...

  12. Contribution of blood platelets to vascular pathology in Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Zhang W

    2013-11-01

    Full Text Available Wei Zhang,1,2 Wei Huang,1 Fang Jing11Department of Pharmacology, Institutes for Advanced Interdisciplinary Research, East China Normal University, Shanghai, People's Republic of China; 2Shanghai Engineering Research Center of Molecular Therapy and Pharmaceutical Innovation, Shanghai, People's Republic of ChinaAbstract: Cerebral amyloid angiopathy (CAA is a critical factor in the pathogenesis of Alzheimer's disease (AD. In the clinical setting, nearly 98% AD patients have CAA, and 75% of these patients are rated as severe CAA. It is characterized by the deposition of the β-amyloid peptide (mainly Aβ40 in the walls of cerebral vessels, which induces the degeneration of vessel wall components, reduces cerebral blood flow, and aggravates cognitive decline. Platelets are anuclear cell fragments from bone marrow megakaryocytes and their function in hemostasis and thrombosis has long been recognized. Recently, increasing evidence suggests that platelet activation can also mediate the onset and development of CAA. First, platelet activation and adhesion to a vessel wall is the initial step of vascular injury. Activated platelets contribute to more than 90% circulating Aß (mainly Aβ1-40, which in turn activates platelets and results in the vicious cycle of Aβ overproduction in damaged vessel. Second, the uncontrolled activation of platelets leads to a chronic inflammatory reaction by secretion of chemokines (eg, platelet factor 4 [PF4], regulated upon activation normal T-cell expressed and presumably secreted [RANTES], and macrophage inflammatory protein [MIP-1α], interleukins (IL-1 β, IL-7, and IL-8, prostaglandins, and CD40 ligand (CD40L. The interaction of these biological response modulators with platelets, endothelial cells, and leukocytes establishes a localized inflammatory response that contributes to CAA formation. Finally, activated platelets are the upholder of fibrin clots, which are structurally abnormal and resistant to degradation

  13. Control of Vascular Streak Dieback Disease of Cocoa with Flutriafol Fungicides

    Directory of Open Access Journals (Sweden)

    Febrilia Nur'aini

    2014-12-01

    Full Text Available Vascular streak dieback caused by the fungus Oncobasidium theobromae is one of the important diseases in cocoa crop in Indonesia. One approach to control the disease is by using fungicides. The aim of this research was to determine the effect of class triazole fungicides to the intensity of the vascular streak dieback disease on cocoa seedling phase, immature and mature cocoa. Experiments were conducted in Kotta Blater, PTPN XII and Kaliwining, Indonesian  Coffee and Cocoa Research Institute. Flutriafol 250 g/l with a concentration 0,05%, 0,1% and 0,15% foliar sprayed on cocoa seedlings, immature and mature cocoa. Active compound combination of Azoxystrobin and Difenoconazole with 0,1% concentration used as a comparation fungicides. The result showed that Flutriafol with 0,05%, 0,1% and 0,15% concentration and Azoxystrobin & Difenoconazol with 0,1% concentration could suppress the vascular streak dieback disease on seedlings. On immature plants, the application of Flutriafol was not effectively suppress the vascular streak dieback disease whereas the fungicide comparison could suppress with the efficacy level of 46.22%. On mature plants,both of fungicides could not suppress the vascular streak dieback disease. Key words: Fungicide, cocoa, vascular streak dieback, triazole, flutriafol, azoxystrobin+difenoconazol

  14. Lymphatic vascular morphogenesis in development, physiology, and disease

    NARCIS (Netherlands)

    Schulte-Merker, Stefan; Sabine, Amelie; Petrova, Tatiana V.

    2011-01-01

    The lymphatic vasculature constitutes a highly specialized part of the vascular system that is essential for the maintenance of interstitial fluid balance, uptake of dietary fat, and immune response. Recently, there has been an increased awareness of the importance of lymphatic vessels in many

  15. Vascular Care in Patients With Alzheimer Disease With Cerebrovascular Lesions Slows Progression of White Matter Lesions on MRI The Evaluation of Vascular Care in Alzheimer's Disease (EVA) Study

    NARCIS (Netherlands)

    Richard, E.; Gouw, A.A.; Scheltens, P.; van Gool, W.A.

    2010-01-01

    Background and Purpose:White matter lesions (WMLs) and cerebral infarcts are common findings in Alzheimer disease and may contribute to dementia severity. WMLs and lacunar infarcts may provide a potential target for intervention strategies. This study assessed whether multicomponent vascular care in

  16. Vascular Care in Patients With Alzheimer Disease With Cerebrovascular Lesions Slows Progression of White Matter Lesions on MRI The Evaluation of Vascular Care in Alzheimer's Disease (EVA) Study

    NARCIS (Netherlands)

    Richard, Edo; Gouw, Alida A.; Scheltens, Philip; van Gool, Willem A.

    2010-01-01

    Background and Purpose-White matter lesions (WMLs) and cerebral infarcts are common findings in Alzheimer disease and may contribute to dementia severity. WMLs and lacunar infarcts may provide a potential target for intervention strategies. This study assessed whether multicomponent vascular care in

  17. Family history of neurodegenerative and vascular diseases in ALS: a population-based study

    NARCIS (Netherlands)

    Huisman, M. H. B.; de Jong, S. W.; Verwijs, M. C.; Schelhaas, H. J.; van der Kooi, A. J.; de Visser, M.; Veldink, J. H.; van den Berg, L. H.

    2011-01-01

    To determine whether the frequency of Parkinson disease (PD), dementia, and vascular diseases in relatives of patients with amyotrophic lateral sclerosis (ALS) differs from the frequency of those diseases in relatives of controls, providing further information about the association between these

  18. Prevention of chronic kidney and vascular disease : Toward global health equity - The Bellagio 2004 Declaration

    NARCIS (Netherlands)

    Dirks, JH; De Zeeuw, D; Agarwal, SK; Atkins, RC; Correa-Rotter, R; D'Amico, G; Bennett, PH; El Nahas, M; Valdes, RH; Kaseje, D; Katz, IJ; Naicker, S; Rodriguez-Iturbe, B; Schieppati, A; Shaheen, F; Sitthi-Amorn, C; Solez, K; Viberti, G; Remuzzi, G; Weening, J.J.

    Chronic kidney disease (CKD) not only reflects target organ injury in systemic vascular disease in the general population and in association with diabetes, hypertension, and smoking, but it is recognized as one of the major risk factors in the pathogenesis and outcome of cardiovascular disease.

  19. Enhanced expression of fibroblast growth factors and receptor FGFR-1 during vascular remodeling in chronic obstructive pulmonary disease.

    NARCIS (Netherlands)

    Kranenburg, A.R.; Boer, W.I.; Krieken, J.H.J.M. van; Mooi, W.J.; Walters, J.E.; Saxena, P.R.; Sterk, P.J.; Sharma, H.S.

    2002-01-01

    Important characteristics of chronic obstructive pulmonary disease (COPD) include airway and vascular remodeling, the molecular mechanisms of which are poorly understood. We assessed the role of fibroblast growth factors (FGF) in pulmonary vascular remodeling by examining the expression pattern of

  20. Enhanced expression of fibroblast growth factors and receptor FGFR-1 during vascular remodeling in chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    A.R. Kranenburg (Andor); W.I. de Boer (Pim); J.H.J.M. van Krieken (Han); W.J. Mooi (Wolter); J.E. Walters (Jane); P.R. Saxena (Pramod Ranjan); P.J. Sterk (Peter); H.S. Sharma (Hari)

    2002-01-01

    textabstractImportant characteristics of chronic obstructive pulmonary disease (COPD) include airway and vascular remodeling, the molecular mechanisms of which are poorly understood. We assessed the role of fibroblast growth factors (FGF) in pulmonary vascular remodeling by

  1. [C-reactive protein and risk of ischaemic vascular and cerebrovascular disease--secondary publication

    DEFF Research Database (Denmark)

    Zacho, J.; Tybjaerg-Hansen, A.; Jensen, J.S.

    2009-01-01

    Elevated levels of C reactive protein (CRP) are associated with increased risk of ischaemic vascular disease. We tested whether this is a causal association. CRP > 3 vs disease of 1.6 and 1.3, respectively. Four...... vascular disease Udgivelsesdato: 2009/5/18...... CRP polymorphisms were associated with a 64% increase in CRP levels, resulting in a theoretically predicted increased risk of 32% and 25% for ischemic heart- and ischemic cerebrovascular disease, respectively. However, these genotype combinations were not associated with an increased risk of ischaemic...

  2. New Insights Into Tobacco-Induced Vascular Disease: Clinical Ramifications.

    Science.gov (United States)

    Cooke, John P

    2015-01-01

    Tobacco smoke contains more than 4,000 compounds. These include phenols, carbonyls, and nitrosamines that may be irritants and carcinogens; particulate matter such as tars; volatiles and gases such as carbon monoxide; and nicotine. Many of these compounds may contribute to the adverse health effects of tobacco. For example, recent findings have shown that the angiogenic and proliferative effects of nicotine are mediated by activation of nicotinic receptors on the vascular cells. Nicotine-induced activation of vascular cells may contribute to pathological neovascularization in cancer, age-related macular degeneration, and atherosclerosis. This review focuses on how nicotine adversely affects cardiovascular health and highlights intriguing new data about nicotine's potent angiogenic and proliferative properties.

  3. The Genesis of Graphic Perseverations in Alzheimer's Disease and Vascular Dementia.

    Science.gov (United States)

    De Lucia, Natascia; Grossi, Dario; Trojano, Luigi

    2015-01-01

    Perseveration is the involuntary production of iterative responses. This study explored graphic perseverative errors in Alzheimer's disease and vascular dementia, to comprehend the neuropsychological correlates of this behavior. We performed a retrospective analysis of graphic productions in 114 individuals with clinical diagnosis of Alzheimer's disease and in 63 individuals with clinical diagnosis of vascular dementia, who completed frontal-executive, visuo-spatial, visuo-constructional, and verbal memory tests. For assessing perseverative behavior, we considered recurrent perseverations (inappropriate re-drawing of a figure drawn in a previous trial) and continuous perseverations (inappropriate replication of the same figure or of its element within one trial) produced in a standard copying task. Two or more graphic perseverative errors occurred in 66/114 individuals with Alzheimer's disease (57.9%) and in 31/63 individuals with vascular dementia (49.2%). Participants with moderate-to-severe dementia produced a significantly higher number of perseverations than individuals with mild dementia. Logistic regression revealed a significant relationship of graphic perseverations with frontal and visuo-constructive impairments, in both Alzheimer's disease and vascular dementia. Graphic perseverations are frequent in both Alzheimer's disease and vascular dementia. Frontal-executive defects can hamper inhibition of iterative graphic productions. Identification of graphic perseverations can be useful for detection and monitoring of frontal-executive impairments throughout the disease course in individuals with dementia.

  4. Pathogenesis of diabetic vascular disease: evidence for the role of reduced heparan sulfate proteoglycan

    DEFF Research Database (Denmark)

    Jensen, Tonny Joran

    1997-01-01

    Insulin-dependent diabetic patients with increased urinary albumin excretion are characterized by elevated blood pressure and declining kidney function. In addition, such patients have a high risk of atherosclerotic vascular disease, proliferative retinopathy, and cardiomyopathy, suggesting...... that albuminuria is a marker of widespread vascular dysfunction. Increased transport of macromolecules across the vascular wall, elevated plasma levels of von Willebrand factor, and impaired fibrinolytic capacity have been demonstrated in albuminuric patients. The cause of this vascular vulnerability...... in susceptible patients is unknown, but increasing evidence has suggested that loss of the proteoglycan heparan sulfate in the vasculature may explain the widespread nature of the disease. Heparan sulfate is important for the glomerular endothelial cell and basement membrane charge densities, the anticoagulant...

  5. Vascular amyloidosis impairs the gliovascular unit in a mouse model of Alzheimer’s disease

    Science.gov (United States)

    Kimbrough, Ian F.; Robel, Stefanie

    2015-01-01

    Reduced cerebral blood flow impairs cognitive function and ultimately causes irreparable damage to brain tissue. The gliovascular unit, composed of neural and vascular cells, assures sufficient blood supply to active brain regions. Astrocytes, vascular smooth muscle cells, and pericytes are important players within the gliovascular unit modulating vessel diameters. While the importance of the gliovascular unit and the signals involved in regulating local blood flow to match neuronal activity is now well recognized, surprisingly little is known about this interface in disease. Alzheimer’s disease is associated with reduced cerebral blood flow. Here, we studied how the gliovascular unit is affected in a mouse model of Alzheimer’s disease, using a combination of ex vivo and in vivo imaging approaches. We specifically labelled vascular amyloid in living mice using the dye methoxy-XO4. We elicited vessel responses ex vivo using either pharmacological stimuli or cell-specific calcium uncaging in vascular smooth muscle cells or astrocytes. Multi-photon in vivo imaging through a cranial window allowed us to complement our ex vivo data in the presence of blood flow after label-free optical activation of vascular smooth muscle cells in the intact brain. We found that vascular amyloid deposits separated astrocyte end-feet from the endothelial vessel wall. High-resolution 3D images demonstrated that vascular amyloid developed in ring-like structures around the vessel circumference, essentially forming a rigid cast. Where vascular amyloid was present, stimulation of astrocytes or vascular smooth muscle cells via ex vivo Ca2+ uncaging or in vivo optical activation produced only poor vascular responses. Strikingly, vessel segments that were unaffected by vascular amyloid responded to the same extent as vessels from age-matched control animals. We conclude that while astrocytes can still release vasoactive substances, vascular amyloid deposits render blood vessels rigid and

  6. Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: The Second Manifestations of ARTerial (SMART) disease study

    NARCIS (Netherlands)

    Beulens, J.W.J.; Algra, A.; Soedamah-Muthu, S.S.; Visseren, F.L.J.; Grobbee, D.E.; Graaf, van der Y.

    2010-01-01

    OBJECTIVE: This study investigated the relation between alcohol consumption and specific vascular events and mortality in a high risk population of patients with clinical manifestations of vascular disease and diabetes. METHODS: Patients with clinically manifest vascular disease or diabetes (n=5447)

  7. Usefulness of Diffusion Tensor Imaging of White Matter in Alzheimer Disease and Vascular Dementia

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, S.; Kinoshita, T.; Matsusue, E.; Fujii, S.; Ogawa, T. [Tottori Univ., Yonago (Japan). Dept. of Radiology

    2004-10-01

    Purpose: To evaluate the usefulness of diffusion tensor imaging in detecting the water diffusivity caused by neuro pathological change in Alzheimer disease and vascular dementia. Material and Methods: Twenty patients with Alzheimer disease, 20 with vascular dementia, and 10 control subjects were examined. Diffusion tensor imaging applied diffusion gradient encoding in six non-collinear directions. Fractional anisotropy values were compared in the genu and splenium of the corpus callosum, and anterior and posterior white matter among the three groups. Results: In the patients with Alzheimer disease, fractional anisotropy values of the posterior white matter were significantly lower than those of controls. In patients with vascular dementia, fractional anisotropy values of the anterior white matter tended to be lower than those of the posterior white matter (P=0.07). Conclusion: Diffusion tensor imaging reflects the neuro pathological changes in the white matter, and may be useful in the diagnosis of Alzheimer disease and vascular dementia. Keywords: Alzheimer disease, .; diffusion tensor imaging, .; vascular dementia.

  8. Effects of cranberry juice consumption on vascular function in patients with coronary artery disease

    Science.gov (United States)

    Cranberry juice contains polyphenolic compounds that could improve endothelial function and reduce cardiovascular disease risk. The objective was to examine the effects of cranberry juice on vascular function in subjects with coronary artery disease. We completed an acute pilot study with no placebo...

  9. Vascular disease patient information page: Abdominal aortic aneurysm (AAA).

    Science.gov (United States)

    Moennich, Laurie Ann; Mastracci, Tara M

    2014-10-01

    Abdominal aortic aneurysm is a silent but often fatal disease. AAA is most common in older people, with both modifiable (such as smoking) and hereditary (family history of AAA) risk factors influencing disease development. Screening for AAA can aid in the early diagnosis and treatment of the disease, reducing complications and death amongst those affected. Advancements in screening techniques, surgical innovations, and graft development strive to further improve patient outcomes and disease management.

  10. Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study.

    Science.gov (United States)

    Barnes, Deborah E; Alexopoulos, George S; Lopez, Oscar L; Williamson, Jeff D; Yaffe, Kristine

    2006-03-01

    Depressive symptoms are common in patients with dementia and may be associated with increased risk of developing dementia. It has been hypothesized that depressive symptoms and dementia may be attributable to underlying vascular disease in some older persons. To test the hypotheses (1) that depressive symptoms are associated with increased risk of developing mild cognitive impairment (MCI), a preclinical state that often precedes dementia, and (2) that the association between depressive symptoms and MCI is attributable to underlying vascular disease. Prospective, population-based, longitudinal study. Random sample of adults 65 years or older recruited from 4 US communities. Subjects were 2220 participants in the Cardiovascular Health Study Cognition Study with high cognitive function at baseline. Depressive symptoms were measured at baseline using the 10-item Center for Epidemiological Studies Depression Scale and were classified as none (0-2 points), low (3-7 points), and moderate or high (>/=8 points). Vascular disease measures at baseline included confirmed history of stroke, transient ischemic attack, diabetes mellitus, or hypertension; carotid artery stenosis; ankle-arm blood pressure index; and small or large infarcts or white matter disease on cerebral magnetic resonance imaging. Mild cognitive impairment was diagnosed after 6 years of follow-up based on the consensus of a team of dementia experts using standard clinical criteria. Diagnosis of MCI. Depressive symptoms at baseline were associated with increased risk of MCI (10.0%, 13.3%, and 19.7% for those with no, low, and moderate or high depressive symptoms, respectively). This association was diminished only slightly by adjustment for vascular disease measures and demographics. Vascular disease measures also were associated with increased risk of MCI, and these associations were not diminished by adjustment for depressive symptoms or demographics. Depressive symptoms were associated with increased risk

  11. Comparison between Alzheimer's disease and subcortical vascular dementia: attentional cortex study in functional magnetic resonance imaging.

    Science.gov (United States)

    Li, C; Zheng, J; Wang, J; Gui, L

    2011-01-01

    Blood oxygen level dependent functional magnetic resonance imaging (fMRI) and the Stroop test were used to assess attentional cortex activation in patients with Alzheimer's disease, subcortical vascular dementia, and normal control subjects. Patients with Alzheimer's disease and subcortical vascular dementia demonstrated similar locations of cortical activation, including the bilateral middle and inferior frontal gyri, anterior cingulate and inferior parietal lobule in response to Stroop colour word stimuli. This activation was distinctly decreased in patients with dementia compared with normal control subjects. Different regions of the brain were activated in patients with Alzheimer's disease and subcortical vascular dementia compared with normal controls. fMRI is a useful tool for the study of dementia in humans and has some potential diagnostic value. Further studies with larger numbers of participants are required.

  12. Advanced Coats’ disease treated with intravitreal bevacizumab combined with laser vascular ablation

    Directory of Open Access Journals (Sweden)

    Villegas VM

    2014-05-01

    Full Text Available Victor M Villegas,1 Aaron S Gold,1 Audina M Berrocal,2 Timothy G Murray11Ocular Oncology and Retina, Miami, FL, USA; 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAPurpose: To evaluate the impact of intravitreal bevacizumab combined with laser vascular ablation in the management of advanced Coats’ disease presenting with exudative retinal detachment.Methods: This was a retrospective review of 24 children that presented with exudative retinal detachments associated with advanced Coats’ disease. Mean patient age was 62 months (range 9–160 months. Presenting signs included retinal detachment in 24 children (100%, vascular telangiectasia in 24 children (100%, and retinal ischemia in 24 children (100%. Twenty of 24 children presented with elevated, vascular leakage in the fovea (83%. Two children presented with sub-retinal fibrosis associated with presumed long-standing retinal detachment without evidence of rhegmatogenous retinal detachment. Ten patients exhibited vascular alterations in the periphery of the second eye without clinical evidence of exudation. All 24 children were treated with a large-spot-size diode laser directly to areas of abnormal telangiectatic vasculature. All 24 children received intravitreal bevacizumab injection. Results: All 24 children had resolution of exudative retinal detachment, ablation of vascular telangiectasia, and anatomic improvement of the retina. No child exhibited progressive retinal detachment and no eye required enucleation. No cases of neovascular glaucoma were seen. Fellow eyes with peripheral vascular alterations showed no progression to exudative vasculopathy during the observation period. Intravitreal bevacizumab injection was not associated with endophthalmitis or systemically-observed complications.Conclusion: Repetitive intravitreal bevacizumab combined with laser vascular ablation may be utilized effectively

  13. Tyrosine Kinase Inhibitors in Pulmonary Vascular Disease

    Directory of Open Access Journals (Sweden)

    John J. Ryan, MD

    2016-12-01

    Full Text Available Chronic myeloid leukemia (CML is a clonal myeloproliferative disorder, characterized by proliferation of granulocytes, caused by a translocation that produces the Philadelphia chromosome resulting in constitutively active BCR-ABL tyrosine kinase. Imatinib and dasatinib are 2 BCR-ABL tyrosine kinase inhibitors (TKI used in the treatment of CML. Since the introduction of dasatinib earlier this decade, more than 100 cases of dasatinib-induced pulmonary arterial hypertension PAH have been reported in Europe. When imatinib was introduced, no such increase in pulmonary vasculopathy was identified. In this perspective piece, the author discusses the work of Guignabert et al., recently published in the Journal of Clinical Investigation, which examined the mechanism through which dasatinib mediates its toxic pulmonary vascular effects.

  14. [New class of drugs for treatment of eye vascular diseases].

    Science.gov (United States)

    Travkin, A G; Romashchenko, A D

    1997-01-01

    Hemolytic ocular film (HOF) represents a polymer-based "puff pastry" whose external layers contain antioxidant emoxipine and the internal layer contains an immobilized thrombolytic enzyme; such a structure ensures a successive multifunctional effect on the main components of pathogenesis: lipid peroxidation, local hemostasis, fibrinolysis, and immune system of patients with vascular abnormalities of the eyes. The drug was used in the treatment of 248 patients with intraocular hemorrhages of traumatic origin. Control group (150 patients with the same condition) was treated traditionally. Application of HOF resulted in complete or almost complete lysis of the blood in 95% of patients; in 5% the effect was null. Traditional therapy helped attain complete lysis of the blood in 9% and partial in 43% of patient; in 48% of patients the effect was null.

  15. Pathophysiology of white matter perfusion in Alzheimer’s disease and vascular dementia

    Science.gov (United States)

    Barker, Rachel; Ashby, Emma L.; Wellington, Dannielle; Barrow, Vivienne M.; Palmer, Jennifer C.; Kehoe, Patrick G.; Esiri, Margaret M.

    2014-01-01

    Little is known about the contributors and physiological responses to white matter hypoperfusion in the human brain. We previously showed the ratio of myelin-associated glycoprotein to proteolipid protein 1 in post-mortem human brain tissue correlates with the degree of ante-mortem ischaemia. In age-matched post-mortem cohorts of Alzheimer’s disease (n = 49), vascular dementia (n = 17) and control brains (n = 33) from the South West Dementia Brain Bank (Bristol), we have now examined the relationship between the ratio of myelin-associated glycoprotein to proteolipid protein 1 and several other proteins involved in regulating white matter vascularity and blood flow. Across the three cohorts, white matter perfusion, indicated by the ratio of myelin-associated glycoprotein to proteolipid protein 1, correlated positively with the concentration of the vasoconstrictor, endothelin 1 (P = 0.0005), and negatively with the concentration of the pro-angiogenic protein, vascular endothelial growth factor (P = 0.0015). The activity of angiotensin-converting enzyme, which catalyses production of the vasoconstrictor angiotensin II was not altered. In samples of frontal white matter from an independent (Oxford, UK) cohort of post-mortem brains (n = 74), we confirmed the significant correlations between the ratio of myelin-associated glycoprotein to proteolipid protein 1 and both endothelin 1 and vascular endothelial growth factor. We also assessed microvessel density in the Bristol (UK) samples, by measurement of factor VIII-related antigen, which we showed to correlate with immunohistochemical measurements of vessel density, and found factor VIII-related antigen levels to correlate with the level of vascular endothelial growth factor (P = 0.0487), suggesting that upregulation of vascular endothelial growth factor tends to increase vessel density in the white matter. We propose that downregulation of endothelin 1 and upregulation of vascular endothelial growth factor in the

  16. Endoplasmic Reticulum Stress in Arterial Smooth Muscle Cells: A Novel Regulator of Vascular Disease

    Science.gov (United States)

    Furmanik, Malgorzata; Shanahan, Catherine M.

    2017-01-01

    Cardiovascular disease continues to be the leading cause of death in industrialised societies. The idea that the arterial smooth muscle cell (ASMC) plays a key role in regulating many vascular pathologies has been gaining importance, as has the realisation that not enough is known about the pathological cellular mechanisms regulating ASMC function in vascular remodelling. In the past decade endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) have been recognised as a stress response underlying many physiological and pathological processes in various vascular cell types. Here we summarise what is known about how ER stress signalling regulates phenotypic switching, trans/dedifferentiation and apoptosis of ASMCs and contributes to atherosclerosis, hypertension, aneurysms and vascular calcification.

  17. Pulmonary vascular complications in portal hypertension and liver disease: A concise review

    Directory of Open Access Journals (Sweden)

    M. Porres-Aguilar

    2013-01-01

    Full Text Available Chronic liver disease and/or portal hypertension may be associated with one of the two pulmonary vascular complications: portopulmonary hypertension and hepatopulmonary syndrome. These pulmonary vascular disorders are notoriously underdiagnosed; however, they have a substantial negative impact on survival and require special attention in order to understand their diagnostic approach and to select the best therapeutic options. Portopulmonary hypertension results from excessive vasoconstriction, vascular remodeling, and proliferative and thrombotic events within the pulmonary circulation that lead to progressive right ventricular failure and ultimately to death. On the other hand, abnormal intrapulmonary vascular dilations, profound hypoxemia, and a wide alveolar-arterial gradient are the hallmarks of the hepatopulmonary syndrome, resulting in difficult-to-treat hypoxemia. The aim of this review is to summarize the latest pathophysiologic concepts, diagnostic approach, therapy, and prognosis of portopulmonary hypertension and hepatopulmonary syndrome, as well as to discuss the role of liver transplantation as a definitive therapy in selected patients with these conditions.

  18. The role of vitamin K in vascular calcification of patients with chronic kidney disease.

    Science.gov (United States)

    Wuyts, Julie; Dhondt, Annemieke

    2016-12-01

    Patients with chronic kidney disease (CKD) are prone to vascular calcification. Pathogenetic mechanisms of vascular calcifications have been broadly studied and discussed such as the role of hyperphosphatemia, hypercalcemia, parathormone, and vitamin D. In recent years, new insights have been gained pointing to vitamin K as a main actor. It has been discovered that vitamin K is an essential cofactor for the activation of matrix Gla protein (MGP), a calcification inhibitor in the vessel wall. Patients with CKD often suffer from vitamin K deficiency, resulting in low active MGP and eventually a lack of inhibition of vascular calcification. Vitamin K supplementation and switching warfarin to new oral anticoagulants are potential treatments. In addition, MGP may have a role as a non-invasive biomarker for vascular calcification.

  19. Serum sclerostin in vascular calcification and clinical outcome in chronic kidney disease.

    Science.gov (United States)

    Zeng, Cong; Guo, Chunyuan; Cai, Juan; Tang, Chengyuan; Dong, Zheng

    2017-11-01

    Sclerostin, a potent soluble inhibitor of the Wnt signalling pathway, is known to inhibit bone formation by suppressing osteocytes differentiation and function. Patients with chronic kidney disease have high levels of serum sclerostin. Sclerostin has been implicated in the pathogenesis of vascular calcification, which may promote the cardiovascular events of morbidity and mortality in chronic kidney disease patients. However, the role of sclerostin in vascular calcification and clinical prognosis in chronic kidney disease remains elusive. While some studies suggested a positive correlation between serum sclerostin and vascular calcification or clinical outcome, other studies showed no or even negative correlation between them. Small sample size, heterogeneity in enrolled patients, discrepancy in anatomical structure examined and differences in the applied assays may be responsible for the discrepant results. Nonetheless, anti-sclerostin antibodies may be a new therapeutic approach to increase bone mass and strength in chronic kidney disease. This review aims to have a better understanding of the relationship of serum sclerostin with vascular calcification and clinical outcome in chronic kidney disease patients, and propose the application of anti-sclerostin therapy in chronic kidney disease.

  20. Frequent coconut milk intake increases the risk of vascular disease in adults

    Directory of Open Access Journals (Sweden)

    Sulistyowati Tuminah

    2015-08-01

    Full Text Available Background Coconut milk is an essential ingredient of the Indonesian cuisine. In view of its saturated fatty acid content, coconut milk has frequently been blamed as a cause of cardiovascular disease. The objective of this study was to determine any association between coconut milk intake and vascular disease among adults. Methods A cross-sectional study was conducted in 2011-2012 on adults aged 25-65 years. Self-reported health and nutritional data were collected by means of questionnaire-based interviews, with the aid of 3-D food models. Medical data comprised blood pressure and anthropometry (waist circumference and body mass index, neurological status, ECG, blood glucose and lipid profile. Data analysis was done using multiple logistic regression. Results A total of 4,187 respondents fullfilled the inclusion criteria. Frequent coconut milk intake (>3 times/week significantly increased the risk of vascular disease by 1.3-fold compared with infrequent coconut milk intake (<2 times/week (OR=1.33; 95% CI: 1.11-1.60; p=0.002 after controlling for age, gender, hypertension, diabetes mellitus and stress. The influence of coconut milk intake on vascular disease risk was lower than that of age, gender, hypertension and diabetes mellitus. Conclusion Frequent coconut milk intake increased the risk of vascular disease in adults. Further investigations are needed about the effect of coconut milk intake on noncommunicable diseases.

  1. Sub-Clinical Cognitive Decline and Resting Cerebral Blood Flow in Middle Aged Men.

    Directory of Open Access Journals (Sweden)

    Otto Mølby Henriksen

    Full Text Available Although dementia is associated with both global and regional cerebral blood flow (CBF changes, little is known about cerebral perfusion in the early pre-clinical stages of cognitive decline preceding overt cognitive dysfunction. The aim of this study was to investigate the association of early sub-clinical cognitive decline with CBF.The study participants were recruited from a cohort of Danish men born in 1953. Based on a regression model we selected men who performed better (Group A, n = 94 and poorer (Group B, n = 95 on cognitive testing at age 57 than expected from testing at age 20. Participants underwent supplementary cognitive testing, blood sampling and MRI including measurements of regional and global CBF.Regional CBF was lower in group B than in group A in the posterior cingulate gyrus and the precuneus. The associations were attenuated when corrected for global atrophy, but remained significant in regions of interest based analysis adjusting for regional gray matter volume and vascular risk factors. No influence of group on global CBF was observed.We conclude that early sub-clinical cognitive decline is associated with reduced perfusion in the precuneus and posterior cingulate gyrus independently of regional atrophy and vascular risk factors, but cannot be statistically separated from an association with global atrophy.

  2. The dysexecutive syndrome associated with ischaemic vascular disease and related subcortical neuropathology: a Boston process approach.

    Science.gov (United States)

    Lamar, Melissa; Price, Cate C; Giovannetti, Tania; Swenson, Rod; Libon, David J

    2010-01-01

    The introduction of diagnostic criteria for vascular dementia has helped to re-define the impact of various subcortical neuropathologies on aging; however, state-of-the-art neuroimaging techniques and autopsy studies suggest that not all structural brain alterations associated with vascular dementia are exclusive to this neurodegenerative process alone. Thus, a detailed analysis of the cognitive phenotype associated with ischaemic vascular disease is key to our understanding of subcortical neuropathology and its associated behaviors. Over the past twenty years, we have operationally defined this cognitive phenotype using the Boston Process Approach to neuropsychological assessment. This has led to both an empirical, as well as a theoretical understanding of three core constructs related to the dysexecutive syndrome associated with ischaemic vascular disease affecting periventricular and deep white matter as well as subcortical structures connecting these regions with the prefrontal cortex. Thus, difficulties with mental set, cognitive control and mental manipulation negatively impact executive functioning. This review will outline the subtle markers underlying this prefrontal dysfunction, i.e., the dysexecutive phenotype, associated with ischaemic vascular disease and relate it to fundamental impairments of gating subserved by basal ganglia-thalamic pathways within and across various dementia syndromes.

  3. The Dysexecutive Syndrome Associated with Ischaemic Vascular Disease and Related Subcortical Neuropathology: A Boston Process Approach

    Directory of Open Access Journals (Sweden)

    Melissa Lamar

    2010-01-01

    Full Text Available The introduction of diagnostic criteria for vascular dementia has helped to re-define the impact of various subcortical neuropathologies on aging; however, state-of-the-art neuroimaging techniques and autopsy studies suggest that not all structural brain alterations associated with vascular dementia are exclusive to this neurodegenerative process alone. Thus, a detailed analysis of the cognitive phenotype associated with ischaemic vascular disease is key to our understanding of subcortical neuropathology and its associated behaviors. Over the past twenty years, we have operationally defined this cognitive phenotype using the Boston Process Approach to neuropsychological assessment. This has led to both an empirical, as well as a theoretical understanding of three core constructs related to the dysexecutive syndrome associated with ischaemic vascular disease affecting periventricular and deep white matter as well as subcortical structures connecting these regions with the prefrontal cortex. Thus, difficulties with mental set, cognitive control and mental manipulation negatively impact executive functioning. This review will outline the subtle markers underlying this prefrontal dysfunction, i.e., the dysexecutive phenotype, associated with ischaemic vascular disease and relate it to fundamental impairments of gating subserved by basal ganglia-thalamic pathways within and across various dementia syndromes.

  4. Inflammation-regulated mRNA stability and the progression of vascular inflammatory diseases.

    Science.gov (United States)

    Herman, Allison B; Autieri, Michael V

    2017-11-15

    Cardiovascular disease remains a major medical and socioeconomic burden in developed and developing societies, and will increase with an aging and increasingly sedentary society. Vascular disease and atherosclerotic vascular syndromes are essentially inflammatory disorders, and transcriptional and post-transcriptional processes play essential roles in the ability of resident vascular and inflammatory cells to adapt to environmental stimuli. The regulation of mRNA translocation, stability, and translation are key processes of post-transcriptional regulation that permit these cells to rapidly respond to inflammatory stimuli. For the most part, these processes are controlled by elements in the 3'-UTR of labile, proinflammatory transcripts. Since proinflammatory transcripts almost exclusively contain AU-rich elements (AREs), this represents a tightly regulated and specific mechanism for initiation and maintenance of the proinflammatory phenotype. RNA-binding proteins (RBPs) recognize cis elements in 3'-UTR, and regulate each of these processes, but there is little literature exploring the concept that RBPs themselves can be directly regulated by inflammatory stimuli. Conceptually, inflammation-responsive RBPs represent an attractive target of rational therapies to combat vascular inflammatory syndromes. Herein we briefly describe the cellular and molecular etiology of atherosclerosis, and summarize our current understanding of RBPs and their specific roles in regulation of inflammatory mRNA stability. We also detail RBPs as targets of current anti-inflammatory modalities and how this may translate into better treatment for vascular inflammatory diseases. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  5. Vascular Disease and Dementias: Paradigm Shifts to Drive Research in New Directions

    Science.gov (United States)

    Kling, Mitchel A.; Trojanowski, John Q.; Wolk, David A.; Lee, Virginia M.-Y.; Arnold, Steven E.

    2012-01-01

    Vascular disease was once considered the principal cause of aging-related dementia. More recently, however, research emphasis has shifted to studies of progressive neurodegenerative disease processes such as those giving rise to neuritic plaques, neurofibrillary tangles, and Lewy bodies. While these studies have led to critical insights and potential therapeutic strategies, interest in the role of systemic and cerebrovascular disease mechanisms waned and has received relatively less attention and research support. Recent studies suggest that vascular disease mechanisms play an important role in the risk for aging-related cognitive decline and disorders. Vascular disease frequently coexists with cognitive decline in aging individuals, shares many risk factors with dementias considered to be of the “Alzheimer-type,” and is observed more frequently than expected in postmortem material from individuals manifesting “specific” disease stigmata such as abundant plaques and tangles. Considerable difficulties have emerged in attempting to classify dementias as being related to vascular vs. neurodegenerative causes, and several systems of criteria have been used. Despite multiple attempts, a lack of consensus remains regarding the optimal means of incorporating vascular disease into clinical diagnostic, neurocognitive, or neuropathologic classification schemes for dementias. We propose here an integrative, rather than a strictly taxonomic approach to the study and elucidation of how vascular disease mechanisms contribute to the development of dementias. We argue that, instead of discriminating between, e.g., “Alzheimer’s disease,” “vascular dementia,” and other diseases, there is a greater need to focus clinical and research efforts on elucidating specific pathophysiologic mechanisms that contribute to dementia phenotypes and neuropathologic outcomes. We outline a multi-tiered strategy, beginning with clinical and public health interventions that can be

  6. Vascular remodeling of the circle of Willis in moyamoya disease.

    Science.gov (United States)

    Mikami, Takeshi; Noshiro, Shouhei; Komatsu, Katsuya; Miyata, Kei; Akiyama, Yukinori; Wanibuchi, Masahiko; Mikuni, Nobuhiro

    2015-10-01

    A positive (outward) remodelling pattern in patients with typical atherosclerotic disease was recognised using magnetic resonance imaging (MRI). In this report, the outer diameter of the circle of Willis was evaluated in patients with moyamoya disease, and its remodelling pattern was verified. A total of 18 consecutive patients with moyamoya disease were included in this analysis. The diameter of the terminal portion of the internal carotid artery (ICA) (C1), proximal portion of the middle cerebral artery (MCA) (M1) and proximal portion of the anterior cerebral artery (A1) was evaluated using fast imaging employing steady-state acquisition (FIESTA) imaging. The outer diameter was estimated using these images, and compared with the control group, and the correlation with magnetic resonance angiography (MRA) scores was calculated for patients with moyamoya disease. The mean diameter of the moyamoya patient group on FIESTA was significantly lower than that of the control group in the C1, M1 and A1 (P moyamoya disease MRA score (y = (0.53x+2.31; R = 0.72), whereas the C1 diameter on the FIESTA image showed only a weak correlation (y = (0.16x+2.47; R = 0.21). We found that the outer diameter of all the vessels around the C1 was generally reduced in patients with moyamoya disease. Diameter of the MCA especially decreases as the disease progresses, similar to the negative (constrictive) remodelling pattern.

  7. [Lyme disease acrodermitis chronica atrophicans: misleading vascular signs].

    Science.gov (United States)

    Blaise, S; Fiandrino, G; Satger, B; Carpentier, P-H

    2014-05-01

    Lyme disease acrodermatitis chronica atrophicans is a tertiary form of Lyme borrelliosis. It occurs at least six months, but also up to several years, after a tick bite. This rare condition is probably underestimated because of the difficult diagnosis. Clinical presentations of acrodermatitis chronic atrophicans are quite variable depending upon the duration of the disease. Complimentary explorations are difficult to interpret and rarely specific. Only rare configurations allow formal diagnosis of Borrelia burgdoferi infection. We present a patient who exhibited an atypical clinical presentation of Lyme disease acrodermatitis chronic atrophicans. The clinical outcome was quite favorable with treatment, confirming the diagnosis. Such treatments, which are well tolerated and highly effective, are essential since an untreated disease can lead to potentially severe neurological involvement. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Klotho deficiency causes vascular calcification in chronic kidney disease

    National Research Council Canada - National Science Library

    Hu, Ming Chang; Shi, Mingjun; Zhang, Jianning; Quiñones, Henry; Griffith, Carolyn; Kuro-o, Makoto; Moe, Orson W

    2011-01-01

    Soft-tissue calcification is a prominent feature in both chronic kidney disease (CKD) and experimental Klotho deficiency, but whether Klotho deficiency is responsible for the calcification in CKD is unknown...

  9. Cortical and subcortical vascular hypointensity on T2* weighted imaging in moyamoya disease.

    Science.gov (United States)

    Noshiro, Shouhei; Mikami, Takeshi; Komatsu, Katsuya; Miyata, Kei; Akiyama, Yukinori; Wanibuchi, Masahiko; Mikuni, Nobuhiro

    2016-02-01

    Decreased cortical and subcortical vascular signals in gradient echo T2* weighted imaging have been reported in acute stroke due to major artery occlusion. The purpose of this study was to evaluate this cortical and subcortical vascular hypointensity (CSVH) in patients with moyamoya disease. Subjects were 20 consecutive patients with moyamoya disease. The numbers of CSVH in each hemisphere were counted and the numbers were compared between patients with moyamoya disease and controls. The distribution of CSVH, clinical features of cases exhibiting large numbers of CSVH and post-operative changes were analysed. Patients with moyamoya disease had significantly more CSVH in the middle cerebral artery territory (p moyamoya disease. Our small series study shows that revascularization surgery can decrease the number of CSVH.

  10. MIXED HYALINE VASCULAR AND PLASMA CELL TYPE CASTLEMAN’S DISEASE: REPORT OF A CASE

    Directory of Open Access Journals (Sweden)

    F. Asgarani

    2006-05-01

    Full Text Available Castleman’s disease (angiofollicular lymphoid hyperplasia includes a heterogeneous group of lymphoproliferative disorders. The cause of this disease remains uncertain. There are two types of localized Castleman’s disease: the more common hyaline vascular and the plasma cell types. Mixed variant is an uncommon localized lesion in general population. The lesions can occur in any part of the body that contains lymphoid tissue, although seventy percent are found in the anterior mediastinum. We report a thirty years old boy with Castleman’s disease who presented with fever, anorexia, weight loss,sweating, anemia and abdominal mass. The histologic examination of the biopsy specimens revealed a mixed hyaline vascular and plasma cell type of Castleman’s disease.

  11. Enhanced Prevalence of Plasmatic Soluble MHC Class I Chain-Related Molecule in Vascular Pregnancy Diseases

    Directory of Open Access Journals (Sweden)

    Jean Baptiste Haumonte

    2014-01-01

    Full Text Available The major histocompatibility complex class I related chain (MIC is a stress-inducible protein modulating the function of immune natural killer (NK cells, a major leukocyte subset involved in proper trophoblast invasion and spiral artery remodeling. Aim of the study was to evaluate whether upregulation of soluble MIC (sMIC may reflect immune disorders associated to vascular pregnancy diseases (VPD. sMIC was more frequently detected in the plasma of women with a diagnostic of VPD (32% than in normal term-matched pregnancies (1.6%, P<0.0001, with highest prevalence in intrauterine fetal death (IUDF, 44% and vascular intrauterine growth restriction (IUGR, 39%. sMIC levels were higher in preeclampsia (PE than in IUFD (P<0.01 and vascular IUGR (P<0.05. sMIC detection was associated with bilateral early diastolic uterine notches (P=0.037, thrombocytopenia (P=0.03, and high proteinuria (P=0.03 in PE and with the vascular etiology of IUGR (P=0.0038. Incubation of sMIC-positive PE plasma resulted in downregulation of NKG2D expression and NK cell-mediated IFN-γ production in vitro. Our work thus suggests that detection of sMIC molecule in maternal plasma may constitute a hallmark of altered maternal immune functions that contributes to vascular disorders that complicate pregnancy, notably by impairing NK-cell mediated production of IFN-γ, an essential cytokine favoring vascular modeling.

  12. Cerebrovascular hemodynamics in Alzheimer's disease and vascular dementia: a meta-analysis of transcranial Doppler studies.

    Science.gov (United States)

    Sabayan, Behnam; Jansen, Steffy; Oleksik, Anna M; van Osch, Matthias J P; van Buchem, Mark A; van Vliet, Peter; de Craen, Anton J M; Westendorp, Rudi G J

    2012-04-01

    Alteration in cerebrovascular hemodynamics has reported in both ageing and dementia. However, it is still unclear whether this alteration follows similar pattern in ageing and in different dementia pathologies. The aim of this meta-analysis was to investigate changes in cerebral blood flow velocity and pulsatility index in two most common forms of dementia; Alzheimer's disease and vascular dementia, using transcranial Doppler studies. A literature search was conducted in Pubmed, EMBASE and Web of Science. After initial screening of 304 articles and removing duplicates, a total of 53 articles, published between 1980 and 2010, were reviewed. Finally 12 articles were included in the meta-analysis. For each study, effect sizes (ES) indicating the standardized mean differences of the hemodynamic measures between two groups were calculated. Using random effect models, pooled estimates of ES were measured. Patients with Alzheimer's disease (ES=-1.09, 95% CI -1.77 to -0.44, p=0.004) and vascular dementia (ES=-1.62, 95% CI -2.26 to -0.98, pAlzheimer's disease (ES=0.5, 95% CI 0.28-0.72, pdementia patients (ES=2.34, 95% CI 1.39-3.29, pAlzheimer's disease had lower pulsatility index (ES=-1.22, 95% CI -1.98 to -0.46, p=0.002) compared to subjects with vascular type of dementia. Patients with Alzheimer's disease and vascular dementia have a pronounced disturbance in their cerebrovascular hemodynamics. The severity of disturbances in cerebral hemodynamics is significantly lower in Alzheimer's disease compared to vascular dementia. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. The Role of Perivascular Adipose Tissue in Non-atherosclerotic Vascular Disease

    Directory of Open Access Journals (Sweden)

    Tetsuo Horimatsu

    2017-11-01

    Full Text Available Perivascular adipose tissue (PVAT surrounds most large blood vessels and plays an important role in vascular homeostasis. PVAT releases various chemokines and adipocytokines, functioning in an endocrine and paracrine manner to regulate vascular signaling and inflammation. Mounting evidence suggests that PVAT plays an important role in atherosclerosis and hypertension; however, the role of PVAT in non-atherosclerotic vascular diseases, including neointimal formation, aortic aneurysm, arterial stiffness and vasculitis, has received far less attention. Increasing evidence suggests that PVAT responds to mechanical endovascular injury and regulates the subsequent formation of neointima via factors that promote smooth muscle cell growth, adventitial inflammation and neovascularization. Circumstantial evidence also links PVAT to the pathogenesis of aortic aneurysms and vasculitic syndromes, such as Takayasu's arteritis, where infiltration and migration of inflammatory cells from PVAT into the vascular wall may play a contributory role. Moreover, in obesity, PVAT has been implicated to promote stiffness of elastic arteries via the production of reactive oxygen species. This review will discuss the growing body of data and mechanisms linking PVAT to the pathogenesis of non-atherosclerotic vascular diseases in experimental animal models and in humans.

  14. Vascular risk factors and Alzheimer’s disease. Therapeutic approaches in mouse models

    NARCIS (Netherlands)

    Wiesmann, M.

    2017-01-01

    The first aim of this thesis was to elucidate the impact of major vascular risk factors like hypertension, apoE4 and stroke during the very early phase of Alzheimer’s disease (AD) using several mice models. Hypertension has proven to be associated with cerebrovascular impairment already at young age

  15. Aspects of Subcortical Ischaemic Vascular Disease : Early clinical manifestations and associations with Type 2 diabetes mellitus

    NARCIS (Netherlands)

    Harten, van B.

    2006-01-01

    Summary Subcortical ischaemic vascular disease (SIVD) is an important cause of cognitive impairment in elderly patients. Screening and diagnostic tests are needed to identify these patients. The HIV dementia scale (HDS) is a reliable and quantitative scale for identifying HIV dementia1. The

  16. Leadless pacemaker implantation in a patient with complex congenital heart disease and limited vascular access

    Directory of Open Access Journals (Sweden)

    Paolo Ferrero

    2016-11-01

    Full Text Available Management of rhythm related issues might be particularly challenging in patients with congenital heart disease due to complex anatomy and restricted vascular access. The leadless technology appears a suitable and attractive alternative for this population. We describe a patient with single ventricle physiology who successfully underwent implantation of a leadless pacemaker.

  17. Evaluation of age and peripheral vascular disease as risk factors for ...

    African Journals Online (AJOL)

    Evaluation of age and peripheral vascular disease as risk factors for diabetic foot ulceration among Nigerian patients without foot ulcers. ... collected included subjects age (years), gender, age at first diagnosis of DM, duration of DM (years) and baseline fasting venous plasma glucose. The subjects were evaluated for ...

  18. Peripheral vascular disease is associated with reduced glycosuria in newly diagnosed type 2 diabetic patients

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Holstein-Rathlou, N H; Siersma, V

    2004-01-01

    was 65.2 years. Urinary glucose concentration (UGC) was determined quantitatively in a freshly voided morning urine specimen. RESULTS: The over-all prevalence of peripheral vascular disease (PVD) was 16.5%. Bivariately, high values of UGC were associated with low prevalence of PVD (p

  19. Cerebrospinal fluid amyloid beta42/phosphorylated tau ratio discriminates between Alzheimer's disease and vascular dementia

    NARCIS (Netherlands)

    de Jong, Daniëlle; Jansen, René W M M; Kremer, H P H; Verbeek, Marcel M

    BACKGROUND: The differentiation of Alzheimer's disease (AD) from vascular dementia (VaD) is hampered by clinical diagnostic criteria with disappointing sensitivity and specificity. The objective of this study was to investigate whether cerebrospinal fluid (CSF) levels of total tau protein (t-tau),

  20. Cerebrospinal fluid amyloid beta42/phosphorylated tau ratio discriminates between Alzheimer's disease and vascular dementia.

    NARCIS (Netherlands)

    Jong, D. de; Jansen, R.W.M.M.; Kremer, H.P.H.; Verbeek, M.M.

    2006-01-01

    BACKGROUND: The differentiation of Alzheimer's disease (AD) from vascular dementia (VaD) is hampered by clinical diagnostic criteria with disappointing sensitivity and specificity. The objective of this study was to investigate whether cerebrospinal fluid (CSF) levels of total tau protein (t-tau),

  1. Neurological signs in relation to type of cerebrovascular disease in vascular dementia

    NARCIS (Netherlands)

    Staekenborg, S.S.; van der Flier, W.M.; van Straaten, E.C.W.; Lane, R.; Barkhof, F.; Scheltens, P.

    2008-01-01

    BACKGROUND AND PURPOSE - The aim of this study was to describe the prevalence of a number of neurological signs in a large population of patients with vascular dementia (VaD) and to compare the relative frequency of specific neurological signs dependent on type of cerebrovascular disease. METHODS -

  2. Thiopurines and inhibition of Rac1 in vascular disease

    NARCIS (Netherlands)

    Marinković, G.

    2015-01-01

    The mechanism of immunosuppressive drug azathioprine is not clear, while azathioprine has been used for 60 years in clinical practice in patients undergoing transplantation surgery or to combat autoimmune disease. Part of the function of azathioprine became evident in specific immune cells, namely T

  3. Coronary circulation in the presence of vascular disease

    NARCIS (Netherlands)

    Laird, J. D.; Spaan, J. A.

    1985-01-01

    This paper discusses three specific aspects of coronary circulation as they relate to the patient with coronary artery disease. Firstly, the normal autoregulatory and metabolic control of the coronary circulation is considered in the light of current understanding of the relevant processes.

  4. Vascular progenitor cells in renal and cardiovascular disease

    NARCIS (Netherlands)

    Westerweel, P.E.

    2008-01-01

    Maintenance of endothelial integrity plays a central role in the protection against the development and progression of renal and atherosclerotic cardiovascular disease (CVD). Damaged or lost endothelial cells may be replaced through proliferation of local endothelium and by circulating bone marrow

  5. Factors Associated With Low Levels of Subclinical Vascular Disease in Older Adults: Multi-Ethnic Study of Atherosclerosis

    OpenAIRE

    Michos, Erin D.; Rice, Kenneth M.; Szklo, Moyses; Burke, Gregory L.; Siscovick, David S; Tracy, Russell P.; Barr, R. Graham; Nettleton, Jennifer A.; Greenland, Philip; David R Jacobs; Post, Wendy

    2009-01-01

    Coronary artery calcium (CAC), carotid intimal medial thickness (cIMT), and reduced ankle brachial indices (ABI) are markers of subclinical vascular disease strongly associated with aging. We identified factors associated with low levels of subclinical vascular disease in 1824 participants ≥70 years in the Multi-Ethnic Study of Atherosclerosis. 452 had low CAC (

  6. Vascular perfusion, body composition and muscle strength in chronic kidney disease patients on regular hemodialysis program

    OpenAIRE

    Bernardino, Bruna; Novo, André; Azevedo, Paulo; Mendes, Eugénia; Preto, Leonel

    2015-01-01

    Hemodialysis is a technique that effectively replaces some functions of the human kidney, allowing the survival of such patients, since loss of kidney function is incompatible with life. In most patients with chronic kidney disease, the level of renal function tends to gradually decrease over time. The most serious outcome of chronic kidney disease is renal failure. The vascular access is vital in patients with chronic renal failure undergoing dialysis and their dysfunction is a major cause o...

  7. Cerebrovascular Disease: Recent Progress in Research and Clinical practice (9) : Vascular Depression-Diagnosis and Treatment-

    OpenAIRE

    宮崎, 一秀; 内山, 真一郎; 岩田, 誠; Kazuhide, MIYAZAKI; Shinichiro, UCHIYAMA; Makoto, IWATA

    2007-01-01

    Depression is a frequent symptom of cerebrovascular disease. Depression associated with cerebrovascular disease includes two entities : post-stroke depression (PSD) and vascular depression (VD). Depression which develops after stroke was named PSD by Robinson et al. They suggested that there was a relationship between the location of the lesion and depression. VD frequently occurs in elderly persons with asymptomatic cerebral infarction. Cerebral white matter lesions identified using magnetic...

  8. Reduced cerebral vascularization in experimental neuronopathic Gaucher disease.

    Science.gov (United States)

    Smith, Nicholas Jc; Fuller, Maria; Saville, Jennifer T; Cox, Timothy M

    2018-01-01

    The glycosphingolipidosis, Gaucher disease, in which a range of neurological manifestations occur, results from a deficiency of acid β-glucocerebrosidase, with subsequent accumulation of β-glucocerebroside, its upstream substrates, and the non-acylated congener β-glucosylsphingosine. However, the mechanisms by which end-organ dysfunction arise are poorly understood. Here, we report strikingly diminished cerebral microvascular density in a murine model of disease, and provide a detailed analysis of the accompanying cerebral glycosphingolipidome in these animals, with marked elevations of β-glucosylsphingosine. Further in vitro studies confirmed a concentration-dependent impairment of endothelial cytokinesis upon exposure to quasi-pathological concentrations of β-glucosylsphingosine. These findings support a premise for pathogenic disruption of cerebral angiogenesis as an end-organ effect, with potential for therapeutic modulation in neuronopathic Gaucher disease. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  9. Vascular Stiffness in Children With Chronic Kidney Disease.

    Science.gov (United States)

    Savant, Jonathan D; Betoko, Aisha; Meyers, Kevin E C; Mitsnefes, Mark; Flynn, Joseph T; Townsend, Raymond R; Greenbaum, Larry A; Dart, Allison; Warady, Bradley; Furth, Susan L

    2017-05-01

    Carotid-femoral pulse wave velocity (cfPWV) is a measure of arterial stiffness associated with cardiovascular events in the general population and in adults with chronic kidney disease. However, few data exist regarding cfPWV in children with chronic kidney disease. We compared observed cfPWV assessed via applanation tonometry in children enrolled in the CKiD cohort study (Chronic Kidney Disease in Children) to normative data in healthy children and examined risk factors associated with elevated cfPWV. cfPWV Z score for height/gender and age/gender was calculated from and compared with published pediatric norms. Multivariable linear regression was used to assess the relationship between cfPWV and age, gender, race, body mass index, diagnosis, urine protein-creatinine ratio, mean arterial pressure, heart rate, number of antihypertensive medications, uric acid, and serum low-density lipoprotein. Of the 95 participants with measured cfPWV, 60% were male, 19% were black, 46% had glomerular cause of chronic kidney disease, 22% had urine protein-creatinine ratio 0.5 to 2.0 mg/mg and 9% had >2.0 mg/mg, mean age was 15.1 years, average mean arterial pressure was 80 mm Hg, and median glomerular filtration rate was 63 mL/min per 1.73 m2 Mean cfPWV was 5.0 m/s (SD, 0.8 m/s); mean cfPWV Z score by height/gender norms was -0.1 (SD, 1.1). cfPWV increased significantly with age, mean arterial pressure, and black race in multivariable analysis; no other variables, including glomerular filtration rate, were independently associated with cfPWV. In this pediatric cohort with mild kidney dysfunction, arterial stiffness was comparable to that of normal children. Future research is needed to examine the impact of chronic kidney disease progression on arterial stiffness and associated cardiovascular parameters in children. © 2017 American Heart Association, Inc.

  10. Sub-clinical middle ear malfunctions in elderly patients; prevalence ...

    African Journals Online (AJOL)

    Sub-clinical middle ear malfunctions in elderly patients; prevalence, pattern and predictors. ... Mean age was 70.1 ± 6.2 years, 77.7% were married. Prevalence of S-MEM ... Independent clinical predictors of S-MEM included previous head injury, diabetes, history of osteoarthritis of knee joints, and absent acoustic reflex.

  11. Dilating venous disease: Pathophysiology and a systematic aspect to different vascular territories.

    Science.gov (United States)

    Yetkin, Ertan; Ileri, Mehmet

    2016-06-01

    Venous disease is a common but overlooked clinical problem and is an important mortality and morbidity factor depending on the effected vascular territory. Different contributing factors play role on the clinical manifestation of the disease. Peripheral varices of lower extremities, hemorrhoids, varicoceles, pelvic varicose veins are the vasculopathy of veins running toward heart but against gravity. We hypothesize that all these clinical entities share common pathophysiologic steps in terms of vascular wall remodeling and vessel wall damage. A systematic approaches to both arterial and venous dilating disease in further studies and research would increase our understanding on the pathophysiology of dilating vascular disease and would provoke to find out new treatment modalities. Varicose remodeling of veins occurs by a complex interplay of various factors including both physical forces and extracellular matrix remodeling mechanisms. This article focuses on the systematic aspects of dilating venous disease with a focus on pathophysiology under the term of "Dilating Venous Disease". Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Role of amyloid peptides in vascular dysfunction and platelet dysregulation in Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ilaria eCanobbio

    2015-03-01

    Full Text Available Alzheimer’s disease (AD is the most common neurodegenerative cause of dementia in the elderly. AD is accompanied by the accumulation of amyloid peptides in the brain parenchyma and in the cerebral vessels. The sporadic form of the AD accounts for about 95% of all cases. It is characterized by a late onset, typically after the age of 65, with a complex and still poorly understood aetiology. Several observations point towards a central role of cerebrovascular dysfunction in the onset of sporadic AD. According to the vascular hypothesis, AD may be initiated by vascular dysfunctions that precede and promote the neurodegenerative process. In accordance to this, AD patients show increased hemorragic or ischemic stroke risks. It is now clear that multiple bidirectional connections exist between AD and cerebrovascular disease, and in this new scenario, the effect of amyloid peptides on vascular cells and blood platelets appear to be central to AD. In this review we analyse the effect of amyloid peptides on vascular function and platelet activation and its contribution to the cerebrovascular pathology associated with AD and the progression of this disease.

  13. Metabolic Vascular Syndrome: New Insights into a Multidimensional Network of Risk Factors and Diseases.

    Science.gov (United States)

    Scholz, Gerhard H; Hanefeld, Markolf

    2016-10-01

    Since 1981, we have used the term metabolic syndrome to describe an association of a dysregulation in lipid metabolism (high triglycerides, low high-density lipoprotein cholesterol, disturbed glucose homeostasis (enhanced fasting and/or prandial glucose), gout, and hypertension), with android obesity being based on a common soil (overnutrition, reduced physical activity, sociocultural factors, and genetic predisposition). We hypothesized that main traits of the syndrome occur early and are tightly connected with hyperinsulinemia/insulin resistance, procoagulation, and cardiovascular diseases. To establish a close link between the traits of the metabolic vascular syndrome, we focused our literature search on recent original work and comprehensive reviews dealing with the topics metabolic syndrome, visceral obesity, fatty liver, fat tissue inflammation, insulin resistance, atherogenic dyslipidemia, arterial hypertension, and type 2 diabetes mellitus. Recent research supports the concept that the metabolic vascular syndrome is a multidimensional and interactive network of risk factors and diseases based on individual genetic susceptibility and epigenetic changes where metabolic dysregulation/metabolic inflexibility in different organs and vascular dysfunction are early interconnected. The metabolic vascular syndrome is not only a risk factor constellation but rather a life-long abnormality of a closely connected interactive cluster of developing diseases which escalate each other and should continuously attract the attention of every clinician.

  14. Metabolic Vascular Syndrome: New Insights into a Multidimensional Network of Risk Factors and Diseases

    Science.gov (United States)

    Scholz, Gerhard H.; Hanefeld, Markolf

    2016-01-01

    Background Since 1981, we have used the term metabolic syndrome to describe an association of a dysregulation in lipid metabolism (high triglycerides, low high-density lipoprotein cholesterol, disturbed glucose homeostasis (enhanced fasting and/or prandial glucose), gout, and hypertension), with android obesity being based on a common soil (overnutrition, reduced physical activity, sociocultural factors, and genetic predisposition). We hypothesized that main traits of the syndrome occur early and are tightly connected with hyperinsulinemia/insulin resistance, procoagulation, and cardiovascular diseases. Methods To establish a close link between the traits of the metabolic vascular syndrome, we focused our literature search on recent original work and comprehensive reviews dealing with the topics metabolic syndrome, visceral obesity, fatty liver, fat tissue inflammation, insulin resistance, atherogenic dyslipidemia, arterial hypertension, and type 2 diabetes mellitus. Results Recent research supports the concept that the metabolic vascular syndrome is a multidimensional and interactive network of risk factors and diseases based on individual genetic susceptibility and epigenetic changes where metabolic dysregulation/metabolic inflexibility in different organs and vascular dysfunction are early interconnected. Conclusion The metabolic vascular syndrome is not only a risk factor constellation but rather a life-long abnormality of a closely connected interactive cluster of developing diseases which escalate each other and should continuously attract the attention of every clinician. PMID:27921043

  15. Peripheral Arteries May Be Reliable Indicators of Coronary Vascular Disease.

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    Hoehmann, Christopher L; Futterman, Bennett; Beatty, Brian Lee

    2017-07-01

    Atherosclerosis is a stronger predictor for ischemic cardiovascular events than traditional risk factors such as race, age, sex, history, and metabolic profile. Previous research had primarily used ultrasound; however, we performed a study using histopathology to more accurately grade atherosclerosis development using the American Heart Association's grading scale. We cross-sectioned 13 different arteries from 48 cadavers and placed them into three separate groups based on anatomic location: central arteries, peripheral arteries, and carotid arteries. The central artery group included arteries that are non-palpable and commonly lead to ischemic diseases when occluded. The peripheral artery group included arteries that are accessible to palpation. The carotid artery group included branches of the carotid artery. We investigated whether a centrally located atherosclerotic vessel was associated with atherosclerosis of a specific peripheral artery. We hypothesized a correlation between carotid, peripheral and central arteries that may point to specific arteries that are more effective to analyze clinically when assessing cardiovascular risk. We observed a correlation between pathology in the left coronary artery and bifurcation of the carotid artery (r = 0.37 P ≤ 0.016), two arteries known to be implicated in ischemic stroke and ischemic heart disease. Importantly, our study demonstrates that the radial artery, a peripheral vessel, exhibited a positive correlation between both the pathologic left coronary (r = 0.33 P ≤ 0.041) and bifurcation of the carotid arteries (r = 0.34 P ≤ 0.025). Therefore, we propose investigating the radial artery as a clinically accessible location to monitor with ultrasound when assessing a patient's risk for ischemic cardiovascular disease. Anat Rec, 300:1230-1239, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. The Role of Various Stressors in the Trigger Mechanism of Raynaud's Disease (Hemorheological and Vascular Reactions

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    Mantskava M.M.

    2014-05-01

    Full Text Available The emergence and spread of stress reactions are provided by the blood circulation system. In its turn, the adequacy of blood circulation depends on the hemorheological and vascular mechanisms. The changeability of their properties appears to be the basis of the increasing of stress stages. From the viewpoint of biophysical reactions, any change and movement occur with the expenditure and accumulation of energy. Higher level of adaptation energy waste and secondary level take place, when a small stressor entails a small expenditure. There is a maximum possible rate of adaptive energy consumption and at this maximum the organism cannot cope with any additional stimulus. At the same time adaptive and stress diseases develop. Let’s consider the duration and manifestation of Raynaud's disease from the perspective of adaptation diseases and diseases of the third grade, which appears to be the cause of the double stress effect - cold and emotional- physical and psychic. Total of 97 patients with Raynaud's disease were examined. For a new vision of the problem it was necessary to find out how the streessors of various nature impact the hemoreheological status and vascular resistance. For this purpose all the patients were examined for a resistance index of resistive arteries of the hand and the indices of erythrocyte aggregation and deformability. The patients were divided into four subgroups. The first subgroup – the patients after chilblain, the second subgroup – the patients with psychic strerssor, the third subgroup – the patients with prolonged chronic stress, and the fourth subgroup – the patients without the differentiation of the stressors. According to the obtained results, it is obvious that at cold and emotional stress (I and II subgroups the hemorheological and vascular parameters are changed. However, this change (hemorheological and vascular is more pronounced at chronic emotional stress (III subgroup as compared both to the

  17. Decreased microRNA is involved in the vascular remodeling abnormalities in chronic kidney disease (CKD.

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    Neal X Chen

    Full Text Available Patients with CKD have abnormal vascular remodeling that is a risk factor for cardiovascular disease. MicroRNAs (miRNAs control mRNA expression intracellularly and are secreted into the circulation; three miRNAs (miR-125b, miR-145 and miR-155 are known to alter vascular smooth muscle cell (VSMC proliferation and differentiation. We measured these vascular miRNAs in blood from 90 patients with CKD and found decreased circulating levels with progressive loss of eGFR by multivariate analyses. Expression of these vascular miRNAs miR-125b, miR-145, and miR-155 was decreased in the thoracic aorta in CKD rats compared to normal rats, with concordant changes in target genes of RUNX2, angiotensin II type I receptor (AT1R, and myocardin. Furthermore, the expression of miR-155 was negatively correlated with the quantity of calcification in the aorta, a process known to be preceded by vascular de-differentiation in these animals. We then examined the mechanisms of miRNA regulation in primary VSMC and found decreased expression of miR-125b, 145, and 155 in VSMC from rats with CKD compared to normal littermates but no alteration in DROSHA or DICER, indicating that the low levels of expression is not due to altered intracellular processing. Finally, overexpression of miR-155 in VSMC from CKD rats inhibited AT1R expression and decreased cellular proliferation supporting a direct effect of miR-155 on VSMC. In conclusion, we have found ex vivo and in vitro evidence for decreased expression of these vascular miRNA in CKD, suggesting that alterations in miRNAs may lead to the synthetic state of VSMC found in CKD. The decreased levels in the circulation may reflect decreased vascular release but more studies are needed to confirm this relationship.

  18. Comparative assessment of vascular function in autoimmune rheumatic diseases: considerations of prevention and treatment.

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    Soltész, Pál; Kerekes, György; Dér, Henriett; Szücs, Gabriella; Szántó, Sándor; Kiss, Emese; Bodolay, Edit; Zeher, Margit; Timár, Orsolya; Szodoray, Péter; Szegedi, Gyula; Szekanecz, Zoltán

    2011-05-01

    Numerous autoimmune-inflammatory rheumatic diseases have been associated with accelerated atherosclerosis or other types of vasculopathy leading to increased cardio- and cerebrovascular disease risk. Traditional risk factors, as well as the role of systemic inflammation including cytokines, chemokines, proteases, autoantibodies, adhesion receptors and others have been implicated in the development of these vascular pathologies. The characteristics of vasculopathies may significantly differ depending on the underlying disease. While classical accelerated atherosclerosis has been associated with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or spondyloarthropathies (SpA), obliterative vasculopathy may rather be characteristic for systemic sclerosis (SSc) or mixed connective tissue disease (MCTD). Antiphospholipid antibodies have been implicated in vasculopathies underlying SLE, antiphospholipid syndrome (APS), RA and MCTD. There is also heterogeneity with respect to inflammatory risk factors. Cytokines, such as tumor necrosis factor-α (TNF-α) or interleukin 6 (IL-6) and immune complexes are primarily involved in arthritides, such as RA, SpA, as well as in SLE. On the other hand, autoantibodies including anti-oxLDL anti-cardiolipin and anti-β2GPI are rather involved in SLE- and APS-associated vasculopathies. Regarding the non-invasive assessment of vascular function, endothelial dysfunction, overt atherosclerosis and vascular stiffness may be indicated by brachial artery flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT) and aortic pulse-wave velocity (PWV), respectively. These abnormalities have been described in most inflammatory rheumatic diseases. While ccIMT and stiffness are relatively stable, FMD may be influenced by many confounding factors. In addition to traditional vasculoprotection, immunosuppressive agents including corticosteroids, traditional and biologic DMARDs may have significant vascular and metabolic

  19. Endogenous sex steroids and cardio- and cerebro-vascular disease in the postmenopausal period.

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    Pappa, Theodora; Alevizaki, Maria

    2012-08-01

    Cardio- and cerebro-vascular diseases are two leading causes of death and long-term disability in postmenopausal women. The acute fall of estrogen in menopause is associated with increased cardiovascular risk. The relative contribution of androgen to this risk is also being recognized. The use of more sensitive assays for estradiol measurement and the study of receptor and carrier protein gene polymorphisms have provided some new information on the clinical relevance of endogenous sex steroids. We provide an update on the role of endogenous sex steroids on cardio- and cerebro-vascular disease in the postmenopausal period. We performed a PubMed search using the terms 'endogenous estrogen', 'androgen', 'cardiovascular disease', 'cerebro-vascular disease', 'stroke', 'carotid artery disease', and 'subclinical atherosclerosis'. The majority of studies show a beneficial effect of endogenous estrogen on the vasculature; however, there are a few studies reporting the contrary. A significant body of literature has reported associations of endogenous estrogen and androgen with early markers of atherosclerosis and metabolic parameters. Data on the relevance of endogenous sex steroids in heart disease and stroke are inconclusive. Most studies support a beneficial role of endogenous estrogens and, probably, an adverse effect of androgens in the vasculature in postmenopausal women. However, the described associations may not always be considered as causal. It is possible that circulating estrogen might represent a marker of general health status or alternatively reflect the sum of endogenous androgens aromatized in the periphery. Elucidating the role of sex steroids in cardio- and cerebro-vascular disease remains an interesting field of future research.

  20. Nanotherapy for Alzheimer's disease and vascular dementia: Targeting senile endothelium.

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    D'Arrigo, Joseph S

    2018-01-01

    Due to the complexity of Alzheimer's disease, multiple cellular types need to be targeted simultaneously in order for a given therapy to demonstrate any major effectiveness. Ultrasound-sensitive coated microbubbles (in a targeted lipid nanoemulsion) are available. Versatile small molecule drug(s) targeting multiple pathways of Alzheimer's disease pathogenesis are known. By incorporating such drug(s) into the targeted "lipid-coated microbubble" [LCM]/"nanoparticle-derived" [ND] (or LCM/ND) nanoemulsion type, one obtains a multitasking combination therapeutic for translational medicine. This multitasking therapeutic targets cell-surface scavenger receptors (mainly class B type I), or SR-BI, making possible for various Alzheimer's-related cell types to be simultaneously searched out for localized drug treatment in vivo. Besides targeting cell-surface SR-BI, the proposed LCM/ND-nanoemulsion combination therapeutic(s) include a characteristic lipid-coated microbubble [LCM] subpopulation (i.e., a stable LCM suspension); such film-stabilized microbubbles are well known to substantially reduce the acoustic power levels needed for accomplishing temporary noninvasive (transcranial) ultrasound treatment, or sonoporation, if additionally desired for the Alzheimer's patient. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Exercise, vascular wall and cardiovascular diseases: an update (part 2).

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    Yung, Lai Ming; Laher, Ismail; Yao, Xiaoqiang; Chen, Zhen Yu; Huang, Yu; Leung, Fung Ping

    2009-01-01

    There is much evidence extolling the virtues of physical activity on cardiovascular disease (CVD). The evidence derives from different population groups where leisure time physical activity reduced the risk of coronary heart disease and cardiovascular mortality in both men and women. Recent meta-analyses have shown that large risk reductions for both ischaemic and haemorrhagic stroke can be achieved by moderate or intense physical activity. There are many data from human and animal studies confirming a beneficial role for exercise in the prevention and treatment of CVD. Physical inactivity and obesity/overweight are not only associated with a number of health-related risk factors, but are considered to be independent risk factors for CVD, type 2 diabetes mellitus and hypertension. Clinical trials confirm that lifestyle interventions (dietary modification and increased physical activity) reduce the risk of progressing from impaired glucose tolerance to type 2 diabetes. Moreover, epidemiological studies indicate that the risk of hypertension increases by being overweight. Modest increases in exercise intensity and frequency have hypotensive effects in sedentary hypertensive patients. Long-term training improves endothelium-dependent dilatation in the aorta and resistance arteries of the heart, whereas short-term training increases endothelial function in coronary conduit arteries. Overall, more scientific evidence will undoubtedly encourage the widespread advocacy of the clinical benefits of exercise therapy in the prevention and treatment of CVD.

  2. Vascular function long term after Kawasaki disease: another piece of the puzzle?

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    Pinto, Fátima F; Gomes, Inês; Loureiro, Petra; Laranjo, Sérgio; Timóteo, Ana T; Carmo, Miguel M

    2017-04-01

    Kawasaki disease is an acute systemic vasculitis. Cardiac complications are frequent and include endothelial dysfunction in patients with coronary anomalies. Thus far, endothelial dysfunction in patients with no coronary lesions is poorly understood. Our aim was to access the vascular function in adolescents and young adults long term after Kawasaki disease, but without coronary aneurysms or any other cardiac risk factors. We carried out a single-centre prospective study in a Portuguese population. We evaluated two groups of subjects: (1) Kawasaki disease patients over 11 years of age, diagnosed >5 years ago, with no coronary lesions or any other risk factors for cardiovascular disease; (2) control group of individuals without cardiovascular risk factors. Patients and controls were clinically assessed. Endo-PAT and carotid intima-media thickness assessment were performed to determine vascular function. In total, 43 Kawasaki disease patients were assessed and compared with 43 controls. Kawasaki disease patients presented a decreased reactive hyperaemia index compared with controls (1.59±0.45 versus 1.98±0.41; pKawasaki disease group. There were no statistically significant changes with regard to laboratory data. Children with Kawasaki disease may have long-term sequelae, even when there is no discernible coronary artery involvement in the acute stage of the disease. Further research is needed to assess whether known strategies to improve endothelial function would bring potential benefits to Kawasaki disease patients.

  3. Perivascular adipose tissue, inflammation and insulin resistance: link to vascular dysfunction and cardiovascular disease.

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    Lastra, Guido; Manrique, Camila

    2015-04-01

    Obesity is a leading risk factor for the development of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD), however the underlying mechanisms still remain to be fully uncovered. It is now well accepted that dysfunctional adipose tissue in conditions of obesity is a critical source of inflammation that impacts the cardiovascular system and contributes to CVD. Although traditionally visceral adipose tissue has been linked to increased CVD risk, there is mounting interest in the role that fat accumulation around the vasculature plays in the pathogenesis of vascular dysfunction. Perivascular adipose tissue (PVAT) is in intimate contact with large, medium and small diameter arterial beds in several tissues, and has been shown to control vascular function as well as remodeling. PVAT does not merely mirror visceral adipose tissue changes seen in obesity, but has unique features that impact vascular biology. In lean individuals PVAT exerts vasodilatory and anti-inflammatory functions, however obesity results in PVAT inflammation, characterized by imbalance between pro- and anti-inflammatory cells as wells as adipokines. PVAT inflammation promotes insulin resistance in the vasculature, thus resulting in impaired insulin-mediated vasodilatory responses and vascular remodeling. In this review we address current knowledge about the mechanisms that link PVAT inflammation to insulin resistance and vascular dysfunction. Indeed, PVAT emerges as a novel type of adipose tissue that participates in the pathogenesis of CVD, independently to a large extent to visceral adipose tissue.

  4. Systemic and Disease-Specific Risk Factors in Vascular Dementia: Diagnosis and Prevention

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    Efraim Jaul

    2017-10-01

    Full Text Available In order to prevent the onset of vascular dementia (VaD in aging individuals, it is critical to detect clinically relevant vascular and systemic pathophysiological changes to signal the onset of its preceding prodromal stages. Identifying behavioral and neurobiological markers that are highly sensitive to VaD classification vs. other dementias is likely to assist in developing novel preventive treatment strategies that could delay the onset of disruptive psychomotor symptoms, decrease hospitalizations, and increase the quality of life in clinically-high-risk aging individuals. In light of empirical diagnostic and clinical findings associated with VaD pathophysiology, the current investigation will suggest a few clinically-validated biomarker measures of prodromal VaD cognitive impairments that are correlated with vascular symptomology, and VaD endophenotypes in non-demented aging people. In prodromal VaD individuals, distinguishing VaD from other dementias (e.g., Alzheimer's disease could facilitate specific early preventive interventions that significantly delay more severe cognitive deterioration or indirectly suppress the onset of dementia with vascular etiology. Importantly, the authors conclude that primary prevention strategies should examine aging individuals by employing comprehensive geriatric assessment approach, taking into account their medical history, and longitudinally noting their vascular, systemic, cognitive, behavioral, and clinical functional status. Secondary prevention strategies may include monitoring chronic medication as well as promoting programs that facilitate social interaction and every-day activities.

  5. Vascular effects of phytoestrogens and alternative menopausal hormone therapy in cardiovascular disease.

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    Gencel, V B; Benjamin, M M; Bahou, S N; Khalil, R A

    2012-02-01

    Phytoestrogens are estrogenic compounds of plant origin classified into different groups including isoflavones, lignans, coumestans and stilbenes. Isoflavones such as genistein and daidzein are the most studied and most potent phytoestrogens, and are found mainly in soy based foods. The effects of phytoestrogens are partly mediated via estrogen receptors (ERs): ERα, ERβ and possibly GPER. The interaction of phytoestrogens with ERs is thought to induce both genomic and non-genomic effects in many tissues including the vasculature. Some phytoestrogens such as genistein have additional non-ER-mediated effects involving signaling pathways such as tyrosine kinase. Experimental studies have shown beneficial effects of phytoestrogens on endothelial cells, vascular smooth muscle, and extracellular matrix. Phytoestrogens may also affect other pathophysiologic vascular processes such as lipid profile, angiogenesis, inflammation, tissue damage by reactive oxygen species, and these effects could delay the progression of atherosclerosis. As recent clinical trials showed no vascular benefits or even increased risk of cardiovascular disease (CVD) and CV events with conventional menopausal hormone therapy (MHT), phytoestrogens are being considered as alternatives to pharmacologic MHT. Epidemiological studies in the Far East population suggest that dietary intake of phytoestrogens may contribute to the decreased incidence of postmenopausal CVD and thromboembolic events. Also, the WHO-CARDIAC study supported that consumption of high soybean diet is associated with lower mortalities from coronary artery disease. However, as with estrogen, there has been some discrepancy between the experimental studies demonstrating the vascular benefits of phytoestrogens and the data from clinical trials. This is likely because the phytoestrogens clinical trials have been limited in many aspects including the number of participants enrolled, the clinical end points investigated, and the lack of

  6. Vascular hyperpolarization in human physiology and cardiovascular risk conditions and disease.

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    Schinzari, F; Tesauro, M; Cardillo, C

    2017-01-01

    Hyperpolarization causing smooth muscle relaxation contributes to the maintenance of vascular homeostasis, particularly in small-calibre arteries and arterioles. It may also become a compensatory vasodilator mechanism upregulated in states with impaired nitric oxide (NO) availability. Bioassay of vascular hyperpolarization in the human circulation has been hampered by the complexity of mechanisms involved and the limited availability of investigational tools. Firm evidence, however, supports the notion that hyperpolarization participates in the regulation of resting vasodilator tone and vascular reactivity in healthy subjects. In addition, an enhanced endothelium-derived hyperpolarization contributes to both resting and agonist-stimulated vasodilation in a variety of cardiovascular risk conditions and disease. Thus, hyperpolarization mediated by epoxyeicosatrienoic acids (EETs) and H 2 O 2 has been observed in coronary arterioles of patients with coronary artery disease. Similarly, ouabain-sensitive and EETs-mediated hyperpolarization has been observed to compensate for NO deficiency in patients with essential hypertension. Moreover, in non-hypertensive patients with multiple cardiovascular risk factors and in hypercholesterolaemia, K Ca channel-mediated vasodilation appears to be activated. A novel paradigm establishes that perivascular adipose tissue (PVAT) is an additional regulator of vascular tone/function and endothelium is not the only agent in vascular hyperpolarization. Indeed, some PVAT-derived relaxing substances, such as adiponectin and angiotensin 1-7, may exert anticontractile and vasodilator actions by the opening of K Ca channels in smooth muscle cells. Conversely, PVAT-derived factors impair coronary vasodilation via differential inhibition of some K + channels. In view of adipose tissue abnormalities occurring in human obesity, changes in PVAT-dependent hyperpolarization may be relevant for vascular dysfunction also in this condition. © 2015

  7. Circulating microparticles from Crohn's disease patients cause endothelial and vascular dysfunctions.

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    Daniela Leonetti

    Full Text Available BACKGROUND: Microparticles (MPs are small vesicles released during cell activation or apoptosis. They are involved in coagulation, inflammation and vascular dysfunction in several diseases. We characterized circulating MPs from Crohn's Disease (CD patients and evaluated their effects on endothelial function and vascular reactivity after in vivo injection into mice. METHODS: Circulating MPs and their cellular origins were examined by flow cytometry from blood samples from healthy subjects (HS and inactive or active CD patients. MPs were intravenously injected into mice. After 24 hours, endothelial function and vascular reactivity were assessed. RESULTS: Circulating MP levels did not differ between HS and inactive CD patients except for an increase in leukocyte-derived MPs in CD. Active CD patients compared to HS displayed increased total circulating MPs, pro-coagulant MPs and those from platelets, endothelium, erythrocytes, leukocytes, activated leukocytes and activated platelets. A significant correlation was found between total levels of MPs, those from platelets and endothelial cells, and the Harvey-Bradshaw clinical activity index. MPs from CD, but not from HS, impaired endothelium-dependent relaxation in mice aorta and flow-induced dilation in mice small mesenteric arteries, MPs from inactive CD patients being more effective than those from active patients. CDMPs induced vascular hypo-reactivity in aorta that was prevented by a nitric oxide (NO-synthase inhibitor, and was associated with a subtle alteration of the balance between NO, reactive oxygen species and the release of COX metabolites. CONCLUSIONS: We provide evidence that MPs from CD patients significantly alter endothelial and vascular function and therefore, may play a role in CD pathophysiology, at least by contributing to uncontrolled vascular-dependent intestinal damage.

  8. Perceived stress and vascular disease: where are we now?

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    Katsarou, Alexia L; Triposkiadis, Filippos; Panagiotakos, Demosthenes

    2013-10-01

    Apart from traditional risk factors, psychosocial characteristics are increasingly considered as potential predictors of cardiovascular disease (CVD). The concept of stress is relevant when discussing the relationship between psychosocial factors and CVD. Among stress types and definitions (ie, marital stress, work stress), "perceived stress" presents a global and comprehensive stress construct and is based on the concept that individuals actively interact with their environment, appraising potentially threatening or challenging events in the light of available coping resources. However, the role of perceived stress in CVD incidence has not yet been completely elucidated. Thus, we evaluate perceived stress as a CVD risk factor by reviewing the literature. We also discuss the relationship between negative affect and CVD development.

  9. CARDIO-VASCULAR RISK FACTORS IN ELDERLY PATIENTS WITH DISEASES OF THE STOMATOGNATHIC SYSTEM

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    Botez C

    2011-09-01

    Full Text Available The association between dental and cardio-vascular diseases is essential as both are highly prevalent. Finding a possible causal relation between cardiovascular disease and chronic periodontal pathology, known to cause tooth loss, is therefore essential. The existence of some risk factors, such as smoking, bacterial infections, malnutrition and nutritional deficiencies, may explain the associations observed between cardio-vascular and oral pathologies. In the case of dental diseases, acceleration of atherosclerosis is supported by the role played by infections. The study – performed between 2008-2009 – analyzed 45 cases, selected from the patients hospitalized in the Medical Clinics of the Military Hospital of Ia[i. The patients included in the study suffered from arterial hypertension (HTA, cardiac insufficiency, ischemic cardiopathy, pectoral angina and subacute infectious endocarditis. All were subjected to a stomatological examination, for establishing their dental hygiene, the stomatological diseases they had had and the treatments performed. There are several ways in which infections of the oral cavity lead to cardiovascular disease. These include: transitory bacteriemia; inflammation and vascular lesions; diet and smoking.

  10. Milk in the diet: good or bad for vascular disease?

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    Givens, D I

    2012-02-01

    CVD still represent the greatest cause of death and disease burden in Europe and there remains uncertainty whether or not diets rich in milk and/or dairy products affect CVD risk. This paper reviews current evidence on this from prospective studies and the role of serum lipids and blood pressure as markers of CVD risk with such diets. Also the potential of animal nutrition-based approaches aimed at reducing CVD risk from consumption of milk and dairy products is outlined. Briefly, the evidence from prospective studies indicates that increased consumption of milk does not result in increased CVD risk and may give some long-term benefits, although few studies relate specifically to cheese and butter and more information on the relationship between milk/dairy product consumption and dementia is needed. Recent data suggest that the SFA in dairy products may be less of a risk factor than previously thought; although this is based on serum cholesterol responses which taken in isolation may be misleading. Milk and some dairy products have counterbalancing effects by reducing blood pressure and possibly BMI control. Despite this, animal nutrition strategies to replace some SFA in milk with cis-MUFA or cis-PUFA are extensive and intuitively beneficial, although this remains largely unproven, especially for milk. There is an urgent need for robust intervention studies to evaluate such milk-fat modifications using holistic markers of CVD risk including central arterial stiffness.

  11. Cancer risk in patients with manifest vascular disease: effects of smoking, obesity, and metabolic syndrome.

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    van Kruijsdijk, Rob C M; van der Graaf, Yolanda; Peeters, Petra H M; Visseren, Frank L J

    2013-07-01

    Patients with vascular disease may be at increased risk of cancer because of shared risk factors and common pathogenesis. Patients with vascular disease (n = 6,172) were prospectively followed for cancer incidence. Standardized incidence ratios (SIRs) were calculated to compare the cancer incidence of the study population with that of the general population. Multivariable-adjusted hazard ratio's (HRs) of cancer were estimated for smoking status, pack-years, body mass index, waist circumference and visceral adipose tissue (VAT), and metabolic syndrome (MetS). During a median follow-up of 5.5 years, 563 patients were diagnosed with cancer. Patients with vascular disease were at increased risk of cancer [SIR = 1.19; 95% confidence interval (CI), 1.10-1.29]. Specifically, risk of lung cancer (SIR = 1.56; 95% CI, 1.31-1.83), as well as bladder cancer (SIR = 1.60; 95% CI, 1.11-2.24) and cancer of the lip, oral cavity, or pharynx in men (SIR = 1.51; 95% CI, 0.89-2.39), and colorectal (SIR = 1.71; 95% CI, 1.11-2.53) and kidney cancer (SIR = 2.92; 95% CI, 1.05-6.38) in women was increased. A relation between smoking and cancer risk was observed (HR for current smokers = 1.37; 95% CI, 1.05-1.73), whereas an increase in VAT was associated with higher breast cancer risk in women (HR = 1.42; 95% CI, 1.03-1.96). No relation between MetS and cancer risk was found. Patients with vascular disease have a 19% higher cancer risk compared to the general population. Smoking increased cancer risk and abdominal obesity is a risk factor for breast cancer in female patients with vascular disease. These results call for awareness of the increased cancer risk in patients with vascular disease among physicians and underline the necessity of lifestyle improvement not only for reducing cardiovascular risk.

  12. Molecular analysis of oral bacteria in dental biofilm and atherosclerotic plaques of patients with vascular disease.

    Science.gov (United States)

    Fernandes, Clarissa Pessoa; Oliveira, Francisco Artur Forte; Silva, Paulo Goberlânio de Barros; Alves, Ana Paula Negreiros Nunes; Mota, Mário Rogério Lima; Montenegro, Raquel Carvalho; Burbano, Rommel Mario Rodriguez; Seabra, Aline Damasceno; Lobo Filho, José Glauco; Lima, Danilo Lopes Ferreira; Soares Filho, Antônio Wilon Evelin; Sousa, Fabrício Bitu

    2014-07-01

    Oral bacteria have been detected in atherosclerotic plaques at a variable frequency; however, the connection between oral health and vascular and oral bacterial profiles of patients with vascular disease is not clearly established. The aim of this study was to evaluate the presence of oral bacterial DNA in the mouth and atherosclerotic plaques, in addition to assessing the patients' caries and periodontal disease history. Thirty samples of supragingival and subgingival plaque, saliva and atherosclerotic plaques of 13 patients with carotid stenosis or aortic aneurysm were evaluated, through real-time polymerase chain reaction, for the presence of Streptococcus mutans (SM), Prevotella intermedia (PI), Porphyromonas gingivalis (PG) and Treponema denticola (TD). All patients were submitted to oral examination using the DMFT (decayed, missing and filled teeth) and PSR (Periodontal Screening and Recording) indexes. Histopathological analysis of the atherosclerotic plaques was performed. Most of the patients were edentulous (76.9%). SM, PI, PG and TD were detected in 100.0%, 92.0%, 15.3% and 30.7% of the oral samples, respectively. SM was the most prevalent targeted bacteria in atherosclerotic plaques, detected in 100% of the samples, followed by PI (7.1%). The vascular samples were negative for PG and TD. There was a statistically significant difference (p<0.05) between the presence of PG and TD in the oral cavity and vascular samples. SM was found at a high frequency in oral and vascular samples, even in edentulous patients, and its presence in atherosclerotic plaques suggests the possible involvement of this bacterium in the disease progression. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Malojcic, Branko; Giannakopoulos, Panteleimon; Sorond, Farzaneh A; Azevedo, Elsa; Diomedi, Marina; Oblak, Janja Pretnar; Carraro, Nicola; Boban, Marina; Olah, Laszlo; Schreiber, Stephan J; Pavlovic, Aleksandra; Garami, Zsolt; Bornstein, Nantan M; Rosengarten, Bernhard

    2017-02-09

    The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. US and ASL are

  14. Erectile dysfunction precedes other systemic vascular diseases due to incompetent cavernous endothelial cell-cell junctions.

    Science.gov (United States)

    Ryu, Ji-Kan; Jin, Hai-Rong; Yin, Guo Nan; Kwon, Mi-Hye; Song, Kang-Moon; Choi, Min Ji; Park, Jin-Mi; Das, Nando Dulal; Kwon, Ki-Dong; Batbold, Dulguun; Lee, Tack; Gao, Zhen Li; Kim, Kyu-Won; Kim, Woo Jean; Suh, Jun-Kyu

    2013-08-01

    Erectile dysfunction is often a harbinger of cardiovascular disease. We sought to gain mechanistic insight at the cellular and molecular levels into why erectile dysfunction precedes the clinical consequences of cardiovascular disease. Diabetes was induced by intraperitoneal streptozotocin injection in 8-week-old C57BL/6J mice. At 8 weeks after diabetes induction, we determined the expression of endothelial cell-cell junction proteins and vascular endothelial permeability in the penis, heart and hind limb by systemic injection of various vascular space markers (350 Da to 2,000 kDa) or by immunohistochemical staining with antibody to oxidized low density lipoprotein. We also investigated the effect of recombinant Ang1 protein on cavernous endothelial permeability. Alterations in the integrity of the endothelial cell-cell junction, including a decrease in endothelial cell-cell junction proteins and an increase in vascular permeability to fluorescent tracers or oxidized low density lipoprotein, were prominent in the cavernous tissue of diabetic mice. In contrast, no significant changes in endothelial cell-cell junction proteins or vascular permeability were noted in heart or hind limb tissue according to the diabetic condition. Intracavernous injection of Ang1 protein, an anti-permeability factor, significantly decreased cavernous endothelial permeability to oxidized low density lipoprotein by restoring endothelial cell-cell junction proteins in diabetic mice. The incompetent cavernous endothelial cell-cell junction in the diabetic condition provides an important clue to why erectile dysfunction is highly prevalent and often precedes other systemic vascular diseases. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Spinal cord stimulation for ischemic heart disease and peripheral vascular disease.

    Science.gov (United States)

    De Vries, J; De Jongste, M J L; Spincemaille, G; Staal, M J

    2007-01-01

    Ischemic disease (ID) is now an important indication for electrical neuromodulation (NM), particularly in chronic pain conditions. NM is defined as a therapeutic modality that aims to restore functions of the nervous system or modulate neural structures involved in the dysfunction of organ systems. One of the NM methods used is chronic electrical stimulation of the spinal cord (spinal cord stimulation: SCS). SCS in ID, as applied to ischemic heart disease (IHD) and peripheral vascular disease (PVD), started in Europe in the 1970s and 1980s, respectively. Patients with ID are eligible for SCS when they experience disabling pain, resulting from ischaemia. This pain should be considered therapeutically refractory to standard treatment intended to decrease metabolic demand or following revascularization procedures. Several studies have demonstrated the beneficial effect of SCS on IHD and PVD by improving the quality of life of this group of severely disabled patients, without adversely influencing mortality and morbidity. SCS used as additional treatment for IHD reduces angina pectoris (AP) in its frequency and intensity, increases exercise capacity, and does not seem to mask the warning signs of a myocardial infarction. Besides the analgesic effect, different studies have demonstrated an anti-ischemic effect, as expressed by different cardiac indices such as exercise duration, ambulatory ECG recording, coronary flow measurements, and PET scans. SCS can be considered as an alternative to open heart bypass grafting (CABG) for patients at high risk from surgical procedures. Moreover, SCS appears to be more efficacious than transcutaneous electrical nerve stimulation (TENS). The SCS implantation technique is relatively simple: implanting an epidural electrode under local anesthesia (supervised by the anesthesist) with the tip at T1, covering the painful area with paraesthesia by external stimulation (pulse width 210, rate 85 Hz), and connecting this electrode to a

  16. Type VIII collagen is elevated in diseases associated with angiogenesis and vascular remodeling

    DEFF Research Database (Denmark)

    Hansen, N. U. B.; Willumsen, N.; Bülow Sand, Jannie Marie

    2016-01-01

    Objectives Type VIII collagen is involved in angiogenesis and remodeling of arteries. We hypothesized that type VIII collagen was upregulated in diseases associated with vascular remodeling, e.g. pulmonary fibrosis and cancer. In this paper we present the development and validation of a competitive...... performance, and in relevant disease cohorts. The developed ELISA was applied for the assessment of type VIII collagen in serum from patients diagnosed with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) and various cancers. Results The C8-C ELISA was technically stable...

  17. Arm exercise testing with myocardial scintigraphy in asymptomatic patients with peripheral vascular disease.

    Science.gov (United States)

    Goodman, S; Rubler, S; Bryk, H; Sklar, B; Glasser, L

    1989-04-01

    Arm exercise with myocardial scintigraphy and oxygen consumption determinations was performed by 33 men with peripheral vascular disease, 40 to 74 years of age (group 2). None had evidence of coronary disease. Nineteen age-matched male control subjects (group 1) were also tested to determine the normal endurance and oxygen consumption during arm exercise in their age group and to compare the results with those obtained during a standard treadmill performance. The maximal heart rate, systolic blood pressure, pressure rate product, and oxygen consumption were all significantly lower for arm than for leg exercise. However, there was good correlation between all these parameters for both types of exertion. The maximal heart rate, work load and oxygen consumption were greater for group 1 subjects than in patients with peripheral vascular disease despite similar activity status. None of the group 1 subjects had abnormal arm exercise ECGs, while six members of group 2 had ST segment changes. Thallium-201 scintigraphy performed in the latter group demonstrated perfusion defects in 25 patients. After nine to 29 months of follow-up, three patients who had abnormal tests developed angina and one of them required coronary bypass surgery. Arm exercise with myocardial scintigraphy may be an effective method of detecting occult ischemia in patients with peripheral vascular disease. Those with good exercise tolerance and no electrocardiographic changes or 201T1 defects are probably at lower risk for the development of cardiac complications, while those who develop abnormalities at low exercise levels may be candidates for invasive studies.

  18. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease

    DEFF Research Database (Denmark)

    Sarwar, N; Gao, P; Seshasai, S R Kondapally

    2010-01-01

    -analysis of individual records of diabetes, fasting blood glucose concentration, and other risk factors in people without initial vascular disease from studies in the Emerging Risk Factors Collaboration. We combined within-study regressions that were adjusted for age, sex, smoking, systolic blood pressure, and body...... for coronary heart disease were higher in women than in men, at 40-59 years than at 70 years and older, and with fatal than with non-fatal disease. At an adult population-wide prevalence of 10%, diabetes was estimated to account for 11% (10-12%) of vascular deaths. Fasting blood glucose concentration was non......-linearly related to vascular risk, with no significant associations between 3.90 mmol/L and 5.59 mmol/L. Compared with fasting blood glucose concentrations of 3.90-5.59 mmol/L, HRs for coronary heart disease were: 1.07 (0.97-1.18) for lower than 3.90 mmol/L; 1.11 (1.04-1.18) for 5.60-6.09 mmol/L; and 1.17 (1...

  19. Randomised intervention study to assess the prevalence of subclinical vascular disease and hidden kidney disease and its impact on morbidity and mortality: The ILERVAS project

    Directory of Open Access Journals (Sweden)

    Àngels Betriu

    2016-07-01

    Conclusions: The ILERVAS project will reveal the prevalence of subclinical vascular disease and hidden kidney disease, determine whether or not their early diagnosis brings health benefits and will also allow investigation of new risk factors.

  20. Erythropoietin resistance in end-stage renal disease patient with gastric antral vascular ectasia

    Directory of Open Access Journals (Sweden)

    Desiree Ji Re Lee

    2015-09-01

    Full Text Available AbstractWe observed a case of recombinant human erythropoietin resistance caused by Gastric Antral Vascular Ectasia in a 40-year-old female with ESRD on hemodialysis. Some associated factors such as autoimmune disease, hemolysis, heart and liver disease were discarded on physical examination and complementary tests. The diagnosis is based on the clinical history and endoscopic appearance of watermelon stomach. The histologic findings are fibromuscular proliferation and capillary ectasia with microvascular thrombosis of the lamina propria. However, these histologic findings are not necessary to confirm the diagnosis. Gastric Antral Vascular Ectasia is a serious condition and should be considered in ESRD patients on hemodialysis with anemia and resistance to recombinant human erythropoietin because GAVE is potentially curable with specific endoscopic treatment method or through surgical procedure.

  1. Studies on the association between Alzheimer's disease and vascular risk factors: reports from China

    Directory of Open Access Journals (Sweden)

    Ya LI

    2015-07-01

    Full Text Available Alzheimer's disease (AD is the most common cause of dementia, accounting for 60% to 80% of all types of dementia. Both genetic and non-genetic factors may take part in the etiopathogenesis of AD. Among them, genetic factors play a decisive role in the development of AD. Gene mutations associated with AD include amyloid β-protein precursor (APP, presenilin-1 (PS-1, presenilin-2 (PS-2 and apolipoprotein Eε4 (ApoEε4 allele gene. Vascular risk factors are the most common causes in non-genetic factors, such as hypertension, diabetes, hypercholesterolemia, smoking, drinking, obesity, intracranial arteriosclerosis, atrial fibrillation and cerebrovascular diseases. We selected three high-quality prospective cohort studies regarding the association of AD with vascular risk factors in Chinese population which were published in foreign journals during the past 5 years, and focused on study methods and results. DOI: 10.3969/j.issn.1672-6731.2015.07.004

  2. Is clopidogrel superior to aspirin in secondary prevention of vascular disease?

    Directory of Open Access Journals (Sweden)

    Algra Ale

    2000-11-01

    Full Text Available Abstract The cornerstone in clinical evidence of the relative efficacy of thienopyridines (clopidogrel, ticlopidine versus aspirin in the secondary prevention of vascular disease is the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events trial. This trial showed a modest benefit in the reduction of vascular events by clopidogrel. The results differed according to qualifying disorder: myocardial infarction, -3.7%; ischaemic stroke, +7.3%; and peripheral arterial disease, +23.8% (P = 0.042. Similar results were found for ticlopidine after brain ischaemia. The safety of clopidogrel appears to be similar to that of aspirin and better than that of ticlopidine. However, the recent report of thrombotic thrombocytopenic purpura in association with clopidogrel causes concern.

  3. Liver hemangioma and vascular liver diseases in patients with systemic lupus erythematosus

    Science.gov (United States)

    Berzigotti, Annalisa; Frigato, Marilena; Manfredini, Elena; Pierpaoli, Lucia; Mulè, Rita; Tiani, Carolina; Zappoli, Paola; Magalotti, Donatella; Malavolta, Nazzarena; Zoli, Marco

    2011-01-01

    AIM: To investigate whether systemic lupus erythematosus (SLE) is associated with benign focal liver lesions and vascular liver diseases, since these have been occasionally reported in SLE patients. METHODS: Thirty-five consecutive adult patients with SLE and 35 age- and sex-matched healthy controls were evaluated. Hepatic and portal vein patency and presence of focal liver lesions were studied by colour-Doppler ultrasound, computerized tomography and magnetic resonance were used to refine the diagnosis, clinical data of SLE patients were reviewed. RESULTS: Benign hepatic lesions were common in SLE patients (54% vs 14% controls, P hepatic hemangioma were observed, both in patients hospitalized for abdominal symptoms, suggesting that vascular liver diseases should be specifically investigated in this population. CONCLUSION: SLE is associated with 5-fold increased odds of liver hemangiomas, suggesting that these might be considered among the hepatic manifestations of SLE. PMID:22110281

  4. 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

    -reactive protein), ischemic vascular diseases (ischemic heart disease, myocardial infarction, ischemic cerebrovascular disease and ischemic stroke) and death after an ischemic heart disease diagnosis. We genotyped the Copenhagen City Heart Study, a prospective study including 10 398 participants with 30-32 years....... Furthermore, the odds/hazard ratios for ischemic vascular disease did not differ from 1.0 for CYP2C9 carriers versus noncarriers. Finally, we found no altered risk of early death after a diagnosis of ischemic heart disease. For all end points, we could exclude even minor changes in risk of disease with 90......% 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...

  5. A combined vascular surgical and clinical genetics approach to diffuse aneurysmal disease

    Science.gov (United States)

    Jones, KA; Canham, N; Renton, S; Pollitt, R; Nesbitt, M; Kopcke, D; Islam, L; Buckley, J; Ghali, N; Vandersteen, A

    2015-01-01

    We report two patients who presented with extensive aneurysmal disease, in association with minimal external physical signs. Patient 1 remained genetically undiagnosed despite multiple structural, biochemical and genetic investigations. He made a good recovery following surgery for popliteal and left axillary artery aneurysms. Patient 2 was diagnosed with vascular type Ehlers–Danlos syndrome, associated with a high degree of tissue and blood vessel fragility, and is being managed conservatively. Early multidisciplinary assessment of such patients facilitates accurate diagnosis and management. PMID:26264107

  6. Changes in Albuminuria Predict Mortality and Morbidity in Patients with Vascular Disease

    OpenAIRE

    Schmieder, Roland E.; Mann, Johannes F. E.; Schumacher, Helmut; Gao, Peggy; Mancia, Giuseppe; Weber, Michael A.; McQueen, Matthew; Koon, Teo; Yusuf, Salim

    2011-01-01

    The degree of albuminuria predicts cardiovascular and renal outcomes, but it is not known whether changes in albuminuria also predict similar outcomes. In two multicenter, multinational, prospective observational studies, a central laboratory measured albuminuria in 23,480 patients with vascular disease or high-risk diabetes. We quantified the association between a greater than or equal to twofold change in albuminuria in spot urine from baseline to 2 years and the incidence of cardiovascular...

  7. Sustained release nitrite therapy results in myocardial protection in a porcine model of metabolic syndrome with peripheral vascular disease

    OpenAIRE

    Bradley, Jessica M.; Islam, Kazi N.; Polhemus, David J.; Donnarumma, Erminia; Brewster, Luke P.; Tao, Ya-Xiong; Goodchild, Traci T.; Lefer, David J.

    2015-01-01

    In a clinically relevant porcine model of metabolic syndrome and peripheral vascular disease, treatment with a novel sustained-release nitrite formulation restored cardiac endothelial nitric oxide synthase, enhancing myocardial nitrite levels, reduced oxidative stress, and improved ex vivo coronary vascular function via endothelium-independent vasodilation mechanism in obese Ossabaw swine.

  8. Laser in situ keratomileusis in patients with collagen vascular disease: a review of the literature.

    Science.gov (United States)

    Simpson, Rachel G; Moshirfar, Majid; Edmonds, Jason N; Christiansen, Steven M; Behunin, Nicholas

    2012-01-01

    To evaluate the current United States Food and Drug Administration (FDA) recommendations regarding laser in situ keratomileusis (LASIK) surgery in patients with collagen vascular diseases (CVD) and assess whether these patients make appropriate candidates for laser vision correction, and offer treatment recommendations based on identified clinical data. A literature search was conducted using PubMed, Medline, and Ovid to identify all existing studies of LASIK in patients with collagen vascular diseases. The search was conducted without date limitations. Keywords used for the search included MeSH terms: laser in situ keratomileusis, LASIK, refractive surgery, ocular surgery, and cataract surgery connected by "and" with the following MeSH and natural-language terms: collagen vascular disease, rheumatic disease, systemic disease, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, seronegative spondyloarthropathy, HLA B27, ankylosing spondylitis, reactive arthritis, psoriatic arthritis. The abstracts for all studies meeting initial search criteria were reviewed; relevant studies were included. No prospective studies were found; however, four retrospective case studies were identified that examined LASIK surgery in patients with CVD. Several case reports were also identified in similar fashion. The FDA considers CVD a relative contraindication to LASIK surgery, due largely to the ocular complications associated with disease in the CVD spectrum. However, recent studies of LASIK in patients with CVD indicate LASIK may be safe for patients with very well-controlled systemic disease, minimal ocular manifestations, and no clinical signs or history of dry-eye symptoms. LASIK surgery may be safe in patients with rheumatoid arthritis or systemic lupus erythematosus and the seronegative spondyloarthropathies if stringent preoperative criteria are met. Evidence suggests patients with Sjögren's syndrome are not suitable candidates for LASIK.

  9. The role of robotic surgical system in the management of vascular disease.

    Science.gov (United States)

    Lin, Judith C

    2013-10-01

    The evolution of minimally invasive treatment for aneurysms and occlusive disease has led to the development of endovascular, laparoscopic, and robot-assisted techniques. This article reviews the current literature on the clinical use of robotic surgical systems in the treatment of patients with aneurysms and occlusive disease. A MEDLINE search was performed using the keywords "robotic, vascular, AND surgery." All pertinent articles concerning the use of the robotic surgical system on aneurysms and occlusive disease were reviewed. The author's personal experience consisted of a retrospective review of a prospectively maintained confidential database on all procedures performed with the da Vinci(®) surgical system. Several robot-assisted laparoscopic series on the treatment of aortic disease were identified, including review articles of potential clinical applications in hybrid, laparoscopic vascular, and endovascular treatments for vascular patients using robotic technology. The use of computer-enhanced or robotic technology as a sole modality for bypass of occlusive disease and repair of abdominal aortic, splenic, and renal aneurysms was described in case series with satisfactory patient outcomes. Current robotic endovascular technology was also described. Minimally invasive techniques using endovascular, laparoscopic, or robot-assisted technology have revolutionized the treatment of aortoiliac, splanchnic, and renal aneurysms and occlusive disease. However, robot-assisted techniques for aortic disease may involve a learning curve and increased operating times. Although endovascular therapy is preferred because of faster recovery, this preference for improved short-term outcomes will be balanced with the superiority and durability of robot-assisted endoscopic methods as comparable to open surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. [Diagnostic value of digital subtraction angiography (DSA) using Toshiba Digiformer X in the cerebrospinal vascular diseases].

    Science.gov (United States)

    Ishikawa, T; Nakagawa, Y; Sawamura, Y; Kobayashi, N; Nagashima, M; Kitaoka, K; Kitagawa, M; Itoh, T; Ohsato, T

    1987-05-01

    Using TOSHIBA Digiformer X, digital subtraction angiography (DSA) was performed in 286 patients, in whom 229 patients of cerebro-spinal vascular disease was included. The authors emphasize the usefulness of DSA in cerebro-spinal vascular disease in relation to conventional angiography. DSA taken by single small dose injection of contrast medium into the ascending aorta clearly demonstrates not only aortic arch and thoracic major vessels, but also cervical vessels and all intracranial vessels. Therefore, we could rapidly understand gross dynamics of the circulation and obtain useful informations prior to catheterization to the selective artery. This advantage of DSA was particularly useful for occlusive vascular diseases. Gradual injection of small dose of contrast medium obviously reduced recoiling of the catheter tip, which enabled the selective angiography with setting of the tip of the catheter at the entrance of cervical major vessels without its sufficient insertion into the selective vessels. This advantage is particularly beneficial for the patients with severe arteriosclerosis who was found to be difficult for selective catheterization. In our experience, demonstration of a presence of aneurysm by DSA was possible in almost all cases of subarachnoid hemorrhage, although spatial resolution of DSA is said to be inferior to the conventional angiography. Real time display of DSA decreased the time required for examination and enabled repeated angiography. This advantage of DSA is especially useful for the patients with spinal arterio-venous malformation and thoracic outlet syndrome.

  11. Asymptomatic carotid artery stenosis in patients with severe peripheral vascular diseases

    Directory of Open Access Journals (Sweden)

    Rasoul Mirsharifi

    2009-04-01

    Full Text Available

    • BACKGROUND: The prevalence of carotid artery stenosis (CAS in the  eneral population is not high enough to justify screening programs. This study was done to determine the prevalence of asymptomatic carotid artery stenosis (ACAS among patients with severe peripheral vascular disease (PVD.
    • METHODS: Between March 2005 and February 2006, 54 consecutive  atients with severe PVD admitted at a vascular surgery unit and underwent carotid duplex scanning in a prospective study. A  uestionnaire was used to collect data concerning known risk factors. Significant CAS was defined as a stenosis of 70% or greater.
    • RESULTS: The mean age was 62.5 years (51-72. Out of 54 patients, 2 (3.7% had an occluded internal carotid artery. Significant CAS was found in 9 (16.7% and its presence was correlated with diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, coronary artery disease, severity of symptoms, ankle-brachial index, and carotid bruit. On multivariate analysis, only hypercholesterolemia and carotid bruit seemed to have independent influence.
    • CONCLUSION: The prevalence of significant ACAS is higher among  atients with severe PVD. This patient population may indicate a  uitable subgroup for screening of ACAS, especially when hypercholesterolemia and carotid bruit are present.
    • KEYWORDS: Carotid artery stenosis, duplex ultrasound scanning, peripheral vascular disease, carotid endarterectomy,
    • cerebrovascular accident.

  12. Treatment of a High-Risk Diabetic Patient with Peripheral Vascular Disease and Osteomyelitis.

    Science.gov (United States)

    Allen, Latricia L; Kalmar, Garrett; Driver, Vickie R

    2016-06-01

    We report a case of calcaneal osteomyelitis that was surgically resected from a patient with diabetes and peripheral vascular disease. A 91-year-old male with history of type 2 diabetes, peripheral vascular disease, balloon angioplasty, and recent (2 months ago) stent of the superficial femoral artery presented to the emergency department with a left heel wound infection probed to bone. The patient reported having been on intravenous Zosyn for several months via an outside infectious disease provider for clinical suspicion of osteomyelitis, but noted no improvement. This report includes information regarding the clinical examination and imaging findings, which were used to assess this high-risk patient. Our patient underwent a partial calcanectomy and completed a 6-week course of intravenous antibiotics. The purpose of this case report is to illustrate limb preservation in a high-risk patient with compromised vascular supply who underwent a partial calcanectomy for treatment of calcaneal osteomyelitis. The patient underwent surgical resection of the calcaneus without complications and healed unremarkably with the ability to ambulate while wearing an ankle foot orthosis with a custom shoe. This report was authorized for publication as an educational report to contribute to generalizable knowledge and does not include any patient health information. Copyright © 2016. Published by Elsevier Inc.

  13. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

    Directory of Open Access Journals (Sweden)

    Wright F

    2012-10-01

    Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

  14. 18F-FDG PET imaging in detection of radiation-induced vascular disease in lymphoma survivors

    DEFF Research Database (Denmark)

    Ripa, Rasmus S.; Hag, Anne Mette; Knudsen, Andreas

    2015-01-01

    Radiation therapy (RT) induces vascular changes that increase the risk of cardiovascular diseases in some patients. The objective was to determine if in vivo positron emission tomography (PET) with fluorodeoxyglucose (18F-FDG) can identify increased vascular inflammation in patients without changes...... in vascular intima media thickness (IMT). Patients previously receiving unilateral RT due to lymphoma were prospectively recruited (N=10). The untreated contralateral artery functioned as control. All patients underwent a dedicated vascular PET/CT. Vascular tracer uptake was quantified by drawing regions...... (P=0.04). Measurement of IMT showed that 4 patients had the highest thickness in the irradiated side, while the other 4 patients had the highest thickness in the non-irradiated side (P=0.8). In conclusion, we found that (18)F-FDG PET imaging may be used to detect vascular changes induced by RT...

  15. (18)F-FDG PET imaging in detection of radiation-induced vascular disease in lymphoma survivors

    DEFF Research Database (Denmark)

    Ripa, Rasmus S; Hag, Anne Mette; Knudsen, Andreas

    2015-01-01

    Radiation therapy (RT) induces vascular changes that increase the risk of cardiovascular diseases in some patients. The objective was to determine if in vivo positron emission tomography (PET) with fluorodeoxyglucose ((18)F-FDG) can identify increased vascular inflammation in patients without...... changes in vascular intima media thickness (IMT). Patients previously receiving unilateral RT due to lymphoma were prospectively recruited (N=10). The untreated contralateral artery functioned as control. All patients underwent a dedicated vascular PET/CT. Vascular tracer uptake was quantified by drawing......- irradiated side (P=0.04). Measurement of IMT showed that 4 patients had the highest thickness in the irradiated side, while the other 4 patients had the highest thickness in the non-irradiated side (P=0.8). In conclusion, we found that (18)F-FDG PET imaging may be used to detect vascular changes induced...

  16. Longitudinal cognitive decline in subcortical ischemic vascular disease--the LADIS Study

    DEFF Research Database (Denmark)

    Jokinen, Hanna; Kalska, Hely; Ylikoski, Raija

    2009-01-01

    BACKGROUND: Cross-sectional studies have indicated that subcortical ischemic vascular disease (SIVD), as defined according to imaging criteria, is associated with a specific clinical and cognitive profile. Much less is known about the long-term cognitive consequences of SIVD. The aim of the study......, education and medial temporal lobe atrophy. CONCLUSIONS: SIVD, as a manifestation of cerebral small vessel disease, is related to progressive cognitive impairment and a considerable risk of developing dementia. SIVD seems to specifically contribute to the deterioration of psychomotor speed, executive...

  17. The relationship between depression and executive function and the impact of vascular disease burden in younger and older adults

    NARCIS (Netherlands)

    Lugtenburg, Astrid; Voshaar, Richard C. Oude; Van Zelst, Willeke; Schoevers, Robert A.; Enriquez-Geppert, Stefanie; Zuidersma, Marij

    2017-01-01

    Background: depression is associated with worse executive function, but underlying mechanisms might differ by age. Aims: to investigate whether vascular disease burden affects the association between depression and executive dysfunction differentially by age. Method: among 83,613 participants of

  18. Cohort study of predictive value of urinary albumin excretion for atherosclerotic vascular disease in patients with insulin dependent diabetes

    DEFF Research Database (Denmark)

    Deckert, T; Yokoyama, H; Mathiesen, E

    1996-01-01

    OBJECTIVE: To examine whether slightly elevated urinary albumin excretion precedes development of atherosclerotic vascular disease in patients with insulin dependent diabetes independently of conventional atherogenic risk factors and of diabetic nephropathy. DESIGN: Cohort study with 11 year follow......, smoking habits, and serum concentrations of total cholesterol, high density lipoprotein cholesterol, sialic acid, and von Willebrand factor. END POINT: atherosclerotic vascular disease assessed by death certificates, mailed questionnaires, and hospital records. RESULTS: Thirty patients developed...... atherosclerotic vascular disease during follow up of 2457 person year. Elevated urinary albumin excretion was significantly predictive of atherosclerotic vascular disease (hazard ratio 1.06 (95% confidence interval 1.02 to 1.18) per 5 mg increase in 24 hour urinary albumin excretion, P = 0.002). Predictive effect...

  19. An update on type 2 diabetes, vascular dementia and Alzheimer's disease.

    Science.gov (United States)

    Exalto, L G; Whitmer, R A; Kappele, L J; Biessels, G J

    2012-11-01

    The risk of dementia is increased in people with type 2 diabetes mellitus (T2DM). This review gives an update on the relation between T2DM and specific dementia subtypes - i.e. Alzheimer's disease and vascular dementia - and underlying pathologies. We will show that while epidemiological studies link T2DM to Alzheimer's disease as well as vascular dementia, neuropathological studies attribute the increased dementia risk in T2DM patients primarily to vascular lesions in the brain. Risk factors for dementia among patients with T2DM are also addressed. Currently, there is evidence that microvascular complications, atherosclerosis and severe hypoglycemic events increase dementia risk. However, for a more complete understanding of risk factors for dementia in T2DM a life time perspective is needed. This should identify which individuals are at increased risk, what are vulnerable periods in life, and what are windows of opportunity for treatment. Currently, there are no DM specific treatments for dementia, but we will review observations from clinical trials that tried to prevent cognitive decline through intensified glycemic control and address other clinical implications of the association between T2DM and dementia. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Cognitive Impairment in Chronic Kidney Disease: Vascular Milieu and the Potential Therapeutic Role of Exercise

    Directory of Open Access Journals (Sweden)

    Ulf G. Bronas

    2017-01-01

    Full Text Available Chronic kidney disease (CKD is considered a model of accelerated aging. More specifically, CKD leads to reduced physical functioning and increased frailty, increased vascular dysfunction, vascular calcification and arterial stiffness, high levels of systemic inflammation, and oxidative stress, as well as increased cognitive impairment. Increasing evidence suggests that the cognitive impairment associated with CKD may be related to cerebral small vessel disease and overall impairment in white matter integrity. The triad of poor physical function, vascular dysfunction, and cognitive impairment places patients living with CKD at an increased risk for loss of independence, poor health-related quality of life, morbidity, and mortality. The purpose of this review is to discuss the available evidence of cerebrovascular-renal axis and its interconnection with early and accelerated cognitive impairment in patients with CKD and the plausible role of exercise as a therapeutic modality. Understanding the cerebrovascular-renal axis pathophysiological link and its interconnection with physical function is important for clinicians in order to minimize the risk of loss of independence and improve quality of life in patients with CKD.

  1. Malnutrition and its association with inflammation and vascular disease in children on maintenance dialysis.

    Science.gov (United States)

    Canpolat, Nur; Caliskan, Salim; Sever, Lale; Tasdemir, Mehmet; Ekmekci, Ozlem Balcı; Pehlivan, Gulseren; Shroff, Rukshana

    2013-11-01

    Malnutrition is associated with both inflammation and atherosclerotic cardiovascular disease in adults with chronic kidney disease. We studied the prevalence of malnutrition and its possible associations with inflammation and vascular disease in children on chronic dialysis. Thirty-three patients on maintenance dialysis (18 peritoneal dialysis, 15 hemodialysis) and 19 age- and gender- matched healthy controls were studied. Nutritional status was assessed by anthropometric measurements including body mass index (BMI), upper arm measurements, multifrequency bioimpedance analysis (BIA) and serum levels of albumin, prealbumin, and cholesterol. Inflammation was assessed by serum levels of C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-alpha. The carotid artery intima thickness (cIMT) was measured to assess vascular disease. Compared with healthy children, patients had lower anthropometric measurements (P Malnutrition was present in 8 (24%) and lower BIA-based fat mass was independently associated with higher IL-6 levels (P = 0.035). An increased cIMT was present in 16 (48.5%); however, there was no difference in cIMT-SDS between patients with and without malnutrition. Carotid IMT did not show any association with nutritional indices; but positively correlated with serum IL-6 (P = 0.037), CRP (P = 0.012), and iPTH (P = 0.009), and independently associated with only iPTH (P = 0.018). Children on dialysis are at an increased risk of malnutrition, inflammation, and vascular disease. Although each of these three conditions exists, there is no interaction among them all. We postulate that the malnutrition-inflammation-atherosclerosis (MIA) complex might not exist in pediatric dialysis patients.

  2. Rac-1 as a new therapeutic target in cerebro- and cardio-vascular diseases.

    Science.gov (United States)

    Carrizzo, Albino; Forte, Maurizio; Lembo, Maria; Formisano, Luigi; Puca, Annibale A; Vecchione, Carmine

    2014-01-01

    Growing evidence indicates that overproduction of reactive oxygen species (ROS) plays a prominent role in the development of cardio- and cerebro-vascular diseases. Among the mechanisms identified to produce oxidative stress in the vascular wall, those mediated by membrane-bound NAD(P)H oxidases represent a major one. NAD(P)H oxidases are a family of enzymes that generate ROS both in phagocytic and non-phagocytic cell types. Vascular NAD(P)H oxidase contains the membrane-bound subunits Nox1, Nox2 (gp91phox), Nox4 and p22phox, the catalytic site of the oxidase, and the cytosolic components p47phox and p67phox. Rac1 (Ras-related C3 botulinum toxin substrate1) is a small GTPase essential for the assembly and activation of NADPH oxidase. Several molecular and cellular studies have reported the involvement of Rac1 in different cardiovascular pathologies, such as vascular smooth muscle proliferation, cardiomyocyte hypertrophy, endothelial cell shape change, atherosclerosis and endothelial dysfunction in hypertension. In addition, increased activation of NADPH oxidase by Rac1 has been reported in animals and humans after myocardial infarction and heart failure. The Rac1/NADPH pathway has also been found involved in different pathologies of the cerebral district, such as ischemic stroke, cognitive impairment, subaracnoid hemorrhage and neuronal oxidative damage typical of several neurodegenerative disorders. In addition, thrombotic events are an important step in the onset of cardio- and cerebrovascular diseases. Rac1 has been found involved also in platelet activation, inducing actin polymerization and lamellipodia formation, which are necessary steps for platelet aggregation. Taken together, the evidence candidates Rac1 as a new pharmacological target of cardiovascular and cerebrovascular diseases. Although the involvement of Rac1 in the beneficial pleiotropic effects of drugs such as statins is well known, and the onset of numerous side effects has raised concern for the

  3. White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal aging

    OpenAIRE

    Barber, R; Scheltens, P.; Gholkar, A.; Ballard, C; McKeith, I; Ince, P.; Perry, R.; O'Brien, J

    1999-01-01

    OBJECTIVES—Alzheimer's disease and vascular dementia are associated with an increase in changes in white matter on MRI. The aims were to investigate whether white matter changes also occur in dementia with Lewy bodies and to examine the relation between white matter lesions and the cognitive and non-cognitive features of dementia with Lewy bodies, Alzheimer's disease, and vascular dementia.
METHODS—Proton density and T2 weighted images were obtained on a 1.0 Tesla MRI sca...

  4. Vascular Dysfunction in a Transgenic Model of Alzheimer's Disease: Effects of CB1R and CB2R Cannabinoid Agonists

    OpenAIRE

    Jorge Navarro-Dorado; Nuria Villalba; Dolores Prieto; Begoña Brera; Ana María Martín-Moreno; Teresa Tejerina; de Ceballos, Maria L

    2016-01-01

    There is evidence of altered vascular function, including cerebrovascular, in Alzheimer's disease (AD) and transgenic models of the disease. Indeed vasoconstrictor responses are increased, while vasodilation is reduced in both conditions. β-Amyloid (Aβ) appears to be responsible, at least in part, of alterations in vascular function. Cannabinoids, neuroprotective and anti-inflammatory agents, induce vasodilation both in vivo and in vitro. We have demonstrated a beneficial effect of cannabinoi...

  5. Effect of diesel exhaust particles on renal vascular responses in rats with chronic kidney disease.

    Science.gov (United States)

    Al Suleimani, Y M; Al Mahruqi, A S; Al Za'abi, M; Shalaby, A; Ashique, M; Nemmar, A; Ali, B H

    2017-02-01

    Several recent studies have indicated the possible association between exposure to particulate air pollution and the increased rate of morbidity and mortality in patients with kidney diseases. The link of this observation to vascular damage has not been adequately addressed. Therefore, this study aims to investigate possible vascular damage that might be associated with exposure to diesel exhaust particles (DP) in adenine (AD)-induced chronic kidney disease (CKD) in rats, and the possible ameliorative effect of gum acacia (GA). CKD was induced by feeding AD (0.75%, w/w), and DP (0.5 mg/kg) was instilled intratracheally every second day and GA was given concomitantly in the drinking water at a dose of 15% w/v. All treatments were given concomitantly for 28 days. Changes in renal blood flow (RBF) and systolic and diastolic blood pressure were monitored in these animals after anesthesia, together with several other endpoints. Exposure to DP significantly reduced RBF and this was significantly potentiated in AD-treated rats. Phenylephrine-induced decreases in RBF and increases in systolic and diastolic blood pressure were severely potentiated in rats exposed to DP, and these actions were significantly augmented in AD-treated rats. GA did not significantly affect the vascular impairment induced by AD and DP given together. This study provides experimental evidence that exposure to particulate air pollution can exacerbate the vascular damage seen in patients with CKD. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 541-549, 2017. © 2016 Wiley Periodicals, Inc.

  6. Vascular damage: a persisting pathology common to Alzheimer's disease and traumatic brain injury.

    Science.gov (United States)

    Franzblau, Max; Gonzales-Portillo, Chiara; Gonzales-Portillo, Gabriel S; Diamandis, Theo; Borlongan, Mia C; Tajiri, Naoki; Borlongan, Cesar V

    2013-11-01

    Alzheimer's disease (AD) and traumatic brain injury (TBI) are both significant clinical problems characterized by debilitating symptoms with limited available treatments. Interestingly, both neurological diseases are characterized by neurovascular damage. This impaired brain vasculature correlates with the onset of dementia, a symptom associated with hippocampal degeneration seen in both diseases. We posit that vascular damage is a major pathological link between TBI and AD, in that TBI victims are predisposed to AD symptoms due to altered brain vasculature; vice versa, the progression of AD pathology may be accelerated by TBI especially when the brain insult worsens hippocampal degeneration. Our hypothesis is supported by recent data reporting expedited AD pathology in presymptomatic transgenic AD mice subjected to TBI. If our hypothesis is correct, treatments targeted at repairing the vasculature may prove effective at treating both diseases and preventing the evolution of AD symptoms in TBI victims. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Aerobic exercise training does not alter vascular structure and function in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Gelinas, Jinelle C; Lewis, Nia C; Harper, Megan I; Melzer, Bernie; Agar, Gloria; Rolf, J Douglass; Eves, Neil D

    2017-08-31

    What is the central question of this study? Chronic obstructive pulmonary disease (COPD) is associated with endothelial dysfunction, arterial stiffness and systemic inflammation, which are linked to increased cardiovascular disease risk. We asked whether periodized aerobic exercise training could improve vascular structure and function in patients with COPD. What is the main finding and its importance? Eight weeks of periodized aerobic training did not improve endothelial function, arterial stiffness or systemic inflammation in COPD, despite improvements in aerobic capacity, blood pressure and dyspnoea. Short-term training programmes may not be long enough to improve vascular-related cardiovascular risk in COPD. Chronic obstructive pulmonary disease (COPD) has been associated with endothelial dysfunction and arterial stiffening, which are predictive of future cardiovascular events. Although aerobic exercise improves vascular function in healthy individuals and those with chronic disease, it is unknown whether aerobic exercise can positively modify the vasculature in COPD. We examined the effects of 8 weeks of periodized aerobic training on vascular structure and function and inflammation in 24 patients with COPD (age, 69 ± 7 years; forced expiratory volume in 1 second as a percentage of predicted (FEV1 %pred), 68 ± 19%) and 20 matched control subjects (age, 64 ± 5 years; FEV1 %pred, 113 ± 16%) for comparison. Endothelial function was measured using brachial artery flow-mediated dilatation, whereas central and peripheral pulse wave velocity, carotid artery intima-media thickness, carotid compliance, distensibility and β-stiffness index were measured using applanation tonometry and ultrasound. Peak aerobic power (V̇O2 peak ) was measured using an incremental cycling test. Upper and lower body cycling training was performed three times per week for 8 weeks, and designed to optimize vascular adaptation by increasing and sustaining vascular shear

  8. Vascular Dementia

    OpenAIRE

    Maria Alekseyevna Cherdak; O V Uspenskaya

    2015-01-01

    This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/S0140-6736(15)00463-8 Vascular dementia is one of the most common causes of dementia after Alzheimer's disease, causing around 15% of cases. However, unlike Alzheimer's disease, there are no licensed treatments for vascular dementia. Progress in the specialty has been difficult because of uncertainties over disease classification and diagnostic criteria, controversy over the e...

  9. Thrombospondin-1 and CD47 regulation of cardiac, pulmonary and vascular responses in health and disease.

    Science.gov (United States)

    Rogers, Natasha M; Sharifi-Sanjani, Maryam; Csányi, Gábor; Pagano, Patrick J; Isenberg, Jeffrey S

    2014-07-01

    Cardiovascular homeostasis and health is maintained through the balanced interactions of cardiac generated blood flow and cross-talk between the cellular components that comprise blood vessels. Central to this cross-talk is endothelial generated nitric oxide (NO) that stimulates relaxation of the contractile vascular smooth muscle (VSMC) layer of blood vessels. In cardiovascular disease this balanced interaction is disrupted and NO signaling is lost. Work over the last several years indicates that regulation of NO is much more complex than previously believed. It is now apparent that the secreted protein thrombospondin-1 (TSP1), that is upregulated in cardiovascular disease and animal models of the same, on activating cell surface receptor CD47, redundantly inhibits NO production and NO signaling. This inhibitory event has implications for baseline and disease-related responses mediated by NO. Further work has identified that TSP1-CD47 signaling stimulates enzymatic reactive oxygen species (ROS) production to further limit blood flow and promote vascular disease. Herein consideration is given to the most recent discoveries in this regard which identify the TSP1-CD47 axis as a major proximate governor of cardiovascular health. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  10. VEGF production and signaling in Müller glia are critical to modulating vascular function and neuronal integrity in diabetic retinopathy and hypoxic retinal vascular diseases.

    Science.gov (United States)

    Le, Yun-Zheng

    2017-10-01

    Müller glia (MG) are major retinal supporting cells that participate in retinal metabolism, function, maintenance, and protection. During the pathogenesis of diabetic retinopathy (DR), a neurovascular disease and a leading cause of blindness, MG modulate vascular function and neuronal integrity by regulating the production of angiogenic and trophic factors. In this article, I will (1) briefly summarize our work on delineating the role and mechanism of MG-modulated vascular function through the production of vascular endothelial growth factor (VEGF) and on investigating VEGF signaling-mediated MG viability and neural protection in diabetic animal models, (2) explore the relationship among VEGF and neurotrophins in protecting Müller cells in in vitro models of diabetes and hypoxia and its potential implication to neuroprotection in DR and hypoxic retinal diseases, and (3) discuss the relevance of our work to the effectiveness and safety of long-term anti-VEGF therapies, a widely used strategy to combat DR, diabetic macular edema, neovascular age-related macular degeneration, retinopathy of prematurity, and other hypoxic retinal vascular disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Correlation of elderly nutritional status with cardio-vascular disease and diabetes

    Directory of Open Access Journals (Sweden)

    Dorosty A R

    2007-07-01

    Full Text Available Background: The effects of population aging are becoming apparent throughout the world. Diseases, such as cardio-vascular disease (CVD and diabetes, are among the most important factors affecting morbidity and mortality, especially in the elderly. These diseases not only result in huge economic costs for treatment and care, but also results in hardship and time lost for relatives of the afflicted individuals. The association between nutritional status and disease is well known. In the present study, the effects of both under-nutrition and over-nutrition on the prevalence of disease are monitored in an urban Iranian elderly population. Thus far, no similar study has been performed in the Iran. Methods: This cross-sectional study was conducted in Isfahan, Iran, during late 2003 on 1694 elderly people (731 males, 963 females, aged 60 years and older. Subjects were randomly chosen from all urban elderly people during a door-to-door and weight and height survey. They were selected using a cluster sampling method, each containing 30 clusters. From each cluster, 58 elderly were selected at random. Using each subjects body mass index (BMI, the nutritional status was categorized as overweight (BMI greater than 25, underweight (BMI less than 19 and normal (having a BMI equal to or more than 19 and equal to or less than 25. Any illnesses known to each subject were also recorded. Results: Results showed that 4.7% of the subjects were underweight and 61.2% overweight. Women were more likely to be overweight and long periods of watching television increased the risk of overweight in all subjects. Being overweight was associated with diabetes and coronary vascular diseases, and lean people were less likely to suffer from such diseases. Conclusion: This study indicates a high prevalence of overweight among the Iranian elderly population, indicating the need for improvement in nutritional status in order to reduce the prevalence of diabetes and CVD.

  12. [The age-related macular degeneration as a vascular disease/part of systemic vasculopathy: contributions to its pathogenesis].

    Science.gov (United States)

    Fischer, Tamás

    2015-03-01

    The wall of blood vessels including those in choroids may be harmed by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic, and genetic impacts (risk factors), which may trigger a protracted response, the so-called host defense response. As a consequence, pathological changes resulting in vascular injury (e. g. atherosclerosis, age-related macular degeneration) may be evolved. Risk factors can also act directly on the endothelium through an increased production of reactive oxygen species promoting an endothelial activation, which leads to endothelial dysfunction, the onset of vascular disease. Thus, endothelial dysfunction is a link between the harmful stimulus and vascular injury; any kind of harmful stimuli may trigger the defensive chain that results in inflammation that may lead to vascular injury. It has been shown that even early age-related macular degeneration is associated with the presence of diffuse arterial disease and patients with early age-related macular degeneration demonstrate signs of systemic and retinal vascular alterations. Chronic inflammation, a feature of AMD, is tightly linked to diseases associated with ED: AMD is accompanied by a general inflammatory response, in the form of complement system activation, similar to that observed in degenerative vascular diseases such as atherosclerosis. All these facts indicate that age-related macular degeneration may be a vascular disease (or part of a systemic vasculopathy). This recognition could have therapeutic implications because restoration of endothelial dysfunction may prevent the development or improve vascular disease resulting in prevention or improvement of age-related macular degeneration as well.

  13. Clinical presentation and outcome of geriatric depression in subcortical ischemic vascular disease.

    Science.gov (United States)

    Bella, R; Pennisi, G; Cantone, M; Palermo, F; Pennisi, M; Lanza, G; Zappia, M; Paolucci, S

    2010-01-01

    Vascular damage of frontal-subcortical circuits involved in mood regulation and cognition might be the main contributor to the pathogenesis of late-life depression, and it is linked to poor response to treatment. To investigate the relationship between executive dysfunction and outcome of depressive symptoms among elderly patients with subcortical ischemic vascular disease. Ninety-two elderly patients with white matter lesions (WMLs) or lacunar infarcts (LAs) on brain MRI and depressive symptomatology were consecutively recruited. Depression was rated with the Hamilton Depression Rating Scale (HDRS). Evaluation of executive functions by means of the Stroop color-word test was performed at entry of the study, and WMLs were categorized into mild, moderate or severe. Mood was reevaluated by means of HDRS after the 12th week of pharmacological treatment. Psychomotor retardation, difficulties at work, apathy, and lack of insight were the predominant symptoms. Fifty-six patients (62.8%) had a neuroradiological picture of WMLs, while the remaining 33 (37.1%) had LAs. Executive dysfunctions significantly and independently predict poor outcome of depressive symptoms. Patients with the severest WMLs showed not only a greater executive dysfunction, but also a minor response to antidepressant treatment. This study supports the vascular depression hypothesis. WMLs are of crucial clinical relevance as they are linked with cognitive symptoms and poor antidepressant outcome. 2009 S. Karger AG, Basel.

  14. Pulmonary vascular abnormalities in chronic obstructive pulmonary disease undergoing lung transplant.

    Science.gov (United States)

    Peinado, Victor I; Gómez, Federico P; Barberà, Joan Albert; Roman, Antonio; Angels Montero, M; Ramírez, Josep; Roca, Josep; Rodriguez-Roisin, Roberto

    2013-12-01

    Little is known about the structure and function relationships of pulmonary vessels in the most severe chronic obstructive pulmonary disease (COPD) spectrum. We investigated morphometric, cellular, and physiologic characteristics of pulmonary arteries from COPD patients undergoing bilateral lung transplant. Seventeen patients with very severe COPD (forced expiratory volume in 1 second, 24% ± 7%) were assessed using inert gas exchange and pulmonary hemodynamics while breathing ambient air and 100% oxygen. Morphometry, in vitro reactivity to hypoxia, and inflammatory cell counts of pulmonary arteries were measured in explanted lungs. Patients had moderate ventilation-perfusion imbalance along with mild release of hypoxic pulmonary vasoconstriction. Mild pulmonary hypertension was observed in 7 patients. Explanted lungs had predominant emphysema with mild small airway involvement. In vitro reactivity was modestly altered, with relatively preserved endothelium-dependent relaxation, and vascular remodelling was discrete, with intense CD8+ T lymphocytes infiltrate. In vitro reactivity correlated with pulmonary vascular resistance (on ambient air) and oxygen-induced pulmonary artery pressure changes. Patients with pulmonary hypertension had more severe morphologic and physiologic emphysema. In end-stage COPD patients undergoing lung transplant, pulmonary vascular involvement is unexpectedly modest, with low-grade endothelial dysfunction. In this sub-set of COPD patients, pulmonary emphysema may constitute the major determinant of the presence of pulmonary hypertension. © 2013 International Society for Heart and Lung Transplantation Published by International Society for the Heart and Lung Transplantation All rights reserved.

  15. Reduced 25-hydroxyvitamin D and risk of Alzheimer's disease and vascular dementia

    DEFF Research Database (Denmark)

    Afzal, Shoaib; Bojesen, Stig E; Nordestgaard, Børge G

    2014-01-01

    BACKGROUND: Vitamin D deficiency has been implicated as a risk factor for dementia in several cross-sectional studies. We tested the hypothesis that reduced plasma 25-hydroxyvitamin D (25[OH]D) is associated with increased risk of Alzheimer's disease (AD) and vascular dementia in the general...... population. METHODS: We measured baseline plasma 25(OH)D in 10,186 white individuals from the Danish general population. RESULTS: During 30 years of follow-up, 418 participants developed AD and 92 developed vascular dementia. Multivariable adjusted hazard ratios for AD were 1.25 (95% confidence interval [CI......], 0.95-1.64) for 25(OH)D less than 25 nmol/L vs. greater than or equal to 50 nmol/L, and 1.29 (95% CI, 1.01-1.66) for less than the 25th seasonally adjusted 25(OH)D percentile vs. more than the 50th seasonally adjusted 25(OH)D percentile. Multivariable adjusted hazard ratios for vascular dementia were...

  16. Small vascular and Alzheimer disease-related pathologic determinants of dementia in the oldest-old.

    Science.gov (United States)

    Sinka, Lidia; Kövari, Enikö; Gold, Gabriel; Hof, Patrick R; Herrmann, François R; Bouras, Constantin; Giannakopoulos, Panteleimon

    2010-12-01

    The relative contributions of Alzheimer disease (AD) and vascular lesion burden to the occurrence of cognitive decline are more difficult to define in the oldest-old than they are in younger cohorts. To address this issue, we examined 93 prospectively documented autopsy cases from 90 to 103 years with various degrees of AD lesions, lacunes, and microvascular pathology. Cognitive assessment was performed prospectively using the Clinical Dementia Rating scale. Neuropathologic evaluation included the Braak neurofibrillary tangle (NFT) and β-amyloid (Aβ) protein deposition staging and bilateral semiquantitative assessment of vascular lesions. Statistics included regression models and receiver operating characteristic analyses. Braak NFTs, Aβ deposition, and cortical microinfarcts (CMIs) predicted 30% of Clinical Dementia Rating variability and 49% of the presence of dementia. Braak NFT and CMI thresholds yielded 0.82 sensitivity, 0.91 specificity, and 0.84 correct classification rates for dementia. Using these threshold values, we could distinguish 3 groups of demented cases and propose criteria for neuropathologic definition of mixed dementia, pure vascular dementia, and AD in very old age. Braak NFT staging and severity of CMI allow for defining most of demented cases in the oldest-old. Most importantly, single cutoff scores for these variables that could be used in the future to formulate neuropathologic criteria for mixed dementia in this age group were identified.

  17. Early pulmonary vascular disease in preterm infants at risk for bronchopulmonary dysplasia.

    Science.gov (United States)

    Mourani, Peter M; Sontag, Marci K; Younoszai, Adel; Miller, Joshua I; Kinsella, John P; Baker, Christopher D; Poindexter, Brenda B; Ingram, David A; Abman, Steven H

    2015-01-01

    Pulmonary hypertension (PH) is associated with poor outcomes among preterm infants with bronchopulmonary dysplasia (BPD), but whether early signs of pulmonary vascular disease are associated with the subsequent development of BPD or PH at 36 weeks post-menstrual age (PMA) is unknown. To prospectively evaluate the relationship of early echocardiogram signs of pulmonary vascular disease in preterm infants to the subsequent development of BPD and late PH (at 36 wk PMA). Prospectively enrolled preterm infants with birthweights 500-1,250 g underwent echocardiogram evaluations at 7 days of age (early) and 36 weeks PMA (late). Clinical and echocardiographic data were analyzed to identify early risk factors for BPD and late PH. A total of 277 preterm infants completed echocardiogram and BPD assessments at 36 weeks PMA. The median gestational age at birth and birthweight of the infants were 27 weeks and 909 g, respectively. Early PH was identified in 42% of infants, and 14% were diagnosed with late PH. Early PH was a risk factor for increased BPD severity (relative risk, 1.12; 95% confidence interval, 1.03-1.23) and late PH (relative risk, 2.85; 95% confidence interval, 1.28-6.33). Infants with late PH had greater duration of oxygen therapy and increased mortality in the first year of life (P < 0.05). Early pulmonary vascular disease is associated with the development of BPD and with late PH in preterm infants. Echocardiograms at 7 days of age may be a useful tool to identify infants at high risk for BPD and PH.

  18. Apraxia for differentiating Alzheimer’s disease from subcortical vascular dementia and mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Ozkan S

    2013-07-01

    Full Text Available Serhat Ozkan,1 Demet Ozbabalik Adapinar,1 Nese Tuncer Elmaci,2 Didem Arslantas31Department of Neurology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey; 2Department of Neurology, Marmara University Medical Faculty, Istanbul, Turkey; 3Department of Public Health, Eskisehir Osmangazi University Medical Faculty, Eskisehir, TurkeyAbstract: Although ideomotor limb apraxia is considered to be a typical sign of cortical pathologies such as Alzheimer’s disease (AD, it has been also reported in subcortical neurodegenerative diseases and vascular lesions. We aimed to investigate the difference between AD, subcortical vascular dementia (SVaD and mild cognitive impairment (MCI patients by means of ideomotor limb apraxia frequency and severity. Ninety-six AD, 72 SVaD, and 84 MCI patients were assessed with the mini-mental status examination (MMSE, clinical dementia rating (CDR and the apraxia screening test of TULIA (AST. Apraxia was significantly more frequent in the AD patients (32.3% than in both of the SVaD (16.7% and MCI (4.8% patients. The frequency of apraxia was also significantly higher in SVaD patients than in MCI patients. AD patients had significantly lower apraxia scores than both SVaD and MCI patients. In addition, a significant difference was found between SVaD and MCI patients in terms of apraxia scores. These results suggest that the widespread belief of the association between apraxia and cortical dementias is not exactly correct. The significant difference between both of the dementia groups and the MCI patients suggests that the absence of apraxia can be an indicator for MCI diagnosis.Keywords: apraxia, Alzheimer’s disease, subcortical vascular dementia, mild cognitive impairment

  19. Laser in situ keratomileusis in patients with collagen vascular disease: a review of the literature

    Directory of Open Access Journals (Sweden)

    Simpson RG

    2012-11-01

    Full Text Available Rachel G Simpson,1 Majid Moshirfar,2 Jason N Edmonds,2 Steven M Christiansen,2 Nicholas Behunin21The University of Arizona College of Medicine, Phoenix, AZ, USA; 2John A Moran Eye Center, The University of Utah School of Medicine, Salt Lake City, UT, USAPurpose: To evaluate the current United States Food and Drug Administration (FDA recommendations regarding laser in situ keratomileusis (LASIK surgery in patients with collagen vascular diseases (CVD and assess whether these patients make appropriate candidates for laser vision correction, and offer treatment recommendations based on identified clinical data.Methods: A literature search was conducted using PubMed, Medline, and Ovid to identify all existing studies of LASIK in patients with collagen vascular diseases. The search was conducted without date limitations. Keywords used for the search included MeSH terms: laser in situ keratomileusis, LASIK, refractive surgery, ocular surgery, and cataract surgery connected by "and" with the following MeSH and natural-language terms: collagen vascular disease, rheumatic disease, systemic disease, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, seronegative spondyloarthropathy, HLA B27, ankylosing spondylitis, reactive arthritis, psoriatic arthritis. The abstracts for all studies meeting initial search criteria were reviewed; relevant studies were included. No prospective studies were found; however, four retrospective case studies were identified that examined LASIK surgery in patients with CVD. Several case reports were also identified in similar fashion.Results: The FDA considers CVD a relative contraindication to LASIK surgery, due largely to the ocular complications associated with disease in the CVD spectrum. However, recent studies of LASIK in patients with CVD indicate LASIK may be safe for patients with very well-controlled systemic disease, minimal ocular manifestations, and no clinical signs or history of dry

  20. Prognosis of vascular mild cognitive impairment includes vascular dementia onset and death by cardiovascular disease: reanalysis from the Osaki-Tajiri project.

    Science.gov (United States)

    Meguro, Kenichi; Akanuma, Kyoko; Meguro, Mitsue; Kasai, Mari; Ishii, Hiroshi; Yamaguchi, Satoshi

    2012-10-01

    The relationship of predementia stage with cerebrovascular disease (CVD) has not been fully clarified. Following our Prevalence Study 1998 in Tajiri, Japan, Incidence Study 2003 disclosed that 17.9% of subjects developed vascular dementia (VaD). Some cases developed after stroke (type I), whereas others already met the criteria for subcortical VaD (SVD) despite very mild stage (Clinical Dementia Rating [CDR] 0.5) and progressed to mild stage (CDR 1) (type II). We hypothesized that prognosis of vascular mild cognitive impairment (MCI) included type II VaD or death due to causes associated with vascular risk factors. Prevalence Study 1998 included 497 randomly selected participants, including 346 with a CDR of 0, 119 with a CDR of 0.5, and 32 with a CDR of 1+. The first 2 groups were targeted for Incidence Study 2003. Based on the database, we reanalyzed the ratio of SVD in the subjects with CDR 0.5 and VaD, prognosis with or without CVD, and 2 types of VaD onset. The criteria for SVD were achieved by 67% of those with VaD and by 7% of those with vascular MCI (ie, CDR 0.5). In the CDR 0 group, CVD had no affect on prognosis; however, in the CDR 0.5 group, CVD had an affect on death by cardiovascular disease. The majority of subjects in the CDR 0 and CDR 0.5-CVD (-) groups were classified as type I, whereas all subjects in the CDR 0.5-CVD (+) group were type II. Although vascular MCI is treatable, it may progress to death as well as apparent dementia. Individuals with this "buried under the community" phenomenon of SVD should be targeted for secondary prevention interventions. Copyright © 2012 National Stroke Association. All rights reserved.

  1. Reduced subclinical carotid vascular disease and arterial stiffness in vegetarian men: The CARVOS Study.

    Science.gov (United States)

    Acosta-Navarro, Julio; Antoniazzi, Luiza; Oki, Adriana Midori; Bonfim, Maria Carlos; Hong, Valeria; Acosta-Cardenas, Pedro; Strunz, Celia; Brunoro, Eleonora; Miname, Marcio Hiroshi; Filho, Wilson Salgado; Bortolotto, Luiz Aparecido; Santos, Raul D

    2017-03-01

    Dietary habits play an important role in the development of atherosclerosis, the most important cause of morbidity and mortality in the world. The objective of this study was to verify if vegetarian (VEG) diet could be related a better profile of subclinical vascular disease evaluated by arterial stiffness and functional and structural properties of carotid arteries, compared to omnivorous (OMN) diet. In this cross-sectional study, 44 VEG and 44 OMN apparently healthy men ≥35years of age, in order to not have confounding risk factors of subclinical atherosclerosis, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C reactive protein (CRP), and arterial stiffness determined by carotid-femoral pulse wave velocity (PWV). Also, carotid intima-media thickness (c-IMT) and distensibility were evaluated. VEG men had lower body mass index, systolic and diastolic blood pressures, fasting serum total cholesterol, LDL and non-HDL-cholesterol, apolipoprotein B, glucose and glycated hemoglobin values in comparison with OMN individuals (all p values <0.05). Markers of vascular structure and function were different between VEG and OMN: PWV 7.1±0.8m/s vs. 7.7±0.9m/s (p<0.001); c-IMT 593±94 vs. 661±128μm (p=0.003); and relative carotid distensibility 6.39±1.7 vs. 5.72±1.8% (p=0.042), respectively. After a multivariate linear regression analysis, a VEG diet was independently and negatively associated with PWV (p value 0.005). A VEG diet is associated with a more favorable cardiovascular diseases biomarker profile and better vascular structural and functional parameters. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Vitamin D Affects Survival Independently of Vascular Calcification in Chronic Kidney Disease

    Science.gov (United States)

    Barreto, Daniela Veit; Barreto, Fellype Carvalho; Liabeuf, Sophie; Temmar, Mohammed; Boitte, Francis; Choukroun, Gabriel; Fournier, Albert; Massy, Ziad A.

    2009-01-01

    Background and objectives: Cardiovascular disease is the main cause of mortality in chronic kidney disease (CKD) patients. Vitamin D might have beneficial effects on vascular health. The aim of this study was to determine the prevalence of vitamin D deficiency (25-hydroxyvitamin D [25D] ≤ 15 ng/ml) and insufficiency (25D levels between 16 and 30 ng/ml) in a cohort of patients at different CKD stages and the relationships between vitamin D serum levels, vascular calcification and stiffness, and the mortality risk. Design, setting, participants & measurements: One hundred forty CKD patients (85 men, mean age 67 ± 12 yr; CKD stages 2 [8%], 3 [26%], 4 [26%], 5 [7%], and 5D [(33%]) were allocated for a prospective study. Serum levels of 25D and 1,25-dihydroxyvitamin D, aortic calcification score, and pulse wave velocity (PWV) were evaluated. Results: There was a high prevalence of vitamin D deficiency (42%) and insufficiency (34%). Patients with 25D ≤ 16.7 ng/ml (median) had a significantly lower survival rate than patients with 25D >16.7 ng/ml (mean follow-up, 605 ± 217 d; range, 10 to 889; P = 0.05). Multivariate adjustments (included age, gender, diabetes, arterial pressure, CKD stage, phosphate, albumin, hemoglobin, aortic calcification score and PWV) confirmed 25D level as an independent predictor of all-cause mortality. Conclusions: Vitamin D deficiency and insufficiency were highly prevalent in this CKD cohort. Low 25D levels affected mortality independently of vascular calcification and stiffness, suggesting that 25D may influence survival in CKD patients via additional pathways that need to be further explored. PMID:19443628

  3. Degree of anemia, indirect markers of hemolysis, and vascular complications of sickle cell disease in Africa.

    Science.gov (United States)

    Dubert, Marie; Elion, Jacques; Tolo, Aissata; Diallo, Dapa Aly; Diop, Saliou; Diagne, Ibrahima; Sanogo, Ibrahima; Belinga, Suzanne; Guifo, Odette; Wamba, Guillaume; Ngo Sack, Françoise; Boidy, Kouakou; Kamara, Ismael; Traore, Youssouf; Diakite, Cheick Oumar; Gbonon, Valérie; Faye, Blaise Felix; Seck, Moussa; Deme Ly, Indou; Chelo, David; N'Guetta, Roland; Diop, Ibrahima Bara; Gaye, Bamba; Jouven, Xavier; Ranque, Brigitte

    2017-11-16

    The hyperhemolysis paradigm that describes overlapping "hyperhemolytic-endothelial dysfunction" and "high hemoglobin-hyperviscous" subphenotypes of sickle cell disease (SCD) patients is based on North American studies. We performed a transversal study nested in the CADRE cohort to analyze the association between steady-state hemolysis and vascular complications of SCD among sub-Saharan African patients. In Mali, Cameroon, and Ivory Coast, 2407 SCD patients (1751 SS or sickle β-zero-thalassemia [Sβ 0 ], 495 SC, and 161 sickle β + -thalassemia [Sβ + ]), aged 3 years old and over, were included at steady state. Relative hemolytic intensity was estimated from a composite index derived from principal component analysis, which included bilirubin levels or clinical icterus, and lactate dehydrogenase levels. We assessed vascular complications (elevated tricuspid regurgitant jet velocity [TRV], microalbuminuria, leg ulcers, priapism, stroke, and osteonecrosis) by clinical examination, laboratory tests, and echocardiography. After adjustment for age, sex, country, and SCD phenotype, a low hemoglobin level was significantly associated with TRV and microalbuminuria in the whole population and with leg ulcers in SS-Sβ 0 adults. A high hemolysis index was associated with microalbuminuria in the whole population and with elevated TRV, microalbuminuria, and leg ulcers in SS-Sβ 0 adults, but these associations were no longer significant after adjustment for hemoglobin level. In conclusion, severe anemia at steady state in SCD patients living in West and Central Africa is associated with elevated TRV, microalbuminuria, and leg ulcers, but these vascular complications are not independently associated with indirect markers of increased hemolysis. Other mechanisms leading to anemia, including malnutrition and infectious diseases, may also play a role in the development of SCD vasculopathy. © 2017 by The American Society of Hematology.

  4. Spectrum of Retinal Vascular Diseases Associated With Paracentral Acute Middle Maculopathy.

    Science.gov (United States)

    Chen, Xuejing; Rahimy, Ehsan; Sergott, Robert C; Nunes, Renata P; Souza, Eduardo C; Choudhry, Netan; Cutler, Nathan E; Houston, Samuel K S; Munk, Marion R; Fawzi, Amani A; Mehta, Sonia; Hubschman, Jean-Pierre; Ho, Allen C; Sarraf, David

    2015-07-01

    To evaluate the spectrum of retinal diseases that can demonstrate paracentral acute middle maculopathy and isolated ischemia of the intermediate and deep capillary plexus. Retrospective, multicenter, observational case series. This is a retrospective case series review of 9 patients (10 eyes) from 5 centers with paracentral acute middle maculopathy lesions and previously unreported retinal vascular etiologies. Case presentations and multimodal imaging, including color photographs, near-infrared reflectance, fluorescein angiography, spectral-domain optical coherence tomography (SD OCT), and orbital color Doppler imaging, are described. Baseline and follow-up findings are correlated with clinical presentation, demographics, and systemic associations. Five men and 4 women, aged 27-66 years, were included. Isolated band-like hyperreflective lesions in the middle retinal layers, otherwise known as paracentral acute middle maculopathy, were observed in all patients at baseline presentation. Follow-up SD OCT analysis of these paracentral acute middle maculopathy lesions demonstrated subsequent thinning of the inner nuclear layer. Novel retinal vascular associations leading to retinal vasculopathy and paracentral acute middle maculopathy include eye compression injury causing global ocular ischemia, sickle cell crisis, Purtscher's retinopathy, inflammatory occlusive retinal vasculitis, post-H1N1 vaccine, hypertensive retinopathy, migraine disorder, and post-upper respiratory infection. Paracentral acute middle maculopathy lesions may develop in a wide spectrum of retinal vascular diseases. They are best identified with SD OCT analysis and may represent ischemia of the intermediate and deep capillary plexus. These lesions typically result in permanent thinning of the inner nuclear layer and are critical to identify in order to determine the cause of unexplained vision loss. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Dysexecutive versus amnestic Alzheimer disease subgroups: analysis of demographic, genetic, and vascular factors.

    Science.gov (United States)

    Mez, Jesse; Cosentino, Stephanie; Brickman, Adam M; Huey, Edward D; Manly, Jennifer J; Mayeux, Richard

    2013-01-01

    The objective of this study was to compare the demographic and vascular characteristics and APOE genotypes of a dysexecutive subgroup of Alzheimer disease (AD) with an amnestic subgroup of AD early in the disease course. A total of 2224 participants from the National Alzheimer's Coordinating Center database who carried a diagnosis of mild cognitive impairment (n=1188) or mild AD (clinical dementia rating ≤1) (n=1036) were included in this study. A subset of the mild cognitive impairment (n=61) and mild AD (n=79) participants underwent an autopsy. A dysexecutive subgroup (n=587) was defined as having executive performance >1 SD worse than memory performance, and an amnestic subgroup (n=549) was defined conversely. Among the autopsy subset, the odds of an AD pathologic diagnosis were compared in the 2 subgroups. The demographics, APOE[Latin Small Letter Open E]4 status, and vascular risk factors were compared in the 2 subgroups. Among the autopsy subset, the odds of having an AD pathologic diagnosis did not differ between the dysexecutive and amnestic subgroups. Under an additive model, participants in the dysexecutive subgroup possessed the APOE[Latin Small Letter Open E]4 allele less frequently compared with those in the amnestic subgroup. The dysexecutive subgroup had a history of hypertension less frequently compared with the amnestic subgroup. These distinct characteristics add to accumulating evidence that a dysexecutive subgroup of AD may have a unique underlying pathophysiology.

  6. CT pulmonary angiography of adult pulmonary vascular diseases: Technical considerations and interpretive pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: bedros.taslakian@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States); Latson, Larry A., E-mail: larry.latson@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States); Truong, Mylene T., E-mail: mtruong@mdanderson.org [Department of Radiology, University of Texas, MD Anderson Cancer Center, TX (United States); Aaltonen, Eric, E-mail: Eric.Aaltonen@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States); Shiau, Maria C., E-mail: Maria.Shiau@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States); Girvin, Francis, E-mail: Francis.Girvin@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States); Alpert, Jeffrey B., E-mail: Jeffrey.Alpert@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States); Wickstrom, Maj, E-mail: Maj.Wickstrom@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States); Ko, Jane P., E-mail: Jane.Ko@nyumc.org [Department of Radiology, NYU Langone Medical Center, NY (United States)

    2016-11-15

    Highlights: • CTPA plays a key role in the evaluation of pulmonary vascular diseases. • Improvements in CT technology have improved visualization of pulmonary arteries. • Knowledge of the technical pitfalls is essential for accurate diagnosis. • Dual energy CT imaging enables parenchymal iodine evaluation. • An awareness of the entities affecting the pulmonary arteries is important. - Abstract: Computed tomography pulmonary angiography (CTPA) has become the primary imaging modality for evaluating the pulmonary arteries. Although pulmonary embolism is the primary indication for CTPA, various pulmonary vascular abnormalities can be detected in adults. Knowledge of these disease entities and understanding technical pitfalls that can occur when performing CTPA are essential to enable accurate diagnosis and allow timely management. This review will cover a spectrum of acquired abnormalities including pulmonary embolism due to thrombus and foreign bodies, primary and metastatic tumor involving the pulmonary arteries, pulmonary hypertension, as well as pulmonary artery aneurysms and stenoses. Additionally, methods to overcome technical pitfalls and interventional treatment options will be addressed.

  7. PINK1 and its familial Parkinson's disease-associated mutation regulate brain vascular endothelial inflammation.

    Science.gov (United States)

    Yunfu, Wang; Guangjian, Liu; Ping, Zhong; Yanpeng, Sun; Xiaoxia, Fang; Wei, Hu; Jiang, Yuan; Jingquan, Hu; Songlin, Wang; Hongyan, Zhang; Yong, Liu; Shi, Chen

    2014-05-01

    Parkinson's disease (PD) is a debilitating disorder that affects movement. Inflammation-mediated endothelial dysfunction has been found to be involved in neurodegenerative diseases, including PD. More than 40 PTEN-induced putative kinase 1 (PINK1) mutations have been found in PD patients. The effects of PINK1 in vascular inflammation are as yet unknown. In this study, our findings revealed that PINK1 can be increased by the inflammatory cytokine tumor necrosis factor-α in primary human brain microvascular endothelial cells (HBMECs). We found that wild-type PINK1 prevents expression of the adhesion molecule vascular cell adhesion molecule-1 (VCAM-1), thus inhibiting the attachment of monocytes to brain endothelial cells. However, PINK1G309D, the loss-of-function mutation associated with early-onset familial PD, promotes expression of VCAM-1 and exacerbates attachment of monocytes to brain endothelial cells. Mechanism studies revealed that overexpression of wild-type PINK1 inhibits the VCAM-1 promoter by inhibiting the transcriptional activity of interferon regulatory factor 1 (IRF-1). However, PINK1G309D promotes the VCAM-1 promoter by increasing the transcriptional activity of IRF-1.

  8. Osteoprotegerin in Chronic Kidney Disease: Associations with Vascular Damage and Cardiovascular Events.

    Science.gov (United States)

    Yilmaz, Mahmut Ilker; Siriopol, Dimitrie; Saglam, Mutlu; Unal, Hilmi Umut; Karaman, Murat; Gezer, Mustafa; Kilinc, Ali; Eyileten, Tayfun; Guler, Ahmet Kerem; Aydin, İbrahim; Vural, Abdulgaffar; Oguz, Yusuf; Covic, Adrian; Ortiz, Alberto; Kanbay, Mehmet

    2016-08-01

    Vascular injury and dysfunction contribute to cardiovascular disease, the leading cause of death in patients with chronic kidney disease (CKD). Osteoprotegerin (OPG) is a soluble member of the tumor necrosis factor receptor superfamily that has been linked to atherogenesis and endothelial dysfunction. Elevated circulating OPG levels predict future cardiovascular events (CVE). Our aim was to evaluate the determinants of circulating OPG levels, to investigate the relationship between OPG and markers of vascular damage and to test whether OPG improves risk stratification for future CVE beyond traditional and renal-specific risk factors in a CKD population. 291 patients with CKD stage 1-5 not on dialysis were included in the study. In the multivariate analysis, OPG was a significant predictor for flow-mediated dilatation, but not for carotid intima media thickness levels. During follow-up (median 36 months, IQR = 32-42 months), 87 patients had CVE. In the Cox survival analysis, OPG levels were independently associated with CVE even after adjustment for traditional and renal-specific cardiovascular risk factors. The addition of OPG to a model based on commonly used cardiovascular factors significantly improved the reclassification abilities of the model for predicting CVE. We show for the first time that OPG improves risk stratification for CVE in a non-dialysis CKD population, above and beyond a model with established traditional and renal-specific cardiovascular risk factors, including estimated glomerular filtration rate and fibroblast growth factor 23.

  9. Headache and biomarkers predictive of vascular disease in a representative sample of US children.

    Science.gov (United States)

    Nelson, Karin B; Richardson, Amanda Kalaydjian; He, Jianping; Lateef, Tarranum M; Khoromi, Suzan; Merikangas, Kathleen R

    2010-04-01

    To examine the association of childhood headache disorders with markers of risk for cardiovascular and cerebrovascular disease. Information was collected on severe or recurrent headache or migraine in childhood or adolescence and on biomarkers predictive of vascular disease. The National Health and Nutrition Survey, a nationally representative health survey. Children or adolescents aged 4 to 19 years (n = 11 770) who took part in the National Health and Nutrition Survey in 1999 through 2004. Headache. Body mass index; levels of C-reactive protein, homocysteine, serum and red blood cell folate, vitamin B(12), methylmalonic acid, total cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, triglycerides, and uric acid; and platelet count. Mean values for body mass index, C-reactive protein, and homocysteine were higher in children with than without headaches, and more children with headaches were in the highest quintile of risk for these factors. Serum and red blood cell folate levels were lower in children with headache. More children with headache were in the highest quintile of risk for 3 or more of these factors. Several important risk factors for long-term vascular morbidity cluster in children and adolescents with severe or recurrent headache or migraine. Further study and screening of children with headaches may permit improved preventive management.

  10. Patients with advanced Parkinson's disease with and without freezing of gait: a comparative analysis of vascular lesions using brain MRI.

    Science.gov (United States)

    Gallardo, M J; Cabello, J P; Pastor, C; Muñoz-Torrero, J J; Carrasco, S; Ibañez, R; Vaamonde, J

    2014-05-01

    Freezing of gait (FOG) is one of the most disabling and enigmatic symptoms in Parkinson's disease. Vascular lesions, observed in magnetic resonance imaging (MRI) scans, may produce or exacerbate this symptom. The study includes 22 patients with Parkinson's disease subjects, 12 with freezing of gait and 10 without. All patients underwent an MRI scan and any vascular lesions were analysed using the modified Fazekas scale. Patients with FOG scored higher on the modified Fazekas scale than the rest of the group. Although the two groups contained the same percentage of patients with vascular lesions (50% in both groups), lesion load was higher in the group of patients with FOG. Vascular lesions in the periventricular area and deep white matter seem to be the most involved in the development of FOG. Vascular lesions may contribute to the onset or worsening of FOG in patients with PD. This study suggests that cerebral vascular disease should be considered in patients with FOG. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  11. Canonical Transient Receptor Potential Channels and Their Link with Cardio/Cerebro-Vascular Diseases.

    Science.gov (United States)

    Xiao, Xiong; Liu, Hui-Xia; Shen, Kuo; Cao, Wei; Li, Xiao-Qiang

    2017-09-01

    The canonical transient receptor potential channels (TRPCs) constitute a series of nonselective cation channels with variable degrees of Ca2+ selectivity. TRPCs consist of seven mammalian members, TRPC1, TRPC2, TRPC3, TRPC4, TRPC5, TRPC6, and TRPC7, which are further divided into four subtypes, TRPC1, TRPC2, TRPC4/5, and TRPC3/6/7. These channels take charge of various essential cell functions such as contraction, relaxation, proliferation, and dysfunction. This review, organized into seven main sections, will provide an overview of current knowledge about the underlying pathogenesis of TRPCs in cardio/cerebrovascular diseases, including hypertension, pulmonary arterial hypertension, cardiac hypertrophy, atherosclerosis, arrhythmia, and cerebrovascular ischemia reperfusion injury. Collectively, TRPCs could become a group of drug targets with important physiological functions for the therapy of human cardio/cerebro-vascular diseases.

  12. Thoracic sympathectomy for peripheral vascular disease can lead to severe bronchospasm and excessive bronchial secretions

    Directory of Open Access Journals (Sweden)

    Vikas Deep Goyal

    2015-01-01

    Full Text Available A 57-year-old male patient suffering from Buerger′s disease presented with pre-gangrenous changes in right foot and ischemic symptoms in right hand. Computed tomographic angiography revealed diffuse distal disease not suitable for vascular bypass and angioplasty. Right lumbar sympathectomy was done using a retroperitoneal approach followed 1 year later by right thoracic sympathectomy using a transaxillary approach. Postoperatively, the patient had severe bronchospasm and excessive secretions in the respiratory tract resistant to theophylline and sympathomimetic group of drugs and without any clinical, laboratory and radiological evidence of infection. The patient was started on anticholinergics in anticipation that sympathectomy might have lead to unopposed cholinergic activity and the symptoms improved rapidly. The patient recovered well and was discharged on 10 th post-operative day.

  13. Sub-clinical mastitis prevalent in dairy cows in Chittagong district of Bangladesh: detection by different screening tests

    Directory of Open Access Journals (Sweden)

    Mukti Barua

    2014-07-01

    Full Text Available Aim: Mastitis is recognized as one of the most costly health disorder affecting dairy cows. An epidemiological study was carried out at some selected farms in Chittagong district of Bangladesh to determine the prevalence and risk factors of sub-clinical mastitis (SCM in dairy cows. Materials and Methods: For conducting the study, some dairy farms of Chittagong were selected from urban and periurban areas by stratified random sampling. A total of 444 quarter samples of 111 (56 from commercial dairy farms and 55 from backyards lactating dairy cows were considered. Sub-clinical mastitis (SCM was determined using three different indirect screening tests: California Mastitis Test (CMT, White Slide Test (WST and Surf Field Mastitis Test (SFMT. Sensitivity and specificity were also determined to measure the accuracy of those tests. Results: The prevalence of SCM by CMT, WST and SFMT were 32.43% (n=144, 33.56% (n=149 and 31.53% (n=140, respectively. Distribution of SCM in relation to different variables at quarter level and animal level was also recorded. The prevalence of SCM was significantly (P4 than others at quarter level. No significant difference (P>0.05 was found in relation to breed. Using CMT as a gold standard, sensitivity and specificity of WST and SFMT were also calculated at 95% confidence interval. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and disease prevalence by WST and SFMT were comparable. Conclusion: This study recommends that regular screening of sub-clinical mastitis will reduce the prevalence of sub-clinical mastitis. The most effective way to control sub-clinical mastitis is to take preventive measures such as regular cleaning of the floor, keeping the udder clean, milkman's cleanliness, dry cow therapy specially in high yielding dairy cows.

  14. Microscope-Integrated Optical Coherence Tomography Angiography in the Operating Room in Young Children With Retinal Vascular Disease.

    Science.gov (United States)

    Chen, Xi; Viehland, Christian; Carrasco-Zevallos, Oscar M; Keller, Brenton; Vajzovic, Lejla; Izatt, Joseph A; Toth, Cynthia A

    2017-05-01

    Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite. To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease. In this case report analysis, OCT imaging in pediatric patients, MIOCTA images were obtained during examination under anesthesia from a young boy with a history of idiopathic vitreous hemorrhage and a female infant with familial exudative vitreoretinopathy. Side-by-side comparison of research MIOCT angiograms and clinically indicated fluorescein angiograms. In 2 young children with retinal vascular disease, the MIOCTA images showed more detailed vascular patterns than were visible on the fluorescein angiograms although within a more posterior field of view. The MIOCTA system allowed visualization of small pathological retinal vessels in the retinal periphery that were obscured in the fluorescein angiograms by fluorescein staining from underlying, preexisting laser scars. This is the first report to date of the use of MIOCTA in the operating room for young children with retinal vascular disease. Further optimization of this system may allow noninvasive detailed evaluation of retinal vasculature during surgical procedures and in patients who could not cooperate with in-office examinations.

  15. HRCT of the lung in collagen vascular diseases; HRCT der Lunge bei Kollagenosen

    Energy Technology Data Exchange (ETDEWEB)

    Diederich, S. [Inst. fuer Klinische Radiologie, Westfaelische Wilhelms-Univ., Muenster (Germany); Roos, N. [Inst. fuer Klinische Radiologie, Westfaelische Wilhelms-Univ., Muenster (Germany); Schmitz-Linneweber, B. [Medizinische Klinik B, Westfaelische Wilhelms-Univ., Muenster (Germany); Gaubitz, M. [Medizinische Klinik B, Westfaelische Wilhelms-Univ., Muenster (Germany); Peters, P.E. [Inst. fuer Klinische Radiologie, Westfaelische Wilhelms-Univ., Muenster (Germany)

    1996-07-01

    Collagen vascular diseases, representing systemic soft tissue disorders, may cause a broad spectrum of pathologic changes of the respiratory tract. The type and extent of manifestations can vary considerably among individuals and entities. This survey describes the chest radiographic and, in particular, high-resolution computed tomographic and, in particular, high-resolution computed tomographic (HRCT) findings of individual lesions of the respiratory tract. It includes fibrosing alveolitis (alveolitis, interstitial pneumonia, pulmonary fibrosis) and bronchial (bronchitis/bronchiolitis, bronchiectasis), pleural and vascular manifestations, as well as lymphadenopathy and abnormalities related to therapy. We present typical patterns of changes in progressive systemic sclerosis (PSS, scleroderma), systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD, Sharp syndrome), Sjoegren syndrome, overlap syndrome and rheumatoid arthritis (RA). Furthermore, we describe findings which are specific for individual entities such as esophageal involvement in PSS, acute pneumonitis and pulmonary hemorrhage in SLE, lymphoproliferative disease in Sjoegren syndrome and necrobiotic nodules in RA. (orig.) [Deutsch] Die Kollagenosen koennen als systemische Bindegewebserkrankungen auch zu einem breiten Spektrum pathologischer Veraenderungen am Respirationstrakt fuehren, wobei sich Art und Ausmass der Manifestationen innerhalb einzelner Entitaeten und zwischen verschiedenen Krankheitsbildern erheblich unterscheiden koennen. In der vorliegenden Uebersicht werden die entsprechenden Befunde von Thoraxuebersichtsaufnahme und insbesondere hochaufloesender Computertomographie (HRCT) beschrieben. Beruecksichtigt werden dabei die fibrosierende Alveolitis (Alveolitis, interstitielle Pneumonie, Lungenfibrose), bronchiale (Bronchitis/Bronchiolitis, Bronchiektasen), pleurale und vaskulaere Manifestationen sowie Lymphadenopathie und therapie-induzierte Befunde. Typische Befundmuster

  16. Should we screen for masked hypertension in patient with vascular disease?

    Directory of Open Access Journals (Sweden)

    Pascal Delsart

    2010-05-01

    Full Text Available Pascal Delsart1, Philippe Marboeuf1, Cedric Delhaye2, Gilles Lemesle2, Claire Mounier-Vehier11Service de Médecine Vasculaire et Hypertension Artérielle, 2Service d’hémodynamique et de Cardiologie B, University Hospital of Lille, FranceBackground: The influence of hypertension on cardiovascular risk is well known. Ambulatory blood pressure measurement (ABPM is able to identify patients with masked hypertension (MH underdetected by clinical BP measurement. The benefit of screening for MH in a highrisk population was investigated.Aims: To detect MH in a population with no prior history of hypertension and medically treated for peripheral or coronary arterial disease.Methods: Thirty-eight consecutive patients with peripheral or coronary artery disease documented with arteriography, without a history of hypertension, and with an admission BP < 140/90 mmHg underwent ABPM after discharge. Ambulatory BP ≥ 125/80 mmHg were defined as MH.Results: MH was found in 11 patients (28.9%. The MH group had a mean systolic and diastolic hospitalization BP significantly higher (127 versus 115 mmHg, respectively, P = 0.002 and 76 versus 66 mmHg, P = 0.01, and tended to have a higher admission systolic BP and pulse pressure (127 versus 121 mmHg, respectively, P = 0.07; and 54 versus 46 mmHg, P = 0.06. The first BP measurement on the 24-hour ABPM was significantly higher in the MH group 140 versus 121 mmHg, P = 0.001, for systolic BP and 84 versus 74 mmHg, P = 0.03, for diastolic BP.Conclusions: MH was found in patients with documented and medically treated vascular disease. BP in the prehypertensive range is associated with MH. Systematic screening for MH in this high-risk population requires further investigation.Keywords: blood pressure, monitoring, masked hypertension, vascular disease

  17. [Hearing disorders in peripheral arterial vascular diseases. A contribution on hearing loss in the aged].

    Science.gov (United States)

    Böhme, G

    1987-12-01

    Otologic-audiologic examination was carried out in 171 patients (aged between 37-86; average age 64) with confirmed internal angiologic peripheral arterial vascular disease. Additional findings were observed in 94 of these patients who revealed an obliteration of the internal carotid artery or cerebral ischaemic stroke. Diseases of the ear were excluded clinically and audiologically. The mean hearing loss shows a sensory-neural high-tone loss in the tone audiogram. The range of scatter increases proportionately to the increase in tone loss. If compared with the physiologic examination of geriatric patients, the total word comprehension and minimal discrimination loss in the speech audiogram point towards a pathologic impairment of hearing in old age. The total word comprehension amounts to 251.20% in the 51-60 age group, 250.40% in the persons 61-70 years of age, 180.96% for the 71-80 age group and 131.67% for those over 80 years of age. The minimal discrimination loss comprises 4.00% for the 51-60 age group, 4.19% for the 61-70 group, 21.35% for 71-80 age bracket and 35.62% for those over 80. On the strength of these findings, an arterial sclerotic vascular disease should be considered as one of the multifactorial genesis of hearing impairment in old age. Special attention should be focussed on decompensation of the total word comprehension and minimal discrimination loss before the age of eighty. This would contribute towards a differentiation of physiologic and pathologic hearing diseases in old age.

  18. A Genetic Variant Associated with Five Vascular Diseases Is a Distal Regulator of Endothelin-1 Gene Expression

    NARCIS (Netherlands)

    Gupta, Rajat M; Hadaya, Joseph; Trehan, Aditi; Zekavat, Seyedeh M; Roselli, Carolina; Klarin, Derek; Emdin, Connor A; Hilvering, Catharina R E; Bianchi, Valerio; Mueller, Christian; Khera, Amit V; Ryan, Russell J H; Engreitz, Jesse M; Issner, Robbyn; Shoresh, Noam; Epstein, Charles B; de Laat, Wouter; Brown, Jonathan D; Schnabel, Renate B; Bernstein, Bradley E; Kathiresan, Sekar

    2017-01-01

    Genome-wide association studies (GWASs) implicate the PHACTR1 locus (6p24) in risk for five vascular diseases, including coronary artery disease, migraine headache, cervical artery dissection, fibromuscular dysplasia, and hypertension. Through genetic fine mapping, we prioritized rs9349379, a common

  19. [Impact of isolated diastolic hypertension on new-onset cardiovascular and cerebro-vascular diseases].

    Science.gov (United States)

    Xing, Fengmei; Dong, Yan; Tao, Jie; Gao, Xinying; Zhou, Jianhui; Chen, Shuohua; Ji, Chunpeng; Yao, Tao; Wu, Shouling

    2014-08-01

    To explore the impact of isolated diastolic hypertension (IDH) on new-onset cardio-cerebral vascular diseases (CVD). This cohort study involved 101 510 participants who were employees of the Kailuan Group-a state-run coal mining company, in 2006 and 2007. Among them, 6 780 subjects were diagnosed with IDH, 35 448 subjects were diagnosed with high-normal blood pressure and 19 460 subjects were diagnosed with normal tension. However, none of them had the history of either cardio-cerebral vascular disease or malignant cancer. Cardio-cerebral vascular events including cerebral infarction, cerebral hemorrhage, acute myocardial infarction were recorded every 6 months during the follow-up (47.1 ± 4.8) period. Multivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events. 1) There were 675 CVD events occurred during the follow-up period. The incidence rates of CVD events (1.7% vs. 0.9%), cerebral infarction (1.0% vs. 0.6%) and cerebral hemorrhage (0.4% vs. 0.1%) were significantly higher in IDH group than that in the normal tension group (all P < 0.05). 2) After adjustment for other established CVD risk factors, the hazards ratios became 1.67 (95% CI: 1.28-2.17) for total CVD events and 1.59 (95% CI: 1.12-2.27) for cerebral infarction and 2.67 (95% CI: 1.54-4.65) for cerebral hemorrhage in the IDH group. 3). In stratified analysis on age, after adjustment for other established CVD risk factors, the hazards ratio was 2.22 (95% CI: 1.41-3.50) for cerebral infarction in lower 60 years old group, while the it was 7.27 (95% CI: 2.58-20.42) for cerebral hemorrhage in groups older than 60 years of age. IDH was the independent risk factor for the total cardio-cerebral vascular events, on both cerebral infarction and cerebral hemorrhage. The predicted values of IDH for different CVD events were diverse on different age groups.

  20. Incremental value of a genetic risk score for the prediction of new vascular events in patients with clinically manifest vascular disease.

    Science.gov (United States)

    Weijmans, Maaike; de Bakker, Paul I W; van der Graaf, Yolanda; Asselbergs, Folkert W; Algra, Ale; Jan de Borst, Gert; Spiering, Wilko; Visseren, Frank L J

    2015-04-01

    Several genetic markers are related to incidence of cardiovascular events. We evaluated whether a genetic risk score (GRS) based on 30 single-nucleotide-polymorphisms associated with coronary artery disease (CAD) can improve prediction of 10-year risk of new cardiovascular events in patients with clinical manifest vascular disease. In 5742 patients with symptomatic vascular disease enrolled in the SMART study, we developed Cox regression models based on the SMART Risk Score (SRS) and based on the SRS plus the GRS in all patients, in patients with a history of acute arterial thrombotic events and in patients with a history of more stable atherosclerosis and without CAD. The discriminatory ability was expressed by the c-statistic. Model calibration was evaluated by calibration plots. The incremental value of adding the GRS was assessed by net reclassification index (NRI) and decision curve analysis. During a median follow-up of 6.5 years (IQR4.0-9.5), the composite outcome of myocardial infarction, stroke, or vascular death occurred in 933 patients. Hazard ratios of GRS ranging from 0.86 to 1.35 were observed. The discriminatory capacity of the SRS for prediction of 10-year risk of cardiovascular events was fairly good (c-statistic 0.70, 95%CI 0.68-0.72), similar to the model based on the SRS plus the GRS. Calibration of the models based on SRS and SRS plus GRS was adequate. No increase in c-statistics, categorical NRIs and decision curves was observed when adding the GRS. The continuous NRI improved only in patients with stable atherosclerosis (0.14, 95%CI 0.03-0.25), increasing further excluding patients with a history of CAD (0.21, 95%CI 0.06-0.36). In patients with symptomatic vascular disease, a GRS did not improve risk prediction of 10-year risk of cardiovascular events beyond clinical characteristics. The GRS might improve risk prediction of first vascular events in the subgroup of patients with a history of stable atherosclerosis. Copyright © 2015 Elsevier

  1. CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL HYPERTENSION: VASCULAR WALL AS THE TARGET ORGAN IN COMORBID PATIENTS

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    N. A. Karoli

    2017-01-01

    Full Text Available Studies of endothelial dysfunction in patients with respiratory diseases have become relevant in recent years. Perhaps endothelial dysfunction and high arterial stiffness bind bronchopulmonary and cardiovascular diseases.Aim. To reveal features of disturbances of arterial wall vasoregulatory function in patients with chronic obstructive pulmonary disease (COPD in the presence and absence of arterial hypertension (HT.Material and methods. The study included 50 patients with COPD with normal blood pressure (BP and 85 patients with COPD and HT. Control group was presented by 20 practically healthy men comparable in age with COPD patients. Tests with reactive hyperemia (endothelium-dependent dilation and nitroglycerin (endothelium-independent dilation were performed in order to evaluate endothelium function. The number of desquamated endotheliocytes in the blood was determined.Results. In patients with COPD and HT in comparison with COPD patients without HT and healthy individuals more pronounced damages of the vascular wall, endothelium vasoregulatory function disturbances and a tendency to the reduction in endothelium-dependent vasodilation were determined both during COPD exacerbation and remission. These differences were most pronounced during the COPD exacerbation. In patients with COPD and HT in comparison with COPD patients without HT the damage of the vascular wall was more pronounced during the remission and endothelium-dependent dilatation disorder – during the exacerbation. The revealed disorders in patients with COPD and HT were associated with smoking status (r=0.61, p<0.01, severity of bronchial obstruction (r=-0.49, p<0.05, and hypoxemia (r=-0.76, p<0.01. We noted relationships between the parameters of 24-hour BP monitoring and remodeling of the brachial artery (r=0.34, p<0.05, endothelium lesion (r=0.25, p<0.05, and impairment of its vasoregulating function (r=-0.58, p<0.05. At that, the following parameters were important: the

  2. 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, B G

    2009-01-01

    -reactive protein), ischemic vascular diseases (ischemic heart disease, myocardial infarction, ischemic cerebrovascular disease and ischemic stroke) and death after an ischemic heart disease diagnosis. We genotyped the Copenhagen City Heart Study, a prospective study including 10 398 participants with 30-32 years....... Furthermore, the odds/hazard ratios for ischemic vascular disease did not differ from 1.0 for CYP2C9 carriers versus noncarriers. Finally, we found no altered risk of early death after a diagnosis of ischemic heart disease. For all end points, we could exclude even minor changes in risk of disease with 90......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...

  3. Effects of unfractionated heparin on renal osteodystrophy and vascular calcification in chronic kidney disease rats.

    Science.gov (United States)

    Meng, Yan; Zhang, Hao; Li, Yingbin; Li, Qingnan; Zuo, Li

    2014-01-01

    Unfractionated heparin (UFH) is the most widely used anticoagulant in hemodialysis for chronic kidney disease (CKD) patients. Many studies have verified that UFH can induce bone loss in subjects with normal bone, but few have focused on its effect on renal osteodystrophy. We therefore investigated this issue in adenine-induced CKD rats. As CKD also impairs mineral metabolism systemically, we also studied the impacts of UFH on serum markers of CKD-mineral and bone disorder (CKD-MBD) and vascular calcification. We administered low and high doses of UFH (1U/g and 2U/g body weight, respectively) to CKD rats and compared them with CKD controls. At sacrifice, the serum markers of CKD-MBD did not significantly differ among the two UFH CKD groups and the CKD control group. The mean bone mineral densities (BMDs) of the total femur and a region of interest (ROI) constituted of trabecular and cortical bone were lower in the high-dose UFH (H-UFH) CKD group than in the CKD control group (Prats indicated secondary hyperparathyroidism, and the femoral trabecular bone volume, but not cortical bone volume, significantly decreased with increasing UFH dose. The same decreasing trend was found in osteoblast parameters, and an increasing trend was found in osteoclast parameters; however, most differences were not significant. Moreover, no distinct statistical differences were found in the comparison of vascular calcium or phosphorus content among the CKD control group and the two UFH CKD groups. Therefore, we concluded that UFH could induce bone loss in CKD rats with secondary hyperparathyroidism, mainly by reducing the trabecular volume and had little effect on cortical bone volume. The underlying mechanism might involve inhibition of osteoblast activity and promotion of osteoclast activity by UFH. We did not find any effect of UFH on vascular calcification in CKD rats with secondary hyperparathyroidism. © 2013.

  4. The combination of stem cells and tissue engineering: an advanced strategy for blood vessels regeneration and vascular disease treatment.

    Science.gov (United States)

    Wang, Ying; Yin, Pei; Bian, Guang-Liang; Huang, Hao-Yue; Shen, Han; Yang, Jun-Jie; Yang, Zi-Ying; Shen, Zhen-Ya

    2017-09-15

    Over the past years, vascular diseases have continued to threaten human health and increase financial burdens worldwide. Transplantation of allogeneic and autologous blood vessels is the most convenient treatment. However, it could not be applied generally due to the scarcity of donors and the patient's condition. Developments in tissue engineering are contributing greatly with regard to this urgent need for blood vessels. Tissue engineering-derived blood vessels are promising alternatives for patients with aortic dissection/aneurysm. The aim of this review is to show the importance of advances in biomaterials development for the treatment of vascular disease. We also provide a comprehensive overview of the current status of tissue reconstruction from stem cells and transplantable cellular scaffold constructs, focusing on the combination of stem cells and tissue engineering for blood vessel regeneration and vascular disease treatment.

  5. [Antiphospholipid syndrome in valvular heart diseases, ischemic heart disease and vascular thrombosis].

    Science.gov (United States)

    Grabowski, M; Brzezińska, A

    2000-01-01

    The antiphospholipid syndrome (APS) leads to venous and arterial thrombosis, cardiac diseases, neurological, gastroenterological and dermatological complications. The role of antiphospholipid antibodies in genesis of thrombi by interaction with plasma clotting factors is well known. There is no evidence of their influence on valvular heart diseases or atherogenesis. This paper presents views and opinions about APS and related cardiovascular complications.

  6. Lung biopsy diagnosis of operative indication in secundum atrial septal defect with severe pulmonary vascular disease.

    Science.gov (United States)

    Yamaki, Shigeo; Kumate, Munetaka; Yonesaka, Susumu; Maeda, Katsuhide; Endo, Masato; Tabayashi, Koichi

    2004-10-01

    Surgical indication was determined by lung biopsy in 91 patients with secundum atrial septal defect (ASD) and severe pulmonary hypertension > 70 mm Hg of pulmonary arterial peak pressure and/or pulmonary vascular resistance of > 8 U/m(2). Pulmonary vascular disease (PVD) in ASD was classified into four types: (1) Musculoelastosis consisting of longitudinal muscle bundles and elastic fibers; surgery is indicated no matter how severely the peripheral small pulmonary arteries are occluded. Surgery was performed in all of the 20 patients, and the postoperative course was uneventful. (2) Plexogenic pulmonary arteriopathy: surgery is indicated for a PVD index < or = 2.3. Surgery was performed in 25 of the 32 patients. The remaining seven patients for whom surgery was not indicated are under follow-up observation. No deaths have occurred among the 32 patients. (3) Thromboembolism of small pulmonary arteries: Surgery is indicated for all such cases. Surgery was indicated in all of the five patients. (4) Mixed type of plexogenic pulmonary arteriopathy and musculoelastosis: Surgery is indicated if the collateral is not observed. Surgery was performed in 15 of the 25 patients. The remaining 10 patients for whom surgery was not indicated are under follow-up observation. Nine of these 91 patients associated with primary pulmonary hypertension were eliminated from this study. No deaths due to PVD occurred among the 82 patients who underwent lung biopsy diagnosis. Lung biopsy diagnosis is concluded to be very effective.

  7. Dietary patterns, involvement in physical activity and body mass index of Romanian adults having cardio-vascular diseases

    Directory of Open Access Journals (Sweden)

    Lucia Maria Lotrean

    2016-05-01

    Full Text Available Promotion of a healthy diet, an active lifestyle and appropriate body weight are important components of cardio-vascular disease prevention and control. This study aimed to assess several dietary patterns, involvement in physical activity and body mass index (BMI of Romanian adults hospitalized because of diagnoses of cardio-vascular diseases (CVD. The study was performed in 2014 in 1 hospital setting from Cluj-Napoca, Romania. It involved 80 adult patients (45 to 78 years old hospitalized with diagnoses of CVD. Anonymous questionnaire assessing several lifestyle related behaviours were filled in by the participants; based on their weight and height, the BMI was calculated. The results show that 76.2% of the participants recognize the role of consumption of fruits and vegetables for cardio-vascular diseases prevention and control, but only 5% meet the recommendations of eating at least 5 portions of fruits and vegetables (around 400 g daily. The majority of the subjects know that the consumption of animal fat increases the risk for cardio-vascular diseases, but, only one out of two patients declared their constant preoccupation for avoiding products rich in saturated fatty acids, such as animal fat, high fat dairy products and high fat meat. Around 80% of the participants know the risk of obesity for cardio-vascular diseases, but 81.2% have a BMI higher than 25. A percentage of 60% of the patients declared that they received general information from health care professionals about diet, physical activity and cardio-vascular disease prevention, while one quarter followed an educational program for this issue and only one out of ten patients followed a personalized program for loosing weight. Comprehensive educational and counselling programs for promoting healthy nutrition and achievement of an appropriate body weight are needed for Romanian adults having CVD

  8. Positive synovial vascularity in patients with low disease activity indicates smouldering inflammation leading to joint damage in rheumatoid arthritis: time-integrated joint inflammation estimated by synovial vascularity in each finger joint.

    Science.gov (United States)

    Fukae, Jun; Isobe, Masato; Kitano, Akemi; Henmi, Mihoko; Sakamoto, Fumihiko; Narita, Akihiro; Ito, Takeya; Mitsuzaki, Akio; Shimizu, Masato; Tanimura, Kazuhide; Matsuhashi, Megumi; Kamishima, Tamotsu; Atsumi, Tatsuya; Koike, Takao

    2013-03-01

    To investigate the relationship between synovial vascularity and joint damage progression in each finger joint of patients with RA under low disease activity during treatment with biologic agents. We studied 310 MCP and 310 PIP joints of 31 patients with active RA who were administered adalimumab (ADA) or tocilizumab (TCZ). Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at weeks 8, 20 and 40. Synovial vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and at week 50. Composite scores of the DAS with 28 joints and the Simplified Disease Activity Index (SDAI) were significantly decreased from baseline to week 8, being sustained at a low level by biologic agents during the observational period. MCP and PIP joints with positive synovial vascularity after week 8 showed more subsequent joint damage progression than joints without synovial vascularity throughout the follow-up. The changes in radiographic progression in these joints were independent of the sum of synovial vascularity from baseline to week 40 or the occasional occurrence of positive synovial vascularity. Smouldering inflammation reflected by positive synovial vascularity under low disease activity was linked to joint damage. The damage progressed irrespective of the severity of positive synovial vascularity. Even with a favourable overall therapeutic response, monitoring of synovial vascularity has the potential to provide useful joint information to tailor treatment strategies. Trial registration. University Hospital Medical Information Network Clinical Trials Registry; http://www.umin.ac.jp/ctr/; UMIN000004476.

  9. [Medical significance of endothelial glycocalyx. Part 2: Its role in vascular diseases and in diabetic complications].

    Science.gov (United States)

    Frati Munari, Alberto C

    2014-01-01

    Endothelial glycocalyx is a layer composed by glycosaminoglycans, proteoglycans and glycoproteins attached to the vascular endothelial luminal surface. Shredding of glycocalyx appears as an essential initial step in the pathophysiology of atherosclerosis and microangiopathic complications of diabetes mellitus, as well as in chronic venous disease. Atherosclerosis risk factors, as hypercholesterolemia (LDL), hyperglycemia, inflammation, salt excess and altered shear stress can damage glycocalyx. This lead to endothelial dysfunction and allows LDL and leukocytes to filtrate to the subendothelial space initiating atheroma plaque formation. Degradation of glycocalyx in diabetes mellitus is mainly due to oxidative stress and enables protein filtration (albuminuria) and endothelial disorder of microangiopathy. Chronic venous hypertension brings to altered shears stress which results in shredded glycocalyx, this allows leukocytes to migrate into venous wall and initiate inflammation leading to morphologic and functional venous changes of the chronic venous disease. Treatment with glycosaminoglycans (sulodexide) prevents or recovers the damaged glycocalyx and several of its consequences. This drug improves chronic venous disease and promotes healing of chronic venous ulcers. It has also been useful in peripheral arterial obstructive disease and in diabetic nephropathy with albuminuria. Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  10. [True and presumed contraindications of beta blockers. Peripheral vascular disease, diabetes mellitus, chronic bronchopneumopathy].

    Science.gov (United States)

    Pozzi, R

    2000-08-01

    Traditional contraindications to beta-blockers are peripheral vascular diseases, diabetes mellitus, chronic obstructive pulmonary disease (COPD) and asthma. Recent data seem to show that rigorous application of these rules are not completely justified and indicate that many patients would be inappropriately excluded from the beneficial effects of this therapy. Appraisal of clear guidelines for a safe use of beta-blockers is thus mandatory for the clinician. A brief review of the effects of beta-adrenergic receptor blockade is offered. The therapy is aimed at blocking beta 1-receptors. On the other hand, the block of beta 2-receptors causes the well known side effects, i.e. vasoconstriction, delayed response to hypoglycemia in diabetic patients, bronchoconstriction. From the first compound, propranolol, with uniform action on beta 1 and beta 2-receptors, further generation of beta-blockers were subsequently developed: beta 1-selective, with intrinsic sympathomimetic activity, and with associated vasodilating "ancillary" property. Some favorable reduction in collateral effects has thus been obtained with new compounds, without reaching complete safety. Examination of exclusion criteria applied in clinical trials offers no useful indications because of their imprecise definition. Examination of the literature and a more accurate understanding of the diseases, traditionally considered contraindications, may help setting up a uniform and clear path: peripheral vascular disease: beta-blockers should be avoided only in those patients with vasospastic disorders, rest pain with severe peripheral vascular disease or nonhealing lesions. In patients with mild to moderate disease, beta-blockers can be prescribed, but careful surveillance for any changes in symptoms related to intermittent claudicatio should be achieved; diabetes mellitus: previous apprehension for the lessening reaction to hypoglycemia in patients treated with insulin has been retracted. Beta-blockers are not

  11. The Effect of Hyperhomocysteinemia on Motor Symptoms, Cognitive Status, and Vascular Risk in Patients with Parkinson's Disease.

    Science.gov (United States)

    Kocer, Bilge; Guven, Hayat; Conkbayir, Isik; Comoglu, Selim Selcuk; Delibas, Sennur

    2016-01-01

    Factors related with hyperhomocysteinemia (HHcy) and the impact of HHcy in Parkinson's disease (PD) are not well understood. We investigated the factors associated with increased levels of homocysteine (Hcy) and the relationship between HHcy and motor symptoms, cognitive status, and vascular risk in patients with Parkinson's disease. Among 60 patients (29 males, 48.3%) with PD, the stage of the disease, the severity of clinical symptoms, and the patients' cognitive status were measured using a modified Hoehn and Yahr Staging Scale (mHY), Unified Parkinson's Disease Rating Scale (UPDRS) II and III, and Mini-Mental State Examination (MMSE), respectively. Patients were also noted for having dyskinesia and hallucinations. Serum vitamin B12, folic acid, and plasma Hcy levels were measured. Furthermore, the presence of vascular risk factors was recorded. Finally, we investigated carotid artery intima-media thickening and stenosis using colour Doppler ultrasonography as well as the presence of ischemic lesions using brain imaging techniques. Plasma Hcy levels were higher with advanced age and in males. In addition, there was an inverse relationship between Hcy and vitamin B12 levels. There was no correlation between HHcy and the stage of the disease, severity of motor symptoms, cognitive status as assessed by the MMSE, vascular risk factors, carotid artery atherosclerotic findings, and ischemic brain lesions. Plasma Hcy levels may rise due to several factors in PD. However, the resulting HHcy has no significant effect on the clinical picture in terms of motor features, cognitive status, and vascular diseases.

  12. [Endothelial dysfunction as a marker of vascular aging syndrome on the background of hypertension, coronary heart disease, gout and obesity].

    Science.gov (United States)

    Vatseba, M O

    2013-09-01

    Under observation were 40 hypertensive patients with coronary heart disease, gout and obesity I and II degree. Patients with hypertension in combination with coronary heart disease, gout and obesity, syndrome of early vascular aging is shown by increased stiffness of arteries, increased peak systolic flow velocity, pulse blood presure, the thickness of the intima-media complex, higher level endotelinemia and reduced endothelial vasodilation. Obtained evidence that losartan in complex combination with basic therapy and metamaks in complex combination with basic therapy positively affect the elastic properties of blood vessels and slow the progression of early vascular aging syndrome.

  13. Nonalcoholic fatty liver disease and vascular disease: State-of-the-art

    Science.gov (United States)

    Fargion, Silvia; Porzio, Marianna; Fracanzani, Anna Ludovica

    2014-01-01

    Nonalcoholic fatty liver disease (NAFLD), the most common of chronic liver disease in Western Country, is closely related to insulin resistance and oxidative stress and includes a wide spectrum of liver diseases ranging from steatosis alone, usually a benign and non-progressive condition, to nonalcoholic steatohepatitis (NASH), which may progress to liver fibrosis and cirrhosis. NAFLD is considered the hepatic manifestation of the metabolic syndrome with which shares several characteristics, however recent data suggest that NAFLD is linked to increased cardiovascular risk independently of the broad spectrum of risk factors of metabolic syndrome. Accumulating evidence suggests that the clinical burden of NAFLD is not restricted to liver-related morbidity and mortality, with the majority of deaths in NAFLD patients related to cardiovascular disease and cancer and not to the progression of liver disease. Retrospective and prospective studies provide evidence of a strong association between NAFLD and subclinical manifestation of atherosclerosis (increased intima-media thickness, endothelial dysfunction, arterial stiffness, impaired left ventricular function and coronary calcification). A general agreement emerging from these studies indicates that patients with NASH are at higher risk of cardiovascular diseases than those with simple steatosis, emphasizing the role of chronic inflammation in the pathogenesis of atherosclerosis of these patients. It is very likely that the different mechanisms involved in the pathogenesis of atherosclerosis in patients with NAFLD have a different relevance in the patients according to individual genetic background. In conclusion, in the presence of NAFLD patients should undergo a complete cardiovascular evaluation to prevent future atherosclerotic complications. Specific life-style modification and aggressive pharmaceutical modification will not only reduce the progression of liver disease, but also reduce morbidity for cardiovascular

  14. Statins are underused in recent-onset Parkinson's disease with increased vascular risk: findings from the UK Tracking Parkinson's and Oxford Parkinson's Disease Centre (OPDC) discovery cohorts.

    Science.gov (United States)

    Swallow, Diane M A; Lawton, Michael A; Grosset, Katherine A; Malek, Naveed; Klein, Johannes; Baig, Fahd; Ruffmann, Claudio; Bajaj, Nin P; Barker, Roger A; Ben-Shlomo, Yoav; Burn, David J; Foltynie, Thomas; Morris, Huw R; Williams, Nigel; Wood, Nicholas W; Hu, Michele T M; Grosset, Donald G

    2016-11-01

    Cardiovascular disease (CVD) influences phenotypic variation in Parkinson's disease (PD), and is usually an indication for statin therapy. It is less clear whether cardiovascular risk factors influence PD phenotype, and if statins are prescribed appropriately. To quantify vascular risk and statin use in recent-onset PD, and examine the relationship between vascular risk, PD severity and phenotype. Cardiovascular risk was quantified using the QRISK2 calculator (high ≥20%, medium ≥10 and <20%, low risk <10%). Motor severity and phenotype were assessed using the Movement Disorder Society Unified PD Rating Scale (UPDRS) and cognition by the Montreal cognitive assessment. In 2909 individuals with recent-onset PD, the mean age was 67.5 years (SD 9.3), 63.5% were men and the mean disease duration was 1.3 years (SD 0.9). 33.8% of cases had high vascular risk, 28.7% medium risk, and 22.3% low risk, while 15.2% of cases had established CVD. Increasing vascular risk and CVD were associated with older age (p<0.001), worse motor score (p<0.001), more cognitive impairment (p<0.001) and worse motor phenotype (p=0.021). Statins were prescribed in 37.2% with high vascular risk, 15.1% with medium vascular risk and 6.5% with low vascular risk, which compared with statin usage in 75.3% of those with CVD. Over 60% of recent-onset PD patients have high or medium cardiovascular risk (meriting statin usage), which is associated with a worse motor and cognitive phenotype. Statins are underused in these patients, compared with those with vascular disease, which is a missed opportunity for preventive treatment. GN11NE062, NCT02881099. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Atypical Vascular Involvement in a Case of Behçet's Disease

    Directory of Open Access Journals (Sweden)

    Alejandro Rodríguez Morata

    2012-01-01

    Full Text Available Introduction. Behçet's disease (BD is a form of vasculitis of unknown etiology which is rare in our environment. It is characterized by a variety of clinical manifestations and usually affects young adults. Recurrent oral and genital ulcers are a characteristic and extremely frequent symptom, but mortality is linked with more significant symptoms such as aortic pseudoaneurysm, pulmonary pseudoaneurysm, and cerebral venous thrombosis. Patient and Method. We present a case of a young male with atypical BD and severe polyvascular involvement (previous cerebral venous thrombosis and current peripheral venous thrombosis, acute ischemia, and peripheral arterial pseudoaneurysm who required urgent surgical intervention due to a symptomatic external iliac pseudoaneurysm. Result. The pseudoaneurysm was successfully treated, we performed an iliofemoral bypass, and we treated it with steroids and immunosuppressive therapy. Conclusions. These rare clinical manifestations highlight the importance of considering BD in young patients, even in usual cases of vascular intervention, whether arterial or venous in nature.

  16. Potential Risk Factors Associated With Vascular Diseases in Patients Receiving Treatment for Hypertension.

    Science.gov (United States)

    Kim, Hyunjung; Park, Joonhong; Chae, Hyojin; Lee, Gun Dong; Lee, Sang Yoon; Lee, Jong Min; Oh, Yong Seog; Kim, Myungshin; Kim, Yonggoo

    2016-05-01

    Currently, the hypertension (HTN) patients undergo appropriate medical treatment, and traditional risk factors are highly controlled. Therefore, potential risk factors of atherosclerotic vascular diseases (AVD) and venous thromboembolisms (VTE) in HTN should be reconsidered. We investigated thrombophilic genetic mutations and existing biomarkers for AVD or VTE in HTN patients receiving treatment. A total of 183 patients were enrolled: AVD with HTN (group A, n=45), VTE with HTN (group B, n=62), and HTN patients without any vascular diseases (group C, n=76). The lipid profile, homocysteine (Hcy) levels, D-dimers, fibrinogen, antithrombin, lupus anticoagulant, and anti-cardiolipin antibody (aCL) were evaluated. Prothrombin G20210A, Factor V G1691A, and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C were analyzed. All patients revealed wild type prothrombin G20210A and Factor V G1691A polymorphisms. The frequency of MTHFR polymorphisms was 677CT (n=84, 45.9%); 677TT (n=46, 25.1%); 1298AC (n=46, 25.1%); and 1298CC (n=2, 1.1%). The MTHFR 677TT genotype tended to increase the odds ratio (OR) to AVD events in HTN patients (OR 2.648, confidence interval 0.982-7.143, P=0.05). The group A demonstrated significantly higher Hcy levels (P=0.009), fibrinogen (P=0.004), and platelet counts (P=0.04) than group C. Group B had significantly higher levels of D-dimers (P=0.0001), platelet count (P=0.0002), and aCL (P=0.02) frequency than group C. The MTHFR 677TT genotype and Hcy level could be potential risk factors associated with development of AVD in HTN patients receiving treatment. D-dimer and aCL might be useful to estimate the occurrence of VTE in them.

  17. Changes in Albuminuria Predict Mortality and Morbidity in Patients with Vascular Disease

    Science.gov (United States)

    Mann, Johannes F. E.; Schumacher, Helmut; Gao, Peggy; Mancia, Giuseppe; Weber, Michael A.; McQueen, Matthew; Koon, Teo; Yusuf, Salim

    2011-01-01

    The degree of albuminuria predicts cardiovascular and renal outcomes, but it is not known whether changes in albuminuria also predict similar outcomes. In two multicenter, multinational, prospective observational studies, a central laboratory measured albuminuria in 23,480 patients with vascular disease or high-risk diabetes. We quantified the association between a greater than or equal to twofold change in albuminuria in spot urine from baseline to 2 years and the incidence of cardiovascular and renal outcomes and all-cause mortality during the subsequent 32 months. A greater than or equal to twofold increase in albuminuria from baseline to 2 years, observed in 28%, associated with nearly 50% higher mortality (HR 1.48; 95% CI 1.32 to 1.66), and a greater than or equal to twofold decrease in albuminuria, observed in 21%, associated with 15% lower mortality (HR 0.85; 95% CI 0.74 to 0.98) compared with those with lesser changes in albuminuria, after adjustment for baseline albuminuria, BP, and other potential confounders. Increases in albuminuria also significantly associated with cardiovascular death, composite cardiovascular outcomes (cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure), and renal outcomes including dialysis or doubling of serum creatinine (adjusted HR 1.40; 95% CI 1.11 to 1.78). In conclusion, in patients with vascular disease, changes in albuminuria predict mortality and cardiovascular and renal outcomes, independent of baseline albuminuria. This suggests that monitoring albuminuria is a useful strategy to help predict cardiovascular risk. PMID:21719791

  18. Caveolin-1 influences vascular protease activity and is a potential stabilizing factor in human atherosclerotic disease.

    Directory of Open Access Journals (Sweden)

    Juan A Rodriguez-Feo

    Full Text Available Caveolin-1 (Cav-1 is a regulatory protein of the arterial wall, but its role in human atherosclerosis remains unknown. We have studied the relationships between Cav-1 abundance, atherosclerotic plaque characteristics and clinical manisfestations of atherosclerotic disease.We determined Cav-1 expression by western blotting in atherosclerotic plaques harvested from 378 subjects that underwent carotid endarterectomy. Cav-1 levels were significantly lower in carotid plaques than non-atherosclerotic vascular specimens. Low Cav-1 expression was associated with features of plaque instability such as large lipid core, thrombus formation, macrophage infiltration, high IL-6, IL-8 levels and elevated MMP-9 activity. Clinically, a down-regulation of Cav-1 was observed in plaques obtained from men, patients with a history of myocardial infarction and restenotic lesions. Cav-1 levels above the median were associated with absence of new vascular events within 30 days after surgery [0% vs. 4%] and a trend towards lower incidence of new cardiovascular events during longer follow-up. Consistent with these clinical data, Cav-1 null mice revealed elevated intimal hyperplasia response following arterial injury that was significantly attenuated after MMP inhibition. Recombinant peptides mimicking Cav-1 scaffolding domain (Cavtratin reduced gelatinase activity in cultured porcine arteries and impaired MMP-9 activity and COX-2 in LPS-challenged macrophages. Administration of Cavtratin strongly impaired flow-induced expansive remodeling in mice. This is the first study that identifies Cav-1 as a novel potential stabilizing factor in human atherosclerosis. Our findings support the hypothesis that local down-regulation of Cav-1 in atherosclerotic lesions contributes to plaque formation and/or instability accelerating the occurrence of adverse clinical outcomes. Therefore, given the large number of patients studied, we believe that Cav-1 may be considered as a novel target

  19. Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Scott Paul J

    2005-01-01

    Full Text Available Abstract Background Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Methods A 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone. Children were matched for age, gender, and type of sickle cell defect. Hospital admissions were recorded for acute chest syndrome, cerebral vascular accident, vaso-occlusive pain crises, and blood transfusions (total, exchange and chronic. Mann-Whitney test and Chi square analysis were used to assess differences between the groups. Results Children with sickle cell disease and asthma had significantly more episodes of acute chest syndrome (p = 0.03 and cerebral vascular accidents (p = 0.05 compared to children with sickle cell disease without asthma. As expected, these children received more total blood transfusions (p = 0.01 and chronic transfusions (p = 0.04. Admissions for vasoocclusive pain crises and exchange transfusions were not statistically different between cases and controls. SS disease is more severe than SC disease. Conclusions Children with concomitant asthma and sickle cell disease have increased episodes of acute chest syndrome, cerebral vascular accidents and the need for blood transfusions. Whether aggressive asthma therapy can reduce these complications in this subset of children is unknown and requires further studies.

  20. Cytochrome P450 1B1 and 2C9 genotypes and risk of ischemic vascular disease, cancer, and chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Kaur-Knudsen, Diljit; Bojesen, Stig E; Nordestgaard, Børge G

    2012-01-01

    The aim of this review is to summarize present knowledge of genetic variation in cytochrome P450 1B1 (CYP1B1) and 2C9 (CYP2C9) genes and risk of tobacco-related cancer, female cancer, chronic obstructive pulmonary disease and ischemic vascular disease. The CYP1B1 and CYP2C9 enzymes metabolize pol...

  1. Patient with rapidly evolving neurological disease with neuropathological lesions of Creutzfeldt-Jakob disease, Lewy body dementia, chronic subcortical vascular encephalopathy and meningothelial meningioma.

    Science.gov (United States)

    Vita, Maria Gabriella; Tiple, Dorina; Bizzarro, Alessandra; Ladogana, Anna; Colaizzo, Elisa; Capellari, Sabina; Rossi, Marcello; Parchi, Piero; Masullo, Carlo; Pocchiari, Maurizio

    2017-04-01

    We report a case of rapidly evolving neurological disease in a patient with neuropathological lesions of Creutzfeldt-Jakob disease (CJD), Lewy body dementia (LBD), chronic subcortical vascular encephalopathy and meningothelial meningioma. The coexistence of severe multiple pathologies in a single patient strengthens the need to perform accurate clinical differential diagnoses in rapidly progressive dementias. © 2016 Japanese Society of Neuropathology.

  2. Sub-clinical Alcohol Consumption and Gambling Disorder.

    Science.gov (United States)

    Harries, Michael D; Redden, Sarah A; Leppink, Eric W; Chamberlain, Samuel R; Grant, Jon E

    2017-06-01

    While it is well established that gambling disorder is associated with alcohol use disorder, less is known regarding whether sub-clinical alcohol consumption increases gambling behavior. This study examined the effects of varying levels of alcohol consumption on clinical and cognitive measures. The sample consisted of 572 non-treatment seeking gamblers age 18-29 who were divided into three groups: non-current drinkers, current drinkers who did not qualify for an alcohol use disorder, and those with an alcohol use disorder (AUD). All subjects were assessed on gambling pathology, severity and impulsivity using the Structured Clinical Interview for Gambling Disorder, Yale Brown Obsessive Compulsive Scale for Pathologic Gambling and the Barratt Impulsive Scale-11 and select cognitive tests. In all of the clinical measures, controlling for age, gender and education, the AUD group was significantly more likely than the non-current and current drinkers to be a pathologic gambler and to be impulsive, compulsive and depressed. On cognitive tasks, controlling for age, gender and education, the AUD group had significantly worse strategy use on a spatial working memory task than both other groups. This study suggests that the relationship between alcohol and gambling may only exist when pathology in both alcohol consumption and gambling behavior is present. Examining this relationship with alcohol consumption as a continuous variable would provide additional insight into the potential effects alcohol consumption has on gambling behavior.

  3. Alzheimer's disease and vascular dementia: one potentially preventable and modifiable disease. Part I: Pathology, diagnosis and screening.

    Science.gov (United States)

    Davey, Dennis A

    2014-01-01

    Alzheimer's disease (AD) and vascular dementia (VaD) frequently coexist and their separation may well be a false dichotomy. The neurodegenerative and cerebrovascular changes vary from the extremes of 'pure AD' to 'pure VaD' and a combination of changes is the most frequent. Both changes have a preclinical phase of decades. The clinical presentation is often out of proportion to the neuropathology to a lesser or greater degree. The diagnosis of dementia or mild cognitive impairment is based on clinical assessment and diagnostic criteria have been published. Neuropsychological testing and specialist evaluation may be required. The UK and US governments propose screening of all older adults. The value of routine screening has been questioned. Consent for testing and counseling are essential.

  4. Adipokines, vascular wall, and cardiovascular disease: a focused overview of the role of adipokines in the pathophysiology of cardiovascular disease.

    Science.gov (United States)

    Maresca, Fabio; Di Palma, Vito; Bevilacqua, Michele; Uccello, Giuseppe; Taglialatela, Vittorio; Giaquinto, Alessandro; Esposito, Giovanni; Trimarco, Bruno; Cirillo, Plinio

    2015-01-01

    Epidemiological evidence has shown that abdominal obesity is closely associated with the development of cardiovascular (CV) disease, suggesting that it might be considered as an independent CV risk factor. However, the pathophysiological mechanisms responsible for the association between these 2 clinical entities remain largely unknown. Adipocytes are considered able to produce and secrete chemical mediators known as "adipokines" that may exert several biological actions, including those on heart and vessels. Of interest, a different adipokine profile can be observed in the plasma of patients with obesity or metabolic syndrome compared with healthy controls. We consider the main adipokines, focusing on their effects on the vascular wall and analyzing their role in CV pathophysiology. © The Author(s) 2014.

  5. Vascular risk profiles for dementia and Alzheimer's disease in very old people: a population-based longitudinal study.

    Science.gov (United States)

    Qiu, Chengxuan; Xu, Weili; Winblad, Bengt; Fratiglioni, Laura

    2010-01-01

    Numerous studies have linked individual vascular factors to dementia including Alzheimer's disease (AD). We investigated different vascular risk profiles in relation to dementia and AD among very old people. A standardized follow-up procedure was applied three times to a dementia-free cohort (n=1270, age >or= 75) over a nine-year period to detect dementia and AD cases using the DSM-III-R criteria. We examined two vascular risk profiles, which were scored by counting the number of corresponding vascular factors: 1) atherosclerotic profile included systolic pressure >or= 160 mmHg, diabetes/prediabetes, and stroke; and 2) cerebral hypoperfusion profile constituted diastolic pressure dementia, including 328 AD cases. All components of vascular profiles were significantly or marginally associated with increased dementia risk. The risk of dementias was increased with increasing score of both risk profiles (p for trend or= 2 in either profile had an approximately twofold-increased risk for dementia and AD. These data suggest that aggregation of atherosclerotic- and hypoperfusion-related vascular factors increases the risk of dementia in very old people. Severe cerebral atherosclerosis and insufficient perfusion are involved in the development of dementia including AD.

  6. Qualitative score of systemic arteriosclerosis by vascular ultrasonography as a predictor of coronary artery disease in type 2 diabetes.

    Science.gov (United States)

    Hirata, Ayumu; Kishida, Ken; Hiuge-Shimizu, Aki; Nakatsuji, Hideaki; Funahashi, Tohru; Shimomura, Iichiro

    2011-12-01

    Patients with type 2 diabetes mellitus (T2DM) are at risk of polyvascular comorbidities and poor prognosis. Non-invasive techniques for early prediction of coronary artery disease (CAD) are desirable to prevent cardiovascular events in these patients. The aim of the present study was to investigate the association between CAD and systemic arteriosclerosis by qualitative vascular ultrasonography. The study subjects were 102 consecutive outpatients with T2DM [males/females = 60/42, age: mean ± SD 67 ± 9 (range, 40-85) years] evaluated by vascular ultrasonography for arteriosclerosis in the abdominal aorta, carotid, renal, and common iliac arteries. The total number of detected arteriosclerotic vascular lesions in the four arteries was determined. CAD was diagnosed by two cardiologists using either stress electrocardiography, myocardial scintigraphy, multi-detector row computed tomography or coronary angiography. Multiple arteriosclerotic vascular lesions (>1) were detected in 64 (63%) patients. The total systemic vascular score was significantly higher in patients with CAD than those without (average score 2.7 versus 1.0, p arteriosclerosis by the total systemic vascular score is potentially useful for the early prediction of CAD in T2DM patients. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Vascular risk factors, vascular disease, lipids and lipid targets in patients with familial dysbetalipoproteinemia : A European cross-sectional study

    NARCIS (Netherlands)

    Koopal, C.|info:eu-repo/dai/nl/413754820; Retterstol, K.; Sjouke, B.; Hovingh, G. K.; Ros, E.; de Graaf, J.; Dullaart, R. P. F.; Bertolini, S.; Visseren, F. L. J.|info:eu-repo/dai/nl/166267678

    Background: Familial dysbetalipoproteinemia (FD), also known as type III hyperlipoproteinemia, is a genetic dyslipidemia characterized by elevated very low density lipoprotein (VLDL) and chylomicron remnant particles that confers increased risk of cardiovascular disease (CVD). The objective of this

  8. Vascular Dysfunction in a Transgenic Model of Alzheimer's Disease: Effects of CB1R and CB2R Cannabinoid Agonists.

    Science.gov (United States)

    Navarro-Dorado, Jorge; Villalba, Nuria; Prieto, Dolores; Brera, Begoña; Martín-Moreno, Ana M; Tejerina, Teresa; de Ceballos, María L

    2016-01-01

    There is evidence of altered vascular function, including cerebrovascular, in Alzheimer's disease (AD) and transgenic models of the disease. Indeed vasoconstrictor responses are increased, while vasodilation is reduced in both conditions. β-Amyloid (Aβ) appears to be responsible, at least in part, of alterations in vascular function. Cannabinoids, neuroprotective and anti-inflammatory agents, induce vasodilation both in vivo and in vitro. We have demonstrated a beneficial effect of cannabinoids in models of AD by preventing glial activation. In this work we have studied the effects of these compounds on vessel density in amyloid precursor protein (APP) transgenic mice, line 2576, and on altered vascular responses in aortae isolated ring. First we showed increased collagen IV positive vessels in AD brain compared to control subjects, with a similar increase in TgAPP mice, which was normalized by prolonged oral treatment with the CB1/CB2 mixed agonist WIN 55,212-2 (WIN) and the CB2 selective agonist JWH-133 (JWH). In Tg APP mice the vasoconstriction induced by phenylephrine and the thromboxane agonist U46619 was significantly increased, and no change in the vasodilation to acetylcholine (ACh) was observed. Tg APP displayed decreased vasodilation to both cannabinoid agonists, which were able to prevent decreased ACh relaxation in the presence of Aβ. In summary, we have confirmed and extended the existence of altered vascular responses in Tg APP mice. Moreover, our results suggest that treatment with cannabinoids may ameliorate the vascular responses in AD-type pathology.

  9. Metabolic syndrome and the development of vascular disease and type 2 diabetes in high-risk patients

    NARCIS (Netherlands)

    Wassink, A.M.J.

    2009-01-01

    Abdominal obesity and its associated insulin resistance play a key role in the clustering of vascular risk factors, known as Metabolic Syndrome. Subjects with Metabolic Syndrome are at increased risk for the development of both type 2 diabetes and cardiovascular disease. Type 2 diabetes and

  10. Blood pressure, white matter lesions and medial temporal lobe atrophy: closing the gap between vascular pathology and Alzheimer's disease?

    NARCIS (Netherlands)

    Korf, E.; Scheltens, P.; Barkhof, F.; Leeuw, H.F. de

    2005-01-01

    BACKGROUND: Vascular factors are recognized as important risk factors for Alzheimer's disease, although it is unknown whether these factors directly lead to the typical degenerative pathology such as medial temporal lobe atrophy. We set out to investigate the relation between blood pressure and

  11. SCHOOL OF HEALTH FOR PATIENTS WITH CARDIO-VASCULAR DISEASES: BALANCE BETWEEN ANDRAGOGIC AND PEDAGOGIC EDUCATIONAL MODELS

    Directory of Open Access Journals (Sweden)

    S. K. Kukushkin

    2016-01-01

    Full Text Available Problems of educational programs for patients with cardio-vascular diseases in schools of health are discussed. Comparison of andragogic (adult education and pedagogic education models are analyzed. The pedagogic education model is currently dominating in school of health. To increase of education efficacy in school of health implementation of andragogic principles is recommended. 

  12. Genetic variation in liver x receptor alpha and risk of ischemic vascular disease in the general population

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, Ruth; Anestis, Aristomenis

    2011-01-01

    Although animal studies indicate that liver X receptor alpha (LXRα) might influence risk of atherosclerosis, data in humans remain scarce. We tested the hypothesis that genetic variation in LXRα associates with risk of ischemic vascular disease and/or plasma lipid and lipoprotein levels in the ge...

  13. Genetic variation in liver x receptor alpha and risk of ischemic vascular disease in the general population

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, Ruth; Anestis, Aristomenis

    2011-01-01

    Although animal studies indicate that liver X receptor alpha (LXRa) might influence risk of atherosclerosis, data in humans remain scarce. We tested the hypothesis that genetic variation in LXRa associates with risk of ischemic vascular disease and/or plasma lipid and lipoprotein levels in the ge...

  14. Lipid Peroxidation Markers in Coronary Artery Disease Patients with Possible Vascular Mild Cognitive Impairment.

    Science.gov (United States)

    Suridjan, Ivonne; Herrmann, Nathan; Adibfar, Alex; Saleem, Mahwesh; Andreazza, Ana; Oh, Paul I; Lanctôt, Krista L

    2017-01-01

    This study examined associations between lipid peroxidation markers and cognition, and associations between these markers and cognitive response to an exercise intervention program, in adults with coronary artery disease at risk of dementia. Lipid peroxidation products were measured in serum in 118 patients (29 possible vascular mild cognitive impairment and 89 controls). Ratios of early- (lipid hydroperoxides, LPH) to late-stage (8-isoprostane, 8-ISO; 4-hydroxy-2-nonenal, 4-HNE) lipid peroxidation products were calculated. Cognitive performance was assessed before and at completion of a 24-week exercise intervention program. A global effect of group on lipid peroxidation markers was observed, adjusting for sex, years of education, and cardiopulmonary fitness (main effect of group F (3,102) = 2.957, p = 0.036). Lower lipid peroxidation at baseline, as determined by lower 8-ISO concentration, was associated with greater improvement in verbal memory (F (1, 64) = 4.738, p = 0.03) and executive function (F (1, 64) = 5.219, p = 0.026) performance. Similarly, higher ratios of 8-ISO/LPH (F (1, 65) = 6.592, p = 0.013) and (8-ISO+4-HNE) to LPH (F (1, 65) = 3.857, p = 0.054), were associated with less improvement in executive function performance over a 24-week exercise intervention. Lipid peroxidation may be a biomarker of early vascular cognitive impairment, and elevated lipid peroxidation might limit the cognitive benefits of exercise in this high-risk population.

  15. Diabetes, Alzheimer disease, and vascular dementia: a population-based neuropathologic study.

    Science.gov (United States)

    Ahtiluoto, S; Polvikoski, T; Peltonen, M; Solomon, A; Tuomilehto, J; Winblad, B; Sulkava, R; Kivipelto, M

    2010-09-28

    To investigate the relation of diabetes to dementia, Alzheimer disease (AD), and vascular dementia (VaD), through analyses of incidence, mortality, and neuropathologic outcomes in a prospective population-based study of the oldest old. The Vantaa 85+ study included 553 residents living in the city of Vantaa, Finland, and aged ≥85 years on April 1, 1991. Survivors were reexamined in 1994, 1996, 1999, and 2001. Autopsies were performed in 291 persons who died during the follow-up (48% of total population). Diabetes was assessed according to self-report, medical record of physician-diagnosed diabetes, or use of antidiabetic medication. Macroscopic infarcts were identified from 1-cm coronal slices of cerebral hemispheres, 5-mm transverse brainstem slices, and sagittal cerebellum slices. Methenamine silver staining was used for β-amyloid, methenamine silver-Bodian staining for neurofibrillary tangles, and modified Bielschowsky method for neuritic plaques. Cox proportional hazards and multiple logistic regression models were used to analyze the association of diabetes with dementia and neuropathology, respectively. Diabetes at baseline doubled the incidence of dementia, AD, and VaD, and increased mortality. Individuals with diabetes were less likely to have β-amyloid (hazard ratio [HR] [95% confidence interval (CI)] was 0.48 [0.23-0.98]) and tangles (HR [95% CI] 0.72 [0.39-1.33]) but more likely to have cerebral infarcts (HR [95% CI] 1.88 [1.06-3.34]) after all adjustments. Elderly patients with diabetes develop more extensive vascular pathology, which alone or together with AD-type pathology (particularly in APOE ε4 carriers) results in increased dementia risk.

  16. Differences in peripheral oxidative stress markers in Alzheimer's disease, vascular dementia and mixed dementia patients.

    Science.gov (United States)

    Hatanaka, Hirokuni; Hanyu, Haruo; Fukasawa, Raita; Hirao, Kentaro; Shimizu, Soichiro; Kanetaka, Hidekazu; Iwamoto, Toshihiko

    2015-12-01

    We determined whether the possible roles of oxidative stress differ in the pathophysiology and cognitive decline of Alzheimer's disease (AD), vascular dementia (VaD) and mixed Alzheimer's/vascular dementia (MD). We measured the levels of diacron reactive oxygen metabolite (dROM), reflecting the amount of organic hydroperoxides, and biological anti-oxidant potential (BAP), measuring the ferric reducing ability of blood plasma, in 72 patients with AD, 27 with VaD, 24 with MD and 53 non-demented outpatients (control group). In addition, endogenous plasma anti-oxidants, such as albumin, total bilirubin and uric acid, were compared among the groups. All participants with VaD and MD showed extensive white matter hyperintensity, in addition to multiple lacunes. The dROM levels were significantly higher in the AD and MD groups than in the control group. The BAP levels were significantly lower in the MD group than in the control, AD and VaD groups. The AD group showed significantly lower levels of bilirubin and uric acid than the control group. The MD group showed a significantly lower level of albumin than the control and AD groups, and a significantly lower level of bilirubin than the control group. The Mini-Mental State examination scores correlated significantly with dROM levels and BAP/dROM ratios in the AD group. An imbalance in pro-oxidant and anti-oxidant defenses is apparently involved in the pathophysiology of the AD and MD groups. The extent of oxidative stress damage might differ in subtypes of dementia by being greater in the MD group than in other types of dementia. Synergic effects of the degenerative element of AD and white matter lesions might be associated with oxidative stress damage in the MD group. © 2015 Japan Geriatrics Society.

  17. Abnormalities associated with progressive aortic vascular dysfunction in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Omar Z Ameer

    2015-05-01

    Full Text Available Increased stiffness of large arteries in chronic kidney disease (CKD has significant clinical implications. This study investigates the temporal development of thoracic aortic dysfunction in a rodent model of CKD, the Lewis polycystic kidney (LPK rat. Animals aged 12 and 18 weeks were studied alongside age-matched Lewis controls (total n=94. LPK rodents had elevated systolic blood pressure, left ventricular hypertrophy and progressively higher plasma creatinine and urea. Relative to Lewis controls, LPK exhibited reduced maximum aortic vasoconstriction (Rmax to noradrenaline at 12 and 18 weeks, and to K+ (12 weeks. Sensitivity to noradrenaline was greater in 18-week-old LPK versus age matched Lewis (effective concentration 50%: 24×10-9 ± 78×10-10 vs. 19×10-8 ± 49×10-9, P<0.05. Endothelium-dependent (acetylcholine and -independent (sodium nitroprusside relaxation was diminished in LPK, declining with age (12 vs. 18 weeks Rmax: 80 ± 8% vs. 57 ± 9% and 92 ± 6% vs. 70 ± 9%, P<0.05, respectively in parallel with the decline in renal function. L-Arginine restored endothelial function in LPK, and L-NAME blunted acetylcholine relaxation in all groups. Impaired nitric oxide synthase (NOS activity was recovered with L-Arginine plus L-NAME in 12, but not 18-week-old LPK. Aortic calcification was increased in LPK rats, as was collagen I/III, fibronectin and NADPH-oxidase subunit p47 (phox mRNAs. Overall, our observations indicate that the vascular abnormalities associated with CKD are progressive in nature, being characterised by impaired vascular contraction and relaxation responses, concurrent with the development of endothelial dysfunction, which is likely driven by evolving deficits in NO signalling.

  18. The use of Intravenous Laser Blood Irradiation (ILBI) at 630–640 nm to prevent vascular diseases and to increase life expectancy

    OpenAIRE

    Mikhaylov, VA

    2015-01-01

    Background and Aims: The mortality rate from vascular diseases is one of the highest. The use of Intravenous Laser Blood Irradiation (ILBI) within the last 30 years has demonstrated high efficacy in the treatment of vascular, cardiac and other systemic diseases.

  19. Relationships between Cognitive Performance, Neuroimaging and Vascular Disease: The DHS-MIND Study.

    Science.gov (United States)

    Hsu, Fang-Chi; Raffield, Laura M; Hugenschmidt, Christina E; Cox, Amanda; Xu, Jianzhao; Carr, J Jeffery; Freedman, Barry I; Maldjian, Joseph A; Williamson, Jeff D; Bowden, Donald W

    2015-01-01

    Type 2 diabetes mellitus increases the risk of cognitive decline and dementia, and elevated burdens of vascular disease are hypothesized to contribute to this risk. These relationships were examined in the Diabetes Heart Study-MIND using a battery of cognitive tests, neuroimaging measures and subclinical cardiovascular disease (CVD) burden assessed by coronary artery calcified (CAC) plaque. We hypothesized that CAC would attenuate the association between neuroimaging measures and cognition performance. Associations were examined using marginal models in this family-based cohort of 572 European Americans from 263 families. All models were adjusted for age, gender, education, type 2 diabetes and hypertension, with some neuroimaging measures additionally adjusted for intracranial volume. Higher total brain volume was associated with better performance on the Digit Symbol Substitution Task and Semantic Fluency (both p ≤ 7.0 × 10(-4)). Higher gray matter volume was associated with better performance on the Modified Mini-Mental State Examination and Semantic Fluency (both p ≤ 9.0 × 10(-4)). Adjusting for CAC caused minimal changes to the results. Relationships exist between neuroimaging measures and cognitive performance in a type 2 diabetes-enriched European American cohort. Associations were minimally attenuated after adjusting for subclinical CVD. Additional work is needed to understand how subclinical CVD burden interacts with other factors and impacts relationships between neuroimaging and cognitive testing measures. © 2015 S. Karger AG, Basel.

  20. Vascular calcification in chronic kidney disease: different bricks in the wall?

    Science.gov (United States)

    Vervloet, Marc; Cozzolino, Mario

    2017-04-01

    A high prevalence of vascular calcification (VC) and a high incidence of cardiovascular events are two key complications of chronic kidney disease. Since most observational studies found a positive association between these two complications, a causal relationship has been assumed. If so, this would render VC a target of therapy. Recent studies, however, suggested this assumption might be an oversimplification. The fundamental aspects of these recent studies are two-fold. The first novel insight is that VC is not a single entity. VC can be the consequence of a wide range of different biological processes, but also of pharmacological interventions. Sometimes it is the underlying process that carries the additional risk, and sometimes it is tissue calcification itself. Both calcium-containing phosphate binders and statin therapy are associated with an increase in VC, but with divergent effects on cardiovascular risk. Moreover, VC can have different anatomical and histological locations. The second novel insight is that the assumption of a straightforward linear association between the amount of VC and risk for clinical events can be challenged. In this review we summarize recent literature that should lead to reconsidering the implications of VC in CKD. This includes an overview of the many different pathways underlying the ultimate occurrence of VC. Finally, we present a nuanced view concerning the pathophysiologic and therapeutic implications of the different types of calcification in patients with chronic kidney disease. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  1. Effect of Vascular Risk Factors on the Progression of Mild Alzheimer's Disease and Lewy Body Dementia.

    Science.gov (United States)

    Bergland, Anne Katrine; Dalen, Ingvild; Larsen, Alf Inge; Aarsland, Dag; Soennesyn, Hogne

    2017-01-01

    Vascular risk factors (VRF) are associated with an increased risk of neurodegenerative disease. To examine the association between VRF and cognitive decline in patients with Alzheimer's disease (AD) and Lewy body dementia (LBD). We included consecutive referrals with mild AD or LBD to dementia clinics in western Norway from 2005 to 2013. The Mini-Mental Status Exam (MMSE) and Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) were administered at baseline and then annually for up to five years. The VRF include diabetes mellitus, hypertension, hypercholesterolemia, overweight and smoking. Generalized Estimating Equations (GEE) were used to examine the potential association between VRF scores and the change in MMSE and CDR-SB scores, adjusting for age, sex, and the apolipoprotein ɛ4 allele (APOE4). A total of 200 patients were included (113 AD, 87 LBD) (mean age 76 years, mean baseline MMSE 24.0, mean follow-up time 3.5 years). Smoking was the only VRF significantly associated with a more rapid cognitive decline, however only in the AD group. Being overweight at baseline was associated with a slower cognitive decline. Moreover, hypertension at baseline predicted a slower decline in MMSE scores. In the LBD group diabetes mellitus was found to be associated with a slower increase in CDR-SB scores. With the exception of smoking, VRF at time of dementia diagnosis were not associated with a more rapid cognitive decline.

  2. Screening for New Biomarkers for Subcortical Vascular Dementia and Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Annika Öhrfelt

    2011-01-01

    Full Text Available Background: Novel biomarkers are important for identifying as well as differentiating subcortical vascular dementia (SVD and Alzheimer’s disease (AD at an early stage in the disease process. Methods: In two independent cohorts, a multiplex immunoassay was utilized to analyze 90 proteins in cerebrospinal fluid (CSF samples from dementia patients and patients at risk of developing dementia (mild cognitive impairment. Results: The levels of several CSF proteins were increased in SVD and its incipient state, and in moderate-to-severe AD compared with the control group. In contrast, some CSF proteins were altered in AD, but not in SVD. The levels of heart-type fatty acid binding protein (H-FABP were consistently increased in all groups with dementia but only in some of their incipient states. Conclusions: In summary, these results support the notion that SVD and AD are driven by different pathophysiological mechanisms reflected in the CSF protein profile and that H-FABP in CSF is a general marker of neurodegeneration.

  3. Vascular dementia.

    Science.gov (United States)

    O'Brien, John T; Thomas, Alan

    2015-10-24

    Vascular dementia is one of the most common causes of dementia after Alzheimer's disease, causing around 15% of cases. However, unlike Alzheimer's disease, there are no licensed treatments for vascular dementia. Progress in the specialty has been difficult because of uncertainties over disease classification and diagnostic criteria, controversy over the exact nature of the relation between cerebrovascular pathology and cognitive impairment, and the paucity of identifiable tractable treatment targets. Although there is an established relation between vascular and degenerative Alzheimer's pathology, the mechanistic link between the two has not yet been identified. This Series paper critiques some of the key areas and controversies, summarises treatment trials so far, and makes suggestions for what progress is needed to advance our understanding of pathogenesis and thus maximise opportunities for the search for new and effective management approaches. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Vascular Vertigo

    Directory of Open Access Journals (Sweden)

    Mazyar Hashemilar

    2017-02-01

    Full Text Available Vertigo is a common complaint in neurology and medicine. The most common causes of vertigo are benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, and vascular disorders. Vertigo of vascular origin is usually limited to migraine, transient ischemic attacks, and ischemic or hemorrhagic stroke. Vascular causes lead to various central or peripheral vestibular syndromes with vertigo. This review provides an overview of epidemiology and clinical syndromes of vascular vertigo. Vertigo is an illusion of movement caused by asymmetrical involvement of the vestibular system by various causes. Migraine is the most frequent vascular disorder that causes vertigo in all age groups. Vertigo may occur in up to 25% of patients with migraine. The lifetime prevalence of migrainous vertigo is almost 1%. Cerebrovascular disorders are estimated to account for 3% to 7% of patients with vertigo. Vestibular paroxysmia has been diagnosed in 1.8% to 4% of cases in various dizziness units. Vasculitic disorders are rare in the general population, but vertigo may be seen in almost up to 50% of patients with different vasculitic syndromes. Conclusions: Migraine, cerebrovascular disorders especially involving the vertebrobasilar territory, cardiocirculatory diseases, neurovascular compression of the eighth nerve, and vasculitis are vascular causes of vertigo syndromes.

  5. Vascular Risk Factors and Cognitive Impairment in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort (CRIC) Study

    Science.gov (United States)

    Xie, Dawei; Yaffe, Kristine; Cohen, Debbie L.; Teal, Valerie; Kasner, Scott E.; Messé, Steven R.; Sehgal, Ashwini R.; Kusek, John; DeSalvo, Karen B.; Cornish-Zirker, Denise; Cohan, Janet; Seliger, Stephen L.; Chertow, Glenn M.; Go, Alan S.

    2011-01-01

    Summary Background and objectives Cognitive impairment is common among persons with chronic kidney disease, but the extent to which nontraditional vascular risk factors mediate this association is unclear. Design, setting, participants, & measurements We conducted cross-sectional analyses of baseline data collected from adults with chronic kidney disease participating in the Chronic Renal Insufficiency Cohort study. Cognitive impairment was defined as a Modified Mini-Mental State Exam score >1 SD below the mean score. Results Among 3591 participants, the mean age was 58.2 ± 11.0 years, and the mean estimated GFR (eGFR) was 43.4 ± 13.5 ml/min per 1.73 m2. Cognitive impairment was present in 13%. After adjustment for demographic characteristics, prevalent vascular disease (stroke, coronary artery disease, and peripheral arterial disease) and traditional vascular risk factors (diabetes, hypertension, smoking, and elevated cholesterol), an eGFR <30 ml/min per 1.73 m2 was associated with a 47% increased odds of cognitive impairment (odds ratio 1.47, 95% confidence interval 1.05, 2.05) relative to those with an eGFR 45 to 59 ml/min per 1.73 m2. This association was attenuated and no longer significant after adjustment for hemoglobin concentration. While other nontraditional vascular risk factors including C-reactive protein, homocysteine, serum albumin, and albuminuria were correlated with cognitive impairment in unadjusted analyses, they were not significantly associated with cognitive impairment after adjustment for eGFR and other confounders. Conclusions The prevalence of cognitive impairment was higher among those with lower eGFR, independent of traditional vascular risk factors. This association may be explained in part by anemia. PMID:20930087

  6. Mitochondrial Respiration after One Session of Calf Raise Exercise in Patients with Peripheral Vascular Disease and Healthy Older Adults.

    Science.gov (United States)

    van Schaardenburgh, Michel; Wohlwend, Martin; Rognmo, Øivind; Mattsson, Erney J R

    2016-01-01

    Mitochondria are essential for energy production in the muscle cell and for this they are dependent upon a sufficient supply of oxygen by the circulation. Exercise training has shown to be a potent stimulus for physiological adaptations and mitochondria play a central role. Whether changes in mitochondrial respiration are seen after exercise in patients with a reduced circulation is unknown. The aim of the study was to evaluate the time course and whether one session of calf raise exercise stimulates mitochondrial respiration in the calf muscle of patients with peripheral vascular disease. One group of patients with peripheral vascular disease (n = 11) and one group of healthy older adults (n = 11) were included. Patients performed one session of continuous calf raises followed by 5 extra repetitions after initiation of pain. Healthy older adults performed 100 continuous calf raises. Gastrocnemius muscle biopsies were collected at baseline and 15 minutes, one hour, three hours and 24 hours after one session of calf raise exercise. A multi substrate (octanoylcarnitine, malate, adp, glutamate, succinate, FCCP, rotenone) approach was used to analyze mitochondrial respiration in permeabilized fibers. Mixed-linear model for repeated measures was used for statistical analyses. Patients with peripheral vascular disease have a lower baseline respiration supported by complex I and they increase respiration supported by complex II at one hour post-exercise. Healthy older adults increase respiration supported by electron transfer flavoprotein and complex I at one hour and 24 hours post-exercise. Our results indicate a shift towards mitochondrial respiration supported by complex II as being a pathophysiological component of peripheral vascular disease. Furthermore exercise stimulates mitochondrial respiration already after one session of calf raise exercise in patients with peripheral vascular disease and healthy older adults. ClinicalTrials.gov NCT01842412.

  7. Statins are underused in recent-onset Parkinson's disease with increased vascular risk: findings from the UK Tracking Parkinson's and Oxford Parkinson's Disease Centre (OPDC) discovery cohorts.

    OpenAIRE

    Swallow, Diane M A; Lawton,Michael A; Grosset, Katherine A; Malek, Naveed; Klein, Johannes; Baig, Fahd; Ruffmann, Claudio; Bajaj, Nin P.; Barker, Roger A.; Ben-Shlomo, Yoav; Burn, David J.; Foltynie, Thomas; Morris, Huw R.; Williams, Nigel; Wood, Nicholas W.

    2016-01-01

    Background Cardiovascular disease (CVD) influences\\ud phenotypic variation in Parkinson’s disease (PD), and is\\ud usually an indication for statin therapy. It is less clear\\ud whether cardiovascular risk factors influence PD\\ud phenotype, and if statins are prescribed appropriately.\\ud Objectives To quantify vascular risk and statin use in\\ud recent-onset PD, and examine the relationship between\\ud vascular risk, PD severity and phenotype.\\ud Methods Cardiovascular risk was quantified using t...

  8. Permanent vascular access in patients with end-stage renal disease, Brazil Acceso vascular permanente en pacientes renales crónicos terminales en Brasil Acesso vascular permanente em pacientes renais crônicos terminais no Brasil

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    Gisele Macedo da Silva

    2011-04-01

    Full Text Available OBJECTIVE: To assess factors associated with the establishment of permanent vascular access for patients with end-stage renal disease. METHODS: Cross-sectional study conducted in a nationally representative sample of Brazilian end-stage renal disease patients in dialysis and transplant centers during 2007. The sample comprised only patients who received hemodialysis as a primary therapy modality and reported the type of vascular access for their primary hemodialysis treatment (N=2,276. Data were from the TRS Project - "Economic and Epidemiologic Evaluation of Modalities of Renal Replacement Therapy in Brazil". Multiple logistic regression analysis was used to assess factors associated with the establishment of permanent vascular access in these patients. RESULTS: About 30% of the patients studied had an arteriovenous vascular access. The following factors were associated with a lower likelihood of having an arteriovenous vascular access as a primary type of access: time of hemodialysis start since the diagnosis of chronic renal failure OBJETIVO: Analizar factores asociados a la provisión de acceso vascular arteriovenoso en Brasil. MÉTODOS: Estudio transversal, nacionalmente representativo, con pacientes con enfermedad renal crónica terminal acompañados en servicios de diálisis o en centros transplantadores en el año de 2007. La muestra incluyó pacientes que tuvieron la hemodiálisis como primera modalidad de tratamiento y que sabían con que tipo de acceso vascular habían iniciado el tratamiento (N=2.276. Los datos son oriundos del Proyecto TRS - "Evaluación económica-epidemiológica de las modalidades de Terapia renal Sustitutiva en Brasil". Fue utilizada la regresión logística múltiple. RESULTADOS: Aproximadamente 30% de los pacientes tenían acceso vascular arteriovenoso. Los factores asociados a la baja probabilidad de tener acceso vascular arteriovenoso como primer tipo de acceso fueron: tiempo de diagnóstico de enfermedad

  9. A new selective vascular endothelial growth factor receptor 2 inhibitor ablates disease in a mouse model of psoriasis.

    Science.gov (United States)

    Yan, Heng-Xiu; Wang, Yong; Yang, Xiao-Nong; Fu, Li-Xin; Tang, Dong-Mei

    2013-08-01

    Psoriasis is a common chronic inflammatory skin disease and its underlying pathogenesis is still not fully understood. Therapeutic interventions are currently limited and restricted to the treatment of symptoms rather than targeting the mechanisms underlying the disease. Vascular remodeling is a hallmark of psoriasis; however, anti-vascular strategies to treat psoriasis have received little attention to date, particularly systemic treatment with a small molecule compound. The aim of this study was to investigate the anti-inflammatory effect of a newly identified vascular endothelial growth factor (VEGF) receptor 2 inhibitor, SKLB1002, and its possible mechanism of action in a transgenic mouse model of psoriasis. Fifteen 8-12-week‑old K14-VEGF transgenic mice received consecutive intraperitoneal (i.p.) injections of SKLB1002, vehicle or saline for 4 weeks. After 4 weeks of treatment, the disease symptoms were assessed and histological analyses were performed on ear sections by hematoxylin and eosin (HE) and immunohistochemistry staining. Systemic treatment with SKLB1002 reduced symptoms of ear inflammation in K14/VEGF transgenic mice, the pathological score was significantly decreased, and acanthosis, focal parakeratosis, hyperkeratosis and hemangiectasis were improved. Furthermore, systemic treatment with SKLB1002 significantly reduced vascular abnormalities, permeability and T-cell infiltration. These results demonstrated that targeted inhibition of VEGFR2 by a small molecule inhibitor is an effective method, which may be a new therapeutic option for psoriasis therapy.

  10. Prediction of vascular dementia and Alzheimer's disease in patients with atrial fibrillation or atrial flutter using CHADS2 score.

    Science.gov (United States)

    Chou, Ruey-Hsing; Chiu, Chun-Chih; Huang, Chin-Chou; Chan, Wan-Leong; Huang, Po-Hsun; Chen, Yu-Chun; Chen, Tzeng-Ji; Chung, Chia-Min; Lin, Shing-Jong; Chen, Jaw-Wen; Leu, Hsin-Bang

    2016-09-01

    Atrial fibrillation (AF) is associated with an increased risk of dementia. However, limited data are available on the predictors of dementia in patients with AF. This study aimed to evaluate whether the CHADS2 score could be a useful tool for risk stratification with regard to dementia occurrence among patients with AF. AF patients were identified from the National Health Insurance sampling database, which has accumulated a total of 1,000,000 participants since 2000. After excluding patients diagnosed with dementia prior to the index day of enrollment, CHADS2 score was measured to investigate its association with the occurrence of dementia, including vascular dementia and Alzheimer's disease. During the mean follow-up period of 3.71 ± 2.78 years, 1135 dementia cases (7.36%) were identified, including 241 cases of vascular dementia and 894 cases of Alzheimer's disease. In multivariate analysis, an increase of 1 point in the CHADS2 score was independently associated with a 54% increase in the risk of vascular dementia (hazard ratio = 1.54; 95% confidence interval, 1.41-1.69; p vascular dementia as well as Alzheimer's disease in patients with AF. Copyright © 2016. Published by Elsevier Taiwan LLC.

  11. Variations in vascular mortality trends, 2001-2010, among 1.3 million women with different lifestyle risk factors for the disease.

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    Cairns, Benjamin J; Balkwill, Angela; Canoy, Dexter; Green, Jane; Reeves, Gillian K; Beral, Valerie

    2015-12-01

    Vascular disease mortality has declined rapidly in most Western countries, against a background of improved treatments and falling prevalence of smoking, but rising obesity. We examined whether this decline differed by lifestyle risk factors for vascular disease. During 2001-2010, there were 9241 vascular disease deaths in a prospective study of 1.3 million women in middle age, about one-quarter of all UK women in the eligible age range (50-64 years in 1996-2001). We estimated percentage declines in mortality from coronary heart disease, cerebrovascular disease and other vascular diseases, overall and by age, smoking, alcohol consumption, adiposity, physical activity, socioeconomic status and age at leaving school. Over 10 years, coronary heart disease mortality fell by half (52%), cerebrovascular disease mortality by two-fifths (42%) and other vascular disease mortality by one-fifth (22%). Lean women experienced greater declines in coronary heart disease mortality than overweight or obese women (70%, 48% and 26%, respectively; P vascular disease mortality than women in the lowest third (41% and 42% and -9%, respectively; P = 0.001). After accounting for multiple testing, there were no other significant differences in vascular mortality trends by any lifestyle risk factor, including by smoking status. Vascular disease mortality trends varied in this cohort by adiposity and socioeconomic status, but not by smoking status or other lifestyle risk factors. Prevention and treatment of vascular disease appear not to have been equally effective in all subgroups of UK women. © The European Society of Cardiology 2014.

  12. Preeclampsia Is a Biomarker for Vascular Disease in Both Mother and Child: The Need for a Medical Alert System

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    Julie Hakim

    2013-01-01

    Full Text Available This paper reviews the literature pertaining to the impact of preeclampsia not only on the mother but particularly on the children. The review points to the higher blood pressure in children born to preeclamptic mothers compared to controls, their increased tendency to suffer strokes, the reduction in their cognitive ability, and their vulnerability to depression. Mechanisms that may induce these changes are emphasized, particularly the placental vascular insufficiency and the resulting hypoxic and proinflammatory environments in which the fetus develops. The hypothesis proposed is that these changes in the fetal-placental environment result in epigenetic programming of the child towards a higher propensity for vascular disease. The review’s main recommendation is that, within ethical boundaries, the medical records of individuals born to preeclamptic mothers should clearly indicate this event and should be made available to the affected individuals so that preventive measures against vascular complications and lifestyle changes that may mitigate the latter can be instituted.

  13. Neuropsychiatric profiles in patients with Alzheimer′s disease and vascular dementia

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    Tushar Kanti Bandyopadhyay

    2014-01-01

    Full Text Available Background/Aims: The aim of the following study is to compare the behavioral and psychological symptoms of dementia (BPSD in patients of Alzheimer disease (AD and vascular dementia (VaD. Materials and Methods: We used National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer′s Disease and Related Disorders Association criteria for diagnosing AD and National Institute of Neurological Disorders and Stroke-Association International pour la Recherche et l′Enseignement en Neurosciences Criteria for diagnosing VaD. VaD cohort was further subcategorized into small vessel and large vessel disease. The severity of cognitive impairment and the BPSD were studied by means of the Clinical Dementia Rating Scale (CDR and the Neuropsychiatric Inventory respectively. Results: We studied 50 AD and 50 VaD patients of whom 38 were small vessels and 12 were large vessels VaD. The severity of dementia was comparable in both groups. The agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, irritability, aberrant motor behavior, appetite and eating behavior and night-time behaviors occurred significantly more frequently in patients with VaD than AD. We found a weak positive correlation between the CDR score and the number of neuropsychiatric symptoms per patient in both cohorts. Elation/euphoria, agitation/aggression was significantly more frequent in patients with large vessel in comparison to small vessel VaD. Conclusions: BPSD are common in both types of dementia and they are more severe in VaD than AD when the groups have similar levels of cognitive impairment.

  14. The role of platelets in the recruitment of leukocytes during vascular disease

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    Ed Rainger, G.; Chimen, Myriam; Harrison, Matthew J.; Yates, Clara M.; Harrison, Paul; Watson, Stephen P.; Lordkipanidzé, Marie; Nash, Gerard B.

    2015-01-01

    Abstract Besides their role in the formation of thrombus during haemostasis, it is becoming clear that platelets contribute to a number of other processes within the vasculature. Indeed, the integrated function of the thrombotic and inflammatory systems, which results in platelet-mediated recruitment of leukocytes, is now considered to be of great importance in the propagation, progression and pathogenesis of atherosclerotic disease of the arteries. There are three scenarios by which platelets can interact with leukocytes: (1) during haemostasis, when platelets adhere to and are activated on sub-endothelial matrix proteins exposed by vascular damage and then recruit leukocytes to a growing thrombus. (2) Platelets adhere to and are activated on stimulated endothelial cells and then bridge blood borne leukocytes to the vessel wall and. (3) Adhesion between platelets and leukocytes occurs in the blood leading to formation of heterotypic aggregates prior to contact with endothelial cells. In the following review we will not discuss leukocyte recruitment during haemostasis, as this represents a physiological response to tissue trauma that can progress, at least in its early stages, in the absence of inflammation. Rather we will deal with scenarios 2 and 3, as these pathways of platelet–leukocyte interactions are important during inflammation and in chronic inflammatory diseases such as atherosclerosis. Indeed, these interactions mean that leukocytes possess means of adhesion to the vessel wall under conditions that may not normally be permissive of leukocyte–endothelial cell adhesion, meaning that the disease process may be able to bypass the regulatory pathways which would ordinarily moderate the inflammatory response. PMID:26196409

  15. Epigenetics and Vascular Diseases: Influence of Non-coding RNAs and Their Clinical Implications.

    Science.gov (United States)

    Elia, Leonardo; Quintavalle, Manuela

    2017-01-01

    Epigenetics refers to heritable mechanisms able to modulate gene expression that do not involve alteration of the genomic DNA sequence. Classically, mechanisms such as DNA methylation and histone modifications were part of this classification. Today, this field of study has been expanded and includes also the large class of non-coding RNAs (ncRNAs). Indeed, with the extraordinary possibilities introduced by the next-generation sequencing approaches, our knowledge of the mammalian transcriptome has greatly improved. Today, we have identifying thousands of ncRNAs, and unsurprisingly, a direct association between ncRNA dysregulation and development of cardiovascular pathologies has been identified. This class of gene modulators is further divided into short-ncRNAs and long-non-coding RNAs (lncRNAs). Among the short-ncRNA sub-group, the best-characterized players are represented by highly conserved RNAs named microRNAs (miRNAs). miRNAs principally inhibit gene expression, and their involvement in cardiovascular diseases has been largely studied. On the other hand, due to the different roles played by lncRNAs, their involvement in cardiovascular pathology development is still limited, and further studies are needed. For instance, in order to define their roles in the cellular processes associated with the development of diseases, we need to better characterize the details of their mechanisms of action; only then might we be able to develop innovative therapeutic strategies. In this review, we would like to give an overview of the current knowledge on the function of ncRNAs and their involvement in the development of vascular diseases.

  16. The role of platelets in the recruitment of leukocytes during vascular disease.

    Science.gov (United States)

    Ed Rainger, G; Chimen, Myriam; Harrison, Matthew J; Yates, Clara M; Harrison, Paul; Watson, Stephen P; Lordkipanidzé, Marie; Nash, Gerard B

    2015-01-01

    Besides their role in the formation of thrombus during haemostasis, it is becoming clear that platelets contribute to a number of other processes within the vasculature. Indeed, the integrated function of the thrombotic and inflammatory systems, which results in platelet-mediated recruitment of leukocytes, is now considered to be of great importance in the propagation, progression and pathogenesis of atherosclerotic disease of the arteries. There are three scenarios by which platelets can interact with leukocytes: (1) during haemostasis, when platelets adhere to and are activated on sub-endothelial matrix proteins exposed by vascular damage and then recruit leukocytes to a growing thrombus. (2) Platelets adhere to and are activated on stimulated endothelial cells and then bridge blood borne leukocytes to the vessel wall and. (3) Adhesion between platelets and leukocytes occurs in the blood leading to formation of heterotypic aggregates prior to contact with endothelial cells. In the following review we will not discuss leukocyte recruitment during haemostasis, as this represents a physiological response to tissue trauma that can progress, at least in its early stages, in the absence of inflammation. Rather we will deal with scenarios 2 and 3, as these pathways of platelet-leukocyte interactions are important during inflammation and in chronic inflammatory diseases such as atherosclerosis. Indeed, these interactions mean that leukocytes possess means of adhesion to the vessel wall under conditions that may not normally be permissive of leukocyte-endothelial cell adhesion, meaning that the disease process may be able to bypass the regulatory pathways which would ordinarily moderate the inflammatory response.

  17. Long-term consequences of developmental vascular defects on retinal vessel homeostasis and function in a mouse model of Norrie disease.

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    Susanne C Beck

    Full Text Available Loss of Norrin signalling due to mutations in the Norrie disease pseudoglioma gene causes severe vascular defects in the retina, leading to visual impairment and ultimately blindness. While the emphasis of experimental work so far was on the developmental period, we focus here on disease mechanisms that induce progression into severe adult disease. The goal of this study was the comprehensive analysis of the long-term effects of the absence of Norrin on vascular homeostasis and retinal function. In a mouse model of Norrie disease retinal vascular morphology and integrity were studied by means of in vivo angiography; the vascular constituents were assessed in detailed histological analyses using quantitative retinal morphometry. Finally, electroretinographic analyses were performed to assess the retinal function in adult Norrin deficient animals. We could show that the primary developmental defects not only persisted but developed into further vascular abnormalities and microangiopathies. In particular, the overall vessel homeostasis, the vascular integrity, and also the cellular constituents of the vascular wall were affected in the adult Norrin deficient retina. Moreover, functional analyses indicated to persistent hypoxia in the neural retina which was suggested as one of the major driving forces of disease progression. In summary, our data provide evidence that the key to adult Norrie disease are ongoing vascular modifications, driven by the persistent hypoxic conditions, which are ineffective to compensate for the primary Norrin-dependent defects.

  18. The Effect of Hyperhomocysteinemia on Motor Symptoms, Cognitive Status, and Vascular Risk in Patients with Parkinson’s Disease

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    Bilge Kocer

    2016-01-01

    Full Text Available Factors related with hyperhomocysteinemia (HHcy and the impact of HHcy in Parkinson’s disease (PD are not well understood. We investigated the factors associated with increased levels of homocysteine (Hcy and the relationship between HHcy and motor symptoms, cognitive status, and vascular risk in patients with Parkinson’s disease. Among 60 patients (29 males, 48.3% with PD, the stage of the disease, the severity of clinical symptoms, and the patients’ cognitive status were measured using a modified Hoehn and Yahr Staging Scale (mHY, Unified Parkinson’s Disease Rating Scale (UPDRS II and III, and Mini-Mental State Examination (MMSE, respectively. Patients were also noted for having dyskinesia and hallucinations. Serum vitamin B12, folic acid, and plasma Hcy ​​levels were measured. Furthermore, the presence of vascular risk factors was recorded. Finally, we investigated carotid artery intima-media thickening and stenosis using colour Doppler ultrasonography as well as the presence of ischemic lesions using brain imaging techniques. Plasma Hcy ​​levels were higher with advanced age and in males. In addition, there was an inverse relationship between Hcy ​​and vitamin B12 levels. There was no correlation between HHcy and the stage of the disease, severity of motor symptoms, cognitive status as assessed by the MMSE, vascular risk factors, carotid artery atherosclerotic findings, and ischemic brain lesions. Plasma Hcy levels may rise due to several factors in PD. However, the resulting HHcy has no significant effect on the clinical picture in terms of motor features, cognitive status, and vascular diseases.

  19. Relationship between Retinal Vascular Caliber and Coronary Artery Disease in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD

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    Marmor Alon

    2013-08-01

    Full Text Available Objective: To evaluate the relationship between retinal vascular caliber and cardiovascular disease in non-alcoholic fatty liver disease (NAFLD patients without diabetes and hypertension. Methods: Intention to treat study of individuals who underwent cardiac computed tomography (CT during a two year period. Coronary artery disease (CAD was defined as stenosis of >50% in at least one major coronary artery. Liver and spleen density were measured by abdominal (CT; intima-media thickness (IMT by Doppler ultrasound; retinal artery and vein diameter by colored-retinal angiography; and metabolic syndrome by ATP III guidelines. Serum biomarkers of insulin resistance, inflammation, and oxidant-antioxidant status were assessed. Results: Compared with 22 gender and age matched controls, the 29 NAFLD patients showed higher prevalence of coronary plaques (70% vs. 30%, p < 0.001, higher prevalence of coronary stenosis (30% vs. 15%, p < 0.001, lower retinal arteriole-to-venule ratio (AVR (0.66 ± 0.06 vs. 0.71 ± 0.02, p < 0.01, higher IMT (0.98 ± 0.3 vs. 0.83 ± 0.1, p < 0.04, higher carotid plaques (60% vs. 40%, p < 0.001, higher homeostasis model assessment of insulin resistance (HOMA (4.0 ± 3.4 vs. 2.0 ± 1.0, p < 0.005, and higher triglyceride levels (200 ± 80 vs. 150 ± 60, p < 0.005 than controls. Multivariate analysis showed fatty liver (OR 2.5; p < 0.01, IMT (OR 2.3 p < 0.001, and retinal AVR ratio (OR 1.5, p < 0.01 to be strongly associated with CAD independent of metabolic syndrome (OR 1.2, p < 0.05. Conclusions: Patients with smaller retinal AVR (<0.7 are likely to be at increased risk for CAD and carotid atherosclerosis in patients with NAFLD even without hypertension or diabetes.

  20. Benzodiazepine Use and Risk of Developing Alzheimer's Disease or Vascular Dementia: A Case-Control Analysis.

    Science.gov (United States)

    Imfeld, Patrick; Bodmer, Michael; Jick, Susan S; Meier, Christoph R

    2015-10-01

    Previous observational studies have associated benzodiazepine use with an increased risk of dementia. However, limitations in the study methods leave questions unanswered regarding the interpretation of the findings. A case-control analysis was conducted using data from the UK-based Clinical Practice Research Datalink (CPRD). A total of 26,459 patients aged ≥65 years with newly diagnosed Alzheimer's disease (AD) or vascular dementia (VaD) between 1998 and 2013 were identified and matched 1:1 to dementia-free controls on age, sex, calendar time, general practice, and number of years of recorded history. Adjusted odds ratios (aORs) were calculated with 95% confidence intervals (CIs) of developing AD or VaD in relation to previous benzodiazepine use, stratified by duration and benzodiazepine type. The aOR (95% CI) of developing AD for those who started benzodiazepines benzodiazepines benzodiazepine use initiated during this prodromal phase, long-term use of benzodiazepines was not associated with an increased risk of developing AD [aOR 0.69 (0.57-0.85)] or VaD [aOR 1.11 (0.85-1.45)]. After taking a prodromal phase into consideration, benzodiazepine use was not associated with an increased risk of developing AD or VaD.

  1. Depression in vascular dementia is quantitatively and qualitatively different from depression in Alzheimer's disease.

    Science.gov (United States)

    Park, J H; Lee, S B; Lee, T J; Lee, D Y; Jhoo, J H; Youn, J C; Choo, I H; Choi, E A; Jeong, J W; Choe, J Y; Woo, J I; Kim, K W

    2007-01-01

    To compare the prevalence and characteristics of depression in vascular dementia (VaD) and Alzheimer's disease (AD) after adjusting for dementia severity and gender. One hundred and eight pairs of VaD and AD patients matched for dementia severity and gender were assessed. Major depressive disorder (MDD) was more prevalent in the VaD group than in the AD group (20.4% in VaD, 10.2% in AD, p = 0.04, Cochran-Mantel-Haenszel, CMH, test) regardless of the dementia severity and gender. The odds ratio for developing MDD in the VaD group versus the AD group was estimated to be 2.20 (95% confidence interval = 1.02-4.74). Neurovegetative symptoms such as 'felt tired and weak all the time' (30.6% in VaD, 13.9% in AD, p = 0.003, CMH test) and 'changed weight without trying' (16.7% in VaD, 6.5% in AD, p = 0.02, CMH test) were more prevalent in the VaD group than in the AD group. Depression in VaD was quantitatively and qualitatively different from that in AD regardless of the severity of dementia and gender; depression was more prevalent, severer and more retarded and vegetative in VaD than in AD. Copyright (c) 2007 S. Karger AG, Basel.

  2. Role of neuropsychological assessment in the differential diagnosis of Alzheimer's disease and vascular dementia

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    Érica Maria Lima Pimentel

    Full Text Available Abstract The prevalence of dementia increases significantly from the age of 65 years, doubling every five years thereafter. Alzheimer's disease (AD and vascular dementia (VaD constitute the two main dementia types. Differentiating them encompasses anamnesis, neurological examination, laboratory and neuroimaging exams and neuropsychological assessment. Neuropsychological assessment produces different findings for each dementia type, and reveals those areas most impaired as well as those most preserved. The aim of the present article was to describe the role of neuropsychology in diagnosing dementia and achieving a differential diagnosis between AD and VaD. A general overview follows of the most widely known instruments used to assess cognitive function in dementia, and the cognitive changes seen in AD and VaD. The conclusion drawn was that there is significant overlap in cognitive changes between both these dementia types, while each type has its own specific characteristics which are identifiable and quantifiable on neuropsychological assessments and provide the basis for reaching a differential diagnosis.

  3. NEUROPSI battery subtest profile in subcortical vascular dementia and Alzheimer's disease

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    Maria Niures P.S. Matioli

    Full Text Available ABSTRACT Objective: To investigate the diagnostic value of subtests of the NEUROPSI battery for differentiating subcortical vascular dementia (SVaD from Alzheimer's disease (AD. Methods: Thirteen patients with mild SVaD, 15 patients with mild probable AD, and 30 healthy controls, matched for age, education and dementia severity (in the case of patients, were submitted to the Mini-Mental State Examination (MMSE and NEUROPSI battery. The performance of AD and SVaD groups on NEUROPSI subtests was compared. The statistical analyses were performed using Kruskal-Wallis, Chi-square and Mann-Whitney tests. The results were interpreted at the 5% significance level (p<0.05. Bonferroni's correction was applied to multiple comparisons (a=0.02. Results: SVaD and AD patients showed no statistical difference in MMSE scores (SVaD=20.8 and AD=21.0; p=1.0 or in NEUROPSI total score (SVaD=65.0 and AD=64.3; p=0.56, suggesting a similar severity of dementia. The AD group performed worse on memory recall (<0.01 and SVaD group was worse in verbal fluency subtests (p=0.02. Conclusion: NEUROPSI's memory and language subtests can be an auxiliary tool for differentiating SVaD from AD.

  4. Pharmacokinetic, pharmacodynamic and clinical profile of novel antiplatelet drugs targeting vascular diseases.

    Science.gov (United States)

    Siller-Matula, Jolanta M; Krumphuber, Julia; Jilma, Bernd

    2010-02-01

    Platelet inhibitors are the mainstay treatment for patients with vascular diseases. The current 'gold standard' antiplatelet agent clopidogrel has several pharmacological and clinical limitations that have prompted the search for more effective platelet antagonists. The candidates include various blockers of the purinergic P2Y12 receptor such as prasugrel, an oral irreversible thienopyridine; two adenosine triphosphate analogues that bind reversibly to the P2Y12 receptor: ticagrelor (oral) and cangrelor (intravenous); elinogrel, a direct-acting reversible P2Y12 receptor inhibitor (the only antiplatelet compound that can be administered both intravenously and orally); BX 667, an orally active and reversible small-molecule P2Y12 receptor antagonist; SCH 530348, SCH 205831, SCH 602539 and E5555, highly selective and orally active antagonists on the protease-activated receptor 1. A number of drugs also hit new targets: terutroban, an oral, selective and specific inhibitor of the thromboxane receptor; ARC1779, a second-generation, nuclease resistant aptamer which inhibits von Willebrand factor-dependent platelet aggregation; ALX-0081, a bivalent humanized nanobody targeting the GPIb binding site of von Willebrand factor and AJW200, an IgG4 monoclonal antibody of von Willebrand factor. The pharmacology and clinical profiles of new platelet antagonists indicate that they provide more consistent, more rapid and more potent platelet inhibition than agents currently used. Whether these potential advantages will translate into clinical advantages will require additional comparisons in properly powered, randomized, controlled trials.

  5. Placental hemostasis and sterile inflammation: New insights into gestational vascular disease.

    Science.gov (United States)

    Kohli, Shrey; Isermann, Berend

    2017-03-01

    Activation of the coagulation and inflammatory systems are physiologically occurring during pregnancy. However, excess activation of either system is well documented in gestational vascular diseases (GVD). GVD are placenta-mediated pregnancy complications and a major cause of feto-maternal morbidity and mortality. The causal relevance of excess coagulation and inflammatory responses for GVD remains largely unknown. Deciphering the causal relationship of excess coagulation and inflammation in GVD may allow conceptualizing new therapeutic approaches to combat GVD. Platelet activation and procoagulant extracellular vesicles (EVs) provide a link between coagulation and inflammation and their activation or generation in GVD is well established. As recently shown EVs cause sterile placental inflammation by activating maternal platelets that release ATP and activate purinergic receptor signaling and NLRP3 inflammasome in the embryonic trophoblast. This thrombo-inflammatory mechanism suggests a novel link between coagulation activation and sterile inflammation in GVD. These findings highlight a role of anti-platelet therapies in GVD. In addition, targeting the inflammasome alone or in combination with platelet inhibition may provide a new therapeutic strategy in GVD. © 2017 Elsevier Ltd. All rights reserved.

  6. The potential of flavanol and procyanidin intake to influence age-related vascular disease.

    Science.gov (United States)

    Holt, Roberta R; Heiss, Christian; Kelm, Malte; Keen, Carl L

    2012-01-01

    Advancing age is an independent major risk factor for cardiovascular disease (CVD). Age-associated impairments in the control of inflammation, excessive oxidative stress, and reduced cellular repair can all contribute to the development and progression of CVD. Current recommendations for both the primary and secondary prevention of CVD promote lifestyle modifications that include the adoption of healthy dietary patterns, such as the consumption of diets rich in plant foods, as these have been associated with a lower lifetime risk for the development of CVD. The potential for a diet rich in plant foods to be cardiovascular protective is also supported by prospective studies that suggest the intake of foods providing high amounts of certain phytochemicals, in particular flavanols and procyanidins, reduce the risk for CVD. These observations are further supported by a number of dietary intervention trials that show improvements in vascular function and reduced platelet reactivity following the consumption of high flavanol foods. In the current article we review a selection of these studies, and comment on some of the potential mechanisms that have been postulated to underlie the health effects of flavanol and procyanidin-rich foods.

  7. Molecular mechanisms of vascular effects of High-density lipoprotein: alterations in cardiovascular disease

    Science.gov (United States)

    Besler, Christian; Lüscher, Thomas F; Landmesser, Ulf

    2012-01-01

    Low high-density lipoprotein (HDL)-cholesterol levels are associated with an increased risk of coronary artery disease (CAD) and myocardial infarction, which has triggered the hypothesis that HDL, in contrast to low-density lipoprotein (LDL), acts as an anti-atherogenic lipoprotein. Moreover, experimental studies have identified potential anti-atherogenic properties of HDL, including promotion of macrophage cholesterol efflux and direct endothelial-protective effects of HDL, such as stimulation of endothelial nitric oxide production and repair, anti-apoptotic, anti-inflammatory and anti-thrombotic properties. Studies in gene-targeted mice, however, have also indicated that increasing HDL-cholesterol plasma levels can either limit (e.g. apolipoprotein A-I) or accelerate (e.g. Scavenger receptor class B type I) atherosclerosis. Moreover, vascular effects of HDL have been observed to be heterogenous and are altered in patients with CAD or diabetes, a condition that has been termed ‘HDL dysfunction’. These alterations in biological functions of HDL may need to be taken into account for HDL-targeted therapies and considering raising of HDL-cholesterol levels alone is likely not sufficient in this respect. It will therefore be important to further determine, which biological functions of HDL are critical for its anti-atherosclerotic properties, as well as how these can be measured and targeted. PMID:22431312

  8. Physical Activity in Chronic Kidney Disease: a Plausible Approach to Vascular Calcification?

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    Carlo Basile

    2014-07-01

    Full Text Available Vascular calcification (VC is a prominent feature that affects up to 40 to 80% of Chronic Kidney Disease (CKD patients depending on the degree of renal impairment. Though etiology and pathogenesis of the different types of VC are far from being elucidated, it is conceivable that an imbalance between promoters and inhibitors represents the condition that triggers VC deposition and progression. In addition to traditional cardiovascular risk factors, several lines of evidence suggest that specific factors may affect the arterial system and prognosis in CKD. Over the last decade, a few pharmacological strategies aimed at controlling different selected risk factors for VC have been investigated yielding conflicting results. In light of the complicated interplay between inhibitors and promoters as well as the fact that VC represents the result of cumulative and prolonged exposure to multiple risk factors, a more comprehensive risk modification approach such as lifestyle modification or physical activity (PA may represent a valid strategy to attenuate VC deposition and progression.We herein aim at reviewing the rationale and current evidence on the potential for lifestyle modification with a specific focus on PA as a cost-effective strategy for VC treatment.

  9. Low Prevalence and Clinical Effect of Vascular Risk Factors in Early-Onset Alzheimer's Disease.

    Science.gov (United States)

    Chen, Yaohua; Sillaire, Adeline Rollin; Dallongeville, Jean; Skrobala, Emilie; Wallon, David; Dubois, Bruno; Hannequin, Didier; Pasquier, Florence

    2017-01-01

    Determinants of early-onset Alzheimer's disease (EOAD) are not well known. In late-onset AD, vascular risk factors (VRFs) are associated with earlier clinical manifestation. The objective of this study was to assess the putative association between VRFs and EOAD. We studied participants with dementia meeting criteria for EOAD (recruited into the French CoMAJ prospective cohort study from 1 June 2009 to 28 February 2014) and age-, gender-matched controls (ratio 1:3, drawn randomly from the French MONA-LISA population-based survey between 2005 and 2007). Demographic data, VRFs, comorbidities, treatments, and APOE genotypes were compared in multivariable logistic regression analyses. We studied 102 participants with dementia (mean±standard deviation age: 59.5±3.8; women: 59.8%) and 306 controls. Compared with controls, EOAD participants had spent less time in formal education (9.9±2.9 versus 11.7±3.8 y; p dementia than in controls (50% versus 29.4%; p = 0.0002), as was the prevalence of depression (48% versus 32%; p testing should be considered more frequently in the context of EOAD.

  10. Huperzine A in the Treatment of Alzheimer's Disease and Vascular Dementia: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Shu-huai Xing

    2014-01-01

    Full Text Available The objective of our study was to perform an updated meta-analysis of placebo-controlled RCTs of Huperzine A (Hup A on patients with Alzheimer's disease (AD and vascular dementia (VD, in order to provide the basis and reference for clinical rational drug use. The primary outcome measures assessed were minimental state examination (MMSE and activities of daily living scale (ADL. Eight AD trials with 733 participants and two VD trials with 92 participants that met our inclusion criteria were identified. The results showed that Hup A could significantly improve the MMSE and ADL score of AD and VD patients, and longer durations would result in better efficacy for the patients with AD. It seemed that there was significant improvement of cognitive function measured by memory quotient (MQ in patients with AD. Most adverse effects in AD were generally of mild to moderate severity and transient. Compared to the patients with AD, Hup A may offer fewer side effects for participants with VD in this study. Therefore, Hup A is a well-tolerated drug that could significantly improve cognitive performance in patients with AD or VD, but we need to use it with caution in the clinical treatment.

  11. 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.

  12. Idiopathic pulmonary fibrosis vs. pulmonary involvement of collagen vascular disease: HRCT findings

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    Lim, Myung Kwan; Im, Jung Gi; Ahn, Joong Mo; Kim, Ji Hye; Lee, Seon Kyu [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1993-11-15

    Both idiopathic pulmonary fibrosis (IPF) and pulmonary involvement of collagen vascular disease (CVD) are well known cause of diffuse interstitial lung disease which lead to fibrosis and honeycombing. We analyzed HRCT findings of 33 patients with IPF and 14 patients with CVD in terms of predominant pattern, site of involvement, mediastinal lymph node enlargement, pleural change and pulmonary volume loss. Criteria of mediastinal lymph node enlargement and pleural thickening were 15 mm in long diameter and 3 mm, respectively. Volume loss of the lung was measured by using hilar height ratio (apex to hilum/hilum to diaphragmatic dome). Mean age was 61 years for IPF and 46 years for CVD and male: female ratio was 27:6, 4:10, respectively. Predominant HRCT pattern was honeycombing for IPF (63%), and ground-glass opacity for CVD (66%) (p=0.001). Predominantly, subpleural involvement was seen in 90% for IPF and 74% for CVD. Mediastinal lymph node enlargement was seen in 47% of the patient with IPF and 14% with CVD (p=0.004). Pleural thickening was seen in 97% of the patients with IPF and 42% with CVD (p=0.002). Pleural effusion was seen in 10% of the patients with IPF and 36% with CVD (p=0.009). Hilar height ratio of more than 1.5 was seen in 84% of the patients with IPF and 29% with CVD. In conclusion, our study shows that patients with IPF are prone to have more progressed stage of pulmonary fibrosis than the patients with CVD on HRCT.

  13. Copeptin, a Marker of Vasopressin, Predicts Vascular Dementia but not Alzheimer's Disease.

    Science.gov (United States)

    Nilsson, Erik D; Melander, Olle; Elmståhl, Sölve; Lethagen, Eva; Minthon, Lennart; Pihlsgård, Mats; Nägga, Katarina

    2016-04-12

    Copeptin is a reliable surrogate marker for the neurohypophyseal hormone vasopressin. Elevated plasma level of copeptin has been associated with cardiovascular and metabolic disease risk. To investigate the association between copeptin and risk of dementia. In all, 18,240 individuals from Malmö, Sweden, were examined between 2002 and 2006 (mean age 69.3 years, 69.8% men). Incident cases of dementia until 31 December 2009 were identified by linkage with the Swedish National Patient Register. To validate the dementia diagnoses, medical records as well as laboratory and neuroimaging data were carefully reviewed. Baseline level of copeptin was measured in frozen plasma in: (1) all participants who were diagnosed with dementia during follow-up, (2) a random sample of 5100 individuals of the cohort. During a median follow-up of 4.2 years, there were 374 incident dementia cases (age range 60-83 years at baseline): 120 were classified as Alzheimer's disease (AD), 84 as vascular dementia (VaD), and 102 as mixed dementia. In logistic regressions adjusted for cardiovascular risk factors, baseline level of copeptin predicted incident VaD (Odds ratio (OR) 1.30 per 1 SD increase in log copeptin, 95% CI 1.03-1.64). Copeptin did not predict incidence of all-cause dementia (OR 1.05, 95% CI 0.94-1.18), AD (OR 0.97, 95% CI 0.79-1.18), or mixed dementia (OR 0.85, 95% CI 0.68-1.05). Elevated plasma level of copeptin is a risk marker for incident VaD, but not for incident AD. This suggests that the vasopressin hormonal system might be involved in the development of VaD.

  14. Color perception differentiates Alzheimer's Disease (AD) from Vascular Dementia (VaD) patients.

    Science.gov (United States)

    Arnaoutoglou, N A; Arnaoutoglou, M; Nemtsas, P; Costa, V; Baloyannis, S J; Ebmeier, K P

    2017-08-01

    Alzheimer's Disease (AD) and Vascular Dementia (VaD) are the most common causes of dementia in older people. Both diseases appear to have similar clinical symptoms, such as deficits in attention and executive function, but specific cognitive domains are affected. Current cohort studies have shown a close relationship between αβ deposits and age-related macular degeneration (Johnson et al., 2002; Ratnayaka et al., 2015). Additionally, a close link between the thinning of the retinal nerve fiber (RNFL) and AD patients has been described, while it has been proposed that AD patients suffer from a non-specific type of color blindness (Pache et al., 2003). Our study included 103 individuals divided into three groups: A healthy control group (n = 35), AD (n = 32) according to DSM-IV-TR, NINCDS-ADRDA criteria, and VaD (n = 36) based on ΝΙΝDS-AIREN, as well as Magnetic Resonance Imaging (MRI) results. The severity of patient's cognitive impairment, was measured with the Mini-Mental State Examination (MMSE) and was classified according to the Reisberg global deterioration scale (GDS). Visual perception was examined using the Ishihara plates: "Ishihara Color Vision Test - 38 Plate." The three groups were not statistically different for demographic data (age, gender, and education). The Ishihara color blindness test has a sensitivity of 80.6% and a specificity of 87.5% to discriminate AD and VaD patients when an optimal (32.5) cut-off value of performance is used. Ishihara Color Vision Test - 38 Plate is a promising potential method as an easy and not time-consuming screening test for the differential diagnosis of dementia between AD and VaD.

  15. Cost-effectiveness of new cardiac and vascular rehabilitation strategies for patients with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Sandra Spronk

    Full Text Available OBJECTIVE: Peripheral arterial disease (PAD often hinders the cardiac rehabilitation program. The aim of this study was evaluating the relative cost-effectiveness of new rehabilitation strategies which include the diagnosis and treatment of PAD in patients with coronary artery disease (CAD undergoing cardiac rehabilitation. DATA SOURCES: Best-available evidence was retrieved from literature and combined with primary data from 231 patients. METHODS: We developed a markov decision model to compare the following treatment strategies: 1. cardiac rehabilitation only; 2. ankle-brachial index (ABI if cardiac rehabilitation fails followed by diagnostic work-up and revascularization for PAD if needed; 3. ABI prior to cardiac rehabilitation followed by diagnostic work-up and revascularization for PAD if needed. Quality-adjusted-life years (QALYs, life-time costs (US $, incremental cost-effectiveness ratios (ICER, and gain in net health benefits (NHB in QALY equivalents were calculated. A threshold willingness-to-pay of $75,000 was used. RESULTS: ABI if cardiac rehabilitation fails was the most favorable strategy with an ICER of $44,251 per QALY gained and an incremental NHB compared to cardiac rehabilitation only of 0.03 QALYs (95% CI: -0.17, 0.29 at a threshold willingness-to-pay of $75,000/QALY. After sensitivity analysis, a combined cardiac and vascular rehabilitation program increased the success rate and would dominate the other two strategies with total lifetime costs of $30,246 a quality-adjusted life expectancy of 3.84 years, and an incremental NHB of 0.06 QALYs (95%CI:-0.24, 0.46 compared to current practice. The results were robust for other different input parameters. CONCLUSION: ABI measurement if cardiac rehabilitation fails followed by a diagnostic work-up and revascularization for PAD if needed are potentially cost-effective compared to cardiac rehabilitation only.

  16. Distinctive Resting State Network Disruptions Among Alzheimer's Disease, Subcortical Vascular Dementia, and Mixed Dementia Patients.

    Science.gov (United States)

    Kim, Hee Jin; Cha, Jungho; Lee, Jong-Min; Shin, Ji Soo; Jung, Na-Yeon; Kim, Yeo Jin; Choe, Yearn Seong; Lee, Kyung Han; Kim, Sung Tae; Kim, Jae Seung; Lee, Jae Hong; Na, Duk L; Seo, Sang Won

    2016-01-01

    Recent advances in resting-state functional MRI have revealed altered functional networks in Alzheimer's disease (AD), especially those of the default mode network (DMN) and central executive network (CEN). However, few studies have evaluated whether small vessel disease (SVD) or combined amyloid and SVD burdens affect the DMN or CEN. The aim of this study was to evaluate whether SVD or combined amyloid and SVD burdens affect the DMN or CEN. In this cross-sectional study, we investigated the resting-state functional connectivity within DMN and CEN in 37 Pittsburgh compound-B (PiB)(+) AD, 37 PiB(-) subcortical vascular dementia (SVaD), 13 mixed dementia patients, and 65 normal controls. When the resting-state DMN of PiB(+) AD and PiB(-) SVaD patients were compared, the PiB(+) AD patients displayed lower functional connectivity in the inferior parietal lobule while the PiB(-) SVaD patients displayed lower functional connectivity in the medial frontal and superior frontal gyri. Compared to the PiB(-) SVaD or PiB(+) AD, the mixed dementia patients displayed lower functional connectivity within the DMN in the posterior cingulate gyrus. When the resting-state CEN connectivity of PiB(+) AD and PiB(-) SVaD patients were compared, the PiB(-) SVaD patients displayed lower functional connectivity in the anterior insular region. Compared to the PiB(-) SVaD or PiB(+) AD, the mixed dementia patients displayed lower functional connectivity within the CEN in the inferior frontal gyrus. Our findings suggest that in PiB(+) AD and PiB(-) SVaD, there is divergent disruptions in resting-state DMN and CEN. Furthermore, patients with combined amyloid and SVD burdens exhibited more disrupted resting-state DMN and CEN than patients with only amyloid or SVD burden.

  17. Transverse versus Longitudinal Incisions for Femoral Artery Exposure in Treating Patients with Peripheral Vascular Disease.

    Science.gov (United States)

    Parikh, Punam P; Rubio, Gustavo A; Patel, Kunal; Gupta, Kapil; Jones, Keith; Rey, Jorge; Robinson, Handel

    2017-09-08

    This study evaluates differences in wound complication rate when transverse versus longitudinal incision is utilized to expose femoral vessels in managing patients with peripheral vascular disease. A retrospective review from 2013 to 2015 was conducted of 150 patients undergoing 156 lower extremity revascularizations with femoral artery exposure through a groin incision. Patients were stratified into 2 groups, transverse versus longitudinal groin incision. Data were reviewed for 3 surgeons that utilize either transverse or longitudinal groin incision in patients undergoing common or iliofemoral endarterectomies, or where femoral artery was used as inflow and/or outflow vessel for limb revascularization. Each group had a comparative outcomes analysis based on incision type. The primary outcome was wound complication, defined as any wound infection, lymphocele, hematoma, dehiscence, pseudoaneurysm, or necrosis. Other outcomes studied included unplanned return to operating room for wound complication, wound vacuum therapy, and soft-tissue flap closure. Data were analyzed using 2-tailed chi-squared test and Student's t-test. Patients in the transverse (n = 85 cases) versus longitudinal (n = 71 cases) cohorts were similar in relation to demographics and comorbidities. Overall mean follow-up was 220 days. Patients with a transverse as compared to longitudinal incision had a significantly lower overall wound complication rate, 7% vs. 42%, respectively (P operating room to manage wound complications than patients with a longitudinal incision (5% vs. 23%, respectively; P exposure may offer a lower risk of wound complications for open procedures as compared to a longitudinal incision. While longitudinal incisions may have higher wound complication rates, incisional approach is contingent on anatomical circumstance and treated disease pattern. Patients should undergo appropriate preoperative counseling regarding wound healing in preparation for limb revascularization

  18. Vasoreactivity induced by acetazolamide in patients with vascular dementia versus Alzheimer's disease.

    Science.gov (United States)

    Likitjaroen, Yuttachai; Suwanwela, Nijasri C; Phanthumchinda, Kammant

    2009-08-15

    Acetazolamide vasoreactive test measures the increment of cerebral blood flow caused by compensatory vasodilatation ability of cerebral vessels which can be detected by transcranial Doppler ultrasound (TCD). This study aimed to compare the vascular reactivity in patients with vascular dementia (VaD) and Alzheimer's disease (AD). AD and VaD patients were recruited from the King Chulalongkorn Hospital Dementia Clinic. Thai Mini-mental State Examination was used for dementia detection. AD and possible VaD were defined by NINCDS/ADRDA and NINDS-AIREN criteria. Patients with extracranial carotid artery stenosis >50% and intracranial artery stenosis were excluded. TCD examination was performed using DWL Multi Dop-T. TCD was performed on MCA with insonation depth between 45 and 60 mm. Baseline end diastolic velocity (EDV), mid systolic velocity (MSV) and peak systolic velocity (PSV) were recorded. The velocities were obtained at 2, 5, 10 and 20 min after acetazolamide (1000 mg) injection. Mean baseline velocities (Vo) and velocities after acetazolamide injection (Va) were compared. Percentage of mean increment velocities was calculated {[(Va-Vo)/Vo]x100%}. Percentage differences of mean velocity change from Vo to Va at each recorded minute were compared. SPSS for Windows version 11.5.0. was used. Nine AD (5 males) and 9 VaD (6 males) were selected. Average ages of VaD and AD groups were 66.11 years-old and 75.22 years-old respectively. Mini-mental State Examination (MMSE) score in VaD and AD were 21.13 and 19.00. Mean baseline EDV and MSV in VaD were higher than AD but mean PSV was lower. The percentage of velocity change after acetazolamide in AD was higher than VaD at 5, 10 and 20 min. However the differences were not statistically significant. Acetazolamide vasoreactive test using TCD may be the additional criterion to differentiate VaD from AD. Further study with more number of subjects for the study or higher dose of acetazolamide may be needed to reveal the

  19. Development and use of sulodexide in vascular diseases: implications for treatment

    Directory of Open Access Journals (Sweden)

    Coccheri S

    2013-12-01

    Full Text Available Sergio Coccheri,1 Ferdinando Mannello2 1Cardiovascular Medicine, University of Bologna, Bologna, 2Department of Biomolecular Sciences (Section Clinical Biochemistry and Cell Biology, University 'Carlo Bo', Urbino, Italy Abstract: Sulodexide (SDX, a sulfated polysaccharide complex extracted from porcine intestinal mucosa, is a blend of two glycosaminoglycan (GAG entities, namely a fast-moving heparin (HP fraction and a dermatan sulfate (DS; 20% component. The compound is unique among HP-like substances in that it is biologically active by both the parenteral and oral routes. A main feature of the agent is to undergo extensive absorption by the vascular endothelium. For this reason, in preclinical studies, SDX administered parenterally displays an antithrombotic action similar to that of HPs but associated with fewer alterations of the blood clotting mechanisms and tests, thus being much less conducive to bleeding risk than HPs. When given orally, SDX is associated with minimal changes in classic coagulation tests, but maintains a number of important effects on the structure and function of endothelial cells (EC, and the intercellular matrix. These activities include prevention or restoration of the integrity and permeability of EC, counteraction versus chemical, toxic or metabolic EC injury, regulation of EC–blood cell interactions, inhibition of microvascular inflammatory and proliferative changes, and other similar effects, thus allowing oral SDX to be considered as an endothelial-protecting agent. The best available clinical evidence of the efficacy of SDX administered orally with or without an initial parenteral phase is the following: alleviation of symptoms in chronic venous disease and especially acceleration of healing of venous leg ulcers; prevention of cardiovascular events in survivors after acute myocardial infarction; marked improvement of intermittent claudication in patients with peripheral occlusive arterial disease; and

  20. Mechanic's hands revisited: is this sign still useful for diagnosis in patients with lung involvement of collagen vascular diseases?

    Science.gov (United States)

    Sohara, Erei; Saraya, Takeshi; Sato, Shinji; Tsujimoto, Naoki; Watanabe, Takayasu; Takata, Saori; Tanaka, Yasutaka; Ishii, Haruyuki; Takizawa, Hajime; Goto, Hajime

    2014-05-17

    The presence of "mechanic's hands" is one of the clinical clues for collagen vascular diseases. However, the exact relevance of "mechanic's hands" in collagen vascular diseases has not been well documented. The aim of this study was to clarify the relevance of "mechanic's hands" to collagen vascular diseases including various skin lesions and interstitial pneumonia. A retrospective review of the medical records of patients with "mechanic's hands" at our hospital between April 2011 and December 2012 was conducted. A PubMed search was also conducted using the term "mechanic's hands". Four patients in our institution and 40 patients obtained from PubMed who had "mechanic's hands" were identified. The most frequent diseases were DM/amyopathic DM (n = 24, 54.5%) and anti-ARS syndrome (n = 17, 38.6%). In these patients, the major skin lesions associated with "mechanic's hands" were periungual erythema (n = 23, 52.3%), Gottron's sign (n = 17, 38.6%), heliotrope rash (n = 10, 22.7%), Raynaud's phenomenon (n = 9, 20.5%), and anti-ARS syndrome (n = 17, 38.6%). Six cases (2 DM, 4 anti-ARS syndrome) had only "mechanic's hands". Antibodies to anti-ARS (n = 24) were Jo-1 (n = 19), PL-7 (n = 3), OJ (n = 1), and PL-12 (n = 1). The presence of "mechanic's hands" together with diverse skin lesions could be a clinical clue to the diagnosis of lung involvement associated with collagen vascular diseases, especially in anti-ARS syndrome or DM/amyopathic DM.

  1. Neurocognitive differential diagnosis of dementing diseases: Alzheimer's Dementia, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder.

    Science.gov (United States)

    Braaten, Alyssa J; Parsons, Thomas D; McCue, Robert; Sellers, Alfred; Burns, William J

    2006-11-01

    Similarities in presentation of Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder, pose differential diagnosis challenges. The current study identifies specific neuropsychological patterns of scores for Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. Neuropsychological domains directly assessed in the study included: immediate memory, delayed memory, confrontational naming, verbal fluency, attention, concentration, and executive functioning. The results reveal specific neuropsychological comparative profiles for Dementia of Alzheimer's Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. The identification of these profiles will assist in the differential diagnosis of these disorders and aid in patient treatment.

  2. Exercise and possible molecular mechanisms of protection from vascular disease and diabetes: the central role of ROS and nitric oxide.

    Science.gov (United States)

    Newsholme, Philip; Homem De Bittencourt, Paulo I; O' Hagan, Ciara; De Vito, Giuseppe; Murphy, Colin; Krause, Mauricio S

    2009-11-23

    It is now widely accepted that hypertension and endothelial dysfunction are associated with an insulin-resistant state and thus with the development of T2DM (Type 2 diabetes mellitus). Insulin signalling is impaired in target cells and tissues, indicating that common molecular signals are involved. The free radical NO* regulates cell metabolism, insulin signalling and secretion, vascular tone, neurotransmission and immune system function. NO* synthesis is essential for vasodilation, the maintenance of blood pressure and glucose uptake and, thus, if levels of NO* are decreased, insulin resistance and hypertension will result. Decreased blood levels of insulin, increased AngII (angiotensin II), hyperhomocysteinaemia, increased ADMA (asymmetric omega-NG,NG-dimethylarginine) and low plasma L-arginine are all conditions likely to decrease NO* production and which are associated with diabetes and cardiovascular disease. We suggest in the present article that the widely reported beneficial effects of exercise in the improvement of metabolic and cardiovascular health are mediated by enhancing the flux of muscle- and kidney-derived amino acids to pancreatic and vascular endothelial cells aiding the intracellular production of NO*, therefore resulting in normalization of insulin secretion, vascular tone and insulin sensitivity. Exercise may also have an impact on AngII and ADMA signalling and the production of pro- and anti-inflammatory cytokines in muscle, so reducing the progression and development of vascular disease and diabetes. NO* synthesis will be increased during exercise in the vascular endothelial cells so promoting blood flow. We suggest that exercise may promote improvements in health due to positive metabolic and cytokine-mediated effects.

  3. Rapid actions of aldosterone in vascular health and disease - friend or foe?

    DEFF Research Database (Denmark)

    Skøtt, Ole; Uhrenholt, Torben Rene; Schjerning, Jeppe

    2006-01-01

    The mineralocorticoid receptor (MR) and the enzyme 11betahydroxysteroid dehydrogenase type 2, which confers aldosterone specificity to the MR, are present in endothelium and vascular smooth muscle. In several pathological conditions aldosterone promotes vascular damage by formation of reactive...... oxygen species. The effect of aldosterone on vascular function, however, is far from clear. By rapid non-genomic mechanisms aldosterone may cause calcium mobilization and vasoconstriction, or may stimulate nitric oxide formation through the PI-3 kinase/Akt pathway and thereby counteract vasoconstriction...... production, therefore depends on the ambient level of oxidative stress. Thus, in situations with low levels of oxidative stress aldosterone may promote vasodilatation, while at higher oxidative stress (high NaCl intake, pre-existing vascular pathological conditions, high oxygen tension in vitro) aldosterone...

  4. Systematic review of clinical applications of monitoring muscle tissue oxygenation with near-infrared spectroscopy in vascular disease.

    Science.gov (United States)

    Boezeman, Reinout P E; Moll, Frans L; Ünlü, Çağdaş; de Vries, Jean-Paul P M

    2016-03-01

    The use of wavelengths of the near-infrared region by near-infrared spectroscopy (NIRS) has been studied for several applications in vascular disease. This systematic review aims to explore the clinical relevance of monitoring muscle tissue oxygenation in vascular disease with NIRS. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases was performed to identify clinical NIRS studies, published until April 2015, involving muscle tissue oxygenation in vascular disease. After screening 183 manuscripts, 38 studies (n=2010) were included. Studies concerned peripheral arterial disease (PAD) (twelve studies, n=848), compartment syndrome of lower extremities (seven studies, n=205), deep vein thrombosis (DVT) (six studies, n=429), buttock and lower extremity ischaemia in abdominal aortic aneurysm repair (six studies, n=139), free flap failure (five studies, n=354), and spinal cord ischaemia in thoracoabdominal aortic aneurysm repair (two studies, n=35). Nine studies compared NIRS with gold standards and provided cut-off values. Four studies regarding chronic compartment syndrome and DVT determined higher sensitivity (78%-97%) than specificity (56%-76%). Two studies regarding PAD and buttock claudication determined higher specificity (87%-95%) than sensitivity (33%-88%). Three studies regarding free flap failure determined sensitivity and specificity of 100%. We found sufficient evidence to use NIRS in clinical setting for assessment of chronic compartment syndrome of lower extremities, and as surveillance tool for detection of free flap failure. So far, clinical relevance of routine use of NIRS in other vascular applications is less clear. Cut-off values to discriminate are not yet unanimous and better validation has to be awaited for. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Amantadine can Ameliorate Lower Urinary Tract Dysfunction and Nocturnal Polyuria in Patients with Parkinson Disease and Vascular Parkinsonism

    OpenAIRE

    Hiromi, Tateno; Tomoyuki, Uchiyama; Tatsuya, Yamamoto; Yuka, Watanabe; Kenichi, Hashimoto; Chiharu, Shibata-yamaguchi; Miki, Fuse; Takao, Kamai; Tomonori, Yamanishi; Ryuji, Sakakibara; Satoshi, Kuwabara; Koichi, Hirata; Department Of Neurology, Dokkyo Medical University; Department Of Neurology, Dokkyo Medical University:Neurourology And Continence Center, Dokkyo Medical University:Department Of Neurology, Chiba University Graduate School Of Medicine; Department Of Neurology, Chiba University Graduate School Of Medicine:Neurourology And Continence Center, Dokkyo Medical University:Department Of Neurology, Chiba University Graduate School Of Medicine

    2015-01-01

    Background:Amantadine is a drug used for patients with Parkinson's disease (PD) and vascular parkinsonism (VP). These patients often have lower urinary tract symptoms (LUTS) and nocturnal polyuria (NP). Thus, we investigated the effect of amantadine on these in parkinsonian patients.Methods:Twenty-two patients with LUTS, including 13 with PD and nine with VP, were recruited. We performed a urinary questionnaire, frequency-volume chart, and residual urine (RU) measurement before and after dail...

  6. Mechanic’s hands revisited: is this sign still useful for diagnosis in patients with lung involvement of collagen vascular diseases?

    OpenAIRE

    Sohara, Erei; Saraya, Takeshi; Sato, Shinji; Tsujimoto, Naoki; Watanabe, Takayasu; Takata, Saori; Tanaka, Yasutaka; Ishii, Haruyuki; Takizawa, Hajime; Goto, Hajime

    2014-01-01

    Background The presence of “mechanic’s hands” is one of the clinical clues for collagen vascular diseases. However, the exact relevance of “mechanic’s hands” in collagen vascular diseases has not been well documented. The aim of this study was to clarify the relevance of “mechanic’s hands” to collagen vascular diseases including various skin lesions and interstitial pneumonia. Methods A retrospective review of the medical records of patients with “mechanic’s hands” at our hospital between Apr...

  7. Variations in vascular mortality trends, 2001?2010, among 1.3 million women with different lifestyle risk factors for the disease

    OpenAIRE

    Cairns, Benjamin J; Balkwill, Angela; Canoy, Dexter; Green, Jane; Reeves, Gillian K; Beral, Valerie

    2015-01-01

    Aims Vascular disease mortality has declined rapidly in most Western countries, against a background of improved treatments and falling prevalence of smoking, but rising obesity. We examined whether this decline differed by lifestyle risk factors for vascular disease. Methods and Results During 2001?2010, there were 9241 vascular disease deaths in a prospective study of 1.3 million women in middle age, about one-quarter of all UK women in the eligible age range (50?64 years in 1996?2001). We ...

  8. Enhanced bronchial expression of vascular endothelial growth factor and receptors (Flk-1 and Flt-1) in patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    A.R. Kranenburg (Andor); W.I. de Boer (Pim); V.K.T. Alagappan (Vijay Kumar Thyagarajan); P.J. Sterk (Peter); H.S. Sharma (Hari)

    2005-01-01

    textabstractBACKGROUND: Ongoing inflammatory processes resulting in airway and vascular remodelling characterise chronic obstructive pulmonary disease (COPD). Vascular endothelial growth factor (VEGF) and its receptors VEGFR-1 (Flt-1) and VEGFR-2 (KDR/Flk-1) could play a role in

  9. Placental vascular dysfunction in diabetic pregnancies: intimations of fetal cardiovascular disease?

    Science.gov (United States)

    Leach, Lopa

    2011-05-01

    In the human placenta, the angioarchitecture of fetal vessels lying in maternal blood is useful for nutrient uptake, but it makes the synthesis, maturation and functioning of placental vessels vulnerable to any alterations in the fetal and maternal environment. This review discusses how the maternal diabetic milieu, and the resultant fetal hyperglycemia and hyperinsulinemia, may act together to produce an altered placental vascular phenotype, which includes increased angiogenesis, altered junctional maturity, increased vascular endothelial-like growth factor (VEGF), altered VEGF and insulin receptor profiles, and upregulation of genes involved in signal transduction, transcription and mitosis in placental endothelial cells. The placental vascular dysfunction does extend to other fetal vascular beds including endothelial cells from umbilical vessels, where there are reports of elevated basal iNOS activity and altered sensitivity to insulin. There is emerging evidence of epigenetic modulation of fetal endothelial genes in diabetes and long-term vascular consequences of this. Thus, placental vascular dysfunction in diabetes may be contributing to and describing disturbances in the fetal vasculature, which may produce an overt pathological response in later life if challenged with additional cardiovascular stresses. © 2011 John Wiley & Sons Ltd.

  10. Effects of unilateral, low-frequency, neuromuscular stimulation on superficial circulation in lower extremities of patients with peripheral vascular disease.

    Science.gov (United States)

    Loubser, P G; Cardus, D; Pickard, L R; McTaggart, W G

    1988-04-01

    The effects of unilateral, low-frequency, neuromuscular stimulation on the circulation in skin of the lower extremities were studied in eight subjects with peripheral vascular disease and eight control subjects with normal peripheral vasculature. Sixty minutes of stimulation (at 2 Hz), of sufficient intensity to produce visible contraction of musculature, was applied through cutaneous electrodes placed over the common peroneal nerve and dorsum of the foot. Systolic and diastolic blood pressure, heart rate, bilateral great-toe photoplethysmographic waveform, and bilateral pedal skin temperature were recorded at 30-min intervals during stimulation and 30 min after stimulation. Mean differences in recordings before and after stimulation were then calculated for each parameter, showing in subjects with peripheral vascular disease significant increases of 5.3 +/- 2.1 mm and 0.5 +/- 0.1 degree C for ipsilateral photoplethysmographic waveform amplitude and pedal skin temperature, respectively. Mean differences for the remaining parameters were not significant. Recorded parameters in the control group did not change after stimulation. These results demonstrate that low-frequency, neuromuscular stimulation produces regional cutaneous vasodilation in subjects with peripheral vascular disease. No evidence of generalized vasodilation after neuromuscular stimulation was found.

  11. In vitro effects of waterpipe smoke condensate on endothelial cell function: a potential risk factor for vascular disease.

    Science.gov (United States)

    Rammah, Mayyasa; Dandachi, Farah; Salman, Rola; Shihadeh, Alan; El-Sabban, Marwan

    2013-05-23

    Despite its increasing popularity, little is known about the health effects of waterpipe smoking (WPS), particularly on the cardiovascular system. To investigate the role of WPS as a risk factor for vascular disease, we evaluated its effect on endothelial cell function, which is an early event in vascular disease pathogenesis. We assessed the changes in cell viability, ROS generation, inflammatory and vasodilatory markers and in vitro angiogenesis of human aortic endothelial cells in response to waterpipe smoke condensate exposure. Mainstream waterpipe smoke condensate (WSC) was generated using a standard laboratory machine protocol. Compared to control, WSC induced cell cycle arrest, apoptosis, and oxidative stress in human primary endothelial cells. In addition, we assayed for impaired endothelium-dependent vasodilation and induced inflammation by studying the effect of WPS on the content and activity of AMPK, eNOS proteins and NF-κB p65 ser536 phosphorylation, respectively. WSC inhibited AMPK/eNOS phosphorylation and induced phosphorylation of p65. Moreover, we evaluated endothelial cells repair mechanism related properties that include migration/invasion and in vitro tube formation upon treatment with WSC. WSC reduced the motility and inhibited angiogenic potential of HAEC cells. WPS induced endothelial cell dysfunction as evident by exerting oxidative stress, inflammation, and impaired endothelial vasodilatory function and repair mechanisms. All together these data provide evidence for the potential contribution of WPS to endothelial dysfunction and thus to vascular disease. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Functional Performance of Alzheimer's Disease and Vascular Dementia in Southern Taiwan

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    Mei-Yuh Shiau

    2006-09-01

    Full Text Available This study investigated the functional performance of two major subtypes of dementia, Alzheimer's disease (AD and vascular dementia (VaD, by the Functional Independence Measure (FIM, and to understand the need for assistance in performing activities of daily living. The subjects comprised 64AD and 21VaD patients who were recruited from two epidemiologic studies of dementia with a total of 3,931 community residents aged 65 years and above in southern Taiwan. The results showed that the severity of dementia was similar between the two groups. The mean score for AD was 82.7 and for VaD was 56.5 for total FIM (p < 0.05, 61.6 and 41.7 for the motor dimension (p < 0.05, and 21.1 and 15.7 for the cognitive dimension (p < 0.05. There were significant differences (p < 0.01 between AD and VaD in six FIM items and borderline or marginal significance (p < 0.05 in most of the FIM items. For AD patients, stairs, lower dressing, bathing, and tub/shower transfer were the most difficult items in the motor dimension, and it was memory in the cognitive dimension. For VaD patients, bathing, upper and lower dressing, and grooming were the most difficult items in the motor dimension, and it was problem solving in the cognitive dimension. VaD patients were more dependent on all FIM items and required more assistance than AD patients. The functional performances of dementia patients were significantly associated with dementia severity and subtypes, together accounting for 40% of the variability in total FIM. In conclusion, most dementia patients are dependent in daily activities and different types and severity of dementia lead to different disability profiles; individualized care is, therefore, most appropriate.

  13. History of depression prior to Alzheimer's disease and vascular dementia verified post-mortem.

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    Brunnström, Hans; Passant, Ulla; Englund, Elisabet; Gustafson, Lars

    2013-01-01

    The aim of this study was to analyze the medical history, with regards to previous remote depression, in patients with neuropathologically verified Alzheimer's disease (AD), vascular dementia (VaD) and mixed AD/VaD. The 201 patients included (115 AD, 44 VaD and 42 mixed AD/VaD) had been referred to the Psychogeriatric/Psychiatric Department, Lund University Hospital, for psychogeriatric investigation and were followed-up with clinical records and detailed information on psychiatric history prior to the onset of dementia. Depression was considered to exist when the patient had consulted a psychiatrist or physician and had been diagnosed with a "depressive episode" or "depression" and when anti-depressants and/or other specific treatments had been prescribed. Twenty patients (10%) had suffered from depression earlier in life well before the onset of dementia. Eight of the 9 AD patients with a previous diagnosis of depression had suffered from only one depressive episode and all had responded well to treatment, with complete recovery. In the VaD group, 8 out of 9 patients suffered two or more depressive episodes and only two recovered completely. Events with a possible significant relationship to depression were seen in 8 of the 9 AD patients but in only 1 of the 9 VaD patients. Psychotic symptoms were more common in VaD than in the AD group. The treatment modality of depression was similar in the groups. In conclusion, a history of depression prior to dementia is more common and more therapy-resistant in VaD than in AD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. PREVALENCE OF CARDIO-VASCULAR DISEASE (CVD RISK FACTORS AMONG AUTO-RICKSHAW DRIVERS

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    Shailendra Chaudhary

    2011-06-01

    Full Text Available Research question: What is the prevalence of some cardio-vascular disease (CVD risk factors among auto-rickshaw drivers (ARDs working in Nagpur city of India? Methods: This cross-sectional study was conducted from June 2007 to December 2008 at the auto-rickshaw stand of Nagpur railway station. Out of total 6000 auto-rickshaw drivers (ARDs of Nagpur city, 296 were studied. Results: Mean age of ARDs was 41.70±9.05 years. Their mean length of occupation was 17 years and average daily working was 11½ hours. 40.20% subjects had habit of tobacco chewing; while 35.14% were smokers and 34.12% were alcohol consumers. Only 16.89% subjects were engaged in regular physical exercise. 27.36% subjects had ‘moderate’ or ‘severe’ self reported stress. Mean weight of these auto-rickshaw drivers was 58.59±9.25 kg; while their mean body mass index (BMI was 21.95±3.48 kg/m2. 14.86% subjects were overweight and another 3.38% had obesity. 37.16% subjects had pre-hypertension; while 104 (35.14% subjects had hypertension. 4.73% of the ARDs also had a family history of hypertension. Conclusions: As the prevalence of various CVD risk factors is high; there is an urgent need of regular health check-ups and appropriate preventive and promotive interventions among these auto-rickshaw drivers.

  15. Increased pulsatility index supports diagnosis of vascular parkinsonism versus idiopathic Parkinson's disease.

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    Caba, L M; Ferrairó, J I T; Torres, I M; Costa, J F V; Muñoz, R B; Martin, A L

    2017-12-29

    The diagnosis of vascular parkinsonism (VP) is based on a series of clinical criteria and neuroimaging findings. An increase in transcranial Doppler ultrasonography pulsatility index (PI) has been described as a frequent finding in patients with VP. We aimed to confirm this association and to determine the PI value with the highest sensitivity and specificity for diagnosis of VP. PI was determined in all patients admitted to Hospital Universitari i Politècnic La Fe due to parkinsonism between January 2012 and June 2016. We assessed the probability of having VP based on PI values in patients with a definite diagnosis of either VP or idiopathic Parkinson's disease (IPD). A ROC curve was created to determine the PI value with the highest sensitivity and specificity. We assessed a total of 146 patients with suspected parkinsonism; 54 (37%) were diagnosed with IPD and 15 (10%) with VP. Patients with VP were significantly older than those with IPD (mean age of 79 vs 68.5, P=.00144) and had a higher PI (median of 1.29 [IQR: 1.09-1.38] vs 0.96 [IQR: 0.89-1.16], P=.01328). In our sample, a PI of 1.09 conferred 84% sensitivity and 70% specificity. In our series, the PI was significantly higher in patients with VP than in those with IPD. We therefore support the use of transcranial Doppler ultrasonography for the initial assessment of elderly patients with akinetic-rigid syndrome. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Vascular branches from cutaneous nerve of the forearm and hand: application to better understanding raynaud's disease.

    Science.gov (United States)

    Umemoto, K; Ohmichi, M; Ohmichi, Y; Yakura, T; Hammer, N; Mizuno, D; Naito, M; Nakano, T

    2017-09-29

    Cutaneous nerves have branches called vascular branches (VBs) that reach arteries. VBs are thought to be involved in arterial constriction, and this is the rationale for periarterial sympathectomy as a treatment option for Raynaud's disease. However, the branching patterns and distribution areas of the VBs remain largely unclear. The aim of the present study was to investigate the anatomical structures of the VBs of the cutaneous nerves. Forty hands and forearms were examined to assess the branching patterns and distribution areas of the VBs of the superficial branch of the radial nerve (SBRN), the lateral antebrachial cutaneous nerve (LACN), the medial antebrachial cutaneous nerve (MACN), and the palmar cutaneous branch of the ulnar nerve (PCUN). VBs reaching the radial and ulnar arteries were observed in all specimens. The branching patterns were classified into six types. The mean distance between the radial styloid process and the point where the VBs reached the radial artery was 34.3 ± 4.8 mm in the SBRN and 38.5 ± 15.8 mm in the LACN. The mean distance between the ulnar styloid process and the point where the VBs reached the ulnar artery was 60.3 ± 25.9 mm in the MACN and 43.8 ± 26.0 mm in the PCUN. This study showed that the VBs of the cutaneous nerves have diverse branching patterns. The VBs of the SBRN had a more limited distribution areas than those of the other nerves. Clin. Anat., 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. Relation between prognosis and collateral circulation or recanalization in occlusive cerebral vascular diseases

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    Saito, Yuko (Tokyo Women' s Medical Coll. (Japan))

    1982-09-01

    CT images and angiograms were compared, in occlusive cerebral vascular diseases with complete stroke in the region of internal carotid artery, and following subjects were discussed. 1) Relation between size of final low density area on CT and prognosis. 2) Effectiveness of collateral circulation and recanalization to the low density area on CT in the territory of occluded artery. For the subject 1,100 cases of infarction of the region of middle cerebral artery were chosen at random, and the prognosis was compared with the size of low density area on CT. For the subject 2,186 cases of infarction in the region on internal carotid artery were selected, and CT images and angiograms were compared, considering the duration between stroke and angiography. With these studies, following conclusions were obtained. There is tendency that cases with the smaller low density areas on CT have the better prognosis. The low density on CT appears inside of the territory of the occluded artery. When there is neither collateral circulation nor recanalization, appearance of the low density on CT is not avoided. Collateral circulation or recanalization is able to rescue the affected area from appearance of low density on CT, even if it is formed later than 6 hours after ictus. The critical period when collateral circulation or recanalization effects on the involved area is variable depending on each cases, but it is suspected to be 24 or 72 hours after onset. Blood supply which begins later than 73 hours after occlusion of artery does not effect on the involved area.

  18. The effects of particle size, shape, density and flow characteristics on particle margination to vascular walls in cardiovascular diseases.

    Science.gov (United States)

    Ta, Hang T; Truong, Nghia P; Whittaker, Andrew K; Davis, Thomas P; Peter, Karlheinz

    2018-01-01

    Vascular-targeted drug delivery is a promising approach for the treatment of atherosclerosis, due to the vast involvement of endothelium in the initiation and growth of plaque, a characteristic of atherosclerosis. One of the major challenges in carrier design for targeting cardiovascular diseases (CVD) is that carriers must be able to navigate the circulation system and efficiently marginate to the endothelium in order to interact with the target receptors. Areas covered: This review draws on studies that have focused on the role of particle size, shape, and density (along with flow hemodynamics and hemorheology) on the localization of the particles to activated endothelial cell surfaces and vascular walls under different flow conditions, especially those relevant to atherosclerosis. Expert opinion: Generally, the size, shape, and density of a particle affect its adhesion to vascular walls synergistically, and these three factors should be considered simultaneously when designing an optimal carrier for targeting CVD. Available preliminary data should encourage more studies to be conducted to investigate the use of nano-constructs, characterized by a sub-micrometer size, a non-spherical shape, and a high material density to maximize vascular wall margination and minimize capillary entrapment, as carriers for targeting CVD.

  19. Percutaneous coronary intervention with ABSORB biodegradable vascular scaffold in patients with left anterior descending artery disease

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    К. М. Ваккосов

    2017-04-01

    Full Text Available Aim. The article evaluates 30-day results of percutaneous coronary intervention (PCI with ABSORB biodegradable vascular scaffold (BVS implanted in the case of stenosis of the left anterior descending (LAD coronary artery in patients with stable angina.Methods. 64 patients with significant (≥ 70% LAD disease were included in the study. At 30 days, scaffold thrombosis and major adverse cardiovascular events (all-cause mortality, myocardial infarction, stroke, target vessel revascularization were evaluated. The indicator of successful percutaneous coronary intervention (residual stenosis ≤20% in the presence of counterpulsation corresponding to TIMI 3rd Grade and in the absence of significant in-patient clinical complications and successful intervention assessed by clinical criteria (successful percutaneous coronary intervention alongside with a decrease in objective and subjective symptoms of myocardial ischemia, or their complete disappearance were also analyzed. Results. Mean age of patients was 61.6±8.5 years, with males accounting for 64%; 33% had earlier MI, 14% – diabetes mellitus. Mean left ventricular ejection fraction was 61.3±6.8%. Left anterior descending artery disease was presented in 89% of patients with SYNTAX Score 6.6±2.2. Mean number of implanted stents was 1.2±0.4, with mean length of the stented segment equal to18.7±1.8 mm and mean diameter 3.2±0.3 mm. At 30-day follow-up, the success of intervention assessed by clinical criteria amounted to 96.9% (n=62; that of myocardial infarction 3.1% (n=2; stent thrombosis 1.56% (n=1; repeated revascularization 1.56% (n=1; major adverse cardiovascular events (MACE 3.1%.Conclusion. The implantation of everolimus-eluting BVS for LAD stenosis demonstrates satisfactory results at 30-day follow-up.Received 16 January 2017. Accepted 21 March 2017.Financing: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

  20. A comparison of genome-wide DNA methylation patterns between different vascular tissues from patients with coronary heart disease.

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    Maria S Nazarenko

    Full Text Available Epigenetic mechanisms of gene regulation in context of cardiovascular diseases are of considerable interest. So far, our current knowledge of the DNA methylation profiles for atherosclerosis affected and healthy human vascular tissues is still limited. Using the Illumina Infinium Human Methylation27 BeadChip, we performed a genome-wide analysis of DNA methylation in right coronary artery in the area of advanced atherosclerotic plaques, atherosclerotic-resistant internal mammary arteries, and great saphenous veins obtained from same patients with coronary heart disease. The resulting DNA methylation patterns were markedly different between all the vascular tissues. The genes hypomethylated in athero-prone arteries to compare with atherosclerotic-resistant arteries were predominately involved in regulation of inflammation and immune processes, as well as development. The great saphenous veins exhibited an increase of the DNA methylation age in comparison to the internal mammary arteries. Gene ontology analysis for genes harboring hypermethylated CpG-sites in veins revealed the enrichment for biological processes associated with the development. Four CpG-sites located within the MIR10B gene sequence and about 1 kb upstream of the HOXD4 gene were also confirmed as hypomethylated in the independent dataset of the right coronary arteries in the area of advanced atherosclerotic plaques in comparison with the other vascular tissues. The DNA methylation differences observed in vascular tissues of patients with coronary heart disease can provide new insights into the mechanisms underlying the development of pathology and explanation for the difference in graft patency after coronary artery bypass grafting surgery.

  1. Diagnostics of vascular diseases as a cause for acute abdomen; Diagnostik vaskulaerer Erkrankungen als Ursache fuer das akute Abdomen

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    Juchems, M.S. [Universitaetsklinikum Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Aschoff, A.J. [Klinikum Kempten-Oberallgaeu, Abteilung fuer Radiologie, Kempten (Germany)

    2010-03-15

    Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.) [German] Vaskulaere Pathologien sind seltene Ursachen fuer den klinischen Zustand eines akuten Abdomens. Liegt eine vaskulaere Erkrankung vor, ist jedoch aufgrund der hohen Mortalitaet eine zuegige Diagnostik von grosser Wichtigkeit. Bei den Erkrankungen der abdominellen Gefaesse sind arterielle von venoesen Ursachen zu unterscheiden. Ein Verschluss der A. mesenterica superior ist die haeufigste Ursache fuer die akute Mesenterialischaemie, daneben sind Blutungen in den abdominellen Gefaessprovinzen des arteriellen Gefaessbaums von Bedeutung. Venoese Pathologien betreffen thrombotische Verschluesse der Pfortader, der V. mesenterica und der V. cava. Die Multidetektor-CT (MDCT) ist zur Diagnostik vaskulaerer Erkrankungen des Abdominalraums praedestiniert. Mit mehrphasigen Untersuchungsprotokollen gelingt es, den arteriellen und venoesen Gefaessbaum zuverlaessig darzustellen und Erkrankungen mit hoher Sensitivitaet und Spezifitaet zu

  2. THE INFLUENCE OF PERIPHERAL NEUROPATHY AND PERIPHERAL VASCULAR DISEASE IN THE OUTCOME OF DIABETIC FOOT MANAGEMENT – A PROSPECTIVE STUDY

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    Sundar Prakash S, Krishnakumar, Chandra Prabha

    2015-04-01

    Full Text Available Objective: Peripheral neuropathy and Peripheral Vascular Disease are the risk factors for the development of diabetic foot. The aim of this study was to evaluate differences and predictors of outcome parameters in patients with diabetic foot by stratifying these subjects according to the severity of these risk factors. Materials and methods: This is a prospective study conducted in 70 patients in the age group of 30-90 years diagnosed as Type II Diabetes with foot ulcers. After detailed clinical examination the following tests were conducted in all the patients: Complete blood count (CBC, Haemoglobin (Hb, Random Blood Sugar (RBS, Erythrocyte Sedimentation rate (ESR, Chest X-ray(CXR, Electrocardiography (ECG, foot X-ray, pus culture, Neuropathy testing by Semmes Weinstein Monofilament Test and Vibration Perception Threshold and Peripheral vascularity assessment by Duplex Doppler. Then grading of the ulcers was done using Wagner’s Grade. The outcome of the patients was assessed by recording the healing time, mode of surgery and amputation rates of the patients. Results: A total of 70 patients with diabetic foot were consecutively included into the study (65.7% male, age (31% in 51-60 years, mean diabetes duration (5.2 years, Ulcer Grade (37% in Grade IV, Foot lesions (45.7% in toe, Blood sugar levels (64% in 300-400 mg/dl, Neuropathy (84%, Peripheral vascular disease (67%, major amputation (7% and mortality (1.4%. Conclusion: All diabetic patients should undergo testing for neuropathy and peripheral vascular disease apart from doing other tests.

  3. The Discovery of Novel Genomic, Transcriptomic, and Proteomic Biomarkers in Cardiovascular and Peripheral Vascular Disease: The State of the Art

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    Stefano de Franciscis

    2016-01-01

    Full Text Available Cardiovascular disease (CD and peripheral vascular disease (PVD are leading causes of mortality and morbidity in western countries and also responsible of a huge burden in terms of disability, functional decline, and healthcare costs. Biomarkers are measurable biological elements that reflect particular physiological or pathological states or predisposition towards diseases and they are currently widely studied in medicine and especially in CD. In this context, biomarkers can also be used to assess the severity or the evolution of several diseases, as well as the effectiveness of particular therapies. Genomics, transcriptomics, and proteomics have opened new windows on disease phenomena and may permit in the next future an effective development of novel diagnostic and prognostic medicine in order to better prevent or treat CD. This review will consider the current evidence of novel biomarkers with clear implications in the improvement of risk assessment, prevention strategies, and medical decision making in the field of CD.

  4. Interstitial lung disease associated with collagen vascular disorders: disease quantification using a computer-aided diagnosis tool

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    Marten, K.; Engelke, C. [University Hospital of Goettingen, Department of Radiology, Goettingen (Germany); Dicken, V. [MeVis Research GmbH, Bremen (Germany); Kneitz, C. [University Hospital of Wuerzburg, Dept. of Rheumatology and Clinical Immunology, Medizinische Klinik and Poliklinik, Wuerzburg (Germany); Hoehmann, M.; Kenn, W.; Hahn, D. [University Hospital of Wuerzburg, Department of Radiology, Wuerzburg (Germany)

    2009-02-15

    The purpose of this study was to evaluate a computer-aided diagnosis (CAD) tool compared to human observers in quantification of interstitial lung disease (ILD) in patients with collagen-vascular disorders. A total of 52 patients with rheumatoid arthritis (n=24), scleroderma (n=14) and systemic lupus erythematosus (n=14) underwent thin-section CT. Two independent observers assessed the extent of ILD (EoILD), reticulation (EoRet) and ground-glass opacity (EoGGO). CAD assessed EoILD twice. Pulmonary function tests were obtained. Statistical evaluation used 95% limits of agreement and linear regression analysis. CAD correlated well with diffusing capacity (DL{sub CO}) (R=-0.531, P<0.0001) and moderately with forced vital capacity (FVC) (R=-0.483, P=0.0008). There was close correlation between CAD and the readers (EoILD vs. CAD: R=0.716, P<0.0001; EoRet vs. CAD: R=0.69, P<0.0001). Subgroup analysis including patients with minimal EoGGO (<15%) strengthened the correlations between CAD and the readers, readers and PFT, and CAD and PFT. EoILD by readers correlated strongly with DL{sub CO} (R=-0.705, P<0.0001) and moderately with FVC (R=-0.559, P=0.0002). EoRet correlated closely with DL{sub CO} and moderately with FVC (DL{sub CO}: R=-0.663; FVC: R=-0.436; P{<=}0.005). The CAD system is a promising tool for ILD quantification, showing close correlation with human observers and physiologic impairment. (orig.)

  5. Vascular Risk Factors and Diseases Modulate Deficits of Reward-Based Reversal Learning in Acute Basal Ganglia Stroke.

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    Ulla K Seidel

    Full Text Available Besides motor function, the basal ganglia have been implicated in feedback learning. In patients with chronic basal ganglia infarcts, deficits in reward-based reversal learning have previously been described.We re-examined the acquisition and reversal of stimulus-stimulus-reward associations and acquired equivalence in eleven patients with acute basal ganglia stroke (8 men, 3 women; 57.8±13.3 years, whose performance was compared eleven healthy subjects of comparable age, sex distribution and education, who were recruited outside the hospital. Eleven hospitalized patients with a similar vascular risk profile as the stroke patients but without stroke history served as clinical control group.In a neuropsychological assessment 7±3 days post-stroke, verbal and spatial short-term and working memory and inhibition control did not differ between groups. Compared with healthy subjects, control patients with vascular risk factors exhibited significantly reduced performance in the reversal phase (F[2,30] = 3.47; p = 0.044; post-hoc comparison between risk factor controls and healthy controls: p = 0.030, but not the acquisition phase (F[2,30] = 1.01; p = 0.376 and the acquired equivalence (F[2,30] = 1.04; p = 0.367 tasks. In all tasks, the performance of vascular risk factor patients closely resembled that of basal ganglia stroke patients. Correlation studies revealed a significant association of the number of vascular risk factors with reversal learning (r = -0.33, p = 0.012, but not acquisition learning (r = -0.20, p = 0.121 or acquired equivalence (r = -0.22, p = 0.096.The previously reported impairment of reward-based learning may be attributed to vascular risk factors and associated diseases, which are enriched in stroke patients. This study emphasizes the necessity of appropriate control subjects in cognition studies.

  6. Sustained release nitrite therapy results in myocardial protection in a porcine model of metabolic syndrome with peripheral vascular disease.

    Science.gov (United States)

    Bradley, Jessica M; Islam, Kazi N; Polhemus, David J; Donnarumma, Erminia; Brewster, Luke P; Tao, Ya-Xiong; Goodchild, Traci T; Lefer, David J

    2015-07-15

    Metabolic syndrome (MetS) reduces endothelial nitric oxide (NO) bioavailability and exacerbates vascular dysfunction in patients with preexisting vascular diseases. Nitrite, a storage form of NO, can mediate vascular function during pathological conditions when endogenous NO is reduced. The aims of the present study were to characterize the effects of severe MetS and obesity on dyslipidemia, myocardial oxidative stress, and endothelial NO synthase (eNOS) regulation in the obese Ossabaw swine (OS) model and to examine the effects of a novel, sustained-release formulation of sodium nitrite (SR-nitrite) on coronary vascular reactivity and myocardial redox status in obese OS subjected to critical limb ischemia (CLI). After 6 mo of an atherogenic diet, obese OS displayed a MetS phenotype. Obese OS had decreased eNOS functionality and NO bioavailability. In addition, obese OS exhibited increased oxidative stress and a significant reduction in antioxidant enzymes. The efficacy of SR-nitrite therapy was examined in obese OS subjected to CLI. After 3 wk of treatment, SR-nitrite (80 mg · kg(-1) · day(-1) bid po) increased myocardial nitrite levels and eNOS function. Treatment with SR-nitrite reduced myocardial oxidative stress while increasing myocardial antioxidant capacity. Ex vivo assessment of vascular reactivity of left anterior descending coronary artery segments demonstrated marked improvement in vasoreactivity to sodium nitroprusside but not to substance P and bradykinin in SR-nitrite-treated animals compared with placebo-treated animals. In conclusion, in a clinically relevant, large-animal model of MetS and CLI, treatment with SR-nitrite enhanced myocardial NO bioavailability, attenuated oxidative stress, and improved ex vivo coronary artery vasorelaxation.

  7. The use of Intravenous Laser Blood Irradiation (ILBI) at 630-640 nm to prevent vascular diseases and to increase life expectancy.

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    Mikhaylov, V A

    2015-03-31

    The mortality rate from vascular diseases is one of the highest. The use of Intravenous Laser Blood Irradiation (ILBI) within the last 30 years has demonstrated high efficacy in the treatment of vascular, cardiac and other systemic diseases. Laser energy at 630-640 nanometers is arguably the most effective for irradiation of blood and the vascular wall. Photons at this wavelength are absorbed by oxygen, improve microcirculation, can change the viscosity of the blood and affect vascular endothelium. In summary, more than 25 years of experience of using laser energy at 630-640 nm has shown that this waveband directly influences the parameters of all cells in the blood, blood plasma, the coagulation process and all the structural components of the vascular wall. Additionally, ILBI directly or indirectly affects the cells of the immune system, hormones, and exchange processes in an organism, thereby not only improving the function of the vascular system, but also the other systems of an organism. It can finally lead to lower the incidence and number of vascular diseases, and indirectly to the reduction of the number of diseases in other organs and even systemically, thus helping to prolong the lifespan.

  8. Differential associations of depressive symptom dimensions with cardio-vascular disease in the community: results from the Gutenberg health study.

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    Matthias Michal

    Full Text Available A current model suggested that the somatic symptom dimension accounts for the adverse effect of depression in patients with coronary heart disease (CHD. In order to test this model we sought to determine in a large population-based sample how symptom dimensions of depression are associated with CHD, biomarkers and traditional risk factors. The associations of cognitive and somatic symptom dimensions of depression with CHD, risk factors, endothelial function, and biomarkers of inflammation and myocardial stress were analyzed cross-sectionally in a sample of n = 5000 Mid-Europeans aged 35-74 years from the Gutenberg Health Study (GHS. Only the somatic symptom dimension of depression was associated with CHD, biomarkers (inflammation, vascular function and cardio-vascular risk factors. When multivariable adjustment was applied by demographic and cardiovascular risk factors, the weak associations of the somatic symptom dimension with the biomarkers disappeared. However, the associations of the somatic symptom dimension with CHD, myocardial infarction, obesity, dyslipidemia and family history of myocardial infarction remained. Both dimensions of depression were independently associated with a previous diagnosis of depression and distressed personality (type D. Thus, our results partly confirm current models: Somatic, but not cognitive-affective symptom dimensions are responsible for the association between depression and CHD, inflammation, vascular function and cardiovascular risk factors in the general population. However, our findings challenge the assumptions that somatic depression might be due to inflammation or vascular dysfunction as consequence of progressed atherosclerotic disease. They rather emphasize a close interplay with life-style factors and with a family history of MI.

  9. [Neurobehavioral manifestation in early period of Alzheimer disease and vascular dementia].

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    Bidzan, Mariola; Bidzan, Leszek

    2014-01-01

    AD and VD are preceded by a preclinical stage. Small but tangible cognitive impairments sometimes occur many years before the onset and diagnosis ofdementia. The ongoing degenerative process can be conductive to behavioural and psychological symptoms. The aim of the study was to investigate the rates of neurobehavioral symptoms in the preclinical stages of AD and VD. Two hundred and ninety one residents of nursery homes were included in the study. Participants of the study did not display symptoms of dementia in accordance with DSM IV criteria and obtained at least 24 points on the MMSE scale and were on the first or second level of the Global Deterioration Scale. Participants were screened for behavioural and psychological symptoms with the NPI-NH scale, while their cognitive functioning was evaluated by means of the ADAS-cog. Participants of the study were evaluated with the MMSE scale annually. Participants who obtained less than 24 points on the MMSE scale were evaluated by a senior psychiatrist. Diagnosis of dementia was done on the basis of DSM criteria. Alzheimer's Disease was diagnosed on the basis of NINCDS-ADRDA criteria and vascular dementia on the NINDS-AIREN criteria. The study was carried out over a period of seven consecutive years. A hundred and fifty people were included in the final analysis--in 111 of them were found not to be afflicted with dementia, 25 were found to have AD and in 14 VD was diagnosed. The control group differed from the AD and VD group with respect to the initial level of cognitive impairment (ADAS-cog) and the intensity of behavioural and psychological symptoms (NPI -NH scale). Particular items of the NPI -NH scale differentiated the two groups to a different degree. In people with AD the greatest differences were observed with respect to agitation/aggression, mood swings, irritability/emotional liability and the rates of anxiety. People with VD, similarly to people with AD, significantly differed from the control group with

  10. Genome and Transcriptome Analysis of the Fungal Pathogen Fusarium oxysporum f. sp. cubense Causing Banana Vascular Wilt Disease

    Science.gov (United States)

    Zeng, Huicai; Fan, Dingding; Zhu, Yabin; Feng, Yue; Wang, Guofen; Peng, Chunfang; Jiang, Xuanting; Zhou, Dajie; Ni, Peixiang; Liang, Changcong; Liu, Lei; Wang, Jun; Mao, Chao

    2014-01-01

    Background The asexual fungus Fusarium oxysporum f. sp. cubense (Foc) causing vascular wilt disease is one of the most devastating pathogens of banana (Musa spp.). To understand the molecular underpinning of pathogenicity in Foc, the genomes and transcriptomes of two Foc isolates were sequenced. Methodology/Principal Findings Genome analysis revealed that the genome structures of race 1 and race 4 isolates were highly syntenic with those of F. oxysporum f. sp. lycopersici strain Fol4287. A large number of putative virulence associated genes were identified in both Foc genomes, including genes putatively involved in root attachment, cell degradation, detoxification of toxin, transport, secondary metabolites biosynthesis and signal transductions. Importantly, relative to the Foc race 1 isolate (Foc1), the Foc race 4 isolate (Foc4) has evolved with some expanded gene families of transporters and transcription factors for transport of toxins and nutrients that may facilitate its ability to adapt to host environments and contribute to pathogenicity to banana. Transcriptome analysis disclosed a significant difference in transcriptional responses between Foc1 and Foc4 at 48 h post inoculation to the banana ‘Brazil’ in comparison with the vegetative growth stage. Of particular note, more virulence-associated genes were up regulated in Foc4 than in Foc1. Several signaling pathways like the mitogen-activated protein kinase Fmk1 mediated invasion growth pathway, the FGA1-mediated G protein signaling pathway and a pathogenicity associated two-component system were activated in Foc4 rather than in Foc1. Together, these differences in gene content and transcription response between Foc1 and Foc4 might account for variation in their virulence during infection of the banana variety ‘Brazil’. Conclusions/Significance Foc genome sequences will facilitate us to identify pathogenicity mechanism involved in the banana vascular wilt disease development. These will thus advance

  11. Vascular Cell Adhesion Molecule-1 Expression and Signaling During Disease: Regulation by Reactive Oxygen Species and Antioxidants

    Science.gov (United States)

    Marchese, Michelle E.; Abdala-Valencia, Hiam

    2011-01-01

    Abstract The endothelium is immunoregulatory in that inhibiting the function of vascular adhesion molecules blocks leukocyte recruitment and thus tissue inflammation. The function of endothelial cells during leukocyte recruitment is regulated by reactive oxygen species (ROS) and antioxidants. In inflammatory sites and lymph nodes, the endothelium is stimulated to express adhesion molecules that mediate leukocyte binding. Upon leukocyte binding, these adhesion molecules activate endothelial cell signal transduction that then alters endothelial cell shape for the opening of passageways through which leukocytes can migrate. If the stimulation of this opening is blocked, inflammation is blocked. In this review, we focus on the endothelial cell adhesion molecule, vascular cell adhesion molecule-1 (VCAM-1). Expression of VCAM-1 is induced on endothelial cells during inflammatory diseases by several mediators, including ROS. Then, VCAM-1 on the endothelium functions as both a scaffold for leukocyte migration and a trigger of endothelial signaling through NADPH oxidase-generated ROS. These ROS induce signals for the opening of intercellular passageways through which leukocytes migrate. In several inflammatory diseases, inflammation is blocked by inhibition of leukocyte binding to VCAM-1 or by inhibition of VCAM-1 signal transduction. VCAM-1 signal transduction and VCAM-1-dependent inflammation are blocked by antioxidants. Thus, VCAM-1 signaling is a target for intervention by pharmacological agents and by antioxidants during inflammatory diseases. This review discusses ROS and antioxidant functions during activation of VCAM-1 expression and VCAM-1 signaling in inflammatory diseases. Antioxid. Redox Signal. 15, 1607–1638. PMID:21050132

  12. [Long-term evaluation of spinal cord electric stimulation in peripheral vascular disease].

    Science.gov (United States)

    Duato Jané, A; Lorente Navarro, C; Azcona Elizalde, J M; Revilla Martín, J M; Marsal Machín, T; Buisán Bardají, J M

    1993-01-01

    We reported an study about the Electric Medullar Stimulation on Peripheral Vascular Pathology, in cases of critical Ischaemia of lower limbs. Short-time and longtime results are exposed. Arteriopathies included into the study were: arteriosclerosis, "mixed arteriopathy and TAO". Examination was made by Doppler-Ultrasonography.

  13. Metabolic syndrome, dysglycaemia and vascular disease: making sense of the evidence

    OpenAIRE

    Preiss, David; Sattar, Naveed

    2007-01-01

    “ ‘Diagnosis' of metabolic syndrome by any current criteria is not needed and adds little to clinical practice. Attention and resources should be focused on the major modifiable risk factors and more should be done to engender sustainable lifestyle changes in all with vascular disease”

  14. The Influence of Education and Age on Neurocognitive Test Performance in Alzheimer's Disease and Vascular Dementia

    Science.gov (United States)

    DenBesten, Nicholas P.

    2009-01-01

    This research involves an examination of the relationship between education and age on a wide array of neuropsychological test measures among patients diagnosed with Alzheimer's and vascular dementia. The purpose of this study was to investigate the role of education as an attenuating factor to neurocognitive decline in dementia. Although numerous…

  15. Under-provision of medical care for vascular diseases for people with dementia in primary care: a cross-sectional review.

    Science.gov (United States)

    Connolly, Amanda; Campbell, Stephen; Gaehl, Ella; Iliffe, Steve; Drake, Richard; Morris, Julie; Martin, Helen; Purandare, Nitin

    2013-02-01

    Vascular diseases contribute to the causation and progression of clinical dementia. To evaluate the quality of medical care for vascular diseases provided to people with dementia, the patient and practice characteristics that influence quality, and to compare care with that provided to those without dementia. Observational, cross-sectional review of primary care records of people with dementia from 52 general practices from five primary care trusts in the UK, and comparison with publicly available summary data on patients without dementia. A total of 700 patients with ≥1 diagnosed vascular disease or risk factor were identified from dementia registers. Quality of care was measured on 30 indicators from the UK Quality and Outcomes Framework (QOF) for hypertension, coronary heart disease, stroke, diabetes mellitus, atrial fibrillation, heart failure, and smoking. Overall quality of vascular care was calculated for each patient with dementia. Level of care received by people with dementia was significantly lower compared with those without dementia for 22 of 30 (73%) indicators; most notably for measurement processes such as peripheral pulses check and neuropathy testing for diabetes, and cholesterol measures for stroke. Among people with dementia, women, those in care homes, and those with fewer comorbid physical conditions and medications were associated with lower scores for overall quality of vascular care. The quality of medical care provided to people with dementia with regard to vascular diseases is not concordant with quality, as defined by the QOF. Research is needed to improve access to high-quality care.

  16. Laparoscopic treatment for retroperitoneal hyaline-vascular type localized Castleman's disease (LCD) in the iliac vessel region.

    Science.gov (United States)

    Le, Aiwen; Shan, Lili; Wang, Zhonghai; Dai, Xiaoyun; Xiao, Tianhui; Zhuo, Rong; Yuan, Rui

    2015-01-01

    To improve the understanding, diagnostic levels, and therapeutic levels of retroperitoneal hyaline vascular type LCD in the iliac vessel region. Diagnostic and therapeutic processes of 4 patients with retroperitoneal LCD in the iliac vessel region were retrospectively analyzed. The median ages of the research patients was 31.3 years old, Pelvic vascular dual-source computed tomography (CT) indicated an abnormal pelvic irregular cloddy intensity shadow with heterogeneous densities and punctate calcified lesions. The enhanced scanning showed significantly enhanced lesions and multiple tortuous vascular images inside and around the lesions. Patients' preoperative diagnoses were all "pelvic mass with unknown characteristics", and retroperitoneal masses were successfully stripped off after the laparoscopic surgery. Intra operative findings indicated 1 mass located at the left obturator nerve, 1 at the left internal iliac artery, and 2 at the right external iliac artery. The postoperative pathological reports suggest a diagnosis of Castleman's disease. Retroperitoneal LCD in the iliac vessel region is generally asymptomatic. Preoperative imaging data may help with the diagnosis, but a confirmed diagnosis depends on the results of the pathological examination. Iliac artery embolization is performed prior to laparoscopic mass stripping if the masses have abundant blood supply, while lymphadenectomy is also applied to those with enlarged lymph nodes.

  17. Calpain mediates pulmonary vascular remodeling in rodent models of pulmonary hypertension, and its inhibition attenuates pathologic features of disease

    Science.gov (United States)

    Ma, Wanli; Han, Weihong; Greer, Peter A.; Tuder, Rubin M.; Toque, Haroldo A.; Wang, Kevin K.W.; Caldwell, R. William; Su, Yunchao

    2011-01-01

    Pulmonary hypertension is a severe and progressive disease, a key feature of which is pulmonary vascular remodeling. Several growth factors, including EGF, PDGF, and TGF-β1, are involved in pulmonary vascular remodeling during pulmonary hypertension. However, increased knowledge of the downstream signaling cascades is needed if effective clinical interventions are to be developed. In this context, calpain provides an interesting candidate therapeutic target, since it is activated by EGF and PDGF and has been reported to activate TGF-β1. Thus, in this study, we examined the role of calpain in pulmonary vascular remodeling in two rodent models of pulmonary hypertension. These data showed that attenuated calpain activity in calpain-knockout mice or rats treated with a calpain inhibitor resulted in prevention of increased right ventricular systolic pressure, right ventricular hypertrophy, as well as collagen deposition and thickening of pulmonary arterioles in models of hypoxia- and monocrotaline-induced pulmonary hypertension. Additionally, inhibition of calpain in vitro blocked intracellular activation of TGF-β1, which led to attenuated Smad2/3 phosphorylation and collagen synthesis. Finally, smooth muscle cells of pulmonary arterioles from patients with pulmonary arterial hypertension showed higher levels of calpain activation and intracellular active TGF-β. Our data provide evidence that calpain mediates EGF- and PDGF-induced collagen synthesis and proliferation of pulmonary artery smooth muscle cells via an intracrine TGF-β1 pathway in pulmonary hypertension. PMID:22005303

  18. We Know More Than We Can Tell About Diabetes and Vascular Disease: The 2016 Edwin Bierman Award Lecture.

    Science.gov (United States)

    Semenkovich, Clay F

    2017-07-01

    The Edwin Bierman Award Lecture is presented in honor of the memory of Edwin L. Bierman, MD, an exemplary scientist, mentor, and leader in the field of diabetes, obesity, hyperlipidemia, and atherosclerosis. The award and lecture recognizes a leading scientist in the field of macrovascular complications and contributing risk factors in diabetes. Clay F. Semenkovich, MD, the Irene E. and Michael M. Karl Professor and Chief of the Division of Endocrinology, Metabolism and Lipid Research at Washington University School of Medicine in St. Louis, St. Louis, MO, received the prestigious award at the American Diabetes Association's 76th Scientific Sessions, 10-14 June 2016, in New Orleans, LA. He presented the Edwin Bierman Award Lecture, "We Know More Than We Can Tell About Diabetes and Vascular Disease," on Sunday, 12 June 2016.Diabetes is a disorder of abnormal lipid metabolism, a notion strongly supported by the work of Edwin Bierman, for whom this eponymous lecture is named. This abnormal lipid environment continues to be associated with devastating vascular complications in diabetes despite current therapies, suggesting that our understanding of the pathophysiology of blood vessel disease in diabetes is limited. In this review, potential new insights into the nature of diabetic vasculopathy will be discussed. Recent observations suggest that while the concept of distinct macrovascular and microvascular complications of diabetes has been useful, vascular diseases in diabetes may be more interrelated than previously appreciated. Moreover, the intermediary metabolic pathway of de novo lipogenesis, which synthesizes lipids from simple precursors, is robustly sensitive to insulin and may contribute to these complications. De novo lipogenesis requires fatty acid synthase, and recent studies of this enzyme suggest that endogenously produced lipids are channeled to specific intracellular sites to affect physiology. These findings raise the possibility that novel approaches

  19. Near-infraread spectroscopy during peripheral vascular surgery

    DEFF Research Database (Denmark)

    Schroeder, Torben Veith; Eiberg, Jonas Peter; Vogt, Katja

    1997-01-01

    Original,Near-infraread spectroscopy,Vascular disease,Vascular by-pass surgery,Perioperative oxymetry......Original,Near-infraread spectroscopy,Vascular disease,Vascular by-pass surgery,Perioperative oxymetry...

  20. Cohort study of predictive value of urinary albumin excretion for atherosclerotic vascular disease in patients with insulin dependent diabetes

    DEFF Research Database (Denmark)

    Deckert, T; Yokoyama, H; Mathiesen, E

    1996-01-01

    , smoking habits, and serum concentrations of total cholesterol, high density lipoprotein cholesterol, sialic acid, and von Willebrand factor. END POINT: atherosclerotic vascular disease assessed by death certificates, mailed questionnaires, and hospital records. RESULTS: Thirty patients developed...... was independent of age; sex; blood pressure; smoking; serum concentrations of total cholesterol, high density lipoprotein cholesterol, sialic acid, and von Willebrand factor; level of haemoglobin A(lc); insulin dose, duration of diabetes, and diabetic nephropathy (hazard ratio 1.04 (1.01 to 1.08) per 5 mg...

  1. Identify potential drugs for cardiovascular diseases caused by stress-induced genes in vascular smooth muscle cells

    Directory of Open Access Journals (Sweden)

    Chien-Hung Huang

    2016-09-01

    Full Text Available Background Abnormal proliferation of vascular smooth muscle cells (VSMC is a major cause of cardiovascular diseases (CVDs. Many studies suggest that vascular injury triggers VSMC dedifferentiation, which results in VSMC changes from a contractile to a synthetic phenotype; however, the underlying molecular mechanisms are still unclear. Methods In this study, we examined how VSMC responds under mechanical stress by using time-course microarray data. A three-phase study was proposed to investigate the stress-induced differentially expressed genes (DEGs in VSMC. First, DEGs were identified by using the moderated t-statistics test. Second, more DEGs were inferred by using the Gaussian Graphical Model (GGM. Finally, the topological parameters-based method and cluster analysis approach were employed to predict the last batch of DEGs. To identify the potential drugs for vascular diseases involve VSMC proliferation, the drug-gene interaction database, Connectivity Map (cMap was employed. Success of the predictions were determined using in-vitro data, i.e. MTT and clonogenic assay. Results Based on the differential expression calculation, at least 23 DEGs were found, and the findings were qualified by previous studies on VSMC. The results of gene set enrichment analysis indicated that the most often found enriched biological processes are cell-cycle-related processes. Furthermore, more stress-induced genes, well supported by literature, were found by applying graph theory to the gene association network (GAN. Finally, we showed that by processing the cMap input queries with a cluster algorithm, we achieved a substantial increase in the number of potential drugs with experimental IC50 measurements. With this novel approach, we have not only successfully identified the DEGs, but also improved the DEGs prediction by performing the topological and cluster analysis. Moreover, the findings are remarkably validated and in line with the literature. Furthermore

  2. The Effect of Vascular Risk Factors on the Efficacy of Rivastigmine Patch and Capsule Treatment in Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    M.R. Farlow

    2011-06-01

    Full Text Available Background: Vascular risk factors (VRF may influence response to rivastigmine in Alzheimer’s disease (AD. Methods: AD patients who participated in a randomized, double-blind, placebo-controlled trial of rivastigmine patch and capsule treatment were stratified by baseline VRF status. Treatment response was evaluated using the AD Assessment Scale-cognitive subscale (ADAS-cog, AD Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC and the AD Cooperative Study-Activities of Daily Living (ADCS-ADL scale. Results: ADAS-cog scores significantly improved in all rivastigmine-treated patients (p Conclusion: VRF may influence AD progression and response to rivastigmine.

  3. Role of actinically provoked systemic elastolysis in polymyalgic vascular disease. A study based on serum fluorescence and haptoglobin

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, J.P.; Argyle, J.C.

    This study of cutaneous elastic tissue and serum fluorescence supports the hypothesis that widespread destruction and resorption of elastic tissue (elastolysis) occurs in the temporal arteritis/polymyalgia rheumatica syndrome. A systemic elastolysis of this nature may be provoked by actinic (radiant) damage to the exposed elastic tissues in the skin and superficial arteries, the archetype of such injury being seen in temporal arteritis. Scattered giant cells are the usual agents of elastolysis but tuberculoid (sarcoid) infiltrates often take over in the later stages. In acute polymyalgia, the phenomenon probably becomes diffuse and humoral. Elastolysis may be a direct pathogenetic link between polymyalgia and other vascular diseases such as idiopathic aneurysm and atherosclerosis.

  4. Vascular endothelial growth factor B-role in metabolism, lipotoxicity and disease

    OpenAIRE

    Mehlem, Annika

    2016-01-01

    Vascular Endothelial Growth Factor B (VEGF-B) was previously shown to control lipid uptake from the bloodstream via the endothelium into tissue cells, and when ablating Vegfb, intra-tissue lipid accumulation was reduced. However, very little is known regarding the metabolic role of VEGF-B in physiologic, or pathophysiologic conditions. In paper I, we characterized the upstream regulatory mechanism controlling VEGF-B expression. We showed in vitro and in vivo that peroxisome ...

  5. How Admission to a Vascular Surgery Department Improves Medical Treatment in Patients with Lower Extremity Peripheral Arterial Disease.

    Science.gov (United States)

    Thiney, Martina; Della Schiava, Nellie; Feugier, Patrick; Lermusiaux, Patrick; Ninet, Jacques; Millon, Antoine; Long, Anne

    2017-04-01

    All patients with lower extremity peripheral arterial disease (LE-PAD) should benefit from recommended pharmacologic therapies including antiplatelet agents, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers (ARBs), and hydroxy-methyl-glutaryl-coenzyme A reductase inhibitors (statins). In the present study, this triple therapy was defined as the best medical treatment. This study was designed to determine the number of patients who received best medical treatment at admission and at discharge from a vascular surgery department. We also examined the number of patients who received adapted medical treatment and every pharmacologic class separately. Finally, we investigated whether there were differences in prescribing rates according to patient characteristics and cardiovascular history, clinical grade of LE-PAD, and the type of surgery practiced. This study is a retrospective chart analysis of 140 consecutive patients admitted to the vascular surgery department of our university hospital, between January 1, 2013, and June 30, 2013. To be included, patients required a vascular surgery for peripheral arterial disease with atherosclerosis. Data from guideline-recommended classes of medications (antiplatelet agents, ACE, ARBs, and statins) at the time of admission and discharge were collected and compared. Best medical treatment was prescribed in 44% patients before hospital admission and in 50% at discharge (P = 0.10). Before hospital admission, 84% of patients had antiplatelet therapy compared with 96% at discharge (P = 0.0004); 73% had a statin, compared with 83% at discharge (P = 0.001); 64% had an ACE inhibitor or ARB, compared with 63% at the time of discharge (P = 1).The proportion of patients receiving best medical treatment at admission and discharge increased in case of coronary artery disease (P = 0.004). There was no difference in prescriptions of best medical treatment and best or adapted treatments at admission and

  6. Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies

    Science.gov (United States)

    Diniz, Breno S.; Butters, Meryl A.; Albert, Steven M.; Dew, Mary Amanda; Reynolds, Charles F.

    2013-01-01

    Background Late-life depression may increase the risk of incident dementia, in particular of Alzheimer’s disease and vascular dementia. Aims To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer’s disease and vascular dementia in individuals with late-life depression in population-based prospective studies. Method A total of 23 studies were included in the meta-analysis. We used the generic inverse variance method with a random-effects model to calculate the pooled risk of dementia, Alzheimer’s disease and vascular dementia in older adults with late-life depression. Results Late-life depression was associated with a significant risk of all-cause dementia (1.85, 95% CI 1.67-2.04, Pvascular dementia (2.52, 95% CI 1.77-3.59, Pvascular dementia was significantly higher than for Alzheimer’s disease (P = 0.03). Conclusions Late-life depression is associated with an increased risk for all-cause dementia, vascular dementia and Alzheimer’s disease. The present results suggest that it will be valuable to design clinical trials to investigate the effect of late-life depression prevention on risk of dementia, in particular vascular dementia and Alzheimer’s disease. PMID:23637108

  7. Late-life depression and risk of vascular dementia and Alzheimer's disease: systematic review and meta-analysis of community-based cohort studies.

    Science.gov (United States)

    Diniz, Breno S; Butters, Meryl A; Albert, Steven M; Dew, Mary Amanda; Reynolds, Charles F

    2013-05-01

    Late-life depression may increase the risk of incident dementia, in particular of Alzheimer's disease and vascular dementia. To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer's disease and vascular dementia in individuals with late-life depression in population-based prospective studies. A total of 23 studies were included in the meta-analysis. We used the generic inverse variance method with a random-effects model to calculate the pooled risk of dementia, Alzheimer's disease and vascular dementia in older adults with late-life depression. Late-life depression was associated with a significant risk of all-cause dementia (1.85, 95% CI 1.67-2.04, Pvascular dementia (2.52, 95% CI 1.77-3.59, Pvascular dementia was significantly higher than for Alzheimer's disease (P = 0.03). Late-life depression is associated with an increased risk for all-cause dementia, vascular dementia and Alzheimer's disease. The present results suggest that it will be valuable to design clinical trials to investigate the effect of late-life depression prevention on risk of dementia, in particular vascular dementia and Alzheimer's disease.

  8. Medical expert system for assessment of coronary heart disease destabilization based on the analysis of the level of soluble vascular adhesion molecules

    Science.gov (United States)

    Serkova, Valentina K.; Pavlov, Sergey V.; Romanava, Valentina A.; Monastyrskiy, Yuriy I.; Ziepko, Sergey M.; Kuzminova, Nanaliya V.; Wójcik, Waldemar; DzierŻak, RóŻa; Kalizhanova, Aliya; Kashaganova, Gulzhan

    2017-08-01

    Theoretical and practical substantiation of the possibility of the using the level of soluble vascular adhesion molecules (sVCAM) is performed. Expert system for the assessment of coronary heart disease (CHD) destabilization on the base of the analysis of soluble vascular adhesion molecules level is developed. Correlation between the increase of VCAM level and C-reactive protein (CRP) in patients with different variants of CHD progression is established. Association of chronic nonspecific vascular inflammation activation and CHD destabilization is shown. The expedience of parallel determination of sVCAM and CRP levels for diagnostics of CHD destabilization and forecast elaboration is noted.

  9. Vascular Contributions in Alzheimer's Disease-Related Neuropathological Changes: First Autopsy Evidence from a South Asian Aging Population.

    Science.gov (United States)

    Wijesinghe, Printha; Shankar, S K; Yasha, T C; Gorrie, Catherine; Amaratunga, Dhammika; Hulathduwa, Sanjayah; Kumara, K Sunil; Samarasinghe, Kamani; Suh, Yoo-Hun; Steinbusch, Harry W M; De Silva, K Ranil D

    2016-10-18

    Evidence from various consortia on vascular contributions has been inconsistent in determining the etiology of sporadic Alzheimer's disease (AD). To investigate vascular risk factors and cerebrovascular pathologies associated in manifestation of AD-related neuropathological changes of an elderly population. Postmortem brain samples from 76 elderly subjects (≥50 years) were used to study genetic polymorphisms, intracranial atherosclerosis of the circle of Willis (IASCW), and microscopic infarcts in deep white matters. From this cohort, 50 brains (≥60 years) were subjected to neuropathological diagnosis using immunohistopathological techniques. Besides the association with age, the apolipoprotein E ɛ4 allele was significantly and strongly associated with Thal amyloid-β phases ≥1 [odds ratio (OR) = 6.76, 95% confidence interval (CI) 1.37-33.45] and inversely with Braak neurofibrillary tangle (NFT) stages ≥III (0.02, 0.0-0.47). Illiterates showed a significant positive association for Braak NFT stages ≥IV (14.62, 1.21-176.73) and a significant negative association for microscopic infarcts (0.15, 0.03-0.71) in deep white matters. With respect to cerebrovascular pathologies, cerebral small vessel lesions (white matter hyperintensities and cerebral amyloid angiopathy) showed a higher degree of associations among them and with AD-related neuropathological changes (p pathology (IASCW), which showed a significant association only with Braak NFT stages ≥I (p = 0.050). These findings suggest that besides age, education, and genetic factors, other vascular risk factors were not associated with AD-related neuropathological changes and urge prompt actions be taken against cerebral small vessel diseases since evidence for effective prevention is still lacking.

  10. Evaluation of magnetic resonance imaging for the differentiation of inflammatory, neoplastic, and vascular intradural spinal cord diseases in the dog.

    Science.gov (United States)

    Masciarelli, Amanda E; Griffin, John F; Fosgate, Geoffrey T; Hecht, Silke; Mankin, Joseph M; Holmes, Shannon P; Platt, Simon R; Kent, Marc; Pancotto, Theresa E; Chen, Annie V; Levine, Jonathan M

    2017-07-01

    Magnetic resonance imaging (MRI) is a common test for dogs with suspected intradural spinal cord lesions, however studies on diagnostic performance for this test are lacking. Objectives of this multi-institutional, retrospective, case-control study were to estimate sensitivity and specificity of MRI for (1) distinguishing between histopathologically confirmed intradural spinal cord disease versus degenerative myelopathy in dogs, (2) categorizing intradural spinal cord diseases as neoplastic, inflammatory, or vascular; and (3) determining tumor type within the etiologic category of neoplasia. Additional aims were to (1) determine whether knowledge of clinical data affects sensitivity and specificity of MRI diagnoses; and (2) report interrater agreement for MRI classification of intradural spinal lesions. Cases were recruited from participating hospital databases over a 7-year period. Three reviewers independently evaluated each MRI study prior to and after provision of clinical information. A total of 87 cases were sampled (17 degenerative myelopathy, 53 neoplasia, nine inflammatory, and eight vascular). Magnetic resonance imaging had excellent (>97.6%) sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data (68.6% vs. 82.4%, P = 0.023). Magnetic resonance imaging had good sensitivity (86.8%) and moderate specificity (64.7-72.5%) for diagnosing neoplasia. Sensitivity was lower for classifying inflammatory lesions but improved with provision of clinical data (48.1% vs. 81.5%, P = 0.015). Magnetic resonance imaging was insensitive for diagnosing vascular lesions (25.0%). Interrater agreement was very good for correctly diagnosing dogs with intradural lesions (ĸ = 0.882-0.833), and good (ĸ = 0.726-0.671) for diagnosing dogs with neoplasia. © 2017 American College of Veterinary Radiology.

  11. 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.

  12. Does vitamin C deficiency increase lifestyle-associated vascular disease progression? Evidence based on experimental and clinical studies.

    Science.gov (United States)

    Tveden-Nyborg, Pernille; Lykkesfeldt, Jens

    2013-12-10

    Despite continuous advances in the prevention of cardiovascular disease (CVD), critical issues associated with an unhealthy lifestyle remain an increasing cause of morbidity and mortality in industrialized countries. A growing body of literature supports a specific role for vitamin C in a number of reactions that are associated with vascular function and control including, for example, nitric oxide bioavailability, lipid metabolism, and vascular integrity. A large body of epidemiological evidence supports a relationship between poor vitamin C status and increased risk of developing CVD, and the prevalence of deficiency continues to be around 10%-20% of the general Western population although this problem could easily and cheaply be solved by supplementation. However, large intervention studies using vitamin C have not found a beneficial effect of supplementation. This review outlines the proposed mechanism by which vitamin C deficiency worsens CVD progression. In addition, it discusses problems with the currently available literature, including the discrepancies between the large intervention studies and the experimental and epidemiological literature. Increased insights into vitamin C deficiency-mediated CVD progression will enable the design of future randomized controlled trials that are better suited to test the efficacy of vitamin C in disease prevention as well as the identification of high-risk individuals which could possibly benefit from supplementation.

  13. Factors associated with low levels of subclinical vascular disease in older adults: multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Michos, Erin D; Rice, Kenneth M; Szklo, Moyses; Burke, Gregory L; Siscovick, David S; Tracy, Russell P; Barr, R Graham; Nettleton, Jennifer A; Greenland, Philip; Jacobs, David R; Post, Wendy

    2009-01-01

    Coronary artery calcium (CAC), carotid intima-media thickness (CIMT), and reduced ankle brachial indices (ABI) are markers of subclinical vascular disease strongly associated with aging. The authors identified factors associated with low levels of subclinical vascular disease in 1824 participants 70 years and older in the Multi-Ethnic Study of Atherosclerosis. A total of 452 had low CAC (0.9), and 165 had a combination index indicating favorable values for all 3 parameters. This combination index was independently associated with younger age (odds ratio [OR] 2.5 per 1 SD [95% confidence interval (CI), 1.8-3.6]), female sex (OR 3.0 [95% CI, 1.9-4.8]), lower body mass index (OR 1.6 per 1 SD [95% CI, 1.2-2.0]), absence of hypertension (OR 1.8 [95% CI, 1.2-2.6]), absence of dyslipidemia (OR 1.6 [95% CI, 1.04-2.4]), and never-smoking (OR 1.7 [95% CI, 1.1-2.6]). No significant associations were observed for C-reactive protein, education, diet, or physical activity. Favorable levels of multiple traditional risk factors, but not several novel risk factors, were associated with subclinical markers of successful cardiovascular aging. (c) 2009 Wiley Periodicals, Inc.

  14. In vivo and in vitro studies establishing haptoglobin as a major susceptibility gene for diabetic vascular disease

    Directory of Open Access Journals (Sweden)

    Rabea Asleh

    2005-04-01

    Full Text Available Rabea Asleh, Andrew P LevyFaculty of Medicine, Technion-Israel Institute of Technology, Haifa, IsraelAbstract: Hemoglobin (Hb released during hemolysis is a potent oxidant. Extracorpuscular Hb may enter the vessel wall and mediate low-density lipoprotein oxidation, thereby promoting the development and progression of atherosclerosis. Haptoglobin (Hp is an antioxidant protein as a result of its ability to bind Hb and block Hb-induced oxidative damage. Hp also facilitates the removal of Hb from the extravascular compartment via the CD163 macrophage scavenger receptor. In man, there are two common alleles for Hp denoted 1 and 2, and correspondingly, three different possible genotypes: Hp1-1, Hp2-1, and Hp2-2. We have recently demonstrated in several longitudinal studies that Hp genotype is an independent risk factor for diabetic vascular complications. Specifically, we have shown that diabetic individuals with Hp 2-2 are more likely to develop nephropathy, retinopathy, and cardiovascular disease as compared with those with Hp2-1 or Hp1-1. Mechanistically, we have found significant Hp type differences in the antioxidant and CD163-mediated scavenging and activation functions of the different Hp protein types. Furthermore, we have demonstrated that these functions are modified in the diabetic state. In this review, we focus on the clinical studies associating the Hp polymorphism and diabetic vascular complications, and the molecular basis behind this interaction.Keywords: diabetes, cardiovascular disease, haptoglobin polymorphism, hemoglobin, oxidative stress

  15. Coronary vascular disease event risk and metabolic syndrome prevalence in patients enrolled in an assertive treatment community program.

    Science.gov (United States)

    Ramudo Cela, Luis; Ávila González, María José; Yáñez Rubal, Juan Carlos; Díaz Platas, Lucía María; Martín Herranz, María Isabel; Díaz Del Valle, Juan Carlos

    2017-11-02

    To examine the risk of coronary vascular disease event (CVDE) and the prevalence metabolic syndrome (MS) and its cardiovascular risk factors (CVRF) in patients with severe mental illnesses enrolled in an assertive treatment community program (ATC) in Spain. We carried out a cross-sectional descriptive study with all of the patients included in an ATC program in 2016 in a health area with 547,328 inhabitants in Galicia, Spain. We identified the CVRF in all the individuals, and calculated MS and 10-year CVDE. We also compared the prevalence of all traits in our cohort and the general population. The 10-year median of coronary vascular disease event (CVDE10) was 8.4%. The percentage of individuals with high CVDE10 (>5%) was 41.2% The CVDE10 median was higher in men than women (10.5% vs 5.1%, penrolled in ATC programs had a 1.5-times higher prevalence of MS and 8 times higher CVDE10 than those reported in the general population. Individual CVRF were also higher in the SMD patients. Prevention, early detection, and comprehensive treatment are important issues for patients with severe mental illnesses. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Outcomes of a standardized surgical and rehabilitation program in transtibial amputation for peripheral vascular disease: a prospective cohort study.

    Science.gov (United States)

    Johannesson, Anton; Larsson, Gert-Uno; Ramstrand, Nerrolyn; Lauge-Pedersen, Henrik; Wagner, Philippe; Atroshi, Isam

    2010-04-01

    To study the outcomes of a new surgical and rehabilitation program for initial unilateral transtibial amputation in patients with peripheral vascular disease. The program consists of sagittal incision, rigid dressing, compression therapy using silicone liner, and direct manufacturing prosthetic technique. A prospective cohort study with 1-yr follow-up. Of the 217 consecutive patients with peripheral vascular disease who underwent transtibial amputation (mean age, 77 yrs; 51% diabetic; 116 could walk before amputation), 119 (55%) were fitted with a prosthesis at a median time of 41 (range, 12-147) days after amputation. Of the prosthetic recipients, 76 (64%) obtained good function with the prosthesis within 6 mos. Within 1 yr, reamputation was performed on 8.2%, and contralateral amputation was performed on 5.5%. The 90-day mortality was 24% (53 patients). The total 1-yr mortality was 40% (86 patients): 17% among patients who received a prosthesis and 67% among those who did not receive a prosthesis or had undergone reamputation. Following this standardized surgical and rehabilitation program, prosthetic fitting was achieved in more than half of transtibial amputees, almost two-thirds of prosthetic recipients obtained good function, and the reamputation rate was low. Comparison with outcomes of alternative strategies is needed.

  17. Randomized trial of the effects of cholesterol-lowering with simvastatin on peripheral vascular and other major vascular outcomes in 20,536 people with peripheral arterial disease and other high-risk conditions.

    Science.gov (United States)

    2007-04-01

    The Heart Protection Study (HPS) provides an opportunity to assess directly the effects of cholesterol-lowering therapy on major vascular events (defined as myocardial infarction, coronary death, stroke, or revascularization) in patients with peripheral arterial disease (PAD). In addition, the effects on peripheral vascular events (ie, non-coronary revascularization, aneurysm repairs, major amputations or PAD deaths) can be assessed. 6748 UK adults with PAD and 13,788 other high-risk participants were randomly allocated to receive 40 mg simvastatin daily or matching placebo, yielding an average LDL cholesterol difference of 1.0 mmol/L (39 mg/dL) during a mean of 5 years. For participants with PAD, allocation to simvastatin was associated with a highly significant 22% (95% CI 15-29) relative reduction in the rate of first major vascular event following randomisation (895 [26.4%] simvastatin-allocated vs 1101 [32.7%] placebo-allocated; P 50 (SE 7) per 1000 without pre-existing PAD. Overall, among all participants, there was a 16% (5-25) relative reduction in the rate of first peripheral vascular event following randomisation (479 [4.7%] simvastatin vs 561 [5.5%] placebo), largely irrespective of baseline LDL cholesterol and other factors. This effect chiefly reflects a 20% (8-31) relative reduction in non-coronary revascularization procedures (334 [3.3%] vs 415 [4.0%]; P = .002). HPS demonstrates the benefits of cholesterol-lowering statin therapy in patients with PAD, regardless of their presenting cholesterol levels and other presenting features. Allocation to 40 mg simvastatin daily reduces the rate of first major vascular events by about one-quarter, and that of peripheral vascular events by about one-sixth, with large absolute benefits seen in participants with PAD because of their high vascular risk. Consequently, statin therapy should be considered routinely for all patients with PAD.

  18. Patients with coronary, cerebrovascular or peripheral arterial obstructive disease differ in risk for new vascular events and mortality: the SMART study.

    Science.gov (United States)

    Achterberg, Sefanja; Cramer, Maarten J M; Kappelle, L Jaap; de Borst, Gert Jan; Visseren, Frank L J; van der Graaf, Yolanda; Algra, Ale

    2010-08-01

    Atherosclerosis causes coronary artery disease (CAD), cerebrovascular disease (CVD) or peripheral arterial obstructive disease (PAOD). The risk of new vascular events and mortality is high. Direct comparisons of vascular event rates are scarce. Vascular risk factors and outcome events of 3563 patients from a university hospital presenting with nondisabling CAD, CVD or PAOD were compared with regression analyses, adjusted for age and sex (median follow-up, 3.9 years). The primary outcome was the composite of myocardial infarction, stroke and vascular death. The risk among the three groups of outcomes was compared using the Cox regression analysis. At baseline, CAD patients were the most obese; PAOD patients smoked the most and suffered more often from hypertension and hyperlipidaemia. The average rate of vascular events was 2.5% per year; the hazard ratio (HR) of CVD/CAD was 1.7 [95% confidence interval (CI): 1.3-2.2] and PAOD/CAD was 1.8 (95% CI: 1.5-2.0). PAOD patients had a higher risk for coronary events than CAD (HR: 1.6; 95% CI: 1.2-2.1). Patients with CVD or PAOD had a higher risk for major bleeding than CAD patients (HR: 2.1; 95% CI: 1.4-3.2). Patients with a recent CVD or PAOD have almost twice the risk for future vascular events than those with CAD.

  19. Self-Management Support Program for Patients With Cardiovascular Diseases: User-Centered Development of the Tailored, Web-Based Program Vascular View

    NARCIS (Netherlands)

    Puijk-Hekman, S.; Gaal, B. van; Bredie, S.J.H.; Nijhuis-Van der Sanden, M.W.G.; Dulmen, A.M. van

    2017-01-01

    BACKGROUND: In addition to medical intervention and counseling, patients with cardiovascular disease (CVD) need to manage their disease and its consequences by themselves in daily life. OBJECTIVE: The aim of this paper is to describe the development of "Vascular View," a comprehensive,

  20. Self-management support program for patients with cardiovascular diseases: user-centered development of the tailored, web-based program vascular view.

    NARCIS (Netherlands)

    Puijk-Hekman, S.; Gaal, B.G.I. van; Bredie, S.J.; Nijhuis-van der Sanden M.W.G.; Dulmen, S. van

    2017-01-01

    Background: In addition to medical intervention and counseling, patients with cardiovascular disease (CVD) need to manage their disease and its consequences by themselves in daily life. Objective: The aim of this paper is to describe the development of “Vascular View,” a comprehensive,

  1. Doppler ultrasound findings correlate with tissue vascularity and inflammation in surgical pathology specimens from patients with small intestinal Crohn's disease.

    Science.gov (United States)

    Sasaki, Tomohiko; Kunisaki, Reiko; Kinoshita, Hiroto; Kimura, Hideaki; Kodera, Teruaki; Nozawa, Akinori; Hanzawa, Akiho; Shibata, Naomi; Yonezawa, Hiromi; Miyajima, Eiji; Morita, Satoshi; Fujii, Shoichi; Numata, Kazushi; Tanaka, Katsuaki; Tanaka, Masanori; Maeda, Shin

    2014-06-14

    Crohn's disease (CD) is routinely evaluated using clinical symptoms, laboratory variables, and the CD activity index (CDAI). However, clinical parameters are often nonspecific and do not precisely reflect the actual activity of CD small-intestinal lesions. The purposes of this prospective study were to compare color Doppler ultrasound (US) findings with histological findings from surgically resected specimens and confirm the hypothesis that color Doppler US can distinguish tissue inflammation and fibrosis. Among 1764 consecutive patients who underwent color Doppler US examinations, 10 patients with CD (12 small-intestinal CD lesions) who underwent US examinations before elective small-intestine resection were evaluated in the present study. Areas of thickened intestinal walls were evaluated in terms of blood flow using color Doppler US imaging. The blood flow was semiquantitatively classified as "hyper-flow" and "hypo-flow" according to the Limberg score. Resected lesions were macroscopically and histopathologically processed. Inflammatory cell infiltration, fibrosis and vascularity were evaluated by myeloperoxidase (granulocytes), CD163 (macrophages), CD79a (B cells), CD3 (T cells), Masson's trichrome (fibrosis), and factor VIII staining (vascular walls). All histopathological images were entered into virtual slide equipment and quantified using a quantitative microscopy integrated system (TissueMorph™). There were no significant differences in disease features or laboratory findings between "hypo-flow" lesions (n = 4) and "hyper-flow" lesions (n = 8). Histopathologically, "hyper-flow" lesions showed significantly greater bowel wall vascularity (factor VIII) (p = 0.047) and inflammatory cell infiltration, including CD163 macrophages (p = 0.008), CD3 T cells, and CD79a B cells (p = 0.043), than did "hypo-flow" lesions. There was no apparent association between the blood flow and CDAI. In this study, active CD lesions were macroscopically

  2. [Diabetes mellitus and aging as a risk factor for cerebral vascular disease: epidemiology, pathophysiology and prevention].

    Science.gov (United States)

    Cantú-Brito, Carlos; Mimenza-Alvarado, Alberto; Sánchez-Hernández, Juan José

    2010-01-01

    Older patients with diabetes have a high risk of vascular complications. They have an increase of approximately 3 times for developing stroke compared with subjects without diabetes. In addition, up to 75-80% of deaths in diabetic patients are associated with major cardiovascular events including stroke. The risk of stroke is high within 5 years of diagnosis for type 2 diabetes is 9% (mortality 21%), that is more than doubles the rate for the general population. From observational registries in a collaborative stroke study in Mexico, we analyzed clinical data, risk factors, and outcome of 1182 diabetic patients with cerebral ischemia, with focus in elderly subjects. There was a high frequency of hyperglycemia during the acute phase of stroke: the median value was 140 mg/dL and 40% had values higher than 180 mg/dL. Clinical outcome was usually unfavorable in elderly stroke patients with diabetes: case fatality rate was 30% at 30 days and survivors had moderate to severe disability, usually as consequence of the propensity to develop more systemic medical complications during hospital stay. Primary stroke prevention studies in patients with diabetes reveal that tight control of glucose is not associated with reduction in stroke risk. Therefore, proper control of other vascular risk factors is mandatory in patients with diabetes, in particular of arterial hypertension.

  3. Renin Phenotypes Characterize Vascular Disease, Autonomous Aldosteronism, and Mineralocorticoid Receptor Activity.

    Science.gov (United States)

    Hundemer, Gregory L; Baudrand, Rene; Brown, Jenifer M; Curhan, Gary; Williams, Gordon H; Vaidya, Anand

    2017-06-01

    Mild cases of autonomous aldosterone secretion may go unrecognized using current diagnostic criteria for primary aldosteronism (PA). To investigate whether the inability to stimulate renin serves as a biomarker for unrecognized autonomous aldosterone secretion and mineralocorticoid receptor (MR) activation. Six hundred sixty-three normotensive and mildly hypertensive participants, who were confirmed to not have PA using current guideline criteria and were on no antihypertensive medications. Participants had their maximally stimulated plasma renin activity (PRA) measured while standing upright after sodium restriction. Tertiles of maximally stimulated PRA were hypothesized to reflect the degree of MR activation: lowest PRA tertile = "Inappropriate/Excess MR Activity;" middle PRA tertile = "Intermediate MR Activity;"; and highest PRA tertile = "Physiologic MR Activity." All participants underwent detailed biochemical and vascular characterizations under conditions of liberalized sodium intake, and associations with stimulated PRA phenotypes were performed. Participants with lower stimulated PRA had greater autonomous aldosterone secretion [higher aldosterone-to-renin ratio (P = 0.002), higher urine aldosterone excretion rate (P = 0.003), higher systolic blood pressure (P = 0.004), and lower renal plasma flow (P = 0.04)] and a nonsignificant trend toward lower serum potassium and higher urine potassium excretion, which became significant after stratification by hypertension status. In participants without clinical PA, the inability to stimulate renin was associated with greater autonomous aldosterone secretion, impaired vascular function, and suggestive trends in potassium handling that indicate an extensive spectrum of unrecognized MR activation.

  4. Family history of vascular disease and the risk of cardiovascular events

    NARCIS (Netherlands)

    Weijmans, M.

    2015-01-01

    A positive family history of cardiovascular disease is an established risk factor for the development of cardiovascular disease. In clinical practice, this evident relation between the presence of cardiovascular disease in families and first cardiovascular events has resulted in family history being

  5. Incidence of new cardiovascular events in patients with and without peripheral arterial disease seen in a vascular surgery clinic.

    Science.gov (United States)

    Chhabra, Amit; Aronow, Wilbert S; Ahn, Chul; Duncan, Kurt; Patel, Jay D; Papolos, Alexander I; Sateesh, Babu

    2012-03-01

    To investigate the incidence of death and of new cardiovascular events at long-term follow-up of patients with and without PAD seen in a vascular surgery clinic. We investigated the incidence of death, new stroke/transient ischemic attack, new myocardial infarction, new coronary revascularization, new carotid endarterectomy, new peripheral arterial disease (PAD) revascularization, or at least one of the above outcomes at long-term follow-up of patients with and without PAD followed in a vascular surgery clinic. At least one of the above outcomes occurred in 259 of 414 patients (63%) with PAD at 33-month follow-up and in 21 of 89 patients (24%) without PAD at 48-month follow-up (pPAD and in 10 of 89 patients (11%) without PAD (p=0.002). Stepwise Cox regression analysis for the time to at least one of the 6 outcomes showed that significant independent risk factors were men (hazard ratio =1.394; 95% CI, 1.072-1.813; p=0.013), estimated glomerular filtration rate (hazard ratio =0.992; 95% CI, 0.987-0.997; p=0.003), and PAD (hazard ratio =3.520; 95% CI, 2.196-5.641; ptime to death showed that significant independent risk factors were age (hazard ratio =1.024; 95% CI, 1.000-1.049; p=0.048), estimated glomerular filtration rate (hazard ratio =0.985; 95% CI, 0.974-0.996; p=0.007), and PAD (hazard ratio =2.157; 95% CI, 1.118-4.160; p=0.022). Patients with PAD have a significantly higher incidence of cardiovascular outcomes, especially death, new PAD revascularization, and new carotid endarterectomy, than patients without PAD followed in a vascular surgery clinic.

  6. Intermittent lighting improves resilience of broilers during the peak phase of sub-clinical necrotic enteritis infection.

    Science.gov (United States)

    Rodrigues, I; Svihus, B; Bedford, M R; Gous, R; Choct, M

    2017-11-03

    Necrotic enteritis, either in its clinical or sub-clinical form is known to cause massive economic losses in the broiler chicken industry. Currently, the use of in-feed antibiotics as growth promoters is discouraged. Therefore, mechanisms to control NE through diet include reduction of digesta viscosity, promotion of lower pH in the gastrointestinal tract (GIT) through acidification of feed, production of short-chain fatty acids and overall stimulation of beneficial bacteria growth. Intermittent lighting programs increase feed retention in the crop and reduce pH in the foregut compartments in comparison with standard commercial lighting programs and therefore may be a valuable, yet underexploited, barrier to prevent the invasion of the GIT by pathogens. In this experiment, a 2 × 2 factorial arrangement of treatments was employed in a randomized design to investigate whether intermittent lighting would increase broiler resilience to sub-clinical necrotic enteritis. A total of 390 Cobb 500 same-hatch, mixed sex, day-old chicks were assigned to 30 floor pens to test the effect of 2 factors, namely, lighting schedule (continuous, 18L:6D vs. intermittent, 1L:3D:1L:3D:1L:3D:1L:3D:2L:6D) and a sub-clinical necrotic enteritis challenge (challenge vs. no challenge). Challenged birds had lower feed intake and weight gain and poorer feed conversion ratio (FCR; P < 0.005). Intermittent lighting reduced feed intake (P < 0.05) without compromising final body weight gain. During the peak phase of Clostridium perfringens Type A infection, the negative impact of the disease challenge on feed efficiency was lower for animals under intermittent lighting than for those under a 18L:6D schedule (2-way interaction, P < 0.005). Thus, in flocks that are raised under antibiotic-free production systems, intermittent lighting programs applied at least during the critical period for necrotic enteritis risks, i.e., d 18-24, may be a practical, non-medicated way to increase resilience of

  7. Reducing Sub-Clinical Symptoms of Anxiety and Depression: A Comparison of Two College Courses

    Science.gov (United States)

    Brown, Stephen; Schiraldi, Glenn R.

    2004-01-01

    Mental health has been declining among college students in recent years. Reports indicate that even sub-clinical symptoms of anxiety and depression can negatively influence life satisfaction and performance. Mental health experts are calling for more efforts to address these concerns among college and general populations. This study examined the…

  8. [Neuroradiological pattern of peripartum cerebro vascular disease medicating transfer to determine care unit].

    Science.gov (United States)

    Lakhdar, Rim; Baffoun, Nader; Hammami, Nadia; Nagi, Sonia; Baccar, Kamel; Drissi, Syrine; Kaddour, Chokri

    2012-03-01

    Pregnancy and puerperium are considered a period of a high risk of stroke responsible in a part of the morbidity and mortality in women. Imaging is the pivotal tool to diagnostics and care. To investigate the clinical and imaging features cerebrovascular complications during pregnancy and in post partum period. We report a retrospective analysis of forty four patients (November 2002 - October 2010) admitted in the intensive car department of the national institute of neurology for cerebro-vascular complications during pregnancy and in post partum period. Cerebro-vascular imaging modalities included cerebral computed tomography (CCT) with and without contrast in 94% of cases, magnetic resonance imaging (MRI) in 30.6% of cases completed by venous angiography MRI in 27.2% of cases and angiography MRI of Willis polygon in 11.3% of cases and by cerebral angiography in 13.6% of cases. Posterior reversible encephalopathy syndrome (PRES) is diagnosed in 61.4 % of cases followed by meningo-cerebral haemorrhage (MCH) in 29.5% and finally cerebral venous thrombosis (CVT) and arterial ischemia in 4.5% of cases each one. The cerebro-vascular complications are revelled in 86.3 % of the cases during the postpartum and were associated with the eclampsia or preeclampsia in 90.9 % of the cases (n=40). CCT showed typical lesions of PRES in 23 patients. It confirms the presence of hematoma in the 13 patients with MCH and find hypodense lesion in one case with ischemic stroke. CCT show direct (delta sign) and indirect signs of CVT. MRI confirms the diagnostic of PRES, when done (11 of 12 cases) and show cortical sub cortical hyper signal on T2 and FLAIR and hypo signal on T1 sequences. MRI was normal in one case. It shows hemorrhagic lesion in the 2 cases of MCH, thrombosis in the cases of CVT and ischemic lesion in the cases of ischemic stroke. CCT and MRI done within 48 hours from admission were decisive for early diagnostic and for fast and adequate care. Early recognition of stroke

  9. Assessing sub-clinical psychosis phenotypes in the general population--a multidimensional approach.

    Science.gov (United States)

    Rössler, Wulf; Ajdacic-Gross, Vladeta; Müller, Mario; Rodgers, Stephanie; Haker, Helene; Hengartner, Michael P

    2015-02-01

    Several studies have demonstrated that expression of a psychosis phenotype can be observed below the threshold of its clinical detection. To date, however, no conceptual certainty has been reported for the validity and reliability of sub-clinical psychosis. Our main objectives were to assess the prevalence rates and severity of various psychosis symptoms in a representative community sample. Furthermore, we wanted to analyze which latent factors are depicted by several currently used psychosis questionnaires. We also examined how those latent factors for sub-clinical psychosis are linked to psychosocial factors, normal personality traits, and coping abilities related to chronic stress. Most of the eight subscales from the Paranoia Checklist and the Structured Interview for Assessing Perceptual Anomalies had a very similar type of distribution, i.e., an inverse Gaussian (Wald) distribution. This supported the notion of a continuity of psychotic symptoms, which we would expect to find for continuously distributed symptoms within the general population. Sub-clinical psychosis can be reduced to two different factors - one representing odd beliefs about the world and odd behavior, and the other one representing anomalous perceptions (such as hallucinations). Persons with odd beliefs and behavior are under greater burden and more susceptible to psychosocial risks than are persons with anomalous perceptions. These sub-clinical psychosis syndromes are also related to stable personality traits. In conclusion, we obtained strong support for the notion that there is no natural cut-off separating psychotic illness from good health. Sub-clinical psychosis of any kind is not trivial because it is associated with various types of social disability. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. LOVASTATIN EFFECT ON VASCULAR REMODELING AND MYOCARDIAL SYSTOLIC AND DIASTOLIC FUNCTION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. S. Kerimkulova

    2008-01-01

    Full Text Available Aim. To study effect of 12-month therapy with lovastatin on vascular remodeling, systolic and diastolic functions of left ventricle (LV.Material and methods. 84 patients (54,3±6,5 y.o. with ischemic heart disease (IHD and dislipoproteinemia were involved in the study. Patients were randomized into 2 groups. Patients of the 1st group (n=44 received lovastatin (20-60 mg daily in addition to hypolipidemic diet and standard therapy. Patients of the 2nd group (n=39 were treated with diet and standard therapy only. Lipid spectrum and transaminase blood levels estimation, carotid duplex ultrasonography, echocardiography were performed initially and after 12 months of treatment.Results. Decrease of carotid intima-media thickness, delay of increasing of LV myocardium mass index, increase of LV ejection fraction was observed in 12 months of treatment in patients of the 1st group. There were not any changes of LV diastolic function in both groups.The conclusion. In patients with IHD and dislipoproteinemia 12 month lovastatin therapy prevents of vascular remodeling and improves LV systolic function.

  11. Vascular calcification and secondary hyperparathyroidism of severe chronic kidney disease and its relation to serum phosphate and calcium levels.

    Science.gov (United States)

    Terai, K; Nara, H; Takakura, K; Mizukami, K; Sanagi, M; Fukushima, S; Fujimori, A; Itoh, H; Okada, M

    2009-04-01

    Various complications consequent on disordered calcium and phosphate homeostasis occur frequently in chronic kidney disease (CKD) patients. Particularly, vascular calcification has high morbidity and mortality rates. There is a clear need for a better CKD model to examine various aspects of this disordered homeostasis. Oral dosing with adenine induced CKD in rats in only 10 days. Serum calcium, phosphate and parathyroid hormone were measured and calcification in aorta was assessed histologically. The effects of varying phosphorus content of diet or treatment with phosphate binders or active vitamin D(3) on these parameters were examined. After adenine dosing, significant hyperphosphatemia, hypocalcemia and secondary hyperparathyroidism (2HPT) were observed during the experimental period of 15 weeks. Aortic calcification was detected in only some of the animals even at 15 weeks (approximately 40%). Treatment with vitamin D(3) for 18 days, even at a low dose (100 ng x kg(-1), 3-4 times week(-1), p.o), caused aortic calcification in all animals and increases in serum calcium levels up to the normal range. The vitamin D(3)-induced calcification was significantly inhibited by phosphate binders which lowered serum phosphate levels and the calcium x phosphate product, although serum calcium levels were elevated. These data suggest that rats dosed orally with adenine provide a more useful model for analysing calcium/phosphate homeostasis in severe CKD. Controlling serum calcium/phosphate levels with phosphate binders may be better than vitamin D(3) treatment in hyperphosphatemia and 2HPT, to avoid vascular calcification.

  12. The Glymphatic Hypothesis of Glaucoma: A Unifying Concept Incorporating Vascular, Biomechanical, and Biochemical Aspects of the Disease

    Directory of Open Access Journals (Sweden)

    Peter Wostyn

    2017-01-01

    Full Text Available The pathophysiology of primary open-angle glaucoma is still largely unknown, although a joint contribution of vascular, biomechanical, and biochemical factors is widely acknowledged. Since glaucoma is a leading cause of irreversible blindness worldwide, exploring its underlying pathophysiological mechanisms is extremely important and challenging. Evidence from recent studies appears supportive of the hypothesis that a “glymphatic system” exists in the eye and optic nerve, analogous to the described “glymphatic system” in the brain. As discussed in the present paper, elucidation of a glymphatic clearance pathway in the eye could provide a new unifying hypothesis of glaucoma that can incorporate many aspects of the vascular, biomechanical, and biochemical theories of the disease. It should be stressed, however, that the few research data currently available cannot be considered as proof of the existence of an “ocular glymphatic system” and that much more studies are needed to validate this possibility. Even though nothing conclusive can yet be said, the recent reports suggesting a paravascular transport system in the eye and optic nerve are encouraging and, if confirmed, may offer new perspectives for the development of novel diagnostic and therapeutic strategies for this devastating disorder.

  13. The Glymphatic Hypothesis of Glaucoma: A Unifying Concept Incorporating Vascular, Biomechanical, and Biochemical Aspects of the Disease.

    Science.gov (United States)

    Wostyn, Peter; De Groot, Veva; Van Dam, Debby; Audenaert, Kurt; Killer, Hanspeter Esriel; De Deyn, Peter Paul

    2017-01-01

    The pathophysiology of primary open-angle glaucoma is still largely unknown, although a joint contribution of vascular, biomechanical, and biochemical factors is widely acknowledged. Since glaucoma is a leading cause of irreversible blindness worldwide, exploring its underlying pathophysiological mechanisms is extremely important and challenging. Evidence from recent studies appears supportive of the hypothesis that a "glymphatic system" exists in the eye and optic nerve, analogous to the described "glymphatic system" in the brain. As discussed in the present paper, elucidation of a glymphatic clearance pathway in the eye could provide a new unifying hypothesis of glaucoma that can incorporate many aspects of the vascular, biomechanical, and biochemical theories of the disease. It should be stressed, however, that the few research data currently available cannot be considered as proof of the existence of an "ocular glymphatic system" and that much more studies are needed to validate this possibility. Even though nothing conclusive can yet be said, the recent reports suggesting a paravascular transport system in the eye and optic nerve are encouraging and, if confirmed, may offer new perspectives for the development of novel diagnostic and therapeutic strategies for this devastating disorder.

  14. Laparoscopic sleeve gastrectomy reduces the predicted coronary heart disease risk and the vascular age in obese subjects.

    Science.gov (United States)

    Iancu, M; Copăescu, C; Şerban, M; Ginghină, C

    2013-01-01

    Obesity is associated with high prevalence of coronary heart disease (CHD) and long term increased cardiovascular morbi-mortality. There are no data regarding the effect of laparoscopic sleeve gastrectomy (LSG) on long-term CHD - risk. It is known that "a man is as old as his arteries" and this concept is illustrated by Framingham coronary risk score, which can predict vascular age. To assess the 10-year CHD risk in patients with obesity, preoperatively, and 6 and 12 months after LSG. 47 consecutive obese subjects (44.7% males, mean age 39.8 years) scheduled for LSG were prospectively studied before and 6 and 12 months after surgery. The 10 years CHD risk and corresponding vascular age were calculated using Framingham risk score. The body mass index (BMI) decreased from 44.6 ± 10.6 kg m2 preoperatively to 32.2 ± 6.9 kg m2 and to 29.4 ± 5.4 kg m2 at 6 and 12 months follow-up (both p 0.05). Mean excessive weight loss (EWL) was 67.3 ± 23.7% and 78.3 ± 23.4% at 6 and 12 months postoperatively. At 6 and 12 months after LSG, there was a marked improvment of lipid profile(decrease of total cholesterol, LDL-cholesterol, triglycerides and increase of HDL-cholesterol) and a significant decrease in prevalence of diabetes mellitus, systemic hypertension and smoking. The 10-year CHD risk reduced from 10.1% preoperatively to 3.5% and to 2.2% at 6 and 12 months after surgery (both p 0.05). Patients' mean vascular age was 65.6 years preoperatively and decreased to 45.8 years 6 month spostoperatively (p 0.05) and to 40.7 years one year after LSG (p 0.05 vs. 6 months postoperatively, p=NS vs.chronological age). In obese subjects, CHD risk is significantly reduced early, beginning with 6 months after LSG and is diminished with 80% one year postoperatively. Despite the fact that not all patients had achieved the ideal weight yet,mean vascular age is similar to their chronological age one year after surgery. Celsius.

  15. Identification of RNF213 as a Susceptibility Gene for Moyamoya Disease and Its Possible Role in Vascular Development

    Science.gov (United States)

    Yamazaki, Satoru; Toyoda, Atsushi; Kikuta, Ken-ichiro; Takagi, Yasushi; Harada, Kouji H.; Fujiyama, Asao; Herzig, Roman; Krischek, Boris; Zou, Liping; Kim, Jeong Eun; Kitakaze, Masafumi; Miyamoto, Susumu; Nagata, Kazuhiro; Hashimoto, Nobuo; Koizumi, Akio

    2011-01-01

    Background Moyamoya disease is an idiopathic vascular disorder of intracranial arteries. Its susceptibility locus has been mapped to 17q25.3 in Japanese families, but the susceptibility gene is unknown. Methodology/Principal Findings Genome-wide linkage analysis in eight three-generation families with moyamoya disease revealed linkage to 17q25.3 (Pmoyamoya disease in East Asian populations (251 cases and 707 controls) with an odds ratio of 111.8 (P = 10−119). Sequencing of RNF213 in East Asian cases revealed additional novel variants: p.D4863N, p.E4950D, p.A5021V, p.D5160E, and p.E5176G. Among Caucasian cases, variants p.N3962D, p.D4013N, p.R4062Q and p.P4608S were identified. RNF213 encodes a 591-kDa cytosolic protein that possesses two functional domains: a Walker motif and a RING finger domain. These exhibit ATPase and ubiquitin ligase activities. Although the mutant alleles (p.R4810K or p.D4013N in the RING domain) did not affect transcription levels or ubiquitination activity, knockdown of RNF213 in zebrafish caused irregular wall formation in trunk arteries and abnormal sprouting vessels. Conclusions/Significance We provide evidence suggesting, for the first time, the involvement of RNF213 in genetic susceptibility to moyamoya disease. PMID:21799892

  16. Vascular diseases of the liver. Clinical Guidelines from the Catalan Society of Digestology and the Spanish Association for the Study of the Liver.

    Science.gov (United States)

    Martín-Llahí, Marta; Albillos, Agustín; Bañares, Rafael; Berzigotti, Annalisa; García-Criado, M Ángeles; Genescà, Joan; Hernández-Gea, Virginia; Llop-Herrera, Elba; Masnou-Ridaura, Helena; Mateo, José; Navascués, Carmen A; Puente, Ángela; Romero-Gutiérrez, Marta; Simón-Talero, Macarena; Téllez, Luis; Turon, Fanny; Villanueva, Cándido; Zarrabeitia, Roberto; García-Pagán, Juan Carlos

    2017-10-01

    Despite their relatively low prevalence, vascular diseases of the liver represent a significant health problem in the field of liver disease. A common characteristic shared by many such diseases is their propensity to cause portal hypertension together with increased morbidity and mortality. These diseases are often diagnosed in young patients and their delayed diagnosis and/or inappropriate treatment can greatly reduce life expectancy. This article reviews the current body of evidence concerning Budd-Chiari syndrome, non-cirrhotic portal vein thrombosis, idiopathic portal hypertension, sinusoidal obstruction syndrome, hepatic vascular malformations in hereditary haemorrhagic telangiectasia, cirrhotic portal vein thrombosis and other rarer vascular diseases including arterioportal fistulas. It also includes a section on the diagnostic imaging of vascular diseases of the liver and their treatment from a haematological standpoint (study of thrombotic diathesis and anticoagulation therapy). All recommendations are based on published studies extracted from PubMed. The quality of evidence and strength of recommendations were rated in accordance with the GRADE system (Grading of Recommendations, Assessment Development and Evaluation). In the absence of sufficient evidence, recommendations were based on the opinion of the committee that produced the guide. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  17. The Kidney-Vascular-Bone Axis in the Chronic Kidney Disease-Mineral Bone Disorder.

    Science.gov (United States)

    Seifert, Michael E; Hruska, Keith A

    2016-03-01

    The last 25 years have been characterized by dramatic improvements in short-term patient and allograft survival after kidney transplantation. Long-term patient and allograft survival remains limited by cardiovascular disease and chronic allograft injury, among other factors. Cardiovascular disease remains a significant contributor to mortality in native chronic kidney disease as well as cardiovascular mortality in chronic kidney disease more than doubles that of the general population. The chronic kidney disease (CKD)-mineral bone disorder (MBD) is a syndrome recently coined to embody the biochemical, skeletal, and cardiovascular pathophysiology that results from disrupting the complex systems biology between the kidney, skeleton, and cardiovascular system in native and transplant kidney disease. The CKD-MBD is a unique kidney disease-specific syndrome containing novel cardiovascular risk factors, with an impact reaching far beyond traditional notions of renal osteodystrophy and hyperparathyroidism. This overview reviews current knowledge of the pathophysiology of the CKD-MBD, including emerging concepts surrounding the importance of circulating pathogenic factors released from the injured kidney that directly cause cardiovascular disease in native and transplant chronic kidney disease, with potential application to mechanisms of chronic allograft injury and vasculopathy.

  18. Microsecond-pulsed dielectric barrier discharge plasma stimulation of tissue macrophages for treatment of peripheral vascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Miller, V., E-mail: vmiller@coe.drexel.edu; Lin, A.; Brettschneider, J.; Fridman, G.; Fridman, A. [AJ Drexel Plasma Institute, Drexel University, Camden, New Jersey 08103 (United States); Kako, F.; Gabunia, K.; Kelemen, S.; Autieri, M. [Department of Physiology, Independence Blue Cross Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania 19140 (United States)

    2015-12-15

    Angiogenesis is the formation of new blood vessels from pre-existing vessels and normally occurs during the process of inflammatory reactions, wound healing, tissue repair, and restoration of blood flow after injury or insult. Stimulation of angiogenesis is a promising and an important step in the treatment of peripheral artery disease. Reactive oxygen species have been shown to be involved in stimulation of this process. For this reason, we have developed and validated a non-equilibrium atmospheric temperature and pressure short-pulsed dielectric barrier discharge plasma system, which can non-destructively generate reactive oxygen species and other active species at the surface of the tissue being treated. We show that this plasma treatment stimulates the production of vascular endothelial growth factor, matrix metalloproteinase-9, and CXCL 1 that in turn induces angiogenesis in mouse aortic rings in vitro. This effect may be mediated by the direct effect of plasma generated reactive oxygen species on tissue.

  19. Association of apolipoprotein E polymorphism in late-onset Alzheimer's disease and vascular dementia in Brazilians

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    D.R.S. Souza

    2003-07-01

    Full Text Available The genetic basis for dementias is complex. A common polymorphism in the apolipoprotein E (APOE gene is considered to be the major risk factor in families with sporadic and late-onset Alzheimer's disease as well as in the general population. The distribution of alleles and genotypes of the APOE gene in late-onset Alzheimer's disease (N = 68, other late-life dementias (N = 39, and in cognitively normal controls (N = 58 was determined, as also was the risk for Alzheimer's disease associated with the epsilon4 allele. Peripheral blood samples were obtained from a total of 165 individuals living in Brazil aged 65-82 years. Genomic DNA was amplified by the polymerase chain reaction and the products were digested with HhaI restriction enzyme. APOE epsilon2 frequency was considerably lower in the Alzheimer's disease group (1%, and the epsilon3 allele and epsilon3/epsilon3 genotype frequencies were higher in the controls (84 and 72%, respectively as were the epsilon4 allele and epsilon3/epsilon4 genotype frequencies in Alzheimer's disease (25 and 41%, respectively. The higher frequency of the epsilon4 allele in Alzheimer's disease confirmed its role as a risk factor, while epsilon2 provided a weak protection against development of the disease. However, in view of the unexpectedly low frequency of the epsilon4 allele, additional analyses in a more varied Brazilian sample are needed to clarify the real contribution of apolipoprotein E to the development of Alzheimer's disease in this population.

  20. Cost-effectiveness of new cardiac and vascular rehabilitation strategies for patients with coronary artery disease

    NARCIS (Netherlands)

    S. Spronk (Sandra); J.L.H.R. Bosch (Ruud); C. Ryjewski (Connie); J. Rosenblum (Judy); G.C. Kaandorp (Guido); J.V. White (John); M.G.M. Hunink (Myriam)

    2008-01-01

    textabstractObjective: Peripheral arterial disease (PAD) often hinders the cardiac rehabilitation program. The aim of this study was evaluating the relative cost-effectiveness of new rehabilitation strategies which include the diagnosis and treatment of PAD in patients with coronary artery disease

  1. Pulmonary vascular remodeling in congenital heart disease : Enhanced expression of heat shock proteins

    NARCIS (Netherlands)

    Geiger, Ralph; Sharma, Hari S.; Mooi, Wolter J.; Berger, Rolf M. F.

    2009-01-01

    In congenital heart disease (CHD), mechanical wall stress by increased pulmonary artery pressure and pulmonary blood flow is believed to play a pivotal role in the pathogenesis of pulmonary plexogenic arteriopathy (PPA). The pathogenesis of this disease that involves significant pulmonary arterial

  2. Vitamin D reduces falls and hip fractures in vascular Parkinsonism but not in Parkinson’s disease

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    Sato Y

    2013-04-01

    Full Text Available Yoshihiro Sato,1 Jun Iwamoto,2 Yoshiaki Honda,1 Nobuko Amano3 1Department of Neurology, Mitate Hospital, Tagawa, Japan; 2Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 3Department of Food and Nutrition, Tezukayama University, Nara, Japan Purpose: Vitamin D supplementation is suggested to reduce the risk of falls in older institutionalized or ambulatory individuals by 20%. The present study was undertaken to address the reduced risk, by vitamin D supplementation, of falls and hip fractures in patients with vascular Parkinsonism (VP and Parkinson’s disease (PD. Patients and methods: In the open-label-study, 94 elderly patients with VP and 92 age-matched patients with PD were followed for 2 years. All patients received 1200 IU ergocalciferol daily. The number of falls per person and incidence of hip fractures were compared between the two groups. Results: At baseline, serum 25-hydroxyvitamin D (25-OHD levels were in the deficient range (<25 nmol/L in all patients, and vitamin D treatment enhanced serum 25-OHD and 1,25-dihydroxyvitamin D levels in both groups. Improved muscle strength of lower extremities was observed in both groups. There was significant difference between the two groups in the number of falls per subject during the 2 years (1.9 ± 0.5 in the PD group and 0.8 ± 0.4 in the VP group, P < 0.001. Hip fractures occurred in seven of 88 in the PD group and one in 90 of the VP group during the 2-year study period (P = 0.035. Conclusion: It is suggested that vitamin D decreases falls and hip fractures in VP by increasing muscle strength but not in PD. Keywords: fall, hip fracture, Parkinson’s disease, vascular Parkinsonism, vitamin D

  3. Tailored Double-Barrel Bypass Surgery Using an Occipital Artery Graft for Unstable Intracranial Vascular Occlusive Disease.

    Science.gov (United States)

    Chung, Yeongu; Lee, Sung Ho; Ryu, Jiwook; Kim, Johnho; Chung, Sang Bong; Choi, Seok Keun

    2017-05-01

    This report describes the need for a tailored approach for intracranial vascular occlusive disease and introduces the usefulness of the OA as a donor artery for interposition graft. A 65-year-old male patient suffered from repeated transient ischemic attack (TIA). Imaging studies revealed complete occlusion of the proximal left side of the internal carotid artery (ICA) and multiple infarction in the watershed zone. We planned superficial temporal artery-middle cerebral artery (STA-MCA) bypass to restore cerebral blood flow and to prevent the progression of infarction. However, the parietal branch of the STA was too small in diameter and not suitable as a single donor for the bypass in order to supply sufficient blood flow. Moreover, the frontal branch of the STA had collateral channels through the periorbital anastomosis into the cerebral cortex that could result in infarction during clamping for anastomosis. We determined that tailored treatment planning was necessary for successful revascularization under these conditions. Thus, we performed a bypass between the parietal branch of the STA and a cortical branch of the MCA as an "insurance bypass." Then we performed another bypass between the frontal branch of the STA and a cortical branch of the MCA using an ipsilateral occipital artery (OA) interposition graft. The patient had no perioperative complications, and postoperative imaging confirmed the restoration of cerebral blood flow. When end-to-side anastomosis in single-branch bypass is not appropriate for cerebral revascularization, a tailored double-barrel "insurance bypass" with an OA interposed graft could be a good alternative treatment modality. In addition, an OA interposition graft is a useful option for double-barrel bypass surgery in such cases of intracranial vascular occlusive disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Native Arterio-Venous Fistula Is the Vascular Access of Choice for Hemodialysis in End Stage Renal Disease

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    Farooq Ahmad Ganie

    2013-06-01

    Full Text Available Objectives: The aim of the study was: Is primary Arterio-venous fistula the vascular access of choice for adequate dialysis and better patient outcome in end stage renal disease. Materials and Methods: The present study was done in the department of cardiovascular and thoracic surgery at Sher-i-Kashmir institute of medical sciences, Soura, Srinagar Kashmir. Native Arterio-Venous (AV fistulas were made in the patients with end stage renal disease for performing hemodialysis. They were followed for patency and adequacy of blood flow during hemodialysis. All the patients were operated under local anesthesia. Results: The results showed that 77% of the AV fistulas based on radial artery with side-to-side anastomosis and 80% of those with end-to-side anastomosis were functionally patent after one year. After two years, the patency rate in side-to-side and end-to-side anastomosis was 50% and 55%, respectively. In addition, the patency rate was 90% in brachial artery based AV fistula with end-to-side anastomosis, whether done primarily or secondarily, at the end of one year. However, a rapid decline was observed in the patency rate during the third year in both radial artery based and brachial artery based AV fistulas. Conclusions: We concluded that Arterialised arm superficial veins after primary AV fistula was the optimal and rational vascular access for hemodialysis providing adequate blood flow during this process. Besides, failure of primary AV fistula should be replaced by secondary AV fistula preferably based on brachial artery.

  5. Effect of personalized dietary intervention on nutritional, metabolic and vascular indices in patients with chronic kidney disease.

    Science.gov (United States)

    Lai, S; Molfino, A; Coppola, B; De Leo, S; Tommasi, V; Galani, A; Migliaccio, S; Greco, E A; Gnerre Musto, T; Muscaritoli, M

    2015-09-01

    Patients with chronic kidney disease (CKD) present a markedly increased cardiovascular (CV) morbidity and mortality since the early stages of the disease and a high prevalence of malnutrition, inflammation, and accelerated atherosclerosis. Personalized nutritional intervention, with of a low-protein diet (LPD), since the early stages of CKD should be able to achieve significant metabolic improvements. In our study we have verified the effects of a personalized dietary intervention in patients in the CKD stages 3/4 KDOQI on nutritional, metabolic and vascular indices. We have evaluated renal function, lipid profile, mineral metabolism, inflammatory indices, and acid-base balance of 16 patients with CKD (stages 3/4 KDOQI). Assessment of nutritional status, body composition, bone mineral density and muscle mass, using body mass index (BMI), handgrip strength, bioelectrical impedance analysis (BIA), and dual energy X-ray absorptiometry (DEXA) was performed. Vascular indices and endothelial dysfunction such as carotid intima-media thickness (cIMT) and the brachial artery flow-mediated dilation (baFMD) were also analyzed. After dietary interventions, we observed a significant increase in plasma bicarbonate (p = 0.004) and vitamin D levels (p = 0.03) and a concomitant significant reduction of phosphorus concentration (p = 0.001) and C-reactive protein (CRP) (p = 0.01). Nutritional intervention potentially plays a major role in reducing the progression of CKD and systemic complications of predialysis patients. A low-protein diet (LPD) ensuring vegetable protein intake and a reduced amount of specific micronutrients should be recommended to stage 3/4 CKD patients in order to ameliorate metabolic profile, renal outcome, and reduce cardiovascular risk factors.

  6. Editor's Highlight: PCB126 Exposure Increases Risk for Peripheral Vascular Diseases in a Liver Injury Mouse Model.

    Science.gov (United States)

    Wahlang, Banrida; Barney, Jazmyne; Thompson, Brendan; Wang, Chunyan; Hamad, Omer M; Hoffman, Jessie B; Petriello, Michael C; Morris, Andrew J; Hennig, Bernhard

    2017-12-01

    The liver is vital for xenobiotic and endobiotic metabolism. Previously, we demonstrated that a compromised liver worsened toxicity associated with exposure to polychlorinated biphenyls (PCBs), through disruption of energy homeostasis. However, the role of a compromised liver in defining dioxin-like PCB126 toxicity on the peripheral vasculature and associated inflammatory diseases is yet to be studied. This study investigated the effects of PCB126 on vascular inflammation linked to hepatic dysfunction utilizing a liver injury mouse model. Male C57Bl/6 mice were fed either an amino acid control diet (CD) or a methionine-choline deficient (MCD) diet in this 14-week study. Mice were exposed to PCB126 (0.5 mg/kg) and analyzed for inflammatory, calorimetric and metabolic parameters. MCD diet-fed mice demonstrated steatosis, indicative of a compromised liver. Mice fed the MCD-diet and subsequently exposed to PCB126 manifested lower body fat mass, increased liver to body weight ratio and alterations in hepatic gene expression related to lipid and carbohydrate metabolism, implicating metabolic disturbances. PCB126-induced steatosis irrespective of the diet type, but only the MCD + PCB126 group exhibited steatohepatitis and fibrosis. Furthermore, PCB126 exposure in MCD-fed mice led to increased plasma inflammatory markers such as Icam-1, plasminogen activator inhibitor-1 and proatherogenic trimethylamine-N-oxide, suggesting inflammation of the peripheral vasculature that is characteristic of atherosclerosis. Taken together, our data provide new evidence of a link between a compromised liver, PCB-mediated hepatic inflammation and vascular inflammatory markers, suggesting that environmental pollutants can promote crosstalk between different organ systems, leading to inflammatory disease pathologies. © The Author 2017. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. Investigation of Aβ phosphorylated at serine 8 (pAβ) in Alzheimer's disease, dementia with Lewy bodies and vascular dementia.

    Science.gov (United States)

    Ashby, Emma L; Miners, James S; Kumar, Sathish; Walter, Jochen; Love, Seth; Kehoe, Patrick G

    2015-06-01

    Deposition of amyloid beta (Aβ) in the brain is one of the defining abnormalities of Alzheimer's disease (AD). Phosphorylation of Aβ at serine 8 (pAβ) has been implicated in its aggregation in vitro and pAβ level has been shown to be significantly elevated in AD. We aimed to assess the specificity of pAβ for AD and have investigated associations of pAβ with parenchymal and cerebrovascular accumulation of Aβ, disease progression, angiotensin-converting enzyme activity and APOE genotype. The distribution of pAβ was studied by immunohistochemistry in sporadic and familial AD, pure dementia with Lewy bodies (DLB), pure vascular dementia (VaD) and age-matched controls. Soluble and insoluble (guanidine-extractable) pAβ level was measured by enzyme-linked immunosorbent assay (ELISA) in the midfrontal and parahippocampal cortex in sporadic AD (n = 20, 10 with Braak tangle stages of III-IV and 10 of stages V-VI), DLB (n = 10), VaD (n = 10) and age-matched controls (n = 20). We found pAβ to be associated with only a subset of Aβ plaques and vascular deposits in sporadic and familial AD, with absent or minimal immunohistochemically detectable pAβ in control, DLB and VaD brains. In both brain regions, insoluble pAβ level was significantly elevated only in advanced AD (Braak tangle stage of V or VI) and in the parahippocampus soluble and insoluble pAβ level increased with the number of APOE ε4 alleles. These results indicate that pAβ accumulation in the parenchyma and vasculature is largely restricted to late-stage AD (Braak tangle stage V-VI). © 2014 British Neuropathological Society.

  8. Effects of HMG-CoA reductase inhibitors on continuous post-inflammatory vascular remodeling late after Kawasaki disease.

    Science.gov (United States)

    Hamaoka, Akiko; Hamaoka, Kenji; Yahata, Tomoyo; Fujii, Maiko; Ozawa, Seiichiro; Toiyama, Kentaro; Nishida, Masashi; Itoi, Toshiyuki

    2010-09-01

    In Kawasaki disease (KD), it has been clinically and experimentally reported that post-inflammatory vascular remodeling would induce the development of arteriosclerosis or early onset of atherosclerosis in the future. The effects of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors on continuous vascular remodeling late after Kawasaki disease were clinically evaluated. We enrolled and treated a total of 11 KD patients (age range, 7-25 years) with fluvastatin (0.5-0.7 mg/kg/day) for 12 months. All of them had significant coronary aneurysmal or stenotic lesions and more than 3 of the following 5 abnormal findings: reduced %flow-mediated dilatation (%FMD), reduced urinary NOx, elevated high-sensitivity C-reactive protein (hs-CRP), reduced urinary 8-isoprostane, and elevated brachial-ankle pulse wave velocity (baPWV; control, ≤1400 cm/s). A statistically significant improvement was observed in each biomarker after fluvastatin treatment: %FMD, from 9.29% (3.41)% to 10.55% (3.27)% (p=0.003) after 3 months; NOx/creatinine (cre), from 1.16 (0.54) µmol/mg cre to 1.30 (0.50) µmol/mg cre (p=0.038) after 12 months; baPWV, from 1175.4 (277.3) cm/s to 1031.8 (155.6) cm/s (p=0.009) after 3 months; hs-CRP, from 0.073 (0.035) mg/dl to 0.028 (0.014) mg/dl (p=0.0002) after 3 months; and 8-iso/cre, from 751.8 (241.8) pg/mg cre to 660.0 (198.5) pg/mg cre (p=0.018) after 3 months. No adverse events were clinically observed in the patients. The results of this study suggested that HMG-CoA reductase inhibitors are useful as an alternative therapeutic strategy for stabilizing continuous post-inflammatory vascular remodeling that results in the development of arteriosclerosis late after KD or early onset of atherosclerosis in the future. Copyright © 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  9. Relationship of cigarette smoking with inflammation and subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    McEvoy, John W; Nasir, Khurram; DeFilippis, Andrew P; Lima, Joao A C; Bluemke, David A; Hundley, W Gregory; Barr, R Graham; Budoff, Matthew J; Szklo, Moyses; Navas-Acien, Ana; Polak, Joseph F; Blumenthal, Roger S; Post, Wendy S; Blaha, Michael J

    2015-04-01

    We sought to assess the impact of smoking status, cumulative pack-years, and time since cessation (the latter in former smokers only) on 3 important domains of cardiovascular disease: inflammation, vascular dynamics and function, and subclinical atherosclerosis. The Multi-Ethnic Study of Atherosclerosis (MESA) cohort enrolled 6814 adults without prior cardiovascular disease. Smoking variables were determined by self-report and confirmed with urinary cotinine. We examined cross-sectional associations between smoking parameters and (1) inflammatory biomarkers (high-sensitivity C-reactive protein [hsCRP], interleukin-6, and fibrinogen); (2) vascular dynamics and function (brachial flow-mediated dilation and carotid distensibility by ultrasound, as well as aortic distensibility by MRI); and (3) subclinical atherosclerosis (coronary artery calcification, carotid intima-media thickness, and ankle-brachial index). We identified 3218 never smokers, 2607 former smokers, and 971 current smokers. Mean age was 62 years and 47% were male. There was no consistent association between smoking and vascular distensibility or flow-mediated dilation outcomes. However, compared with never smokers, the adjusted association between current smoking and measures of either inflammation or subclinical atherosclerosis was consistently stronger than for former smoking (eg, odds ratio for hsCRP>2 mg/L of 1.7 [95% confidence interval, 1.5-2.1] versus 1.2 [1.1-1.4], odds ratio for coronary artery calcification>0 of 1.8 [1.5-2.1] versus 1.4 [1.2-1.6], respectively). Similar associations were seen for interleukin-6, fibrinogen, carotid intima-media thickness, and ankle-brachial index. A monotonic association was also found between higher pack-year quartiles and increasing inflammatory markers. Furthermore, current smokers with hsCRP>2 mg/L were more likely to have increased carotid intima-media thickness, abnormal ankle-brachial index, and coronary artery calcification>75th percentile for age, sex

  10. Serum Soluble Vascular-Cell Adhesion Molecule-1 (VCAM-1 in Patients with Acute and Chronic Liver Diseases

    Directory of Open Access Journals (Sweden)

    Mario Pirisi

    1996-01-01

    Full Text Available Our ai m was to ascertai n the degree of variation of serum soluble vascular cell adhesion moleculeI (VCAM-1 concentrations according to the nature and the severity of an underl ying liver disease . One-hundred forty sera collected from 123 patients (83 male, 40 female with acute hepatitis (n=14. mi Id chronic Ii ver disease (n=52 or cirrhosis (n=57 of different etiologies as well as from 17 healthy blood donors (8 male, 9 female were studied. Soluble VCAM-I concentration was measured immunoenzymatically. One-way analysis of variance revealed a significant variability of the mean values of soluble VCAM-1 among groups (F=80.02, p <0.000 I. All groups of patients had higher soluble VCAM-I than controls; moreover, patients with acute hepatitis and patients with cirrhosis had higher soluble VCAM-1 levels than patients with mild chronic liver disease (Bonferroni's test. p <0.(1. These results did not change after stratification of patients according to the etiology (viral or toxic of liver disease (two-way analysis of variance: grouping factor diagnosis, F=60.39, p <0.000 I; grouping factor etiology. F= 1.73, p NS. Cholinesterase, total bilirubin, circulating thrombocytes and blood urea nitrogen were the independent predictors of the concentration of soluble VCAM-1. In conclusion, patients with liver disease have high serum soluble VCAM-1, which seems to reflect more the severity of impairment of liver function rather than the etiologic nature of the disease.

  11. Diabetes, insulin resistance and vascular disease among Indian Asians and Europeans.

    Science.gov (United States)

    Chambers, John C; Kooner, Jaspal S

    2002-05-01

    Indian Asians account for one-fifth of all cardiovascular deaths worldwide. Cardiovascular mortality in Indian Asians overseas is higher than in indigenous populations. Diabetes, insulin resistance, and related metabolic disturbances are more common among Indian Asians than Europeans and may account for up to 70% of major Q wave ECG abnormalities in Asians. Previous studies provide evidence that genetic and environmental factors, the latter including intrauterine growth retardation, reduced physical activity, increased weight, and dietary intake, contribute to the high prevalence of diabetes and insulin resistance in Asians. The importance of conventional coronary risk factors is emphasized by studies showing higher prevalence of cigarette smoking, hypertension, and hypercholesterolemia in migrant and urban Indians compared with rural Indians. Recent studies suggest that new risk factors, including C-reactive protein, homocysteine, and lipoprotein(a), are increased among Indian Asians compared with Europeans and may contribute to part of the excess cardiovascular risk in Asians. Further work is needed to identify the precise genetic and environmental mechanisms underlying increased vascular risk in Indian Asians. Clinical strategies must be developed that identify Indian Asians at increased risk and assess the effectiveness of treatment for insulin resistance, and other cardiovascular risk factors, in this racial group.

  12. Cigarette Smoke Modulates Vascular Smooth Muscle Phenotype: Implications for Carotid and Cerebrovascular Disease

    Science.gov (United States)

    Jabbour, Pascal M.; Tjoumakaris, Stavropoula I.; Gonzalez, Fernando; Hasan, David M.; Rosenwasser, Robert H.; Owens, Gary K.; Koch, Walter J.; Dumont, Aaron S.

    2013-01-01

    Background The role of smooth muscle cell (SMC) phenotypic modulation in the cerebral circulation and pathogenesis of stroke has not been determined. Cigarette smoke is a major risk factor for atherosclerosis, but potential mechanisms are unclear, and its role in SMC phenotypic modulation has not been established. Methods and Results In cultured cerebral vascular SMCs, exposure to cigarette smoke extract (CSE) resulted in decreased promoter activity and mRNA expression of key SMC contractile genes (SM-α-actin, SM-22α, SM-MHC) and the transcription factor myocardin in a dose-dependent manner. CSE also induced pro-inflammatory/matrix remodeling genes (MCP-1, MMPs, TNF-α, IL-1β, NF-κB). CSE increased expression of KLF4, a known regulator of SMC differentiation, and siKLF4 inhibited CSE induced suppression of SMC contractile genes and myocardin and activation of inflammatory genes. These mechanisms were confirmed in vivo following exposure of rat carotid arteries to CSE. Chromatin immune-precipitation assays in vivo and in vitro demonstrated that CSE promotes epigenetic changes with binding of KLF4 to the promoter regions of myocardin and SMC marker genes and alterations in promoter acetylation and methylation. Conclusion CSE exposure results in phenotypic modulation of cerebral SMC through myocardin and KLF4 dependent mechanisms. These results provides a mechanism by which cigarette smoke induces a pro-inflammatory/matrix remodeling phenotype in SMC and an important pathway for cigarette smoke to contribute to atherosclerosis and stroke. PMID:23967268

  13. Regional vascular density-visual field sensitivity relationship in glaucoma according to disease severity.

    Science.gov (United States)

    Shin, Joong Won; Lee, Jiyun; Kwon, Junki; Choi, Jaewan; Kook, Michael S

    2017-12-01

    To study whether there are global and regional relationships between peripapillary vascular density (pVD) assessed by optical coherence tomography angiography (OCT-A) and visual field (VF) mean sensitivity at different glaucoma stages. Microvascular images and peripapillary retinal nerve fibre layer (pRNFL) thicknesses were obtained using a Cirrus OCT-A device in 91 glaucoma subjects. The pVD was measured at various spatial locations according to the Garway-Heath map, using a MATLAB software (The MathWorks, Natick, Massachusetts). VF mean sensitivity (VFMS) was recorded in the 1/L scale. Global and regional vasculature-function (pVD vs VFMS) relationships were assessed in separate patient groups at mild and moderate-to-advanced stages of glaucoma. The pVDs at superotemporal and inferotemporal regions were significantly associated with corresponding VFMS in mild glaucoma (pglaucoma, there were significant associations between pVD and VFMS, regardless of location. The association between global pVD and VFMS was significantly stronger than that between global pRNFL thickness and VFMS in moderate-to-advanced stage glaucoma (p glaucoma. OCT-A may be useful in monitoring glaucoma at various stages. © 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.

  14. Vascular biology of preeclampsia.

    Science.gov (United States)

    Myatt, L; Webster, R P

    2009-03-01

    Preeclampsia, a pregnancy-specific syndrome characterized by hypertension, proteinuria and edema, resolves on delivery of the placenta. Normal pregnancy is itself characterized by systemic inflammation, oxidative stress and alterations in levels of angiogenic factors and vascular reactivity. This is exacerbated in preeclampsia with an associated breakdown of compensatory mechanisms, eventually leading to placental and vascular dysfunction. The underlying pathology of preeclampsia is thought to be a relatively hypoxic or ischemic placenta. Both the placenta and maternal vasculatures are major sources of reactive oxygen and nitrogen species which can interact to produce peroxynitrite a powerful prooxidant that covalently modifies proteins by nitration of tyrosine residues, to possibly alter vascular function in preeclampsia. The linkage between placental hypoxia and maternal vascular dysfunction has been proposed to be via placental syncytiotrophoblast basement membranes shed by the placenta or via angiogenic factors which include soluble flt1 and endoglin secreted by the placenta that bind vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) in the maternal circulation. There is also abundant evidence of altered reactivity of the maternal and placental vasculature and of the altered production of autocoids in preeclampsia. The occurrence of preeclampsia is increased in women with preexisting vascular disease and confers a long-term risk for development of cardiovascular disease. The vascular stress test of pregnancy thus identifies those women with a previously unrecognized at risk vascular system and promotes the development of preeclampsia. Preexisting maternal vascular dysfunction intensif