Academic literature on the topic 'Cerebrovascular disease – Patients – Longitudinal studies'
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Journal articles on the topic "Cerebrovascular disease – Patients – Longitudinal studies"
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Chong, Joanna Su Xian, Hyemin Jang, Hee Jin Kim, Kwun Kei Ng, Duk L. Na, Jae Hong Lee, Sang Won Seo, and Juan Zhou. "Amyloid and cerebrovascular burden divergently influence brain functional network changes over time." Neurology 93, no. 16 (September 11, 2019): e1514-e1525. http://dx.doi.org/10.1212/wnl.0000000000008315.
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ObjectiveTo examine the effects of baseline Alzheimer disease and cerebrovascular disease markers on longitudinal default mode network (DMN) and executive control network (ECN) functional connectivity (FC) changes in mild cognitive impairment (MCI).MethodsWe studied 30 patients with amnestic MCI (aMCI) and 55 patients with subcortical vascular MCI (svMCI) with baseline Pittsburgh Compound B (PiB)–PET scans and longitudinal MRI scans. Participants were followed up clinically with annual MRI for up to 4 years (aMCI: 26 with 2 timepoints, 4 with 3 timepoints; svMCI: 13 with 2 timepoints, 16 with 3 timepoints, 26 with 4 timepoints).Resultsβ-Amyloid (Aβ) burden was associated with longitudinal DMN FC declines, while cerebrovascular burden was associated with longitudinal ECN FC changes. When patients were divided into PiB+ and PiB− groups, PiB+ patients showed longitudinal DMN FC declines, while patients with svMCI showed longitudinal ECN FC increases. Direct comparisons between the 2 groups without mixed pathology (aMCI PiB+ and svMCI PiB−) recapitulated this divergent pattern: aMCI PiB+ patients showed steeper longitudinal DMN FC declines, while svMCI PiB− patients showed steeper longitudinal ECN FC increases. Finally, using baseline PiB uptake and lacune numbers as continuous variables, baseline PiB uptake showed inverse U-shape associations with longitudinal DMN FC changes in both MCI subtypes, while baseline lacune numbers showed mainly inverse U-shape relationships with longitudinal ECN FC changes in patients with svMCI.ConclusionsOur findings underscore the divergent effects of Aβ and cerebrovascular burden on longitudinal FC changes in the DMN and ECN in the predementia stage, which reflect the underlying pathology and may be used to track early changes in Alzheimer disease and cerebrovascular disease.
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Swanwick, Gregory RJ, Michael Kirby, Robert F. Coen, Conor P. Maguire, Desmond O'Neill, Bernard J. Walsh, Davis Coakley, and Brian A. Lawlor. "Effects of co-existent cerebrovascular disease on rate of progression in Alzheimer's disease." Irish Journal of Psychological Medicine 13, no. 3 (September 1996): 91–94. http://dx.doi.org/10.1017/s0790966700002615.
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AbstractObjective: The aim of this study was to determine whether patients with possible Alzheimer's disease (AD) who do not meet criteria for vascular dementia but who nonetheless have clinical or radiographic evidence of cerebrovascular disease (CVD), differ in presentation or rate of progression from patients with probable AD.Method: Baseline cognitive and functional scores were obtained from 154 patients who had either possible or probable AD. Repeat data after a 12 month interval were obtained on 73 of these patients. Baseline data and rates of progression were compared for probable AD patients and possible AD patients with evidence of co-existent CVD.Results: The diagnostic groups did not differ at baseline with a mean mini-mental state examination (MMSE) score of 18.1. Comparison of the longitudinal data showed a mean annual drop of 4.1 points on the MMSE in both groups.Conclusions: The patients with and without evidence of co-existent CVD did not differ either at baseline or prognostically suggesting that evidence of CVD does not affect the rate of progression in AD. However, further longitudinal studies using neuropathological criteria are warranted to determine whether such data can be interpreted in favour of including possible AD cases in clinical trials of probable AD.
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Lahti, M., J. Tiihonen, H. Wildgust, M. Beary, R. Hodgson, E. Kajantie, C. Osmond, K. Räikkönen, and J. Eriksson. "Cardiovascular morbidity, mortality and pharmacotherapy in patients with schizophrenia." Psychological Medicine 42, no. 11 (March 12, 2012): 2275–85. http://dx.doi.org/10.1017/s0033291712000396.
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BackgroundPatients with schizophrenia have excess cardiovascular morbidity and mortality. Previous studies suggest that this may be partly due to inadequate somatic treatment and care, such as non-optimal use of lipid-lowering and antihypertensive pharmacotherapy, but longitudinal studies on such aetiological pathways are scarce.MethodWe investigated the use of lipid-lowering and antihypertensive pharmacotherapy, and the risk of hospitalization for and death from coronary heart disease and stroke among patients with schizophrenia in a birth cohort of 12 939 subjects (Helsinki Birth Cohort Study). This cohort was followed for over 30 adult years by using national databases on cardio- and cerebrovascular hospitalizations and mortality and on reimbursement entitlements and use of drugs for treatment of hypertension, dyslipidaemia, coronary heart disease and diabetes.ResultsIndividuals with schizophrenia had a higher risk of hospitalization for coronary heart disease [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.03–2.57], and mortality from this disease was markedly higher (HR 2.92, 95% CI 1.70–5.00), particularly among women (p=0.001 for women, p=0.008 for men). Women with schizophrenia had also marginally increased stroke mortality (p=0.06). However, patients with schizophrenia used less lipid-lowering (odds ratio 0.47, 95% CI 0.27–0.80) and antihypertensive drug treatment (HR 0.37, 95% CI 0.22–0.61).ConclusionsIn this longitudinal study, coronary heart disease morbidity was increased and coronary heart disease mortality markedly increased in patients, especially in women with schizophrenia. These patients nevertheless received less antihypertensive and lipid-lowering treatment.
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Burkauskas, J., P. Lang, A. Bunevičius, J. Neverauskas, M. Bučiūtė-Jankauskienė, and N. Mickuvienė. "Cognitive function in patients with coronary artery disease: A literature review." Journal of International Medical Research 46, no. 10 (August 29, 2018): 4019–31. http://dx.doi.org/10.1177/0300060517751452.
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Objective Cognitive function impairment is a well-documented complication of cerebrovascular disease (CBVD). Less is known about what factors affect the deterioration of cognitive function in patients with coronary artery disease (CAD). The aim of this review is to explore recent studies investigating factors associated with cognitive function in patients with CAD. Methods Studies published from 2010 to 2016 were identified through a systematic search of MEDLINE/PubMed and were included if they addressed factors affecting cognitive function in the CAD population. Results Of the 227 publications identified, 32 were selected for the review. Five factors tentatively affecting cognitive function in patients with CAD were identified: coronary artery bypass grafting (CABG) surgery, apolipoprotein E4 (APOE4) genotype, left ventricular ejection fraction (LVEF), medication use, and various hormones and biomarkers. Conclusion New techniques in CABG surgery have proven to alleviate postoperative cognitive decline. Researchers are still debating the effects of APOE4 genotype, LVEF, and the use of cardiovascular medications on cognitive function. Thyroid hormones and biomarkers are associated with cognitive function, but the exact nature of the association is debatable. Longitudinal studies should clarify those associations. In addition, cross-sectional studies addressing other causes of cognitive decline in patients with CAD are warranted.
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Di Perri, Tullio, Maurizio Guerrini, Franco Laghi Pasini, Angela Acciavatti, Daniela Pieragalli, Cinzia Galigani, Pier Leopoldo Capecchi, Alfredo Orrico, Massimo Franchi, and Patrizia Blardi. "Hemorheological Factors in the Pathophysiology of Acute and Chronic Cerebrovascular Disease." Cephalalgia 5, no. 2_suppl (May 1985): 71–77. http://dx.doi.org/10.1177/03331024850050s212.
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The hemorheologic changes in three groups of patients suffering from acute and chronic cerebrovascular diseases were studied. Firstly, a horizontal study on 57 patients with definite stroke and on 49 patients with TIA was made. Plasma viscosity, whole blood filtration rate, fibrinogen concentration and hematocrit were evaluated as markers of the rheological property of blood. Blood samples were drawn within 6 h from the onset of vascular syndrome. The findings were compared with values obtained in 112 as controls. At the same time, washed red cell filtration rate, together with lactoferrin, betaglucuronidase and beta-thromboglobulin plasma level were assayed. In both groups the onset of the vascular storm was associated with a marked increase of plasma fibrinogen and of blood and plasma viscosity and a significant decrease of whole blood filterability. Lactoferrin, betaglucuronidase and beta-thromboglobulin levels were also significantly increased. Following this, a longitudinal study was performed on 27 patients with definite stroke and 32 patients with TIA. The clinical regression of acute stroke was associated with the progressive reduction of rheological abnormalities. Finally, 81 patients with clinical diagnosis of cerebrovascular disease due to previous stroke or repeated TIA were studied together. An increase of blood viscosity, of fibrinogen concentration and of hematocrit and a decrease of blood filtration rate together with higher levels of beta-thromboglobulin were registered. These results confirm the existence of an association between CVD and hemorheological alterations and suggest more in depth research directed towards identifying the significance of these alterations in the pathogenesis of tissue ischemia. They also serve to introduce a rationale for the pharmacological and therapeutical corrections of these syndromes.
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Solmi, M., N. Veronese, B. Beatrice, R. Stella, S. Paolo, G. Davide, E. Collantoni, et al. "Prevalence, incidence and comparative meta-analysis of all-cause and specific-cause cardiovascular disease in patients with serious mental illness." European Psychiatry 41, S1 (April 2017): S319—S320. http://dx.doi.org/10.1016/j.eurpsy.2017.02.238.
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Patients with severe mental illness (SMI) have been described at higher risk of cardiovascular disease (CVD). The aim of this systematic review and meta-analysis was to quantify prevalence, incidence, cross-sectional association and longitudinal increased risk of coronary heart disease (CHD), stroke, transient ischemic attack and cerebrovascular disease (CBVD), heart failure (HF), peripheral vascular disease (PVD), death due to CVD, and any CVD in patients with SMI. We included 92 studies, with a total population of 3,371,461 patients (BD = 241,226, MDD = 476,102, SCZ = 1,721,586, SMI = 932,547) and 113,925,577 controls. Pooled prevalence of any CVD in SMI was 9.9% (95% CI = 7.4–13.3) (33 studies, 360,144 patients). Compared to controls, after adjusting for a median of 7 confounders, SMI was associated with higher risk of CVD in cross-sectional studies, OR:1.53 (95% CI = 1.27–1.83) (11 studies), with CHD OR: 1.51 (95% CI = 1.47–1.55) (5 studies), with CBVD OR: 1.42 (95% CI = 1.21–1.66) (6 studies), and tended to be associated with HF OR: 1.28 (95% CI = 0.99–1.65) (4 studies). Cumulative incidence was 3.6 CVD events in a median follow-up period of 8.4 years (range: 1.76–30). After considering a median of 6 confounders, SMI was associated with higher longitudinal risk of CVD in longitudinal studies HR: 1.78 (95% CI = 1.6, 1.98) (31 studies), of CHD: HR: 1.54 (95% CI 1.30–1.82) (18 studies), of CBVD HR: 1.64 (95% CI 1.26–2.14) (11 studies), of HF HR:2.10 (95% CI 1.64–2.70) (2 studies), of PVD, unadjusted RR: 3.11 (95% CI 2.46–3.91) (3 studies), of death due to CVD, HR 1.85 (95% CI 1.53–2.24) (16 studies). In this meta-analysis, the association between SMI and CVD has been quantified in a world representative sample; we suggest prevention of CVD should be warranted as standard care in SMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Gong, Xin, Xiaoli Wang, Tianxing Shi, Jianwei Shi, Wenya Yu, Liang Zhou, Ning Chen, Jiaoling Huang, and Zhaoxin Wang. "Disease composition and epidemiological characteristics of primary care visits in Pudong New Area, Shanghai: a longitudinal study, 2016–2018." BMJ Open 10, no. 11 (November 2020): e040878. http://dx.doi.org/10.1136/bmjopen-2020-040878.
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ObjectivesThis study aims to analyse the disease composition of primary care visits rather than specialist visits, the former of which had scarcely been studied. We adopted specific disease classification (International Statistical Classification of Diseases and Related Health Problems, 10th Revision), disease system and communicable/non-communicable/injury disease classification, and variations of sex and age were also analysed.SettingWe extracted data from all community health service centres (CHSCs) and community health service stations in Pudong, Shanghai, from 2016 to 2018 using the electronic health record systems of the Pudong health information centre.ParticipantsOur data included all 46 720 972 primary care visits from 2016 to 2018 in CHSCs in Pudong.ResultsWe found that the top five diseases in primary care visits continued to be primary hypertension, problems related to medical facilities, chronic ischaemic heart disease, unspecified diabetes mellitus and acute upper respiratory infection. Lipoprotein metabolism disorder visits continued to increase over the study years. The numbers and proportions of patients with hypertension and unspecified diabetes were higher among men than women, and other cerebrovascular diseases were higher among women than men. The top five disease systems were circulatory system diseases, respiratory system diseases, endocrine/nutritional/metabolic diseases, factors influencing health status and digestive system diseases. The rankings of respiratory system and endocrine/nutritional/metabolic diseases rose over time. Non-communicable diseases (NCDs) accounted for approximately 90% of the primary care visits—a much higher percentage than other causes. The top five NCDs in primary care visits were cardiovascular and circulatory diseases, musculoskeletal disorders, diabetes, digestive diseases and urogenital diseases. Compared with women, men suffered from cardiovascular diseases at an earlier age.ConclusionsDifferent from specialist visits, common diseases, especially NCDs, were the main disease composition of current primary healthcare visits while the former focused on intractable diseases such as tumours, indicating that primary healthcare had played the role of gatekeeper of the healthcare system.
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Sánchez Muñoz-Torrero, Juan F., Guillermo Escudero-Sánchez, Julián F. Calderón-García, Sergio Rico-Martín, Nicolás Roberto Robles, M. Asunción Bacaicoa, José N. Alcalá-Pedrajas, Guadalupe Gil-Fernández, and Manuel Monreal. "Systolic Blood Pressure and Outcomes in Stable Outpatients with Recent Symptomatic Artery Disease: A Population-Based Longitudinal Study." International Journal of Environmental Research and Public Health 18, no. 17 (September 4, 2021): 9348. http://dx.doi.org/10.3390/ijerph18179348.
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Objectives: The most appropriate targets for systolic blood pressure (SBP) levels to reduce cardiovascular morbidity and mortality in patients with symptomatic artery disease remain controversial. We compared the rate of subsequent ischemic events or death according to mean SBP levels during follow-up. Design: Prospective cohort study. FRENA is an ongoing registry of stable outpatients with symptomatic coronary (CAD), cerebrovascular (CVD) or peripheral artery disease (PAD). Setting: 24 Spanish hospitals. Participants: 4789 stable outpatients with vascular disease. Results: As of June 2017, 4789 patients had been enrolled in different Spanish centres. Of these, 1722 (36%) had CAD, 1383 (29%) CVD and 1684 (35%) PAD. Over a mean follow-up of 18 months, 136 patients suffered subsequent myocardial infarction, 125 had ischemic stroke, 74 underwent limb amputation, and 260 died. On multivariable analysis, CVD patients with mean SBP levels 130–140 mm Hg had a lower risk of mortality than those with levels <130 mm Hg (hazard ratio (HR): 0.39; 95% CI: 0.20–0.77), as did those with levels >140 mm Hg (HR: 0.46; 95% CI: 0.26–0.84). PAD patients with mean SBP levels >140 mm Hg had a lower risk for subsequent ischemic events (HR: 0.57; 95% CI: 0.39–0.83) and those with levels 130–140 mm Hg (HR: 0.47; 95% CI: 0.29–0.78) or >140 mm Hg (HR: 0.32; 95% CI: 0.21–0.50) had a lower risk of mortality. We found no differences in patients with CAD. Conclusions: In this real-world cohort of symptomatic arterial disease patients, most of whom are not eligible for clinical trials, the risk of subsequent events and death varies according to the levels of SBP and the location of previous events. Especially among patients with large artery atherosclerosis, PAD or CVD, SBP <130 mm Hg may result in increased mortality. Due to potential factors in this issue, Prospective, well designed studies are warranted to confirm these observational data.
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Wang, Chung-Yuan, Hong-Hsi Hsien, Kuo-Wei Hung, Hsiu-Fen Lin, Hung-Yi Chiou, Shu-Chuan Jennifer Yeh, Yu-Jo Yeh, and Hon-Yi Shi. "Multidiscipline Stroke Post-Acute Care Transfer System: Propensity-Score-Based Comparison of Functional Status." Journal of Clinical Medicine 8, no. 8 (August 16, 2019): 1233. http://dx.doi.org/10.3390/jcm8081233.
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Few studies have investigated the characteristics of stroke inpatients after post-acute care (PAC) rehabilitation, and few studies have applied propensity score matching (PSM) in a natural experimental design to examine the longitudinal impacts of a medical referral system on functional status. This study coupled a natural experimental design with PSM to assess the impact of a medical referral system in stroke patients and to examine the longitudinal effects of the system on functional status. The intervention was a hospital-based, function oriented, 12-week to 1-year rehabilitative PAC intervention for patients with cerebrovascular diseases. The average duration of PAC in the intra-hospital transfer group (31.52 days) was significantly shorter than that in the inter-hospital transfer group (37.1 days) (p < 0.001). The intra-hospital transfer group also had better functional outcomes. The training effect was larger in patients with moderate disability (Modified Rankin Scale, MRS = 3) and moderately severe disability (MRS = 4) compared to patients with slight disability (MRS = 2). Intensive post-stroke rehabilitative care delivered by per-diem payment is effective in terms of improving functional status. To construct a vertically integrated medical system, strengthening the qualified local hospitals with PAC wards, accelerating the inter-hospital transfer, and offering sufficient intensive rehabilitative PAC days are the most essential requirements.
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Yeh, Wen-Shuo, Shih-Cheng Yang, Chih-Ming Liang, Yu-Chi Li, Wei-Chen Tai, Chen-Hsiang Lee, Yao-Hsu Yang, et al. "The Role of Non-Selective β-Blockers in Compensated Cirrhotic Patients without Major Complications." Medicina 56, no. 1 (December 30, 2019): 14. http://dx.doi.org/10.3390/medicina56010014.
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Background and Objectives: Non-selective β-blockers (NSBB) could prevent decompensation and hepatocellular carcinoma (HCC) in cirrhotic patients with clinically significant portal hypertension (CSPH), but remained uncertain for compensated cirrhotic patients without major complications. We aimed to compare the clinical outcomes between propranolol users and non-users of a CC group without major complications. Material and Methods: We conducted this population-based cohort study by using the Taiwanese Longitudinal Health Insurance Database 2000. Propranolol users (classified as cumulative defined daily dose (cDDD)) and non-PPL users were matched with a 1:1 propensity score in both cohorts. Results: This study comprised 6896 propranolol users and 6896 non-propranolol users. There was no significant impact on the development of spontaneous bacterial peritonitis between the two groups (aHR: 1.24, 95% confidence interval (CI): 0.88~1.75; p = 0.2111). Male gender, aged condition, and non-liver related diseases (peripheral vascular disease, cerebrovascular disease, dementia, pulmonary disease, and renal disease) were the independent risk factors of mortality. PPL users had significantly lower incidence of HCC development than non-users (aHR: 0.81, p = 0.0580; aHR: 0.80, p = 0.1588; and aHR: 0.49, p < 0.0001 in the groups of 1–28, 29–90, and >90 cDDD, respectively). Conclusion: The current study suggested that high cumulative doses of propranolol could decrease the risk of hepatocellular carcinoma among compensated cirrhotic patients without major complications. Further large-scale prospective studies are still required to confirm the findings in this study. Results: It remained uncertain whether non-selective β-blockers (NSBB) could prevent decompensation and hepatocellular carcinoma (HCC) in compensatory cirrhotic patients without major complications. This study aimed to compare the clinical outcomes between propranolol users and non-users of the CC group without major complications.
Dissertations / Theses on the topic "Cerebrovascular disease – Patients – Longitudinal studies"
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Scannell, Alice Updike. "The Longterm Psychosocial Impacts of Caregiving on the Caregivers of Persons with Stroke." PDXScholar, 1989. https://pdxscholar.library.pdx.edu/open_access_etds/1312.
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This study is a Time 4 (T4) follow-up interview of ninety-three caregivers of persons who experienced a first stroke between 2 to 4 years (mean = 36 months) prior to the T4 interview. The first wave of data collection occurred within two months after the stroke. The second and third waves occurred six and twelve months, respectively, after the first interview. The caregivers were identified by the person with stroke as being the person closest to him/her who would be responsible for care after the stroke.
Data were gathered at all four interviews using reliable and valid measures for depressive symptomatology (CES-D; Radloff, 1977), psychological well-being (IPWB; Berkman, 1971), and caregiver burden (Zarit, 1980). The contribution of social support to caregiver well-being was also investigated. Additional areas of investigation at T4 included coping strategies (F-Copes; McCubbin, Larsen, and Olson, 1981), caregiver adjustment, and the respondents' perception of themselves as "caregivers".
The mean scores of depressive symptomatology, perceived burden, negative well-being, and positive well-being did not change significantly over the four points in time. However, the percentage of the sample having CES-D levels of 16 and above (indicating potential diagnosis of clinical depression) decreased by ten percent between T1 and T4. About ten percent of the respondents who were at risk for clinical depression at T4 reported high levels of depressive symptoms at all four interviews.
Respondents who specifically thought of themselves as "caregivers" (sixty-two percent) were significantly more likely to report high levels of depressive symptoms, to experience high levels of strain and caregiver burden, and to be caring for persons who were more severely impaired by the stroke than those who did not.
Caregiver characteristics contributed more to the variance in depressive symptoms and psychological well-being than did characteristics of the stroke. However, depressive symptomatology and perceived burden were significantly associated with both the functional capacity of the person with stroke and with an index of stroke severity comprised of communication impairments and negative personality/behavior changes since the stroke.
The findings from this study have implications for stroke management programs, caregiver intervention planning, and health care policy.
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Ross, Amy Psychiatry Faculty of Medicine UNSW. "Longitudinal study of cognitive and functional brain changes in ageing and cerebrovascular disease, using proton magnetic resonance spectroscopy." Awarded by:University of New South Wales. School of Psychiatry, 2005. http://handle.unsw.edu.au/1959.4/27329.
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The neurophysiological basis of cognition changes with age is relatively unexplained, with most studies reporting weak relationships between cognition and measures of brain function, such as event related potentials, brain size and cerebral blood flow. Proton magnetic resonance spectroscopy (1H-MRS) is an in vivo method used to detect metabolites within the brain that are relevant to certain brain processes. Recent studies have shown that these metabolites, in particular N-acetyl aspartate (NAA), which is associated with neuronal viability, correlate with performance on neuropsychological tests or other measures of cognitive function in patients with a variety of cognitive disorders associated with ageing and in normal ageing subjects. We have studied the relationship between metabolites and cognitive function in elderly patients 3 months and 3 years after a stroke or transient ischemic attack (TIA) and in an ageing comparison group. Metabolites were no different between stroke/TIA patients and elderly controls, however, there were significant metabolite differences between stroke/TIA patients with cognitive impairment (Vascular Cognitive Impairment and Vascular Dementia) and those without. Frontal measures of NAA and NAA/Cr predicted cognitive decline over 12 months and 3 years in stroke/TIA patients and elderly controls, and these measures were superior predictors than structural MRI measures. Longitudinal stability of metabolites in ageing over 3 years was associated with stability of cognitive function. The results indicate that 1H-MRS is a useful tool in differentiating stroke/TIA patients with and without cognitive impairment, with possibly superior predictive ability than structural MRI for assessing future cognitive decline. The changes in 1H-MRS that occur with ageing and cognitive decline have implications for the neurophysiological mechanisms and processes that are occurring in the brain, as well as application to clinical diagnosis, the early detection of pathology and the examination of longitudinal change.
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Rau, Marie Therese. "Elderly stroke patients and their partners: a longitudinal study of social support and well-being changes associated with a disabling stroke." PDXScholar, 1986. https://pdxscholar.library.pdx.edu/open_access_etds/478.
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This investigation explored the relationship of demographic, social network, social support, and stroke-related factors to depressive symptomatology and well-being in 50 elderly individuals who had recently suffered a first, completed stroke and their partners. Data were gathered at two points in time, with interviews scheduled six months apart. Outcome measures included the CES-D depression scale and the Index of Psychological Well-Being. Data were analyzed using descriptive statistics, correlational procedures, multiple regression, and change-focused regression analyses. For the caregivers, lower depression levels at Time 1 were associated with better subjective health, less concern about being able to care for the patient in the future, higher levels of patient ADL functioning, greater perceived pre-stroke instrumental support, and greater patient optimism. At Time 2, lower caregiver depression scores were associated with lower levels of perceived burden, fewer health problems or negative changes in health status, fewer negative network interactions, greater network density, greater frequency of network contacts, and fewer perceived personality and behavior changes in the patient. Best predictors of depression score for the caregivers at Time 1 were subjective health rating, the patient's level of ADL functioning, degree of concern about ability to care for the patient in the future, the proportion of the network providing instrumental support, and the percent of reciprocal confiding relationships reported. At Time 2, best predictors of depression were level of perceived caregiver burden, objective health score, and network density. The best predictor of caregiver depression level over time was Time 1 depression level. Perceived caregiver burden was also a strong predictor of depression score. For the patients, higher depression scores at Time 1 were associated with whether they felt they could have done anything to prevent the stroke, higher levels of concern about their partner's ability to care for them in the future, and greater reported frequency of pre-stroke disagreement with their partners. At Time 2, higher levels of depressive symptomatology were associated with decreased satisfaction with amount of social contact, a greater proportion of friends in the post-stroke network, a greater degree of perceived negative health change, and change in employment status.
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Man, Lai-mei, and 文麗媚. "An exploratory study for the health seeking pattern of stroke survivors on alternative medicine." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31978617.
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Goodall, William Christopher. "Neuropsychological studies of reading and writing." Thesis, University of Stirling, 1994. http://hdl.handle.net/1893/59.
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This thesis investigates the reading and writing of two patients with brain injuries due to cerebro-vascular accidents. Background tests show both patients to be moderately anomic and to have severe impairments in reading and writing nonwords. Investigations of the locus of impairment in AN's nonword reading showed her to have normal orthographic analysis capabilities but impairments in converting single and multiple graphemes into phonemes and in phonemic blending. The central issue studied was the role of lexical but non-semantic processes in reading aloud, writing to dictation and copying. For this purpose a "familiar nonword" paradigm was developed in which the patients learned to read or write a small set of nonwords either with or without any associated semantics. Both AN and AM were able to learn to read nonwords to which no meanings were attached but they could still not read novel nonwords. Both patients were unable to report any meanings for the familiar nonwords when they read them and there was no evidence that learning to read them improved their sub-lexical processing abilities. These results are evidence for a direct lexical route from print to sound that is dedicated to processing whole familiar words. It was also shown with AN that if nonwords are given meanings then learning is faster than if they are not given meanings. Experiments designed to test the hypothesis that nonwords are read by analogy to words found no support for it. Both patients have severe impairments in writing novel nonwords to dictation. As they can repeat spoken nonwords after they have failed to write them, this is not due to a short-term memory impairment. Despite their nonword writing impairments, both patients were able to write to dictation the meaningless nonwords that they had previously learned to read at the first attempt, and AN did so one month after learning to read them. Neither patient however, could write novel nonwords made by reordering the letters of the familiar nonwords. Furthermore, the familiar nonwords used spellings that are of a priori low probability. The familiar nonwords must therefore have been written using lexical knowledge. Tests of semantic association showed that the familiar nonwords evoked no semantic information that the patients could report. Function words dictated to AN evoked little semantic information but she wrote them to dictation significantly better than nonwords made by reordering their letters. These results are evidence for a direct lexical route for writing to dictation. Copying was studied both with and without a five second delay between presentation and response. AN was better at delayed copying of meaningless but familiar nonwords than she was at copying novel nonwords. She was also better at delayed copying of six-letter, bi-syllabic nonwords that she had been trained to copy than she was at copying novel nonwords made by recombining the first and second halves of the familiar nonwords such that these halves retained their positions from the parent nonwords. AN was better at copying function words than nonwords made by reordering their letters. She was also better at copying function words than she was at reading or writing them to dictation. These results are evidence for a direct lexical route for copying. AN and AM were both able to write to dictation nonwords that they had never heard or written before but with which they had been made visually familiar during a visual discrimination task. They must have used lexical knowledge to do so because the spellings used were of a priori very low probability. The creation of lexical orthographic information which can be retrieved from novel auditory input raises difficulties for current models and various possible interpretations are discussed. Finally, some of the possible implications of the re-learning abilities shown by these patients, for rehabilitation procedures are discussed briefly.
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Hultdin, Johan. "Homocysteine in cardiovascular disease with special reference to longitudinal changes." Doctoral thesis, Umeå : Medical Biosciences, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-529.
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Waterfall, A. Christine. "Needs of caregivers of stroke survivors." Virtual Press, 2002. http://liblink.bsu.edu/uhtbin/catkey/1246469.
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Stroke is a medical event that has serious consequences for the survivor, his family, and society. Stroke is the third leading cause of death in the United States, and two-thirds of stroke survivors are permanently disabled with one-half of these survivors considered severely impaired. The economic burden from stroke is estimated to be $30 billion annually in health care costs and lost productivity.This study described the needs of 35 caregivers of stroke survivors within 24 hours of discharge to home from an acute care "safety net" teaching hospital in Indiana and how well those needs were met. Two subscales, (a) the Need for Information and (b) Patient Care Needs, of the Home Caregiver Need Survey were used. The theoretical framework for this study was the Neuman Systems Model.The stroke survivors were over 50 years old (77.1 %), half were African-American and half were Caucasian, and about a quarter were minimally impaired (25.8%) and less than a quarter were very impaired (22.9%) cognitively and/or physically upon discharge to home. Their caregivers were their children (48.6%) or spouses (28.6%), half of whom worked full-time outside the home. Most (85.7%) caregivers were female, in good health, and with no experience (81.8%) in caring for patients at home.School of Nursing
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Chen, Wenjia. "Longitudinal studies of disease progression, health care costs and health-related quality of life in patients with asthma." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/59297.
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This thesis examines the burden of asthma and its determinants though a series of longitudinal observational studies. Objectives: 1) To quantify the natural history of severe asthma and the impact of early risk factors; 2) To examine the influence of socioeconomic status (SES) on excess direct medical costs of moderate-to-severe asthma and guideline-based asthma care; 3) To estimate excess costs of asthma and the economic implications of comorbidities; 4) To assess the joint influences of asthma control and comorbidity on health-related quality of life. Methods: For the first three objectives, administrative health data (for the period of 1997-2013) were obtained from British Columbia (BC) Ministry of Health, and for the last objective data were obtained from the Economic Burden of Asthma (EBA) study in BC. Various models for longitudinal data were applied for each objective. Findings: 1) Most patients (83%) with incident severe asthma transitioned to milder states after 10 years. Low SES and comorbidity at disease onset led to worse long-term prognosis. 2) Across both individual- and neighborhood-levels, there was evidence that low-SES asthma patients and/or their care providers did not follow guideline-based asthma care and subsequently incurred substantially greater excess costs of asthma. 3) Excess costs in patients with asthma were $1187/year (95%CI $1130─$1243) overall, with comorbidity-attributable costs five times higher than asthma-attributable costs, all of which greatly increased with age. 4) Changes in asthma control had a greater effect on disease-specific (AQ5D) than generic (EQ5D) utilities, whereas changes in comorbidity burden had a larger impact on EQ5D than AQ5D utilities. Conclusions: With several novel methodology techniques, this thesis provided evidence for the first-time on the long-term trajectory and burden of asthma. Projection of cost and effectiveness of decisions and policies in asthma care requires a robust understanding of the natural history of asthma, effect of risk factors on this trajectory, and estimates of costs and health-related quality of life associated with asthma. This thesis provides new evidence on all such parameters. These findings have direct relevance to estimating cost-effectiveness of health technologies in asthma and can result in more informed decision-making in health policy and clinical practice.Pharmaceutical Sciences, Faculty of
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Dreyer, Sonette. "An investigation into the immediate effect of patellar taping on knee control in patients with adult acquired hemiplegia due to stroke." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/1671.
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Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2009.The ability to walk has been rated by stroke patients as one of the most important goals of their rehabilitation. Knee control is a key element in normal gait. Currently, treatment options aimed at improving poor knee control in stroke patients are often costly, need specialised equipment and have poor patient compliance. The purpose of the current study was to assess whether medial patellar taping could improve knee control in stroke patients. Gait speed, dynamic standing balance, knee alignment and whether the subjects experienced any subjective stabilising effect on the knee after taping were tested. Twenty subjects diagnosed with hemiplegia after a stroke served as their own controls in a repeated measures experimental study. Results indicated that dynamic standing balance as tested by the Step Test (p=0.063) and the Timed-up-and-go test (p=0.099) (Wilcoxon test) showed marginal improvement after taping. This improvement in dynamic standing balance may indicate that neuro-motor control and/or eccentric knee control had improved. There was no change in walking speed and knee alignment as tested by change in the Q-angle (Wilcoxon test). However, a decrease in the Q-angle correlated with an improvement in dynamic standing balance as tested by the Step Test (p=0.029) (Spearman‟s test). Participants with decreased Q-angles after taping possibly had better knee alignment and were more willing to accept weight on their affected leg indicating a change in quadriceps activation. No change in walking speed (p=0.351) (Wilcoxon test) before and after taping may indicate that there was no change in the magnitude of contraction and/or concentric activity in the quadriceps muscle. Thirty percent of the participants reported a subjective change in knee stability after taping. Subjective change did not, however, significantly correlate with either of the balance tests, walking speed or Q-angle measurements. The possibility that medial patellar taping may be useful in treating poor knee control in stroke patients during dynamic balance activities should be investigated further.
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Clements, Meredith L. "Chemotherapy-Induced Alopecia and Quality-of-Life: Ovarian and Uterine Cancer Patients and the Aesthetics of Disease." Scholar Commons, 2017. http://scholarcommons.usf.edu/etd/6815.
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This study is an examination of ovarian and uterine cancer patients’ perceptions of chemotherapy-induced alopecia and how it impacts quality-of-life over the course of chemotherapy. The chapters in this dissertation address the following research questions: How do ovarian and uterine cancer patients communicate about their experiences of alopecia over the course of chemotherapy? How does chemotherapy-induced alopecia influence patients’ understandings of quality-of-life? Longitudinal interviews were conducted with a patient population of twenty-three, and each patient was interviewed at least twice over the course of chemotherapy. The data set was composed of fifty-five interviews, and a thematic analysis was performed across interview transcripts.
Analysis of the data revealed four themes: 1) chemotherapy-induced alopecia and quality-of-life; 2) the “mirror moment”; 3) performance of social roles; and 4) gendered visibility. Data indicate ovarian and uterine cancer patients experienced substantial daily distress related to chemotherapy-induced alopecia. The ability to perform social roles deemed important to patients’ quality-of-life such as the familial roles of partner and mother/grandmother were negatively impacted by hair loss. Patients’ distress concerning alopecia was strongly connected to the ability to function in the public sphere without feeling approachable or being approached by “strangers” because of their alopecia.
Clinicians might consider repeatedly asking about chemotherapy-induced alopecia over the course of chemotherapy, both because it could help patients cope with the side effect and because it may generate dialogue related to other important concerns late-stage cancer patients may feel are too trivial to mention in clinical discussions. Women’s social and familial roles may be impacted by alopecia and chemotherapy in unique ways that deserve additional study.
Books on the topic "Cerebrovascular disease – Patients – Longitudinal studies"
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Feldenkrais, Moshé. Body awareness as healing therapy: The case of Nora. Berkeley, Calif: North Atlantic Books/Frog, 1993.
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Lindmark, Birgitta. Evaluation of functional capacity after stroke with special emphasis on motor function and activities of daily living. Uppsala: Uppsala University, 1988.
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Feldenkrais, Moshe. Body awareness as healing therapy: The case of Nora. Berkeley, Calif: North Atlantic Books/Frog, 1993.
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Cognitive and perceptual dysfunction: A clinical reasoning approach to evaluation and intervention. Philadelphia: F.A. Davis, 1999.
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National LTC Resource Center (U.S.), ed. Family care in the year after a stroke or a hip fracture: Highlights of an in-depth study. Minneapolis, Minn: The Center, 1996.
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Family care in the year after a stroke or a hip fracture: Highlights of an in-depth study. Minneapolis, Minn: National LTC Resource Center, University of Minnesota, Institute for Health Services Research, School of Public Health, 1996.
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Banerjee, Amitava, and Kaleab Asrress. Screening for cardiovascular disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0351.
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Screening involves testing asymptomatic individuals who have risk factors, or individuals who are in the early stages of a disease, in order to decide whether further investigation, clinical intervention, or treatment is warranted. Therefore, screening is classically a primary prevention strategy which aims to capture disease early in its course, but it can also involve secondary prevention in individuals with established disease. In the words of Geoffrey Rose, screening is a ‘population’ strategy. Examples of screening programmes are blood pressure monitoring in primary care to screen for hypertension, and ultrasound examination to screen for abdominal aortic aneurysm. The effectiveness and feasibility of screening are influenced by several factors. First, the diagnostic accuracy of the screening test in question is crucial. For example, exercise ECG testing, although widely used, is not recommended in investigation of chest pain in current National Institute for Health and Care Excellence guidelines, due to its low sensitivity and specificity in the detection of coronary artery disease. Moreover, exercise ECG testing has even lower diagnostic accuracy in asymptomatic patients with coronary artery disease. Second, physical and financial resources influence the decision to screen. For example, the cost and the effectiveness of CT coronary angiography and other new imaging modalities to assess coronary vasculature must be weighed against the cost of existing investigations (e.g. coronary angiography) and the need for new equipment and staff training and recruitment. Finally, the safety of the investigation is an important factor, and patient preferences and physician preferences should be taken into consideration. However, while non-invasive screening examinations are preferable from the point of view of patients and clinicians, sometimes invasive screening tests may be required at a later stage in order to give a definitive diagnosis (e.g. pressure wire studies to measure fractional flow reserve in a coronary artery). The WHO’s principles of screening, first formulated in 1968, are still very relevant today. Decision analysis has led to ‘pathways’ which guide investigation and treatment within screening programmes. There is increasing recognition that there are shared risk factors and shared preventive and treatment strategies for vascular disease, regardless of arterial territory. The concept of ‘vascular medicine’ has gained credence, leading to opportunistic screening in other vascular territories if an individual presents with disease in one territory. For example, post-myocardial infarction patients have higher incidence of cerebrovascular and peripheral arterial disease, so carotid duplex scanning and measurement of the ankle–brachial pressure index may be valid screening approaches for arterial disease in other territories.
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AlJaroudi, Wael. Risk Assessment Before Noncardiac Surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0014.
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Perioperative risk assessment is essential in screening patients before noncardiac surgery. Cardiovascular complications such as fatal and non-fatal myocardial infarction (MI), ventricular arrhythmia, pulmonary edema, and stroke are important in-hospital causes of morbidity and mortality intra and post-operatively. The optimal approach is to identify patients at increased risk so that appropriate testing and therapeutic interventions are undertaken a priori to minimize such risk. The initial preoperative evaluation includes identification of surgery-specific risk, patient exercise functional capacity and clinical risk profile. Patients with major predictors of events such as acute coronary syndromes, recent MI, unstable arrhythmia, and severe valvular disease warrant further management and optimization that often lead to delaying surgery. Those with three or more predictors (history of ischemic heart disease, compensated heart failure, diabetes, renal insufficiency, or history of cerebrovascular disease) undergoing high- risk surgery often require stress testing. Although data from randomized prospective trials are lacking, numerous studies have demonstrated the utility of myocardial perfusion imaging (MPI) for determination of perioperative cardiac risk. The goal of this chapter is to review the use of MPI for preoperative risk assessment and the recommendations from the current guidelines. The focus will be on short-term and long-term prognosis including special groups such as after coronary stenting and before vascular surgery, liver and renal transplantation.
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Eder, Lihi. The clinical course and outcome of psoriatic arthritis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198737582.003.0021.
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In contrast to early reports, it is now appreciated that psoriatic arthritis (PsA) can present as a destructive, progressive, and disabling arthritis with consequences as severe as those of rheumatoid arthritis. Longitudinal cohort studies of PsA patients contributed important knowledge about long-term outcomes, such as development of structural joint damage, remission achievement, and physical function. These studies identified predictors for improved outcomes including male gender and lower burden of inflammation at presentation while delayed diagnosis, disability, and joint damage are associated with worse long-term outcomes. These findings suggest early diagnosis and aggressive control of inflammation are important as they may prevent the occurrence of subsequent joint damage. The latter is strongly correlated with long-term outcomes, such as reduced physical function and increased mortality. Development of prediction models using clinical measures, laboratory biomarkers, and imaging is warranted to stratify patients with early disease into risk groups for long-term outcomes.
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Lameire, Norbert. Renal outcomes of acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0238_update_001.
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This chapter summarizes the accumulating evidence that incomplete or even apparent complete recovery of renal function after acute kidney injury (AKI) may be an important contributor to a growing number of incident chronic kidney disease (CKD) and end-stage renal disease (ESRD) cases, largely in excess of the global growth in CKD prevalence. Evidence based on epidemiologic studies supports the notion that even after adjustment for several important covariates AKI is independently associated with an increased risk for both CKD and ESRD. Several risk factors for the subsequent development of CKD among survivors of AKI have been identified. Besides well-known risk factors for CKD in general, such as hypertension, older age, congestive heart failure, diabetes, and proteinuria, AKIN staging and duration also predict longitudinal CKD development. These characteristics may identify a category of at-risk AKI patients at the time of hospital discharge that will need long follow-up times for appropriate screening and surveillance measures for CKD.
Book chapters on the topic "Cerebrovascular disease – Patients – Longitudinal studies"
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Piepgras, A., P. Schmiedek, G. Leinsinger, R. L. Haberl, C. M. Kirsch, and K. M. Einhäupl. "Follow-up Studies of Cerebrovascular Reserve Capacity in Patients with Cerebrovascular Disease." In Stimulated Cerebral Blood Flow, 263–67. Berlin, Heidelberg: Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77102-6_29.
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Przybyszewski, Andrzej W., Stanislaw Szlufik, Piotr Habela, and Dariusz M. Koziorowski. "Multimodal Learning Determines Rules of Disease Development in Longitudinal Course with Parkinson’s Patients." In Studies in Big Data, 235–46. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-77604-0_17.
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Tangri, Navdeep, and Claudio Rigatto. "Longitudinal Studies 5: Development of Risk Prediction Models for Patients with Chronic Disease." In Methods in Molecular Biology, 145–56. New York, NY: Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4939-2428-8_8.
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Tangri, Navdeep, and Claudio Rigatto. "Longitudinal Studies 5: Development of Risk Prediction Models for Patients with Chronic Disease." In Methods in Molecular Biology, 179–91. New York, NY: Springer US, 2021. http://dx.doi.org/10.1007/978-1-0716-1138-8_10.
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Compston, J. E., S. J. S. Ryde, R. J. Motley, E. O. Crawley, W. D. Evans, and W. D. Morgan. "Longitudinal Study of Total Body Calcium Measurements in Patients with Inflammatory Bowel Disease: Correlations with Quantitative CT and Single Photon Absorptiometry." In In Vivo Body Composition Studies, 75–78. Boston, MA: Springer US, 1990. http://dx.doi.org/10.1007/978-1-4613-1473-8_10.
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Müller, Andreas, and Martin Meier. "Assessment of Renal Volume with MRI: Experimental Protocol." In Methods in Molecular Biology, 369–82. New York, NY: Springer US, 2021. http://dx.doi.org/10.1007/978-1-0716-0978-1_21.
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AbstractRenal length and volume are important parameters in the clinical assessment of patients with diabetes mellitus, kidney transplants, or renal artery stenosis. Kidney size is used in primary diagnostics to differentiate between acute (rather swollen kidneys) and chronic (rather small kidney) pathophysiology. Total kidney volume is also an established biomarker in studies for the treatment of autosomal dominant polycystic kidney disease (ADPKD). There are several factors influencing kidney size, and there is still a debate on the value of the measured kidney size in terms of renal function or cardiovascular risk. The renal volume is most often calculated by measuring the three axes of the kidney, on the assumption that the organ resembles an ellipsoid. By default, the longitudinal and transverse diameters of the kidney are measured. In animal models renal length and volume1 are also important parameters in the assessment of organ rejection after transplantation and in determination of kidney failure due to renal artery stenosis, recurrent urinary tract infections, or diabetes mellitus. In general total kidney volume (TKV) is a valuable parameter for predicting prognosis and monitoring disease progression in animal models of human diseases like polycystic kidney disease (PKD) or acute kidney injury (AKI) and chronic kidney disease (CKD).This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This analysis protocol is complemented by two separate chapters describing the basic concept and experimental procedure.
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Quigley, Naomi, and Ruth-Aoibheann O’Leary. "Postoperative Cerebrovascular Injury." In Cardiothoracic Critical Care, 307–12. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190082482.003.0032.
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This chapter studies perioperative stroke, which is defined as an ischemic or hemorrhagic infarction that occurs either during surgery or in the first 30 postoperative days. Risk factors for perioperative stroke can be categorized as patient- and procedure-related. Preoperative carotid endarterectomy should be considered particularly in patients with symptomatic disease or tight stenosis. Given the patient and procedural risk factors, there is a high index of suspicion for perioperative stroke. Timely computed tomography angiogram is key to diagnosis as it can overrule intraparenchymal hemorrhage and demonstrate large-vessel occlusion. Thrombectomy may be considered in the first 12 hours following symptom onset, especially in posterior circulation strokes. Meanwhile, anticoagulation in this setting requires multidisciplinary input due to the risk of hemorrhagic transformation but is likely safe 14 days post-stroke.
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"A Survey of Transesophageal Echocardiography." In 50 Studies Every Anesthesiologist Should Know, edited by Anita Gupta, Elena N. Gutman, Michael E. Hochman, Anita Gupta, Elena N. Gutman, and Michael E. Hochman, 65–68. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190237691.003.0013.
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This case focuses on the use of cardiac stents vs. coronary artery bypass surgery for severe coronary artery disease by asking the question: Should patients with severe coronary artery disease (three-vessel and/or left main disease) be treated with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)? For patients with three-vessel and/or left main coronary artery disease, CABG reduced rates of major cardiovascular and cerebrovascular events compared with PCI. This difference was largely driven by a reduction in the need for repeat revascularization procedures among patients receiving CABG. Patients who received PCI had a lower rate of stroke, however, which may make PCI an attractive option for some patients. In addition, the authors suggest that patients with less complex coronary artery disease (as assessed using the SYNTAX score) may be particularly good candidates for PCI, but this hypothesis requires further validation.
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Penman, Alan D., Kimberly W. Crowder, and William M. Watkins. "Botulinum A Toxin Injection as a Treatment for Blepharospasm." In 50 Studies Every Ophthalmologist Should Know, 275–78. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190050726.003.0045.
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In this chapter a case series is described of the use of botulinum A toxin for the treatment of blepharospasm in thirty-nine patients with blepharospasm due to various causes—essential, Meige’s syndrome, hand apraxia, cerebrovascular disease, and parkinsonism. A reduction of abnormal movement occurred in all patients, lasting up to 170 days. Both the amount and the duration of effect were dose dependent. Tearing, dry-eye symptoms, or transient ptosis occurred in 20% of injections, especially in patients who had had previous eyelid surgery. Botulinum A toxin injection into the orbicularis oculi muscle was found to be a safe, simple, and symptomatically helpful treatment for blepharospasm that can be repeated at intervals as required.
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Thomas, Gregory S., and Myrvin H. Ellestad. "Sports Medicine and Cardiac Rehabilitation for Coronary and Peripheral Artery Disease Patients." In Ellestad's Stress Testing, edited by Gregory S. Thomas, L. Samuel Wann, and Myrvin H. Ellestad, 495–516. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190225483.003.0026.
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The chapter Sports Medicine and Cardiac Rehabilitation for Coronary and Peripheral Artery Disease (CAD) reviews the benefits and potential risks of physical activity and the opportunity for particular benefit in patients with coronary artery disease and peripheral artery disease (PAD). Longitudinal studies of large populations have found a benefit to habitual exercise on cardiovascular health, including decreasing cardiovascular mortality. A physiologic training effect is not required for benefit. Mild exercise is better than inactivity and increasing activity provides even greater benefit. Athletic training induces expected electrocardiographic changes at rest in athletes. Prescribing exercise with or without an exercise test is discussed in asymptomatic individuals as well as prior to participation in traditional cardiac rehabilitation or a supervised exercise program for patients with peripheral artery disease. PAD patients often do not have classic intermittent claudication yet are able to benefit from exercise therapy.
Conference papers on the topic "Cerebrovascular disease – Patients – Longitudinal studies"
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Backhouse, EV, SD Shenkin, A. McIntosh, I. Deary, M. Bastin, S. de Rooij, T. Roseboom, and JM Wardlaw. "P53 Birth and childhood factors and late life cerebrovascular disease: an analysis of 3 longitudinal cohort studies." In Society for Social Medicine, 61st Annual Scientific Meeting, University of Manchester, 5–8 September 2017. BMJ Publishing Group Ltd, 2017. http://dx.doi.org/10.1136/jech-2017-ssmabstracts.154.
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Dupay, A., P. Snyder, W. Lee, and S. Baek. "Surface Parameterization of an Abdominal Aortic Aneurysm to Characterize Geometrical Evolution During Longitudinal Study of Patients." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80737.
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For an abdominal aortic aneurysm (AAA) in vivo there are multiple tissues contacting its boundary, none of which have been fully considered for their effect throughout disease progression. Trends such as arterial asymmetry, surface curvature flattening, and arterial tortuosity could be significantly influenced by both surrounding tissue and hemodynamic factors. In order to quantify either the combined or separate influence of such factors during disease progression a precise characterization of aneurysm geometry evolution is needed. Multiple methods for geometrical parameterization of abdominal aortic aneurysms (AAAs) have been previously developed using isolated patient CT scan data but the focus has been mainly on the association of such geometrical parameters with the rupture risk and the efficacy of the parameterization is not fully investigated for a longitudinal study yet (multiple CT scans per patient at progressive intervals) [1]. For this study we have produced a series of 3D models for AAAs in longitudinal studies, developed an arterial centerline generation algorithm, and automated a geometric parameterization procedure for the arterial surfaces. It should be noted that the caliber of our collection of data is relatively rare as it is high resolution, features many patients, and on average has 4–5 images per patient.
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Belch, J. J. F., A. Zoma, I. M. Richards, K. McLaughlin, R. D. Sturrock, and C. D. Forbes. "VASCULAR DAMAGE AND FACTOR VIII RELATED ANTIGEN IN THE RHEUMATIC DISEASES." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644088.
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F. VIII is produced by the blood vessel wall. Noxious stimuli increase endothelial release of F. VIII Related Antigen (VIII R:Ag). It might be expected that the development of vasculitis would be associated with increased levels of VIII R:Ag. Eight patient groups have been studied; 25 patients with systemic sclerosis, 19 with systemic lupus erythematosus, 15 with rheumatoid arthritis (RA) plus vasculitis, 19 with systemic vasculitis and 14 with atherosclerosis. These were compared to 29 patients with primary Raynaud's Disease, 15 with RA without vasculitis and 50 controls. Results show that where there was evidence of vascular disease, VIII R:Ag was elevated.VIII R:Ag appeared a more specific marker for vascular damage than ESR or CRP. Further longitudinal studies in 11 patients showed good correlation between progression of vascular disease and VIII R:Ag.
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Jaghargh, Ehsan Rajabi, Prabir Roy-Chaudhury, Paul Succop, and Rupak K. Banerjee. "A Longitudinal Assessment of Wall Shear Stress Variation on Arteriovenous Fistula Maturation." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53541.
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Arteriovenous (AV) fistula is the most preferred form of vascular access for end-stage renal disease patients. Acute changes in hemodynamics and in particular wall shear stress (WSS) immediately after fistula placement are followed by the dilation of the vasculature luminal area to recover the normal physiological condition before surgery. However, vasodilation in AV fistula is not well understood and thus, the major goal of this study is to assess the longitudinal effect of wall shear stress on fistula maturation. Six AV fistulae with curved (n = 3) and straight (n = 3) configurations are created between the femoral artery and vein of three Yorkshire pigs. Anatomical configuration and flow measurements are performed at 2D (D: days), 7D, and 28D post-surgery. It is shown that fistulae with relatively higher baseline axial WSS may result in better maturation as compared to the ones with lower levels of baseline axial WSS. This finding is novel and hasn’t been reported in previous studies. Moreover, it is found that the longitudinal variation of WSS is also of high importance in prediction of the maturation of AV fistula. Fistulae whose mean axial WSS decreases over time achieve larger mean area, and therefore, favorable remodeling, while an increasing trend of axial WSS is detrimental to fistulae maturation. Also, it is found that curved fistula as compared to the straight configuration results in larger luminal area over time and thus, is the preferred form of AV fistula.