Journal articles on the topic 'Peripheral vascular diseases Diagnosis'
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Nakashima, Rieko, and Yoshinori Inoue. "3. Vascular Laboratory and Diagnosis of Peripheral Arterial Diseases." Nihon Naika Gakkai Zasshi 97, no. 2 (2008): 304–8. http://dx.doi.org/10.2169/naika.97.304.
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Хрыщанович, В. Я. "Diagnosis and Management of Peripheral Artery Diseases." Кардиология в Беларуси, no. 3 (July 13, 2020): 390–408. http://dx.doi.org/10.34883/pi.2020.12.3.009.
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Распространенность заболеваний периферических артерий (ЗПА) во всем мире достигает порядка 200 миллионов человек. Самым частым клиническим проявлением ЗПА является перемежающая хромота, возникающая вследствие недостаточного кровоснабжения пораженной конечности. В настоящем обзоре литературы обобщены и систематизированы последние достижения в области диагностики и лечения пациентов с перемежающей хромотой. Тщательный сбор анамнеза и физикальное обследование являются первоочередными мероприятиями для установления предварительного диагноза и направлены на дифференциацию сосудистых и нейрогенных причин перемежающей хромоты. Лодыжечно-плечевой индекс относится к наиболее часто используемым методам скрининга и диагностики ЗПА. Основу лечения составляют четыре взаимодополняющих подхода: немедикаментозное и лекарственное лечение для купирования симптомов хронической ишемии, фармакотерапия для вторичной профилактики сердечно-сосудистых осложнений, открытая или эндоваскулярная реваскуляризация для увеличения дистанции безболевой ходьбы. Недавнее исследование COMPASS продемонстрировало преимущества комбинированного применения 2,5 мг ривароксабана дважды в день и аспирина в части снижения уровня неблагоприятных сердечно-сосудистых событий, при этом отмечался более высокий риск геморрагических осложнений. На сегодняшний день цилостазол является единственным препаратом, обладающим доказанной терапевтической эффективностью в отношении перемежающей хромоты. Программы лечебной физкультуры под наблюдением врача либо в домашних условиях способствуют улучшению коллатерального кровообращения и увеличивают дистанцию ходьбы без боли. Назначение высоких доз статинов и антитромбоцитарных препаратов абсолютно обосновано всем пациентам с ЗПА. Ингибиторы ангиотензин-превращающего фермента обеспечивают дополнительное снижение кардиоваскулярных рисков, в особенности у пациентов с сахарным диабетом и артериальной гипертензией. The prevalence of peripheral artery disease (PAD) worldwide reaches about 200 million people. The most frequent clinical manifestation of PAD is intermittent claudication, which occurs due to insufficient blood supply to the affected limb. This literature review summarizes and systematizes recent advances in the diagnosis and treatment of patients with intermittent claudication.Thorough case history collection and physical examination are the primary measures for making a preliminary diagnosis, which is aimed at differentiating the vascular and neurogenic causes of intermittent claudication. The ankle-shoulder index is one of the most commonly used methods for screening and diagnosing PAD. The basis of treatment consists of four complementary approaches: non-pharmacological and pharmacological treatment for the relief of symptoms of chronic ischemia, pharmacotherapy for the secondary prevention of cardiovascular complications, open or endovascular revascularization to increase the distance of pain-free walking. A recent COMPASS study demonstrated the benefits of combining 2.5 mg of rivaroxaban twice daily with aspirin in reducing adverse cardiovascular events, however there was a higher risk of hemorrhagic complications. Today, cilostazol is the only drug with proven therapeutic effectiveness against intermittent claudication. Physical therapy programs under the supervision of a doctor or at home help to improve collateral blood circulation and increase the walking distance without pain. The administration of high doses of statins and antiplatelet drugs is absolutely justified in all patients with PAD. Angiotensin converting enzyme inhibitors provide an additional reduction in cardiovascular risks, especially in patients with diabetes and hypertension.
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Heidrich. "Frequency of non-vascular accompanying diseases in patients with peripheral arterial disease." Vasa 33, no. 3 (August 1, 2004): 155–58. http://dx.doi.org/10.1024/0301-1526.33.3.155.
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Background: Since there are so far no relevant figures on the frequency of non-vascular associated diseases in patients with peripheral arterial disease (PAD), an analysis was carried out to determine how frequently co-morbidity is found in such patients. Patients and methods: In the course of a retrospective analysis, 1693 patients (55.4% men, 44.6% women/average 68.6 years) with peripheral arterial diseases (PAD) of Fontaine stage II to IV were examined to find out how often cardiopulmonary, gastrointestinal, haematological, endocrinological, neurological, orthopaedic, urological-nephrological, psychiatric diseases and tumours were seen. Result: Coronary ischaemic heart disease was present in 63.1% of the cases, heart failure existed in 20.7%, hypertension in 57.9%, endocrine and metabolic diseases in 60.4%, gastrointestinal diseases in 14.8%, pulmonary diseases in 14.5%, psychological and behavioural deficiencies in 16.2%, orthopaedic diseases in 21.6%, haematological diseases in 9.0%, urological diseases in 16.9%, chronic renal insufficiency in 7.3% and malignant tumours in 5.8%. Conclusions: The frequency of non-vascular co-morbidity in patients with PAD necessitates systematic interdisciplinary diagnosis prior to any therapy decision to take into account the patient’s associated diseases, life expectancy and current quality of life.
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Szabó, Katalin Judit, Róza Ádány, József Balla, Zoltán Balogh, Zoltán Boda, István Édes, István Fekete, et al. "Advances in the prevention, diagnosis and therapy of vascular diseases." Orvosi Hetilap 153, no. 13 (April 2012): 483–98. http://dx.doi.org/10.1556/oh.2012.29340.
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Atherosclerosis is a systemic disease affecting the coronary, carotid, intracerebral, renal and peripherial arteries. The early morphological and functional impairments could be detected in the second or third decades of life and their progression depend on the number and severity of risk factors and individual susceptility. Although the vascular risk factors (smoking, overweight, age, unhealthy diet, lack of physical exercise, hypertension, diabetes mellitus, chronic kidney disease and dyslipidemia) are the same and common in the different vascular diseases, the present clinical routine artificially classifies the diagnosis and therapy of different vascular diseases into different subfields of medicine with the negative impact of possible polypragmasia. Recently, worldwide health surveys (e.g. REACH registry) have proven the usefulness of a holistic approach in the diagnosis and therapy of multiorgan-affected vascular patients. This review summarizes the multidisciplinary advances and future perspective of vascular diseases. Orv. Hetil., 2012, 153, 483–498.
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Kolesov, S. N. "Thermosemiotic raynaud’s phenomenon for gastrointestinal pathology in children." Medical alphabet 1, no. 8 (March 14, 2019): 51–57. http://dx.doi.org/10.33667/2078-5631-2019-1-8(383)-51-57.
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The results of long-term thermal imaging (TI) studies of local peripheral vegetative-vascular disorders in children with diseases of the gastrointestinal tract are summarized. TI cntena for the diagnosis of different variants of Raynaud's phenomenon depending on the gender and age of patients are formulated.
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Nishikawa, Yuriko, Osamu Fukayama, Takayuki Hoshino, Naondo Takido, and Kunihiko Mabuchi. "Analysis of the Blood Flow in the Finger Tip for the Diagnosis of Peripheral Vascular Diseases." IEEJ Transactions on Electronics, Information and Systems 136, no. 12 (2016): 1779–84. http://dx.doi.org/10.1541/ieejeiss.136.1779.
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Chkheidze, Rati, and Peter Pytel. "What Every Neuropathologist Needs to Know: Peripheral Nerve Biopsy." Journal of Neuropathology & Experimental Neurology 79, no. 4 (March 18, 2020): 355–64. http://dx.doi.org/10.1093/jnen/nlaa012.
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Abstract Peripheral neuropathy is a common disorder with many possible etiologies including metabolic diseases, inflammatory conditions, infections, malignancy, inherited diseases, drugs, and toxins. In most instances, diagnosis and treatment plan can be established based on clinical presentation, family history, laboratory results, genetic testing, and electrophysiological studies. But in some situations, a peripheral nerve biopsy remains a valuable tool. This is especially true in patients with rapidly progressive disease, with atypical presentation or for whom other approaches fail to yield a definitive diagnosis. The pathologic examination starts with basic decisions about specimen triage. A few basic questions help to provide an initial framework for the assessment of a nerve biopsy—is the specimen adequate; are there inflammatory changes; are there vascular changes; is there amyloid; are there changes to axonal density and the Schwann cell-myelin-axon unit. In the appropriate context and with such an approach peripheral nerve biopsies can still represent a clinically helpful test.
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Editorial, Article. "2017 ESC GUIDELINES ON THE DIAGNOSIS AND TREATMENT OF PERIPHERAL ARTERIAL DISEASES, IN COLLABORATION WITH THE EUROPEAN SOCIETY FOR VASCULAR SURGERY (ESVS)." Russian Journal of Cardiology, no. 8 (September 9, 2018): 164–221. http://dx.doi.org/10.15829/1560-4071-2018-8-164-221.
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Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries.Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS)
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Hammoud, Ahmad, Alexey Tikhomirov, Galina Myasishcheva, Zein Shaheen, Alexander Volkov, Andrey Briko, and Sergey Shchukin. "Multi-Channel Bioimpedance System for Detecting Vascular Tone in Human Limbs: An Approach." Sensors 22, no. 1 (December 26, 2021): 138. http://dx.doi.org/10.3390/s22010138.
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Vascular tone plays a vital role in regulating blood pressure and coronary circulation, and it determines the peripheral vascular resistance. Vascular tone is dually regulated by the perivascular nerves and the cells in the inside lining of blood vessels (endothelial cells). Only a few methods for measuring vascular tone are available. Because of this, determining vascular tone in different arteries of the human body and monitoring tone changes is a vital challenge. This work presents an approach for determining vascular tone in human extremities based on multi-channel bioimpedance measurements. Detailed steps for processing the bioimpedance signals and extracting the main parameters from them have been presented. A graphical interface has been designed and implemented to display the vascular tone type in all channels with the phase of breathing during each cardiac cycle. This study is a key step towards understanding the way vascular tone changes in the extremities and how the nervous system regulates these changes. Future studies based on records of healthy and diseased people will contribute to increasing the possibility of early diagnosis of cardiovascular diseases.
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Antonenko, L. M., N. V. Vakhnina, and D. O. Gromova. "Cognitive impairment, dizziness, and unsteadiness in hypertensive patients." Neurology, Neuropsychiatry, Psychosomatics 12, no. 5 (October 25, 2020): 92–97. http://dx.doi.org/10.14412/2074-2711-2020-5-92-97.
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Hypertension is a widespread disease related to modifiable vascular risk factors for stroke and chronic cerebrovascular diseases. The pathogenetic basis of brain damage in hypertension is cerebral microangiopathy that leads to vascular cognitive impairment (CI), instability, and falls. Microcirculatory changes in the presence of hypertension at the initial stages of cerebrovascular disease occur without visible clinical manifestations of brain damage. Pathogenetically justified treatment used at an early stage of the disease makes it possible to achieve good results in the prevention of vascular brain damage. An important aspect of selecting effective therapy is the competent diagnosis of the causes of dizziness and instability, which can be caused not only by brain damage, but also by peripheral vestibular system diseases. Early diagnosis of vascular CI, selection of adequate therapy, and prevention of their further progression are of great importance. The studies performed have shown the high efficacy of vinpocetine (Cavinton®) that has a multifactorial mechanism of action in the treatment and prevention of CI, dizziness, and instability caused by cerebrovascular disease.
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Linnemann, Birgit, and Matthias Erbe. "Raynauds phenomenon - assessment and differential diagnoses." Vasa 44, no. 3 (May 4, 2015): 0166–77. http://dx.doi.org/10.1024/0301-1526/a000426.
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Raynauds phenomenon (RP) is characterised by paroxysmal reversible episodes of vasospasm, usually involving peripheral small vessels of the fingers or toes and resulting in a triple-colour change starting with pallor and followed by cyanosis and erythema. Attacks are typically triggered by cold or emotional stress. The diagnosis of RP can be made on the basis of the patients clinical symptoms. Primary RP occurs without underlying disease and is considered a benign condition. A normal erythrocyte sedimentation rate, negative testing for antinuclear antibodies, normal nailfold capillaries and the absence of structural micro- or macrovascular damage and other diseases lead to the diagnosis of primary RP. Digital photoplethysmography and pulse contour analysis can be used as an additional tool to exclude structural macro- or microvascular disease. In contrast, secondary RP is associated with other diseases, mainly connective tissue diseases such as systemic sclerosis. If there is a suspicion of secondary RP, a thorough laboratory and vascular assessment is required to make the diagnosis of underlying disease. Acrocyanosis and erythromelalgia are additional functional vascular disorders that can be easily distinguished when patients are carefully assessed for their history and clinical symptoms.
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Krupatkin, A. I. "Functional Studies of Peripheral Circulation and Tissue Microcirculation in Traumatology and Orthopedics: Opportunities and Perspectives." N.N. Priorov Journal of Traumatology and Orthopedics 7, no. 1 (February 25, 2000): 66–69. http://dx.doi.org/10.17816/vto101540.
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Based on the long-term experience the necessity of angiologic investigations in traumatology and orthopedics is defined. Classification of the modern instrumental methods for the examination of peripheric blood circulation and tissular microcirculation of locomotor system is suggested. The main perspective directions of the investigations are defined. They include the study of angiologic peculiarities in injuries and orthopedic diseases, diagnosis of pre- and postoperative vascular disturbances, their prevention and treatment.
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Ulanovskaya, Ekaterina V., Victor V. Shilov, Aleksandr A. Kovshov, Tatyana A. Zolotareva, Natalia A. Ladogubets, and Nadezhda I. Kuprina. "Early diagnosis of the upper extremities vessels occupational diseases in machine-building workers." Russian Journal of Occupational Health and Industrial Ecology 62, no. 8 (September 28, 2022): 520–25. http://dx.doi.org/10.31089/1026-9428-2022-62-8-520-525.
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The economic development of the State depends on the work of the able-bodied population. The cardiovascular system is highly reactive and reacts to many harmful production factors: noise, vibration, ionizing radiation, etc. Spastic vascular changes are the precursors of peripheral angiodistonic syndrome, which is part of the symptom complex of vibration disease, and accompanies polyneuropathy from physical overstrain. Detection of the disease at the initial stage of development for the appointment of timely prevention and treatment is the main task of modern medicine. Ultrasound examination, as one of the imaging methods in radiation diagnostics, successfully copes with this problem. The study aims to develop criteria for early diagnosis of occupational pathology of the vessels of the upper extremities in workers of machine-building production. We have examined 126 workers of the machine-building plant using standard clinical and laboratory methods, ultrasound examination of the vessels of the upper extremities and X-ray examination of the hands. The main harmful production factors in the workplace were local and general vibration, the severity of the labor process, noise. The severity of the labor process of at least class 3.1 with a work experience of 21 years contributed to the development of spastic changes in the vessels of the upper extremities in power engineering workers. Patients complained in 25% of cases, although an objective examination by a neurologist revealed no pathological changes characteristic of the pathology of the vascular bed. There were radiological changes in the hands in 83% of the examined workers and manifested as a violation of local circulation: cyst-like rearrangement in the bones of the wrists were in 40% of cases, in the form of periarticular osteopenia - in 70% of cases. The most informative method of early diagnosis of vascular changes in the main arteries of the upper extremities is ultrasound. At the same time, the characteristic signs are an increase in the resistance index with the preservation of speed indicators (recorded in 100% of cases), a violation of venous outflow in 82%, pathological vascular tortuosity in 76%. Ethics. The Local Ethics Committee of the North-Western Scientific Center of Hygiene and Public Health has approved the study, Protocol No. 23.1 of 10/28/2020.
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Golovach, I. Yu, and Ye D. Yehudina. "Peripheral nervous system lesion in systemic vasculitis - issues of diagnosis and treatment." Terapevticheskii arkhiv 91, no. 12 (December 15, 2019): 63–69. http://dx.doi.org/10.26442/00403660.2019.12.000206.
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Vasculitis is a clinically diverse group of diseases with histopathological signs of blood vessel inflammation, which contributes to vascular damage and ischemic damage to the affected tissues. Vasculitic neuropathy is a common complication of the primary systemic vasculitides, such as polyartertis nodosa and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, systemic diseases of the connective tissue - systemic lupus erythematosus and Sjogren syndrome, vasculitis associated with infection, most often viral hepatitis C and B and non - systemic vasculitis neuropathy. Vessels of medium and small caliber are involved in the pathological process in these diseases. With all vasculitis, except for those caused by the direct effect of the infectious trigger on the blood vessel walls, the main pathogenetic mechanism is an autoimmune process with the development of vasa nervorum vasculitis - small arteries and vessels that supply peripheral nerves, and the outcome - nerve ischemia. The classic clinical presentation is an acute or subacute painful multifocal neuropathy that has a predilection for the lower extremities, affects two or more named nerves, and progresses in a step wise manner. However, vasculitic neuropathy can manifest in a variety of ways, including asymmetric polyneuropathies and distal symmetric sensory neuropathies, and it also can be slowly progressive, particularly in cases of nonsystemic vasculitic neuropathy (NSVN), a form of vasculitis that clinically remains restricted to peripheral nerves. Nerve biopsy can help establish the diagnosis of a systemic vasculitis, particularly when other organ involvement is not clinically apparent, and is required for diagnosis of NSVN. Neuropathy due to systemic vasculitis should be treated in accordance with the recommendations for the treatment of the underlying disease. In NSVH, the main medicine of choice are glucocrticoids, and in severe/progressive cases, pulse therapy with cyclophosphamide.
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Lambova, Sevdalina N. "The Place of Nailfold Capillaroscopy Among Instrumental Methods for Assessment of Some Peripheral Ischaemic Syndromes in Rheumatology." Folia Medica 58, no. 2 (June 1, 2016): 77–88. http://dx.doi.org/10.1515/folmed-2016-0011.
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AbstractMicro- and macrovascular pathology is a frequent finding in a number of common rheumatic diseases. Secondary Raynaud’s phenomenon (RP) is among the most common symptoms in systemic sclerosis and several other systemic autoimmune diseases including a broad differential diagnosis. It should be also differential from other peripheral vascular syndromes such as embolism, thrombosis, etc., some of which lead to clinical manifestation of the blue toe syndrome.The current review discusses the instrumental methods for vascular assessments.Nailfold capillaroscopy is the only method among the imaging techniques that can be used for morphological assessment of the nutritive capillaries in the nailfold area. Laser-Doppler flowmetry and laser-Doppler imaging are methods for functional assessment of microcirculation, while thermography and plethysmography reflect both blood flow in peripheral arteries and microcirculation. Doppler ultrasound and angiography visualize peripheral arteries. The choice of the appropriate instrumental method is guided by the clinical presentation. The main role of capillaroscopy is to provide differential diagnosis between primary and secondary RP. In rheumatology, capillaroscopic changes in systemic sclerosis have been recently defined as diagnostic. The appearance of abnormal capillaroscopic pattern inherits high positive predictive value for the development of a connective tissue disease that is higher than the predictive value of antinuclear antibodies. In cases of abrupt onset of peripheral ischaemia, clinical signs of critical ischaemia, unilateral or lower limb involvement, Doppler ultrasound and angiography are indicated. The most common causes for such clinical picture that may be referred to rheumatologic consultation are the antiphospholipid syndrome, mimickers of vasculitides such as atherosclerosis with cholesterol emboli, and neoplasms.
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Alving, Barbara M., Charles W. Francis, William R. Hiatt, and Mark R. Jackson. "Consultations on Patients with Venous or Arterial Diseases." Hematology 2003, no. 1 (January 1, 2003): 540–58. http://dx.doi.org/10.1182/asheducation-2003.1.540.
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Abstract Advances in vascular biology and drug development, as well as improved interventional techniques, are yielding multiple new treatments for patients with venous and/or arterial thrombosis. Hematologists who are providing consultations for these patients often participate in a multidisciplinary approach to provide optimal care. New anticoagulants, simplified and validated tests for detecting vascular disease, and improved interventional procedures can all reduce the morbidity and mortality that result from venous and arterial thrombosis. In this chapter, different aspects of the diagnosis and treatment of these disorders are addressed by a hematologist, an expert in vascular medicine, and a vascular surgeon. The key to the prevention and treatment of venous and arterial thrombosis is anticoagulant and antiplatelet therapy. In Section I, Dr. Charles Francis, a hematologist with expertise in thrombosis and hemostasis, describes the clinical trials that have resulted in the approval of newer anticoagulants such as fondaparinux and the thrombin- specific inhibitors. He also reviews the clinical trials that have shown the efficacy of the new oral anticoagulant ximelagatran. Although currently under study primarily for the prevention and treatment of venous thrombosis, these anticoagulants are likely to undergo evaluation for use in arterial thrombosis. Peripheral arterial disease (PAD), which affects as many as 12% of individuals over the age of 65 years, provides a diagnostic and therapeutic challenge to physicians across multiple subspecialties. Dr. William Hiatt, a specialist in vascular medicine, discusses in Section II the epidemiology and manifestations of PAD, the best ways in which to diagnose this disorder and determine its severity, and the most appropriate pharmacologic treatment. In Section III, Dr. Mark Jackson, a vascular surgeon, describes interventional procedures that have been developed or are under development to treat arterial thrombosis. He also reviews the status of inferior vena caval filters that are retrievable.
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Askin, Lutfu, Hakan Duman, Ali Ozyıldız, and Okan Tanriverdi. "Association of Serum Chemerin Levels with Coronary Artery Disease: Pathogenesis and Clinical Research." Cardiovascular Innovations and Applications 4, no. 4 (July 1, 2020): 251–56. http://dx.doi.org/10.15212/cvia.2019.0572.
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Recent studies have revealed that chemerin plays an essential role in the development of cardiovascular diseases. Autopsy studies found a strong correlation between the secretion of chemerin in peripheral tissues and aortic and coronary atherosclerosis. Plasma chemerin is a marker of systemic inflammation and is associated with metabolic syndrome. Chemerin plays a vital role in vascular inflammation and atherogenesis. Plasma chemerin levels are increased in patients with dilated cardiomyopathy, and chemerin is associated with left ventricular dysfunction. In this review, we focus on chemerin expression, chemerin processing, its biological function, and its role in the diagnosis of cardiovascular diseases.
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Ismail, Hassan M., Kyoo Jackson, and Daniel Smith. "Diagnosis and Treatment of Peripheral Arterial Disease Compared with Other Atherosclerotic Vascular Diseases in a University Primary Care Clinic." Journal of Investigative Medicine 54, no. 5 (July 2006): 255–61. http://dx.doi.org/10.2310/6650.2006.05049.
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Chekhovska, G. S. "ROLE OF DERMATOSCOPY IN CHRONIC DERMATOSES DIAGNOSIS." International Medical Journal, no. 2 (July 15, 2020): 53–56. http://dx.doi.org/10.37436/2308-5274-2020-2-11.
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Dermatoscopy is a valuable auxiliary non−invasive method used in the diagnosis of inflammatory, parasitic and viral skin diseases. Treatment of dermatoses is based on the results of analysis of melanin, follicular−horny and vascular components. Diagnosis begins with polarized dermatoscopy and then progresses to non−polarized using immersion fluid. At dermatoscopic inspection of a psoriatic plaque the point vessels evenly distributed along all the surface (a symptom of "scattered red pepper") are noted. Eczema is characterized by focal accumulation of blood vessels in the form of dots, peeling, yellowish crusts. Examination of discoid lupus erythematosus foci often reveals individual linear or branched vessels, their location is random. Red herpes zoster is dermatoscopically characterized by vascular structures in the form of large granular horny plugs of whitish color with a pearly sheen. The most informative is dermatoscopy in the differential diagnosis of erythematous form of rosacea and seborrheic dermatitis. On the erythematous background, dilated vessels around the sebaceous hair follicles, large vascular polygons formed from vessels thicker than in healthy skin and seborrheic dermatitis are found. At inspection of the fresh centers of a sclero−atrophic lichen diffuse unstructured zones of white color with a peripheral erythematous corolla and with numerous light comedic structures on a surface are visualized. At dermatoscopy of the Little − Lassueur syndrome in follicular papules on skin gray, violet points located in the form of a circle are noted. Dermatoscopy is increasingly used in dermatology, especially in the differential diagnosis of dermatoses of inflammatory and parasitic nature.
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Kim, Esther Lee, and Andrew A. Moshfeghi. "Wide-field Imaging of Retinal Diseases." US Ophthalmic Review 08, no. 02 (2015): 125. http://dx.doi.org/10.17925/usor.2015.08.02.125.
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Retinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. In particular, wide-field retinal imaging is quickly moving to the forefront in imaging the posterior segment. While conventional fundus imaging captures 30 to 50° field of view in a single capture, significant advances have been made in the past 2 decades to increase the viewing angle, speed, and accuracy of fundus photography, such that a single-field capture is now up to 200°. Moreover, multiple imaging modalities, including color fundus photography, fluorescein angiography, and autofluorescence, are now available a single wide-field imaging platform. This breadth of functionality makes wide-field imaging especially useful in peripheral retinal vascular diseases, such as diabetic retinopathy, posterior uveitis, and retinopathy of prematurity. This review aims to provide a historical perspective on wide-field retinal imaging, highlight the imaging platforms currently available, discuss the advantages and disadvantages of wide-field versus conventional fundus imaging, summarize the current clinical applications of wide-field retinal imaging, and provide an outlook for its future implications.
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Lee, Ji-Na, and Jae-Wang Kim. "Pyoderma gangrenosum : two case reports." Journal of Medicine and Life Science 12, no. 2 (December 1, 2015): 58–64. http://dx.doi.org/10.22730/jmls.2015.12.2.58.
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Pyoderma gangrenosum is a rare, often destructive, neutrophilic dermatosis characterized by painful, necrotic superficialulceration, central suppurative exudate and a peripheral undermined border. Five clinical variants are recently recognized asfollows: classic(ulcerative), bullous, pustular, vegetative and peristomal types. Pyoderma gangrenosum is often a diagnosis ofexclusion, as there are no specific laboratory or histopathologic findings to confirm the diagnosis. Accordingly, it is difficult todiagnose, and often requires a work-up for underlying systemic diseases. Mimickers include infection, vascular insufficiency,systemic vasculitides, autoimmune disease, skin cancer or exogenous tissue injury. Herein, we present two cases of ulcerativepyoderma gangrenosum occurring on the legs, along with a comprehensive review.
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Moutinho, Mariana, Inês Simões, Sónia Rodrigues, Daisy Abreu, Emanuel Silva, Paulo Sousa, and José Fernandes e. Fernandes. "Global Impact of Peripheral Obstructive Arterial Disease in Portugal: An Eight Year Study." Acta Médica Portuguesa 32, no. 5 (May 31, 2019): 348. http://dx.doi.org/10.20344/amp.10822.
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Introduction: Peripheral arterial disease has an important impact on morbidity/mortality. The objective of this study was to quantify the impact of this disease in Portugal during the last eight years, expressed by the volume of admissions, treatment strategies and associated morbidity and mortality.Material and Methods: We collected data from the Diagnosis Related Group national database on primary diagnosis, procedures codes, demographic variables, a number of risk factors, and mortality of all cases admitted from 2009 to 2016 with a primary diagnosis of peripheral arterial disease coded according to the 9th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-9).Results: In this study, peripheral arterial disease led to 27 684 hospitalisations, which corresponded to 26.7% of all admissions for vascular disease in this period. Approximately 49.9% of patients were admitted to the emergency department. The volume of procedures in patients with claudication decreased over the eight years, unlike patients with critical ischaemia, in which the number of procedures increased.Discussion: Age and the presence of cardiovascular risk factors have been associated with the severity of disease, as observed in our series. Overall hospital mortality varied, being significantly higher in patients with more advanced severity of the disease.Conclusion: Peripheral arterial disease represents an important burden in the overall volume of admissions in Portuguese public hospitals. A large number of patients was admitted in the context of emergency.
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Ripa, Matteo, Lorenzo Motta, Teresa Florit, Jean-Yves Sahyoun, Veronika Matello, and Barbara Parolini. "The Role of Widefield and Ultra Widefield Optical Coherence Tomography in the Diagnosis and Management of Vitreoretinal Diseases." Diagnostics 12, no. 9 (September 17, 2022): 2247. http://dx.doi.org/10.3390/diagnostics12092247.
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Background: This study reports on the advantages of wide-field (WF)- and ultra-widefield (UWF)- optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in managing different vitreoretinal diseases in a real-life setting using the new WF—Swept Source (SS)—OCT Xephilio S1 (Canon, Tokyo, Japan). Methods: We conducted an observational retrospective case series study involving 1472 eyes that underwent retinal scans with Canon Xephilio® OCT-S1 between 1 March 2021 and 1 December 2021 at Eyecare Clinic (Brescia, Italy). All patients underwent routine ophthalmologic examinations along with WF and UWF color fundus retinography with Clarus 500™ (Carl Zeiss Meditec, Inc., Dublin, CA, USA) and Xephilio® OCT-S1. WF SS-OCT, UWF-OCT, WF-OCTA, and UWF-OCTA were taken by using Xephilio® OCT-S1. Results: We analyzed 122 peripheral retinal lesions, 144 retinal detachment, 329 high myopic eyes, 37 pediatric cases, 60 vascular retinopathies, 15 choroidal lesions, and 90 eyes as follow-up post vitreoretinal surgery. The OCT-S1 was the only reliable and diagnostic exam for peripheral lesions, pediatric and high myopic cases, and significantly influenced the management in 10% of cases and the postoperative follow-up. Conclusions: WF and UWF OCT and OCTA imaging may help in the management of several vitreoretinal diseases, becoming an indispensable tool for the high-quality management of patients.
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Rockenschaub, Patrick, Andrew Hayward, and Laura Shallcross. "Antibiotic Prescribing Before and After the Diagnosis of Comorbidity: A Cohort Study Using Primary Care Electronic Health Records." Clinical Infectious Diseases 71, no. 7 (October 21, 2019): e50-e57. http://dx.doi.org/10.1093/cid/ciz1016.
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Abstract Background Comorbidities such as diabetes and chronic obstructive pulmonary disease (COPD) increase patients’ susceptibility to infections, but it is unclear how the onset of comorbidity impacts antibiotic use. We estimated rates of antibiotic use before and after diagnosis of comorbidity in primary care to identify opportunities for antibiotic stewardship. Methods We analyzed UK primary care records from the Clinical Practice Research Datalink. Adults registered between 2008–2015 without prior comorbidity diagnoses were eligible for inclusion. Monthly adjusted rates of antibiotic prescribing were estimated for patients with new-onset stroke, coronary heart disease, heart failure, peripheral arterial disease, asthma, chronic kidney disease, diabetes, or COPD in the 12 months before and after diagnosis and for controls without comorbidity. Results 106 540/1 071 943 (9.9%) eligible patients were diagnosed with comorbidity. Antibiotic prescribing rates increased 1.9- to 2.3-fold in the 4–9 months preceding diagnosis of asthma, heart failure, and COPD before declining to stable levels within 2 months after diagnosis. A less marked trend was seen for diabetes (rate ratio, 1.55; 95% confidence interval, 1.48–1.61). Prescribing rates for patients with vascular conditions increased immediately before diagnosis and remained 30%–39% higher than baseline afterwards. Rates of prescribing to controls increased by 17%–28% in the months just before and after consultation. Conclusions Antibiotic prescribing increased rapidly before diagnosis of conditions that present with respiratory symptoms (COPD, heart failure, asthma) and declined afterward. Onset of respiratory symptoms may be misdiagnosed as infection. Earlier diagnosis of these comorbidities could reduce avoidable antibiotic prescribing.
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Stajic, Zoran, Zdravko Mijailovic, Mirjana Bogavac, Biljana Lazovic, and Maja Stojanovic. "Cardiovascular diseases during pregnancy and delivery." Medical review 66, no. 11-12 (2013): 507–13. http://dx.doi.org/10.2298/mpns1312507s.
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Introduction. Nowadays, cardiovascular diseases are the leading cause of maternal morbidity and mortality in the current obstetric practice. Physiologically Adapted Mechanisms of the Cardiovascular System in Pregnancy. It is normal that during pregnancy some physiological adaptive changes of the cardiovascular system occur and they may contribute to the deterioration of the clinical cardiac status of a patient with preexisting or acquired cardiovascular disease. The most prominent adaptive mechanisms include the increase of circulating blood volume, decrease of peripheral vascular resistance and decrease of plasma colloid-oncotic pressure. Most Frequent Diseases of the Cardiovascular System in Pregnancy. Due to these changes, pregnant women are prone to tachycardia, palpitations and peripheral edema. Maternal counseling is obligatory for each pregnant woman in order to decrease the maternal morbidity and mortality. The most important predictors of maternal mortality for pregnant women with cardiovascular diseases are severity of pulmonary hypertension, hemodynamic significance of valvular lesion, cyanosis and functional status in heart failure. Cardiovascular diseases in pregnant women may be congenital or acquired. The most frequent congenital cardiac diseases are atrial and ventricular septal defects as well as persistent ductus arteriosus. These diseases are mainly diagnosed and corrected before the pregnancy, or left untreated if hemodynamically insignificant. The most frequent acquired cardiovascular diseases during pregnancy include arrhythmias, ischemic heart disease, rheumatic mitral stenosis and insufficiency, arterial hypertension and aortic dissection. Conclusion. In all cases of pregnancy associated with cardiovascular diseases, early recognition of cardiovascular disease is crucial, as well as correct diagnosis and referral to a tertiary centre equipped for a multidisciplinary approach of specialists experienced in high-risk pregnancies and deliveries in order to prevent maternal mortality.
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Lyapina, E. P., A. A. Shuldyakov, A. V. Sofina, G. M. Kozhevnikova, A. Kh Nurpeisova, A. N. Danilov, A. V. Anashchenko, et al. "Clinical characteristics and mechanisms underlying the development of organ pathology in patients with chronic brucellosis." Infekcionnye bolezni 19, no. 3 (2021): 67–77. http://dx.doi.org/10.20953/1729-9225-2021-3-67-77.
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Objective. To analyze specific characteristics and mechanisms underlying the development of organ pathology in patients with chronic brucellosis (CB). Patients and methods. This study included more than 500 patients with CB treated in Saratov hospitals in 2003–2018. In addition to standard examination, all study participants have undergone the assessment of their lipid peroxidation/antioxidant defense system, levels of major cytokines, markers of endotoxicosis (ET), and tissue-specific autoreactive antibodies. Results and discussion. The vast majority of patients (98.2%) had their musculoskeletal system affected; lesions to the autonomic nervous system and peripheral nervous system were observed in 97.5% and 88.8% of patients, respectively; almost half of males (45%) had their reproductive organs affected; approximately one-third of participants (26.7–32.9%) had cardiovascular disorders with myocardial lesions. The severity of systemic inflammation, ET, and autoimmune reactions depended on the CB activity and determined the development of organ pathology. We found that vascular and mechanical factors were important for the development of lesions to the peripheral nervous system and reproductive organs in men. Patients, in whom the diagnosis of CB was verified 2 years following onset of symptoms, were more likely to develop exacerbations, had more organs and systems affected, and had higher risk of disability. Conclusion. Comprehensive examination revealed multiple organ lesions in all CB patients, associated not only with damage caused by the pathogen at the site of specific inflammation, but also with the involvement of vascular and mechanical factors, as well as the consequences of systemic inflammatory response, ET, and autoimmune reactions. Late diagnosis was associated with more severe clinical manifestations of CB. Key words: brucellosis, clinical manifestations of chronic brucellosis, systemic inflammation, endotoxicosis
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Mohamadi, Mohammad Hosein, Alireza Rai, Mansour Rezaei, and Alireza Khatony. "Lack of Association between Interarm Systolic Blood Pressure Difference and Coronary Artery Disease in Patients Undergoing Elective Coronary Angiography." International Journal of Hypertension 2021 (May 6, 2021): 1–7. http://dx.doi.org/10.1155/2021/6665039.
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Aim. Peripheral vascular disease (PVD) and coronary artery disease (CAD) are, in many cases, asymptomatic and not usually diagnosed. The timely diagnosis of peripheral vascular diseases can act as an indicator or practical evidence of CAD. Therefore, this study was conducted to determine the relationship between interarm systolic blood pressure difference (IASBPD) and severity and number of coronary artery stenosis. Methods. The samples in this cross-sectional study consisted of 578 patients who were candidates for coronary angiography, with an average age of 57.5 ± 10.5 years. Patients were classified according to CAD and number and severity of coronary artery stenosis. The relationship between IASBPD and presence or lack of CAD as well as the number and severity of coronary artery stenosis was studied. The sensitivity, specificity, and positive predictive value of IASBPD index were calculated for the detection of CAD using the Kappa coefficient. Results. There was no statistically significant relationship between IASBPD, CAD, and severity and number of coronary artery stenosis. This index had low sensitivity and predictive value in the diagnosis of CAD and stenosis in coronary arteries in comparison with angiography. Conclusion. The results showed that the IASBPD index cannot be a valid criterion for the diagnosis of CAD as well as the number and severity of coronary artery stenosis. More studies with larger sample sizes and different designs are needed in this regard to achieve more conclusive results.
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Dalai, Sibasankar, Aravind V. Datla, Sreekanth Matcha, Noopur Parikh, and Swetha N. Rongali. "Lower limb peripheral arterial diseases: diagnosis, management and the effect of pedal arch reconstruction on the overall outcomes." International Journal of Scientific Reports 8, no. 4 (March 23, 2022): 108. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20220753.
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<p class="abstract">Peripheral arterial diseases (PAD) are a significant cause of morbidity and limb loss. PAD is estimated to affect 237 million people worldwide. Atherosclerosis accounts for 95% of the cases of PAD. The progression of atherosclerosis gradually narrows the vascular lumen and leads to ischemia. Of the several risk factors implicated in PAD, smoking is most significant. The diagnosis of PAD requires a high index of suspicion. Over 50% of the patients are asymptomatic. A sizeable portion attributes their mild to moderate symptoms to general ageing rather than PAD and fails to seek medical advice. Claudication is a classical symptom of PAD. With the progression of the disease, rest pain, ulcerations, or gangrene can develop. PAD can be diagnosed by thorough history-taking, detailed physical examination (including objective measures like an ankle-brachial index) and imaging modalities such as duplex ultrasonography, contrast-enhanced ultrasound, magnetic resonance angiography, computed tomography angiography, and digital subtraction angiogram. Early identification and risk factor modification are crucial for improving the outcomes in PAD patients. Treatment strategies include lifestyle modifications, pharmacotherapy and revascularisation (surgical or endovascular). With the recent technological advances, coupled with its minimally invasive nature, the popularity of Endovascular therapy (ET) is increasing. However, the procedure of pedal arch reconstruction and the role ET can play in improving the outcomes of patients with poor pedal vascularity is still debated. The aim of the study was to find answer some of the queries on the topic of ET for the management of PAD of the lower limbs.</p>
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Jin, Lei, and Yu Liu. "Clinical Manifestations, Pathogenesis, Diagnosis and Treatment of Peripheral Neuropathies in Connective Tissue Diseases: More Diverse and Frequent in Different Subtypes than Expected." Diagnostics 11, no. 11 (October 21, 2021): 1956. http://dx.doi.org/10.3390/diagnostics11111956.
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Purpose of review: To discuss and summarize recent findings in peripheral neuropathy (PN) related to connective tissue diseases (CTD) including its prevalence, clinical manifestations, pathogenesis, diagnosis and treatment. Recent findings: Although PN is a common complication in CTD and has been well studied, recent research has shown that PN is more diverse and frequent in different subtypes of CTD than was expected. The incidence of PN in Sjögren’s syndrome and rheumatoid arthritis (RA) varies according to different disease subtypes, and the pathogenesis of neuropathic pain in different subtypes of eosinophilic granulomatosis with polyangiitis (EGPA) may also differ. Neurogenic inflammation, autoantibody-mediated changes, ischemia of the vascular wall and metabolic mechanisms have been shown to contribute to the pathogenesis of PN in CTD. Moreover, allergic inflammation has been recently identified as a possible new mechanism producing peripheral neuropathic pain associated with MPO-ANCA negative EGPA patients. Glucocorticoids are routinely used to relieve pain caused by PN. However, these steroids may cause hyperalgesia, exacerbate neuropathic pain, and activate the early phase of pain induction and produce hyperalgesia. Recently, neuroactive steroids, such as progesterone, tetrahydroprogesterone and testosterone, have been shown to exert protective effects for several PN symptoms, and in particular neuropathic pain. Neuroactive steroids will be an interesting topic for future research into PN in CTD. Summary: It is essential for the diagnosis and treatment of PN in CTD to be updated. Timely diagnosis, appropriate treatments, and multidisciplinary care are essential to minimize morbidity and decrease the risk of permanent neurologic deficits. Further studies are needed to guide diagnosis and treatment.
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Sollini, Martina, Chiara Lauri, Roberto Boni, Elena Lazzeri, Paola Anna Erba, and Alberto Signore. "Current Status of Molecular Imaging in Infections." Current Pharmaceutical Design 24, no. 7 (May 14, 2018): 754–71. http://dx.doi.org/10.2174/1381612824666180110103348.
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There is an increased need to find non-invasive tools for early diagnosis and follow-up of infections. Nuclear medicine techniques may be used to diagnose, localize and evaluate the severity and the extent of infections before the occurrence of anatomical abnormalities. This review focuses on different approaches based on radiolabelled cells, peptides and antibodies or [18F]FDG to image infective diseases in agreement with what is being jointly evaluated by the European Association of Nuclear Medicine (EANM). This is particularly relevant, since the EANM has strated a wide program of collaboration with other European clinical societies to define common diagnostic flow-charts in many of these infective diseases. It emerges the role of radiolabelled WBC by SPECT/CT for prosthetic joint infections and of FDG by PET/CT for spondylodiscitis. Comparable values of accuracy have been described for WBC and FDG in the diagnosis of vascular fgraft infections, diabetic gfoot, endocarditis and peripheral bone osteomyelitis, with some exceptions.
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Firescu, Dorel, Radu Andy Sascau, Gheorghe Raftu, Cristian Statescu, Tudor Cuciureanu, and Dan Iulian Cuciureanu. "Thermography as Method of Paraclinic Diagnosis in Diabetic Polyneuropathy." Revista de Chimie 70, no. 4 (May 15, 2019): 1449–54. http://dx.doi.org/10.37358/rc.19.4.7147.
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The concept of polyneuropathy comprises the etiological diversity of neurological syndromes characterized by the formation of bilateral and symmetrical lesions of limb peripheral nerves; symmetrical distal sensory-motor polyneuropathy is the most common form of diabetic neuropathy; it is the most frequent chronic complication of diabetes and more than half of the patients make this complication throughout their lives, both pathogenetic mechanisms and epidemiology, its diagnosis and treatment generate many controversy and challenges for both researchers and practitioners. The study batch consisted of 40 diabetic patients admitted to the Neurology Clinic of the Clinical Recovery Hospital and the Diabetes Clinic between January 2014 and December 2018 who were diagnosed according to clinical and electrophysiological criteria, the etiology of which was type II diabetes with a history of more than 5 years of development and who were examined the lower limb skin according to the local protocol. Thermography is already used as a diagnostic and monitoring tool for patients suffering from neuropathies, especially in the case of complex regional pain syndrome (sympathetic reflex dystrophy) and in our case of diabetic polyneuropathy. This non-invasive exploration has great potential for future research on its use in the diagnosis of other neurological diseases involving the peripheral nervous system. Medical imaging analysis provides a useful way to diagnose and monitor multiple physical illnesses; infrared imaging provides information about infrared energy from the surface of the skin. Emission of infrared radiation changes after nerve damage and vascular occlusions.
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Huseby, Carol J., Elaine Delvaux, Danielle L. Brokaw, and Paul D. Coleman. "Blood Transcript Biomarkers Selected by Machine Learning Algorithm Classify Neurodegenerative Diseases including Alzheimer’s Disease." Biomolecules 12, no. 11 (October 29, 2022): 1592. http://dx.doi.org/10.3390/biom12111592.
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The clinical diagnosis of neurodegenerative diseases is notoriously inaccurate and current methods are often expensive, time-consuming, or invasive. Simple inexpensive and noninvasive methods of diagnosis could provide valuable support for clinicians when combined with cognitive assessment scores. Biological processes leading to neuropathology progress silently for years and are reflected in both the central nervous system and vascular peripheral system. A blood-based screen to distinguish and classify neurodegenerative diseases is especially interesting having low cost, minimal invasiveness, and accessibility to almost any world clinic. In this study, we set out to discover a small set of blood transcripts that can be used to distinguish healthy individuals from those with Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, Friedreich’s ataxia, or frontotemporal dementia. Using existing public datasets, we developed a machine learning algorithm for application on transcripts present in blood and discovered small sets of transcripts that distinguish a number of neurodegenerative diseases with high sensitivity and specificity. We validated the usefulness of blood RNA transcriptomics for the classification of neurodegenerative diseases. Information about features selected for the classification can direct the development of possible treatment strategies.
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Pascart, T., P. Carpentier, L. Norberciak, J. Legrand, E. Houvenagel, F. Becce, and J. F. Budzik. "OP0175 IDENTIFYING PERIPHERAL VASCULAR MONOSODIUM URATE CRYSTAL DEPOSITION WITH DUAL-ENERGY CT: FACT OR FICTION? THE VASCURATE STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 109.2–109. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4522.
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Background:The close relationship between gout and cardiovascular diseases is well established. A growing hypothesis explaining this association would be that monosodium urate (MSU) crystals are deposited within vessel walls. Dual-energy computed tomography (DECT) can identify and quantify MSU crystal deposition in soft tissues. It remains unclear whether vascular spots exhibiting DECT attenuation characteristics of MSU are artefacts or true MSU crystal deposits.Objectives:The objectives of this study were to determine whether the presence of peripheral vascular MSU crystal deposition identified with DECT is associated with the extent of MSU deposits in joint soft tissues, and if this association persists over time under urate-lowering therapy.Methods:Patients with a clinical suspicion or established gout diagnosis prospectively underwent DECT for identification and quantification of the MSU crystal burden in their knees and feet. Some of these patients were also enrolled in the GOUT-DECTUS longitudinal study, and thus underwent follow-up DECT scans of their knees and feet at 6, 12 and 24 months. DECT scans were examined for the presence of vascular spots ≥0.01 cm3 classified as MSU crystal deposits according to the default post-processing settings. Multiple linear regressions adjusting on serum urate levels and gout diagnosis were implemented to determine the association between DECT MSU crystal volume in joint soft tissues, and the presence of vascular MSU deposits. Mixed linear models were used to compare DECT volumes of MSU crystal deposition in soft tissues between vascular MSU positive and negative patients during follow-up.Results:A total of 169 patients were included, of which 140 had a final diagnosis of gout, including 15 also included in the longitudinal study. Patients were mostly male (78.8%) and were 65.5 ± 14.6 years old. Among gout patients, disease duration was 9.3 ± 9.9 years and 56.5% were urate lowering therapy-naive. A total of 11/29 (37.9%) controls and 40/140 (28.6%) gout patients presented with a least one vascular spot of DECT MSU deposition, with an average volume of 0.02 ± 0.02 cm3, and all subjects also presented at least one vascular calcification. In the feet, patients positive for vascular DECT MSU crystal deposition had an MSU volume of 3.81 ± 10.06 cm3 in joint soft tissues, compared with 1.85 ± 7.72 cm3 for those without vascular MSU deposition (p=0.018). In the knees, patients with vascular MSU deposition had an MSU crystal volume of 6.03 ± 24.13 cm3 in joint soft tissues, compared with 0.83 ± 2.88 cm3 for those without vascular evidence of MSU deposition. In the longitudinal subgroup analysis, coefficients of the fixed effects for the presence of vascular MSU deposits on the MSU crystal volume in joint soft tissues was 0.4 (p=0.35) in the feet and 1.21 (p=0.03) in the knees. The presence of vascular DECT MSU deposits was associated with a 3.4-fold increase in MSU crystal volume in knee joint soft tissues throughout follow-up.Conclusion:This study suggests that some vascular spots identified with DECT as MSU crystal deposition may be real and not artefacts. This correlation remains throughout follow-up in the knees. However, the comparable prevalence of vascular DECT MSU deposits between gout patients and controls, the systematic co-existence of vascular calcifications and the uneven regression under urate-lowering therapy requires further analysis to determine which DECT spots are artefacts and which are not.References:[1]Dual-Energy Computed Tomography Detection of Cardiovascular Monosodium Urate Deposits in Patients With Gout. Klauser AS, Halpern EJ, Strobl S, Gruber J, Feuchtner G, Bellmann-Weiler R, Weiss G, Stofferin H, Jaschke W.Disclosure of Interests:Tristan Pascart Grant/research support from: Research Grant Horizon Pharma, Consultant of: Novartis, BMS, Sanofi, Pfizer,, Speakers bureau: Novartis, BMS, Paul Carpentier: None declared, Laurène Norberciak: None declared, Julie Legrand: None declared, Eric Houvenagel Speakers bureau: Janssen, Novartis, Fabio Becce: None declared, Jean-François Budzik: None declared
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Pokharel, Babu Ram, and Sanu Raja Amatya. "Spectrum of Neurological Diseases in Tertiary Care Centre of Nepal." Nepal Journal of Neuroscience 16, no. 3 (December 31, 2019): 58–61. http://dx.doi.org/10.3126/njn.v16i3.27360.
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Neurological cases in Nepal are not reported much. Neurological diseases are associated to poor health outcomes including mortality, disability and hospitalization. Epidemiology and clinical pattern of neurological disorders in developing countries remain largely unknown. This is a descriptive study to understand the burden of disease faced by neurologists and internists in a hospital of Nepal. This is a retrospective study of medical records of patients admitted in the Neurology unit of medical ward of Dhulikhel Hospital. A total of 318 patients were admitted during the period of July 2014to January 2015. Diagnosis was established by clinical, radiological, nerve conduction studies, electroencephalography and cerebrospinal fl uidanalysis. A total of 318 patients records during the above mentioned period were reviewed. Common neurological diseases identified were vascular: 138(43.40%); seizure: 60(18.87%); infectious: 20(6.29%); demyelinating: 12(3.77%); degenerative: 14(4.40%); peripheral neuropathy:14(4.40%); and others (mass lesion, ataxia, myelopathy) 60(18.87%). Cerebrovasculardisease is the most common cause of admission of patients in the neurological unit of the hospital. There are differences in the neurological diseases with respect to age, gender and ethnicity.
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Ulanovskaya, Ekaterina V., Victor V. Shilov, Aleksandr A. Kovshov, Nadezhda I. Kuprina, and Alexandr N. Nikanov. "Ultrasound examination of the upper extremity vessels in the early diagnosis of peripheral angiodystonic syndrome of occupational etiology." Hygiene and sanitation 101, no. 8 (September 14, 2022): 915–20. http://dx.doi.org/10.47470/0016-9900-2022-101-8-915-920.
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Introduction. The cardiovascular system reacts to almost all occupational hazards. Various methods for diagnostics, in particular ultrasound, may help to identify preclinical forms of the disease. The study aims to development of criteria for early diagnosis of occupational diseases of the vessels of the upper extremities in machine-building workers. Materials and methods. One hundred twenty-six workers of a machine-building plant were examined using standard clinical and laboratory methods, ultrasound examination of the vessels of the upper extremities and X-ray examination of the hands. Results. Laboring job, hand-arm and whole-body vibration, and noise with an average work experience of 21 years are risk factors for spastic changes in the vessels of the upper extremities in workers of machine-building production. X-ray changes in the hands are determined in 83% of cases and manifest themselves as a violation of local blood circulation, cystic restructuring in the bones of the wrists, and peri-articular osteopenia. Characteristic signs of vascular pathology detected by ultrasound are an increase in the resistance index with the preservation of speed indices (in 100%), impaired venous outflow (in 82%), and pathological tortuosity of blood vessels (in 76%). Limitations. We did not standardize workers depending on tobacco smoking due to the low number of workers in certain occupations. Conclusion. The results of ultrasound examination of the main vessels of the upper extremities in power engineering workers showed the presence of spastic vascular changes, which, with further exposure to occupational hazards, develop into angiodystonic syndrome, which is one of the syndromes of effects of vibration or polyneuropathy.
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Lapko, Inna V., Alla V. Zheglova, Kristina V. Klimkina, and Inessa A. Bogatyreva. "Neurohumoral regulation under exposure to vibration and physical overloads." Hygiene and sanitation 101, no. 10 (October 23, 2022): 1200–1205. http://dx.doi.org/10.47470/0016-9900-2022-101-10-1200-1205.
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Introduction. In response to the action of various occupational factors, central regulatory mechanisms, including the hypothalamus, are involved. Clarification of the influence of the hypothalamus on the indicators of peripheral blood circulation, peripheral innervation and bone metabolism under the influence of vibration and physical overloads is relevant for the diagnosis and treatment of occupational diseases of a neurological profile. The aim of the study. To establish the relationship between hypothalamic disorders and functional indicators of occupational diseases of the peripheral nervous system under the influence of vibration and physical overloads. Material and methods. One hundred fifteen tunnellers and machinists of the drilling rig of JSC “KMAruda Combine”, 26 tunnellers of the drainage mine of JSC “Stoilensky Mining and Processing Plant”, 65 workers of auxiliary occupations were examined. Depending on the influencing factor, they were divided into four groups with occupational neurological pathology, the fifth group was control Examined cases were divided into subgroups: A - without hypothalamic disorders and B - with hypothalamic syndrome. The criteria for the diagnosis of hypothalamic syndrome are clinical. All the examined patients underwent rheovasography, stimulation electroneuromyography of the extremities, ultrasound densitometry. Results. It was found that in patients with vibration disease from the effects of local or general vibration, especially when combined with lumbosacral radiculopathy during rheovasography, there are decrements in pulse blood filling, changes in vascular tone in vessels of various calibers and venous dysfunction, which are aggravated against the background of hypothalamic disorders. Hypothalamic disorders contribute to the aggravation of peripheral nerve indices: a decrease in the amplitude of the M-response, the rate of propagation of excitation along sensory axons and an increase in the value of residual latency. Functional assessment of bone tissue revealed the greatest prevalence of osteopenia syndrome in patients with vibration disease and its combined forms with lumbosacral radiculopathy in subgroups with hypothalamic-pituitary dysfunction (up to 33.6%). The frequency of detected functional disorders was established to increase with the progression of occupational diseases. Limitations. The study was conducted in workers with neurological occupational diseases exposed to vibration and physical overloads. Conclusions. Neurohumoral disorders, manifested by hypothalamic syndrome caused by exposure to general and local vibration in combination with physical overloads, contribute to the development or aggravation of functional changes in the body of workers, aggravating the course of occupational diseases of the peripheral nervous system, which can be used to develop diagnostic and treatment methods, and study the pathogenesis of diseases.
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Aboyans, Victor, Jean-Baptiste Ricco, Marie-Louise E. L. Bartelink, Martin Björck, Marianne Brodmann, Tina Cohnert, Jean-Philippe Collet, et al. "2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)." European Heart Journal 39, no. 9 (August 26, 2017): 763–816. http://dx.doi.org/10.1093/eurheartj/ehx095.
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Aboyans, Victor, Jean-Baptiste Ricco, Marie-Louise E. L. Bartelink, Martin Bjorck, Marianne Brodmann, Tina Cohnert, Jean-Philippe Collet, et al. "2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)." Revista Española de Cardiología (English Edition) 71, no. 2 (February 2018): 111. http://dx.doi.org/10.1016/j.rec.2017.12.014.
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Aboyans, Victor, Martin Björck, Marianne Brodmann, Jean-Philippe Collet, Martin Czerny, Marco De Carlo, A. Ross Naylor, et al. "Questions and answers on diagnosis and management of patients with Peripheral Arterial Diseases: a companion document of the 2017 ESC Guidelines for the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)." European Heart Journal 39, no. 9 (August 26, 2017): e35-e41. http://dx.doi.org/10.1093/eurheartj/ehx499.
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Aboyans, Victor, Martin Björck, Marianne Brodmann, Jean-Philippe Collet, Martin Czerny, Marco De Carlo, A. Ross Naylor, et al. "Questions and Answers on Diagnosis and Management of Patients with Peripheral Arterial Diseases: A Companion Document of the 2017 ESC Guidelines for the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)." European Journal of Vascular and Endovascular Surgery 55, no. 4 (April 2018): 457–64. http://dx.doi.org/10.1016/j.ejvs.2017.08.014.
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Shahira, Shahira, Biju Thomas, Amitha Ramesh, Santhosh Shenoy, and Anegundi Raghavendra Vamsi. "An Unusual Presentation of Peripheral Ossifying Fibroma in an Elderly Male - A Case Report." Journal of Evolution of Medical and Dental Sciences 10, no. 33 (August 16, 2021): 2847–50. http://dx.doi.org/10.14260/jemds/2021/579.
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Peripheral ossifying fibroma (POF) is a reactive process of the gingiva that develops due to irritation or minor trauma. Females are more affected than males suggesting a hormonal influence. This case report describes a case of peripheral ossifying fibroma in a 48-year-old male patient in 33, 34 regions in contrast to its common occurrence in young females. Histopathological examination is necessary to confirm the diagnosis. Surgical excision is the treatment of choice to prevent recurrence. One year follow up of the case showed no signs of recurrence. Gingival overgrowth is a common feature of the various types of gingival disease in the oral cavity. Gingival diseases and conditions can be due to genetic disorder, specific infections, inflammatory and immune conditions and lesions, reactive processes, neoplasms, endocrine, nutritional, and metabolic diseases, traumatic lesions and gingival pigmentation.1 Reactive processes are non-neoplastic nodular swellings that develop in response to local irritation or minor trauma. The term epulis is exophytic processes confined to the gingiva.2 Kfir et al. classified epulides into fibrous epulis, peripheral ossifying fibroma, pyogenic granuloma (vascular epulis), peripheral giant cell granuloma (or central).3 Ossifying fibromas in the oral cavity can be classified into central and peripheral type. The central type expands from the medullary cavity of the bone, arising from the endosteum or the periodontal ligament (PDL) adjacent to the root apex. Peripheral type arises from the soft tissues overlying the alveolar process which is contiguous with the periodontal ligament. 4 This article presents a case of POF in a male patient.
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Hunt, Kristin E., Mohamed E. Salama, Cordelia E. Sever, and Kathryn Foucar. "Bone Marrow Examination for Unexplained Cytopenias Reveals Nonspecific Findings in Patients With Collagen Vascular Disease." Archives of Pathology & Laboratory Medicine 137, no. 7 (July 1, 2013): 948–54. http://dx.doi.org/10.5858/arpa.2011-0603-oa.
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Context.—Collagen vascular diseases are frequently included in the differential diagnosis for unexplained cytopenias and often prompt a bone marrow biopsy in this patient population to exclude malignancy. Few large-scale studies have characterized the bone marrow morphology in patients with collagen vascular disease, and most are limited to systemic lupus erythematosus or rheumatoid arthritis. Objective.—To identify morphologic and immunohistochemical abnormalities specific to each of a wide range of collagen vascular disease cases. Design.—We examined 102 cases of collagen vascular disease and 38 controls and evaluated the complete blood count, peripheral blood morphology, bone marrow morphology, as well as immunohistochemical staining, for numerous cell lineages. Results.—Bone marrow findings, including abnormalities such as lymphoid aggregates, lipogranulomas, or abnormal localization of immature precursors, were not significantly different as compared to the control group. Conclusions.—Bone marrow examination in patients with collagen vascular disease with cytopenias seldom provides new information. Caution should be exercised in interpreting morphologic findings suggestive of myelodysplasia since these are of a reactive nature in up to 27% of patients with collagen vascular disease. In a cost-effective diagnostic strategy, successful utilization may favor postponing a bone marrow biopsy while a more standardized autoimmune diagnostic panel is being performed.
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Wolska, Marta, Pamela Czajka, and Marek Postuła. "Intermittent claudication - the meaning of pharmacological and non-pharmacological therapy in chronic treatment." Medycyna Faktów 14, no. 3 (September 30, 2021): 240–43. http://dx.doi.org/10.24292/01.mf.0321.4.
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Intermittent claudication is a typical sign of peripheral vascular disease, which results from limited arterial blood flow due to atherosclerosis, appears during exercises and is relieved after a short break. Intermittent claudication often presents as a pain in the calf muscle after walking a particular distance. Physical examination, detailed interview and ankle–brachial index are key elements of the diagnostic process, which allows for diagnosis of peripheral artery disease. The treatment is dependent on multiple factors, including the dynamics of the disease and coexisting diseases. The aim of the treatment of patients with intermittent claudication is reducing the risk of cardiovascular complications and improving the quality of life. The treatment is based on a conservative therapy, especially march training. The pharmacological treatment is limited to a few medications, which are rarely used. In the advanced stage of the disease the most appropriate option seems surgery.
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Kelvin Nkemakonam Orji, Onyinye Happiness Ike, Mima Wariso, Cyprian Emeka Oguji, Chimdike Godswill Omejua, Ikenna Kingsley Uchendu, Victor Chisom Makata, Hilary Emuebie, and Samuel Edwin Inalegwu. "Review on cardiovascular disease and antihypertensive drugs effect on the circulating biomarkers of heart disease." GSC Biological and Pharmaceutical Sciences 20, no. 3 (September 30, 2022): 120–29. http://dx.doi.org/10.30574/gscbps.2022.20.3.0346.
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Cardiovascular diseases (CVD), a group of diseases that affect the heart and blood vessels have posed high morbidity rate to humans, with the second-high mortality rate after cancer. These diseases include hypertension, coronary artery disease, cardiac dysrhythmias, cerebrovascular disease, valvular heart disease, cardiomyopathies, peripheral vascular disease, and congenital cardiac abnormalities. These diseases have been observed to affect people of older age and have higher susceptibility in male than the female counterparts. Some circulating biomarkers such as C-reactive protein, cardiac troponin I, myostatin, homocystein, dimethylarginine, e.t.c have been found to be indispensable in the diagnosis and prediction of possible occurrence of CVD. It has been postulated that C-reactive protein rises in acute inflammation and may contribute to further atherosclerosis by stimulating macrophage uptake of low density lipoprotein cholesterol (LDL-C). Antihypertensive drugs are used to combat these diseases and they come in different forms with variable mechanisms of action. Antihypertensive drugs have been postulated to have lowering effect on circulating biomarkers of CVD. However, prophylactic measures are highly recommended.
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Egorova, E. K., A. L. Melikyan, I. N. Subortseva, E. A. Domonova, O. Y. Silveystrova, D. I. Chebotarev, and A. M. Kovrigina. "Kaposi’s sarcoma in HIV-negative patient with primary myelofi brosis." Russian journal of hematology and transfusiology 66, no. 3 (October 25, 2021): 433–44. http://dx.doi.org/10.35754/0234-5730-2021-66-3-433-444.
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Introduction. Kaposi’s sarcoma (КS) is a multi-focal malignant tumor of vascular origin with a predominant lesion of the skin, involving internal organs and lymph nodes. Epidemic and immunosuppressive variants of the disease are considered to be the most studied and common. The main reason for the development of the immunosuppressive variant is the use of immunosuppressive drugs in patients after transplantation of solid organs. Descriptions of the development of Kaposi’s sarcoma in patients with diseases of the hematopoietic system are rare.Aim — to describe a rare combination of a malignant tumor of vascular origin (Kaposi’s sarcoma) and a chronic myeloproliferative disease: primary myelofi brosis.Main findings. To verify the diagnosis of Kaposi’s sarcoma in a patient with primary myelofi brosis, the following were used: histological, immunohistochemical studies of skin biopsies and the polymerase chain reaction method with detection of a fl uorescent signal in “real time” in biological material samples (peripheral blood, smear from the mucous membrane of the oropharynx, skin biopsies from lesions) with quantitative determination of the activity of the human herpes virus 8. A comprehensive examination made it possible to establish the fi nal diagnosis of multiple malignant neoplasms and recommend treatment.
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Olkhovskiy, I. A., A. S. Gorbenko, M. A. Stolyar, D. A. Grischenko, O. A. Tkachenko, and T. L. Martsinkevich. "Somatic mutation of the V617F JAK2 gene in patients of the cardiovascular diseases." Terapevticheskii arkhiv 91, no. 7 (July 15, 2019): 25–28. http://dx.doi.org/10.26442/00403660.2019.07.000245.
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The JAK2 V617F somatic mutation is one of the most frequent markers of CHIP (clonal hematopoiesis of indeterminate potential). CHIP is characterized by the presence of a myeloid cells clone in peripheral blood in the absence of the sufficient reasons to diagnose the hematologic disease. The CHIP is proposed as a potential independent risk factor for vascular pathology. The aim of this study is to identify carriers of JAK2 V617F mutation among patients admitted for planned hospitalization at the Federal Center of Cardiovascular Surgery of Krasnoyarsk. Materials and methods. The study included 930 venous blood samples. JAK2 V617F mutation was detected by using the allele - specific real time polymerase chain reaction. Results. JAK2 V617F mutation was detected in 15 (1.6%) patients, but only two of them had blood cell count that could cause a hematological disease to be suspected. Conclusion. The inclusion of the JAK2 V617F mutation detection in the complex of laboratory tests of the cardiovascular patients can facilitate the timely identification of patients with increased thrombotic risk, as well as the timely diagnosis of myeloproliferative diseases.
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Kockaya, G., Z. Çalışkan, G. Oğuzhan, S. Ökçün, Ş. M. Ertürk, and C. Çallı. "PCV26 COMPARISON OF CLINICAL AND ECONOMIC OUTCOMES OF MAGNETIC RESONANCE IMAGING WITH GADOBUTROL, GADOTERIC ACID AND PERIPHERAL ANGIOGRAPHY IN DIAGNOSIS OF VASCULAR DISEASES." Value in Health 23 (May 2020): S94. http://dx.doi.org/10.1016/j.jval.2020.04.131.
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Halliday, Alison, and Jeroen J. Bax. "The 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in Collaboration With the European Society for Vascular Surgery (ESVS)." European Journal of Vascular and Endovascular Surgery 55, no. 3 (March 2018): 301–2. http://dx.doi.org/10.1016/j.ejvs.2018.03.004.
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Palladino, Raffaele, Adam G. Tabak, Kamlesh Khunti, Jonathan Valabhji, Azeem Majeed, Christopher Millett, and Eszter P. Vamos. "Association between pre-diabetes and microvascular and macrovascular disease in newly diagnosed type 2 diabetes." BMJ Open Diabetes Research & Care 8, no. 1 (April 2020): e001061. http://dx.doi.org/10.1136/bmjdrc-2019-001061.
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ObjectiveThe associated risk of vascular disease following diagnosis of type 2 diabetes in people previously identified as having pre-diabetes in real-world settings is unknown. We examined the presence of microvascular and macrovascular disease in individuals with newly diagnosed type 2 diabetes by glycemic status within 3 years before diagnosis.Research design and methodsWe identified 159 736 individuals with newly diagnosed type 2 diabetes from the UK Clinical Practice Research Datalink database in England between 2004 and 2017. We used logistic regression models to compare presence of microvascular (retinopathy and nephropathy) and macrovascular (acute coronary syndrome, cerebrovascular and peripheral arterial disease) disease at the time of type 2 diabetes diagnosis by prior glycemic status.ResultsHalf of the study population (49.9%) had at least one vascular disease, over one-third (37.4%) had microvascular disease, and almost a quarter (23.5%) had a diagnosed macrovascular disease at the time of type 2 diabetes diagnosis.Compared with individuals with glycemic values within the normal range, those detected with pre-diabetes before the diagnosis had 76% and 14% increased odds of retinopathy and nephropathy (retinopathy: adjusted OR (AOR) 1.76, 95% CI 1.69 to 1.85; nephropathy: AOR 1.14, 95% CI 1.10 to 1.19), and 7% higher odds of the diagnosis of acute coronary syndrome (OR 1.07, 95% CI 1.03 to 1.12) in fully adjusted models at time of diabetes diagnosis.ConclusionsMicrovascular and macrovascular diseases are detected in 37%–24% of people with newly diagnosed type 2 diabetes. Pre-diabetes before diagnosis of type 2 diabetes is associated with increased odds of microvascular disease and acute coronary syndrome. Detection of pre-diabetes might represent an opportunity for reducing the burden of microvascular and macrovascular disease through heightened attention to screening for vascular complications.
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Nasto, Lefter, and Tanyo Kavrakov. "Delayed Treatment and Missed Opportunities for Limb Salvage in Patients with Peripheral Arterial Embolism." Open Access Macedonian Journal of Medical Sciences 8, B (September 30, 2020): 775–78. http://dx.doi.org/10.3889/oamjms.2020.4738.
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BACKGROUND: The peripheral arterial embolism (PAE) is a sudden decrease in limb perfusion due to acute occlusion of peripheral artery which leads to ischemic tissue damage, that can threaten the limb of a patient and requires immediate revascularization. It is estimated that the incidence of acute limb emoblism in the general population is around 14/100,000 inhabitants per year. Accurate and timely diagnosis is crucial to salvage the patient’s limb and sometimes the patient’s life. In cases of complete arterial occlusion and absence of collateral perfusion, irreversible damage can occur within 4 to 6 hours. The fundamental definition for treatment of acute peripheral arterial embolism is revascularisation. Revascularisation is either performed endovascularly or by an open surgical approach. A suspicion of acute ischemia based on history and physical examination warrants heparin administration and vascular surgery consultation. Delays in the management of acute peripheral arterial ischemia due to an embolism are common and associated with poor limb - salvage outcomes.
AIM: Our study aims to identify medical consultations and cardiovascular assessments undergone by patients in the period prior to being hospitalised, in order to evaluate for missed or delayed opportunities for diagnosis.
METHODS: Retrospective cohort study, utilising the medical documentation and previous outpatiently or inhospital consultations. Adult patients undergone treatment due to peripheral arterial embolism were identified and analyzed. Patients were identified through the administrative hospital database using the International Classification of Diseases. Hospitalised patients with those medcodes between 1st January 2010 - 1st March 2020 were recorded.
RESULTS: Following exclusion, 424 patients (mean age 68.5 ± 5.85 years) were included. 159 patients (66.8%) had visited their family doctors or other medical specialist before admission and in all of the cases was initiated therapeutic approach. The rest of the cohort 79 patients (33.2%) presented lately due to other social reasons. The group of 159 patients that admitted lately due to medical indications - diagnostic, healthcare - administrative or treatment related problems are subject of our study. The largest group including 113 (71%) patients were treated outpatientley by vascular surgeons with preventative medications.17 patients (10.6%) were directed outpatientley to orthopaedic surgeon due to suspicion of trauma.15 patients (9.4%) were treated by their family doctors with pain relief medications. The rest of the 14 patients (8.8%) were treated by neurosurgeons or neurologists due to a suspicion of cauda eniqua and other neuropathies. The majority of the patients 108 (67.9%) were free of complains at the discharge, 11.3% of the studied cohort were with minimal post-treatment complains (numbness, coldness, absent peripheral pulsations, insignificant claudicatio). Amputation rate was 14.4%, incidence of rethrombosis 8.8% and recurrent embolism frequency around 3.7%. Death was registered in 21 cases (13.2%).
CONCLUSION: The consequences of acute limb embolism such as prolonged hospitalization, major limb amputation, and/or death have a profound socioeconomic impact. Unrecognition of this vascular pathology and differential diagnosis difficulties are possibly leading factors for delayed or missed treatment.