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peripheral artery disease in elderly

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https://www.readbyqxmd.com/read/27905692/remote-pre-procedural-ischemic-stroke-was-the-strongest-risk-for-stroke-and-death-associated-with-carotid-stenting-a-single-center-experience
#1
Mária Rašiová, Ľubomír Špak, Ľudmila Farkašová, Štefan Pataky, Martin Koščo, Marek Hudák, Matej Moščovič, Norbert Leško
BACKGROUND: The goal of carotid artery stenting (CAS) is to decrease the stroke risk in patients with carotid stenosis. This procedure carries an immediate risk of stroke and death and many patients do not benefit from it, especially asymptomatic patients. Patient selection for carotid procedure who benefit from procedure and who is the procedure hazardous for is important. Remote ischemic stroke is known risk factor for stroke reccurence during surgery. The aim of our study was to determine the periprocedural complication risk (within 30 days after CAS) associated with carotid stenting (stroke, death) between patients with remote pre- procedural ischemic stroke and without it; to analyse periprocedural risk in other specific patient subgroups treated with CAS and to determine the impact of observed variables on all- cause mortality during long-term follow-up...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27898199/microsurgical-reconstruction-in-patients-greater-than-80-years-old
#2
Paul I Heidekrueger, Albrecht Heine-Geldern, Milomir Ninkovic, Frank Herter, Daniel Schmauss, Thiha Aung, P Niclas Broer
BACKGROUND: Demographic change implies that the human population is getting older and the elderly are living longer. Consequently, achieving good functional and aesthetic outcomes in microvascular procedures, especially in very old patients with higher incidence of atherosclerosis and vessel calcifications, constitutes a microsurgical challenge. This study evaluates the feasibility of microsurgical procedures in a very old patient cohort. PATIENTS AND METHODS: Between 2009 and 2015, 754 patients underwent 838 free flap reconstructions...
November 29, 2016: Microsurgery
https://www.readbyqxmd.com/read/27834825/independent-factors-of-changes-of-ankle-brachial-index-in-peripheral-arterial-occlusive-disease-in-elderly-patients-with-or-without-diabetes
#3
Ewelina Bąk, Czesław Marcisz, Monika Kadłubowska, Anna Michalik, Bożena Krawczyk, Dorota Dobrzyń-Matusiak, Sylwia Krzemińska, Tomasz Fiałkowski, Elżbieta Glądys, Agnieszka Drosdzol-Cop
Peripheral arterial disease (PAD) belongs to the commonly-occurring pathologies associated with elderly age. A simple tool for defining the severity of PAD is the ankle-brachial index (ABI). The purpose of this research was to determine independent factors of changes of ABI in elderly patients with occlusive PAD disease (PAOD) with and without diabetes. The research was carried out on 49 elderly patients with PAOD, including 29 patients with type 2 diabetes, and 20 patients without diabetes. The concentration of interleukin-6 (IL-6), E-selectin, fibrinogen, and C-reactive protein (CRP) in the blood serum was marked...
November 8, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27762107/sensitivity-and-specificity-of-pulse-oximetry-and-ankle-brachial-index-for-screening-asymptomatic-peripheral-vascular-diseases-in-type-2-diabetes-mellitus
#4
M Satheesh Kumar, Ayush Lohiya, Viviktha Ramesh, Priyamadhaba Behera, Sarika Palepu, S A Rizwan
OBJECTIVES: To compare pulse oximetry and Ankle-Brachial Index (ABI) with duplex ultrasonography as reference standard to determine the diagnostic accuracy for screening asymptomatic PVD in type 2 diabetes mellitus. METHODS: This cross-sectional study was conducted in 2012 at tertiary hospital in Madurai among diabetic patients attending the medicine outpatient department (OPD). Type 2 Diabetes Mellitus patients, asymptomatic with regards to symptoms and signs of PVD, aged above 40 years were included...
August 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27754194/br-05-2-angioplasty-of-atherosclerotic-renal-artery-stenosis-who-benefits
#5
Donghoon Choi
: Atherosclerotic renal artery stenosis is an increasingly recognized medical problem especially in elderly patients. It commonly occurs with systemic manifestations including hypertension (HTN), chronic kidney disease (CKD) or atherosclerotic diseases including coronary or peripheral artery disease. Significant renal artery stenosis may result in HTN, ischemic nephropathy, however it is still in debate about the benefit of revascularization. Although several randomized controlled trials including Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) and Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study has failed to reveal a significant benefit of angioplasty, angioplasty with medical therapy is increasingly accepted in some patients with certain clinical conditions...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753962/os-10-01-prevalence-of-carotid-plaque-and-role-of-cardiovascular-risk-factors-in-a-very-elderly-population-are-atherosclerosis-and-aging-synonyms
#6
Francesco Spannella, Federico Giulietti, Silvia Buscarini, Piero Giordano, Maddalena Ricci, Emma Espinosa, Riccardo Sarzani
OBJECTIVE: Age is considered one of the main risk factors for cardiovascular (CV) disease and aging seems to play a central role in the onset and progression of atherosclerosis. AIM: to compare the prevalence of carotid plaque in a very elderly population without history of peripheral arterial disease (PAD) and major adverse cardiovascular events (MACE), with the prevalence in a population of hypertensive adults. DESIGN AND METHOD: We studied 179 patients: 69 hospitalized very elderly (mean age: 88...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753881/ish-ada-02-comparison-of-pulse-wave-velocity-and-pulse-pressure-amplification-in-the-association-with-target-organ-damages-in-the-community-based-elderly-the-northern-shanghai-study
#7
Bin Bai, Jin Xiong, Yuyan Lv, Shikai Yu, Jiadela Teliewubai, Chen Chi, Yiwu Zhou, Kai Wang, Le Wang, Yi Zhang, Yawei Xu
OBJECTIVE: To investigate the discrepancy between PWV and PPA in association with hypertensive TODs in the elderly population. DESIGN AND METHOD: From June 2014 to August 2015, a total of 1599 community-based elderly subjects (age > 65 years old) located in the northern Shanghai were recruited. The carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TODs indicators including the ratio of the early ventricular filling velocity (E) to the peak velocity of tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (IMT), estimated glomerular filtration rate (eGFR), urinary albumin-creatinine rate (ACR) were assessed on each participant...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27694111/the-clinical-efficacy-and-long-term-prognostic-value-of-stress-echocardiography-in-octogenarians
#8
Sothinathan Gurunathan, Asrar Ahmed, Jatinder Pabla, Nikos Karogiannis, Alina Hua, Grace Young, Benoy Nalin Shah, Roxy Senior
INTRODUCTION: Although stress echocardiography (SE) is invaluable in younger populations, its prognostic value may be attenuated in the elderly due to shorter life expectancy and the frequent presence of severe comorbidities. This study sought to evaluate the clinical effectiveness of SE in octogenarians, particularly its prognostic value over clinical variables, in predicting hard events. METHODS: A total of 374 consecutive octogenarians who underwent SE for evaluation of coronary artery disease (CAD) were assessed for feasibility, diagnostic accuracy and safety of the test, and followed up for hard outcomes (all-cause mortality, cardiovascular (CV) deaths and non-fatal myocardial infarction (NFMI))...
September 30, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27665938/center-based-patient-care-enhances-survival-of-elderly-patients-suffering-from-peripheral-arterial-disease
#9
Clemens Höbaus, Carsten Thilo Herz, Florian Obendorf, Marie-Therese Howanietz, Thomas Wrba, Renate Koppensteiner, Gerit-Holger Schernthaner
OBJECTIVES: Recent advances in catheter-based intervention in patients with symptomatic peripheral arterial disease (PAD) have halved mortality. Mortality of PAD patients still remains high compared to other clinical forms of atherosclerosis. Intensified patient care might increase adherence to medical management and benefit the survival of PAD patients. METHODS: Two patient cohorts were compared in a longitudinal prospective follow-up study. 370 PAD patients were included in the intensified center-based vascular medicine group (VMC group) and 332 PAD patients were treated by their usual primary care physician (PCP group)...
September 24, 2016: Annals of Medicine
https://www.readbyqxmd.com/read/27645616/microsurgical-reconstruction-for-post-traumatic-defects-of-lower-leg-in-the-elderly-a-comparative-study
#10
Lingyun Xiong, Emre Gazyakan, Matthias Wähmann, Amir Bigdeli, Thomas Kremer, Leila Harhaus, Jiaming Sun, Ulrich Kneser, Christoph Hirche
BACKGROUND: Lower leg microsurgical reconstruction in the elderly is challenging, especially for post - traumatic defects. The present study aimed to evaluate the risk factors, management and outcome of free tissue transfer in patients older than 65 years of post-traumatic defects. METHODS: Retrospective chart review was performed for all patients older than 18 years undergoing free tissue transfer for post-traumatic lower leg reconstruction from April 2000 to November 2014...
September 6, 2016: Injury
https://www.readbyqxmd.com/read/27643359/os-10-01-prevalence-of-carotid-plaque-and-role-of-cardiovascular-risk-factors-in-a-very-elderly-population-are-atherosclerosis-and-aging-synonyms
#11
Francesco Spannella, Federico Giulietti, Silvia Buscarini, Piero Giordano, Maddalena Ricci, Emma Espinosa, Riccardo Sarzani
OBJECTIVE: Age is considered one of the main risk factors for cardiovascular (CV) disease and aging seems to play a central role in the onset and progression of atherosclerosis. AIM: to compare the prevalence of carotid plaque in a very elderly population without history of peripheral arterial disease (PAD) and major adverse cardiovascular events (MACE), with the prevalence in a population of hypertensive adults. DESIGN AND METHOD: We studied 179 patients: 69 hospitalized very elderly (mean age: 88...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643174/ish-ada-02-comparison-of-pulse-wave-velocity-and-pulse-pressure-amplification-in-the-association-with-target-organ-damages-in-the-community-based-elderly-the-northern-shanghai-study
#12
Bin Bai, Jin Xiong, Yuyan Lv, Shikai Yu, Jiadela Teliewubai, Chen Chi, Yiwu Zhou, Kai Wang, Le Wang, Yi Zhang, Yawei Xu
OBJECTIVE: To investigate the discrepancy between PWV and PPA in association with hypertensive TODs in the elderly population. DESIGN AND METHOD: From June 2014 to August 2015, a total of 1599 community-based elderly subjects (age > 65 years old) located in the northern Shanghai were recruited. The carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TODs indicators including the ratio of the early ventricular filling velocity (E) to the peak velocity of tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (IMT), estimated glomerular filtration rate (eGFR), urinary albumin-creatinine rate (ACR) were assessed on each participant...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643151/br-05-2-angioplasty-of-atherosclerotic-renal-artery-stenosis-who-benefits
#13
Donghoon Choi
UNLABELLED: Atherosclerotic renal artery stenosis is an increasingly recognized medical problem especially in elderly patients. It commonly occurs with systemic manifestations including hypertension (HTN), chronic kidney disease (CKD) or atherosclerotic diseases including coronary or peripheral artery disease. Significant renal artery stenosis may result in HTN, ischemic nephropathy, however it is still in debate about the benefit of revascularization. Although several randomized controlled trials including Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) and Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study has failed to reveal a significant benefit of angioplasty, angioplasty with medical therapy is increasingly accepted in some patients with certain clinical conditions...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27598000/how-valuable-is-physical-examination-of-the-cardiovascular-system
#14
REVIEW
Andrew Elder, Alan Japp, Abraham Verghese
Physical examination of the cardiovascular system is central to contemporary teaching and practice in clinical medicine. Evidence about its value focuses on its diagnostic accuracy and varies widely in methodological quality and statistical power. This makes collation, analysis, and understanding of results difficult and limits their application to daily clinical practice. Specific factors affecting interpretation and clinical application include poor standardisation of observers' technique and training, the study of single signs rather than multiple signs or signs in combination with symptoms, and the tendency to compare physical examination directly with technological aids to diagnosis rather than explore diagnostic strategies that combine both...
July 27, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27579174/the-kidney-transplant-evaluation-process-in-the-elderly-reasons-for-being-turned-down-and-opportunities-to-improve-cost-effectiveness-in-a-single-center
#15
Beatrice P Concepcion, Rachel C Forbes, Aihua Bian, Heidi M Schaefer
Background. The kidney transplant evaluation process for older candidates is complex due to the presence of multiple comorbid conditions. Methods. We retrospectively reviewed patients ≥60 years referred to our center for kidney transplantation over a 3-year period. Variables were collected to identify reasons for patients being turned down and to determine the number of unnecessary tests performed. Statistical analysis was performed to estimate the association between clinical predictors and listing status...
2016: Journal of Transplantation
https://www.readbyqxmd.com/read/27555569/primary-and-key-secondary-results-from-the-rocket-af-trial-and-their-implications-on-clinical-practice
#16
Rohan Shah, Manesh R Patel
BACKGROUND: The safety and efficacy of the oral anticoagulant rivaroxaban were studied in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF trial). A number of subanalyses of the ROCKET AF trial have subsequently analyzed the use of rivaroxaban in special patient populations. METHODS: The outcomes of the ROCKET AF trial were reviewed. The use of rivaroxaban in higher risk populations, as determined by the presence of co-morbidities included in the CHADS2 criteria, was analyzed...
August 23, 2016: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/27526424/-cardio-vascular-risk-factors-control-in-elderly-patients-with-peripheral-artery-disease
#17
Dorota Studzińska, Barbara Gryglewska, Maria Wojnarowska, Joanna Paleń, Bogusław Rudel, Tomasz Grodzicki
OBJECTIVE: The assessment of control of modifiable risk factors among elderly patients with peripheral artery disease (PAD) admitted to the hospital angiology ward. METHODS: The results of treatment of dyslipidemia (DL), hypertension (HT), diabetes mellitus (DM) and prevalence of cigarette smoking were assessed among older (>65 years old, group I) and younger patients (group II) with PAD in a admission day to hospital. RESULTS: The study population included 154 patients (I--92 and II--65 subjects) aged 67...
2016: Przegla̧d Lekarski
https://www.readbyqxmd.com/read/27515746/low-use-of-statins-for-secondary-prevention-in-primary-care-a-survey-in-a-northern-swedish-population
#18
Gunnar Nilsson, Eva Samuelsson, Lars Söderström, Thomas Mooe
BACKGROUND: Cholesterol-lowering therapy with statins is recommended in established cardiovascular disease (CVD) and should be considered for patients at high cardiovascular risk. We surveyed statin treatment before first-time myocardial infarction in clinical practice compared to current guidelines, in patients with and without known CVD in primary care clinics with general practitioners (GPs) on short-term contracts vs. permanent staff GPs. METHODS: A total of 931 patients (345 women) in northern Sweden were enrolled in the study between November 2009 and December 2014 and stratified by prior CVD, comprising angina pectoris, revascularisation, ischaemic stroke or transitory ischaemic attack, or peripheral artery disease...
2016: BMC Family Practice
https://www.readbyqxmd.com/read/27493833/mobility-related-consequences-of-reduced-lower-extremity-peripheral-nerve-function-with-age-a-systematic-review
#19
REVIEW
Rachel E Ward, Paolo Caserotti, Jane A Cauley, Robert M Boudreau, Bret H Goodpaster, Aaron I Vinik, Anne B Newman, Elsa S Strotmeyer
The objective of this study is to systematically review the relationship between lower-extremity peripheral nerve function and mobility in older adults. The National Library of Medicine (PubMed) was searched on March 23, 2015 with no limits on publication dates. One reviewer selected original research studies of older adults (≥65 years) that assessed the relationship between lower-extremity peripheral nerve function and mobility-related outcomes. Participants, study design and methods of assessing peripheral nerve impairment were evaluated and results were reported and synthesized...
August 2016: Aging and Disease
https://www.readbyqxmd.com/read/27439082/cardiovascular-events-in-a-physical-activity-intervention-compared-with-a-successful-aging-intervention-the-life-study-randomized-trial
#20
Anne B Newman, John A Dodson, Timothy S Church, Thomas W Buford, Roger A Fielding, Stephen Kritchevsky, Daniel Beavers, Marco Pahor, Randall S Stafford, Anita D Szady, Walter T Ambrosius, Mary M McDermott
IMPORTANCE: Whether sustained physical activity prevents cardiovascular disease (CVD) events in older adults is uncertain. OBJECTIVE: To test the hypothesis that cardiovascular morbidity and mortality would be reduced in participants in a long-term physical activity program. DESIGN, SETTING, AND PARTICIPANTS: The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, randomized trial. Participants were recruited at 8 centers in the United States...
August 1, 2016: JAMA Cardiology
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