Circulatory Reflexes in Cerebral Ischaemia Involving Different Vascular Territories

1970 ◽  
Vol 38 (4) ◽  
pp. 491-502 ◽  
Author(s):  
M. Gross
Keyword(s):  
Statistical Analysis ◽  
Arterial Pressure ◽  
Cerebrovascular Disease ◽  
Internal Carotid ◽  
Transient Ischaemic Attacks ◽  
Vasoconstrictor Response ◽  
Ischaemic Cerebrovascular Disease ◽  
Significant Difference ◽  
Valsalva's Manoeuvre ◽  
Circulatory Reflexes

1. Circulatory reflex function was assessed in a series of subjects with chronic ischaemic cerebrovascular disease and compared with a group of subjects with no known cerebrovascular disease by intra-arterial pressure responses to Valsalva's manoeuvre. 2. Circulatory reflexes were impaired in the patients with cerebrovascular disease as compared with controls, but statistical analysis indicated that age was a more important factor than chronic cerebrovascular disease in producing the deterioration. 3. No significant difference was found in the circulatory reflex function of subjects with ischaemia in the internal carotid territory when compared with those having ischaemia in the vertebrobasilar territory. 4. Combined ischaemia in both carotid and vertebrobasilar territories significantly impaired the cardioaccelerator but not the vasoconstrictor response to Valsalva's manoeuvre. 5. No significant difference was found in circulatory reflex function in subjects who had suffered cerebral infarction as opposed to transient ischaemic attacks.

Blood Pressure Lability in Ischaemic Cerebrovascular Disease

1970 ◽  
Vol 38 (5) ◽  
pp. 563-572 ◽  
Author(s):  
M. Gross ◽  
J. Marshall
Keyword(s):  
Blood Pressure ◽  
Cerebral Infarction ◽  
Cerebrovascular Disease ◽  
Automatic Monitoring ◽  
Vascular Disorder ◽  
Transient Ischaemic Attacks ◽  
Ischaemic Cerebrovascular Disease ◽  
Significant Difference ◽  
Blood Pressures ◽  
Blood Pressure Lability

1. In a survey of blood pressures taken over 24-hr periods by automatic monitoring in a series of men with ischaemic cerebrovascular disease, the variances of the readings were used to compare the lability of blood pressure in subjects subdivided according to the territory of the vascular disorder. 2. The findings that diastolic variance during the daytime in vertebrobasilar ischaemia was significantly higher than in controls and that in both carotid and vertebrobasilar ischaemia, but not controls, daytime variance was higher than night variance, were explicable on the basis that variance is directly related to the height of the blood pressure. 3. There was no evidence that cerebral ischaemia itself, whether in the carotid or vertebrobasilar territories, was associated with abnormal blood pressure lability. 4. It did not appear likely that there was any significant difference between blood pressure lability in subjects who had had cerebral infarction and those who had had transient ischaemic attacks.

scholarly journals Simultaneous PET-MRI imaging of cerebral blood flow and glucose metabolism in the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease

2019 ◽  
Vol 47 (7) ◽  
pp. 1668-1677 ◽  
Author(s):  
Bixiao Cui ◽  
Tianhao Zhang ◽  
Yan Ma ◽  
Zhongwei Chen ◽  
Jie Ma ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Glucose Metabolism ◽  
Cerebrovascular Disease ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Bypass Surgery ◽  
Internal Carotid ◽  
Ischaemic Cerebrovascular Disease ◽  
Before And After

Abstract Purpose Cerebral blood flow (CBF) and glucose metabolism are important and significant factors in ischaemic cerebrovascular disease. The objective of this study was to use quantitative hybrid PET/MR to evaluate the effects of surgery treatment on the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease. Methods Fifteen patients diagnosed with ischaemic cerebrovascular disease were evaluated using a hybrid TOF PET/MR system (Signa, GE Healthcare). The CBF value measured by arterial spin labelling (ASL) and the standardized uptake value ratio (SUVR) measured by 18F-FDG PET were obtained, except for the infarct area and its contralateral side, before and after bypass surgery. The asymmetry index (AI) was calculated from the CBF and SUVR of the ipsilateral and contralateral cerebral hemispheres, respectively. The ΔCBF and ΔSUVR were calculated as the percent changes of CBF and SUVR between before and after surgery, and paired t tests were used to determine whether a significant change occurred. Spearman’s rank correlation was also used to compare CBF with glucose metabolism in the same region. Results The analysis primarily revealed that after bypass surgery, a statistically significant increase occurred in the CBF on the affected side (P < 0.01). The postprocedural SUVR was not significantly higher than the preprocedural SUVR (P > 0.05). However, the postprocedural AI values for CBF and SUVR were significantly lower after surgery than before surgery (P < 0.01). A significant correlation was found between the AI values for preoperative CBF and SUVR on the ipsilateral hemisphere (P < 0.01). Conclusions The present study demonstrates that a combination of ASL and 18F-FDG PET could be used to simultaneously analyse changes in patients’ cerebral haemodynamic patterns and metabolism between before and after superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery. This therefore represents an essential tool for the evaluation of critical haemodynamic and metabolic status in patients with symptomatic unilateral ischaemic cerebrovascular disease.

STRUCTURAL AND FUNCTIONAL VASCULAR CHANGES IN HIGH NORMAL ARTERIAL PRESSURE

2020 ◽  
Vol 23 (1) ◽  
pp. 7-11
Author(s):  
P. Nikolov
Keyword(s):  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Pressure ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Aortic Pressure ◽  
Large Arteries ◽  
Central Aortic Pressure ◽  
Significant Difference

The PURPUSE of the present study is changes in function and structure of large arteries in individuals with High Normal Arterial Pressure (HNAP) to be established. MATERIAL and METHODS: Structural and functional changes in the large arteries were investigated in 80 individuals with HNAP and in 45 with optimal arterial pressure (OAP). In terms of arterial stiffness, pulse wave velocity (PWV), augmentation index (AI), central aortic pressure (CAP), pulse pressure (PP) were followed up in HNAP group. Intima media thickness (IMT), flow-induced vasodilatation (FMD), ankle-brachial index (ABI) were also studied. RESULTS: Significantly increased values of pulse wave velocity, augmentation index, central aortic pressure, pulse pressure are reported in the HNAP group. In terms of IMT and ABI, being in the reference interval, there is no significant difference between HNAP and OAP groups. The calculated cardiovascular risk (CVR) in both groups is low. CONCLUSION: Significantly higher values of pulse wave velocity, augmentation index, central aortic pressure and pulse pressure in the HNAP group are reported.

scholarly journals Assessment of the Health Behaviours and Value-Based Health Analysis of People Aged 50+ Who Were Hospitalized Due to Cardiovascular Disease

2021 ◽  
Vol 18 (8) ◽  
pp. 4221
Author(s):  
Izabela Gąska ◽  
Katarzyna Sygit ◽  
Elżbieta Cipora ◽  
Marian Sygit ◽  
Anna Pacian ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Statistical Analysis ◽  
Eating Habits ◽  
Health Behaviours ◽  
Public Health Care ◽  
Health Practices ◽  
Body Parts ◽  
Significant Difference ◽  
Health Care Unit ◽  
Student’S T

Introduction: The basic determinant of healthy behaviour—among other human behaviours—is the fact that it consistently affects health. Nowadays, health behaviour studies are considered to be an important method of measuring the health of a population. Objective: To assess the health behaviours and value-based health analysis of people aged 50+ who were hospitalized due to cardiovascular disease, depending on the selected descriptive variables. Materials and methods: The study was conducted between April 2018 and December 2018 among 411 subjects aged 50+ who were hospitalized due to cardiovascular disease at the Independent Public Health Care Unit in Sanok (Podkarpackie voivodship in Poland). The method used in the study was a diagnostic survey. The study used the authors’ survey questionnaire and two standardized tests: Inventory of Health-Related Behaviour (IHB) and List of Health Criteria (LHC). A statistical analysis was carried out in the R program, version 3.5.1. The obtained results were subjected to thorough statistical analysis using the following tests: Student’s t, Mann–Whitney U, ANOVA, Kruskal–Wallis, Fisher’s Least Significant Difference (LSD), Pearson, and Spearman. Results: The strongest correlation between health status and health behaviours (according to the IHB questionnaire) was in the area of ‘health practices’, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. Based on the LHC questionnaire, the most important health criteria according to the subjects were ‘not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. A positive correlation was found in the group of respondents where the ‘preventive health behaviours’ were more intense; herein, the more important criterion for the respondents was ‘eating properly’. Conclusions: Respondents aged 50+ and hospitalized for cardiovascular diseases indicated (based on the IHB questionnaire) that health behaviours in the area of ‘health practices’ had the strongest correlation with their health, while the lowest correlation was found in the areas of ‘correct eating habits’ and ‘preventive behaviours’. According to the respondents, the most important criteria determining health (according to the LHC questionnaire) included ’not feeling any physical ailments’; ‘having all body parts functional’; ‘feeling well’; ‘eating properly’; and ‘infrequent need of going to the doctor’. Based on the information collected from the respondents, it was found that the most important criteria determining health depended on selected descriptive variables, such as age, gender, place of residence, education, and marital status.

scholarly journals POS0586 RHEUMATOID ARTHRITIS IS AN INFLAMMATORY DISEASE WITH A HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Subclinical Atherosclerosis ◽  
External Carotid ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared

Comparative Analysis of Patients with Robotic Hiatal Hernia Repairs with and without Collis Gastroplasty

2021 ◽  
pp. 000313482198905
Author(s):  
John A. Perrone ◽  
Stephanie Yee ◽  
Manrique Guerrero ◽  
Antai Wang ◽  
Brian Hanley ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Statistical Analysis ◽  
Hospital Stay ◽  
Hiatal Hernia ◽  
Collis Gastroplasty ◽  
Significant Difference ◽  
Related Quality

Introduction After extensive mediastinal dissection fails to achieve adequate intra-abdominal esophageal length, a Collis gastroplasty(CG) is recommended to decrease axial tension and reduce hiatal hernia recurrence. However, concerns exist about staple line leak, and long-term symptoms of heartburn and dysphagia due to the acid-producing neoesophagus which lacks peristaltic activity. This study aimed to assess long-term satisfaction and GERD-related quality of life after robotic fundoplication with CG (wedge fundectomy technique) and to compare outcomes to patients who underwent fundoplication without CG. Outcomes studied included patient satisfaction, resumption of proton pump inhibitors (PPI), length of surgery (LOS), hospital stay, and reintervention. Methods This was a single-center retrospective analysis of patients from January 2017 through December 2018 undergoing elective robotic hiatal hernia repair and fundoplication. 61 patients were contacted for follow-up, of which 20 responded. Of those 20 patients, 7 had a CG performed during surgery while 13 did not. There was no significant difference in size and type of hiatal hernias in the 2 groups. These patients agreed to give their feedback via a GERD health-related quality of life (GERD HRQL) questionnaire. Their medical records were reviewed for LOS, length of hospital stay (LOH), and reintervention needed. Statistical analysis was performed using SPSS v 25. Satisfaction and need for PPIs were compared between the treatment and control groups using the chi-square test of independence. Results Statistical analysis showed that satisfaction with outcome and PPI resumption was not significantly different between both groups ( P > .05). There was a significant difference in the average ranks between the 2 groups for the question on postoperative dysphagia on the follow-up GERD HRQL questionnaire, with the group with CG reporting no dysphagia. There were no significant differences in the average ranks between the 2 groups for the remaining 15 questions ( P > .05). The median LOS was longer in patients who had a CG compared to patients who did not (250 vs. 148 min) ( P = .01). The LOH stay was not significantly different ( P > .05) with a median length of stay of 2 days observed in both groups. There were no leaks in the Collis group and no reoperations, conversions, or blood transfusions needed in either group. Conclusion Collis gastroplasty is a safe option to utilize for short esophagus noted despite extensive mediastinal mobilization and does not adversely affect the LOH stay, need for reoperation, or patient long-term satisfaction.

scholarly journals Age and Overweight Are Not Contraindications for a Breast Reconstruction with a TMG-Flap—A Risk and Complication Analysis of a Retrospective Double Center Study Including 300 Patients

2021 ◽  
Vol 10 (5) ◽  
pp. 926
Author(s):  
Karl Schwaiger ◽  
Laurenz Weitgasser ◽  
Maximilian Mahrhofer ◽  
Kathrin Bachleitner ◽  
Selim Abed ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Data Extraction ◽  
Free Flaps ◽  
Risk Groups ◽  
The Elderly ◽  
Demographic Development ◽  
Autologous Breast Reconstruction ◽  
Significant Difference

Introduction: The transverse myocutaneous gracilis (TMG) flap has become a popular and reliable alternative for autologous breast reconstruction. Initially described as a valuable tissue source for women with low body-mass index, indications nowadays have widely expanded. The Western civilization demographic development with its aging population and the steady growing average BMI has led to increasing breast reconstructions with TMG flaps in overweight and aged individuals. Patients and Methods: A total of 300 TMG free flaps for unilateral autologous breast reconstruction were evaluated in the form of a retrospective double center cohort study. Data extraction, study group formation and statistical analysis (One-way analysis of variance (ANOVA), Pearson’s chi-squared statistical analysis and relative risk calculation) were done specifically to evaluate age and BMI as risk factors for postoperative complications and outcome. Results: No significant differences in patients’ age and BMI in the complication groups compared to the no-complication group could be found. No significant difference regarding the occurrence of complications could be found in any of the formed risk-groups. No significant increase of minor-, major- or overall complications, flap loss or revision surgeries were found in the elderly patient groups or for patients with overweight. Conclusion: Age and overweight do not significantly increase the risk for postoperative complications after breast reconstructions with free TMG flaps. The findings of this study support the fact that microsurgical breast reconstruction with a free TMG flap should not solely be reserved for younger patients and females with a lower BMI.

In vivo exploration of brain phosphorus 31 metabolism in patients with senile dementia of Alzheimer type

1994 ◽  
Vol 9 (2) ◽  
pp. 105-109
Author(s):  
G Mecheri ◽  
Y Bissuel ◽  
J Dalery ◽  
JL Terra ◽  
G Balvay ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Senile Dementia ◽  
Phospholipid Metabolism ◽  
Alzheimer Type ◽  
Dementia Of Alzheimer Type ◽  
Non Invasive ◽  
Significant Difference ◽  
The Brain

SummaryIn vivo NMR 31p spectroscopy is a non invasive, non ionizing method of exploration of energy and phospholipid metabolism in the brain. This study consisted of comparing 31p spectra in five patients with Senile Dementia of Alzheimer Type (SDAT) with those of four controls of similar ages. Abnormal phosphonionocsters (PME) concentrations, either high or low, were found in the patients, but statistical analysis did not elicit any significant difference relative to controls.

Additive Interactions between Propofol and Ketamine When Used for Anesthesia Induction in Female Patients 

1995 ◽  
Vol 82 (3) ◽  
pp. 641-648 ◽  
Author(s):  
T. W. Hui ◽  
T. G. Short ◽  
W. Hong ◽  
T. Suen ◽  
T. Gin ◽  
...  
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
Additional Term ◽  
Anesthesia Induction ◽  
Response Curves ◽  
Intravenous Anesthesia ◽  
Verbal Command ◽  
Female Patients ◽  
Loss Of Response ◽  
Significant Difference

Background Propofol and ketamine may be paired for anesthesia induction and for total intravenous anesthesia. The nature of any sedative interactions occurring between propofol and ketamine are unknown. The combination when used for anesthesia induction in female patients was studied. Methods Quantal dose-response curves were determined in 180 female patients to whom the drugs were administered individually and in combination. Two minutes after administering the drugs, two endpoints were assessed. First, loss of response to verbal command (hypnosis) and then, in those who failed to respond to this endpoint, loss of response to a 5-s transcutaneous tetanus (anesthesia). Interactions were analyzed by fitting the data to a mathematical model in which response was analyzed in terms of the doses of the two drugs and an additional term included to describe nonadditive interactions. The incidences of apnea, arterial pressure, and heart rate changes during the first 5 min were recorded. Results At the hypnotic endpoint, the ED50s were 1.10 mg/kg propofol (95% CIs 0.93-1.27), 0.39 mg/kg ketamine (95% CIs 0.27-0.46), and the combination of 0.63 mg/kg propofol and 0.21 mg/kg ketamine (95% CIs 0.53/0.18-0.73/0.24). At the anesthetic endpoint, the ED50s were 1.85 mg/kg propofol (95% CIs 1.58-2.36) 0.66 mg/kg ketamine (95% CIs 0.58-0.77), and the combination of 1.05 mg/kg propofol and 0.35 mg/kg ketamine (95% CIs 0.88/0.29-1.27/0.42). The effects were additive at both endpoints; there was no evidence of an interaction. The ED50s for apnea were 1.61 mg/kg propofol (95% CIs 1.39-1.94), greater than 0.85 mg/kg ketamine and for the combination 1.50 mg/kg propofol and 0.50 mg/kg ketamine (95% CIs 1.15/0.38-3.09/1.03). The addition of ketamine did not significantly alter the ED50 for apnea of propofol. There was a significant difference in the arterial pressures among the three groups (P &lt; 0.001). Using the combination, the cardiostimulant effects of ketamine balanced the cardiodepressant effects of propofol. There was no change in arterial pressure or heart rate after the noxious stimulus. Conclusions When using the combination, doses were additive at hypnotic and anesthetic endpoints. Ketamine had no influence on the incidence of apnea after propofol, and the net hemodynamic effects were minimal.

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