Peripheral Vascular Changes after Treatment of Severe Hypertension

1982 ◽  
Vol 63 (s8) ◽  
pp. 77s-79s ◽  
Author(s):  
T. Gudbrandsson ◽  
L. Hansson ◽  
H. Herlitz ◽  
R. Sivertsson
Keyword(s):  
Structural Changes ◽  
Matched Control ◽  
Malignant Hypertension ◽  
Control Group ◽  
Vascular Changes ◽  
Peripheral Vascular ◽  
Maximal Dilatation ◽  
Resistance Vessels ◽  
Vascular Beds

1. Blood flow resistance was studied in two peripheral vascular beds in 15 patients with previous malignant hypertension and in a matched group of patients with treated ‘benign’ hypertension and in matched control subjects. Studies were made during rest and after the induction of maximal vasodilatation. 2. In the hand (representing mainly a skin vessel bed), both hypertensive groups had significantly higher resistance at maximal dilatation than the normotensive group (2.5 and 2.5 units respectively as compared with 1.9 units, P < 0.01). 3. In the calf muscle vascular bed the patients with previous malignant hypertension had the most severe changes. Resistance at maximal dilatation was 2.4 units as compared with 1.9 units in the group with ‘benign’ hypertension (P < 0.05) and 1.6 units in the control group (P < 0.001 and P < 0.05 respectively). 4. These findings indicate structural changes in the resistance vessels of both hypertensive groups, which means that, in spite of substantial long-term lowering of blood pressure, arteriolar vascular changes remain. Accordingly, these changes may not be entirely reversible. The degree of reversibility also appears to be different in the two vascular beds studied.

scholarly journals Non-coronary Interventions: An Introduction to Peripheral Arterial Interventions

2016 ◽  
Vol 11 (2) ◽  
pp. 128
Author(s):  
Brock Cookman ◽  
Suhail Allaqaband ◽  
Tonga Nfor ◽  
◽  
◽  
...  
Keyword(s):  
Strong Relationship ◽  
Ageing Population ◽  
Peripheral Vascular ◽  
Endovascular Interventions ◽  
Cardiovascular Morbidity And Mortality ◽  
Vascular Beds ◽  
Peripheral Arterial ◽  
Peripheral Artery Diseases ◽  
Broad Understanding

With an ageing population, the burden of peripheral artery diseases (PADs) is increasing. The treatment of these diseases has largely been performed by interventional radiologists, vascular surgeons and interventional cardiologists. Due to the strong relationship between PAD and overall cardiovascular morbidity and mortality, cardiologists need to play a greater role in the management of PAD. The physician who cares for the patient with peripheral vascular disease should have a broad understanding of atherosclerotic disease involving all vascular beds. Endovascular interventions play a major role in relieving symptoms and reducing morbidity related to PAD, but long-term optimal medical treatment is an essential determinant of prognosis. This paper reviews current endovascular/percutaneous interventions for PAD.

Enlargement of cerebrospinal fluid spaces in long-term benzodiazepine abusers

1987 ◽  
Vol 17 (4) ◽  
pp. 869-873 ◽  
Author(s):  
C. Schmauss ◽  
J.-C. Krieg
Keyword(s):  
Low Dose ◽  
Matched Control ◽  
Control Group ◽  
High Dose ◽  
Withdrawal Therapy ◽  
The Mean ◽  
Dose Dependent ◽  
Dose Dependent Effect ◽  
Age And Sex

SynopsisIn 17 benzodiazepine (BDZ) dependent in-patients a CT scan was performed before initiation of withdrawal therapy. The evaluation of the ventricular to brain ratio (VBR) by standardized and computerized measurements revealed significantly higher mean VBRs for both high-and low-dose BDZ-dependent patients compared to the mean VBR of an age- and sex-matched control group. In addition, the mean VBR of high-dose BDZ-dependent patients (N = 8) was significantly higher than the mean VBR of low-dose BDZ-dependent patients (N = 9). This difference could not be accounted for by the age of the patients or duration of BDZ-dependency and, therefore, suggests a dose-dependent effect of BDZs on the enlargement of internal CSF-spaces. On the other hand, higher values for the width of external CSF-spaces were found to be related to increasing age of the patients and duration of BDZ-dependency.

Cognitive impairment in long-term benzodiazepine users

1988 ◽  
Vol 18 (2) ◽  
pp. 365-374 ◽  
Author(s):  
Susan Golombok ◽  
Parimala Moodley ◽  
Malcolm Lader
Keyword(s):  
Neuropsychological Tests ◽  
Matched Control ◽  
Control Group ◽  
Therapeutic Practice ◽  
The Past ◽  
Visual Spatial ◽  
Wide Range ◽  
High Doses ◽  
One Year

SynopsisIn view of the very extensive and often prolonged use of benzodiazepines in therapeutic practice, this study was designed to investigate whether or not cognitive ability is impaired in longterm benzodiazepine users, and to determine the nature and extent of any deficit. Fifty patients currently taking benzodiazepines for at least one year, thirty-four who had stopped taking benzodiazepines, and a matched control group of subjects who had never taken benzodiazepines or who had taken benzodiazepines in the past for less than one year were administered a battery of neuropsychological tests designed to measure a wide range of cognitive functions. It was found that patients taking high doses of benzodiazepines for long periods of time perform poorly on tasks involving visual-spatial ability and sustained attention. This is consistent with deficits in posterior cortical cognitive function.

The definition of fibromyalgia

2018 ◽  
Author(s):  
Mike Shipley
Keyword(s):  
Chronic Pain ◽  
Matched Control ◽  
Control Group ◽  
Evidence Based ◽  
Matched Control Group ◽  
Primary Fibromyalgia ◽  
Management Approaches ◽  
Definition Of ◽  
Normal Controls

The landmark paper discussed in this chapter is ‘Primary fibromyalgia (fibrositis): Clinical study of 50 patients with matched normal controls’, published by Yunus et al. in 1981. Over the years, long-term pain has had a confusing variety of names and, to some extent, that confusion persists. Chronic pain can be defined as pain which persists beyond the time expected for healing. Yunus et al. were the first to define fibromyalgia (fibrositis), as they called it, developing evidence-based diagnostic guidelines by comparing a group of patients with a pain-free matched control group. Based on their work, they also suggested a series of pain management approaches which remain valid today.

Influence of Long-Term Malnutrition on Educational Performance

1988 ◽  
Vol 2 (3) ◽  
pp. 167-174
Author(s):  
L C Rajapaksa ◽  
DN Fernando
Keyword(s):  
Matched Control ◽  
Control Group ◽  
Educational Performance ◽  
Deviant Behaviour ◽  
Normal Children ◽  
Economically Deprived ◽  
Class Information ◽  
Development Quotient ◽  
Socio Economic Factors

A random sample of 60 Grade I school children, who were chronically malnourished, were studied along with an age-sex matched control group of nutritionally “normal” children from the same class, information on environmental factors were obtained from the parents and a behavioural assessment was done by the teacher. Two sets of tests in language and arithmetic were used to measure educational performance. In addition, a development quotient was obtained for each child. The majority of the stunted children were from an economically deprived background and were likely to show a deviant behavioural pattern. They also had a lower level of educational performance. This study indicates that inter-relationships between socio-economic factors, stunting, deviant behaviour and development quotient influence educational performance, even though the relative contributions made by each of these factors vary.

Establishing the Efficacy and Cost Effectiveness of Community Intensive Case Management of Long-Term Mentally Ill: A Matched Control Group Study

2000 ◽  
Vol 34 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Neil Joseph Preston ◽  
Sam Fazio
Keyword(s):  
Case Management ◽  
Mentally Ill ◽  
Repeated Measures ◽  
Matched Control ◽  
Control Group ◽  
Inpatient Service ◽  
Service Utilisation ◽  
Intensive Case Management ◽  
Matched Control Group

Objective: The study attempted to identify whether chronic mentally ill persons after receiving intensive case management (ICM) could demonstrate improved inpatient service utilisation compared with a matched control group cohort. Costings were measured to observe whether the increase in providing intensive outpatient contacts would be offset by savings in reduced inpatient service utilisation. Method: Eighty ICM patients were matched on ICD-9 diagnosis, age, gender, length of illness, age at first inpatient and outpatient contact, marital status, educational level, employment status, country of birth, year of arrival to Australia and religion. Inpatient bed-days and outpatient contacts were recorded and compared 12 months prior to ICM treatment, 12 and 24 months after ICM using within/between group repeated measures analysis of variance. Results: The ICM group demonstrate significant reductions in inpatient service utilisation both within the 12- and 24-month period after receiving ICM treatment. The cost differential by 24 months of treatment was $801 475 in favour of the ICM model. The increase in costs of outpatient contacts were offset by a significant reduction in inpatient service utilisation. Conclusion: When outpatient contacts averaged one contact a week for the duration of the study period no significant reductions in inpatient service utilisation was recorded, as demonstrated by comparison with the matched control group. By increasing outpatient contacts by 3–4 contacts a week, inpatient contacts reduced by 36.8%. ICM is an efficacious and cost effective way to implement community-based services to the chronically long-term mentally ill.

Assessment of Peripheral Vascular Effects of Antimigraine Drugs in Humans

Cephalalgia ◽  
1995 ◽  
Vol 15 (4) ◽  
pp. 288-291 ◽  
Author(s):  
NM van Es ◽  
TA Bruning ◽  
J Camps ◽  
PC Chang ◽  
GJ Blauw ◽  
...  
Keyword(s):  
Blood Flow ◽  
Brachial Artery ◽  
Venous Occlusion ◽  
Finger Blood Flow ◽  
Peripheral Vascular ◽  
Vascular Effects ◽  
Antimigraine Drugs ◽  
Resistance Vessels ◽  
Vascular Beds ◽  
Therapeutic Doses

The vascular beds of the forearm and finger can be used to study the peripheral effects of antimigraine drugs under normal and pathologic circumstances. We have investigated the novel antimigraine drug sumatriptan, a selective agonist for 5HT1 receptors. Its antimigraine effect may be attributed, at least in part, to constriction of cranial arteriovenous anastomoses (AVAs). In assessing the peripheral vascular effects of sumatriptan we used a forearm and finger blood flow model. Forearm blood flow (FBF) is mainly determined by resistance vessels, whereas finger blood flow (FiBF) mainly involves skin vessels, which contain many AVAs. Changes in FBF and FiBF can be assessed using venous occlusion plethysmography. Changes in AVA flow are determined by measuring the patency of the vascular beds of the forearm and hand to well-defined radiolabeled microspheres, which are injected into the brachial artery. We report the effects of sumatriptan on FBF, FiBF and AVA flow when administered into the brachial artery of healthy volunteers, and discuss the peripheral vascular effects of therapeutic doses of sumatriptan when given subcutaneously in migraine patients during and between attacks.

scholarly journals P-P47 Impact of neoadjuvant chemotherapy on postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Lulu Tanno ◽  
Charlotte Davies ◽  
Claire Stevens ◽  
Richard Fristedt ◽  
Ali Arshad ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Matched Control ◽  
Neoadjuvant Treatment ◽  
Current Evidence ◽  
Control Group ◽  
Borderline Resectable ◽  
Long Term Follow Up ◽  
Drain Amylase

Abstract Background Pancreatic adenocarcinoma (PDAC) is one of the most lethal tumours with a five-year survival rate of less than 7% for all stages. However, current evidence suggests neoadjuvant treatment (NAT) may have survival benefits in those with borderline resectable disease. Post-operative pancreatic fistula (POPF) is a potential complication after pancreaticoduodenectomy (PD) and is associated with long-term morbidity. The rate of developing POPF post-PD in those receiving NAT is currently unclear. Methods Patients undergoing PD (both classical and pylorus-preserving) were identified from a prospectively collected local database. Those who received NAT prior to surgery were identified, and case-matched controls based on their age and sex, were then identified from the database. Post-operative drain amylase levels were used to compare POPF between groups. For the analysis, drain amylase levels greater than three times the upper limit of normal at day five were consistent with biochemical POPF. Results A total of 34 patients (14 females, 20 males) underwent PD after receiving NAT at our unit from January 2013 to July 2021. The median age was 66 years at the time of surgery. Two patients (5.9%) in the NAC group had biochemical leaks on day five compared to 4 (11.8%) in the case-matched control group (p = 0.7). Conclusions Our early data suggest a possibility of a lower incidence of biochemical POPF in those undergoing PD post-NAT. Aetiology on the development of POPD post-NAT is still unclear, and this requires further study and long-term follow up.  

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