scholarly journals Beneficial Effect of Exercise on Cognitive Function during Peripheral Arterial Disease: Potential Involvement of Myokines and Microglial Anti-Inflammatory Phenotype Enhancement

2019 ◽  
Vol 8 (5) ◽  
pp. 653 ◽  
Author(s):  
Marina Leardini-Tristao ◽  
Anne-Laure Charles ◽  
Anne Lejay ◽  
Mégane Pizzimenti ◽  
Alain Meyer ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Peripheral Arterial Disease ◽  
Cognitive Dysfunction ◽  
Arterial Disease ◽  
Public Health Issue ◽  
Information Processing Speed ◽  
Critical Ischemia ◽  
Inflammatory Phenotype ◽  
Anti Inflammatory ◽  
Peripheral Arterial

Peripheral arterial disease (PAD), leading to intermittent claudication, critical ischemia with rest pain, and/or tissue damage, is a public health issue associated with significant morbidity and mortality. Little is known about the link between PAD, cognitive function, and whether exercise might reduce cognitive dysfunction in PAD patients, as previously observed concerning both quality of life and prognosis. This review highlights the fact that patients suffering from PAD often demonstrate cognitive dysfunction characterized by reduced performance in nonverbal reasoning, reduced verbal fluency, and decreased information processing speed and a greater risk for progression toward dementia. Further, the data presented support that physical exercise, likely through myokine secretion and microglial anti-inflammatory phenotype enhancement, might participate in the cognition protection in common clinical settings.

Peripheral Arterial Disease and Cognitive Function

2003 ◽  
Vol 65 (5) ◽  
pp. 757-763 ◽  
Author(s):  
Shari R. Waldstein ◽  
Carol F. Tankard ◽  
Karl J. Maier ◽  
Jessica R. Pelletier ◽  
Joseph Snow ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Peripheral Arterial

scholarly journals Pharmacological therapy in critically ill patients with peripheral and concomitant arteriopathy

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 166-173
Author(s):  
Nicola Troisi ◽  
Antonio Trani ◽  
Pierluigi Antonino Cappiello
Keyword(s):  
Peripheral Arterial Disease ◽  
Clinical Manifestations ◽  
Arterial Disease ◽  
Risk Profile ◽  
Pharmacological Therapy ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Critical Ischemia ◽  
Good Safety Profile ◽  
Peripheral Arterial

Peripheral arterial disease is one of the most frequent clinical manifestations of atherosclerotic disease. The clinical picture of critical ischemia of the lower limbs is often burdened by high mortality and the risk of limb amputation. The direct and indirect prostanoids, and in particular iloprost and cilostazol, are effective in the medical treatment of peripheral arterial disease. We describe here five clinical cases in which iloprost and cilostazol have been successfully administered in arterial patients with various concomitant cardiovascular diseases, highlighting a good safety profile in relation to the cardiocascular risk profile (Cardiology).

scholarly journals A diabeteses láb ischaemiás eredete. Epidemiológia, a diagnózis nehézségei, prevenciós és revascularisatiós lehetőségek

2017 ◽  
Vol 158 (6) ◽  
pp. 203-211 ◽  
Author(s):  
Endre Kolossváry ◽  
Zoltán Bánsághi ◽  
Gábor Viktor Szabó ◽  
Zoltán Járai ◽  
Katalin Farkas
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Diagnostic Tools ◽  
Public Health Issue ◽  
Effective Prevention ◽  
Increased Risk ◽  
Peripheral Arterial

Abstract: “Diabetic foot” as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations. Available vascular centers with special expertise and diagnostic tools are the prerequisite for efficient diagnosis supporting timely recognition of peripheral arterial disease. In course of treatment of diabetic foot with ischemic origin, beyond effective medical treatment revascularization (open vascular surgery or endovascular procedures) has paramount importance for prevention of limb loss. Vascular teams of vascular specialists, vascular surgeons and interventional radiologist in dedicated centers in multidisciplinary cooperation with other professions represent public health issue in effective prevention. Orv. Hetil., 2017, 158(6), 203–211.

scholarly journals PROTECTIVE FACTORS AGAINST DEPRESSION IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASE WITH CRITICAL LIMB ISCHEMIA

2017 ◽  
Vol 64 (4) ◽  
pp. 296-299
Author(s):  
Liliana Veronica Diaconescu ◽  
◽  
Ion Diaconescu ◽  
Keyword(s):  
Social Support ◽  
Peripheral Arterial Disease ◽  
Coping Strategies ◽  
Depression Scale ◽  
Limb Ischemia ◽  
Psychosocial Interventions ◽  
Arterial Disease ◽  
Active Coping ◽  
Critical Ischemia ◽  
Peripheral Arterial

Introduction. The aim of the study was to assess the extent to which psychosocial factors (social support and coping strategies) may have a protective role against depression in patients with peripheral arterial disease (PAD). Methods. The design of the study was transversal and included 37 patients with PAD with critical ischemia (32 men, 5 women, mean age = 62.41). They were administered Center for Epidemiologic Studies Depression Scale, Duke-UNC Functional Social Support Questionnaire and COPE inventory. Results. Depressive symptoms were found at 28.6% of the patients. There were low scores of perceived social support at 32.4% of the patients. Depression correlated (p<.001) positively with mental disengagement (r=.791), denial (r=.672), behavioral disengagement (r=.760), restraint (r=.075) and negatively with social support (r= -.879) and positive reinterpretation (r=-.844), active coping (r=-.776), use of emotional support (r=-.624). Discussion. PAD patients experience depression. Is highlighted the buffer role of social support and of active coping strategies in facing a chronic disease. Conclusions. Recognition and evaluation for depression in patients with PAD followed by identifying psychosocial interventions may be useful in improving outcomes of these patients.

scholarly journals Is There a Risk Factor More Responsible for Disaster?

2015 ◽  
Vol 61 (3) ◽  
pp. 245-247
Author(s):  
Carasca Cosmin ◽  
Muresan Vasile Adrian ◽  
Tilea Ioan ◽  
Magdas Annamaria ◽  
Carasca Emilian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Risk Level ◽  
Critical Ischemia ◽  
Medium Risk ◽  
Peripheral Arterial

Abstract Background: Risk factors for peripheral arterial disease are generally the same as those responsible for the ischemic heart disease and in both cases are overlapping risk factors involved in the etiology of atherosclerosis, such as smoking, dyslipidemia, diabetes and hypertension. Case report: We present a case of a 61 years old male, whose ischemic peripheral symptoms began in 2003, at the age of 49, presenting as a Leriche syndrome. The patient was subjected to first revascularization procedure consisting in aortic-bifemoral grafting in the same year. General examination revealed no risk factors except smoking. Only a year after, he returns with critical right lower limb ischemia due to bypass thrombosis, therefore two thrombectomies were performed followed by a right side femoro-popliteal bypassing with Dacron prosthesis. The patient’s condition was good until 2008 when a femoro-popliteal bypass using inverted autologus saphenous vein was imposed due to occlusion of the previous graft. In 2013 the patient was readmitted to hospital with left lower limb critical ischemia. A femoro-popliteal bypass was performed, followed by two thrombectomies and the amputation of the left thigh. Up to this date, the patient kept smoking. Discussions: Although our patient has a low/medium risk level of atherosclerosis by Framingham score and a minimum Prevent III score, all the surgical revascularization procedures were not able to avoid the amputation. Conclusions: There are enough reasons to believe that smoking as a single risk factor can strongly influence the unfavorable progression to amputation in patients with peripheral arterial disease.

Ischemic Neuropathy

2018 ◽  
pp. 123-136
Author(s):  
Jagan Devarajan ◽  
Beth H. Minzter
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Disease Process ◽  
Arterial Disease ◽  
Comorbid Conditions ◽  
Critical Ischemia ◽  
Tissue Ischemia ◽  
Treatment Measures ◽  
Pulse Doppler ◽  
Peripheral Arterial

This chapter discusses the subset of ischemic neuropathy which is due primarily to peripheral arterial disease. Peripheral arterial disease affects 5% of men and 2.5% of women and results in ischemic pain and claudication. Disease progression occurs in a small minority of patients to a stage of critical ischemia with rest pain and threatens limb survival. Ischemic neuropathy encompasses pain due to several stages of progression of tissue ischemia. Patients may have multiple comorbid conditions due to the same pathological process that affects coronary, cerebral, and other circulations. Diabetes mellitus is commonly associated with vascular ischemia and results in arterial occlusive diseases. Pathological changes involve demyelination, axonal loss, and disorderly remyelination. In addition to simple palpation of a pulse, Doppler flow estimation and angiography are used to determine the location and extent of the disease process. Ankle-brachial index, toe-brachial index, and digital flow estimations are more sensitive methods used for early identification. In addition to controlling risk factors and the management of comorbid conditions, medication and procedures to restore blood flow play a prominent role in management of ischemic neuropathy. Sympatholysis and spinal cord stimulation are effective methods to help manage chronic pain in advanced cases that are refractory to conventional treatment measures.

scholarly journals Epidemiological Analysis of Lower Limb Revascularization for Peripheral Arterial Disease over 12 years in the Public Health System in Brazil

2021 ◽  
Author(s):  
Nelson Wolosker ◽  
Marcelo Fiorelli Alexandrino da Silva ◽  
Maria Fernanda Portugal ◽  
Nickolas Stabellini ◽  
Antonio Eduardo Zerati ◽  
...  
Keyword(s):  
Public Health ◽  
Peripheral Arterial Disease ◽  
Health System ◽  
Lower Limb ◽  
Endovascular Procedures ◽  
Public Health System ◽  
Arterial Disease ◽  
High Morbidity ◽  
Critical Ischemia ◽  
Peripheral Arterial

Objectives: Worldwide, peripheral arterial disease (PAD) is a disorder with high morbidity, affecting more than 200 million people. Our objective was to analyse the surgical treatment for PAD performed in the Unified Health System of Brazil over 12 years based on publicly available data. Methods: The study was conducted with data analysis available on the DATASUS platform of the Brazilian Health Ministry, assessing procedure technique distribution throughout the years, mortality and cost. Results: A total of 129,424 procedures were analysed (either for claudicants or critical ischemia, proportion unknown). The vast majority of procedures were Endovascular (65.49%), with a tendency for increase in this disproportion (p<0.001). There were 3,306 in-hospital deaths (mortality of 2.55%), with lower mortality in the Endovascular group (1.2% vs. 5.0%, p=0.008). The overall governmental investment for these procedures was U$ 238,010,096.51, and Endovascular Procedures were on average significantly more expensive than Open Surgery (U$ 1,932.27 v. U$ 1,517.32; p=0.016). Conclusions: In the Brazilian Public Health System, lower limb revascularizations occurred with gradual growing frequency between 2008 and 2019. Endovascular procedures were vastly more common, and related to lower in-hospital mortality rates, but higher procedural costs.

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