1/30. Aortic dissection in young patients with chronic hypertension.We describe four patients aged 14 to 21 years who developed acute aortic dissection. In three of the four patients, the course was fatal, despite aggressive medical and surgical intervention. All four patients had sustained systemic hypertension related to chronic renal insufficiency. The patients had no other identifiable risk factors for aortic dissection, including congenital cardiovascular disease, advanced atherosclerosis, vasculitis, trauma, pregnancy, or family history of aortic dissection. Although aortic dissection is rare in individuals younger than 40 years of age, young patients with sustained systemic hypertension are at increased risk for this serious and often fatal condition. physicians must be aware of this rare complication of hypertension and consider aortic dissection in the differential diagnosis of unusual chest, abdominal, and back pain in hypertensive children, adolescents, and young adults.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/30. Internuclear ophthalmoplegia following minor head injury: a case report.Internuclear ophthalmoplegia (INO) is a common sign of multiple sclerosis in young patients and of vascular diseases in older people. Traumatic bilateral internuclear ophthalmoplegia following severe head injuries may occur. We present the unusual case of a young patient suffered from bilateral INO as an isolated finding after a minor head injury, without other signs of brain stem or cortical injury. The ophthalmoplegia has persisted for 22 months.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/30. Use of topical recombinant human platelet-derived growth factor-BB (becaplermin) in healing of chronic mixed arteriovenous lower extremity diabetic ulcers.lower extremity ulcers cause significant morbidity and mortality in patients with diabetes. The primary factors that contribute to the development of this type of ulcer are peripheral neuropathy and peripheral vascular disease, which are often accompanied by infection. lower extremity diabetic ulcers are chronic and difficult to treat, in part due to underlying pathologic conditions in individuals with diabetes that can contribute to impaired wound healing. This article reports the author's experience with treatment of chronic lower extremity ulcers of mixed etiologies with recombinant human platelet-derived growth factor--BB [rhPDGF-BB, REGRANEX (becaplermin) Gel 0.01%] in a patient with multiple risk factors including long-standing insulin-dependent type 2 diabetes.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/30. The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract.BACKGROUND: The treatment of angiodysplasia and watermelon stomach, vascular abnormalities implicated in gastrointestinal bleeding of obscure origin, is a major clinical problem. AIM: To determine the efficacy of octreotide in patients with long-standing gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, resistant to previous treatments and not suitable for surgery because of old age and/or concomitant disorders. patients AND methods: We treated 17 patients (seven had isolated angiodysplasia, seven had multiple upper and lower gastrointestinal angiodysplasia, and three had watermelon stomach) with octreotide (0. 1 mg subcutaneous t.d.s. for 6 months). Six of the patients had liver cirrhosis, one had Glanzmann-type platelet derangement, two had cardiovascular diseases and one had chronic uraemia. RESULTS: octreotide treatment stopped bleeding in 10 patients. A transient improvement was observed in four, who needed subsequent cyclical retreatment to correct low haemoglobin levels. No effect was observed in three, probably due to the severity of the concomitant disorders. CONCLUSIONS: octreotide is a safe drug that may be useful to control the recurrent gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, especially in patients who are not candidates for surgery due to old age and/or concomitant disorders.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/30. Sudden cortical hearing loss for speech: a case report.A 35-yr-old male patient experienced a sudden loss of speech understanding due to a bilateral cerebrovascular disease. A detailed summary of audiological and neurological findings was presented. Findings indicated that the presence of Pa waves of the Middle Latency Response (MLR) may be a positive prognosis for improvement in hearing thresholds and speech understanding.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
6/30. Living with peripheral vascular disease: a review of the literature.Peripheral vascular disease is a debilitating condition that can significantly reduce a patient's quality of life. It affects mainly older people and causes severe chronic pain that can make even simple activities of daily living impossible. This paper reviews the literature on the management of PVD, with specific emphasis on the patient experience of living with the condition.- - - - - - - - - - ranking = 5keywords = vascular disease (Clic here for more details about this article) |
7/30. Differences in diffusion-weighted and T2-weighted magnetic resonance imaging findings in the acute and chronic stages of ischemic cerebrovascular disease--two case reports.A 71-year-old man presented with sudden onset of vertigo and a 77-year-old man suffered consciousness disturbance. diffusion-weighted magnetic resonance (MR) imaging on admission showed hyperintense areas in the left cerebellar hemisphere in the first patient and in the brainstem in the second patient. Both patients were treated with argatroban and edaravone, and the neurological deficits markedly improved one month after admission. T2-weighted MR imaging one month after the onset showed much smaller hyperintense areas compared with the findings on admission in both patients. These results indicate that findings of hyperintense areas by diffusion-weighted MR imaging in the acute stage of ischemic cerebrovascular disease indicate not only the ischemic core but also parts of the reversible incomplete ischemic lesion and suggest that intensive treatment in the acute stage might reverse ischemic brain damage in some patients.- - - - - - - - - - ranking = 5keywords = vascular disease (Clic here for more details about this article) |
8/30. Chronic paroxysmal headache: two cases with cerebrovascular disease.Paroxysmal headaches often occur in benign headache disorders such as episodic cluster headache, chronic paroxysmal hemicrania (CPH) and episodic paroxysmal hemicrania. We report 2 patients with paroxysmal headaches occurring in association with cerebrovascular disease. The first patient had paroxysmal headaches from an arteriovenous malformation which resolved following embolization. In the second patient, headache followed a cerebral infarction and responded to treatment with indomethacin. We suggest that vascular disease may cause paroxysmal headaches resembling CPH. patients with an atypical presentation of CPH warrant a neuroimaging procedure.- - - - - - - - - - ranking = 6keywords = vascular disease (Clic here for more details about this article) |
9/30. Vascular risk management through nurse-led self-management programs.In current clinical practice, adequate cardiovascular risk reduction is difficult to achieve. Treatment is primarily focused on clinical vascular disease and not on long-term risk reduction. Pertinent to success in vascular risk reduction are proper medication use, weight control, healthy food choices, smoking cessation, and physical exercise. Atherosclerotic vascular disease and its risk constitute a chronic condition, which poses specific requirements on affected patients and caregivers who should be aware of the chronicity. In patients with vascular disease, there is lack of awareness of their chronic condition because of the invisibility of most risk factors. In other patient groups with chronic illness, self-management programs were successful in achieving behavioral change. This strategy can also be useful for patients with vascular disease to adapt and adhere to an improved lifestyle. Self-management refers to the individual's ability to manage both physical and psychosocial consequences including lifestyle changes inherent to living with a chronic condition. Interventions that promote self-management are based on enhancing self-efficacy. In self-management, attention can be given to what is important and motivational to the individual patient. In this article the challenge of nursing care promoting self-management for patients with vascular risk and how this care can be applied will be explained. nurses can play a central role in vascular risk management with a self-management approach for patients with chronic vascular disease. In vascular prevention clinics, nursing care can be delivered that includes medical treatment of vascular risks (hypertension, hypercholesterolemia, hyperglycemia, and hyperhomocystinemia) and counseling on promoting self-management (changes in diet, body weight, smoking habits, and level of exercise). Nursing interventions based on self-management promotion can provide a new and promising approach to actually achieve vascular risk reduction.- - - - - - - - - - ranking = 5keywords = vascular disease (Clic here for more details about this article) |
10/30. Metabolic and skeletal complications of hiv infection: the price of success.Over the past 10 years, in conjunction with the broad availability of potent antiretroviral regimens, the care of human immunodeficiency virus (hiv)-infected patients has shifted from prevention and treatment of opportunistic infections and malignancies to management of the metabolic and related complications associated with hiv infection and its treatment. Metabolic disorders, including lipodystrophy, dyslipidemia, and insulin resistance, occur at a high rate in hiv-infected individuals receiving highly active antiretroviral therapy (HAART). These disorders are associated with increased risk of cardiovascular disease and have become an important cause of morbidity and mortality in hiv-infected patients. Herein, we present the case of a patient with hiv infection who responded well to HAART but developed multiple complications potentially related to this therapy. This article reviews the clinical characteristics of the metabolic and skeletal disturbances observed in hiv infection and discusses strategies for their management.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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