How To Assess a Claudication and When To Intervene

AbstractPurpose of the ReviewPeripheral artery disease (PAD) affects close to 200 million people worldwide. Claudication is the most common presenting symptom for patients with PAD. This review summarizes the current diagnostic and treatment options for patients with claudication. Comprehensive history and physical examination in order to differentiate between claudication secondary to vascular disease vs. neurogenic causes is paramount for initial diagnosis. Ankle-brachial index is the most commonly used test for screening and diagnostic purposes. Treatment consists of four different approaches, which are best utilized in combination: non-pharmacological treatment for claudication improvement, pharmacological treatment for claudication improvement, pharmacological treatment for secondary risk reduction, and interventional treatment for claudication improvement.Recent FindingsCilostazol is the only Food and Drug Administration (FDA)-approved agent for symptomatic treatment of claudication. Supervised exercise programs provide the maximum benefit for claudication improvement, but home-based exercise programs are an alternative. High-intensity statins and an antiplatelet agent should be prescribed to all patients with PAD. Angiotensin-converting-enzyme inhibitors can provide additional risk reduction, especially in patients with diabetes or hypertension. Rivaroxaban of low dosage (2.5  mg twice daily) in combination with aspirin further decreases cardiovascular risk, but t...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research

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Abstract Human epididymis protein 4 (HE4) is an available tumor biomarker mainly for detecting ovarian cancer. However, it is unknown whether it can be a novel indicator for diagnosis of diabetic kidney disease (DKD). The aim of this study was to investigate the possibility of serum HE4 as a novel biomarker for DKD in patients with type 2 diabetes mellitus (T2DM). We enrolled 236 patients with T2DM and 82 healthy individuals. Serum HE4 was detected by ARCHITECT i2000 and compared between T2DM patients and healthy controls. The relationships between various variables and HE4 were analyzed by univariate or multivari...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
This study is to identify the circular RNA (circRNA) expression profile that is functionally related to pancreatic islet β-cell autophagy and their potential regulation mechanisms in type 2 diabetes mellitus (T2DM). T2DM rat model was constructed by administration of high-fat and high-sugar diet. β-cells were isolated from islets by flow cytometry. CircRNA expression profile in β-cells was detected by circRNA microarrays, and the differentially expressed circRNAs were identified and validated by qRT-PCR. MicroRNA (miRNA) target prediction software and multiple bioinformatic approaches were used to construct ...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
In this study, sitagliptin nanoparticles (sizes ranging from 210 to 618 nm) were developed. The bioadhesion properties of the nanoparticles, as well as the swelling of the nanoparticles on the mucus membrane aided in sustained drug release. The pattern of drug release was in accordance with the Peppas model. Fourier-transform infrared (FTIR) spectroscopy demonstrated that there were no significant interactions between sitagliptin and chitosan. Differential scanning calorimetry (DSC) results showed an absence of drug peaks due to the fact that the drug was present in an amorphous state. Mucoadhesive nanoparticles wer...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Conclusion: The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future. PMID: 31815129 [PubMed - in process]
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Abstract Globally, the prevalence of metabolic syndrome (MetS) and its components which are the major cardiovascular disease (CVD) risk factors, is higher among patients with severe mental illness (SMI) compared to the general population. This is mainly due to the deleterious lifestyles characterized by physical inactivity, excessive alcohol consumption, smoking, and unhealthy diets common among patients with SMI as well as due to cardiometabolic effects of psychotropic medications. Despite these conditions being highly prevalent among patients with SMI, little attention is given to these conditions during routine...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
CONCLUSIONS In a rat model of maternal PCOS, exposure to androgens in utero resulted in dysbiosis of the intestinal microbiota and metabolic disorders of the newborn female rats. PMID: 31815927 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Authors: Lanthier L, Huard G, Plourde MÉ, Cauchon M PMID: 31812446 [PubMed - as supplied by publisher]
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
Analyst, 2020, Advance Article DOI: 10.1039/C9AN01679A, PaperKyu Shik Eom, Yi Jae Lee, Hye Won Seo, Ji Yoon Kang, Joon Sub Shim, Soo Hyun Lee To provide rapid and accurate determination of cholesterol, we have developed a simple, disposable, enzyme-based salivary cholesterol biosensor. To cite this article before page numbers are assigned, use the DOI form of citation above. The content of this RSS Feed (c) The Royal Society of Chemistry
Source: RSC - Analyst latest articles - Category: Chemistry Authors: Source Type: research
CONCLUSIONS: Hemodynamically stable patients under AT with blunt hepatic or splenic injuries (grade ≤ III) and no signs of peritonitis, may be good candidates for NOM, despite their bleeding tendency. The type of AT does not seem to influence the final outcome. Reversal of AT should be stratified individually. KEY WORDS: Antithrombotic therapy, Hemodynamic stability, Non-operative management. PMID: 31814603 [PubMed - in process]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
CONCLUSIONS: Reported complication rates associated with femoral VCD implantation are low. However, in some cases VCD implantation may account for severe complications including limb losses. Therefore, an adequate patient selection is necessary to detect those cases at higher risk for complications. PMID: 31814376 [PubMed - as supplied by publisher]
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
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