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Mediasclerosis And Diabetes

Klaudija Batinic, Clemens Höbaus, Milan Grujicic, Angelika Steffan, Finka Jelic, David Lorant, Thomas Hörtenhuber, Florian Hoellerl, Johanna-Maria Brix, Guntram Schernthaner, Renate Koppensteiner, Gerit-Holger Schernthaner
OBJECTIVE: YKL-40 is secreted by macrophages in atherosclerotic lesions and involved in plaque rupture. YKL-40 is elevated in coronary artery disease, and predicts cardiovascular mortality. Experimental in vivo and in vitro data suggest a role of YKL-40 in tissue remodeling. A disease modulating potency of YKL-40 was not investigated in peripheral arterial disease (PAD). METHODS: We measured YKL-40 in 460 subjects: 316 PAD: 71 normal glucose metabolism (PAD-NGM), 90 pre-diabetes (PAD-PREDM) and 155 diabetes (PAD-DM); 20 diabetes with atherosclerosis but without PAD (AS-DM); 85 diabetes without macro-vascular complications (DM) and 39 healthy controls (CO)...
June 2012: Atherosclerosis
M Dreyer
The increase in prevalence of diabetes mellitus and in life expectancy cause the growing number of diabetic patients with peripheral artery disease (PAD). Patients with long standing diabetes suffer frequently (about 70%) from peripheral sensory neuropathy. Therefore these patients miss the symptoms of claudication. Patients with silent ischemia will be classified to stadium I (Fontaine) instead to stadium II or III or their diagnosis will be missed at all. The clinical investigation of the food pulses should be done at least once per year in all patients with diabetes mellitus...
May 2011: Der Internist
David Peter Lorant, Milan Grujicic, Clemens Hoebaus, Johanna-Maria Brix, Florian Hoellerl, Guntram Schernthaner, Renate Koppensteiner, Gerit-Holger Schernthaner
OBJECTIVE: Low levels of fetuin-A, a systemic calcification inhibitor, are linked to mortality in patients on dialysis. In contrast, elevated fetuin-A is associated with cardiovascular events in non-renal patients. We investigated fetuin-A in patients with type 2 diabetes and peripheral arterial disease (PAD). RESEARCH DESIGN AND METHODS: We studied fetuin-A in 76 patients with PAD and normal glucose metabolism (NGM-PAD) and in 129 patients with PAD and type 2 diabetes (type 2 diabetes-PAD)...
January 2011: Diabetes Care
M M H Hermans, U Gladziwa
An X-ray of the abdomen of a diabetic dialysis patient showed typical signs of extra-skeletal calcification with mediasclerosis and calcification of the vasa deferentia.
November 3, 2007: Nederlands Tijdschrift Voor Geneeskunde
E Zander, P Heinke, J Reindel, K D Kohnert, U Kairies, J Braun, L Eckel, W Kerner
BACKGROUND: Diabetic patients have increased prevalence of peripheral arterial disease (PAD). It is not clearly shown whether the prognostic factors are identical in relation to the type of diabetes. This study was done to compare the associations of PAD with risk factors and with micro- and macrovascular complications of inpatients with type 1 and type 2 diabetes. METHODS: In a retrospective cross-sectional study 1087 patients with type 1 diabetes and 1060 patients with type 2 diabetes were examined...
November 2002: VASA. Zeitschrift Für Gefässkrankheiten
M Lepäntalo, F Biancari, E Tukiainen
Lower limb ischaemia is one of the determinants in the development of diabetic foot ulcers and the most important factor preventing their healing. There are a number of misleading factors masking the presence of atherosclerotic disease and tissue damage; these are reduced inflammatory response to infection, autosympathectomy and mediasclerosis, which all diminish the clinical suspicion of ischaemia. Therefore, adequate assessment of the lower limb circulation should be routinely performed in complicated diabetic foot...
September 2000: Diabetes/metabolism Research and Reviews
C Sucker, P Lanzer
PATHOGENESIS: Arteriosclerosis and Mönckeberg's mediasclerosis are vascular diseases associated with calcification of the artery wall. While mediasclerosis in most cases develops in type 2 diabetic patients, arteriosclerosis is the result of a combination of different vascular risk factors. Mönckeberg's mediasclerosis typically involves the tunica media, whereas arteriosclerosis-associated calcifications primarily involve the intima. CLINICS: Isolated mediasclerosis does not cause narrowing of the blood vessel...
April 15, 2000: Medizinische Klinik
J Langholz, O Stolke, C Behrendt, B Blank, B Fessler, H Heidrich
We examined the accuracy of colour flow detection of lower limb arteries in relation to Fontaine's criteria of obstructed peripheral circulation. Assessments were conducted in relation to stages I and II as well as to stages III and IV and compared to the corresponding i. a.-DSA: On comparing the total of all ultrasound results in stages (I-IV) with those of arteriography (92 calf arteries) we found a sensitivity between 80 and 90% and a specificity between 90 and 97%. Results did not differ from these values in the subgroups Fontaine II-IV...
December 1993: Ultraschall in der Medizin
G H Hübner, A Köhler, H J Triebel, H Podhaisky
A 51-year-old diabetic showed symptoms of a hypertensive crisis with a systolic blood pressure above 300 mmHg. The antihypertensive therapy failed and the Doppler-pressure values were also too high for all limb arteries. Duplex-sonography and soft-x-ray examination showed a mediasclerosis of arms and legs. The true pressure, measured at the still compressable arteries of the fingers was relatively low. There was symptomatic improvement after completion of the antihypertensive therapy.
1995: VASA. Zeitschrift Für Gefässkrankheiten
H U Janka, E Standl, H Mehnert
Data of 623 nonselected diabetic outpatients are presented who were screened for peripheral vascular disease (PVD) and for cardiovascular risk factors. PVD was diagnosed in 15.9% of the diabetic patients (14.4% women and 18.0% men). Nine percent of the patients had signs of marked mediasclerosis at the ankle level. Multivariate statistical analysis revealed that PVD was closely associated with systolic hypertension and also with the duration of diabetes, a relationship that was highly significant (P less than 0...
March 1980: Diabetes Care
M J Lepäntalo, J Haajanen, O Lindfors, P Paavolainen, T M Scheinin
Segmental blood pressure criteria for below-knee amputations were assessed retrospectively. 40 patients underwent 44 below-knee amputations for advanced lower limb ischaemia. Preoperative systolic blood pressure measurements using a Doppler device as a distal sensor were performed on 31 limbs to be amputated. Healing occurred in all limbs with calf systolic pressures of 68 mmHg or more and distal thigh systolic pressures of 100 mmHg or more. With calf pressures below 35 mmHg and distal thigh pressures of 60 mmHg or less, all amputations failed...
1982: Acta Chirurgica Scandinavica
G Bauer, H Jantsch
Short-wave therapy has been an established form of therapy for many decades and is unanimously regarded as harmless when properly applied. The possibility of burn injuries occurring is known, yet hardly any cases have been reported. In the case under review, a diabetic, after only a short treatment, suffered very severe burns that ultimately led to the amputation of three toes. Clinical and histopathological analysis established the presence of mediasclerosis of the large leg arteries as well as microangiopathy and peripheral neuropathy...
1985: Zeitschrift Für Rechtsmedizin. Journal of Legal Medicine
M Lepäntalo, H Isoniemi, L Kyllönen
The predictability of below-knee amputation healing was evaluated in 69 patients with severe distal ischaemia with or without diabetes mellitus. A special attempt was made to find out predictors of amputation failure. Of 71 amputations performed 20 failed. Preoperative systolic blood pressures and skin perfusion pressures were significantly higher at the level of amputation in patients whose amputations healed than in those whose amputations failed, mean 69.5 (SD 33.4) mmHg and 55.9 (SD 27.0) mmHg vs. 41.5 (SD 31...
1987: Annales Chirurgiae et Gynaecologiae
G Reichel
200 years have gone by since the autonomic disturbance in diabetes mellitus has been described for the first time ever. There is a great deal of information on the close relationship between somatic and visceral symptoms in diabetic polyneuropathy (PNP), so that there should be talked about only of one form of manifestations within the meaning of a distal symmetric somatovisceral PNP. The longer fibres such as the vagal fibres of the viscus, sympathetic fibres of the eye are affected at first and more intensively in the autonomic region same as in the sensory and motor region...
April 1987: Fortschritte der Neurologie-Psychiatrie
M Hirschl, M Francesconi, M M Hirschl
We assessed in 1662 consecutive diabetic patients systolic arm-ankle indexes by a Doppler ultrasonic method. In those patients with indexes greater than or equal to 1.3 directional Doppler sonometry and mercury strain gauge plethysmography were performed. In some instancies electronic oscillography, duplex sonography and vital microscopy were additionally done. In 4.45% of the patients functional findings of a mediasclerosis could be encountered. Location of arterial mediacalcinosis was documented by x-ray examinations...
1991: VASA. Zeitschrift Für Gefässkrankheiten
H U Janka, E Standl, F Oberparleiter, G Bloss, H Mehnert
623 non-selected diabetic outpatients were screened by the Doppler-ultrasonic-method for peripheral vascular disease. Additional angiologic work up was performed to define the location of stenosis and obliteration. 15.9% of the diabetics were shown to have peripheral vascular disease and 57% of those denied claudication. 9% of the patients had signs of mediasclerosis. The predilection of peripheral vascular disease in diabetics for the arteries below the knee (peripheral type) was confirmed in our study. Patients with a pelvic or femoropopliteal type of peripheral vascular disease showed a high frequency of cardiovascular risk factors...
February 23, 1979: Medizinische Klinik
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