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1.
Intention of Older Women to Consume 100% Watermelon Juice for Vascular Health: An Application of Theory of Planned Behavior.
Jung, SE, Ellis, AC, Crowe-White, K
Journal of nutrition in gerontology and geriatrics. 2018;(2):130-143
Abstract
To strengthen randomized controlled trials (RCT) evaluating the efficacy of 100% watermelon juice on vascular function of older women, theory-driven behavioral analysis as well as comparative sensory analysis of the intervention and placebo were conducted. The Theory of Planned Behavior was adopted to assess psychosocial determinants of intention to consume watermelon juice. Sensory attributes were assessed utilizing hedonic scales. Analysis included Structural Equation Modeling with maximum likelihood. The measurement model provided a good fit (x2 = 70.22, df = 38; RMSEA = 0.07, CFI = 0.98; NFI = 0.95). Attitude (γ = 0.36), subjective norm (γ = 0.43), and perceived behavioral control (γ = 0.21,) were significant predictors (p < 0.001) of intention. Participants identified no significant differences in sensorial attributes between beverages, thereby minimizing sensory bias and discrimination. Similar approaches may help other RCT investigating novel foods and bioactive compounds bridge gaps between efficacy and effectiveness.
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2.
Workplace Strategies to Prevent Sitting-induced Endothelial Dysfunction.
Kruse, NT, Hughes, WE, Benzo, RM, Carr, LJ, Casey, DP
Medicine and science in sports and exercise. 2018;(4):801-808
Abstract
UNLABELLED Prolonged sitting induces endothelial dysfunction in healthy young adults, which has been demonstrated to be offset by intermittent fidgeting and standing. No information exists on the effect of sitting and endothelial dysfunction in sedentary middle-age adults, and whether common workplace counterinterventions (i.e., desk standing/desk pedaling) mitigate sitting-induced endothelial dysfunction. PURPOSE The objective of this study was to examine whether breaking up prolonged sitting with intermittent standing or underdesk pedaling prevents sitting-induced popliteal artery endothelial dysfunction in middle-age sedentary, overweight/obese office workers. HYPOTHESIS We tested the hypothesis that sitting-induced leg endothelial dysfunction would be prevented by intermittent standing or desk pedaling. METHODS Thirteen middle-age, sedentary overweight/obese subjects (10 men, 3 women; age, 38 ± 3 yr; body mass index, 29.7 ± 2 kg·m) participated in three separate testing sessions in a randomized order: 1) 4 h of uninterrupted sitting, 2) 4 h of sitting interrupted with four 10-min bouts of standing, and 3) 4 h of sitting interrupted with four 10-min bouts of light-intensity desk pedaling. Doppler ultrasound-measured popliteal artery flow-mediated dilation and associated measures (e.g., shear rate, blood velocity) were measured immediately before and immediately after each intervention (sit, stand, and desk pedaling). RESULTS Four hours of uninterrupted sitting induced a significant impairment in popliteal artery flow-mediated dilation (baseline: 3.1% ± 0.3%, post: 1.6% ± 0.5%; P < 0.05). Interestingly, neither intermittent standing (baseline: 3.2% ± 0.4%, post: 1.9% ± 0.5%; P < 0.05) nor intermittent desk pedaling (baseline: 3.2% ± 0.4%, post: 1.9% ± 0.4%; P < 0.05) was effective at preventing excessive sitting-induced endothelial dysfunction. CONCLUSIONS Prolonged sitting-induced leg endothelial dysfunction cannot be prevented by brief intermittent bouts of standing or desk pedaling in middle-age sedentary overweight/obese adults.
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3.
Strategies for Achieving Healthy Vascular Aging.
Nowak, KL, Rossman, MJ, Chonchol, M, Seals, DR
Hypertension (Dallas, Tex. : 1979). 2018;(3):389-402
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4.
Prognostic and therapeutic implications of vascular disease in patients with atrial fibrillation.
Shahid, F, Pastori, D, Violi, F, Lip, GYH
Pharmacological research. 2018;:149-159
Abstract
Atrial fibrillation (AF) is associated with a 5-fold increase in the risk of ischemic stroke, and AF-related stroke patients have a higher mortality and greater morbidity than patients with non-AF related stroke. AF and vascular disease share a close relationship, with the concomitant presence of both disease states leading to a dramatic rise in future cardiovascular events. Indeed, the presence of peripheral artery disease independently predicts stroke in patients with AF. Myocardial infarction (MI) is another well-established risk factor for the development of AF; however, the role of pre-existing AF in MI is less well evidenced, with recent studies showing that this population more frequently develops coronary ischaemic events and has a higher risk of mortality than sinus rhythm patients. Finally, complex aortic plaque is associated with heightened thromboembolic risk in AF patients. Recent data from clinical trials with non-vitamin K antagonist oral anticoagulants (NOACs) provided new insights on the prognostic implications of vascular disease coexistence in AF patients, and randomised trials testing a combination of NOAC with antiplatelet agents are ongoing. This review article provides an overview of recent data linking adverse outcomes in concomitant AF and vascular disease and the clinical trial evidence for possible therapeutic targets.
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5.
The role of MR imaging in the assessment of renal allograft vasculature.
Gondalia, R, Vernuccio, F, Marin, D, Bashir, MR
Abdominal radiology (New York). 2018;(10):2589-2596
Abstract
Renal allograft dysfunction after transplantation is a relatively common occurrence with various potential etiologies. Vascular etiologies are of particular importance as early surgical or minimally invasive intervention can, in some cases, salvage the graft. Diagnosis of vascular pathology resulting in allograft dysfunction requires a thorough workup, of which imaging is a key component. Generally, ultrasound is the first-line imaging modality. More recently, MRI has been shown to be an effective and safe modality for diagnosis of vascular pathology after renal transplantation, particularly for diagnosis of transplant renal artery stenosis. This review will summarize imaging modalities that are most commonly used in evaluating vascular pathology after renal transplantation, with a focus on the various contrast- and non-contrast-enhanced MR techniques described in the literature and used at our institution. Of particular interest is the relatively recent utilization of the non-gadolinium containing iron-based contrast agent, ferumoxytol, in time-resolved contrast-enhanced MR angiography.
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6.
Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials.
Kakkos, SK, Allaert, FA
International angiology : a journal of the International Union of Angiology. 2017;(2):93-106
Abstract
INTRODUCTION Venoactive drugs (VADs) are considered an important component of the medical (conservative) treatment of chronic venous disorders (CVDs). However, the efficacy of certain VADs on one or more individual leg symptoms may have not been extensively studied to justify a high level or grade of recommendation in guidelines on CVD. The aim of the present systematic review and meta-analysis was to study the effectiveness of VADs containing Ruscus across the spectrum of defined venous symptoms. EVIDENCE ACQUISITION On November 14 2016, a literature search of the databases MEDLINE and Scopus was performed, supplemented by hand searching, to identify randomized double-blind placebo-controlled trials on Ruscus extracts in patients with CVD. EVIDENCE SYNTHESIS The main outcome measures were the effects of Ruscus on individual symptoms and leg edema, which were expressed as risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI). Trial quality of evidence was graded using the GRADE system. We identified 10 trials, mostly with low risk of bias, on 719 patients. On qualitative analysis, Ruscus significantly improved seven defined leg symptoms, including pain, heaviness, fatigue, feeling of swelling, cramps, itching and paresthesia compared to placebo. On quantitative analysis, Ruscus compared with placebo, assessed as a categorical variable, reduced leg pain (RR=0.35, P=0.01, number needed to treat [NNT] 5, with no heterogeneity), heaviness (RR=0.26, P<0.00001, NNT=2.4, with a small amount of heterogeneity), feeling of swelling (RR=0.53, P<0.0001, NNT=4, with considerable heterogeneity, minimized after sensitivity analysis), paresthesia (RR=0.27, P<0.0001, NNT=1.8), global symptoms (RR=0.54, P<0.00001, NNT=4.3) and the total number of venous symptoms (RR 0.41, P=0.002). Similarly, Ruscus compared to placebo, assessed as a continuous variable reduced pain (SMD=-0.80, 95% CI: -1.21 to -0.39), heaviness (SMD=-1.23, 95% CI: -1.60 to -0.86), fatigue (SMD -1.16, 95% CI: -1.71 to -0.61), feeling of swelling (SMD=-2.27, 95% CI: -3.83 to -0.70), and paresthesia (SMD=-0.86, 95% CI: -1.51 to -0.21). Regarding objective assessments of leg edema, the use of Ruscus compared with placebo reduced ankle circumference (SMD=-0.74, 95% CI: -1.01 to -0.47) and leg or foot volume (SMD=-0.61, 95% CI: -0.91 to -0.31). The existing evidence, where sufficient, was mostly of high quality. CONCLUSIONS Based on high quality evidence, Ruscus extracts are highly effective in reducing symptoms and edema of patients with CVD.
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7.
Clues to vascular disorders at non-contrast CT of the chest, abdomen, and pelvis.
Esterson, YB, Berkowitz, JL, Friedman, B, Hines, JJ, Shah, PK, Grimaldi, GM
Abdominal radiology (New York). 2017;(8):2175-2187
Abstract
Non-contrast chest CT scans are commonly performed while CT scans of the abdomen and pelvis are performed in a select subset of patients; those with limited renal function, an allergy to iodinated contrast, in the setting of suspected renal calculus, retroperitoneal hematoma, common duct calculus, abdominal aortic aneurysm with or without rupture, and in patients undergoing a PET-CT scan. In the absence of intravenous contrast, vascular structures may prove challenging to evaluate, yet their assessment is an important component of every non-contrast CT examination. We describe the key imaging features of both arterial and venous pathology, and review clues and common associated non-vascular findings, which can help the radiologist identify vascular disorders at non-contrast CT. Briefly, alternative imaging options are discussed.
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8.
Vascular Imaging Techniques of the Spinal Cord.
Vargas, MI, Barnaure, I, Gariani, J, Boto, J, Pellaton, A, Dietemann, JL, Kulcsar, Z
Seminars in ultrasound, CT, and MR. 2017;(2):143-152
Abstract
The various imaging techniques used to depict vascular lesions of the spinal cord are described in this article with particular emphasis on magnetic resonance imaging (MRI), vascular sequences, and advantages of high-field MRI. Technical vascular protocols are discussed in computed tomography, MRI, and conventional angiography. The diverse magnetic resonance angiography protocols are presented as well as their findings, specificities, and pitfalls. A review of the vascular anatomy and the most common pathologies analyzed by magnetic resonance angiography and conventional angiography is described.
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9.
Macrovascular complications in pregnancy and diabetes.
Sahay, RK, Pydi, VM
JPMA. The Journal of the Pakistan Medical Association. 2016;(9 Suppl 1):S56-9
Abstract
This review discusses macrovascular conditions which may occur during pregnancy complicated by diabetes. It describes the effect of dyslipidaemia and hypertension on foeto-maternal outcomes and explores the pathogenesis of these states.
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10.
Neurovascular manifestations of connective-tissue diseases: A review.
Kim, ST, Brinjikji, W, Lanzino, G, Kallmes, DF
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. 2016;(6):624-637
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Abstract
Patients with connective tissue diseases are thought to be at a higher risk for a number of cerebrovascular diseases such as intracranial aneurysms, dissections, and acute ischemic strokes. In this report, we aim to understand the prevalence and occurrences of such neurovascular manifestations in four heritable connective tissue disorders: Marfan syndrome, Ehlers-Danlos syndrome, Neurofibromatosis Type 1, and Loeys-Dietz syndrome. We discuss the fact that although there are various case studies reporting neurovascular findings in these connective tissue diseases, there is a general lack of case-control and prospective studies investigating the true prevalence of these findings in these patient populations. Furthermore, the differences observed in the manifestations and histology of such disease pathologies encourages future multi-center registries and studies in better characterizing the pathophysiology, prevalence, and ideal treatment options of neurovascular lesions in patents with connective tissue diseases.