.RU

References - старонка 41

84

(10), 1192-1197.

Abstract: The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) is a randomized, double-blind, placebo-controlled trial designed to test the hypothesis that treatment with pravastatin will diminish risk of: subsequent major vascular events in a cohort of men and women (70 to 82 years old) with preexisting vascular disease or significant risk of developing this condition. Five thousand eight hundred four men and women in addition to receiving advice on diet and smoking, have been randomized equally to treatment with 40 mg pravastatin/day or matching placebo in 3 centers (Cork, Ireland, Glasgow, Scotland, and Leiden, The Netherlands). Following an average 3.5-year intervention period, a primary assessment will be made of the influence of this therapy on major vascular events (a combination of coronary heart disease, death, nonfatal myocardial infarction, and fatal and nonfatal stroke). A number of additional analyses will also be conducted on the individual components of the primary end point, on men, on women, and on subjects with and without previous evidence of vascular disease. Finally, an assessment will be made of the effects of treatment on cognitive function, disability, hospitalization or institutionalization, vascular mortality, and all-cause mortality. (C) 1999 by Excerpta Medica, inc

Keywords: all-cause mortality/assessment/CARDIOVASCULAR RISK/CHOLESTEROL/cognitive function/cohort/combination/coronary/coronary heart disease/death/design/diet/disability/disease/effects/function/heart/heart disease/hospitalization/infarction/institutionalization/intervention/Ireland/men/mortality/myocardial/myocardial infarction/Netherlands/NEW-YORK/placebo/placebo-controlled trial/pravastatin/primary/randomized/risk/Scotland/smoking/STATINS/STROKE/test/therapy/treatment/trial/vascular/vascular disease/women

Sheps, S.G. (1999), Overview of JNC VI: New directions in the management of hypertension and cardiovascular risk. American Journal of Hypertension,

12

(8), 65S-72S.

Abstract: Treatment recommendations for hypertension as outlined in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) are constantly evolving and being refined as new information on the disease becomes evident. Uncontrolled hypertension is a major antecedent of stroke, heart failure, coronary heart disease, and end-stage renal disease. The increasing incidences of both cardiovascular and renal diseases fuel the need for improved control of hypertension. In fact, according to the National Health and Nutrition Examination Survey (NHANES), about 69% of Americans whose blood pressure is greater than 140/90 mm Hg are aware of it, about half are getting treatment for it, and only about one-quarter are adequately controlled. These observations fuel the need for improved patient management guidelines. JNC VI makes several changes from the previous JNC V to assist physicians in the diagnosis, treatment, and improved management of patients with hypertension. These changes include reporting adult blood pressure in two new ways, via staging and risk factor classification. A high-normal classification (systolic: 130 to 139 mm Hg, or diastolic: 85 to 89 mm Hg) is included in JNC VI because of the clinical importance of such blood pressure contributing to cardiovascular disease. Additionally, clinicians are advised to assign a patient to one of three risk categories that, in addition to hypertension stage, influence the decision to select antihypertensive drug therapy. Lifestyle modification is an important component at each stage. These and other changes and highlights of recent studies supporting the need for more intensive blood pressure control are discussed in this paper. Am J Hypertens 1999; 12:65S-72S (C) 1999 American Journal of Hypertension, Ltd

Keywords: adult/antihypertensive drug therapy/antihypertensive therapy/AWARENESS/blood/blood pressure/blood pressure control/cardiovascular/cardiovascular disease/cardiovascular risk/cardiovascular risk factors/classification/clinical/control/control of hypertension/coronary/coronary heart disease/diagnosis/diastolic/disease/diseases/drug/drug therapy/end stage renal disease/end-stage renal disease/endstage renal disease/failure/guidelines/HEALTH/heart/heart disease/heart failure/hypertension/incidences/information/JNC V/lifestyle modification/management/MINNESOTA/NEW-YORK/patients/POPULATION/pressure/pressure control/PREVALENCE/renal/renal disease/risk/risk factor/SCIENCE/STROKE/studies/systolic/therapy/treatment/TRENDS

Sherif, K. (1999), Benefits and risks of oral contraceptives. American Journal of Obstetrics and Gynecology,

180

(6), S343-S348.

Abstract: The major benefits of modern low-dose oral contraceptives include relative safety and a high degree of efficacy, decreasing the need for abortion or surgical sterilization; reduced risks of bacterial (but not viral) pelvic inflammatory disease and of endometrial and ovarian cancer; improved menstrual regularity with less dysmenorrhea and blood flow; and, when low-dose combination (not progestogen-only) oral contraceptives are used, reduced acne and hirsutism. Major risks are cardiovascular. Preliminary data from nonrandomized studies suggest that oral contraceptives containing third- generation progestogens are associated with increased risk of venous thromboembolism, particularly in carriers of the coagulation factor V Leiden mutation. The risk of arterial thrombosis, such as myocardial infarction or stroke, may be directly related to estrogen dose, particularly in women who have hypertension, smoke, or are >35 years old. Considering that only users aged greater than or equal to 30 years who smoke greater than or equal to 25 cigarettes/d have a higher estimated mortality rate than that of pregnant women, the benefits of oral contraceptives appear to outweigh their risks

Keywords: aged/arterial/arterial thrombosis/bacterial/benefits/blood/blood flow/cancer/cardiovascular/cardiovascular disease/cigarette smoking/coagulation/combination/contraceptives/disease/efficacy/estrogen/ESTROGEN REPLACEMENT/factor V/factor V Leiden/factor V Leiden mutation/flow/hypertension/infarction/INSULIN-RESISTANCE/JUN/Leiden mutation/LOUIS/low dose/low-dose ethinyl estradiol/mortality/mortality rate/mutation/myocardial/myocardial infarction/oral/oral contraceptives/ovarian cancer/PA/POSTMENOPAUSAL WOMEN/progestogens/rate/risk/risks/safety/ST-LOUIS/stroke/studies/THERAPY/third-generation progestogens/thromboembolism/thrombosis/USERS/venous thromboembolism/women

Shoemaker, J.K., Hogeman, C.S. and Sinoway, L.I. (1999), Contributions of MSNA and stroke volume to orthostatic intolerance following bed rest. American Journal of Physiology-Regulatory Integrative and Comparative Physiology,

277

(4), R1084-R1090.

Abstract: We examined whether the altered orthostatic tolerance following 14 days of head-down tilt bed rest (HDBR) was related to inadequate sympathetic outflow or to excessive reductions in cardiac output during a 10- to 15-min head-up tilt (HUT) test. Heart rate, blood pressure (BP, Finapres), muscle sympathetic nerve activity (MSNA, microneurography), and stroke volume blood velocity (SW, Doppler ultrasound) were assessed during supine 30 degrees (5 min) and 60 degrees (5-10 min) HUT positions in 15 individuals who successfully completed the pre- HDBR test without evidence of orthostatic intolerance. Subjects were classified as being orthostatically tolerant (OT, n = 9) or intolerant (OI, n = 6) following the post-HDBR test. MSNA, BP, and SW during supine and HUT postures were not altered in the OT group. Hypotension during 60 degrees HUT in the post-bed rest test for the OI group (P < 0.05) was associated with a blunted increase in MSNA (P < 0.05). SW was reduced following HDBR in the OI group (main effect of HDBR, P < 0.02). The data support the hypothesis that bed rest-induced orthostatic intolerance is related to an inadequate increase in sympathetic discharge that cannot compensate for a greater postural reduction in stroke volume

Keywords: activity/bed rest/blood/blood pressure/blood velocity/BLOOD-FLOW/BP/Canada/cardiac/cardiac output/Doppler/Doppler ultrasound/effect/Finapres/HEAD-DOWN TILT/head-up tilt/HYPOTENSION/microneurography/muscle/muscle sympathetic nerve activity/nerve/NOREPINEPHRINE/orthostatic/orthostatic intolerance/orthostatic tolerance/PHYSIOLOGICAL/postural/pressure/presyncope/rate/RATS/RELEASE/SPACEFLIGHT/stroke/stroke volume/support/sympathetic/sympathetic nerve activity/SYMPATHETIC-NERVE ACTIVITY/SYNCOPE/test/tilt/ultrasound/velocity/volume

Singh, P.N., Lindsted, K.D. and Fraser, G.E. (1999), Body weight and mortality among adults who never smoked. American Journal of Epidemiology,

150

(11), 1152-1164.

Abstract: In a 12-year prospective study, the authors examined the relation between body mass index (BMI) and mortality among the 20,346 middle-aged (25-54 years) and older (55-84 years) non- Hispanic white cohort members of the Adventist Health Study (California, 1976-1988) who had never smoked cigarettes and had no history of coronary heart disease, cancer, or stroke. In analyses that accounted for putative indicators (weight change relative to 17 years before baseline, death during early follow-up) of pre existing illness, the authors found a direct positive relation between BMI and all-cause mortality among middle-aged men (minimum risk at BMI (kg/m(2)) 15-22.3, older men (minimum risk at BMI 13.5-22.3), middle-aged women (minimum risk at BMI 13.9-20.6), and older women who had undergone postmenopausal hormone replacement (minimum risk at BMI 13.4- 20.6). Among older women who had not undergone postmenopausal hormone replacement, the authors found a J-shaped relation (minimum risk at BMI 20.7-27.4) in which BMI <20.7 was associated with a twofold increase in mortality risk (hazard ratio (HR) = 2.2, 95% confidence interval (CI) 1.3, 3.5) that was primarily due to cardiovascular and respiratory disease. These findings not only identify adiposity as a risk factor among adults, but also raise the possibility that very lean older women can experience an increased mortality risk that may be due to their tower levels of adipose tissue-derived estrogen

Keywords: adults/ADVENTIST HEALTH/all-cause mortality/BMI/body/body mass/body mass index/body weight/BREAST-CANCER/CA/cancer/cardiovascular/cohort/confidence/coronary/coronary heart disease/CORONARY HEART-DISEASE/death/disease/estradiol/estrogen/ESTROGEN REPLACEMENT THERAPY/experience/follow up/FOLLOW-UP/HEALTH/heart/heart disease/Hispanic/history/index/indicators/MASS INDEX/men/menopause/mortality/mortality risk/obesity/OLDER PERSONS/PLACE/POSTMENOPAUSAL WOMEN/prospective/prospective study/respiratory/respiratory disease/risk/risk factor/RISK-FACTORS/smoking/stroke/UNITED-STATES/weight/women

Skutta, B., Furst, G., Eilers, J., Ferbert, A. and Kuhn, F.P. (1999), Intracranial stenoocclusive disease: Double-detector helical CT angiography versus digital subtraction angiography. American Journal of Neuroradiology,

20

(5), 791-799.

Abstract: Background and purpose: To our knowledge, no large-scale studies comparing the accuracy of ct angiography (Cta) To intraarterial digital subtraction angiography (Dsa) Of intracranial stenosis have been reported. We attempted to determine the diagnostic value of intracranial ct angiography (Cta) Of normal vasculature and variants as well as of stenoocclusive disease. Methods: One-hundred and twelve patients underwent cta and intraarterial angiography, and 2205 vascular segments were examined to ascertain presence, visibility, and degree of arterial stenoses (N = 105) As well as anatomic variants. Source, maximum intensity projection (Mip), And mip-generated multiplanar reformatted (Mpr) Images were evaluated. Results: All 55 anatomic variants were identified correctly, visibility of small-vessel segments was increased from 75% to 83% by using source images, mpr was helpful in differentiating distal vertebral hypoplasia from stenosis and in overcoming artifacts. All 43 occlusive segments were graded correctly (Sensitivity = 100%, predictive value = 93.4%) As follows: Severely stenotic ([N = 23], Sensitivity = 78%, predictive value = 81.8%); Moderately stenotic ([N = 36], Sensitivity = 61%, predictive value = 84.6%); And mildly stenotic ([N = 3], Sensitivity = 66%, predictive value = 28%), Normal segments (N = 2100) Had a sensitivity of 99.5%, And cta evinced a specificity of 99% for detecting stenoocclusive disease. Approximately one-third of wrong assessments were related to the petrous segment of the carotid artery. Conclusion: Cta with double-detector technology and advanced postprocessing algorithms, including mpr, is about as reliable as mra in depicting the vasculature of the anterior and posterior circulation and in grading intracranial stenoocclusive lesions, with the exception of the petrous segment of the carotid artery, cta might be superior to mra in the evaluation of poststenotic low-flow segments

Keywords: accuracy/ACUTE ISCHEMIC STROKE/advanced/algorithms/ANEURYSMS/angiography/arterial/artery/ARTERY STENOSIS/artifacts/assessments/carotid/carotid artery/circulation/COLLIMATION/CT/CT angiography/digital subtraction/digital subtraction angiography/disease/evaluation/FLOW/Germany/helical/hypoplasia/intraarterial/intracranial/intracranial stenosis/knowledge/lesions/MAXIMUM INTENSITY PROJECTION/MR- ANGIOGRAPHY/NEURORADIOLOGY/patients/posterior/posterior circulation/predictive/projection/sensitivity/SPIRAL CT/stenosis/studies/technology/vascular/vasculature/vertebral

Sloan, F.A., Taylor, D.H. and Picone, G. (1999), Costs and outcomes of hip fracture and stroke, 1984 to 1994. American Journal of Public Health,

89

(6), 935-937.

Abstract: Objectives. This study quantified changes in Medicare payments and outcomes for hip fracture and stroke from 1984 to 1994. Methods. We studied National Long Term Care Survey respondents who were hospitalized for hip fracture (n = 887) or stroke (n = 878) occurring between 1984 and 1994. Changes in Medicare payment and survival were primary outcomes. We also assessed changes in functional and cognitive status. Results. Medicare payments within 6 months increased following hip fracture (103%) or stroke (51%). Survival improved for stroke(P < .001) and to a lesser extent for hip fracture (P = .16). Condition- specific improvements were found in functional and cognitive status. Conclusions. During the period 1984 to 1994, Medicare payments for hip fracture and stroke rose and there were some improvements in survival and other outcomes

Keywords: AMERICANS/DC/DISABILITY/fracture/functional/HEALTH/hip fracture/IMPROVED SURVIVAL/JUN/Medicare/MINNESOTA/NURSING-HOME/outcomes/POPULATION/PREVALENCE/primary/PUBLIC-HEALTH/RATES/REHABILITATION/ROCHESTER/specific/status/stroke/survival/WASHINGTON

Stergiou, G.S., Thomopoulou, G.C., Skeva, I.I. and Mountokalakis, T.D. (1999), Prevalence, awareness, treatment, and control of hypertension in Greece - The Didima study. American Journal of Hypertension,

12

(10), 959-965.

Abstract: To assess the prevalence and the levels of awareness, treatment, and control of hypertension in the rural population of Greece, a cross-sectional survey of the total population age greater than or equal to 18 years of the village Didima was conducted. The survey included an interview and blood pressure (BP) measurement on two clinic visits. Hypertension was defined as systolic BP greater than or equal to 140 mm Hg and or diastolic BP greater than or equal to 90 mm Hg or current treatment with antihypertensive drugs. The same BP threshold was used for the assessment of hypertension control. A total of 694 inhabitants participated (response rate 76.4%), and 665 were analyzed. The prevalence of hypertension was 28.4% (men 30.2%, women 27.1%). Of the subjects age greater than or equal to 65 years, 50% had hypertension. Although 73% of participants were measuring their BP at least once a year, overall, 39.2% of hypertensives were unaware of the diagnosis (men 50%, women 30.5%), 6.3% were aware but not treated (men 4.8%, women 7.6%), 27.5% were treated but not controlled (men 22.6%, women 31.4%), and 27% were treated and controlled (men 22.6%, women 30.5%). These results suggest that, in the rural population of Greece, hypertension is a common risk factor with considerable potential for improvement in levels of control. (C) 1999 American Journal of Hypertension, Ltd

Keywords: age/antihypertensive drugs/assessment/awareness/blood/blood pressure/BLOOD-PRESSURE/BP/common/control/control of hypertension/CORONARY HEART-DISEASE/diagnosis/diastolic/drugs/Greece/HEALTH/hypertension/improvement/MANAGEMENT/measurement/men/NEW-YORK/NUTRITION/POPULATION/pressure/prevalence/rate/response/risk/risk factor/rural/rural population/SCIENCE/SOCIETY/STROKE/survey/systolic/threshold/total/treatment/women

Stolz, E., Gerriets, T., Fiss, I., Babacan, S.S., Seidel, G. and Kaps, M. (1999), Comparison of transcranial color-coded duplex sonography and cranial CT measurements for determining third ventricle midline shift in space-occupying stroke. American Journal of Neuroradiology, 2010-07-19 18:44 Читать похожую статью
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • Контрольная работа
  • © Помощь студентам
    Образовательные документы для студентов.