Atherosclerosis Of Cerebral Vessels Research Articles

Clinical efficacy and safety of Ethoxidol in cerebrovascular diseases

Evaluation of efficacy and clinical safety of ethylmethylhydroxypyridine malate (Ethoxidol) in cerebrovascular disease in out-patient, and in-patient setting. In the observational study was included of the 70 patients (aged 62.84±6.54 y.o) diagnosed with unspecified cerebrovascular disease, hypertensive encephalopathy, atherosclerosis of cerebral vessels. To access neurological deficit Montreal Scale (MoCA test) was used, MFI-20 test for asthenia. Berg balancing (BBS-test), tinnitus severity score (THI), and general clinical condition score also were recorded. Quality assurance was evaluated by VAS, and EQ-VAS Scores (European life quality gr). Interventions were identical, except treated received Ethoxidol 200 mg IV once/day, or 200 mg IM once/day and 200 mg per os (400 mg/day) during 7 days, follow up by oral administration of Ethoxidol 600 mg/day (200 mg TID) for the period of 53 days. The results of the observational study has shown of high clinical efficacy and tolerability of the Ethoxidol therapy. Statistical significance between baseline and treatment period was recorded on the 7th and 60th day of observation (p<0.001). Stabilization of the archived condition persisted on the 60th day. Ethoxidol administration reduced asthenia cognitive dysfunction, dizziness, balance disorders, and tinnitus. CGI Score revealed reduction of the severity of patient's condition and total of clinical improvement; EQ-VAS Score showed growth of quality of life. The majority of patients were satisfied with performed therapy, attending physicians highlight Ethoxidol safety. Serious adverse events weren't recorded. Ethoxidol was considered as efficient and safe medication for in-patient and out-patient treatment of patient with cerebrovascular diseases (chronic cerebral ischemia).

Features of responding to stress of elderly patients with chronic brain ischemia

The aim of the study. To study the peculiarities of responding to stress, the stress resistance and adaptation of older men and women with chronic brain ischemia, as well as the stressboard effect of Mexidol.Material and methods. 124 patients aged 60–74 years old are surveyed: 72 men and 52 women (average age, respectively, 65.3 ± 0.4 and 64.7 ± 0.7 years) with Chronic Brain Ischemia I–II stage against the background of arterial hypertension and its combinations with atherosclerosis of cerebral vessels. The level of psychosocial stress was determined on the Holmes-Ray scale. Features of the response of patients to stress was studied using the methodology Scale of Psychological Stress PSM-25 and S. Rogenzweig. Stress resistance was investigated using S. Kuhlen's stress resistance self-resistant test and Villianson. The level of anxiety was determined using a scale of Ch.D. Spilberger and Yu.L. Khanin, depressed – backup questionnaire. The type of adaptation reactions was studied in the leukocyte blood formula on the percentage ratio of lymphocytes and segmented neutrophils, taking into account the representation of other formed elements.Results. The level of stress in older women with Chronic Brain Ischemia was higher than in men. The predominance of the intrinsic orientation of the reaction to stress and resolving the type of response to men, and the extrapunitive or self-defense type among women, which may indicate the largerness of the latter. The level of stress resistance was lower in women than in men, which correlated with higher indicators of situational anxiety. Adverse adaptation reactions were more often registered in women than in men. The course of treatment with Mexidol of elderly patients with chemical leads to a decrease in the severity of subjective and objective symptoms, alarming disorders, increases the stress resistance and adaptive capabilities of the body, which is confrmed by an increase in the number of persons with favorable adaptation reactions. The high effciency and safety of sequential therapy with Mexidol (injections, then the tableted form of Mexidol Forte 250) is shown.

CELLULAR COMPOSITION STATE AND MICROFLORA OF ORAL MUCOSAL EPITHELIUM OF PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA

The cell composition and microflora of oral mucosal epithelium smearsand the hormonal composition of oral fluid in patients with chronic cerebral ischemiawere studied. We examined 54 patientsaged 45-65 years suffering from cerebral blood circulation disorders caused by atherosclerosis of cerebral vessels and under outpatient observation. In patients with chronic cerebral ischemia, a decrease in the size of the neutrophil pool and epithelial cell pool was noted in saliva smears, against the background of an increase in the number of lymphocytes (threefold) and “bare nuclei” -more than ten times, which indicates a weakening of local protection and is considered as a pathogenetically significantindicator. Smears of buccal epithelial cells revealed yeast-like fungi of the Candida genus (C.albicans), whose content reached 105CFU/ml in 61.44% of cases and averaged 82.5±6.4% of strains in CCI patients. Free progesterone increased 1.9-fold in oral fluid, whereas estradiol levels decreased 5-fold and cortisol increased 1.6-fold.Keywords: chronic cerebral ischemia, buccal cells, candidiasis, sex hormones.

Impaired Aβ clearance: a potential link between atherosclerosis and Alzheimer's disease.

Alzheimer’s Disease (AD) and atherosclerosis remain two of the largest public health burdens in the world today. Although traditionally considered distinct pathological entities, mounting epidemiologic, clinical and experimental evidence suggests that cerebrovascular atherosclerosis and AD interact reciprocally to disrupt brain structure and function. Whereas the hypoperfusion and hypoxia caused by atherosclerosis of cerebral vessels may enhance the production of amyloid-β peptide (Aβ), a peptide central to AD pathology, Aβ, in turn, may promote formation of atherosclerotic lesions through vascular oxidative stress and endothelial dysfunction leading to additional vascular damage. Here, we briefly review evidence suggesting that impaired clearance of Aβ is an additional, simultaneously occurring mechanism by which AD and cerebrovascular disease may be causally linked. We examine the literature supporting mechanisms by which flow-limiting large-artery stenosis, arterial stiffening and microvascular dysfunction could contribute to AD pathophysiology by impairing Aβ clearance and elevating brain levels of Aβ. Finally, we highlight the need for further research to improve our understanding of the complex interactions of AD and atherosclerosis with Aβ clearance, which may ultimately serve to guide the development of novel diagnostic and therapeutic approaches for this devastating and highly prevalent condition.

Identification of circulatory diseases and their risk during medical examination of an adult population: methodological aspects

To study the efficiency of a methodology for the active detection of coronary heart disease (CHD) and cerebrovascular diseases (CVD) during medical examination and to determine the need and possible ways of its improvement. The medical examinations of 19.4 million people (94.6% of all the citizens who had undergone medical examinations in all the regions of Russia in 2013) were analyzed and the methodological aspects of identification of the circulatory diseases (CDs) that were induced by coronary and cerebral vessel atherosclerosis and had common risk factors, primarily CHD and CVD, were assessed. The medical examinations revealed 2,915,445 cases of CDs and their suspicions, during which its clinical diagnosis was established in 57.2%. The suspected disease requiring that its diagnosis should be further specified; off-medical examinations revealed hypertension in more than 770,000 cases, CHD in 232,000, and CVD in 146,000. The proportion of stable angina pectoris of all angina cases was much higher at a young age (25.6%) than at middle (15.6%) and elderly (11.3%) ages. Brachiocephalic artery stenoses were detected in almost 13,000 cases. According to the official health statistics, within the years preceding the introduction of large-scale medical examinations, there was a slight rise in new CD cases among the adult population of Russia, which was more significant in 2013 (according to the preliminary data) than in 2012. The methodology for the active detection of CDs through a two-step medical examination, which is used during a follow-up, makes it possible to substantially increase detection rates for CDs. There has been shown to be a need for the better quality and completeness of diagnostic examination in real practice.

Concurrent stenoses: A common etiology of stroke in Asians.

Atherosclerosis of cerebral vessels is a common cause of stroke. Racial differences in the distribution of cerebrovascular occlusive disease are well documented. Extracranial stenosis is more common in Caucasians, while intracranial stenosis is more common in Asians, Hispanics and African-Americans. Concurrent atherosclerosis of extracranial and intracranial vessels is common in Asians. The incidence of concurrent stenoses ranges from 10% to 48% in patients with symptomatic cerebrovascular disease. The long-term prognosis of these patients is poor and they are at high risk of further vascular events or death. The purpose of this review is to examine the epidemiology, risk factors, stroke mechanism and genetics of concurrent stenoses and to discuss strategies for treatment.

Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease

The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS. Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. "Extracranial stenosis" was defined as >50% stenosis in the extracranial ICA, and "intracranial," as >50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis. Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm(3) in the extracranial and 8.59 cm(3) in the intracranial stenosis groups. In univariate analysis, age (P < .0001), SBP and DBP (P = .004), and HTN (P = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis (P = .04). In multivariate analysis including extracranial stenosis, only age (P < .0001) and HTN (P = .03) demonstrated independent effects on WMHV. In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis.

Helicobacter pylori infection and the CD14 C(−260)T gene polymorphism in ischemic stroke

Introduction There is increasing evidence that infective pathogens such as Helicobacter pylori is linked to atherosclerosis of cerebral vessels. As an independent contributing factor, the CD14 receptor–lipopolysaccharide complex plays an important role in activating inflammatory reactions. In particular, the C(−260)T polymorphism in the CD14 receptor may be implicated in atherosclerotic disease. In this study, we investigated a possible association between H. pylori infection and the polymorphism of CD14, and ischemic stroke. Materials and methods A total of 125 patients with ischemic stroke and 125 age- and sex-matched controls were included in the study. The stroke subtype of each of the patients was characterized based on the underlying etiology. H. pylori serologic status and the CD14 genotype were determined in both patients and controls. Results H. pylori seropositivity was more common in the stroke patients than in the controls (80.0% vs. 60.0%, P = 0.001). Moreover, H. pylori seropositivity was more common in the stroke subtype of large artery disease (87.7%, P < 0.001). The distribution of CD14 genotypes was as follows: patients, T/T 21.6%, C/T 63.2%, C/C 15.2%; controls, T/T 19.2%, C/T 57.6%, C/C 23.2%. There was no significant difference between these two CD14 genotype distributions. Conclusions These results suggest that H. pylori infection is a risk factor for ischemic stroke and that CD14 polymorphism is not.

Age-Related Features of Neuropsychological Disorders in Parkinson's Disease

Parkinson's disease (parkinsonism) is one of the most widespread neurological diseases in the world: 1.5% of the population between the ages of 70 and 79 suffer from it (Huber & Cummings, 1992). Contemporary studies of parkinsonism are not restricted to investigation of the pathogenesis and treatment of motor disorders (tremor, rigidity, hypokinesia, postural disorders): possible disorders in higher mental functions (HMFs) are also analyzed. However, specialists agree on neither the frequency nor the causes of these disorders. The pathogenesis of defects in HMFs has been linked to accelerated aging of the brain (Albert, 1978), to primary biochemical disorders (independent of age), to the effects of drug therapy, to acute and chronic intoxications (carbon monoxide, manganese), to an accompanying atherosclerosis of cerebral vessels, etc. James Parkinson himself, who described this disease, said that disorders of intelligence were not characteristic of it (Parkinson, 1817). The frequency of disorders of HMFs secondary to parkinsonism varies from 4% to 93%, depending on the investigator. The relation of these defects to age is also variously interpreted. Most authors note that the neuropsychological symptoms are more marked and more global if the illness has a late onset (Iakhno, Damulin, & Goncharov, 1992; Huber & Cummings, 1992); but there are data indicating that the tendency toward a buildup of defects is manifested differently depending on which mental function is being examined (Korsakova & Moskvichiute, 1985), and that some disorders (for example, motor disorders) are much more marked in younger patients (Lesser et al., 1979; Mjones, 1949). There is no doubt that disagreements on these issues have to do with differences in the methods used to detect defects and to the methodological approaches to their interpretation.

Italian multicenter study of reversible cerebral ischemic attacks Part 5. Risk factors and cerebral atherosclerosis

As part of a prospective study, the influence of several premorbid and environmental factors on the presence, extent and severity of cerebral vessel atherosclerosis was studied in 462 patients with clinical diagnosis of RIA who underwent cerebral angiography. The extent and severity of atherosclerosis of the cerebral vessels was quantified using extracranial and intracranial cerebrovaseular scores (ECS, ICS) based on the number and severity of the lesions in 11 extracranial and 21 intracranial arterial segments. Results of univariate and multivariate analyses indicate that the presence of atherosclerotic changes of cerebral vessels, as shown by angiography, was strongly related with age in both sexes. The lesions were more frequent in males, in particular under age 55. Elevated cholesterol was associated with a higher incidence of atherosclerotic lesions. Smoking was associated with a higher incidence of extracranial lesions. Age, smoking and history of hypertension were the best predictors of the extent and severity of cerebral vessel atherosclerosis.

Age-related occurence of antibodies to cardiac tissue and vessels in the sera of healthy persons and patients with atherosclerosis

The paper concerns the frequency and intensity of reactions between water-soluble protein of aorta and myocardium and sera of persons of different age patterns. Specificity of the seropositive reactions observed has been demonstrated with the help of inhibition reactions and selective adsorption methods. An increased occurrence of reactions to cardiovascular tissue with age has been noted. Statistically significant values of the frequency of these reactions was found using sera of atherosclerotic patients. In the case of atherosclerosis of aorta and coronary vessels the reactions to protein of myocardium were predominant. In atherosclerosis of cerebral vessels and hypertension the reactions to aortic protein were paramount. Possible mechanisms of these phenomena are discussed.

Natural history and surgical treatment of occlusive cerebrovascular disease evaluated by serial arteriography.

NATURAL HISTORY AND SURGICAL TREATMENT OF OCCLUSIVE CEREBROVASCULAR DISEASE EVALUATED BY SERIAL ARTERIOGRAPHYRAYMOND B. BAUER, M.D., R. S. BOULOS, M.D. and JOHN S. MEYER, M.D.Audio Available | Share

Perplexities in Cerebrovascular Disease

Editorials1 January 1963Perplexities in Cerebrovascular DiseaseCLARK H. MILLIKAN, M.D., F.A.C.P.CLARK H. MILLIKAN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-1-191 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFazekas, Alman, and Sullivan in their paper "Prognostic Uncertainties in Cerebral Vascular Disease," in this issue of the ANNALS, report data obtained in the careful clinical and laboratory investigation of 25 patients with aortocranial disease; 12 had arterial surgery while 13 did not, and all patients were treated with anticoagulants. Their observations exemplify a number of the complex unsolved problems that hamper the clinician in the diagnosis and treatment of occlusive cerebral vascular disease. Although intracranial or extracranial atherosclerosis of cerebral vessels (or both) appears to be the basic pathologic change associated with clinical findings of focal cerebral ischemia, severe... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Section of Neurology Mayo Clinic Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCerebrovascular Pathology and Pathogenesis as a Basis of Neuroradiological DiagnosisStenosierende und obliterierende zerebrale Gefäßprozesse 1 January 1963Volume 58, Issue 1Page: 191-192KeywordsAnticoagulantsAtherosclerosisCerebral ischemiaCerebrovascular diseasesClinical laboratoriesResearch designResearch laboratoriesVascular diseasesVascular surgery ePublished: 1 December 2008 Issue Published: 1 January 1963 PDF downloadLoading ...