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[PMID]: 29521415
[Au] Autor:Fowkes G; Gillespie IN
[Ad] Address:Department of Public Health Sciences, The University of Edinburgh, Teviot Place, Edinburgh, UK, EH8 9AG.
[Ti] Title:WITHDRAWN: Angioplasty (versus non surgical management) for intermittent claudication.
[So] Source:Cochrane Database Syst Rev;3:CD000017, 2018 Mar 09.
[Is] ISSN:1469-493X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intermittent claudication is pain in the legs due to muscle ischaemia associated with arterial stenosis or occlusion. Angioplasty is a technique that involves dilatation and recanalisation of a stenosed or occluded artery. OBJECTIVES: The objective of this review was to determine the effects of angioplasty of arteries in the leg when compared with non surgical therapy, or no therapy, for people with mild to moderate intermittent claudication. SEARCH METHODS: Sources searched include the Cochrane Peripheral Vascular Diseases Group's Specialized Trials Register (August 2006), the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2006) and reference lists of relevant articles. The review authors also contacted investigators in the field and handsearched relevant conference proceedings (August 2006). SELECTION CRITERIA: Randomised trials of angioplasty for mild or moderate intermittent claudication. DATA COLLECTION AND ANALYSIS: The contact author selected suitable trials and this was checked by the other review author. Both review authors assessed trial quality independently. The contact author extracted data and this was cross checked by the other review author. MAIN RESULTS: Two trials with a total of 98 participants were included. The average age was 62 years old with 20 women and 78 men. Participants were followed for two years in one trial and six years in the other.At six months follow up, mean ankle brachial pressure indices were higher in the angioplasty groups than control groups (mean difference 0.17; 95% confidence interval (CI) 0.11 to 0.24). In one trial, walking distances were greater in the angioplasty group, but in the other trial, in which controls underwent an exercise programme, walking distances did not show a greater improvement in the angioplasty group. At two years follow up in one trial, the angioplasty group were more likely to have a patent artery (odds ratio 5.5; 95% CI 1.8 to 17.0) but not a significantly better walking distance or quality of life. In the other trial, long term follow up at six years demonstrated no significant differences in outcome between the angioplasty and control groups. AUTHORS' CONCLUSIONS: These limited results suggest that angioplasty may have had a short term benefit, but this may not have been sustained.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1002/14651858.CD000017.pub2

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[PMID]: 29520431
[Au] Autor:Lindgren HIV; Qvarfordt P; Bergman S; Gottsäter A; Swedish Endovascular Claudication Stenting Trialists
[Ad] Address:Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden. hans.lindgren@skane.se.
[Ti] Title:Primary Stenting of the Superficial Femoral Artery in Patients with Intermittent Claudication Has Durable Effects on Health-Related Quality of Life at 24 Months: Results of a Randomized Controlled Trial.
[So] Source:Cardiovasc Intervent Radiol;, 2018 Mar 08.
[Is] ISSN:1432-086X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intermittent claudication (IC) is commonly caused by lesions in the superficial femoral artery (SFA), yet invasive treatment is still controversial and longer term patient-reported outcomes are lacking. This prospective randomized trial assessed the 24-month impact of primary stenting with nitinol self-expanding stents compared to best medical treatment (BMT) alone in patients with stable IC due to SFA disease on health-related quality of life (HRQoL). METHODS: One hundred patients with stable IC due to SFA disease treated with BMT were randomized to either stent (n = 48) or control (n = 52) group. HRQoL assessed by Short Form 36 Health Survey (SF-36) and EuroQoL 5-dimensions (EQ5D) 24 months after treatment were primary outcome measures. Walking Impairment Questionnaire, ankle-brachial index (ABI), and walking distance were secondary outcomes. RESULTS: Significantly better SF-36 Physical Component Summary (P = 0.024) and physical domain scores such as Physical Function (P = 0.012), Bodily Pain (P = 0.002), General Health (P = 0.037), and EQ5D (P = 0.010) were reported in intergroup comparison between the stent and the control group. Both ABI (from 0.58 ± 0.11 to 0.85 ± 0.18; P < 0.001 in the stent group and from 0.63 ± 0.17 to 0.69 ± 0.18; P = 0.036 in the control group) and walking distance (from 170 ± 90 m to 616 ± 375 m; P < 0.001 in the stent group and from 209 ± 111 m to 331 ± 304 m; P = 0.006 in the control group) improved significantly in intragroup comparisons. CONCLUSIONS: In patients with IC caused by lesions in the SFA, primary stenting compared to BMT alone was associated with significant improvements in HRQoL, ABI, and walking distance durable up to 24 months of follow-up. Clinical Trial Registration http://www.clinicaltrials.gov . Unique Identifier: NCT01230229.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Cl] Clinical Trial:ClinicalTrial
[St] Status:Publisher
[do] DOI:10.1007/s00270-018-1925-0

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[PMID]: 29518253
[Au] Autor:Fakhry F; Fokkenrood HJ; Spronk S; Teijink JA; Rouwet EV; Hunink MGM
[Ad] Address:Departments of Epidemiology & Radiology, Erasmus MC, Dr Molewaterplein 40, PO Box 2040, Rotterdam, Netherlands, 3015 GD.
[Ti] Title:Endovascular revascularisation versus conservative management for intermittent claudication.
[So] Source:Cochrane Database Syst Rev;3:CD010512, 2018 Mar 08.
[Is] ISSN:1469-493X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intermittent claudication (IC) is the classic symptomatic form of peripheral arterial disease affecting an estimated 4.5% of the general population aged 40 years and older. Patients with IC experience limitations in their ambulatory function resulting in functional disability and impaired quality of life (QoL). Endovascular revascularisation has been proposed as an effective treatment for patients with IC and is increasingly performed. OBJECTIVES: The main objective of this systematic review is to summarise the (added) effects of endovascular revascularisation on functional performance and QoL in the management of IC. SEARCH METHODS: For this review the Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (February 2017) and the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1). The CIS also searched trials registries for details of ongoing and unpublished studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing endovascular revascularisation (± conservative therapy consisting of supervised exercise or pharmacotherapy) versus no therapy (except advice to exercise) or versus conservative therapy (i.e. supervised exercise or pharmacotherapy) for IC. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, extracted data, and assessed the methodological quality of studies. Given large variation in the intensity of treadmill protocols to assess walking distances and use of different instruments to assess QoL, we used standardised mean difference (SMD) as treatment effect for continuous outcome measures to allow standardisation of results and calculated the pooled SMD as treatment effect size in meta-analyses. We interpreted pooled SMDs using rules of thumb (< 0.40 = small, 0.40 to 0.70 = moderate, > 0.70 = large effect) according to the Cochrane Handbook for Systematic Reviews of Interventions. We calculated the pooled treatment effect size for dichotomous outcome measures as odds ratio (OR). MAIN RESULTS: We identified ten RCTs (1087 participants) assessing the value of endovascular revascularisation in the management of IC. These RCTs compared endovascular revascularisation versus no specific treatment for IC or conservative therapy or a combination therapy of endovascular revascularisation plus conservative therapy versus conservative therapy alone. In the included studies, conservative treatment consisted of supervised exercise or pharmacotherapy with cilostazol 100 mg twice daily. The quality of the evidence ranged from low to high and was downgraded mainly owing to substantial heterogeneity and small sample size.Comparing endovascular revascularisation versus no specific treatment for IC (except advice to exercise) showed a moderate effect on maximum walking distance (MWD) (SMD 0.70, 95% confidence interval (CI) 0.31 to 1.08; 3 studies; 125 participants; moderate-quality evidence) and a large effect on pain-free walking distance (PFWD) (SMD 1.29, 95% CI 0.90 to 1.68; 3 studies; 125 participants; moderate-quality evidence) in favour of endovascular revascularisation. Long-term follow-up in two studies (103 participants) showed no clear differences between groups for MWD (SMD 0.67, 95% CI -0.30 to 1.63; low-quality evidence) and PFWD (SMD 0.69, 95% CI -0.45 to 1.82; low-quality evidence). The number of secondary invasive interventions (OR 0.81, 95% CI 0.12 to 5.28; 2 studies; 118 participants; moderate-quality evidence) was also not different between groups. One study reported no differences in disease-specific QoL after two years.Data from five studies (n = 345) comparing endovascular revascularisation versus supervised exercise showed no clear differences between groups for MWD (SMD -0.42, 95% CI -0.87 to 0.04; moderate-quality evidence) and PFWD (SMD -0.05, 95% CI -0.38 to 0.29; moderate-quality evidence). Similarliy, long-term follow-up in three studies (184 participants) revealed no differences between groups for MWD (SMD -0.02, 95% CI -0.36 to 0.32; moderate-quality evidence) and PFWD (SMD 0.11, 95% CI -0.26 to 0.48; moderate-quality evidence). In addition, high-quality evidence showed no difference between groups in the number of secondary invasive interventions (OR 1.40, 95% CI 0.70 to 2.80; 4 studies; 395 participants) and in disease-specific QoL (SMD 0.18, 95% CI -0.04 to 0.41; 3 studies; 301 participants).Comparing endovascular revascularisation plus supervised exercise versus supervised exercise alone showed no clear differences between groups for MWD (SMD 0.26, 95% CI -0.13 to 0.64; 3 studies; 432 participants; moderate-quality evidence) and PFWD (SMD 0.33, 95% CI -0.26 to 0.93; 2 studies; 305 participants; moderate-quality evidence). Long-term follow-up in one study (106 participants) revealed a large effect on MWD (SMD 1.18, 95% CI 0.65 to 1.70; low-quality evidence) in favour of the combination therapy. Reports indicate that disease-specific QoL was comparable between groups (SMD 0.25, 95% CI -0.05 to 0.56; 2 studies; 330 participants; moderate-quality evidence) and that the number of secondary invasive interventions (OR 0.27, 95% CI 0.13 to 0.55; 3 studies; 457 participants; high-quality evidence) was lower following combination therapy.Two studies comparing endovascular revascularisation plus pharmacotherapy (cilostazol) versus pharmacotherapy alone provided data showing a small effect on MWD (SMD 0.38, 95% CI 0.08 to 0.68; 186 participants; high-quality evidence), a moderate effect on PFWD (SMD 0.63, 95% CI 0.33 to 0.94; 186 participants; high-quality evidence), and a moderate effect on disease-specific QoL (SMD 0.59, 95% CI 0.27 to 0.91; 170 participants; high-quality evidence) in favour of combination therapy. Long-term follow-up in one study (47 participants) revealed a moderate effect on MWD (SMD 0.72, 95% CI 0.09 to 1.36; P = 0.02) in favour of combination therapy and no clear differences in PFWD between groups (SMD 0.54, 95% CI -0.08 to 1.17; P = 0.09). The number of secondary invasive interventions was comparable between groups (OR 1.83, 95% CI 0.49 to 6.83; 199 participants; high-quality evidence). AUTHORS' CONCLUSIONS: In the management of patients with IC, endovascular revascularisation does not provide significant benefits compared with supervised exercise alone in terms of improvement in functional performance or QoL. Although the number of studies is small and clinical heterogeneity underlines the need for more homogenous and larger studies, evidence suggests that a synergetic effect may occur when endovascular revascularisation is combined with a conservative therapy of supervised exercise or pharmacotherapy with cilostazol: the combination therapy seems to result in greater improvements in functional performance and in QoL scores than are seen with conservative therapy alone.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1002/14651858.CD010512.pub2

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[PMID]: 29516399
[Au] Autor:Maguire SC; Fleming CA; O'Brien G; McGreal G
[Ad] Address:Department of Vascular Surgery, Mercy University Hospital, Cork, Ireland. semaguir@tcd.ie.
[Ti] Title:Lumbar sympathectomy can improve symptoms associated with ischaemia, vasculitis, diabetic neuropathy and hyperhidrosis affecting the lower extremities-a single-centre experience.
[So] Source:Ir J Med Sci;, 2018 Mar 07.
[Is] ISSN:1863-4362
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Lumbar sympthectomy (LS) was traditionally performed for intermittent claudication but is now eclipsed by revascularisation for that indication. However, it retains a role in the management of critical limb ischaemia and other conditions causing lower limb pain with or without ischaemia. We report the role of LS in modern surgical practice when revascularisation and pain management options have been exhausted. METHODS: A medical chart review was performed on all patients who underwent LS in our unit from 2005 to 2016 (inclusive). Symptomatology, surgical indications and patient outcomes were reported. RESULTS: Twenty-seven cases were performed in total (21 unilateral, 3 bilateral). Underlying diagnoses were as follows: PAD [59.3% (n = 16)], hyperhidrosis [18.5% (n = 5)] and equal numbers of complex regional pain syndrome, diabetic neuropathy and vasculitis [7.4% (n = 2) each]. Overall, 85.2% (n = 23) had improvement or resolution of symptoms at 1 month and 70.3% (n = 19) had persistent improvement of symptoms at 1 year. Non-PAD patients had superior outcomes with 90.9% (n = 10) reporting improved symptomatology at 1 month and nearly three quarters [72.8% (n = 8)] maintaining this improvement at 1 year. Only four patients required subsequent major amputation, all in the severe PAD group. CONCLUSION: Lumbar sympathectomy can improve symptoms associated with ischaemia, vasculitis, diabetic neuropathy and hyperhidrosis. Non-PAD patients have the greatest benefit.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1007/s11845-018-1775-4

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[PMID]: 29512615
[Au] Autor:Kahyaoglu M; Agca M; Çakmak EÖ; Geçmen Ç; Izgi IA
[Ad] Address:Department of Cardiology, Kartal Kosuyolu Yüksek Ihtisas Training and Research Hospital, Istanbul, Turkey. mkahyaoglu09@hotmail.com.
[Ti] Title:Contrast-induced encephalopathy after percutaneous peripheral intervention.
[So] Source:Turk Kardiyol Dern Ars;46(2):140-142, 2018 Mar.
[Is] ISSN:1308-4488
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:Contrast-induced encephalopathy (CIE) is a rare complication of angiography. Presently reported is the case of a patient diagnosed with CIE following peripheral angioplasty with the non-ionic contrast agent, iohexol. A 66-year-old male patient described intermittent claudication and peripheral arterial disease was suspected. Lower extremity angiography was performed, and following dilation of a 7.0x150-mm balloon, a 9.0x57-mm stent was placed in the lesioned vessel. The patient subsequently developed confusion and cortical blindness, and a seizure occurred 1 hour after the procedure. An emergency cerebral computed tomography scan did not reveal any signs of intracerebral hemorrhage. The neurological symptoms disappeared within 24 hours after hydration and sedative medication. CIE was diagnosed based on the patient`s clinical course findings and cerebral imaging.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review
[do] DOI:10.5543/tkda.2017.16517

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[PMID]: 29506947
[Au] Autor:Kalbaugh CA; Gonzalez NJ; Luckett DJ; Fine J; Brothers TE; Farber MA; Beck AW; Hallett JW; Marston WA; Vallabhaneni R
[Ad] Address:Department of Surgery, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: corey_kalbaugh@med.unc.edu.
[Ti] Title:The impact of current smoking on outcomes after infrainguinal bypass for claudication.
[So] Source:J Vasc Surg;, 2018 Mar 02.
[Is] ISSN:1097-6809
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Although smoking cessation is a benchmark of medical management of intermittent claudication, many patients require further revascularization. Currently, revascularization among smokers is a controversial topic, and practice patterns differ institutionally, regionally, and nationally. Patients who smoke at the time of revascularization are thought to have a poor prognosis, but data on this topic are limited. The purpose of this study was to evaluate the impact of smoking on outcomes after infrainguinal bypass for claudication. METHODS: Data from the national Vascular Quality Initiative from 2004 to 2014 were used to identify infrainguinal bypasses performed for claudication. Patients were categorized as former smokers (quit >1 year before intervention) and current smokers (smoking within 1 year of intervention). Demographic and comorbid differences of categorical variables were assessed. Significant predictors were included in adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) by smoking status for outcomes of major adverse limb event (MALE), amputation-free survival, limb loss, death, and MALE or death. Cumulative incidence curves were created using competing risks modeling. RESULTS: We identified 2913 patients (25% female, 9% black) undergoing incident infrainguinal bypass grafting for claudication. There were 1437 current smokers and 1476 former smokers in our study. Current smoking status was a significant predictor of MALE (HR, 1.27; 95% CI, 1.00-1.60; P = .048) and MALE or death (HR, 1.22; 95% CI, 1.03-1.44; P = .02). Other factors found to be independently associated with poor outcomes in adjusted models included black race, below-knee bypass grafting, use of prosthetic conduit, and dialysis dependence. CONCLUSIONS: Current smokers undergoing an infrainguinal bypass procedure for claudication experienced more MALEs than former smokers did. Future studies with longer term follow-up should address limitations of this study by identifying a data source with long-term follow-up examining the relationship of smoking exposure (pack history and duration) with outcomes.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  7 / 8842 MEDLINE  
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[PMID]: 29449058
[Au] Autor:Aboyans V; Sevestre MA; Désormais I; Lacroix P; Fowkes G; Criqui MH
[Ad] Address:CHU de Limoges, service de cardiologie, 87042 Limoges, France; Faculté de médecine, Inserm U1094, 87025 Limoges, France. Electronic address: victor.aboyans@unilim.fr.
[Ti] Title:Épidémiologie de l'artériopathie des membres inférieurs. [Epidemiology of lower extremity artery disease].
[So] Source:Presse Med;47(1):38-46, 2018 Jan.
[Is] ISSN:2213-0276
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:It is estimated that more than 200 million individuals are affected by lower extremity artery disease (LEAD) worldwide. This prevalence has increased between 2000 and 2010 by 25%, especially in low/middle income countries. In France, about one million people are affected by this condition. Almost two-thirds of patients with LEAD are asymptomatic. This explains the interest of the measurement of the ankle-brachial index (ABI), an objective and harmless diagnostic tool. An ABI≤0.90 is considered as diagnostic for LEAD. The detection of symptomatic LEAD requires standardized questionnaires identifying intermittent claudication. Epidemiological studies on chronic limb-threatening ischemia (CLTI) - the most severe presentation of the disease - are scarce: the prevalence is estimated around 0.5-2.0% after the age of 40, mostly affecting elderly people. Similar to other atherosclerotic diseases, the risk factors are multiple (genetic factors, traditional risk factors, metabolic and inflammatory factors, socioeconomic factors), with different weighs of association as compared to coronary artery diseases. Due to their high prevalence and strength of association, cigarette smoking and hypertension are the most frequent purveyors of this disease in population. Diabetes mellitus is a strong risk factor, and its increasing prevalence contributes to the global epidemics of LEAD. In claudicants, the 5-year amputation risk is estimated at 5%, increasing to 25% at one year in case of CLTI. However, the main risk is related to general cardiovascular events. It is estimated that patients with LEAD present concomitantly coronary and cerebrovascular disease in respectively 50% and 20% of cases. The non-cardiovascular mortality, especially related to cancer, is also higher than in general population. Overall, the control of traditional risk factors has a beneficial effect both for the limb and general prognosis.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process

  8 / 8842 MEDLINE  
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[PMID]: 29395558
[Au] Autor:Garrigues D; Ferrari B; Petrissans Ferrando N; Guiraut T
[Ad] Address:Clinique de Saint-Orens, centre de réadaptation cardiovasculaire et pulmonaire, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France. Electronic address: d.garrigues@clinique-saint-orens.fr.
[Ti] Title:Réadaptation vasculaire de l'artériopathie oblitérante des membres inférieurs en 2018. [Vascular rehabilitation in lower-extremity artery diseasein 2018].
[So] Source:Presse Med;47(1):66-71, 2018 Jan.
[Is] ISSN:2213-0276
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:WHAT WE KNEW: The vascular rehabilitation is an effective treatment for patients with an intermittent claudication linked to lower-extremity artery disease. This treatment increases the claudication distance of 180% with the Gardner's protocol (30 to 60 minutes of walking at least 3 times a week, walking until appearance of a mild pain) and allows also to control the vascular risk factors. This treatment is not enough prescribed for many reasons and often requires a hospitalization in a rehabilitation centre. WHAT WE KNOW NOW: Walking rehabilitation remains the base of the treatment of lower-extremity artery disease. Many walking protocols can be proposed. For a similar efficiency, patients are not obliged to walk until appearance of a pain but only until appearance of a discomfort. Exercises other than walking have been tested and can be used. Heart Rehabilitation Centres will propose more often vascular rehabilitation including hospitalisations for complex patients or out-management for non-complex patients. With a lower cost, the walking rehabilitation could be also realised at home by the patient himself with a certain degree of supervision with good results. Supervision means the use of a podometer, weekly advices given by phone by a Vascular Physician or a Physiotherapist, one walking session once a week in a rehabilitation centre. Connected devices could be also helpful allowing increasing of the patients' motivation. Simultaneously, it is necessary that the patients observe the recommendations of the World Health Organisation by performing weekly 150 minutes of mild-intensity endurance's activity in order to minimise their long-term vascular risk. Finally, the respective place of the revascularisations and walking rehabilitation remains to be clarify in case of intermittent claudication due to a superficial femoral artery lesion.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process

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[PMID]: 29264710
[Au] Autor:Xie X; Xu X; Sun C; Yu Z
[Ad] Address:Department of Infectious Disease, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, Zhengzhou, Henan, 450052, China.
[Ti] Title:Protective effects of cilostazol on ethanol-induced damage in primary cultured hepatocytes.
[So] Source:Cell Stress Chaperones;23(2):203-211, 2018 Mar.
[Is] ISSN:1466-1268
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Alcoholic liver disease (ALD) caused by excessive alcohol consumption is associated with oxidative stress, mitochondrial dysfunction, and hepatocellular apoptosis. Cilostazol, a licensed clinical drug used to treat intermittent claudication, has been reported to act as a protective agent in a spectrum of diseases. However, little information regarding its role in ethanol-induced hepatocellular toxicity has been reported. In the current study, we investigated the protective effects and mechanisms of cilostazol on ethanol-induced hepatocytic injury. Rat primary hepatocytes were pretreated with cilostazol prior to ethanol treatment. MTT and LDH assay indicated that ethanol-induced cell death was ameliorated by cilostazol in a dose-dependent manner. Our results display that overproduction of intracellular reactive oxygen species (ROS) and 4-hydroxy-2-nonenal (4-HNE) induced by ethanol was attenuated by pretreatment with cilostazol. Furthermore, cilostazol significantly inhibited ethanol-induced generation of ROS in mitochondria. Importantly, it was shown that cilostazol could improve mitochondrial function in primary hepatocytes by restoring the levels of ATP and mitochondrial membrane potential (MMP). Additionally, cilostazol was found to reduce apoptosis induced by ethanol using a terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. Mechanistically, we found that cilostazol prevented mitochondrial pathway-mediated apoptotic signals by reversing the expression of Bax and Bcl2, the level of cleaved caspase-3, and attenuating cytochrome C release. These findings suggest the possibility of novel ALD therapies using cilostazol.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Data-Review
[do] DOI:10.1007/s12192-017-0828-3

  10 / 8842 MEDLINE  
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[PMID]: 29481920
[Au] Autor:Fernández S; Parodi JC; Moscovich F; Pulmari C
[Ad] Address:Chief of Vascular Surgery, Hospital Malvinas Argentinas, Buenos Aires, Argentina.
[Ti] Title:Reversal of Lower Extremity Intermittent Claudication and Rest Pain by Hydration.
[So] Source:Ann Vasc Surg;, 2018 Feb 23.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Medical treatment of disabling intermittent claudication or critical limb threatening ischemia causing rest pain often fails or has partial response. METHODS: In this pilot study thirty-six patients (12 females) affected by disabling intermittent claudication or rest pain of the lower extremities were exposed to a daily 3 L water intake for up to six weeks. Cutaneous foot temperature, ankle/brachial index, time and distance of claudication and pain intensity were recorded before and at the completion of the hydration period. RESULTS: Patients with a mean ± SE age of 71 ± 2 years (range 40 - 86), had disabling claudication (less than a 100 meters) for more than five months while 11 % reported pain at rest. A six-week water intake of more than 2,500 mL/24 hours was achieved in 35 of the 36 patients enrolled in the study. Increased water intake was associated with significant improvements in median ankle/brachial index (from 0.60 to 0.76; p: <0.0001) and skin temperature (1 dorsal right toe from 29.95°C to 30.0°C, p < 0.001). Supervised treadmill exercise based on time and distance to report claudication improved from 100 meters to 535 meters (p <0.0001) and time to claudication from 1.25 to 6.25 minutes (p <0.0001). CONCLUSIONS: This study suggests that hydration attained by daily water consumption of more than 2.5 L has a robust impact in reducing the symptoms of disabling claudication and rest pain caused by peripheral vascular disease.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher


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