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Topic: Microvascular disease

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	Microvascular disease (Site not responding. Last check: 2007-11-03)
		Microvascular disease is a process through which the very small branches of arteries throughout the body become damaged.
		Microvascular disease is a common component of other conditions, such as diabetes mellitus and autoimmune diseases.
		In microvascular disease the commonest cause is chemicals within the blood that damage the very delicate lining of the small arteries and causes the blood to clot in the artery and block it.
	www.simondodds.com /pathology/microvascular.htm (344 words)

	NIH Guide: ISCHEMIC HEART DISEASE IN BLACKS
		Research is needed to improve the diagnosis of microvascular disease and to translate knowledge of the etiology of the disease at the molecular, cellular and physiologic levels into new therapeutic modalities.
		Microvascular cells can now be isolated from ventricular tissue of adult rats and their function can be studied in vitro alone and in co-culture with ventricular myocytes.
		By contrast, NIDDM is a disease of insulin resistance and hyperglycemia.
	grants.nih.gov /grants/guide/rfa-files/RFA-HL-95-005.html (5404 words)

	[No title]
		Although the degree of glycemia in diabetic patients is strongly related to the risk of microvascular complications, the relation of glycemia to macrovascular disease in Type 2 diabetes is less certain.
		Macrovascular disease seen in diabetic patients is similar to non-diabetic patients, with the major difference is that it occurs at an earlier age and with increased frequency.
		Mild microvascular disease is defined by early background retinopathy, and/or microalbuminuria and/or mild neuropathy.
	www.pitt.edu /AFShome/s/u/super1/public/html/lecture/lec1921/013.htm (257 words)

	children with DIABETES - Diabetes Dictionary: M
		A disease of the large blood vessels that sometimes occurs when a person has had diabetes for a long time.
		Three kinds of macrovascular disease are coronary disease, cerebrovascular disease, and peripheral vascular disease.
		Disease of the smallest blood vessels that sometimes occurs when a person has had diabetes for a long time.
	www.childrenwithdiabetes.com /dictionary/m.htm (1045 words)

	NIH Guide: SPECIALIZED CENTERS OF RESEARCH (SCORS) IN ISCHEMIC HEART DISEASE IN BLACKS
		Although histopathologic abnormalities such as small vessel disease, interstitial fibrosis and myocardial hypertrophy have been demonstrated in patients with diabetic heart disease, the pathogenesis of this disease is poorly understood.
		Microvascular Disease Dysfunction of the cardiac microcirculation has been reported in patients who suffer chest pain and have electrocardiographic evidence of ischemia despite normal or near normal angiograms.
		Microvascular cells can be isolated from ventricular tissue of adult rats and their function can be studied in vitro alone and in co-culture with ventricular myocytes.
	grants.nih.gov /GRANTS/guide/rfa-files/RFA-HL-98-015.html (8505 words)

	intro
		Although microvascular and neuropathic complications of NIDDM are responsible for the lion’s share of the morbidity of diabetes, it is macrovascular disease that is the killer of people with NIDDM.
		In contrast, survival rates on dialysis are worse among whites, and, in contrast to microvascular disease, coronary heart disease is less common in minorities.
		The major risk factor for microvascular disease is hyperglycemia, and this persists when patients are stratified by age or insulin treatment.
	journal.diabetes.org /diabetesspectrum/96v9n01/23.htm (1857 words)

	IIR 02-286 Risk Factor Trajectory and Variability: Predictors of Vascular Disease?
		The high prevalence of type 2 diabetes among veterans and potential for a rapid increase in incidence of type 2 diabetes is of grave concern because type 2 diabetes increases risk of cardiovascular and microvascular diseases.
		Understanding reason(s) for differences in cardiovascular and microvascular disease risk among persons with type 2 diabetes is critically important to veterans due to the high prevalence of type 2 diabetes among veterans and the substantial morbidity and mortality caused by vascular diseases.
		As our long-term goal is to develop a cost-effective method for identifying veterans with type 2 diabetes at highest risk for cardiovascular and microvascular disease, we are including in our explanatory models measures shown to be associated with increased cardiovascular and/or microvascular risk that are relatively inexpensive and commonly measured during standard clinical care.
	www.hsrd.research.va.gov /research/abstracts/IIR_02-286.htm (704 words)

	Nat' Academies Press, The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of ...
		Microvascular disease was defined as retinopathy, neuropathy, and urinary albumin excretion.
		Although the study lacked the statistical power to measure the effect on macrovascular disease, the trend was for fewer events in the tightly controlled group.
		The effect of tighter control on macrovascular disease resulted in a nonsignificant trend, with a 16 percent reduction in the risk of combined fatal or nonfatal myocardial infarction and sudden death in the intensively treated group.
	www.nap.edu /books/0309068460/html/118.html (5492 words)

	a10 (Site not responding. Last check: 2007-11-03)
		Eye: Microvascular disease of the retina can result in proliferation of small pre-retinal vessels which are structurally abnormal and prone to hemorrhage.
		Peripheral nervous system: Microvascular disease and abnormal polyol accumulation in nerve tissue result in classic "stocking and glove" peripheral neuropathy which typically affects the longest sensorimotor nerves first (those of the distal lower extremities).
		Cardiovascular: Diabetes is one of the five major risks of coronary heart disease and peripheral vascular disease, and correction of hyperglycemia does not restore the risk to baseline population risk.
	lrcgwf.usuf2.usuhs.mil /cc/Diabetes/a10.htm (582 words)

	eMedicine - Diabetic Foot Infections : Article by Burke A Cunha, MD, MACP
		Infections in patients with diabetes are difficult to treat because these patients have impaired microvascular circulation, which limits the access of phagocytic cells to the infected area and results in a poor concentration of antibiotics in the infected tissues.
		In the extremities, microvascular disease due to "sugar-coated capillaries" limits the blood supply to the superficial and deep structures.
		An infectious disease specialist should be consulted in the treatment of all patients with diabetic foot infections to optimize the antimicrobial therapy.
	www.emedicine.com /med/topic3547.htm (5030 words)

	Meniere's Disease Information Center -- Cause of Meniere's Disease
		If Meniere's Disease is the same as "idiopathic endolymphatic hydrops," and the cause of your symptoms is known, then you cannot have Meniere's Disease, by definition.
		Some cases of Meniere's Disease are believed by some authorities to be autoimmune in origin, simply because the symptoms in these cases respond to immunosuppressant drugs such as prednisone, methotrexate, and others (see our treatment page).
		That is to say that patients, having settled upon some event that preceded their Meniere's Disease symptoms, become convinced merely because of the timing that the event is the "cause" of their Meniere's Disease.
	www.menieresinfo.com /cause.html (1459 words)

	Microvascular Screening In DM (Site not responding. Last check: 2007-11-03)
		New research recommends that annual screening for early markers of microvascular disease be started at around the age of 10 years in children with type 1 diabetes.
		The investigators explain that the influence of puberty on the risk for microvascular disease has led to the recommendation of screening at such a young age.
		The report is published in the July issue of the Archives of Disease in Childhood (2002;87:10-12).
	www.indegene.com /Ped/Home/indPed_Ind_News_15-07-2002_1.asp (235 words)

	Management of Hyperglycemia
		Type 2 diabetes is primarily a disease of older adults, and it is associated with obesity.
		Diabetic nephropathy, the leading cause of end-stage renal disease, is a microvascular disease.
		The risk of coronary artery disease is increased two- to four-fold in people with type 2 diabetes; cardiovascular disease is the cause of death in almost 80% of these patients.
	www.cmecorner.com /macmcm/pcp/pcp2000_03.htm (2404 words)

	Recent Student Publications - Memory & Aging Program
		Recent evidence has suggested that microvascular basement membrane injury may be a critical factor in the pathogenesis of AD-related dementia.
		This disease is characterized by frequent subcortical ischaemic events, vascular dementia accompanied by frontal-like symptoms and a higher proportion of depression.
		The frequency of notch3 mutations in the large population of older people with subcortical cerebrovascular disease is not known, and the relationship between specific mutations and the phenotypic expression of CADASIL, such as the pattern of subcortical hyperintensities on MRI, has not been studied.
	www.butler.org /body.cfm?id=171 (1508 words)

	ABC of arterial and venous disease: Vascular complications of diabetes -- Donnelly et al. 320 (7241): 1062 -- BMJ
		ABC of arterial and venous disease: Vascular complications of diabetes -- Donnelly et al.
		Data from WHO multinational study of vascular disease in diabetes showing survival in patients with type 1 and type 2 diabetes according to degree of proteinuria (none, slight, or heavy) at baseline.
		The ABC of arterial and venous disease is edited by Richard Donnelly, professor of vascular medicine, University of Nottingham
	bmj.bmjjournals.com /cgi/content/full/320/7241/1062 (2228 words)

	Management of Diabetes in the Elderly
		Diabetes is the most frequent cause of blindness and renal failure in the United States, and the microvascular complications of diabetes rise with increasing duration of disease and worsening glycemic control.
		Although improving glycemic control clearly reduces microvascular complications, it is important to recognize that the incidence of severe or end-stage microvascular complications is much lower for type 2 diabetic patients than for type 1 patients, presumably because of their older age of onset and increased competing risks for death.
		To properly evaluate the potential benefits of therapeutic interventions on microvascular complications in type 2 diabetes, clinicians must carefully consider the patient's age at onset, overall health status/expected survival, and existing level of glycemic control.
	journal.diabetes.org /clinicaldiabetes/v17n11999/Pg19.htm (4805 words)

	MANAGEMENT OF DIAABETES MELLITUS
		Conversely, patients with advanced microvascular complications and/or major comorbid illness may be less likely to show survival benefit, may continue to show progression of microvascular disease, and frequently may be at increased risk for severe hypoglycemic morbidity when normoglycemic control is attempted.
		Long-term outcomes (survival and occurrence of microvascular complications) of treatment of DM are related to the degree of glycemic control achieved, but not to the means used to achieve control (diet/exercise vs. oral hypoglycemic agent vs. insulin, or any known combination therapy).
		Therefore, it should be recognized that maximal benefits of glycemic control in preventing the progression of microvascular disease to the endpoints of visual loss or chronic renal insufficiency accrue over a period of time longer than that of the study period of the aforementioned trial.
	www.humanitas.com /vha/dm/expanded_g.htm (8255 words)

	Hypertension Online Slides - macrovascular, ACE inhibitor, microvascular
		Overall, there is strong evidence that pharmacologic therapy of hypertension in patients with diabetes is effective in producing substantial decreases in cardiovascular and microvascular diseases.
		Hypertension (BP ≥140/90 mmHg) is an extremely common co-morbid condition in diabetes, affecting from 20 to 60% of patients with diabetes, depending on obesity, ethnicity, and age.
		Rates for both myocardial infarction and microvascular endpoints were strongly associated, to a similar degree, with increasing systolic blood pressure.
	www.hypertensiononline.org /slides2/slide01.cfm?q=macrovascular (3198 words)

	Direct Association Present Between Systolic Blood Pressure And Complications Of Diabetes (Site not responding. Last check: 2007-11-03)
		The UKPDS study has shown that in patients with type2 diabetes mellitus, the risk of microvascular disease, stroke and death can be reduced by a strict control of blood pressure (from 154/87mmHg to 144/82mmHg).
		It is known that increased incidence of cardiovascular disease, neurovascular disease and renal disease is higher in patients with type2 diabetes.
		The aim of this study was to evaluate the association between macrovascular and microvascular complications and systolic blood pressure from the UKPDS data.
	www.indegene.com /Gen/Jour/indJour_BMJ_Sum_End_12-08-2000_2.asp (540 words)

	Comparison of the Effect of Plasma Glucose Concentrations on Microvascular Disease Between Pima Indian Youths and ...
		Comparison of the Effect of Plasma Glucose Concentrations on Microvascular Disease Between Pima Indian Youths and Adults -- Krakoff et al.
		Comparison of the Effect of Plasma Glucose Concentrations on Microvascular Disease Between Pima Indian Youths and Adults
		PG for youths, suggesting that microvascular disease was less
	care.diabetesjournals.org /cgi/content/abstract/24/6/1023 (246 words)

	Lipids Online Slides: complications, diabetes, UKPDS, glycemic control
		There was no statistically significant reduction in the incidence of stroke or peripheral vascular disease in the intensively treated group compared with the group treated with conventional glycemic control.
		All macrovascular disease constituted a majority of cases in each group, 58% in the intensive treatment group and 60% in the conventional treatment group.
		Renal disease accounted for only 2% of deaths in the intensive treatment group and 1% in the conventional treatment group.
	www.lipidsonline.org /slides/slide01.cfm?q=complications (1118 words)

	Results in (Site not responding. Last check: 2007-11-03)
		Although the increased death rate is mainly due to cardiovascular disease, deaths from non-cardiovascular causes are also increased.
		A diagnosis of diabetes immediately increases the risk of developing various clinical complications that are largely irreversible and due to microvascular or macrovascular disease.
		In the diabetes control and complications trial--a landmark study in type 1 diabetes--the number of clinically important microvascular endpoints was reduced by 34-76% in patients allocated to intensive insulin (that is, a 10% mean reduction in glycated haemoglobin ([Hb.sub.A1c]) concentration from 8.0% to 7.2%).
	www.findarticles.com /p/articles/mi_m0999/is_7241_320/ai_61995034 (364 words)

	Arsenic ingestion and increased microvascular disease risk: observations from the south-western arseniasis-endemic area ...
		Arsenic ingestion and increased microvascular disease risk: observations from the south-western arseniasis-endemic area in Taiwan -- Chiou et al.
		Arsenic ingestion and increased microvascular disease risk: observations from the south-western arseniasis-endemic area in Taiwan
		diseases was 7.51% [95% confidence interval (CI) 7.50–7.51]
	ije.oxfordjournals.org /cgi/content/abstract/34/4/936 (322 words)

	A neuropathological study of vascular factors in late-life depression -- Thomas et al. 70 (1): 83 -- Journal of ...
		to vascular dementia in that it is proposed that vascular disease
		Our two hypotheses were that there would be an increase in atheroma and in microvascular disease in the depressed group.
		Depression is a risk factor for coronary artery disease in men: the precursors study.
	jnnp.bmjjournals.com /cgi/content/full/70/1/83 (3366 words)

	Clinical Trial: Blood Pressure and Glucose Lowering for the Prevention of Vascular Disease in High Risk Patients With ...
		The purpose of this study is to provide information on the risks and benefits of routine blood pressure lowering (regardless of blood pressure level), and intensive lowering of blood glucose levels, in patients with Type 2 diabetes at high risk of cardiovascular events.
		The major outcomes of the study will be cardiovascular events (heart attack, stroke or dying as a result of cardiovascular disease), as well as new or worsening diabetic eye and kidney disease.
		Patients with type 2 diabetes are at increased risks of macrovascular and microvascular disease, both of which are reduced by control of raised blood pressure in hypertensive individuals.
	www.clinicaltrials.gov /ct/show/NCT00145925 (848 words)

	NEJM -- Angina due to coronary microvascular disease in hypertensive patients without left ventricular hypertrophy
		When angina occurs in patients with hypertension, it is usually attributed to coronary artery disease or left ventricular hypertrophy.
		To determine the contribution of coronary microvascular abnormalities to angina in patients with hypertension, we evaluated hypertensive patients without coronary artery disease or left ventricular hypertrophy by measuring the coronary responses to rapid atrial pacing before and after administration of ergonovine.
		Thus, angina in hypertensive patients without epicardial coronary disease may be caused by myocardial ischemia, which appears to be due to an abnormally elevated resistance of the coronary microvasculature.
	content.nejm.org /cgi/content/abstract/319/20/1302 (1255 words)

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