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Thesis (Ph. D.)--Ohio State University, 2005. / Title from first page of PDF file. Includes bibliographical references (p. 128-139).

Thesis submitted in fulfilment of the requirements for the degree Masters of Technology: Radiography in the Faculty of Health and Wellness Sciences at the Cape Peninsula University of Technology / BACKGROUND: Diabetic patients are at increased risk of cardiovascular events and stroke, and its prevention is therefore the desired goal. In the arsenal of available techniques, ultrasound plays a vital role in primary healthcare. It is reliable, cost-effective and a noninvasive diagnostic tool that may prove beneficial for screening individuals at risk of cardiovascular disease (CVD) and stroke in SA. OBJECTIVE: To determine the interrelationships between carotid ultrasound findings with glycaemia status and contributing risk factors of atherosclerosis in the selected population. METHODS: Initially blinded by the glycaemia status, blood results, contributing risks and patient demographics, both carotid arteries were evaluated with duplex ultrasound (DUS), during July 2010 – July 2011. Using graphs, figures, frequency tables, means and standard deviations for the selected study population, univariate, multivariate and stepwise regression analysis was done to determine the association between ultrasound findings and risk factors for atherosclerosis. The hypothesis tested in this study was to determine if there is an increased incidence of carotid artery intima-media thickening (CIMT), plaque formation and stenosis in patients diagnosed with T2DM and hyperglycaemia in a very specific sub-population of mixedancestory, residing in Bellville South Africa (BSA). RESULTS: Of 534 subjects, 375 were of mixed ancestry and ≥35yrs of age, which met the inclusion criteria for the carotid ultrasound substudy. The glycaemic status for each individual was established, and 44% (165/375) were diagnosed hyperglycaemic, of which 66.7% (110/165) were diabetic (T2DM) and 33.3% (55/165) were pre-diabetic (Pre-DM). Majority (56%:265/375) had a normal glycaemic status. The ultrasound measurement of the carotid wall thicknesses (Mean Rt. and Lt. CIMT) revealed a statistically significant rise from normal glycaemia status to DM status for both the males (p = 0.0115*; p = 0.0259*) and females (p < 0.0001**; p < 0.0001**) respectively. In terms of plaques and internal carotid artery (ICA) stenosis (124/375), when grouped into normal and hyperglycaemic sub-groups, indicated plaque presence and some form of narrowing. A <50% stenotic ratio noted in 61% (76/124) of the hyperglycaemic group, that was 1.6 times higher than those with normal glycaemia (48/124). Predisposing factors demonstrated significantly higher levels in the females than in the males. The univariate multiple regression analysis after adjusted R² of 0.3247 for all independent variables (predisposing /contributing risk factor markers) of age (yrs.), SBP (mmHg), hs-CRP (mg/L), S-Cotinine (ng/mL) and LDL (mmol/L) showed statistically significant positive associations with dependent variable of the mean carotid wall thickness (p < 0.0001**, p< 0.0001**, p = 0.0033*, p = 0.0409* and p = 0.0044)* respectively. Statistically significant positive differences and standard error (SE), for every unit of change (1yr.) of age (yrs.), as a contributing factor for herosclerosis, there was a change in the mean carotid wall thickness as predicted according to this model. The total contribution of independent risk factors to CIMT ultrasound measurements were calculated as 34.5% (Adjusted R² = 0.3247). In the multivariate stepwise regression analysis, the independent variables of age (p< 0.0001) ** and systolic blood pressure (p < 0.0001) ** showed the strongest positive association with carotid wall thickeness changes. The hs-CRP (mg/L) inflammatory markers (p = 0.0014)* and LDL (mmol/L) (p = 0.0208)* were the 2nd and 3rd highest positive associated contributory risk factors for carotid artery wall thickening. The hip circumference (p = 0.0008)* and waist circumference (p = 0.0 555) + risk factors related to obesity was significant and approached significance, respectively, with the predicted increase of carotid artery wall thickening. CONCLUSION: Subjects diagnosed with T2DM and hyperglycaemia had increased levels of CIMT, plaques and carotid artery stenosis, compared to those subjects without T2DM. Age and systolic blood pressure, inflammatory (raised hs-CRP) and LDL cholesterol changes, and central (truncal) waist circumference adiposity, were positively associated with increased carotid intima media thickness. Smoking (S-Cotinine) and gender also reflected a direct relationship with CIMT changes. The hip circumference adiposity and diastolic blood pressure measurements were not directly associated with an increase in CIMT, which are in keeping with hypertension and obesity formulas. These findings confirm the association of thickened CIMT, plaques and stenosis with ‘unhealthy’ T2DM subjects at higher risk of CVD and stroke. The total contribution of independent risk factors to CIMT measurements were calculated as 34.5% (Adjusted R² =0.3247). The gathered information, discussion of results, and concluding statements thereby supports the recommendation of carotid artery ultrasound evaluation, for screening and diagnosis in primary health care, for ‘flagging’ high risk individuals at risk of stroke, so that lifestyle changes and appropriate management is early adopted.

Darbo tikslas – įvertinti miego arterijų angioplastikos ir stentavimo ankstyvuosius ir vėlyvuosius rezultatus bei poveikį darančius veiksnius. Metodai. Tyrimo metu vertintos VMAS procedūros atliktos 2006-2013 metais. Iš viso buvo atliktos 227 procedūros 211 pacientų; iš jų 156 (75,3 proc.) vyrams ir 55 (24,7 proc.) moterims. Rezultatai. Tyrimas atskleidė, kad esant 3 aortos lanko tipui VMAS procedūros trukmė buvo reikšmingai ilgesnė, o mikroembolai apsaugos sistemose buvo nustatyti dažniau. Mikroembolai apsaugos sistemose buvo nustatyti dažniau kai VMAS procedūra truko ilgiau. Apsaugos sistemos atliekant VMAS procedūrą buvo naudotos 70,9 proc. pacientų. Vyrams ir jaunesnio amžiaus pacientams VMAS procedūros metu apsauga buvo taikyta dažniau. Mikroembolai apsaugos sistemose buvo nustatyti 17,6 proc. pacientų ir dažniau buvo nustatyti naudojant FilterWire EZ ir Embo-shield-NAV apsaugos sistemas. Didesnė dešinės VMA stenozė buvo dažnesnė rūkantiems pacientams, o kairės VMA sirgusiems miokardo infarktu bei rūkantiems. Apsauga dažniau buvo taikyta pacientams kurie turėjo didelio laipsnio kairės VMA stenozę. Ankstyvuoju po procedūriniu periodu vyrų ir moterų mirštamumas atitinkamai buvo 1,2 proc. ir 1,8 proc., o 2 metų laikotarpyje buvo 18,7 proc. ir 28,6 proc. Pacientų mirštamumas 2 metų laikotarpyje, kuriems buvo naudotos apsaugos sistemos buvo mažesnis. Galimybę patirti komplikacijas (GSI ar PSIP) didino 3 aortos lanko tipas ir dešinės bendrosios miego arterijos stenozė, mažino... [toliau žr. visą tekstą] / The aim - to assess the carotid artery angioplasty and stenting early and late results and influencing factors. Methods. The study assessed CAS procedures performed in 2006-2013. A total of 227 procedures performed in 211 patients, of which 156 (75.3%) males and 55 (24.7%) females. Results. The study revealed that CAS procedure duration among patient with 3 aortic arch type was significantly longer and the microemboli protection systems were used more frequently. Protection systems were used more frequently when the CAS procedure lasted longer. Protection systems in CAS procedure was used in 70.9% patients. In men and younger patients protection system has been used more frequently. Microemboli in the protection systems have been identified by 17.6% patients and were more determined using the EZ FilterWire and Emboshield-NAV protection system. Increased right ICA stenosis was more common in patients who smoke, and left ICA with a history of myocardial infarction and smoking. Protection system was often used in patients who have had severe left ICA stenosis. The lethality rate in the early post procedural period among men and women was 1.2% and 1.8%, and in 2-year period was 18.7% and 28.6%, respectively. The lethality rate during 2-year period, which have been used for protective systems have been lower. The possibility to experience complications (stroke or TIA) increased 3 aortic arch type and the right common carotid artery stenosis, reduced protection systems using. Focal... [to full text]

The aim - to assess the carotid artery angioplasty and stenting early and late results and influencing factors. Methods. The study assessed CAS procedures performed in 2006-2013. A total of 227 procedures performed in 211 patients, of which 156 (75.3%) males and 55 (24.7%) females. Results. The study revealed that CAS procedure duration among patient with 3 aortic arch type was significantly longer and the microemboli protection systems were used more frequently. Protection systems were used more frequently when the CAS procedure lasted longer. Protection systems in CAS procedure was used in 70.9% patients. In men and younger patients protection system has been used more frequently. Microemboli in the protection systems have been identified by 17.6% patients and were more determined using the EZ FilterWire and Emboshield-NAV protection system. Increased right ICA stenosis was more common in patients who smoke, and left ICA with a history of myocardial infarction and smoking. Protection system was often used in patients who have had severe left ICA stenosis. The lethality rate in the early post procedural period among men and women was 1.2% and 1.8%, and in 2-year period was 18.7% and 28.6%, respectively. The lethality rate during 2-year period, which have been used for protective systems have been lower. The possibility to experience complications (stroke or TIA) increased 3 aortic arch type and the right common carotid artery stenosis, reduced protection systems using. Focal... [to full text] / Darbo tikslas – įvertinti miego arterijų angioplastikos ir stentavimo ankstyvuosius ir vėlyvuosius rezultatus bei poveikį darančius veiksnius. Metodai. Tyrimo metu vertintos VMAS procedūros atliktos 2006-2013 metais. Iš viso buvo atliktos 227 procedūros 211 pacientų; iš jų 156 (75,3 proc.) vyrams ir 55 (24,7 proc.) moterims. Rezultatai. Tyrimas atskleidė, kad esant 3 aortos lanko tipui VMAS procedūros trukmė buvo reikšmingai ilgesnė, o mikroembolai apsaugos sistemose buvo nustatyti dažniau. Mikroembolai apsaugos sistemose buvo nustatyti dažniau kai VMAS procedūra truko ilgiau. Apsaugos sistemos atliekant VMAS procedūrą buvo naudotos 70,9 proc. pacientų. Vyrams ir jaunesnio amžiaus pacientams VMAS procedūros metu apsauga buvo taikyta dažniau. Mikroembolai apsaugos sistemose buvo nustatyti 17,6 proc. pacientų ir dažniau buvo nustatyti naudojant FilterWire EZ ir Embo-shield-NAV apsaugos sistemas. Didesnė dešinės VMA stenozė buvo dažnesnė rūkantiems pacientams, o kairės VMA sirgusiems miokardo infarktu bei rūkantiems. Apsauga dažniau buvo taikyta pacientams kurie turėjo didelio laipsnio kairės VMA stenozę. Ankstyvuoju po procedūriniu periodu vyrų ir moterų mirštamumas atitinkamai buvo 1,2 proc. ir 1,8 proc., o 2 metų laikotarpyje buvo 18,7 proc. ir 28,6 proc. Pacientų mirštamumas 2 metų laikotarpyje, kuriems buvo naudotos apsaugos sistemos buvo mažesnis. Galimybę patirti komplikacijas (GSI ar PSIP) didino 3 aortos lanko tipas ir dešinės bendrosios miego arterijos stenozė, mažino... [toliau žr. visą tekstą]

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2009. / Title from title screen (site viewed February 25, 2010). PDF text: 1 v. (ca. 280 p. : ill.). UMI publication number: AAT 3386755. Includes bibliographical references. Also available in microfilm and microfiche formats.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13259号 / 論医博第2177号 / 新制||医||1037(附属図書館) / (主査)教授 横出 正之, 教授 富樫 かおり, 教授 湊谷 謙司 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23807号 / 医博第4853号 / 新制||医||1058(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 湊谷 謙司, 教授 YOUSSEFIAN Shohab, 教授 石見 拓 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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