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Background: Coronary artery calcification (CAC) is common in chronic kidney disease (CKD) patients, and is demonstrable in fifty percent of incident dialysis patients. Therefore, the process of CAC initiation likely occurs in the pre-dialysis period. Pre-dialysis CKD patients have been shown to have a substantially higher burden of CAC than age and sex matched controls from the general population. Consequently, the hypothesis that CKD itself is a risk factor for CAC occurrence is biologically plausible. Objective: 1) To quantify the relationship between CKD and CAC in stage three to five CKD patients without known cardiovascular disease. 2) To estimate the strengths of associations between traditional cardiovascular disease risk factors, non- traditional cardiovascular disease risk factors and CAC in this patient population. Methods: This cross-sectional study investigated one hundred and nineteen CKD patients (excluding dialysis) receiving care at a single hospital in Kingston, Ontario, Canada. For the primary objective, correlational analyses were performed to evaluate associations between a priori selected variables of kidney function and CAC scores, as well as other a priori chosen variables of interest. Results: Mean and median CAC scores were 566.5 SD: 1108 and 111 (inter-quartile range 2 to 631.5) respectively. CAC correlated with age (r = 0.44, p<0.001), body mass index (r = 0.28, p = 0.002), high density lipoprotein cholesterol (r = -0.23, p = 0.01), diabetes mellitus (r = 0.23, p = 0.01), and the cardiovascular risk score (r = 0.35; p < 0.001). By multivariable linear regression controlling for eGFR and diabetes, age (ß = 0.05, 95% CI 0.03-0.06; p<0.001), body mass index (ß = 0.04, 0.02 - 0.07; p=0.001), and serum calcium (ß = 0.9, 0.15 - 1.6; p=0.02), were risk factors for CAC. Results from multivariable logistic regression modeling demonstrated consistent findings. Limitations: Inadequate sample size and uncontrolled confounding are possible limitations, but are unlikely to have changed the main study findings. Conclusions: In this study, traditional cardiovascular disease risk factors and serum calcium were associated with coronary artery calcification. No association was demonstrated between CKD and CAC. Studies exploring potential protective mechanisms against coronary artery calcification are needed.

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This thesis explores the relationship between memory self-report, depression and neuropsychological performance at both baseline and six months following coronary artery bypass graft surgery (CABG). An additional important refinement on previous work included the adoption of a theoretically driven approach to calculate post-test change scores (Standardized Based Regression) in order to control measurement error, practice effects and regression-to-the-mean. A further important refinement included the analysis of different subtypes of depression and how they affect patient perceptions of memory over time. A prospective study of 64 elective CABG surgery patients (mean age 65.4 years) was undertaken pre-operatively and six months post-operatively, along with the assessment of 50 normal control participants (mean age 68.6 years). The neuropsychological test battery was selected in accordance with the Statement of Consensus on the Assessment of Neurobehavioural Outcomes after Cardiac Surgery (Murkin et al., 1995). Standardized self-report measures of depression and memory self-report were also included, namely the DASS and MAC-S. Unexpectedly, results showed that both CABG patients and controls scored in the 'normal' range for depression at both testing intervals. However, at baseline assessment, analyses showed small, significant correlations between memory self report and depression as well as between memory self-report and the CVLT variable Short Delay Free Recall. The depressive subscales of Inertia and Self-deprecation also emerged as significant predictors of memory self-report using hierarchical regression analysis. At follow-up assessment, no significant correlations were found between memory self report, depression or any neuropsychological variable. However, the DASS depression subscale of Devaluation of Life entered as a significant predictor of memory self-report. Collectively, these results provide little evidence of a relationship between subjective and objective measures of memory. However, they indicate that relatively non-depressed patients can show mild variants of the cognitive biases and symptoms classically related to clinical depression and that these symptoms correlate significantly with perceptions of memory. Although no consistent trends were found over time, excluding any inferences of causality, this study was the first to systematically examine the relationship between depressive symptoms and memory self-report, with a view to assisting clinicians to identify patients more inclined to over-report memory failure. / Thesis (PhD)--University of South Australia, 2006.

Coronary artery bypass grafting (CABG) is the most common cardiac surgical operation performed in western countries, and is also increasingly being performed in developing countries. However the long-term results of CABG using the saphenous vein graft have not been satisfactory. Surgeons have therefore been seeking a better conduit. The radial artery (RA) is a potentially suitable alternative conduit and has to date provided good early results. This thesis investigates the utility of the RA as a coronary artery bypass graft from a number of perspectives. It demonstrates the safety of RA harvesting by examining hand collateral circulation using anatomical dissection, physical examination using the modified Allen test, measuring digital blood pressure, and examining the flow velocity in the digital artery using Doppler ultrasound. Anatomical examinations revealed consistent continuity between the RA and ulnar artery in the hand through either superficial or deep palmar arches. The modified Allen test was found to be useful as a screening test compared with the Doppler dynamic test and digital blood pressure index. A histological comparison was made between pre-existing intimal disease in the RA compared with that in the standard conduit the internal thoracic artery (ITA). The RA showed a higher prevalence and degree of intimal disease than ITA. Risk factors for intimal hyperplasia in the RA were age, diabetes, smoking and peripheral vascular disease. The only predictor for medial calcification was age. (For complete abstract open document)

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 5 uppsatser.

Thesis (Ph.D.)--University of Tennessee Health Science Center, 2007. / Title from title page screen (viewed on July 18, 2008). Research advisor: Dr. Carol Lynn Thompson, PhD. Document formatted into pages (xiv,151 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 132-144).

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 136-140).