Systematic Review of Guidelines on Peripheral Artery Disease Screening

Ferket, Bart S.; Spronk, Sandra; Çölkesen, Ersen B.; Hunink, M. G. Myriam

doi:10.1016/j.amjmed.2011.06.027

Cited by 63 publications

(47 citation statements)

References 38 publications

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“…Recent studies suggest that the early deteetion and sereening of PAD patients eould lead to health benefits in 2 ways: through avoiding the progression of PAD, and by helping prevent eardiovaseular and eerebrovaseular events and their assoeiated mortalities (10). Areeent study showed that the risks of mortality were similar in symptomatie and asymptomatie PAD patients.…”

Section: Discussionmentioning

confidence: 98%

Onychomycosis as a Warning Sign for Peripheral Arterial Disease

Fukunaga¹,

Washio²,

Ogura³

et al. 2013

Acta Derm Venerol

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Peripheral arterial disease (PAD) is associated with inereased risk of cardiovascular and eerebrovaseular diseases. Inereasing age, smoking, hyperlipidaemia, diabetes, hypertension, and male gender have been identified as risk factors for PAD (1). The possible role of dermatologieal diseases in the early detection of PAD remains unknown.Onyehomyeosis (OM) is a common disease, aeeounting for up to half of all reported nail diseases, with an estimated prevalence of 10% in the general population (2-4). Previous studies found that OM was assoeiated with inereasing age, gender, diabetes, psoriasis, smoking and immune dysfunction (5-7). Meanwhile, a study of patients attending a vascular clinic reported that PAD might be an independent predictor of OM (7).Based on these results, we hypothesized that OM might represent an independent elinieal sign for the early deteetion of PAD. A university-based eross-seetional study of elderly dermatologieal patients with or without microscopically eonfirmed OM was performed to clarify the role of OM as an independent predictor of PAD. MATERIAES AND METHODSPatients aged > 50 years old who visited the outpatient or inpatient dermatology clinic of Kobe University Hospitalwere randomly enrolled in this study. This study was approved by the institutional review board. Oral and written informed consents for the study were obtained from all subjects. Both feet were examined clinically in all patients. Nail specimens from patients with clinical dystrophy of atiy toenails were examined by potassium hydroxide microscopy to detect the presence of fiingal filaments. The nail specimens were also cultured in Sabouraud dextrose agar slants with ehloramphenicol (Nikken bio medical laboratory, Kyoto, Japan).Participants completed questionnaires about age, gender, hypertension, hyperlipidaemia, smoking, diabetes, and eardiovaseular and eerebrovaseular diseases.The ankle brachial pressure index (ABI) was measured in both legs. Patients with an ABI <0.9 (8) in at least one side of the leg were considered to have PAD. The mean ABI value for both legs was calculated in the OM and control groups.All analyses were performed using SPSS 16.0 (SPSS Inc, Chicago, IL, USA). Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were estimated by logistic regression models to investigate independent associations between risk factors (age, gender, hypertension, hyperlipidaemia, smoking, diabetes, cardiovascular disease, eerebrovaseular disease, and PAD) and OM. Student's /-test and Pearson's x' test were used to compare differences in continuous and categorical variables between the OM and control groups. Two-sided probability values <0.05 were considered significant. Continuous variables are presented as means ± standard deviation (SD). RESUETSA total of 86 subjects partieipated in the study, 40 men and 46 women, with a mean age of 71.2 years. There were 44 patients in the OM group (found to be positive by mieroseopy) and 42 patients in the eontrol group (without OM). Trichophyton rubrum accounted for 68% ...

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Section: Discussionmentioning

confidence: 98%

Onychomycosis as a Warning Sign for Peripheral Arterial Disease

Fukunaga¹,

Washio²,

Ogura³

et al. 2013

Acta Derm Venerol

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“…Pedal pulses can be palpable in 17-20 % of patients with significant arterial disease suggesting that the presence of pedal pulses alone can be misleading and unreliable for the assessment of vascular supply [18]. For a person with an ABPI of 0.9-1.3 indicating normal vascular supply, high compression should always be considered.…”

Section: Single Component or Multiple Componentsmentioning

confidence: 99%

“…It is defined as the ratio of the highest ankle systolic blood pressure divided by the highest brachial systolic blood pressure. According to a systematic review of eight international guidelines on screening for perfusion deficits, ABI was unanimously recommended as the primary diagnostic tool for PAD in the case of clinical suspicion based on symptoms and clinical findings [18]. Other uncommon conditions associated with leg ulcers are described in Table 3.…”

Section: Management Of Venous Stasis Diseasementioning

confidence: 99%

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Management of Venous Stasis Ulcers in the Older Adult

Woo

LeBlanc

Livingston³

2015

Curr Geri Rep

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Venous stasis disease is common among older adults due to calf muscle pump failure, immobility, chronic edema, and obesity. Increased venous pressure increases the capillaries' permeability allowing fluid, proteins, and blood cells to leak into the tissues. Ulceration is precipitated by reduced oxygen diffusion to the skin and microvasculature damages. While most chronic leg ulcers are caused by venous stasis disease, there is a need to rule out other underlying pathologies including arterial, neuropathic, metabolic, hematological, infectious, malignant, and inflammatory diseases. Compression therapy with high stiffness index is the mainstay of treatment for venous leg ulcers. Adherence to compression therapy could be a challenge in the older population due to reduced dexterity, muscle strength, range of motion, and flexibility. Medications such as pentoxifylline, flavonoids, and zinc have been shown to have a positive role in the management of venous disease.

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“…En esencia, se trata de estimar el riesgo individual de sufrir un ECV con la mayor exactitud posible y de actuar sobre los FRCV modificables, con mayor o menor intensidad dependiendo del riesgo estimado [58][59][60][61][62][63] (algoritmo 3, fig. 3).…”

Section: Repercusión Cardiovascularunclassified