Peripheral Arterial Disease in Women: an Overview of Risk Factor Profile,Clinical Features,and Outcomes

Purpose of Review

Peripheral arterial disease (PAD) is the third most common manifestation of cardiovascular disease (CVD), following coronary artery disease (CAD) and stroke. PAD remains underdiagnosed and under-treated in women.

Recent Findings

Women with PAD experience more atypical symptoms and poorer overall health status. The prevalence of PAD in women increases with age, such that more women than men have PAD after the age of 40 years. There is under-representation of PAD patients in clinical trials in general and women in particular. In this article, we address the lack of women participants in PAD trials. We then present a comprehensive overview of the epidemiology/risk factor profile, clinical features, treatment, and outcomes.

Summary

PAD is prevalent in women and its global burden is on the rise despite a decline in global age-standardized death rate from CVD. The importance of this issue has been underlined by the American Heart Association’s (AHA) “Call to Action” scientific statement on PAD in women. Large-scale campaigns are needed to increase awareness among physicians and the general public. Furthermore, effective treatment strategies must be implemented.

     

Forced splenectomy in surgery on the organs of the abdominal cavity

Forced splenectomy aggravates the postoperative course. During operation the surgeon must take all the prophylactic measures to prevent any injury of the spleen. All the patients subjected to forced splenectomy should be given antibiotics during the postoperative period.     

Morpho-functional characteristics of invagination esophago-enteric and esophago-gastric anastomoses

The morphological and functional features of invagination ++esophago-enteric and esophagogastric anastomoses were studied in 234 of 266 patients who underwent gastrectomy or proximal resection of the stomach for cancer in 1972-1989. Two valuable stable properties were found to be characteristic in normally functioning invagination anastomosis: reliable anti-reflux properties and evacuation in portions. They are ensured by the obturating apparatus of the anastomosis, which consists of a valve and a muscular sphincter. No functional disorders on the part of the anastomosis were encountered in all periods after the operation in 174 (74.4%) patients. Complications developed in 60 (25.6%) patients (acute anastomositis, spasm of the anastomosis, reflux esophagitis, cicatricial stricture, and the dumping syndrome); they were attended by disorders of the function of the anastomosis due to temporary or constant disorders of the function of the obturating apparatus.     

Hippocampal synaptic plasticity induced by excitatory amino acids includes changes in sensitivity to the calcium channel blocker, omega-conotoxin

The hippocampus is widely used in investigations of different forms of synaptic plasticity, including long-term potentiation and kindling. Receptors for excitatory amino acids (EAAs) play a prominent role in these phenomena. Recently, is has been demonstrated that exposure of hippocampal slices to EAAs and related agonists produces biphasic effects on excitatory synaptic transmission: initial blockade of synaptic responses is followed by a delayed recovery. The recovered responses demonstrate altered pharmacological properties: they acquire sensitivity to N-methyl-D-aspartate (NMDA) antagonists during L-glutamate (Glu) exposure and lose sensitivity to both NMDA and non-NMDA antagonists under L-aspartate (Asp). These changes persist for many hours. It was suggested that this form of hippocampal plasticity may involve transitions between distinct states of synaptic functioning. To explore this possibility, we investigated several properties of synaptic transmission in the initial and EAA-modified states. Here we report that hippocampal postsynaptic potentials (PSPs) evoked under Glu or Asp exposure completely lose sensitivity to omega-conotoxin GVIA (omega-CgTX), a potent, specific, and irreversible blocker of certain types of neuronal calcium channels. After washout of the EAA, sensitivity to the toxin is regained. These results indicate that prolonged EAA exposure induces profound changes in the machinery of synaptic transmission, which include, but are not limited to, changes in calcium channel functioning.     

Effect of Cavinton on convulsions caused by chemical substances

Cavinton was shown to protect mice against convulsions induced by corazol, strychnine and thiosemicarbazide. In addition, cavinton exhibited a definite antagonism to convulsive reactions produced by systemic administration of penicillin to cats and a combined administration of penicillin (intramuscularly) with tryptophan metabolite, quinolinic acid (intracerebroventricularly). The anticonvulsant action of cavinton is suggested to be due to the involvement of the brain GABA- and serotonergic mechanisms. It is reasonable to test cavinton as a drug for treating some forms of epilepsy.