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- Elmstahl, S., et al.
(författare)
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Hydrotherapy of patients with intermittent claudication : A novel approach to improve systolic ankle pressure and reduce symptoms
- 1995
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Ingår i: International Angiology. - 0392-9590. ; 14:4, s. 389-394
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To study the effects of alternating cold and hot water therapy on walking ability and systolic blood pressure in claudicants. Experimental design. A prospective case study with repeated measurements before and 1, 4 and 12 months after treatment. The systolic blood pressure levels were measured with an occlusion cuff for brachial and ankle and with a strain gauge for the first toe. Study population. Twenty consecutively included patients, 11 women and 9 men; mean age 73.9 yrs, with intermittent claudication according to clinical examination and ankle-arm systolic blood pressure (AAI) below 0.90. Intervention. Alternate hot and cold hydrotherapy of the legs were given at ten 25-minute treatments during a three-week period. The outcome measures were maximal walking ability (MW), walking ability before pain (PW) and systolic blood pressures of toe, ankle, arm and AAI. Results. Fourtheen patients (70%) reported reduced pain after treatment and their PW increased from 134 ± 29 m to 415 ± 119 m 12 months later (p < 0.05) and the MW in the total group increased form 348 ± 75 m to 523 ± 103 m. Systolic blood pressure increased in right ankle and toe one month after treatment in the total group. Among those who reported improved walking ability one year after treatment, systolic blood pressure in both right and left ankles and toes increased; e.g. right toe increasing from 72 ± 7 to 86 ± 2 (p < 0.001). Improvements of systolic blood pressure in left and right leg and changes of walking ability were correlated, in the order of 0.60 to 0.81, p < 0.05. Conclusions. Showering the legs of claudicants improved walking ability and blood pressures which sustained up to 1-year later. This therapy might be an additional alternative to conservative treatment of intermittent claudication.
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| 2. |
- Siennicki-Lantz, Arkadiusz, et al.
(författare)
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How to interpret differing cerebral blood flow patterns estimated with 99tcm-hmpao and 99tcm-ecd spet in a healthy population
- 1999
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Ingår i: Nuclear Medicine Communications. - : Ovid Technologies (Wolters Kluwer Health). - 0143-3636. ; 20:3, s. 219-226
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Tidskriftsartikel (refereegranskat)abstract
- Two radiopharmaceuticals, 99Tcm-hexamethyl propylene amine oxime (99Tcm-HMPAO) and 99Tcm-ethyl cysteinate dimer (99Tcm-ECD), are currently used to determine cerebral blood flow. 99Tcm-ECD is, by virtue of its greater stability, superceding 99Tcm-HMPAO for routine examinations. Since the clinical assessment of 99Tcm-ECD images is usually based on experience with 99Tcm-HMPAO, we used both radiopharmaceuticals to compare regional cerebral blood flow in the same individuals. Eleven healthy subjects aged 67.1 ± 6.3 years (mean ± S.D.) underwent 99Tcm-ECD followed by 99Tcm-HMPAO single photon emission tomography. Cerebral blood flow was quantified in cortical and central regions of interest (basal ganglia, ventricles, white matter) in relation to cerebellar uptake. The intra-subject comparison of cerebral blood flow in the cortical areas revealed higher levels of perfusion in the posterior parietal, parieto-occipital and temporo-occipital areas using 99Tcm-ECD. In contrast to the cortical areas, cerebral blood flow in the central areas was greater using 99Tcm-HMPAO, especially in the centrum semiovale, basal ganglia, frontal white matter and frontal horns. This difference in cerebral blood flow when imaging healthy individuals with 99Tcm-ECD and 99Tcm-HMPAO should be taken into account in clinical practice when changing from one radiopharmaceutical to the other.
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| 3. |
- Siennicki-Lantz, A., et al.
(författare)
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Orthostatic hypotension in Alzheimer's disease : Result or cause of brain dysfunction?
- 1999
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Ingår i: Aging clinical and experimental research. - 0394-9532. ; 11:3, s. 155-160
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Tidskriftsartikel (refereegranskat)abstract
- In Alzheimer's disease (AD), an association was found between autonomic dysfunction and frontal hypoperfusion in brain during orthostatic testing. To ascertain whether frontal hypoperfusion is dependent on longitudinal effects of hemodynamic disturbances, or contributes to them, we studied the relationship between the presence of orthostatic hypotension (OH) and resting cerebral blood flow (CBF) in late stages of AD. Twelve women with senile dementia of Alzheimer type (SDAT), and 15 non-demented women (mean age 82.6 years, SD 3.8 vs 81.8 years, SD 3.5) were examined with the orthostatic test. Four of 12 patients with SDAT, and 9 controls had OH (defined as systolic blood pressure fall ≥ 20 mmHg). CBF was determined under resting conditions using 600 Mbq 99mTc HMPAO single photon emission computerized tomography (SPECT), and quantified in cortical areas in relation to cerebellum. In patients with SDAT and OH, CBF was lower in frontal and parieto-frontal cortical areas than in SDAT patients without OH. The former group was younger and had a shorter dementia duration. No significant differences in CBF were observed between controls with vs without OH. No differences in SDAT patients with or without OH were observed in the Berger dementia scale or Katz' ADL index. No difference in incidence of symptoms related to autonomic disturbances (diarrhea, obstipation, dysphagia, vertigo) was observed in either the SDAT or control group with regard to OH presence. We conclude that during the course of AD, OH can contribute to frontal brain changes and may exacerbate the disease. The further involvement of frontal dysfunction in aggravating blood pressure dysregulation in the elderly is discussed.
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