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- Henein, Michael Y., et al.
(author)
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Diabetes and coronary circulation : from pathology to imaging
- 2021
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In: Diabetes and cardiovascular disease. - Amsterdam : Elsevier. - 9780128174289 ; , s. 227-267
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Book chapter (peer-reviewed)abstract
- Coronary artery disease (CAD) is the leading cause of mortality and morbidity among patients with diabetes mellitus. Despite the large fall in CAD mortality in the general population over the last four decades, the overall risk of CAD in people with diabetes did not change significantly. Compared to the general population, diabetics have a higher prevalence, extent, and severity of CAD and a higher risk of mortality due to myocardial infarction and to a lesser extent to stroke. Also, cardiovascular disease has been shown to develop earlier in individuals with diabetes and is followed by worse event-related survival than in nondiabetics. Although most data on the relationship between diabetes and CAD refer to type 2 diabetes, cardiovascular disease remains the leading cause of mortality even in patients with type 1 diabetes. Chronic hyperglycemia and insulin resistance have a key role in inducing coronary atherosclerosis by promoting inflammation and endothelial dysfunction. In diabetic patients, once the coronary atherogenesis has started, the progression from early lesions to plaque rupture or erosion follows the same pathological pathway as in the general population. Although the risk of CAD has been traditionally associated with coronary stenosis severity, more recent research has led to a paradigm shift, with more emphasis on total coronary plaque burden. Both clinical and postmortem studies have shown that diabetics have significantly greater total plaque burden compared to nondiabetics. Direct, invasive, and noninvasive visualization of atherosclerotic lesions allows accurate evaluation of the extent of disease and degree of plaque calcification. However, imaging of the presence and extent of plaque inflammatory activity, using positron emission tomography or cardiac magnetic resonance, may serve in identifying individuals with a more severe atherosclerotic disease who may benefit from intensive treatment.
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- Johnsson, Åse (Allansdotter), 1966, et al.
(author)
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Incidental findings and their handling in the Swedish CArdioPulmonary bioimage study (SCAPIS)
- 2017
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In: Incidental Radiological Findings. - Cham : Springer International Publishing. - 0942-5373 .- 2197-4187. - 9783319425818 - 9783319425795 - 9783319826127 ; , s. 91-101
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Book chapter (peer-reviewed)abstract
- The Swedish CArdioPulmonary bioImage Study (SCAPIS) combines the use of new imaging technologies, large-scale proteomics/metabolomics/genomics, and epidemiological analyses to extensively characterize a Swedish cohort of 30,000 men and women aged between 50 and 64 years. Its main aims are to improve risk prediction and to optimize our ability to study mechanisms of cardiopulmonary diseases. SCAPIS is currently recruiting at six sites in Sweden, and a pilot study was conducted in 2012 to test the feasibility of the comprehensive study protocol. In the planning phase, it was recognized that the detailed phenotyping used in SCAPIS would identify a large number of clinical findings in need of medical attention. This was confirmed by evaluation of results from the pilot study. Here we focus on pulmonary nodules and asymptomatic coronary artery stenosis. These clinical features were observed in a large number of participants, and the clinical handing and prognosis related to these observations are unclear. They thus posed great challenges for the study in their practical and ethical handling. This chapter describes how we developed procedures to handle these findings based on existing evidence and expert consensus as well as deliberations on ethical issues.
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- Daníelsson, Guomundur, et al.
(author)
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Venous ulcers associated with superficial venous insufficiency
- 2018
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In: Vascular Surgery : Cases, Questions and Commentaries - Cases, Questions and Commentaries. - Cham : Springer International Publishing. - 9783319659350 - 9783319659367 ; , s. 589-597
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Book chapter (peer-reviewed)abstract
- A 59-year-old female secretary was referred for evaluation and treatment of a non-healing painful ulcer on the medial aspect of her right lower leg. The ulcer had been recurrent almost every year for the past 9 years, often healing during the winter season. She had since early childhood been overweight (currently 87 kg, 170 cm, body mass index 30) and had difficulty in using compression stocking. She was otherwise healthy. She had two children, the first child born when she was 32 year of age and her second child 2 years later. After the birth of her second child she began to notice varicose veins on the lower leg on both sides and she often felt tiredness and heaviness in the leg in the afternoon. There was no history of deep venous thrombosis. She had been on birth control pills for 10 years and was currently on hormone replacement therapy because of severe postmenopausal symptoms. She had been treated at a local dermatological clinic for the past 2 years and was now being evaluated by a vascular surgeon. Clinical evaluation showed that she had 5 × 5 cm well-granulated ulceration above the right median malleolus which was surrounded by brownish leathery skin. She had slight swelling of the right leg with large varicosities below the knee. The left leg had large varicosities below the knee but no swelling or skin changes. Doppler examination revealed clear reflux in the groin that could be followed over both great saphenous veins (GSV) down the thigh. A possible minimal reflux was also noted in the popliteal fossa on the right side, although it was difficult to confirm this when the Doppler examination was repeated. Foot arteries were palpable on the dorsum of the foot on both sides.
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- Sunnegårdh, Jan, 1948
(author)
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Medfödda hjärtfel.
- 2008
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In: Socialstyrelsens riktlinjer för hjärtsjukvård.. - Stockholm : Socialstyrelsen. - 9172018747
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Book chapter (other academic/artistic)
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