Possible erythrocyte contributions to and exacerbation of the post-thrombolytic no-reflow phenomenon.

Background: Reperfusion injury often occurs with therapeutic intervention addressing the arterial occlusions causing acute myocardial infarction and stroke. The no-reflow phenomenon has been ascribed to leukocyte plugging and blood vessel constriction in the microcirculation.

Objective: To assess possible red cell contributions to post-thrombolytic no-reflow phenomenon.

Clinical significance of ankle systolic blood pressure following exercise in assessing calf muscle tissue ischemia in peripheral artery disease.

Our primary objective assessed whether a decline in ankle systolic blood pressure (SBP) to less than 50 mm Hg after treadmill exercise is associated with lower extremity ischemia, as measured by calf muscle hemoglobin oxygen saturation (StO(2)). Eighty-four patients with peripheral artery disease (PAD) completed a treadmill test. Ankle SBP <50 mm Hg following exercise was observed in only 49% (group 1), whereas 51% had ankle SBP ≥50 mm Hg (group 2).

Caffeine and blood pressure response: sex, age, and hormonal status.

Purpose: The pressor effect of caffeine has been established in young men and premenopausal women. The effect of caffeine on blood pressure (BP) remains unknown in postmenopausal women and in relation to hormone replacement therapy (HRT) use.

Materials And Methods: In a randomized, 2-week cross-over design, we studied 165 healthy men and women in 6 groups: men and premenopausal women (35-49 yrs) vs.

The effect of hypercholestrolemia on calf muscle hemoglobin oxygen saturation in patients with intermittent claudication.

The purpose was to compare calf muscle hemoglobin oxygen saturation and exercise performance in hypercholesterolemic and normocholesterolemic patients with peripheral arterial disease. Hypercholesterolemic and normocholesterolemic patients had similar ankle/ brachial index (0.72 +/- 0.

Exclusion of first-episode deep-vein thrombosis after-hours using D-dimer.

The objective of this study was to test the safety of withholding anticoagulant treatment and additional call-back diagnostic testing with ultrasound in patients who have a negative D-dimer at presentation. Patients with signs and symptoms of deep-vein thrombosis who presented to the emergency department after regular hours and on weekends underwent D-dimer testing using the STA-Liatest D-di. In patients with negative D-dimer results, heparin therapy was withheld, and no further diagnostic testing for deep-vein thrombosis was done as part of the initial evaluation.

Prevention of central venous catheter-associated thrombosis: a meta-analysis.

Purpose: Anticoagulant prophylaxis in patients with central venous catheters is controversial. We performed a meta-analysis of randomized controlled trials of anticoagulant prophylaxis in patients with central venous catheters.

Methods: MEDLINE and EMBASE were searched up to May 2006, supplemented by manual searches of conference proceedings and bibliographies.

The effect of current cigarette smoking on calf muscle hemoglobin oxygen saturation in patients with intermittent claudication.

The purpose of this study was to compare calf muscle hemoglobin oxygen saturation response during exercise between smokers and non-smokers with peripheral arterial disease. Patients limited by intermittent claudication who were smokers (n = 12) were compared with those who had not smoked (n = 28) for at least 1 year prior to investigation. Ankle/brachial index (ABI) measurements were obtained with Doppler ultrasound, and maximal calf blood flow was measured by venous occlusion plethysmography.

The influence of obesity on calf blood flow and vascular reactivity in older adults.

Objective: To determine whether differences in vascular reactivity existed among normal weight, overweight, and obese older men and women, and to examine the association between abdominal fat distribution and vascular reactivity.

Methods: Eighty-seven individuals who were 60 years of age or older (age = 69 +/- 7 yrs; mean +/- SD) were grouped into normal weight (BMI < 25; n = 30), overweight (BMI > or = 25 and < 30; n = 28), or obese (BMI > or = 30; n = 29) categories. Calf blood flow (BF) was assessed by venous occlusion strain-gauge plethysmography at rest and post-occlusive reactive hyperemia.

The relationship between arterial elasticity and metabolic syndrome features.

The purpose of this study was to examine the effects of metabolic syndrome (MS) features on arterial elasticity of the large and small arteries in apparently healthy adults, to examine the effect of clustered features of MS, and to determine which features are most predictive of large and small artery elasticity. The subjects for this study consisted of 126 men and women, age 45 years and older. The subjects rested supine while pulse contour analysis was measured from the radial artery by using an HDI/Pulsewave CR-2000 instrument (Hypertension Diagnostic, Inc) to assess arterial elasticity in the large and small arteries.

Sex differences in the hemodynamic responses to mental stress: Effect of caffeine consumption.

The effect of caffeine on stress responses was compared in 25 men and 22 women in a 2-week placebo-controlled, double-blind, randomized crossover trial. On each week, participants abstained from all dietary sources of caffeine before undergoing a 6-h laboratory protocol under placebo or caffeine exposure followed by a 30-min mental stressor with blood pressure (BP) and cardiovascular hemodynamic assessments. On the placebo session, men and women showed a significant BP increase to stress, although women had significant cardiac responses whereas men had vascular responses.

Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels.

Objective: Caffeine increases cortisol secretion in people at rest or undergoing mental stress. It is not known whether tolerance develops in this response with daily intake of caffeine in the diet. We therefore tested the cortisol response to caffeine challenge after controlled levels of caffeine intake.

Hemodynamic mechanisms underlying the incomplete tolerance to caffeine's pressor effects.

Blood pressure (BP) and cardiovascular hemodynamics were assessed at baseline and after caffeine administration in a 4-week, placebo-controlled, double-blind, randomized, crossover trial of caffeine tolerance formation. Half of the subjects developed tolerance to the pressor effect of caffeine, whereas the other half continued to show increases in BP after caffeine ingestion (F = 16.7, p <0.

Caffeine tolerance is incomplete: persistent blood pressure responses in the ambulatory setting.

Background: Caffeine in dietary doses is a well-established pressor agent. Tolerance to this pressor effect occurs in only about half of regular consumers in acute laboratory tests. The clinical significance of this incomplete tolerance depends on whether the pressor effect is maintained throughout the day with repeated intake.

Ferriman Gallwey self-scoring I: performance assessment in women with polycystic ovary syndrome.

Objective: The objective of this study was to determine performance characteristics of Ferriman Gallwey self-scoring in women with the polycystic ovary syndrome.

Design: A simultaneous Ferriman Gallwey map scoring design was used.

Setting: The study was performed at the General Clinical Research Center in a university medical center.

Negative D-dimer result to exclude recurrent deep venous thrombosis: a management trial.

Background: All of the available diagnostic tests for deep venous thrombosis (DVT) have limitations for excluding acute recurrent DVT. Measurement of plasma d-dimer by using an automated quantitative assay may be useful as a rapid exclusion test in patients with suspected recurrent DVT.

Objective: To test the safety of withholding additional diagnostic testing and heparin treatment in patients who have a negative d-dimer result at presentation (using the automated quantitative assay STA-Liatest D-di), regardless of their symptoms.

Cardiovascular effects of caffeine in men and women.

Caffeine increases blood pressure (BP). In men, acute BP elevations after caffeine intake are due to an increase in vascular resistance, with no change in cardiac output. The hemodynamic effects of caffeine have not been studied in women.

Clinical utility of D-dimer in patients with suspected pulmonary embolism and nondiagnostic lung scans or negative CT findings.

Background: The diagnosis of pulmonary embolism is difficult because the clinical diagnosis is nonspecific and all of the objective tests have limitations. The assay for plasma d-dimer may be useful as an exclusion test if results are negative. We conducted a prospective cohort study that evaluated the clinical utility (usefulness) of an automated quantitative d-dimer test in the diagnosis of patients with suspected pulmonary embolism.

Blood pressure response to caffeine shows incomplete tolerance after short-term regular consumption.

Caffeine acutely raises blood pressure (BP). The clinical significance of this effect depends on whether BP responses persist in persons who consume caffeine on a daily basis. Accordingly, the ability of caffeine to raise BP after 5 days of regular daily intake was tested in a randomized controlled trial.

Sensitivity and specificity of ultrasonography in the diagnosis of upper extremity deep vein thrombosis: a systematic review.

Objectives: To determine the sensitivity and specificity of ultrasonography in the diagnosis of upper extremity deep vein thrombosis and to determine the safety of withholding anticoagulant therapy in patients with negative ultrasonographic results.

Data Sources: The MEDLINE database was searched for literature published from January 1, 1980, to December 31, 2000, that evaluated ultrasonography for the diagnosis of upper extremity deep vein thrombosis. Bibliographies of the retrieved articles were cross-checked to identify additional studies.