ABSTRACT
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality.Patients with COPD have a cardiovascular risk three times greater than the normal population and cardiac disease accounts for about 50% of deaths in these patients. Arterial stiffness is a marker of increased cardiovascular risk and a predictor for cardiovascular morbidity and mortality. There is evidence of increased aortic stiffness in COPD. The aim of our study is to determine parameters of carotid arterial stiffness in patients with stable COPD. PATIENTS AND METHODS: We enrolled 38 patients with COPD and 36 matched controls. All subjects were evaluated by clinical history and spirometry; parameters of carotid stiffness (beta stiffness index - 13 stiffness index, arterial compliance - AC, pulse wave velocity - PWV, augmentation index - AIx) were determined using an ultrasound device (ALOKA ProSound a 10). RESULTS: Patients with COPD have increased markers of arterial stiffness compared to controls (B stiffness index,p=0.03; AC, p=0.002; carotid PWV, p<0.001; Alx, p<0.001). There were no differences between the two groups regarding the classical cardiovascular risk factors with the exception of smoking history. Patients with severe pulmonary disease had more increased 13 stiffness index and PWV than those with mild and moderate disease(p=0.03, respectively p=0.004). CONCLUSIONS: Patients with COPD had increased carotid arterial stiffness. In severe forms of COPD, arterial stiffness seems to be more important than in mild and moderate pulmonary disease.
Subject(s)
Carotid Arteries/physiopathology , Elasticity/physiology , Pulmonary Disease, Chronic Obstructive/physiopathology , Severity of Illness Index , Aged , Blood Flow Velocity/physiology , Cardiovascular Diseases/epidemiology , Case-Control Studies , Female , Humans , Male , Middle Aged , Respiratory Function Tests , Risk Factors , SpirometryABSTRACT
We report a case of type II heparin-induced thrombocytopenia, which occurred after heart surgery in a 71-year-old female patient with several cardiovascular risk factors. The diagnosis of heparin-induced thrombopenia was suspected because association of multifocal arterial and venous thrombosis and detection of antiplatelet-factor 4 antibodies with a drop of more than 50% in the platelet count. Until diagnostic of heparin-induced thrombocytopenia was made, clopidogrel was introduced because of well-documented ischemia in middle-cerebral artery territory. The platelets subsequently increased by near 30%. The diagnosis of heparin-induced thrombocytopenia was finally confirmed a few days later by detection of antiplatelet-factor 4 antibodies associated with a positive platelet aggregation test for unfractionated heparin. Heparin was replaced by sodium danaparoid. These measures did not change the unfavorable outcome and death of the patient. The increase in the platelet count after fortuitous clopidogrel introduction raises the question of the role of antiaggregant agents in association with anticoagulants for the treatment of type II heparin-induced thrombocytopenia.
Subject(s)
Fibrinolytic Agents/adverse effects , Heparin/adverse effects , Platelet Aggregation Inhibitors/therapeutic use , Thrombocytopenia/chemically induced , Thrombocytopenia/drug therapy , Ticlopidine/analogs & derivatives , Aged , Clopidogrel , Fatal Outcome , Female , Humans , Ticlopidine/therapeutic useABSTRACT
In the following study we've proposed to realize a comparison between the results obtained from two previous studies, regarding to smoking in 17 years of age adolescent population from Timisoara, along 10 years, in the period 1994-2004. We've revealed that the presence of this behavior is real in both studies and the trend is in an ascendant evolution. Compared with the boys, the girls have an increased tendency of daily smoking and smoke a greater number of cigarettes per day.
