The effect of statin therapy on the progression of carotid artery stenosis in relation to stenosis severity.

OBJECTIVES: To examine the effect of early statin treatment on progression of arteriosclerosis in internal carotid arteries (ICA); to compare the progression of arteriosclerosis in ICA of patients treated with a statin to the progression seen in drug-naïve patients. PATIENTS AND METHODS: We performed repetitive Doppler scans of 363 carotid arteries with ICA stenosis > or =40% in 254 patients over time. Information on statin therapy and other risk factors for stroke were correlated with the annual change in degree of ICA stenosis. RESULTS: In statin-treated patients, 19% of ICA stenosis showed a progression while 74% showed a regression of stenosis. In statin-naïve patients, 63% of stenotic arteries showed a progression, while a reduction could be observed in 28%. Decrease of ICA stenosis was most accentuated in patients with a mild stenosis and was independent of serum cholesterol levels. CONCLUSION: Treatment with statins already in early stages of ICA stenosis might delay the progression and even reverse the degree of stenosis.

Effect of simvastatin in preventing progression of carotid artery stenosis.

This study examines the effect of simvastatin on progression of carotid artery stenosis and shows that the drug substantially reversed the anticipated disease development. This finding indicates that treatment with simvastatin may reduce the risk for stroke in patients with known carotid artery disease.

The postpolio syndrome--a critical comment to the diagnosis.

OBJECTIVES: The postpolio syndrome (PPS) is said to comprise symptoms which are characteristic of a specific disorder affecting former polio sufferers many years after their acute disease. Localized muscular weakening with or without attendant pain and atrophy are claimed to separate patients with PPS from persons with unspecific common symptoms from the musculoskeletal system. Therefore our objective was to evaluate the specificity of the symptoms of the PPS. MATERIAL AND METHODS: Eighty-one former polio sufferers were, based on clinical examination and a questionnaire, compared with 116 gender and age matched controls. RESULTS: Significant differences between patients and controls of self-reported muscular weakening and pain in different locations were found. However, the level of similar complaints reported by the controls also was considerable. CONCLUSION: We question the validity of the diagnosis in cases without localized atrophy or other objective signs of denervation.

Failure to influence the VIP level in the cerebrospinal fluid by transcutaneous nerve stimulation in humans.

Low-frequency transcutaneous nerve stimulation (TNS) is known to produce a prolonged and widespread cutaneous vasodilatation. This is associated with a moderate but significant increase of 30-35% in the concentration of the vasoactive intestinal polypeptide (VIP) in the cubital vein plasma. A possible source of this increased plasma VIP following TNS is the central nervous system. This possibility is tested in the present experiment. The concentration of VIP in the cerebrospinal fluid (CSF) was determined by radioimmunoassay in 9 patients with no organic disease of the central nervous system, before and at various intervals (15, 30 and 45 min) after the onset of TNS. No significant change in the VIP level of the cerebrospinal fluid was encountered, although the stimulation evoked rises in finger temperature indicating effectiveness of the stimulation. It is concluded that the stimulation-induced increase in plasma VIP is due to release of VIP outside the brain.