Lower extremity blood flow in healthy men: effect of smoking, cholesterol, and physical activity--a Doppler study.

Tobacco smoking is one of the principal risk factors of peripheral arterial disease (PAD); cholesterol level has a lesser impact. The effect of leisure-time physical activity (LTPA) has not been studied in depth. The aim of this study was to determine the relative effects of smoking, total cholesterol, and leisure-time physical activity on blood flow parameters in the lower extremities of healthy middle-aged men with no prior symptoms or diagnosis of PAD. The authors examined 130 men, aged 40-65 years, free of known arterial disease and hypertension. The men had either a total cholesterol concentration of < 5.7 or > 7.0 mmol/L, and were either smokers or nonsmokers. LTPA was addressed by a questionnaire. Ankle-brachial index (ABI) was calculated and Doppler examination of the femoral artery was performed before and after an exercise test. Tobacco smoking related significantly to abnormal ABI and Doppler results (odds ratio [OR] 2.42) while the total cholesterol level did not. LTPA had a favorable effect (OR 0.51). Abnormal ABI response was greatest in smokers with high total cholesterol (p < 0.01). Tobacco smoking is a significant risk factor for abnormal ABI response and blood flow abnormalities in healthy men. Regular physical activity has a measurable protective effect. An abnormal ABI suggests early atherosclerosis and indicates risk factor assessment and physician intervention.

Functional study of the dermal microcirculation in systemic sclerosis.

To measure the effect of cooling on digital blood pressure we used a strain-gauge and photoplethysmograph, with an automatic cooling device. Eighteen patients were compared with 18 matched controls. Laser-doppler technique was used to measure the perfusion changes after heating a small area of the skin in 5 locations on the body, readings were given in perfusion units. Eighteen patients with systemic sclerosis were compared with 25 individuals with primary Raynaud's phenomenon and 30 healthy controls. Cooling to 10 degrees C caused a significant digital blood pressure drop of 58 mmHg in patients with systemic sclerosis and 61 mmHg in Raynaud's phenomenon, as compared with controls. The microcirculation in patients with systemic sclerosis responded in the same way to local heating as in the normal population, increasing the perfusion to the same extent. In conclusion, an unselected group of patients with systemic sclerosis have normal dermal microcirculatory response to heating in spite of severe cold intolerance.

[Impotence among Icelandic males 1986-1991].

The estimated prevalence of impotence in western societies approximates 7%. A retrospective descriptive study was performed on 282 Icelandic males (mean age 53.5 years, range 19-79) referred for evaluation of impotence during the period 1986-1991. Diagnostic modalities included measurements of nocturnal penile tumescence (NPT) and penilebrachial index (PBI), hormonal profile and cavernosography. In 55% the NPT was abnormal. In contrast, only 8.2% of PBI was abnormally low. By logistic regression abnormal NPT results correlated with increasing age. Measurements of hormonal profile was performed in 73.4% of the patients. Testosterone was found to be below normal in 12.1%. However, primary or secondary hypogonadism was only found in 3.9% and elevated prolactin in 2.8%. By cavernosography, venous leakage was demonstrated in 3.2% of the men and subsequently ligation of the dorsal penile vein was performed. A trial of testosterone treatment was given in 39.4% of the patients. Impotence is a common complaint among men. Psychological factors predominate in young men and the contribution of somatic etiologic factors increases with age. In the majority of patients relatively simple studies can give useful information on the etiology of impotence.