[Comparison of the results of surgical and endovascular treatment in patients with peripheral arterial disease of the lower extremities in the femoropopliteal region]. / Porovnanie výsledkov pouzitia chirurgickej a endovaskulárnej liecby u pacientov s periférnym artériovým ochorením dolných koncatín vo femoropopliteálnej oblasti.

INTRODUCTION: Results of previous studies comparing bypass surgery and percutaneous transluminal angioplasty in peripheral artery disease are ambiguous. Therefore, the aim of our study was to analyse and compare the long-term results of surgical and endovascular revascularisation in patients with peripheral artery disease in the femoropopliteal region. MATERIAL AND METHODS: 255 patients with peripheral artery disease who underwent bypass surgery or percutaneous transluminal angioplasty for newly diagnosed infrainguinal lesions in the femoropopliteal region were retrospectively identified and analyzed. Clinical and technical success, primary and secondary patency, improvement of critical limb ischaemia symptoms and improvement of the claudication interval were assessed within 1 year following treatment. Secondary evaluated outcomes were complications including haematoma after intervention, the need for revascularization and need for amputation of the thigh within 1 year after the intervention. Clinical outcomes were statistically evaluated as odds ratio and confidence interval. RESULTS: Patients were divided into two groups: the first one was formed by 93 (36.47%) patients who underwent bypass surgery, the second one consisted of 162 (63.53%) patients who underwent endovascular therapy - percutaneous transluminal angioplasty. We could not find differences in clinical and technical success, primary and secondary patency and claudication interval improvement between the treatment groups within 1 year of follow-up after the intervention. In comparison to the endovascular group, we observed a 1.85 times higher rate of clinical improvement of critical limb ischaemia symptoms after 1 year following the intervention in the bypass surgery group patients OR 1.85 (1.10-3.10), p=0.020. Multiple logistic regression analysis showed that type of intervention was the only predictor of improvement in critical limb ischemia symptoms, independently of claudication interval before intervention, age, gender, active smoking, diabetes mellitus, hypertension and ischaemic heart disease (p=0,004). The bypass surgery group had a higher incidence of haematoma due to intervention than the endovascular group OR 4.23 (1.27-14.15), p=0.019. No differences were detected between the treatment groups in the need for revascularisation or amputation of the thigh within 1 year following intervention. CONCLUSION: The use of bypass surgery has been associated with a higher rate of clinical improvement in critical limb ischaemia symptoms after 1 year of intervention and presence of haematoma after the intervention. No differences were detected between patients with peripheral artery disease in the femoropopliteal region treated by bypass surgery or percutaneous transluminal angioplasty in clinical and technical success, primary and secondary patency, nor in the improvement of the claudication interval during 1 year of follow-up. We also could not observe differences in the need for revascularisation or amputation of the thigh within 1 year following the intervention.

[Dissection of arteria poplitea, managed with endovascular procedure]. / Disekcia arteria poplitea riesená endovaskulárne.

Arterial dissection of a peripheral artery involving an extremity is a rare event. We report a case of nonaneurysmal dissection of the popliteal artery that occurred in a 61-year-old man who was admitted with acute limb ischemia. Ultrasound examination was suggestive of arterial dissection and endovascular treatment was undertaken before irreversible ischemia developed. Successful management depends on consideration of the diagnosis, particularly when other, more common diseases have been excluded.

[The Gothenburg study of women and alcohol: low occurrence of abuse--increase appears to have abated]. / Studie i Göteborg om kvinnor och alkohol: låg förekomst av missbruk--ökningen förefaller ha avklingat.

Prevalence of alcohol dependence and abuse (ADA) was determined in a cohort of women selected by stratified random sampling from the general population in Gothenburg. A questionnaire was administered to 3,130 women and 399 were interviewed. Questions were asked about social background, living conditions, family and working life. Volume and frequency of alcohol intake were recorded, and diagnoses were made according to DSM-III. We found that the one-year prevalence of ADA was 1.5 percent and the life time prevalence 3.3 percent. In a follow-up five years after base-line, the prevalence of ADA was unchanged, while indicators of high alcohol consumption and high episodic drinking showed reduced levels of problem drinking.

[The Gothenburg study of women and alcohol: problems during childhood and adolescence important risk factors]. / Studie i Göteborg om kvinnor och alkohol: problem under barn- och ungdomsåren en stor riskfaktor.

This is a part of longitudinal study concerning women and alcohol in Gothenburg. The aim was to find out more about risk factors for alcohol dependence and abuse (ADA) among women in the general population, as well as social conditions and life style among these women. Several indicators of dissatisfactory childhood conditions, and particularly sexual abuse before age 13, were related to ADA in adulthood. Early substance abuse, such as having been intoxicated before age 15 and having used narcotics before 18, was strongly related to future ADA. Our findings point to the need of paying attention to mental health problems in childhood and youth, and to prevent early use of alcohol and drugs.

Alcoholism and depression in a Swedish female population: co-morbidity and risk factors.

OBJECTIVE: Our aims were to study associations between depressive disorders and alcohol dependence/abuse (ADA) in a female population-based sample, and to identify risk indicators common to both depressive disorders and ADA. METHOD: Three hundred and sixteen women in a stratified randomized sample were interviewed face to face. They were asked about their childhood/adolescence and alcohol habits. Clinical lifetime diagnoses according to DSM-III-R were made. Depressive disorders includes different mood disorders. RESULTS: Half the women with ADA also had a depressive disorder, and 25% of the women with depressive disorders also had ADA. Alcohol intoxication before the age of 15 and psychological and/or psychiatric problems before the age of 18 years increased the risk for ADA and depressive disorders in our study. CONCLUSION: Our results support previous findings of an association between depressive disorders and ADA, beginning early in life.

Sexual abuse and alcoholism in a female population.

AIMS: (1) To study the prevalence of childhood sexual abuse before the age of 18 years (CSA) and life-time sexual abuse (LSA) in a Swedish female, general population, (2) to analyse associations between CSA and life-time alcohol dependence or abuse (ADA), and (3) to identify possible confounding factors. DESIGN AND PARTICIPANTS: The study was conducted in two phases. Phase 1: an alcohol problem screening questionnaire was sent to 3130 women aged 25-65. The answers were scored. Phase 2: based on the questionnaire scores, a randomly selected stratified sample of 479 women was invited for an interview. Of these, 316 women participated in a structured face-to-face interview. SETTING: A sector of Göteborg city with 100,000 inhabitants. MEASUREMENTS: The interviews focused on substance use and on social, psychological and behavioural characteristics, including experiences of sexual abuse. Clinical psychiatric diagnoses were made according to DSM-III-R. Bivariate analyses and multivariate logistic regression analyses were performed. FINDINGS: The prevalence of CSA and LSA was 9.8% and 13.9%, respectively. CSA increased the risk for life-time ADA and anxiety, but not for depression. When potential confounding factors (e.g. early background factors, depression and anxiety) were adjusted for, CSA under 13 years of age still predicted ADA in multivariate analyses, but CSA under 18 years of age did not. CONCLUSIONS: LSA, and especially CSA under 13 years of age, are factors that should be considered in treatment of women with ADA and in psychiatric treatment of women.

Factors in childhood and youth predicting alcohol dependence and abuse in Swedish women: findings from a general population study.

The aim was to assess risk factors during childhood and youth for alcohol dependence/abuse (ADA) in a population-based study of Swedish women. A total of 316 women were interviewed after stratified random sampling in the general population and a screening questionnaire. The interviews focused on social, psychological and behaviour characteristics as well as on early substance use patterns. Alcohol diagnoses were made according to DSM-III-R and CIDI-SAM. Experiences of sexual abuse before the age of 13 years, a history of psychological or psychiatric problems, early deviant behaviour and an episode of alcohol intoxication before the age of 15 years were significantly associated with ADA in a logistic model. General indicators of low social class were not associated with increased risk of ADA in a multivariate analysis. Sexual abuse in childhood was the strongest predictor of ADA. This association has potential public health importance, and should be addressed in future studies on women and alcohol.