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Vascular
Published in Anna Kowalewski, SBAs and EMQs in Surgery for Medical Students, 2021
This patient is suffering from thromboangiitis obliterans (Buerger’s disease), a condition where there is recurrent inflammation and thrombosis of the arteries and veins of the hands and feet. It is strongly associated with smoking, and first- line therapy is for the patient to quit smoking completely. However, they may require opioid analgesia.
Unexplained Fever Associated With Hypersensitivity and Auto-Immune Diseases
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Thromboangiitis obliterans is a rare disease of young (under 40) and heavy smoker men. It can also affect women.29 It is an exceptional cause of U.F. Its classical presentation is variable, insidious, or abrupt, with a venous superficial thrombosis, limited, which tends to recur, and can mimic erythema nodosum. Some fever usually accompanies the thrombosis (see Chapter 25).
Impaired Fibrinolysis in Cigarette Smokers
Published in Pia Glas-Greenwalt, Fibrinolysis in Disease Molecular and Hemovascular Aspects of Fibrinolysis, 2019
Cigarette smoking has long been associated with thrombotic vascular disease. Smoking is associated with a two- to fourfold increase in risk of coronary heart disease and a greater than 70% excess rate of death from coronary heart disease. Smoking acts in synergy with other factors (hypertension, hypercholesterolemia, diabetes) to further increase the risk of coronary disease.1,2 Smokers account for 70% of patients with atherosclerosis obliterans and virtually all those with thromboangiitis obliterans.1 There is a higher risk of stroke and stroke-related mortality in smokers compared to nonsmokers, especially in younger individuals.1,3 Since many of these diseases are associated with abnormalities of the fibrinolytic system, it is not unexpected that many investigators have postulated that chronic cigarette smoking might impair fibrinolysis. This chapter summarizes the abnormalities found in the fibrinolytic system of chronic smokers and, in an attempt to determine how these abnormalities arise, reviews the conflicting data on the effect of acute cigarette smoking on fibrinolysis.
Difference in vasoconstrictors: oxymetazoline vs. brimonidine
Published in Journal of Dermatological Treatment, 2021
Nwanneka Okwundu, Abigail Cline, Steven R. Feldman
Additionally, cardiovascular events are more severe adverse effects that could theoretically occur with these medications especially in patients with co-morbid cardiovascular conditions such as hypertension, orthostatic hypotension, or heart disease. This is because α-adrenergic drugs can tone the blood vessels and alter blood pressure. There is also the potential for an increased risk of angle closure glaucoma in patients with narrow-angle glaucoma (22). Furthermore, patients who have vascular insufficiency such as Raynaud’s, scleroderma, Sjogren’s, or thromboangiitis obliterans may suffer further reduction in blood flow due to vasoconstriction of vessels, causing severe exacerbation of their symptoms. Despite these real and potential adverse effects, brimonidine and oxymetazoline are beneficial and effective in improving the quality of life in patients with rosacea.
Network pharmacology-based approach to research the effect and mechanism of Si-Miao-Yong-An decoction against thromboangiitis obliterans
Published in Annals of Medicine, 2023
Jiaxi Zou, Weiming Xu, Ziyun Li, Ping Gao, Fangyuan Zhang, Yuting Cui, Jingqing Hu
As a chronic, occlusive, nonatherosclerotic, inflammatory vascular disease, thromboangiitis obliterans (TAO) targets small- and medium-sized arteries as well as veins in the extremities. As a global disease, TAO is distributed all over the globe, but its prevalence is more common in the Middle East and East Asia [1]. In China, the distribution of TAO patients has geographical and ethnic differences; for example, the incidence rate is higher in the north of the Yellow River, especially in the northeast, and the incidence rate of Hui is higher than that of Han in the northwest [2]. The average age of onset of TAO is from 30 to 40 years, and fewer patients are over 40 years old. However, the number of affected elderly patients has increased in recent decades [3].
Thromboangiitis obliterans plasma-derived exosomal miR-223-5p inhibits cell viability and promotes cell apoptosis of human vascular smooth muscle cells by targeting VCAM1
Published in Annals of Medicine, 2021
Ying Deng, Jindong Tong, Weijun Shi, Zhongyi Tian, Bo Yu, Jingdong Tang
Thromboangiitis obliterans (TAO), also called Buerger’s disease, is a non-atherosclerotic, inflammatory vascular disorder that primarily affects small- or medium-sized arteries and veins in extremities [1]. TAO is closely associated with tobacco exposure and is characterized by the presence of a highly inflammatory thrombus in the affected vessels [2]. The vascular event-free survival of TAO patients is reported to be 41% at 5 years and 24% at 10 years [3]. Although more than a century has passed since its discovery, the pathogenesis of TAO remains elusive [4].