Peripheral arterial disease(PAD) is a common disorder associated with a high risk of cardiovascular mortality and continues to be under-recognized. The major risk factors for PAD are similar to those for coronary and ...Peripheral arterial disease(PAD) is a common disorder associated with a high risk of cardiovascular mortality and continues to be under-recognized. The major risk factors for PAD are similar to those for coronary and cerebrovascular disease. Management includes exercise program, pharmacologic therapy and revascularization including endovascular and surgical approach. The optimal revascularization strategy, endovascular or surgical intervention, is often debated due to the paucity of head to head randomized controlled studies. Despite significant advances in endovascular interventions resulting in increased utilization over surgical bypass, significant challenges still remain. Platelet activation and aggregation after percutaneous transluminal angioplasty of atherosclerotic arteries are important risk factors for re-occlusion/restenosis and life-threatening thrombosis following endovascular procedures. Antiplatelet agents are commonly prescribed to reduce the risk of myocardial infarction, stroke and death from cardiovascular causes in patients with PAD. Despite an abundance of data demonstrating efficacy of antiplatelet therapy in coronary artery disease and cerebrovascular disease, there is a paucity of clinical information, clinical guidelines and randomized controlled studies in the PAD population. Hence, data on antiplatelet therapy in coronary interventions is frequently extrapolated to peripheral interventions. The aim of this review article is to elucidate the current data on revascularization and the role and duration of antiplatelet and anticoagulant therapy in re-vascularized lower limb PAD patients.展开更多
Environmental concerns associated with nutrient-oriented eutrophication phenomenon have become a serious issue and a major cause of water quality deficiency nowadays. This necessitated eutrophication to occupy a front...Environmental concerns associated with nutrient-oriented eutrophication phenomenon have become a serious issue and a major cause of water quality deficiency nowadays. This necessitated eutrophication to occupy a front seat in research accompanied with climate change. Climate change has revealed to be a key player and a main contributor in the occurrence of such phenomenon. This paper discusses the ever-growing concern about eutrophication as a cause of climate change. Climate change affects storms intensity, changing the precipitation regime and increasing temperature. These effects increase the nutrient loading diffusion and cause excessive nutrients accompanied with storm water runoff, domestic wastewaters, and agricultural discharges to pour into water bodies. Eutrophication conversely contributes in the global wanning by releasing greenhouse gases from deoxygenated waters and sediments. Some control and mitigation measures are needed to fight climate change and achieve desired water quality goals. These measures include mitigation of climate change causes, enhancement of natural ecohydrological processes, application of proper integrated water resource management and participation of communities and governments.展开更多
Introduction:Early intervention in patients with congenitally disconnected pulmonary artery improves long-term outcome.Case presentation:We present 3 cases of isolated disconnected pulmonary artery in the absence of a...Introduction:Early intervention in patients with congenitally disconnected pulmonary artery improves long-term outcome.Case presentation:We present 3 cases of isolated disconnected pulmonary artery in the absence of associated structural heart disease during a period of 3 years.Conclusion:Transcatheter stenting of the feeding ductus arteriosus re-established pulmonary artery flow and growth.Successful surgical repair was achieved,and normal perfusion and complete function of the ipsilateral lung were regained.展开更多
文摘Peripheral arterial disease(PAD) is a common disorder associated with a high risk of cardiovascular mortality and continues to be under-recognized. The major risk factors for PAD are similar to those for coronary and cerebrovascular disease. Management includes exercise program, pharmacologic therapy and revascularization including endovascular and surgical approach. The optimal revascularization strategy, endovascular or surgical intervention, is often debated due to the paucity of head to head randomized controlled studies. Despite significant advances in endovascular interventions resulting in increased utilization over surgical bypass, significant challenges still remain. Platelet activation and aggregation after percutaneous transluminal angioplasty of atherosclerotic arteries are important risk factors for re-occlusion/restenosis and life-threatening thrombosis following endovascular procedures. Antiplatelet agents are commonly prescribed to reduce the risk of myocardial infarction, stroke and death from cardiovascular causes in patients with PAD. Despite an abundance of data demonstrating efficacy of antiplatelet therapy in coronary artery disease and cerebrovascular disease, there is a paucity of clinical information, clinical guidelines and randomized controlled studies in the PAD population. Hence, data on antiplatelet therapy in coronary interventions is frequently extrapolated to peripheral interventions. The aim of this review article is to elucidate the current data on revascularization and the role and duration of antiplatelet and anticoagulant therapy in re-vascularized lower limb PAD patients.
文摘Environmental concerns associated with nutrient-oriented eutrophication phenomenon have become a serious issue and a major cause of water quality deficiency nowadays. This necessitated eutrophication to occupy a front seat in research accompanied with climate change. Climate change has revealed to be a key player and a main contributor in the occurrence of such phenomenon. This paper discusses the ever-growing concern about eutrophication as a cause of climate change. Climate change affects storms intensity, changing the precipitation regime and increasing temperature. These effects increase the nutrient loading diffusion and cause excessive nutrients accompanied with storm water runoff, domestic wastewaters, and agricultural discharges to pour into water bodies. Eutrophication conversely contributes in the global wanning by releasing greenhouse gases from deoxygenated waters and sediments. Some control and mitigation measures are needed to fight climate change and achieve desired water quality goals. These measures include mitigation of climate change causes, enhancement of natural ecohydrological processes, application of proper integrated water resource management and participation of communities and governments.
文摘Introduction:Early intervention in patients with congenitally disconnected pulmonary artery improves long-term outcome.Case presentation:We present 3 cases of isolated disconnected pulmonary artery in the absence of associated structural heart disease during a period of 3 years.Conclusion:Transcatheter stenting of the feeding ductus arteriosus re-established pulmonary artery flow and growth.Successful surgical repair was achieved,and normal perfusion and complete function of the ipsilateral lung were regained.
