Behavior And Arteriosclerosis

During the past decade, cardiovascular medicine has made significant strides in the diagnosis and treatment of coronary heart disease and related disorders as well as developing a better understanding of potential preventive, risk-reduc ing measures. Highly sophisticated diagnostic instrumentation, surgical pro cedures, and emergency medical care have undoubtedly contributed greatly to the trend of declining mortality from cardiovascular events. In the course of the extensive research efforts associated with this area, it has become increas ingly apparent that the identified coronary risk factors share the common ele ment of lifestyle as a major determiner of health behaviors associated with these factors. Further, it is suspected that behavioral and environmental factors may playa significant contributory role toward the etiology and progression of arteriosclerosis through their effects on the central and peripheral nervous sys tems and associated neurohormonal response. Considerable research effort has been devoted to identifying the risks asso ciated with smoking, elevated blood pressure, and serum cholesterol. Research development and modification is being vigorously pursued. Behavioral research exploring the role of psychological stress factors, social support networks, stressful life events, and the Type AlB behavior patterns has uncovered poten tially meaningful associations between behavioral factors and arteriosclerosis, as discussed in the succeeding chapters of this book.

This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Selected as an outstanding book in vascular surgery by members of the Society for Vascular Surgery.* This unique new text describes the current understanding of the etiology and pathogenesis of human atherosclerosis. It also details the methods for quantitating and characterizing both experimental and clinical lesions, and describes the methods for preparing available animal models. Providing an in-depth review of each of these topics, the text organizes the information in one volume for the convenience of the reader. The text is divided into two sections. First is a description of the cell biology, biochemistry and pharmacology of normal vessels and of atherosclerotic human lesions, with details of the methods to accurately characterize and quantitate the disease. Secondly, it presents a description of the methods for preparing the available experimental animal models, including a discussion of the distribution and pathological characteristics of the lesions. It also includes comparisons of human atherosclerosis and experimental animal models. Intended to provide a basis for expediting future research in this priority health care area, this text compiles the available information for those who treat patients with atherosclerosis or who are involved in atherosclerosis research. It is of particular interest to students, physicians, and academic and commercial researchers.

This book aims to provide non-specialist healthcare practitioners with current, focused and objective information on the most common vascular diseases encountered in daily clinical practice. In day-to-day clinical practice many healthcare practitioners do not have a working knowledge of the most common vascular diseases that frequently arise in patient care. Some of these topics include: aneurysms, peripheral arterial disease, diabetic foot, venous thromboembolism, cerebrovascular disease, aortic dissection, and acute limb ischemia. These commonly encountered vascular diseases are becoming public health issues due to their high morbidity and mortality as well as increasing healthcare costs. Since patients with vascular diseases are often referred to non-specialists, the general practitioner must know how to proper handle the most common vascular diseases encountered in daily clinical practice. For each disease the concept, epidemiology, natural history, diagnosis and treatment are described, followed by essential advice on what the non-specialist can do for the patient and when to refer the patient to a specialist.

This wide ranging work provides a complete representation of the present state of knowledge of the vascular endothelium. The volume comprises 20 chapters by experts who have made significant contributions to research in the vascular endothelium. The text discusses the structure, development and function of the normal vascular endothelium, considers conditions that lead to the disruption of vascular physiology and provides a comprehensive description of pathologies and their treatment.