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Hello, I am looking for someone to write an article on Use of Carotid IMT in risk stratification of hypogonadal men with atherosclerosis and coronary artery disease. It needs to be at least 2000 words
Hello, I am looking for someone to write an article on Use of Carotid IMT in risk stratification of hypogonadal men with atherosclerosis and coronary artery disease. It needs to be at least 2000 words. It results from coronary atherosclerosis, which is directly associated with several well defined risk factors, including smoking, diabetes mellitus, hypertension, obesity, hyperlipidemia, lack of exercise, and familial predisposition. Despite a wide variance in CHD mortality between countries, men are consistently twice as likely to die from CHD as their female counterparts. Is it possible that a male hormone like testosterone is partly responsible for this It is well known that serum levels of testosterone decline with age, and low testosterone is positively associated with other cardiovascular risk factors. Testosterone exhibits a number of potential cardioprotective actions. Testosterone administration is reported to reduce serum levels of the pro-inflammatory cytokines interleukin (IL)-1, tumor necrosis factor (TNF ) and to increase levels of the anti-inflammatory cytokine IL-10 among others.Lower testosterone levels have also been correlated with carotid atherosclerosis as shown by Jones (146). Most epidemiological studies of risk factors for atherosclerosis and clinical trials for the prevention of disease have used the morbidity and mortality that results from coronary artery disease (CAD), stroke, and peripheral vascular disease as measures of the disease process in older adults. But this does not mean that the younger population is immune to atherosclerotic process. There is a larger subset of population that is prone to presenile atherosclerosis, particularly those with a family history. This is a very important group of patients that need to be identified early, so that preventive and remedial measures may be suitably instituted, before occlusive process occurs. Traditionally this screening process has used blood investigations like lipid analysis, blood sugar analysis, cardiac evaluations tests like cardiac enzymes, and echo. But is there a possibility of a test, simple enough to be easily reproducible, done quickly and noninvasively, and which carries a prognostic significance
Carotid IMT studies using Doppler is increasingly been seen as an important marker for prediction of CAD. This is a new field, which has assumed great significance. It is increasingly being identified as a screening procedure and a marker to assess prognosis. This is an office procedure, noninvasive, simple enough to be reproducible, with least patient discomfort. Is it possible to link somehow, the use of testosterone, carotid IMT and the risk of atherosclerosis so that a combined analysis gives us greater confidence in patient management
We know now that carotid IMT is significant in atherosclerosis. We know that testosterone levels are lower in elderly males, possibly being a cause in development of CAD. Studies have linked low testosterone levels with greater IMT. Thus it seems plausible to use low testosterone levels and carotid IMT in the screening and follow up of patients at risk for development of CAD and patients who have had CAD and are being managed for prevention of further events.
2) Use of carotid IMT as risk stratification tool and how it is measured
Carotid IMT is a noninvasive procedure based on the use of the common Ultrasound technology with suitable modification. The technique uses a B-mode real-time ultrasound with a high resolution. B-mode ultrasound imaging technology has evolved to the extent that the walls of superficial arteries can be imaged non-invasively, in real-time, and with high resolution. Bots has shown the use of The Meijer's Arc, which allows a standardized circumferential scan of the left and right carotid artery (2986). In his article he has used the Meijer Arc to standardize the points of examination on both sides of the neck, and also as a reference for future examination.
