WorldWideScience

Sample records for vasculares estromales para

  1. Lipoinjerto laminar: un tratamiento prometedor con factores vasculares estromales para las vulvo-vaginitis crónicas Lipoenxertia laminar: um tratamento promissor com factores vasculares estromais para as vulvo-vaginetes crônicas Lamellar fatgrafting: a promissing treatment with stromal vascular fraction in recurrent vulvo-vaginitis

    Directory of Open Access Journals (Sweden)

    Ithamar N. Stocchero

    2009-09-01

    Full Text Available Una de las situaciones más problemáticas para la vida íntima de una mujer, sobre todo si es joven, son las vulvo-vaginitis de repetición. Junto al herpes genital recidivante, suele ser causa de disarmonía en la relación de pareja por la situación en sí y por la frecuente presencia de dolor. Presentamos un caso exitoso en el que se aplicó un nuevo tratamiento consistente en la utilización de liponinjerto laminar submucoso, con preservación de la fracción vascular estromal (FVE, rica en células tronco derivadas de ese tejido (ADSCs, capaces de inducir neoangiogénesis que promoverá la defensa inmunológica normal de la mucosa de la vagina. De esta forma evitamos el uso de antibióticos y de otras terapias más costosas y, sobre todo, favoreciendo una vida sexual normal. Describimos en el presente artículo la técnica empleada.Uma das situações mais inconvenientes para a vida íntima de uma mulher, mormente jovem, é a vulvo-vaginite de repetição. Se acompanhada de herpes genital recidivante, não raro estabelece a desarmonia entre o casal dada à inconveniência da situação, além da dor, freqüentemente presente. Buscar o tratamento adequado, não prescrevendo apenas a antibióticoterapia, mas visando aumentar a resistência imunológica local da paciente, tem sido o objetivo de pesquisas nos últimos anos. Com o conhecimento da ação inflamatória induzida pelo tecido adiposo, associada à transferência de fatores vasculares estromais (FVE, grande fonte de células-tronco derivadas daquele tecido (ADSCs - Adipose- Derived Stromal/Stem Cells,bem como de indutores da angiogênese, facilitadora do acesso de células de defesa, foi idealizada uma nova e promissora linha de tratamento para estas pacientes: a lipoenxertia laminar. Relata-se a técnica bem sucedida, utilizada neste caso.One of the most inconvenient situations for a woman, mostly if young, is the recurrent vulvo-vaginitis. With the presence of a returning genital

  2. Diferenciación de las células estromales de tejido adiposo de rata para la obtención de células con fenotipo oligodendroglial

    OpenAIRE

    Vellosillo Huerta, Lara

    2015-01-01

    Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Anatomía, Histología y Neurociencia. Fecha de lectura: 23-10-2015 La obtención de células oligodendrogliales a partir de tejidos no esenciales y accesibles es de gran interés, tanto para el desarrollo de terapias de reemplazo celular en enfermedades desmielinizantes, como para el estudio de las patologías que afectan a la mielinizacion. Las células estromales de tejido adipo...

  3. Evaluación de la fibroína de seda como biomaterial de soporte para el crecimiento de células mesenquimales estromales de pulpa dental

    Directory of Open Access Journals (Sweden)

    Lyda Caballero Mendez

    2016-06-01

    Full Text Available Objetivo. Evaluar la fibroína de la seda obtenida del gusano de seda Bombyx mori L como material de soporte para el crecimiento de células mesenquimales estromales de pulpa dental (CMPD. Métodos. La fibroína fue obtenida a partir de capullos de gusanos de seda Bombyx mori L criados en la Granja El Pílamo, propiedad de la Universidad Tecnológica de Pereira. Se realizaron procedimientos para obtención de películas de fibroína íntegras y resistentes a condiciones de cultivo. Las CMPD fueron obtenidas a partir de un donante de diente premolar, la pieza dental se cortó con disco de diamante para la obtención de la pulpa que fue sometida a disgregación enzimática. Las células obtenidas se subcultivaron hasta el segundo pase para después ser transferidas a cajas de cultivo que contenían películas de fibroína, se sometieron a condiciones inherentes al proceso de incubación con seguimiento de su crecimiento y viabilidad celular durante 27 días. Resultados. Al final del periodo de incubación, se observaron películas integras, estables y resistentes que permitieron el crecimiento celular. Conclusión. Se plantea el uso de la fibroína como un biopolímero natural que brinda un soporte mecánico, un microambiente óptimo y un mimetismo de la estructura organizacional de los tejidos, postulándose como un potencial biomaterial para procesos de crecimiento de células en Medicina Regenerativa basada en Ingeniería de Tejidos.

  4. Malformaciones vasculares: claves diagnósticas para el radiólogo Vascular malformations: diagnostic clues for the radiologist

    Directory of Open Access Journals (Sweden)

    Ricardo García Mónaco

    2012-12-01

    Full Text Available Las malformaciones vasculares son enfermedades raras ocasionadas por errores en el desarrollo embriológico de los vasos sanguíneos. Estas lesiones, junto con los tumores vasculares, constituyen las anomalías vasculares. En el caso de las malformaciones vasculares, éstas se denominan de acuerdo al vaso que conforma la lesión y se clasifican según las características del flujo en malformaciones de bajo o alto flujo. Si bien la mayor parte son diagnosticadas según criterios clínicos, algunas lesiones requieren de estudios complementarios tanto para el establecimiento de un correcto diagnóstico como para la evaluación de su extensión. La ecografía Doppler suele ser el estudio inicial para conocer las características hemodinámicas y contribuir al diagnóstico diferencial entre un tumor y una malformación vascular. La resonancia magnética (RM es el mejor método para evaluar la extensión de las lesiones y su relación con estructuras adyacentes. El diagnóstico preciso del tipo de malformación vascular es importante por su pronóstico y tratamiento diferentes. La Radiología Intervencionista constituye uno de los pilares fundamentales en el manejo terapéutico. Es altamente recomendable un abordaje multidisciplinario dada la complejidad de estas lesiones, particularmente en la elección de las opciones terapéuticas y en el seguimiento clínico de los pacientes.Vascular malformations are rare conditions resulting from the abnormal development of blood vessels. These lesions, together with vascular tumors, represent the vascular anomalies. Vascular malformations are named according to which type of vessel is affected and are classified into high- or low-flow malformations on the basis of flow characteristics. Most vascular malformations are diagnosed according to clinical criteria. However, some require imaging studies to confirm the diagnosis or assess its extension. Doppler ultrasound is the usual initial study for hemodynamic

  5. Valoración de autocuidados en el acceso vascular para hemodiálisis

    OpenAIRE

    José Luis García Araque; David Sancho Cantus

    2015-01-01

    Introducción: Diversos estudios han evidenciado la falta de formación y en consecuencia la falta de autocuidados en los pacientes renales sometidos a hemodiálisis y con acceso vascular. La enfermería debe asumir su rol de entrenadora de pacientes crónicos para que alcancen una situación de equilibrio entre sus deseos y lo que deben hacer, para que así puedan asumir la responsabilidad en la autoprovisión de los cuidados básicos del mismo. El objetivo fue evaluar los conocimientos que tiene el ...

  6. Valoración de autocuidados en el acceso vascular para hemodiálisis

    Directory of Open Access Journals (Sweden)

    José Luis García Araque

    2015-09-01

    Full Text Available Introducción: Diversos estudios han evidenciado la falta de formación y en consecuencia la falta de autocuidados en los pacientes renales sometidos a hemodiálisis y con acceso vascular. La enfermería debe asumir su rol de entrenadora de pacientes crónicos para que alcancen una situación de equilibrio entre sus deseos y lo que deben hacer, para que así puedan asumir la responsabilidad en la autoprovisión de los cuidados básicos del mismo. El objetivo fue evaluar los conocimientos que tiene el paciente sobre las necesidades de cuidado de su acceso vascular. Metodología: El presente estudio se realizó en el Centro de Hemodiálisis Fresenius Sagunto situado en la población de Canet D'en Berenguer (Valencia.Se utilizaron dos instrumentos de medición; un cuestionario para pacientes con fístula arteriovenosa, y otro para pacientes con catéter venoso central, donde se incluyen aspectos generales del autocuidado, acciones para mantener el acceso vascular en óptimas condiciones y medidas generales de aplicación en caso de emergencia. Los cuestionaros fueron recogidos durante el periodo comprendido entre el 1 de junio y el 5 de junio del 2015. Se realizó un muestreo por selección intencionada y se consiguió la colaboración de 57 pacientes. Resultados: El nivel de conocimientos de autocuidados del acceso vascular de los pacientes fue alto en la mayoría de los casos. Los pacientes fueron predominantemente de sexo masculino, pertenecientes a la tercera edad, de estado civil casado, tenían un nivel de estudios básicos, tenían una fístula arteriovenosa como acceso vascular y disponían de bastante experiencia y tiempo de tratamiento. Conclusiones: Obtenemos como conclusión final que la hipótesis planteada: "una deficiencia de autocuidados del paciente del centro de hemodiálisis Fresenius Sagunto sobre su AV como consecuencia de un déficit de conocimientos" no se cumple en la muestra de pacientes estudiados.

  7. Salvamento de acesso vascular para hemodiálise: relato de caso Hemodialysis vascular access salvage: case report

    Directory of Open Access Journals (Sweden)

    Milton Alves das Neves Junior

    2010-09-01

    Full Text Available A insuficiência renal crônica (IRC tem alta prevalência e a maior parte dos pacientes acometidos está em programa de hemodiálise necessitando, portanto, de acesso vascular. As fístulas arteriovenosas (FAV são os acessos mais indicados e duradouros. Mesmo em casos de complicações, deve-se tentar o salvamento desses acessos. Trabalhos da literatura mostram a possibilidade de salvamento das FAV's, mesmo de maneira tardia. Deve-se tentar sempre a reparação do acesso atual, evitando o esgotamento do sistema venoso. Este trabalho relata o caso de uma paciente de 69 anos com IRC apresentando uma trombose de FAV braquiocefálica com drenagem para veia basílica por ramos colaterais, o que a tornou maturada. Essa veia foi utilizada no reparo do acesso, evitando o uso de cateteres.Chronic renal insufficiency (CRI has high prevalence and the majority of the patients are in hemodialysis program and, then, they need a vascular access. Arteriovenous fistulas (AVF are the more indicated accesses and have a long term use. Even in cases of complications, the salvage of theses accesses must be tried. Researches of literature show the possibility of access salvage of AFV's, even in a long time after the complication. The repair of thepresent access must always be tried, avoiding the depletion of the venous system. This study is a case report of a 69 years-old female patient with CRI presenting thrombosis of a brachial-cefalic AFV with drainage to basilic vein by collateral branches, which maturated that vein. Basilic vein was used on the access repair, avoiding catheter use.

  8. Estudio in vitro de permeabilidad, porosidad y crecimiento celular en membranas electrohiladas para prótesis vasculares

    Directory of Open Access Journals (Sweden)

    Raúl A. Valencia

    2017-03-01

    Conclusiones: La variación de estructuras microporosas de gran área superficial para obtener implantes con la técnica de electrospinning, incide en el crecimiento celular y subsecuentemente en la permeabilidad y la porosidad, hecho que abre una gran oportunidad para su uso potencial en aplicaciones vasculares de diámetros pequeños.

  9. Rescate de un acceso vascular para hemodiálisis: a propósito de un caso

    Directory of Open Access Journals (Sweden)

    Isabel Crehuet Rodríguez

    2015-12-01

    Full Text Available El mejor acceso vascular (AV para hemodiálisis (HD es, sin duda, la fístula arteriovenosa interna nativa (FAVI ya que presenta más ventajas y menos complicaciones que otros accesos vasculares. Enfermería, gracias a los protocolos de vigilancia del AV, juega un papel fundamental en la detección temprana de las complicaciones que puedan llevar a la pérdida del mismo. Realizamos este estudio con dos objetivos: 1 Dar a conocer un caso clínico de una FAVI en el que aparecieron sucesivamente varias complicaciones. 2 Analizar la importancia que tiene la existencia de un equipo multidisciplinar para los accesos vasculares, tanto en la realización y seguimiento del mismo como en el tratamiento de las complicaciones que pudieran aparecer. Se estudia a un paciente varón con enfermedad renal crónica estadio V, portador de una FAVI radiocefálica derecha que, en una inspección rutinaria del AV cuando acude a la sesión de HD, enfermería detecta disminución de soplo y thrill apareciendo primero una trombosis, seguida de una estenosis tratada quirúrgicamente y finalmente una grave infección en la herida quirúrgica por un germen Gram negativo. A lo largo del estudio se van presentando las sucesivas complicaciones que surgieron y las estrategias desarrolladas por los miembros del equipo multidisciplinar: enfermeras, nefrólogos y cirujanos vasculares, entre otros, para solventarlas, lo cual finalmente se consiguió llegando a rescatar un acceso vascular que, a priori, dábamos por perdido.

  10. Escalas para avaliação da sobrecarga de cuidadores de pacientes com Acidente Vascular Encefálico

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    2012-10-01

    Full Text Available O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.

  11. Validación transcultural del cuestionario PEQ (Prostesis Evaluation Questionnaire) para amputados vasculares protetizados

    OpenAIRE

    Benavent Cervera, José Vicente

    2013-01-01

    Actualmente no hay escalas específicas validadas en español para pacientes protetizados. El propósito de este trabajo es validar al español, un instrumento de fácil administración, específico para pacientes de miembro inferior amputados y protetizados, y que mida la calidad de vida relacionada con el uso de la prótesis. OBJETIVO. Obtener una versión culturalmente equivalente del cuestionario PEQ (Prostesis Evaluation Questionnaire) en español para su uso en pacientes amputados protetizados. M...

  12. Predictive factors for spasticity among ischemic stroke patients Fatores preditivos para espasticidade após acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    Rita de Cássia dos Reis Moura

    2009-12-01

    Full Text Available Spasticity is a determining for functional loss following ischemic stroke. OBJECTIVE: To detect possible predictive factors for its occurrence. METHOD: Demographic, clinical and tomographic data on 146 stroke patients were analyzed. RESULTS: Spasticity was noted more frequently among patients who underwent physiotherapy (pA espasticidade é fator determinante para perda funcional após o acidente vascular cerebral isquêmico (AVCI. OBJETIVO: Detectar possíveis fatores preditivos para a ocorrência da espasticidade. MÉTODO: Foram analisados dados demográficos, clínicos e tomográficos de 146 pacientes pós-AVCI. RESULTADOS: Na análise univariada a espasticidade foi notada com maior freqüência em pacientes que realizaram fisioterapia (p<0,0001; OR=19,4; 95% CI: 4,4-84,5, com maior tempo de duração desse tratamento (p=0,028; OR=4,80; 95% CI: 1,1-8,3 e que realizavam trabalho braçal (p=0,041; OR=2,2; 95% CI: 1,02-4,6, renda menor (p=0,038, referência de dor (p<0,0001; OR=107,0; 95% CI: 13,5-847,3 e seu aparecimento simultâneo à espasticidade (p<0,0001, acidente vascular cerebral (AVC pregresso (p=0,001; OR=4,2; 95% CI: 1,7-10,3, fraqueza muscular (p<0,0001; OR=91,9; 95% CI: 12,0-699,4, lesão tomográfica extensa (p=0,01 e lesão afetando mais de um lobo cerebral (p=0,018. Na análise de regressão multivariada a atividade braçal apresentou risco relativo de 2,9; acidente vascular cerebral prévio com risco relativo de 3,9 e lesão tomográfica extensa risco relativo de 3,6. CONCLUSÃO: A espasticidade afetou um quarto da população estudada e esteve associada ao trabalho braçal, AVC pregresso, lesões tomográficas extensas, diminuição da renda individual, realização de fisioterapia, realização de fisioterapia por um período maior, presença de dor, surgimento da dor simultânea à espasticidade e alteração da força.

  13. Modelo basado en SIG para el estudio de la mortalidad por enfermedad cerebro-vascular

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Tangarife Villa

    2013-06-01

    Full Text Available En los últimos 15 años el estudio para una de las tres primeras causas de muerte a nivel mundial –enfermedad cerebrovascular (ECV– se caracteriza por utilizar el enfoque epidemiológico tradicional y sus técnicas de análisis estadístico bivariado y multivariado orientadas a identificar su composición según variables de persona y explorar relaciones con sus determinantes pero sin impactar significativamente su ocurrencia, sin embargo, en el presente artículo se identifica como alternativa de análisis la modelación espacio-temporal con SIG a niveles de desagregación detallados; en este sentido el análisis comparativo de los modelos utilizados en los estudios conocidos, desvela el uso de datos y técnicas de análisis espacial básicas para identificar patrones como los evidenciados en los cinturones de diabetes y ECV en USA o el clúster colombiano de enfermedades del aparato circulatorio identificado en la región andina que sugiere un comportamiento similar para la ECV. El panorama anterior demanda la combinación de enfoques con énfasis en sus técnicas de análisis avanzadas –análisis multi-criterio, kriging, interpolación, correlación y regresión espacial– soportadas con SIG y por lo tanto, como contribución final se propone un modelo integrado dirigido a impactar positivamente la mortalidad por ECV.

  14. Modelo basado en SIG para el estudio de la mortalidad por enfermedad cerebro-vascular

    OpenAIRE

    Carlos Alberto Tangarife Villa; Libardo Londoño Ciro

    2013-01-01

    RESUMENEn los últimos 15 años el estudio para una de las tres primeras causas de muerte a nivel mundial –enfermedad cerebrovascular (ECV)– se caracteriza por utilizar el enfoque epidemiológico tradicional y sus técnicas de análisis estadístico bivariado y multivariado orientadas a identificar su composición según variables de persona y explorar relaciones con sus determinantes pero sin impactar significativamente su ocurrencia, sin embargo, en el presente artículo se identifica como alternati...

  15. Therapeutic interventions for vascular depression: a systematic review Intervenções terapêuticas para a depressão vascular: uma revisão sistemática

    Directory of Open Access Journals (Sweden)

    Andre Russowsky Brunoni

    2011-12-01

    Full Text Available OBJECTIVE: Vascular depression (VaD hypothesis supports a bidirectional relationship between cerebrovascular risk factors (CRFs and depression. We examined whether such concept is appropriate for clinical interventions; i.e., whether treating depressive symptoms has an impact on cerebrovascular risk and vice-versa. METHOD: Systematic review on interventional studies published from October-1997 to April-2010 on MEDLINE and other databases. Search terms were "depressive disorder" (MeSH, "cerebrovascular disorders" (MeSH, and a batch of highly accurate terms to search for experimental and quasi-experimental trials. We used a structured questionnaire to assess the adequacy of the VaD criteria used for vascular, depression, neuroimaging, and neuropsychological features, as well as the main results of each study. RESULTS: Of the 357 retrieved studies, 12 met our eligibility criteria. These studies adequately reported depression criterion, moderately reported neuroimaging and neuropsychological criteria, and showed severe flaws in vascular assessment. Efficacy trials suggested that nimodipine, transcranial magnetic stimulation, carotid stent placement, and citalopram were effective for VaD. Exploratory studies suggested that white-matter hyperintensities and global vascular risk are predictors of poor response. Although the low quality of the studies hinders the findings' generalization, studies of higher validity support the VaD concept for interventions. CONCLUSION: VaD seems to be a useful concept for clinical interventions; however, further trials should refine CRFs criteria to assess its impact on antidepressant efficacy.OBJETIVO: A hipótese da depressão vascular (DV defende uma correlação bidirecional entre fatores de risco cerebrovasculares e depressão. Nós investigamos se este conceito é apropriado para intervenções clínicas - ou seja, se o tratamento de sintomas depressivos modifica o risco cerebrovascular e vice-versa. M

  16. Risco para trauma vascular: proposta do diagnóstico e validação por peritos Riesgo para trauma vascular: propuesta del diagnóstico y validación por peritos Risk for vascular trauma: diagnosis proposal and validation by experts

    Directory of Open Access Journals (Sweden)

    Cristina Arreguy-Sena

    2009-02-01

    Full Text Available Pesquisa de validação conceitual e de conteúdo que objetivou compor o título, os mecanismos de vulnerabilidade e os fatores de risco para o diagnóstico de enfermagem "Risco para Trauma Vascular", segundo a taxonomia da NANDA, bem como validar os elementos desse diagnóstico, a partir da opinião de 60 peritos. Foram identificados 51 fatores relacionados a cinco eixos: medicação e forma/periodicidade de infusão; cateter intravascular e permanência num mesmo sítio; fixação do cateter intravascular; indivíduo, seus hábitos, padrão comunicacional, estilo de vida e capacidade sensório-motora; e decisões profissionais, política institucional e procedimento. Destes, foram validados 28 fatores de vulnerabilidade (escore > 0,80. Os resultados evidenciaram "Risco para Trauma Vascular" ser um novo diagnóstico de enfermagem; sugere-se a validação clínica do mesmo.Investigación de validación conceptual y de contenido con objeto de componer el título, los mecanismos de vulnerabilidad y los factores de riesgo para el diagnóstico de enfermería "Riesgo para Trauma Vascular", según la propuesta de la taxonomía de la NANDA, y también validar los elementos de ese diagnóstico, a partir de la opinión de 60 peritos. Fueron identificados 51 factores relacionados a cinco ejes: medicación y forma/periodicidad de infusión; cateter intravascular y permanencia en un mismo sitio; fixación del cateter intravascular; individuo, sus hábitos, patrón comunicacional, estilo de vida y capacidad sensorio-motora; y decisiones profesionales, política institucional y procedimiento. De estos, fueron validados 28 factores de vulnerabilidad (score > 0,80. Los resultados evidenciaron que "Riesgo para Trauma Vascular" es un nuevo diagnóstico de enfermería; su validación clínica es sugerida.This concept and content validation study aimed to compose the title, vulnerability mechanisms and risk factors for the nursing diagnosis "Risk for Vascular

  17. Nova técnica para treinamento em acessos vasculares guiados por ultrassom utilizando modelo de tecido animal New technique for ultrasound-guided vascular access training using an animal tissue model

    Directory of Open Access Journals (Sweden)

    Robson Barbosa de Miranda

    2012-03-01

    Full Text Available A ultrassonografia Doppler deixou de ter seu uso apenas como método diagnóstico e vem galgando espaço nos procedimentos terapêuticos. Com maior aplicabilidade e uso de cateteres venosos centrais e procedimentos guiados por ultrassom, há preocupação com a melhora da eficácia e segurança durante o procedimento, assim como com a diminuição das potenciais complicações. Para isso, o treinamento da técnica em modelos (phantoms é desejável. Os modelos industrializados para treinamento em acesso vascular guiado por ultrassom são caros e não reproduzem adequadamente a ecotextura e a densidade dos tecidos humanos. Na tentativa de treinar e aprimorar os profissionais para o uso do ultrassom em procedimentos de acessos vasculares, desenvolveu-se um modelo animal de baixo custo, fácil confecção e excelente aplicabilidade.Duplex ultrasonography has not been used only as a noninvasive diagnostic method. Recently it has been applied for therapeutic procedures. Due to the increasing use and applicability of central venous catheters and eco-guided vascular procedures, there are concerns about improving results regarding accuracy and safety, reducing complication rates during those procedures. It would be desirable that training was accomplished using phantoms before actual procedures in human subjects. Industrialized phantoms are expensive and they do not reproduce human's ecographic density and texture. In order to train and improve ultrasound guided vascular access, we have developed a cheap animal tissue model, which is of easy preparation and applicability.

  18. Cuidados Paliativos: o necessário para o idoso com acidente vascular encefálico

    Directory of Open Access Journals (Sweden)

    Sônia Maria Dorta Ferreira

    2014-03-01

    Full Text Available A expectativa de vida do ser humano tem aumentado nas últimas décadas, o que vem exigindo o avanço da qualidade dos cuidados destinados a pessoas com fragilidades, especialmente em decorrência do crescimento considerável das doenças crônicas. Dentre essas doenças, destaca-se o acidente vascular encefálico (AVE que acomete grande parte da população idosa, ocasionando perdas e sequelas significativas. Formas inovadoras quanto à essência do cuidar devem ser estudadas e praticadas em nossa sociedade, reconhecendo-se como exemplar nesse sentido a intervenção em cuidados paliativos, que pode melhorar a qualidade de vida e confortar uma pessoa nos seus últimos dias. Nessa direção, objetiva este trabalho enfatizar a necessidade e o valor dos cuidados paliativos para a pessoa idosa com AVE e, para tal, foi realizado um levantamento da pesquisa científica sobre a temática nas principais revistas indexadas. Os resultados indicaram um número limitado de produção científica a esse respeito, assim como se verifica a escassez de serviços que assistam os idosos no final da vida, evidenciando ainda o desconhecimento dos serviços de cuidados paliativos à maior parte dos doentes e suas famílias. Os dados mostram que são múltiplos os sintomas físicos e psicológicos que comprometem a qualidade de vida dessas pessoas em terminalidade, e que a comunicação é essencial nas relações entre paciente, cuidador, família e equipe de saúde. No caso de idosos com AVE, a presença dos Cuidados Paliativos torna-se ainda mais relevante na relação desses pacientes com familiares e outros profissionais. Trabalhos futuros envolvendo os variados aspectos dos Cuidados Paliativos são necessários, para que se possa assegurar um atendimento mais competente e efetivo a essa população.

  19. Perfis comunicativos e desenvolvimento de tarefas para reabilitação discursiva pós-acidente vascular cerebral unilateral

    OpenAIRE

    Gindri,Gigiane

    2013-01-01

    Esta tese teve como objetivo geral caracterizar os perfis comunicativos de adultos com acometimentos neurológicos após acidente vascular cerebral (AVC) unilateral, de hemisfério direito ou de hemisfério esquerdo, assim como visou a desenvolver tarefas para um programa de reabilitação da comunicação com ênfase no discurso, teórica e empiricamente embasado. Assim, foram desenvolvidos três estudos, um teórico e dois, empíricos. No estudo teórico, fez-se uma revisão sistemática para verificar qua...

  20. Motivo de "escolha" de diálise peritoneal: exaustão de acesso vascular para hemodiálise? Reason for "choosing" peritoneal dialysis: exhaustion of vascular access for hemodialysis?

    Directory of Open Access Journals (Sweden)

    Paulo Novis Rocha

    2010-03-01

    Full Text Available INTRODUÇÃO: Pouco se conhece sobre a evolução de pacientes que iniciam DP como única alternativa. OBJETIVOS: Descrever o perfil clínico-demográfico e a ocorrência de peritonite em uma amostra de pacientes convertidos de HD para DP por exaustão de acesso vascular. MÉTODOS: Revisão dos prontuários de todos os pacientes do programa de DP do HGRS. RESULTADOS: Foram estudados 22 pacientes com idade mediana de 47,9 anos, 54,5% de homens, 84,2% de negros ou mulatos, 68,2% procedentes do interior da Bahia. DP foi a modalidade inicial de TRS em apenas quatro pacientes. Os 18 pacientes restantes iniciaram TRS através de HD; neste grupo, predominou o início de HD de forma emergencial e através de cateter duplo-lúmen (CDL. Em uma mediana de 7,7 meses em HD, a maioria dos pacientes (64,7% usou mais de quatro CDL. Em apenas 7/18 (39% pacientes, a conversão de HD para DP foi feita por escolha do paciente; na maioria dos casos, 11/18 (61%, o motivo de conversão foi exaustão de acesso vascular para HD. Peritonite foi mais frequente nos pacientes que entraram em HD por exaustão de acesso vascular que no restante do grupo. CONCLUSÕES: O início de TRS de forma emergencial através de HD utilizando CDL pode levar a uma rápida exaustão de acesso vascular, deixando a DP como única alternativa viável. Este modo inadequado de "seleção" de pacientes para DP está associado a maiores chances de ocorrência de peritonite.INTRODUCTION: Little is known about the prognosis of patients beginnig peritoneal dialysis (PD as their last alternative. OBJECTIVES: To describe the clinical-demographic profile of patients switching from hemodialysis (HD to PD, due to exhaustion of the HD vascular access, and the occurrence of peritonitis among them. METHODS: Review of the medical records of all patients in the PD program of the Hospital Roberto Santos in the city of Salvador, state of Bahia, Brazil. RESULTS: The study comprised 22 patients (median age, 47

  1. Fatores de risco para trauma vascular durante a quimioterapia antineoplásica: contribuições do emprego do risco relativo Factores de riesgo para el trauma vascular durante la quimioterapia antineoplásica: contribuciones del empleo del riesgo relativo Risk factors for vascular trauma during antineoplastic chemotherapy: contributions of the use of relative risk

    Directory of Open Access Journals (Sweden)

    Cíntia Capucho Rodrigues

    2012-01-01

    Full Text Available OBJETIVO: identificar a relação entre os fatores de risco para trauma vascular e o surgimento de eventos adversos de infiltração ou flebite por quimioterapia antineoplásica. MÉTODOS: Estudo de abordagem quantitativa observacional com 30 mulheres com câncer de mama. RESULTADOS: O tipo de material do cateter apresentou associação que sugere risco (RR=2,76; IC=1,199; 6,369; o fator velocidade de infusão apresentou RR=2,22; entretanto, IC= 0,7672; 6,436; os fatores trajetória, número de punção e mobilidade da veia apresentaram RROBJETIVO: identificar la relación entre los factores de riesgo para el trauma vascular y el surgimiento de eventos adversos de infiltración o flebitis por quimioterapia antineoplásica. MÉTODOS: Estudio de abordaje cuantitativo observacional realizado con 30 mujeres con cáncer de mama. RESULTADOS: El tipo de material del catéter presentó asociación que sugiere riesgo (RR=2,76; IC=1,199; 6,369; el factor velocidad de infusión presentó RR=2,22; mientras que, IC= 0,7672; 6,436; los factores trayectoria, número de punción y movilidad de la vena presentaron RROBJECTIVE: To identify the relationship between risk factors for vascular trauma and the emergence of adverse events of infiltration or phlebitis for antineoplastic chemotherapy. METHODS: A study with a quantitative, observational method with 30 women with breast cancer. RESULTS: The type of catheter material presented an association that suggested risk (RR = 2.76, CI = 1.199, 6.369; the infusion rate factor presented RR = 2.22, however, CI = 0.7672, 6.436; the trajectory factors, number of punctures and vein mobility presented RR <1, but these cannot be considered as protective factors. Insertion site and the visibility of the vein presented a risk close to 1. CONCLUSION: The use of a metal catheter for venipuncture was considered in this study as a factor for Risk for Vascular Trauma. An analysis of the association for the RR showed these results

  2. Acidente vascular encefálico como fator de risco para incontinência urinária em: idosos institucionalizados

    OpenAIRE

    Quadros, Layse Biz; Bezerra, Poliana Penasso

    2017-01-01

    Trata-se de estudo com objetivo de analisar os fatores de risco (faixa etária, gênero, comorbidades/hábitos de vida, potencial de deambulação, presença de declínio cognitivo e ocorrência de acidente vascular encefálico) para a incontinência urinária nos idosos institucionalizados. Pesquisa descritiva e transversal, incluídos 76 idosos institucionalizados. Ocorrência da incontinência urinária determinada através do Incontinence Questionnaire e do acidente vascular encefálico pela avaliação clí...

  3. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

  4. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    2013-04-01

    Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

  5. VASCULAR DEMENTIA

    Directory of Open Access Journals (Sweden)

    Maria Alekseyevna Cherdak

    2010-01-01

    vascular cognitive disorders and vascular dementia (VD. The heterogeneity of vascular cognitive disorders, concurrence of vascular and neurodegenerative diseases are discussed. Data from studies of specific therapy for VD are given.

  6. Escalas para avaliação da sobrecarga de cuidadores de pacientes com Acidente Vascular Encefálico Escalas para evaluación de la sobrecarga de cuidadores de pacientes con Accidente Vascular Encefálico Scales for evaluation of the overload of caregivers of patients with Stroke

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    2012-10-01

    Full Text Available O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.El objetivo de esto estudio fue evaluar las escalas disponibles en literatura para evaluar la sobrecarga de cuidadores de pacientes acometidos por accidente vascular encefálico. Una revisión bibliográfica fue desarrollada en tres bases de datos: LILAS, CINAHL y SCOPUS. En 23 trabajos seleccionados, 24 diferentes escalas fueron identificadas, siendo las principales: el Caregiver Strain Index, la Caregiver Burden Scale, el Caregiver Reaction Assessment, el Sense of Competence Questionnaire, la Relatives Stress Scale y la Zarit Burden Interview. El uso de escalas para mensurar sobrecarga es una herramienta importante en el contexto donde se inserta el cuidador. Es más confiable utilizar más que uno instrumento de mensuración. Por esto, la validación de escalas es importante para esta población.The objective of the study was to evaluate the available productions in literature about scales to measure the overload of caregivers of patients with stroke. It was carried out a bibliographical revision in three databases: LILACS, CINAHL and SCOPUS. In 23 works, 24 different scales were identified, and the most cited were: the

  7. Transition of care for the elderly after cerebrovascular accidents - from hospital to the home Transición del cuidado del adulto mayor despues del accidente cerebral vascular del hospital para casa Transição do cuidado com o idoso após acidente vascular cerebral do hospital para casa

    Directory of Open Access Journals (Sweden)

    Rosalina Aparecida Partezani Rodrigues

    2013-02-01

    Full Text Available OBJECTIVE: to examine the transition of care in families caring for elderly persons who suffered the first episode of a cerebrovascular accident. METHODOLOGY: an instrumental ethnographic case study was used. The sample comprised 20 subjects: 10 caregivers and 10 elderly persons aged 65 or over, of both sexes, with diagnoses of first episode of cerebrovascular accident, capable of communicating, and requiring care from a main carer in their family. The data was collected through interviews, observation, existing documentation and field notes. Qualitative analysis techniques were used to codify and classify the data and to formulate significant categories, which generated typologies of care. RESULTS AND DISCUSSION: The central idea was the Transition of Care and showed the context in three typologies: The care process for the dependent elderly person, Strategies for the care process and Impact and acceptance of the limitations. CONCLUSION: The data indicates that caring for an elderly person after a cerebrovascular accident is a challenge for the family. The data permitted it possible to elaborate a proposal for a model for the organization of the work, with a view to holistic care delivery in the health services, forming a care network, which constitutes an advance for the area of nursing.OBJETIVO: examinar la transición del cuidado en familias que cuidan de adultos mayores que sufrieron el primer episodio de accidente cerebral vascular. METODOLOGÍA: Fue utilizado el estudio de caso etnográfico instrumental. La muestra fue constituida de 20 sujetos, siendo 10 cuidadores y 10 adultos con 65 años y más, de ambos sexos, con diagnóstico de primer episodio de accidente cerebral vascular, capaces de comunicarse, demandando cuidado de un cuidador principal en la familia. Los datos fueron colectados por medio de entrevistas, observaciones, documentos existentes y notas de campo. Fueron utilizadas las técnicas de análisis cualitativo para

  8. Adherence to standard precaution in the peripheral vascular access Siguiendo las precauciones padrón para procedimiento de inserción vascular periférico Adesão às precauções padrão no acesso vascular periférico

    Directory of Open Access Journals (Sweden)

    Melissa Alves Cirelli

    2007-06-01

    Full Text Available This prospective and quantitative study was carried out in a small private general hospital, where the adherence to standard precaution in the peripheral vascular access was evaluated. The data were collected through a questionnaire aiming to characterize the nursing team's knowledge and opinion about standard precautions and the availability of materials. In addition, a systemized observation of the procedures of vein puncture and medicine administration was performed. It was identified that 84.4% of the punctures had been carried out without gloves or previous hand washing; in 29.7% of the procedures, needles were recapped and 93.2% of the professionals reported adequate material supply. Concluding, the professionals expose themselves and patients to unnecessary risks of infection. The nursing team must be the focus of continuous interventions and future actions in order to minimize the risk of infection in the procedure of peripheral vascular access.Estudio prospectivo, cuantitativo, realizado en un hospital general privado de poca complejidad, donde fue evaluado el seguimiento de las precauciones patrón para realizar inserción vascular periférica. Los datos fueron recolectados por medio de un cuestionario, con el objetivo de determinar las características del conocimiento y de opinión del equipo de enfermería sobre los temas de adhesión, precauciones patrón, disponibilidad de materiales; y por observación sistémica de los procedimientos de punción venosa y administración de medicamentos. Se identificó que 84,4% de las punciones fueron realizadas sin guantes y sin lavado previo de manos, 29,7% de las veces hubo reutilización de agujas y 93,2% de los profesionales afirmó tener una adecuada cantidad de materiales. Se concluyó que los profesionales exponen a sus pacientes y a sí mismos a riesgos de infección innecesaria. El equipo de enfermería debe enfocar su intervención y actividades futuras con el objetivo de minimizar el

  9. Antisépticos para la prevención de la infección relacionada con catéteres vasculares: revisión sistemática

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Rodríguez Calero

    2015-12-01

    Full Text Available Objetivo: determinar el antiséptico más indicado para la prevención de la infección relacionada con catéteres vasculares durante su inserción y mantenimiento. Metodología: revisión sistemática. Se incluyeron ensayos clínicos aleatorizados en castellano, inglés, portugués y catalán publicados entre 2000-2013, sobre antisépticos en la inserción o mantenimiento de catéteres vasculares en pacientes adultos. Se excluyeron catéteres de diálisis, tunelizados, apósitos y catéteres impregnados, pacientes quemados e inmunodeprimidos. Selección inicial por título y resumen. Se utilizaron las escalas CASPEe y JADAD. 6 revisores seleccionaron y analizaron los estudios de forma independiente, ciega y pareada. Resultados: 77 artículos cumplieron los criterios de inclusión, 6 fueron seleccionados tras la revisión crítica. No se cumplieron criterios de homogeneidad para realizar metaanálisis. Conclusiones: Existen pocos ensayos de calidad que permitan actualizar las recomendaciones de las guías de práctica clínica. Los indicios apuntan a la clorhexidina como antiséptico de elección para el cuidado de catéteres vasculares.

  10. Vascular Cures

    Science.gov (United States)

    ... is the first national program to bring the power of the patient to vascular research and care. ... Our recent national Vascular Research Summit brought together leaders from 31 institutions to generate collaborative projects for ...

  11. Reservação da arcada vascular do cólon direito para o alongamento mesenterial na cirurgia do reservatório ileal

    Directory of Open Access Journals (Sweden)

    Juvenal Ricardo Navarro Góes

    Full Text Available OBJETIVO: Avaliar a eficácia da preservação da arcada vascular do cólon direito (AVCD na manutenção da perfusão sangüínea do reservatório após manobras de alongamento do mesentério ileal. MÉTODOS: O estudo incluiu 46 pacientes (janeiro/1990 a julho/2000, para o tratamento de retocolite ulcerativa (RCU e polipose adenomatosa familiar (PAF, que foram divididos em dois grupos: grupo com preservação da arcada (CPA, 27 pacientes, média de idade - 34,0 (19-53 anos, 15 (55,6% eram do sexo feminino e 24 (88,9% eram brancos; e grupo sem preservação da arcada (SPA, 19 pacientes, média de idade 41,5 (13 - 62 anos, oito (42,1% eram do sexo feminino e 18 (94,8% eram brancos. Trinta pacientes (65,2% apresentavam RCU e 16 (34,7% PAF. Foram comparadas a ocorrência de complicações atribuídas à má perfusão sangüínea ou tensão na anastomose ileoanal, assim como as indicações de reoperações. RESULTADOS: No grupo CPA, em quatro pacientes (18,5%, as complicações estavam relacionadas ao comprometimento da viabilidade intestinal ou à tensão ao nível da anastomose. No grupo SPA, estas complicações ocorreram em sete pacientes (36,9%. Foram reoperados três pacientes (11,1% do grupo CPA, por causas relacionadas ou à má perfusão sangüínea ou à tensão excessiva no nível da anastomose e no grupo SPA cinco (26,3%, pela mesma causa. CONCLUSÕES: Apesar das limitações metodológicas, observou-se tendência para menor ocorrência de complicações isquêmicas no grupo com preservação da AVCD. Quando o abaixamento do reservatório ileal tem que ser ao nível da linha pectínea, torna-se importante a perfusão sangüínea via AVCD como auxiliar na preservação de sua viabilidade.

  12. Estudio crítico de la flora vascular del Lugar de Interés Comunitario "Muela de Cortes y Caroche" (Valencia). Bases para su gestión y conservación

    OpenAIRE

    Ferrer-Gallego, Pedro Pablo

    2014-01-01

    Se realiza un estudio de la flora vascular del Lugar de Interés Comunitario (LIC) Muela de Cortes y el Caroche (Valencia, España). El objetivo general de este trabajo es el conocimiento de los táxones presentes en este territorio y la compilación de la información referente a su presencia en la zona. Como objetivos concretos, se destaca: 1) la búsqueda y selección de áreas de interés para la conservación por la presencia de especies de elevado valor en el conjunto de la flora v...

  13. Adipocitocinas como marcadores para la valoración del pronóstico y terapéutica de la enfermedad vascular periférica en la insulino-resistencia

    OpenAIRE

    Torres Wilches, Miguel Ángel

    2008-01-01

    La adiponectina, citocina producida por adipocitos diferenciados y protectora ante enfermedades cardiovasculares y diabetes mellitus (DM), fue evaluada para esclarecer si los fármacos usados en la terapia de estas patologías, podrían influir en sus efectos. En esta valoración utilizamos un modelo animal (ratón normal) y pacientes con Enfermedad Vascular Periférica (PVD) y/o Insulino-Resistencia (IR). Estudiamos la actividad sobre los niveles circulantes de adiponectina, y factores relacionado...

  14. Nuevo dispositivo para el aislamiento de la fracción estromal vascular a partir de lipoaspirados humanos: método de obtención y análisis de calidad celular

    Directory of Open Access Journals (Sweden)

    S. Dos-Anjos

    2013-12-01

    Full Text Available El tejido adiposo obtenido mediante liposucción es una fuente idónea para aislar células con potencial terapéutico, las denominadas células de la fracción estromal vascular (FEV, que incluyen células madre mesenquimales. Estas células se han convertido en una de las principales herramientas de terapia celular autóloga para diversas aplicaciones médicas, y en los últimos años se han ido desarrollando diversas tecnologías para su aislamiento y uso clínico. En este trabajo presentamos un nuevo método rápido, sencillo y eficiente para el aislamiento de células de la FEV mediante un dispositivo médico cerrado que permite recoger y procesar lipoaspirados humanos en el mismo procedimiento quirúrgico de manera coste-efectiva. Además describimos los métodos llevados a cabo para cuantificar la calidad, seguridad y eficacia del inóculo celular obtenido.

  15. [Vascular dementia

    NARCIS (Netherlands)

    Leeuw, H.F. de; Gijn, J. van

    2004-01-01

    Vascular dementia is one of the most frequently occurring dementia syndromes. Its prevalence is about 5% among subjects above 85 years of age. Elevated blood pressure and atherosclerosis are the most important risk factors. According to international criteria, vascular dementia usually occurs within

  16. BREVE ESTUDO DO ESTADO DA ARTE SOBRE ACIDENTE VASCULAR CEREBRAL E SERIOUS GAMES PARA APLICAÇAO NO PROJETO “AVC” DO NÚCLEO DE TECNOLOGIA ASSISTIVA DA UFS

    Directory of Open Access Journals (Sweden)

    Saulo Lordão Andrade Barros

    2013-03-01

    Full Text Available O Acidente Vascular Cerebral é uma das principais causas de morte e de sequelas no mundo. A doença atinge cerca de 16 milhões de pessoas anualmente, dessas, seis milhões morrem. No Brasil, é a principal causa de morte e incapacidade, gerando impactos econômicos e sociais. O trabalho de recuperação desses pacientes é de suma importância para diminuir os impactos causados. Para isto, o presente artigo traz uma revisão da literatura existente sobre a doença e seu tratamento, com foco na utilização de novas tecnologias, como o uso de jogos eletrônicos sérios, a fim de aprimorar o trabalho de recuperação tanto no âmbito físico quanto no emocional.

  17. Vascular ring

    DEFF Research Database (Denmark)

    Schmidt, Anne Mette S; Larsen, Signe H; Hjortdal, Vibeke E

    2018-01-01

    BACKGROUND: Vascular ring is a rare cause of recurrent respiratory infections, dysphagia and stridor. Surgical repair is considered safe but the long-term outcomes are unclear. The purpose of this study was to investigate the mortality and morbidity following vascular ring surgery in a single...... age of 1.4 years (range 0.008-64 years) were operated for vascular ring. Median follow-up was 6.8 years (range 2.4-34 years). Presenting symptoms were stridor (52%), dysphagia or vomiting (52%) and recurrent respiratory infections (48%). There were no early or late deaths. Three months postoperatively...

  18. Novedades corológicas destacables para la flora vascular de Andalucía (sur de España)

    OpenAIRE

    Fuentes, Julián; Cueto, Miguel; Benavente, Alfredo

    2017-01-01

    Se presentan 31 citas de 21 taxones herborizados en Andalucía, aportando nuevos datos corológicos de especial interés. Abstract Chorological news highlights for vascular flora of Andalusia (South Spain) 31 records of 21 taxa, herborized in Andalusia, are shown. New chorological data of special interest are included.

  19. Acceso vascular inusual para cateterismo cardiaco en pacientes con cardiopatía congénita compleja: reporte de un caso Unusual vascular access for cardiac catheterization in patients with complex congenital heart disease: a case report

    Directory of Open Access Journals (Sweden)

    Walter Mosquera

    2012-01-01

    Full Text Available La obtención del acceso vascular es fundamental en la realización de diferentes procedimientos de cateterismo cardíaco. Los cateterismos a repetición y las cirugías cardíacas múltiples pueden resultar en una marcada incidencia de pérdida de estos sitios de acceso, razón por la cual, en algunas oportunidades, es necesario el uso de técnicas no convencionales. Se reporta el caso de un paciente de un año de edad en quien fue necesario el abordaje retroperitoneal de la arteria ilíaca común.Obtaining vascular access is essential in the realization of different cardiac catheterization procedures. The recurrent catheterizations and multiple cardiac surgeries may result in marked incidence of loss of these access sites, which is why sometimes it is necessary to use unconventional techniques. We report the case of a one year old patient that necessitated the retroperitoneal approach of the common iliac artery.

  20. Vascular anomalies

    Directory of Open Access Journals (Sweden)

    Murthy Jyotsna

    2005-01-01

    Full Text Available Management of vascular anomalies is an emerging multidisciplinary, super-specialisation field involving several surgical, medical and radiological specialties. Over the years, development in this field has been limited because of complex nomenclature and lack of consensus on the best practice for treatment of some of the more complex vascular anomalies. It was only in 1996 that the International Society of the Study of Vascular Anomalies defined nomenclature for the anomalies and gave clear guidelines on management, allowing for improved clinical practices. As in all fields of clinical medicine, the correct diagnosis of the vascular anomalies is essential to choose the appropriate treatment. This paper gives clear guidelines for diagnosis, understanding of the anomalies and discusses their management.

  1. Vascular Dementia

    OpenAIRE

    Maria Alekseyevna Cherdak; O V Uspenskaya

    2015-01-01

    This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/S0140-6736(15)00463-8 Vascular dementia is one of the most common causes of dementia after Alzheimer's disease, causing around 15% of cases. However, unlike Alzheimer's disease, there are no licensed treatments for vascular dementia. Progress in the specialty has been difficult because of uncertainties over disease classification and diagnostic criteria, controversy over the e...

  2. Vascular Vertigo

    Directory of Open Access Journals (Sweden)

    Mazyar Hashemilar

    2017-02-01

    Full Text Available Vertigo is a common complaint in neurology and medicine. The most common causes of vertigo are benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, and vascular disorders. Vertigo of vascular origin is usually limited to migraine, transient ischemic attacks, and ischemic or hemorrhagic stroke. Vascular causes lead to various central or peripheral vestibular syndromes with vertigo. This review provides an overview of epidemiology and clinical syndromes of vascular vertigo. Vertigo is an illusion of movement caused by asymmetrical involvement of the vestibular system by various causes. Migraine is the most frequent vascular disorder that causes vertigo in all age groups. Vertigo may occur in up to 25% of patients with migraine. The lifetime prevalence of migrainous vertigo is almost 1%. Cerebrovascular disorders are estimated to account for 3% to 7% of patients with vertigo. Vestibular paroxysmia has been diagnosed in 1.8% to 4% of cases in various dizziness units. Vasculitic disorders are rare in the general population, but vertigo may be seen in almost up to 50% of patients with different vasculitic syndromes. Conclusions: Migraine, cerebrovascular disorders especially involving the vertebrobasilar territory, cardiocirculatory diseases, neurovascular compression of the eighth nerve, and vasculitis are vascular causes of vertigo syndromes.

  3. Vascular Access Procedures

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Vascular Access Procedures A vascular access procedure inserts a flexible, ... the limitations of Vascular Access Procedures? What are Vascular Access Procedures? A vascular access procedure involves the insertion ...

  4. Vascular Access for Hemodialysis

    Science.gov (United States)

    ... Adequacy Eating & Nutrition for Hemodialysis Vascular Access for Hemodialysis What is a vascular access? A vascular access ... Set Up the Vascular Access Well before Starting Hemodialysis Patients should set up a vascular access well ...

  5. What Is Vascular Disease?

    Science.gov (United States)

    ... Policy What Is Vascular Disease? What Is Vascular Disease? Vascular disease is any abnormal condition of the blood ... Privacy Policy × Your ticket for the: What Is Vascular Disease? Title What Is Vascular Disease? USD Close Print

  6. Utilização da fotogrametria digital e da estabilometria para avaliação postural pós-acidente vascular encefálico

    OpenAIRE

    Thaís Silva Mucciaroni

    2015-01-01

    O acidente vascular encefálico (AVE) é uma desordem neurológica aguda, de origem vascular, que pode gerar alterações de postura e equilíbrio nos pacientes acometidos. Este trabalho teve como objetivo avançar com o conhecimento relacionado à presença de alterações posturais e de equilíbrio em pacientes pós-AVE, com a utilização da fotogrametria digital e da estabilometria estática. Participaram desse estudo 31 pacientes hemiparéticos pós-AVE que foram divididos em três grupos de alterações mot...

  7. Vascular dementia.

    Science.gov (United States)

    O'Brien, John T; Thomas, Alan

    2015-10-24

    Vascular dementia is one of the most common causes of dementia after Alzheimer's disease, causing around 15% of cases. However, unlike Alzheimer's disease, there are no licensed treatments for vascular dementia. Progress in the specialty has been difficult because of uncertainties over disease classification and diagnostic criteria, controversy over the exact nature of the relation between cerebrovascular pathology and cognitive impairment, and the paucity of identifiable tractable treatment targets. Although there is an established relation between vascular and degenerative Alzheimer's pathology, the mechanistic link between the two has not yet been identified. This Series paper critiques some of the key areas and controversies, summarises treatment trials so far, and makes suggestions for what progress is needed to advance our understanding of pathogenesis and thus maximise opportunities for the search for new and effective management approaches. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. [Vascular trauma].

    Science.gov (United States)

    Furuya, T; Nobori, M; Tanaka, N

    1999-07-01

    Vascular trauma is essentially acute arterial obstruction, often combined with hemorrhage, fracture, and infection. It can be both life-threatening and limb-threatening and needs an emergency operation. In vascular trauma patient, multiple fracture and organ injury, such as brain, lung, liver, spleen, kidney, or gastrointestinal tract should be evaluated to decide treatment priority. When the pulse distal from the injured site is absent or diminished, vascular trauma is most likely and reconstruction should be accomplished within "the golden time (6-8 hours)". Intimal damage followed by platelet aggregation and thrombus formation will necessitate resection and repair of the site instead of simple thrombectomy. Although autogenous vein is the first choice, artificial graft can be implanted for short segment in non-infected field.

  9. Evidências de intervenções para aumento da força muscular e melhora da marcha em indivíduos pós- acidente vascular encefálico

    OpenAIRE

    Lucas Rodrigues Nascimento

    2015-01-01

    Dados recentes indicam que mais de 30 milhões de pessoas no mundo sobreviveram a um episódio de Acidente Vascular Encefálico (AVE). Após a ocorrência do AVE, observa-se que mais de 80% dos sobreviventes apresentam fraqueza muscular contralateral à lesão encefálica e consideráveis limitações para deambulação, o que compromete a participação social desses indivíduos. Estudos prévios indicaram que Indivíduos pós-AVE apresentam deficiência em força muscular e limitações em marcha com valores apro...

  10. VASCULAR SURGERY

    African Journals Online (AJOL)

    Venous thromboembolism (VTE) is a complex and serious condition encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), usually in the lower extremities.1,2. Thromboses can result from venous stasis, vascular injury or hypercoagulability, and those involving the deep veins proximal to the knee are ...

  11. Papel del tejido perivascular en la regulación del tono vascular: repercusión en el uso de puentes aorto-coronarios para revascularización miocárdica Role of perivascular tissue in vascular tone regulation: repercussion in the use of aortocoronary bypass for myocardial revascularization

    Directory of Open Access Journals (Sweden)

    Patricio López-Jaramillo

    Full Text Available Desde hace más de treinta años, la inserción quirúrgica de puentes aorto-coronarios autólogos de vena safena y de arteria mamaria, constituye el tratamiento de elección para pacientes con enfermedad coronaria severa. La vida útil de estos injertos ha demostrado ser mayor en los colgajos de tipo arterial, aunque su uso está limitado por la restringida disponibilidad de los mismos. Por esta razón, y a pesar de que tienen mayor riesgo de presentar oclusión, los injertos de vena safena son los que más se usan en estos procedimientos de reperfusión miocárdica. Aún no se han esclarecido del todo las razones por las cuales los injertos venosos se ocluyen luego de su inserción en los lechos arteriales; no obstante, se ha propuesto que podría deberse a diferentes factores como: trauma mecánico quirúrgico, aumento de la presión arterial y disminuido estrés de fricción. En 1996 se describió la técnica "no-touch" de preparación de los injertos venosos, en la cual se implantaron los puentes venosos en los lechos coronarios junto con el tejido peri-vascular que los circunda, y demostró mejorar la vida útil de este tipo de injertos. Recientemente se ha propuesto que el tejido adiposo peri-vascular podría desempeñar un papel en la regulación del tono vascular, e incluso se ha descrito la existencia de un factor relajante derivado del adipocito (ADRF, cuya naturaleza no se ha esclarecido completamente. El objetivo de este articulo es revisar los diferentes factores vinculados con la oclusión de los injertos aorto-coronarios, las posibles vías fisiopatológicas que configuran este fenómeno, las nuevas alternativas quirúrgicas utilizadas para la preparación de los injertos venosos y los avances en la descripción del ADRF y su papel en la regulación del tono vascular.Since more than thirty years, surgical insertion of autologous aortocoronary bypasses from saphenous vein and mammary artery constitute the election treatment for

  12. Actividades para la corrección de la apraxia constructiva en pacientes con secuelas de enfermedad cerebro-vascular = Activities for the correction of constructive apraxia in patients with sequels of brain-vascular illness

    Directory of Open Access Journals (Sweden)

    Torres Aguilar, Maydane

    2008-09-01

    Full Text Available RESUMENObjetivo: Evaluar un sistema de actividades realizadas para la corrección y compensación de la apraxia constructiva después de la exploración neuropsicológica. Método: Con el propósito de evaluar este sistema de actividades, se realizó un estudio prospectivo experimental con 15 pacientes que permanecieron en el Centro Internacional de Investigaciones y Restauración Neurológica (CIREN durante un período de 54 días que recibieron tratamiento defectológico (Terapia Ocupacional diario. En consecuencia se aplicó una escala evaluativa pre y post-intervención terapéutica comparándose los resultados.Resultados: A través de la escala de puntaje aplicada se obtuvo un incremento de recuperación en cuanto a la realización de las actividades sin niveles de ayuda ni modelos previos de un 93,4% post-intervención, como promedio, en los pacientes analizados.Conclusiones: Se observó una mejor asociación entre la idea del movimiento y la ejecución motora así como entre la percepción visual y la acción apropiada, después de la intervención.SUMMARYA great number of patients with Encephalic Static Lesions suffer psychic and motor alterations that avoid him to develop it more usually possible in his social environment. One of the psychic alterations that are frequently presented is the constructive apraxia which can appear in different grades, depending among other factors, of the severity of the damage. This unchains difficulties that go from the less complex, as the reproduction of drawings until others of more complexity like daily basic activities. Objectives: Evaluate system of activities for correction and/or compensation the constructive apraxia after neuro-psychological exploration. Methods and Material: With the proposal to check the effectiveness of this system of activities we carry out a prospective and experimental study with 15 patients that were in CIREN (International Centre of Research and Neurological Restoration

  13. IMPACTO DE UM SERVIÇO DE DIAGNÓSTICO E TRATAMENTO DA DISFAGIA PARA PACIENTES COM ACIDENTE VASCULAR ENCEFÁLICO E DISFAGIA

    OpenAIRE

    Hausberger, Carmen Silvana Vieira

    2014-01-01

    INTRODUÇÃO:O adequado diagnóstico e gerenciamento dos distúrbios da deglutição e da alimentação são procedimentos importantes, devido à alta incidência e prevalência da disfagia e suas potenciais consequências. Estabelecer o diagnóstico e o prognóstico dadisfagia é fundamental para nortear o gerenciamento deste distúrbio e a redução da morbidade e mortalidade a ele associado.OBJETIVO: Avaliar o impacto de um Serviço de Diagnóstico e Tratamento da Disfagia em pacientes acometidos por Acidente ...

  14. Perfil Clínico-Epidemiológico de Pacientes que inician Terapia Intensiva con Estatinas para La Prevención Secundaria de Enfermedad Vascular en España

    Directory of Open Access Journals (Sweden)

    Diego Macías Saint Gerons

    2015-01-01

    Full Text Available Las nuevas recomendaciones respecto a la utilización de estatinas potentes y/o dosis altas (terapia intensiva para el tratamiento de la enfermedad cardiovascular se han basado en la extrapolación de los resultados de los ensayos clínicos. El objetivo fue describir el perfil clínico-epidemiológico de los pacientes que inician tratamiento con estatinas para la prevención secundaria en España y estudiar qué factores determinan la utilización de estatinas en terapia intensiva. Métodos: Estudio transversal a partir de 88.751 pacientes ≥45 años con enfermedad cardiovascular que iniciaron tratamiento con estatinas (enero 2007-diciembre 2011. Los tratamientos con dosis superiores a 40 mg/día de simvastatina (o estatina equipotente se consideraron terapia intensiva. Se construyeron modelos de regresión logística multivariante con el fin de examinar la asociación de las variables relacionadas con la prescripción de terapia intensiva respecto al uso de la terapia moderada. Resultados: Se identificó a 16.857 personas adultas que iniciaron tratamiento con estatinas para la prevención secundaria. Los factores predictores para el inicio de terapia intensiva fueron el año de prescripción, sexo masculino (odds ratio ajustada: 1,70; IC95%: 1,44-2,00, edad >75 años (1,39; 1,15-1,69, historia previa de enfermedad isquémica coronaria (1,71; 1,44-2,04, accidente isquémico transitorio de cualquier localización (1,24; 0,97-1,59, tabaquismo (1,62; 1,34-1,95, hipertensión (1,41; 1,20-1,65 y tratamiento reciente con fibratos (2,32; 1,27-4,26. Conclusiones: La utilización de terapia intensiva con estatinas está determinada por el tipo de evento vascular previo y con la edad (>75 años, en los que el balance beneficio-riesgo podría ser discutible. No se encuentran diferencias estadísticamente significativas en función del c-LDL.

  15. Validade e confiabilidade do teste do esfigmomanômetro modificado para a avaliação da força muscular de membros inferiores e tronco de indivíduos na fase crônica do acidente vascular encefálico

    OpenAIRE

    Lucas Araujo Castro e Souza

    2013-01-01

    A fraqueza muscular é comumente observada em indivíduos acometidos pelo Acidente Vascular Encefálico (AVE). Os métodos comumente utilizados para avaliar este desfecho na clínica apresentam importantes desvantagens. Os objetivos deste estudo foram: a) investigar a validade de critério concorrente e confiabilidades teste-reteste e interexaminadores do TEM para avaliar a força muscular de MMII e tronco de indivíduos na fase crônica do AVE;e b) verificar se o uso de diferentes formas de operacion...

  16. Terapia gênica com fator de crescimento endotelial vascular 165 para pacientes com angina refratária: mobilização de células progenitoras endoteliais

    Directory of Open Access Journals (Sweden)

    Clarissa G. Rodrigues

    2013-08-01

    Full Text Available FUNDAMENTO: O fator de crescimento endotelial vascular (VEGF - vascular endothelial growth factor induz a mobilização de células progenitoras endoteliais (CPEs com capacidade de proliferação e diferenciação em células endoteliais, contribuindo, dessa forma, para o processo angiogênico. OBJETIVO: Buscamos avaliar o comportamento de CPEs em pacientes com doença cardíaca isquêmica e angina refratária que receberam injeções intramiocardicas de 2000 µg de VEGF165 como terapia única. MÉTODOS: O estudo foi uma subanálise de um ensaio clínico. Pacientes com doença cardíaca isquêmica avançada e angina refratária foram avaliados para inclusão no estudo. Os critérios de inclusão foram: sinais e sintomas de angina e/ou insuficiência cardíaca apesar de tratamento medicamentoso máximo e área de isquemia miocárdica de, no mínimo, 5% conforme avaliado por uma tomografia computadorizada por emissão de fóton único (TCEFU. Os critérios de exclusão foram: idade > 65 anos, fração de ejeção do ventrículo esquerdo < 25% e cancer diagnosticado. Os pacientes cujos níveis de CPE foram avaliados foram incluídos. A intervenção consistiu na administração de 2000 µg de VEGF 165 de plasmídeo injetado no miocárdio isquêmico. A frequência de células CD34+/KDR+ foi analisada por citometria de fluxo antes e 3, 9, e 27 dias após a intervenção. RESULTADOS: Um total de 9 pacientes foram incluídos, 8 homens, média de idade de 59,4 anos, fração de ejeção ventricular esquerda de 59,3%, e classe de angina predominante III. Observou-se um aumento significativo dos níveis de CPEs no terceiro dia após a intervenção. Todavia, 9 e 27 dias após a intervenção, os níveis de CPEs foram similares aos basais. CONCLUSÃO: Identificamos uma mobilização transitória de CPE, com pico no terceiro dia após a intervenção com VEGF 165 em pacientes com angina refratária. Todavia, os níveis de CPEs apresentaram-se semelhantes

  17. Plant Vascular Biology 2013: vascular trafficking.

    Science.gov (United States)

    Ursache, Robertas; Heo, Jung-Ok; Helariutta, Ykä

    2014-04-01

    About 200 researchers from around the world attended the Third International Conference on Plant Vascular Biology (PVB 2013) held in July 2013 at the Rantapuisto Conference Center, in Helsinki, Finland (http://www.pvb2013.org). The plant vascular system, which connects every organ in the mature plant, continues to attract the interest of researchers representing a wide range of disciplines, including development, physiology, systems biology, and computational biology. At the meeting, participants discussed the latest research advances in vascular development, long- and short-distance vascular transport and long-distance signalling in plant defence, in addition to providing a context for how these studies intersect with each other. The meeting provided an opportunity for researchers working across a broad range of fields to share ideas and to discuss future directions in the expanding field of vascular biology. In this report, the latest advances in understanding the mechanism of vascular trafficking presented at the meeting have been summarized.

  18. Bioprinting for vascular and vascularized tissue biofabrication.

    Science.gov (United States)

    Datta, Pallab; Ayan, Bugra; Ozbolat, Ibrahim T

    2017-03-15

    Bioprinting is a promising technology to fabricate design-specific tissue constructs due to its ability to create complex, heterocellular structures with anatomical precision. Bioprinting enables the deposition of various biologics including growth factors, cells, genes, neo-tissues and extra-cellular matrix-like hydrogels. Benefits of bioprinting have started to make a mark in the fields of tissue engineering, regenerative medicine and pharmaceutics. Specifically, in the field of tissue engineering, the creation of vascularized tissue constructs has remained a principal challenge till date. However, given the myriad advantages over other biofabrication methods, it becomes organic to expect that bioprinting can provide a viable solution for the vascularization problem, and facilitate the clinical translation of tissue engineered constructs. This article provides a comprehensive account of bioprinting of vascular and vascularized tissue constructs. The review is structured as introducing the scope of bioprinting in tissue engineering applications, key vascular anatomical features and then a thorough coverage of 3D bioprinting using extrusion-, droplet- and laser-based bioprinting for fabrication of vascular tissue constructs. The review then provides the reader with the use of bioprinting for obtaining thick vascularized tissues using sacrificial bioink materials. Current challenges are discussed, a comparative evaluation of different bioprinting modalities is presented and future prospects are provided to the reader. Biofabrication of living tissues and organs at the clinically-relevant volumes vitally depends on the integration of vascular network. Despite the great progress in traditional biofabrication approaches, building perfusable hierarchical vascular network is a major challenge. Bioprinting is an emerging technology to fabricate design-specific tissue constructs due to its ability to create complex, heterocellular structures with anatomical precision

  19. Confiabilidade e validade do teste do esfigmonômetro modificado para mensuração clínica da força muscular de membros inferiores e tronco de indivíduos na fase subaguda pós acidente vascular encefálico

    OpenAIRE

    Eliza Maria Lara

    2015-01-01

    O teste do esfigmomanômetro modificado (TEM) demonstrou ser um método adequado para avaliar força muscular de indivíduos na fase crônica do acidente vascular encefálico (AVE). Dada a sua grande aplicabilidade clínica, pode também ser um método promissor para a avaliação da força muscular de indivíduos na fase subaguda pós-AVE. Esses indivíduos apresentam características específicas e distintas das apresentadas na fase crônica do AVE. Dessa forma, para que o TEM seja utilizado em indivíduos...

  20. Determinación inmunohistoquímica y utilidad pronóstica del receptor del factor de crecimiento epidérmico en los tumores estromales gastrointestinales Immnunohistochemical expression of epidermal growth factor and its prognostic value for gastrointestinal stromal tumors

    Directory of Open Access Journals (Sweden)

    D. Padilla

    2008-12-01

    Full Text Available Introducción: el receptor del factor de crecimiento epidérmico, EGFR(HER-1, es un receptor de tirosina quinasas cuya activación permite un aumento de la proliferación celular, angiogénesis, proceso metastásico y disminución de la apoptosis celular. Nuestro objetivo es conocer el valor pronóstico de la inmunotinción de EGFR en tumores estromales gastrointestinales (GIST. Pacientes y método: estudio retrospectivo que incluye todos los GIST intervenidos quirúrgicamente entre 1995-2007 en el Servicio de Cirugía General y del Aparato Digestivo del Hospital General de Ciudad Real. Variables clínicas: edad, sexo, clínica, mortalidad, recidiva. Variables patológicas: a macroscópicas: localización, diámetro; b microscópicas: necrosis tumoral, índice mitótico, tipo celular; y c inmunohistoquímicas: vimentina (V9, Dako A/s; actina del músculo liso (HHF-35, Biogenex; CD34 (QBEND/10; S100 (Policlonal Dako A/S; CD117 (c-kit Rabbit, antihuman polyclonal antibody, 1:600; PDGFR-alfa (Rabbit polyclonal antibody, 1:50, Sta. Cruz Biotechnology. Variables moleculares pronósticas: P-53, PAb240 (DakoCytomation, 1:75, Ki-67, clona MIB1 (Dako, 1:120 y EGFR pharmDx™ Dako Autostainer (Dako, Dinamarca. Criterios de malignidad: criterios de Fletcher. Resultados: entre 1995 y 2007, 35 GIST, fueron intervenidos quirúrgicamente en nuestro Servicio. Edad media: 61,11 ± 11,02, siendo mujeres en el 62,9% de los casos. Debutaron con hemorragia digestiva en un 40%. La mediana de seguimiento fue de 28 meses (3-133. La mortalidad fue de 54,3%, con recidiva del 40%. Variables morfológicas: la localización más frecuente fue gástrica, 51,4% (18. Existió necrosis tumoral en un 57,1%, 20. El patrón celular fue fusocelular en un 57,1%, y epitelioide en un 14,3%. El diámetro máximo fue de 9,58 ± 6,29. El índice mitótico por 50 campos de gran aumento fue de 13,44 ± 16,08. En un 51,45%, 18, fueron neoplasias de alto riesgo. Valores inmunohistoqu

  1. Terapia baseada em realidade virtual usando o leap motion controller para reabilitação do membro superior após acidente vascular cerebral = Virtual reality therapy using the leap motion controller for post-stroke upper limb rehabilitation Virtual reality therapy using the Leap Motion Controller for post-stroke upper limb rehabilitation

    Directory of Open Access Journals (Sweden)

    Soares, Nayron Medeiros

    2017-01-01

    Full Text Available OBJETIVOS: Avaliar a aplicabilidade de um sensor de movimento, baseado em realidade virtual, para promover a reabilitação do membro superior após um acidente vascular cerebral. RELATO DOS CASOS: Três pacientes após acidente vascular cerebral realizaram um treino para reabilitação do membro superior com realidade virtual usando a tecnologia Leap Motion Controller e o jogo Playground 3D®, durante três dias consecutivos. No primeiro e no terceiro dia, foram avaliados com os testes Caixa e Blocos, Coordenação Óculo-Manual de Melo e Estimulação Magnética Transcraniana. No último dia, foram aplicadas Fichas de Avaliação da Experiência do paciente. Após o treinamento proposto, observou-se diminuição do limiar motor em ambos os hemisférios cerebrais e melhores desempenhos nos testes que avaliaram a habilidade manual e óculo-manual. A terapia proposta foi bem recebida pelos pacientes testados. CONCLUSÕES: Não foram observados efeitos adversos e os resultados mostram-se promissores e precisos no treinamento realizado com realidade virtual usando a tecnologia Leap Motion Controller e o jogo Playground 3D®. O treinamento proporcionou uma participação ativa dos pacientes na reabilitação das sequelas de extremidade superior após um acidente vascular cerebral

  2. Las plantas vasculares acuaticas estrictas y su conservacion en Mexico

    National Research Council Canada - National Science Library

    Mora-Olivo, Arturo; Luis Villasenor, Jose; Martinez, Mahinda

    2013-01-01

    Con base en el analisis de la riqueza y distribucion de las hidrofitas vasculares estrictas, se identificaron las entidades federativas mas relevantes para la conservacion de los humedales de Mexico y su flora asociada...

  3. Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

    Directory of Open Access Journals (Sweden)

    Sueli Luciano Pires

    2004-09-01

    Full Text Available Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é significativamente freqüente (87,8% entre pacientes idosos com AVCi, independentemente do sexo e da faixa etária. Tabagismo (46,9% e etilismo (35,1% revelaram-se fatores de riscos modificáveis freqüentes especialmente entre os homens. As cardiopatias (27,0%, o Diabete Melito (19,9% e as dislipidemias (15,6% também se revelaram fatores de risco modificáveis freqüentes em pacientes idosos com AVCi, em ambos os sexos e em ambas as faixas etárias estudadas (60 a 70 anos e mais que 71 anos. Foi relativamente baixa a freqüência de hiperuricemia nesta amostra.Two hundred and sixty two patients with clinical diagnosis of permanent ischemic stroke, all of them aged 60 or more were retrospectively studied from the 1015 cerebrovascular diseases (CVD records of the Atherosclerosis Ligue of the Neurology Clinics of the ISCMSP, from 1990 to 2002. The study emphasized modifiable risk factors frequencies for ischemic stroke in this population, considering gender and age of the patients. Results have evidenced that systemic arterial hypertension is a main risk factor significantly frequent in old people (87.8%, independently of gender and age. Smoking (46.9% and alcohol consumption (35.1% have revealed to be very frequent important modifiable risk factors especially among men. Lower frequencies have been presented for cardiac diseases (27.0%, Diabetes Melitus (19.9%, and dislipidemia (15.6% as risk factors for ischemic stroke in old people of both

  4. Collagen vascular disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001223.htm Collagen vascular disease To use the sharing features on this page, ... previously said to have "connective tissue" or "collagen vascular" disease. We now have names for many specific conditions ...

  5. 269. Veinte años de experiencia con homoinjertos vasculares criopreservados en la infección vascular

    Directory of Open Access Journals (Sweden)

    E. Quintana

    2012-04-01

    Conclusiones: Este estudio a largo plazo contribuye a mantener la indicación para el implante de homoinjertos vasculares criopreservados en las infecciones vasculares. Los resultados demuestran un comportamiento satisfactorio en esta población multimórbida.

  6. Análisis entre la recirculación medida por termodilución (BTM® y la presión venosa dinámica inicial como métodos para la detección de estenosis del acceso vascular protésico Analysis of recirculation measured by thermodilution (BTM® and initial dynamic venous pressure as methods for the detection of stenosis in prosthetic vascular access

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Marín González

    2012-12-01

    Full Text Available Introducción: Los problemas de acceso vascular suponen la mayor causa de morbilidad y mortalidad en el paciente en hemodiálisis. La estenosis es a su vez la principal causa de disfunción del acceso vascular protésico, y cuando éste problema no se logra detectar a tiempo, puede derivar en trombosis. Existen múltiples procedimientos para la detección de disfunción del acceso vascular desde la exploración física, mediciones de presión y flujo, así como pruebas de imagen no invasivas e invasivas. La Presión Venosa Dinámica inicial, es una herramienta sencilla de seguimiento del acceso vascular. Objetivos: El objetivo del estudio es correlacionar la presión venosa dinámica inicial y la recirculación como métodos de vigilancia del acceso vascular en pacientes en hemodiálisis. Material y métodos: Se evaluaron de forma prospectiva 21 pacientes con prótesis durante 1 año. Se registraron signos clínicos y parámetros de medición objetivos como recirculación por termodilución, presión venosa dinámica inicial con flujo de sangre de 200 ml/min, tiempo de hemostasia, y KT/V por OCM, contrastándose con los hallazgos de las pruebas de imagen. Se realizaron mediciones mensualmente, con un total de 244. Resultados: La prótesis de PTFE representó el 16,6% de los accesos vasculares en nuestra unidad durante el periodo de estudio. La media de edad fue de 63 años con un 57% de mujeres. El tiempo medio de diálisis fue de 225 min con un Kt/V por OCM de 1,44. De los signos clínicos, la mayor incidencia fue presencia de pseudoaneurismas, en un 42,8%. La media de recirculación fue 10,46±2,68% y la presión venosa dinámica inicial 94,51±19,58 mmHg. Se registraron en total 21 eventos: 14 fistulografías+ angioplastia, 4 trombosis con reparación quirúrgica, 2 fistulografías sin necesidad de angioplastia y una trombosis no recuperada. Cuando se compararon las mediciones de recirculación y presión venosa dinámica inicial, con la

  7. Ensayo clínico de asignación aleatoria, para evaluar la eficacia de dos técnicas de compresión en la disminución de complicaciones en el sitio de acceso vascular femoral, posterior a cateterismo diagnóstico y terapéutico

    OpenAIRE

    Ramírez-Gutiérrez,Álvaro Eduardo; Eid-Lidt,Guering; Esquinca-Vera,Juan Carlos; Damas-de los Santos,Félix; Pérez-González,Alberto; Kimura-Hayama,Eric; Bacilio-Pérez,Ulises; Gaspar-Hernández,Jorge

    2012-01-01

    Objetivo: Comparar la incidencia de falla en la hemostasia y frecuencia de eventos vasculares, durante y después de la compresión con dos maniobras diferentes. Métodos: Se realizó un ensayo clínico de asignación aleatoria a compresión mecánica o compresión manual, para el retiro de introductor en arteria femoral posterior a cateterismo diagnóstico o terapéutico. Resultados: Se incluyeron 100 pacientes en el grupo de compresión con compresor (grupo uno) y 112 de forma manual (grupo dos). La fa...

  8. Caracterización celular y funcional del receptor para colágeno DDR1 en la respuesta del microambiente al tumor metastásico.

    OpenAIRE

    González Cebollero, Mercedes

    2016-01-01

    El cáncer se ha considerado una enfermedad definida y dirigida por la inestabilidad genómica, las alteraciones cromosómicas y las mutaciones genéticas. Sin embargo, en la actualidad, la influencia de las células estromales no malignas del microambiente tumoral está claramente establecida. Los tumores son tejidos complejos, compuestos no sólo por las células malignas, sino también, por células estromales genéticamente estables, incluyendo a fibroblastos y macrófagos además de la matriz extrace...

  9. Vascular grading of angiogenesis

    DEFF Research Database (Denmark)

    Hansen, S; Grabau, D A; Sørensen, Flemming Brandt

    2000-01-01

    The study aimed to evaluate the prognostic value of angiogenesis by vascular grading of primary breast tumours, and to evaluate the prognostic impact of adding the vascular grade to the Nottingham Prognostic Index (NPI). The investigation included 836 patients. The median follow-up time was 11...... years and 4 months. The microvessels were immunohistochemically stained by antibodies against CD34. Angiogenesis was graded semiquantitatively by subjective scoring into three groups according to the expected number of microvessels in the most vascular tumour area. The vascular grading between observers...... was moderately reproduced (kappa = 0.59). Vascular grade was significantly associated with axillary node involvement, tumour size, malignancy grade, oestrogen receptor status and histological type. In univariate analyses vascular grade significantly predicted recurrence free survival and overall survival for all...

  10. Uterine vascular lesions.

    Science.gov (United States)

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management.

  11. Vascular biology of preeclampsia.

    Science.gov (United States)

    Myatt, L; Webster, R P

    2009-03-01

    Preeclampsia, a pregnancy-specific syndrome characterized by hypertension, proteinuria and edema, resolves on delivery of the placenta. Normal pregnancy is itself characterized by systemic inflammation, oxidative stress and alterations in levels of angiogenic factors and vascular reactivity. This is exacerbated in preeclampsia with an associated breakdown of compensatory mechanisms, eventually leading to placental and vascular dysfunction. The underlying pathology of preeclampsia is thought to be a relatively hypoxic or ischemic placenta. Both the placenta and maternal vasculatures are major sources of reactive oxygen and nitrogen species which can interact to produce peroxynitrite a powerful prooxidant that covalently modifies proteins by nitration of tyrosine residues, to possibly alter vascular function in preeclampsia. The linkage between placental hypoxia and maternal vascular dysfunction has been proposed to be via placental syncytiotrophoblast basement membranes shed by the placenta or via angiogenic factors which include soluble flt1 and endoglin secreted by the placenta that bind vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) in the maternal circulation. There is also abundant evidence of altered reactivity of the maternal and placental vasculature and of the altered production of autocoids in preeclampsia. The occurrence of preeclampsia is increased in women with preexisting vascular disease and confers a long-term risk for development of cardiovascular disease. The vascular stress test of pregnancy thus identifies those women with a previously unrecognized at risk vascular system and promotes the development of preeclampsia. Preexisting maternal vascular dysfunction intensified by placental factors is possibly responsible for the individual pathologies of preeclampsia.

  12. Vascular grading of angiogenesis

    DEFF Research Database (Denmark)

    Hansen, S; Grabau, D A; Sørensen, Flemming Brandt

    2000-01-01

    years and 4 months. The microvessels were immunohistochemically stained by antibodies against CD34. Angiogenesis was graded semiquantitatively by subjective scoring into three groups according to the expected number of microvessels in the most vascular tumour area. The vascular grading between observers...

  13. Resonancia magnética versus tomografía computada para la detección de lesiones vasculares agudas en pacientes que consultan por síntomas de accidente cerebrovascular

    OpenAIRE

    Brazzelli, Miriam; Peter A.G. Sandercock; Chappell, Francesca M.; Celani, Maria Grazia; Righetti, Enrico; Arestis, Nicholas; Wardlaw, Joanna M.; Deeks, Jonathan J

    2013-01-01

    Antecedentes: La resonancia magnética (RM) se utiliza cada vez con mayor frecuencia para el diagnóstico del accidente cerebrovascular isquémico agudo aunque ha sido debatida su sensibilidad para la detección precoz de la hemorragia intracerebral. La tomografía computada (TC) se usa ampliamente en el tratamiento clínico del accidente cerebrovascular agudo, especialmente para la exclusión rápida de la hemorragia intracerebral. Objetivos: Comparar la precisión diagnóstica de la RM de difusión...

  14. Vascular cognitive impairment and vascular dementia

    Directory of Open Access Journals (Sweden)

    Klavdija Ovčar

    2017-09-01

    Full Text Available In the developed world, five to ten percent of people older than 65 years have dementia. One fifth of dementia etiologies are due to vascular brain lesions (VaD – vascular dementia. A milder form is called vascular cognitive impairment (VCI. The main clinical criteria for VaD are: 1. cognitive decline verified with standardized cognitive test/scale, 2. evidence of the associated vascular brain lesion, 3. excluded reversible causes of cognitive decline. The main risk factors for VaD are age, atherosclerosis, diabetes and hypertension. They play a key role in pathogenesis of the cognitive impairment. Depending on the damaged brain region, different cognitive domains may be affected with or without other neurological signs. These diversities in the clinical picture challenge the correct diagnosis. Unique feature of VaD is its progression, which can be stopped, if patients receive an appropriate treatment.The treatment of VCI and VaD symptoms is similar to that in Alzheimer’s disease. More importantly, VCI may be slowed down or even stopped with proper secondary stroke prevention and good rehabilitation. The most efficient is primary stroke prevention with healthy lifestyle and treatment of acquired risk factors.

  15. Vascular disease burden in Indian subjects with vascular dementia.

    Science.gov (United States)

    Chandra, Mina; Anand, Kuljeet Singh

    2015-01-01

    Vascular disease factors like hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease contribute to the development of vascular dementia. As comorbidity of vascular disease factors in vascular dementia is common, we investigated the vascular disease burden in subjects with vascular dementia. To investigate the vascular disease burden due to four vascular disease factors: hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease in Indian subjects with vascular dementia. In this study, 159 subjects with probable vascular dementia (as per NINDS-AIREN criteria) attending the memory clinic at a tertiary care hospital were assessed for the presence of hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease using standardised operational definitions and for severity of dementia on the Clinical Dementia Rating (CDR) scale. The data obtained was subjected to appropriate statistical analysis. Dyslipidaemia (79.25 per cent) was the most common vascular disease factor followed by hypertension (73.58 per cent), ischaemic heart disease (58.49 per cent), and diabetes mellitus (40.80 per cent). Most subjects (81.1 per cent) had two or more vascular disease factors. Subjects with more severe dementia had more vascular disease factors (sig 0.001). People with moderate to severe dementia have a significantly higher vascular disease burden; therefore, higher vascular disease burden may be considered as a poor prognostic marker in vascular dementia. Subjects with vascular dementia and their caregivers must manage cognitive impairment and ADL alongside managing serious comorbid vascular diseases that may worsen the dementia.

  16. Vascular remodelling in asthma.

    Science.gov (United States)

    Walters, Eugene Haydn; Soltani, Amir; Reid, David William; Ward, Chris

    2008-02-01

    We review the recent literature, focusing on 2006 and 2007, to produce an update on the patho-biology of angiogenesis and vascular endothelial growth factor in the asthmatic airway. In terms of conceptual development in asthma research, airway inflammation and remodelling have been regarded as separate processes or perhaps as sequential, with early inflammation leading later to remodelling. Recent insights identify a central role for vascular endothelial growth factor in stimulating both inflammation and vascular remodelling coincidentally, with the full panoply of vascular endothelial growth factor mediated events being complex and wide. Both nitric oxide and matrix metalloproteinase-9 induction may be important downstream pathogenic mechanisms. Virus-mediated exacerbations are a prime manifestation of the oscillating trajectory of clinical asthma. The early stimulation of vascular endothelial growth factor production is probably a central aetiological mechanism, with secondary inflammation and angiogenesis. The time scale of the latter, especially, fits with the time scale of clinico-physiological changes after exacerbation. These vascular endothelial growth factor induced changes are potentially modifiable with therapy. Insights into the importance of vascular endothelial growth factor and angiogenesis in asthma pathogenesis now lead to potential new therapeutic possibilities and elucidate why recent advances in asthma therapeutics have been so successful.

  17. Understanding Vascular Endothelium

    OpenAIRE

    Gimbrone, Michael A.

    2014-01-01

    Understanding Vascular Endothelium : Nature’s Container for Blood The entire cardiovascular system, from the chambers of the heart to the smallest capillaries of peripheral tissues, is lined by a single-cell-thick continuous layer—the vascular endothelium. For many years, this gossamer membrane was thought to function largely as an inert barrier, passively separating the reactive components of the circulating blood from the cells and connective tissue matrix of the various organs of the body....

  18. Hypercholesterolaemia and vascular dementia

    OpenAIRE

    Appleton, Jason P.; Scutt, Polly; Sprigg, Nikola; Bath, Philip M.

    2017-01-01

    Vascular dementia (VaD) is the second commonest cause of dementia. Stroke is the leading cause of disability in adults in developed countries, the second major cause of dementia and the third commonest cause of death. Traditional vascular risk factors–diabetes, hypercholesterolaemia, hypertension and smoking–are implicated as risk factors for VaD. The associations between cholesterol and small vessel disease (SVD), stroke, cognitive impairment and subsequent dementia are complex and as yet no...

  19. Perfil Clínico-Epidemiológico de Pacientes que inician Terapia Intensiva con Estatinas para La Prevención Secundaria de Enfermedad Vascular en España

    OpenAIRE

    Diego Macías Saint Gerons; César de la Fuente Honrubia; Diana González Bermejo; Dolores Montero; Gil, Miguel J; Antonio Salvador Sanz; Fernando de Andrés Trelles; Ferrán Catalá López

    2015-01-01

    Las nuevas recomendaciones respecto a la utilización de estatinas potentes y/o dosis altas (terapia intensiva) para el tratamiento de la enfermedad cardiovascular se han basado en la extrapolación de los resultados de los ensayos clínicos. El objetivo fue describir el perfil clínico-epidemiológico de los pacientes que inician tratamiento con estatinas para la prevención secundaria en España y estudiar qué factores determinan la utilización de estatinas en terapia intensiva. Métodos: Estudio t...

  20. Antioxidants and vascular health.

    Science.gov (United States)

    Bielli, Alessandra; Scioli, Maria Giovanna; Mazzaglia, Donatella; Doldo, Elena; Orlandi, Augusto

    2015-12-15

    Oxygen free radicals and other reactive oxygen species (ROS) are common products of normal aerobic cellular metabolism, but high levels of ROS lead to oxidative stress and cellular damage. Increased production of ROS favors vascular dysfunction, inducing altered vascular permeability and inflammation, accompanied by the loss of vascular modulatory function, the imbalance between vasorelaxation and vasoconstriction, and the aberrant expression of inflammatory adhesion molecules. Inflammatory stimuli promote oxidative stress generated from the increased activity of mitochondrial nicotinamide adenine dinucleotide phosphate oxidase, particularly of the Nox4 isoform, with the consequent impairment of mitochondrial β-oxidation. Vascular dysfunction due to the increase in Nox4 activity and ROS overproduction leads to the progression of cardiovascular diseases, diabetes, inflammatory bowel disease, and neurological disorders. Considerable research into the development of effective antioxidant therapies using natural derivatives or new synthetic molecules has been conducted. Antioxidants may prevent cellular damage by reducing ROS overproduction or interfering in reactions that involve ROS. Vitamin E and ascorbic acid are well known as natural antioxidants that counteract lipid peroxidative damage by scavenging oxygen-derived free radicals, thus restoring vascular function. Recently, preliminary studies on natural antioxidants such as goji berries, thymus, rosemary, green tea ginseng, and garlic have been conducted for their efficacy in preventing vascular damage. N-acetyl-cysteine and propionyl-L-carnitine are synthetic compounds that regulate ROS production by replacing endogenous antioxidants in both endothelial and smooth muscle cells. In this review, we consider the molecular mechanisms underlying the generation of oxidative stress-induced vascular dysfunction as well as the beneficial effects of antioxidant therapies.

  1. Estudo de fatores clínicos preditivos para crises epilépticas após acidente vascular cerebral isquêmico Preditive clinical factors for epileptic seizures after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Marcia Maiumi Fukujima

    1996-06-01

    Full Text Available Apresentamos aspectos clínicos de 35 pacientes com acidente vascular cerebral isquêmico que evoluíram com crises epilépticas (Grupo 1, comparando-os a 35 pacientes com AVCI sem crises epilépticas (Grupo 2. A comparação das idades entre os grupos não mostrou diferença significante. O sexo masculino e a raça branca predominaram em ambos os grupos. Diabetes melito, hipertensão arterial, ataque isquêmico transitório, acidente vascular cerebral pregresso, enxaqueca, doença de Chagas, embolia cerebral cardiogênica e uso de anticoncepcional oral não diferiram significantemente entre os grupos. Tabagismo e etilismo foram significantemente mais freqüentes no Grupo 1 (pPreditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1 were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2. The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p<0,05. Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.

  2. Vascularized epiphyseal transplant.

    Science.gov (United States)

    Innocenti, Marco; Delcroix, Luca; Romano, G Federico; Capanna, Rodolfo

    2007-01-01

    In skeletally immature patients, the transfer of vascularized epiphysis along with a variable amount of adjoining diaphysis may provide the potential for growth of such a graft, preventing future limb length discrepancy. This article describes the authors' experience with the vascularized transfer of the proximal fibular epiphysis in the reconstruction of large bone defects including the epiphysis in a series of 27 patients ranging in age from 2 to 11 years. The follow-up, ranging from 2 to 14 years, has been long enough to allow some evaluation of the validity, indications, and limits of this reconstructive option.

  3. Hypercholesterolaemia and vascular dementia.

    Science.gov (United States)

    Appleton, Jason P; Scutt, Polly; Sprigg, Nikola; Bath, Philip M

    2017-07-15

    Vascular dementia (VaD) is the second commonest cause of dementia. Stroke is the leading cause of disability in adults in developed countries, the second major cause of dementia and the third commonest cause of death. Traditional vascular risk factors-diabetes, hypercholesterolaemia, hypertension and smoking-are implicated as risk factors for VaD. The associations between cholesterol and small vessel disease (SVD), stroke, cognitive impairment and subsequent dementia are complex and as yet not fully understood. Similarly, the effects of lipids and lipid-lowering therapy on preventing or treating dementia remain unclear; the few trials that have assessed lipid-lowering therapy for preventing (two trials) or treating (four trials) dementia found no evidence to support the use of lipid-lowering therapy for these indications. It is appropriate to treat those patients with vascular risk factors that meet criteria for lipid-lowering therapy for the primary and secondary prevention of cardiovascular and cerebrovascular events, and in line with current guidelines. Managing the individual patient in a holistic manner according to his or her own vascular risk profile is recommended. Although the paucity of randomized controlled evidence makes for challenging clinical decision making, it provides multiple opportunities for on-going and future research, as discussed here. © 2017 The Author(s).

  4. Depression in vascular dementia.

    NARCIS (Netherlands)

    Naarding, P.; Koning, I. de; Kooten, F. van; Dippel, D.W.; Janzing, J.G.E.; Mast, R.C. van der; Koudstaal, P.J.

    2003-01-01

    OBJECTIVE: To study the presence of different dimensions of depression in subjects with vascular dementia. BACKGROUND: After a stroke, cognitive, affective and behavioural disturbances are common. It has been suggested that the nature of affective symptomatology can help to differentiate organic

  5. Vascular management in rotationplasty.

    Science.gov (United States)

    Mahoney, Craig R; Hartman, Curtis W; Simon, Pamela J; Baxter, B Timothy; Neff, James R

    2008-05-01

    The Van Nes rotationplasty is a useful limb-preserving procedure for skeletally immature patients with distal femoral or proximal tibial malignancy. The vascular supply to the lower limb either must be maintained and rotated or transected and reanastomosed. We asked whether there would be any difference in the ankle brachial index or complication rate for the two methods of vascular management. Vessels were resected with the tumor in seven patients and preserved and rotated in nine patients. One amputation occurred in the group in which the vessels were preserved. Four patients died secondary to metastatic disease diagnosed preoperatively. The most recent ankle brachial indices were 0.96 and 0.82 for the posterior tibial and dorsalis pedis arteries, respectively, in the reconstructed group. The ankle brachial indices were 0.98 and 0.96 for the posterior tibial and dorsalis pedis arteries, respectively, in the rotated group. Outcomes appear similar using both methods of vascular management and one should not hesitate to perform an en bloc resection when there is a question of vascular involvement.

  6. Mini tunelizador moldável: um avanço técnico no acesso vascular para hemodiálise Mini moldable tunneler: a technical improvement for hemodialysis access

    Directory of Open Access Journals (Sweden)

    Fabio Henrique Rossi

    2011-12-01

    Full Text Available CONTEXTO: A confecção de fístula para hemodiálise pode envolver a criação de túnel para a acomodação do enxerto - veia autóloga ou prótese sintética. O trajeto e a extensão dependem do local escolhido para a realização das anastomoses e posicionamento do trajeto do enxerto. Na atualidade, os tunelizadores utilizados são constituídos de estruturas cilíndricas metálicas rígidas, que tornam necessário o uso de múltiplos tamanhos e conformações. OBJETIVO: Testar a utilização de um único mini tunelizador universal metálico e moldável na cirurgia de confecção de fístula para hemodiálise. MÉTODOS: Trata-se de um estudo piloto. O tunelizador desenvolvido consiste de uma estrutura cilíndrica e modular composta de fio de aço inoxidável moldável interno, com manopla em extremidade proximal e dupla ponta cônica intercambiável em extremidade distal e bainha cilíndrica externa de polietileno. O tunelizador foi utilizado em dez cirurgias de confecção de fístulas para hemodiálise em membros superiores e inferiores, e o sucesso de sua aplicabilidade e a frequência de complicações precoces foram observados. RESULTADOS: Suas características de maleabilidade e conformibilidade permitiram a utilização do mesmo tunelizador nos diversos tipos de fístulas realizadas. A ponta cônica distal com duplo diâmetro, intercambiável, permitiu que o mesmo aparato fosse aplicado na utilização de veia autógena ou prótese sintética. Todas as cirurgias foram seguidas de sucesso e com baixos índices de complicações precoces. CONCLUSÃO: A versatilidade do mini tunelizador metálico maleável e moldável permitiu sua utilização em todas as fístulas realizadas, independentemente do sítio das anastomoses e o trajeto de acomodação escolhido, sem complicações e com excelente índice de perviedade. Os dados sugerem que o mini tunelizador metálico maleável moldável pode ser utilizado com segurança e vantagens nas

  7. Renal posttransplant's vascular complications

    Directory of Open Access Journals (Sweden)

    Bašić Dragoslav

    2003-01-01

    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

  8. Desarrollo de un sistema de adquisición de datos para la medición de la presión arterial de la rata : Su uso para el estudio de lo efectos de los hidrolizados de amaranto sobre el sistema vascular

    OpenAIRE

    Fritz, Mariana

    2009-01-01

    Los principales objetivos a alcanzar fueron los siguientes: a) Estudio de las condiciones óptimas para la toma de presión, sobre todo temperatura e inmovilización del animal. b) Sistemas especiales para controlar la presión en el manguito oclusor de flujo. c) Adaptación del sistema de adquisición para la toma y procesamiento de las señales de presión. d) Toma de presión por métodos directos, utilizando catéteres flexibles, implantados mediante un equipa...

  9. Vascular manifestations of Behcet's disease

    Directory of Open Access Journals (Sweden)

    Regina Georgiyeva Goloeva

    2010-01-01

    Conclusion. Vascular disorders in BD were diagnosed in one fourth of the patients, mainly in young male patients. Severe thromboses with the development of chronic venous insignificance, Budd-Chiari syndrome, pulmonary and iliac artery aneurysms, and arterial thromboses were observed in male patients only. Vascular events were associated with erythema nodosum and epididymitis; in these concomitances, the vascular risk was substantially increased. Vascular death rates were 2,2%.

  10. Flora vascular y vegetación de los humedales de Puerto Viejo

    Directory of Open Access Journals (Sweden)

    María I. La Torre

    2011-07-01

    Full Text Available El presente trabajo corresponde al primer reporte de flora vascular para el Humedal de Puerto Viejo, Cañete, Lima. Para esta localidad fueron registrados entre marzo del 2003 y julio del 2009, un total de 32 especies de plantas vasculares, agrupadas en 28 géneros y 15 familias. Las Magnoliópsida fueron el grupo dominante con 20 de los taxones. Del total de especies registradas el 34% (11 taxones corresponden a especies consideradas introducidas.

  11. Resonancia magnética versus tomografía computada para la detección de lesiones vasculares agudas en pacientes que consultan por síntomas de accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Miriam Brazzelli

    2013-01-01

    Conclusiones de los autores: La RMD parece ser más sensible que la TC para la detección precoz del accidente cerebrovascular isquémico en pacientes sumamente seleccionados. Sin embargo, la variabilidad en la calidad de los estudios incluidos y la presencia de los sesgos de espectro e incorporación tornan dudosa la confiabilidad y la posibilidad de generalizar los resultados observados. Se requieren estudios adicionales bien diseñados, sin sesgos metodológicos, con muestras de pacientes más representativas y estimaciones de la practicidad y los costos, a fin de determinar qué pacientes deben ser sometidos a RM y qué pacientes a TC en el caso de presunto accidente cerebrovascular agudo.

  12. Engineering vascularized skeletal muscle tissue

    NARCIS (Netherlands)

    Levenberg, Shulamit; Rouwkema, Jeroen; Macdonald, Mara; Garfein, Evan S.; Kohane, Daniel S.; Darland, Diane C.; Marini, Robert; van Blitterswijk, Clemens; Mulligan, Richard C.; D'Amore, Patricia A.; Langer, Robert

    2005-01-01

    One of the major obstacles in engineering thick, complex tissues such as muscle is the need to vascularize the tissue in vitro. Vascularization in vitro could maintain cell viability during tissue growth, induce structural organization and promote vascularization upon implantation. Here we describe

  13. The Vascular Depression Hypothesis: Mechanisms Linking Vascular Disease with Depression

    Science.gov (United States)

    Taylor, Warren D.; Aizenstein, Howard J.; Alexopoulos, George S.

    2013-01-01

    The ‘Vascular Depression’ hypothesis posits that cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between late-life depression, vascular risk factors, and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in late-life depression, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression but also provide guidance on the potential repurposing of pharmacological agents that may improve late-life depression outcomes. PMID:23439482

  14. Brain Vascular Imaging Techniques

    Directory of Open Access Journals (Sweden)

    Bàrbara Laviña

    2016-12-01

    Full Text Available Recent major improvements in a number of imaging techniques now allow for the study of the brain in ways that could not be considered previously. Researchers today have well-developed tools to specifically examine the dynamic nature of the blood vessels in the brain during development and adulthood; as well as to observe the vascular responses in disease situations in vivo. This review offers a concise summary and brief historical reference of different imaging techniques and how these tools can be applied to study the brain vasculature and the blood-brain barrier integrity in both healthy and disease states. Moreover, it offers an overview on available transgenic animal models to study vascular biology and a description of useful online brain atlases.

  15. Plant Vascular Biology 2010

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Biao

    2014-11-17

    This grant supported the Second International Conference on Plant Vascular Biology (PVB 2010) held July 24-28, 2010 on the campus of Ohio State University, Columbus, Ohio. Biao Ding (Ohio State University; OSU) and David Hannapel (Iowa State University; ISU) served as co-chairs of this conference. Biao Ding served as the local organizer. PVB is defined broadly here to include studies on the biogenesis, structure and function of transport systems in plants, under conditions of normal plant growth and development as well as of plant interactions with pathogens. The transport systems cover broadly the xylem, phloem, plasmodesmata and vascular cell membranes. The PVB concept has emerged in recent years to emphasize the integrative nature of the transport systems and approaches to investigate them.

  16. Pathophysiology of vascular dementia

    Directory of Open Access Journals (Sweden)

    Rizzo Claudia

    2009-11-01

    Full Text Available Abstract The concept of Vascular Dementia (VaD has been recognized for over a century, but its definition and diagnostic criteria remain unclear. Conventional definitions identify the patients too late, miss subjects with cognitive impairment short of dementia, and emphasize consequences rather than causes, the true bases for treatment and prevention. We should throw out current diagnostic categories and describe cognitive impairment clinically and according to commonly agreed instruments that document the demographic data in a standardized manner and undertake a systematic effort to identify the underlying aetiology in each case. Increased effort should be targeted towards the concept of and criteria for Vascular Cognitive Impairment and Post-Stroke Dementia as well as for genetic factors involved, especially as these categories hold promise for early prevention and treatment.

  17. Vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    N.V. Vakhnina

    2014-01-01

    Full Text Available Vascular pathology of the brain is the second most common cause of cognitive impairment after Alzheimer's disease. The article describes the modern concepts of etiology, pathogenetic mechanisms, clinical features and approaches to diagnosis and therapy of vascular cognitive impairment (VCI. Cerebrovascular accident, chronic cerebral circulatory insufficiency and their combination, sometimes in combination with a concomitant neurodegenerative process, are shown to be the major types of brain lesions leading to VCI. The clinical presentation of VCI is characterized by the neuropsychological status dominated by impairment of the executive frontal functions (planning, control, attention in combination with focal neurological symptoms. The diagnosis is based on comparing of the revealed neuropsychological and neurological features with neuroimaging data. Neurometabolic, acetylcholinergic, glutamatergic, and other vasoactive drugs and non-pharmacological methods are widely used to treat VCI. 

  18. Pathophysiology of vascular dementia

    OpenAIRE

    Rizzo Claudia; Duro Giovanni; Iemolo Francesco; Castiglia Laura; Hachinski Vladimir; Caruso Calogero

    2009-01-01

    Abstract The concept of Vascular Dementia (VaD) has been recognized for over a century, but its definition and diagnostic criteria remain unclear. Conventional definitions identify the patients too late, miss subjects with cognitive impairment short of dementia, and emphasize consequences rather than causes, the true bases for treatment and prevention. We should throw out current diagnostic categories and describe cognitive impairment clinically and according to commonly agreed instruments th...

  19. Pulmonary vascular imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fedullo, P.F.; Shure, D.

    1987-03-01

    A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any ideal technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the gold standard for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation-perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques.

  20. Update on Vascular Dementia.

    Science.gov (United States)

    Khan, Ayesha; Kalaria, Raj N; Corbett, Anne; Ballard, Clive

    2016-09-01

    Vascular dementia (VaD) is a major contributor to the dementia syndrome and is described as having problems with reasoning, planning, judgment, and memory caused by impaired blood flow to the brain and damage to the blood vessels resulting from events such as stroke. There are a variety of etiologies that contribute to the development of vascular cognitive impairment and VaD, and these are often associated with other dementia-related pathologies such as Alzheimer disease. The diagnosis of VaD is difficult due to the number and types of lesions and their locations in the brain. Factors that increase the risk of vascular diseases such as stroke, high blood pressure, high cholesterol, and smoking also raise the risk of VaD. Therefore, controlling these risk factors can help lower the chances of developing VaD. This update describes the subtypes of VaD, with details of their complex presentation, associated pathological lesions, and issues with diagnosis, prevention, and treatment. © The Author(s) 2016.

  1. Elaboração de um manual ilustrado de exercícios domiciliares para pacientes com hemiparesia secundária ao acidente vascular encefálico (AVE Elaboration of an illustrated home exercise manual for stroke patients with hemiparesis

    Directory of Open Access Journals (Sweden)

    Adriana Maria Barsante Santos

    2012-03-01

    Full Text Available A realização de exercícios físicos para pacientes com sequelas motoras pós-acidente vascular encefálico (AVE é essencial para a recuperação funcional. Programas educacionais podem facilitar a repetição dos exercícios em casa e contribuir para o tratamento. Este trabalho teve como objetivo elaborar e aplicar um manual de exercícios domiciliares para pacientes com AVE. O estudo consistiu em duas etapas: na primeira foi elaborado um manual de exercícios domiciliares (piloto com fotos e textos simples para facilitar a compreensão. Foi realizada uma avaliação funcional de cada paciente e selecionados os exercícios mais adequados, que deveriam ser feitos em casa. Esse manual foi aplicado a 17 pacientes, 70% crônicos e 30% agudos. Após 15 dias, o paciente retornava e era solicitado que reproduzisse os exercícios e informasse o nível de compreensão das fotos e do texto do manual e se sentia dor ao realizá-los. As fotos e os exercícios referidos como difíceis foram revistos, e criada a versão teste que foi aplicada em outros 23 pacientes, dando origem à versão final do manual. A avaliação do manual piloto foi insatisfatória, sendo que apenas 56% referiram aprovação das fotos e 87% do texto. Após a reformulação, a compreensão das fotos e do texto alcançou valores acima de 98%. Foi possível obter um manual ilustrado de exercícios domiciliares, de fácil aplicação e compreensão, específico e individualizado, para pacientes com AVE e adaptável aos diferentes quadros motores.The practice of exercises for patients with motor sequels post-stroke is essential for the functional recovery. Educational programs can facilitate the repetition of the exercises at home and contribute to the treatment. The objective of this study was to elaborate a home exercise manual for stroke patients. The study consisted of two stages: in the first one, a home exercise manual was made (pilot with pictures and simple text to facilitate

  2. [How Treatable is Vascular Dementia?].

    Science.gov (United States)

    Mori, Etsuro

    2016-04-01

    Vascular dementia is an umbrella term, encompassing the pathological changes in the brain due to cerebrovascular disease that result in dementia. Vascular dementia is the second most common form of dementia, after Alzheimer's disease. In this paper, I outline the concept of vascular dementia, the key aspects of the disease that are yet to be clarified, and the current status of clinical trials. Assessing these factors, I discuss how treatable vascular dementia presently is. Use of the term'vascular dementia'is riddled with uncertainties regarding disease classification, and non-standardized diagnostic criteria. There are difficulties in determining the exact relationship between cerebrovascular pathology and cognitive impairment. The comorbid effects of Alzheimer's pathology in some individuals also present an obstacle to reliable clinical diagnosis, and hinder research into effective management approaches. Vascular dementia is preventable and treatable, as there are established primary and secondary prevention measures for the causative cerebrovascular diseases, such as vascular risk factor intervention, antiplatelet therapy, and anticoagulation, amongst others. However, unlike Alzheimer's disease, there are no established symptomatic treatments for vascular dementia. Clinical trials of cholinesterase inhibitors and memantine indicate that they produce small cognitive benefits in patients with vascular dementia, though the exact clinical significance of these is uncertain. Data are insufficient to support the widespread use of these drugs in vascular dementia. Rehabilitation and physical and cognitive exercise may be beneficial, but evidence of cognitive benefit and relief of neuropsychiatric symptoms due to exercise is lacking.

  3. Fatores de risco para acidente vascular encefálico após cirurgia de revascularização do miocárdio Risk factors for stroke after coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Dinaldo Cavalcanti de Oliveira

    2008-10-01

    Full Text Available FUNDAMENTO: O acidente vascular encefálico (AVE é uma temida complicação após cirurgia de revascularização do miocárdio (CRM, com incidência entre 1,3% e 4,3%. OBJETIVO: Identificar fatores preditores de AVE após CRM, na era moderna da cirurgia cardíaca. MÉTODOS: Este é um estudo caso-controle de 65 pares de pacientes, no qual o pareamento foi realizado por sexo, idade (+ 3 anos e data da CRM (+ 3 meses. Os casos são pacientes submetidos à CRM eletiva com circulação extracorpórea (CEC, que apresentaram AVE (definido como déficit clínico neurológico até 24 horas de pós-operatório e confirmado por exame de imagem, e os controles aqueles submetidos à CRM eletiva com CEC sem AVE. RESULTADOS: A análise univariada revelou que o número de vasos revascularizados foi associado com a ocorrência de AVE após a CRM (3 ± 0,8 vs. 2,76 ± 0,8, p = 0,01. Na análise multivariada por regressão logística condicional, a hipertensão arterial sistêmica [OR: 6,1 (1,5 - 24, p = 0,009] e o diabete melito [OR: 3,1 (1,09 - 11, p= 0,03] foram determinantes de maior chance de AVE após CRM, e o infarto agudo do miocárdio > 1 mês determinante de menor chance [OR: 0,1 (0,03 - 0,36, p = 0,003]. CONCLUSÃO: Hipertensão e diabete melito foram identificados como preditores independentes de AVE nas primeiras 24 horas de pós-operatório de CRM. Em pacientes com tais fatores de risco, é possível que o conhecimento dos mecanismos causadores da injúria cerebral represente uma estratégia capaz de diminuir a incidência de AVE após CRM.BACKGROUND: Stroke is a feared complication after coronary artery bypass grafting surgery (CABG, with an incidence between 1.3 and 4.3%. OBJECTIVE: To identify predictive factors for stroke after CABG in the modern era of cardiac surgery. METHODS: This is a case-control study of 65 pairs of patients, paired by sex, age (+ 3 years and date of CABG (+ 3 months. The cases were patients submitted to elective CABG

  4. [Estrogens and vascular thrombosis].

    Science.gov (United States)

    Colmou, A

    1982-09-01

    The incidence of thromboses among young women has increased with widespread use of oral contraceptives (OCs) due to the significant thromboembolic risk of estrogen. Estrogens intervene at the vascular, platelet, and plasma levels as a function of hormonal variations in the menstrual cycle, increasing the aggregability of the platelets and thrombocytes, accelerating the formation of clots, and decreasing the amount of antithrombin III. Estrogens are used in medicine to treat breast and prostate cancers and in gynecology to treat dysmenorrhea, during the menopause, and in contraception. Smoking, cardiovascular disease and hypertension, hypercholesterolemia, and diabetes are contraindicators to estrogen use. Thrombosis refers to blockage of a blood vessel by a clot or thrombus. Before estrogens are prescribed, a history of phlebitis, obesity, hyperlipidemia, or significant varicosities should be ruled out. A history of venous thrombosis, hyperlipoproteinemia, breast nodules, serious liver condition, allergies to progesterone, and some ocular diseases of vascular origin definitively rule out treatment with estrogens. A family history of infarct, embolism, diabetes, cancer, or vascular accidents at a young age signals a need for greater patient surveillance. All patients receiving estrogens should be carefully observed for signs of hypertension, hypercholesterolemia, hypercoagulability, or diabetes. Nurses have a role to play in carefully eliciting the patient's history of smoking, personal and family medical problems, and previous and current laboratory results, as well as in informing the patients of the risks and possible side effects of OCs, especially for those who smoke. Nurses should educate patients receiving estrogens, especially those with histories of circulatory problems, to avoid standing in 1 position for prolonged periods, avoid heat which is a vasodilator, avoid obesity, excercise regularly, wear appropriate footgear, and follow other good health

  5. The pathobiology of vascular dementia.

    Science.gov (United States)

    Iadecola, Costantino

    2013-11-20

    Vascular cognitive impairment defines alterations in cognition, ranging from subtle deficits to full-blown dementia, attributable to cerebrovascular causes. Often coexisting with Alzheimer's disease, mixed vascular and neurodegenerative dementia has emerged as the leading cause of age-related cognitive impairment. Central to the disease mechanism is the crucial role that cerebral blood vessels play in brain health, not only for the delivery of oxygen and nutrients, but also for the trophic signaling that inextricably links the well-being of neurons and glia to that of cerebrovascular cells. This review will examine how vascular damage disrupts these vital homeostatic interactions, focusing on the hemispheric white matter, a region at heightened risk for vascular damage, and on the interplay between vascular factors and Alzheimer's disease. Finally, preventative and therapeutic prospects will be examined, highlighting the importance of midlife vascular risk factor control in the prevention of late-life dementia. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Anaesthesia for vascular emergencies.

    Science.gov (United States)

    Ellard, L; Djaiani, G

    2013-01-01

    Patients presenting with vascular emergencies including acute aortic syndrome, ruptured thoracic or abdominal aortic aneurysms, thoracic aortic trauma and acute lower limb ischaemia have a high risk of peri-operative morbidity and mortality. Although anatomical suitability is not universal, endovascular surgery may improve mortality and the results of ongoing randomised controlled trials are awaited. Permissive hypotension pre-operatively should be the standard of care with the systolic blood pressure kept to 50-100 mmHg as long as consciousness is maintained. The benefit of local anaesthesia over general anaesthesia is not definitive and this decision should be tailored for a given patient and circumstance. Cerebrospinal fluid drainage for prevention of paraplegia is often impractical in the emergency setting and is not backed by strong evidence; however, it should be considered postoperatively if symptoms develop. We discuss the pertinent anaesthetic issues when a patient presents with a vascular emergency and the impact that endovascular repair has on anaesthetic management. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

  7. Pediatric vascularized composite allotransplantation.

    Science.gov (United States)

    Doumit, Gaby; Gharb, Bahar Bassiri; Rampazzo, Antonio; Papay, Francis; Siemionow, Maria Z; Zins, James E

    2014-10-01

    Vascularized composite allotransplantation (VCA) has experienced a growing acceptance, which has led to a debate centered on extending the indications of the procedure to include pediatric patients. The aim of this article was to discuss such indications based on the evidence in pediatric solid organ transplantation, reconstructive surgery in children, and VCA in adult patients. Papers published on the outcomes of pediatric solid organ transplantation, growth after replantation of extremities, vascularized autologous tissue transfer, craniofacial surgery, orthognathic procedures, facial fractures, and outcomes after repair of peripheral nerves in children were reviewed. Although the outcomes of solid organ transplantation in children have improved, the transplanted organs continue to have a limited lifespan. Long-term immunosuppressive therapy exposes the patients to an increased lifetime risk of infections, diabetes, hypertension, dyslipidemia, cardiovascular disease, and malignancy. Growth impairment and learning disabilities are other relevant drawbacks, which affect the pediatric recipients. Nonadherence to medication is a common cause of graft dysfunction and loss among the adolescent transplant recipients. Rejection episodes, hospitalizations, and medication adverse effects contribute negatively to the quality of life of the patients. Although normal growth after limb transplantation could be expected, pediatric facial transplant recipients may present with arrest of growth of transplanted midfacial skeleton. Considering the non-life-threatening nature of the conditions that lead to eligibility for VCA, it is suggested that it is premature to extend the indications of VCA to include pediatric patients under the currently available immunosuppressive protocols.

  8. Spinal Cord Vascular Disease

    Directory of Open Access Journals (Sweden)

    Abdoreza Ghoreishi

    2017-02-01

    Full Text Available The spinal cord is subject to many of the same vascular diseases that involve the brain, but its anatomy and embryology render it susceptible to some syndromes that do not have intracranial counterparts.The embryonic arterial supply to the spinal cord derives from intradural vessels that enter at each spinal level and divide to follow the dorsal and ventral roots. SPINAL CORD ISCHEMIA: The midthoracic levels of the spinal cord are traditionally considered to be the most vulnerable to compromise from hypoperfusion, but more recent evidence suggests that the lower thoracic cord is at greater risk . The actual prevalence of spinal cord infarction is unknown, but is generally cited as representing 1% to 2% of all central neurovascular events and 5% to 8% of all acute myelopathies. Weakness (100%, sensory loss (89%, back pain at onset (82%, and urinary complaints requiring catheterization (75% were the most common symptoms of cord ischemia at the time of presentation . Weakness most commonly affects both legs. Examination typically reveals flaccid paresis accompanied by diminished superficial and tendon reflexes below the level of the lesion. Preservation of strength and reflexes suggests the rare syndrome of posterior spinal artery territory infarction. Weakness most commonly affects both legs. Examination typically reveals flaccid paresis accompanied by diminished superficial and tendon reflexes below the level of the lesion. Preservation of strength and reflexes suggests the rare syndrome of posterior spinal artery territory infarction.   Aortic pathologies with regional hemodynamic compromise are the most common cause of spinal cord infarction, accounting for 30% to 40% of cases.                                                                                 The medical management of spinal cord ischemia is generally supportive and focused on reducing risk for

  9. Temporary vascular shunting in vascular trauma: A 10-year review ...

    African Journals Online (AJOL)

    Five patients with non-viable limbs had the vessel ligated. Conclusions. A TIVS in the damage control setting is both life- and limb-saving. These shunts can be inserted safely in a facility without access to a surgeon with vascular surgery experience if there is uncontrollable bleeding or the delay to definitive vascular surgery ...

  10. Temporary vascular shunting in vascular trauma: A 10-year review ...

    African Journals Online (AJOL)

    part of a damage control procedure, 7 patients were referred from a hospital without access to vascular surgical facilities with the TIVS in situ, and in the remaining 6 patients the TIVS was inserted during repair of a lower limb fracture with an associated vascular injury. Damage control procedure. Twenty-two patients had a ...

  11. Additive Manufacturing of Vascular Grafts and Vascularized Tissue Constructs.

    Science.gov (United States)

    Elomaa, Laura; Yang, Yunzhi Peter

    2017-10-01

    There is a great need for engineered vascular grafts among patients with cardiovascular diseases who are in need of bypass therapy and lack autologous healthy blood vessels. In addition, because of the severe worldwide shortage of organ donors, there is an increasing need for engineered vascularized tissue constructs as an alternative to organ transplants. Additive manufacturing (AM) offers great advantages and flexibility of fabrication of cell-laden, multimaterial, and anatomically shaped vascular grafts and vascularized tissue constructs. Various inkjet-, extrusion-, and photocrosslinking-based AM techniques have been applied to the fabrication of both self-standing vascular grafts and porous, vascularized tissue constructs. This review discusses the state-of-the-art research on the use of AM for vascular applications and the key criteria for biomaterials in the AM of both acellular and cellular constructs. We envision that new smart printing materials that can adapt to their environment and encourage rapid endothelialization and remodeling will be the key factor in the future for the successful AM of personalized and dynamic vascular tissue applications.

  12. Nutrition and vascular dementia.

    Science.gov (United States)

    Perez, L; Heim, L; Sherzai, A; Jaceldo-Siegl, K; Sherzai, A

    2012-04-01

    The objective of this review was to elucidate the relationship between VaD and various nutritional factors based on epidemiological studies. Vascular dementia (VaD) is the second most common type of dementia. The prevalence of VaD continues to increase as the US population continues to grow and age. Currently, control of potential risk factors is believed to be the most effective means of preventing VaD. Thus, identification of modifiable risk factors for VaD is crucial for development of effective treatment modalities. Nutrition is one of the main modifiable variables that may influence the development of VaD. A systematic review of literature was conducted using the PubMed, Web of Science, and CINAHL Plus databases with search parameters inclusive of vascular dementia, nutrition, and vascular cognitive impairment (VCI). Fourteen articles were found that proposed a potential role of specific nutritional components in VaD. These components included antioxidants, lipids, homocysteine, folate, vitamin B12, and fish consumption. Antioxidants, specifically Vitamin E and C, and fatty fish intake were found to be protective against VaD risk. Fried fish, elevated homocysteine, and lower levels of folate and vitamin B12 were associated with increased VaD. Evidence for dietary lipids was inconsistent, although elevated midlife serum cholesterol may increase risk, while late-life elevated serum cholesterol may be associated with decreased risk of VaD. Currently, the most convincing evidence as to the relationship between VaD and nutrition exists for micronutrients, particularly Vitamin E and C. Exploration of nutrition at the macronutrient level and additional long term prospective cohort studies are warranted to better understand the role of nutrition in VaD disease development and progression. At present, challenges in this research include limitations in sample size, which was commonly cited. Also, a variety of diagnostic criteria for VaD were employed in the studies

  13. The Danish Vascular Registry, Karbase

    Directory of Open Access Journals (Sweden)

    Eldrup N

    2016-10-01

    Full Text Available Nikolaj Eldrup,1,2 Charlotte Cerqueira,3 Louise de la Motte,2,4 Lisbet Knudsen Rathenborg,2,4 Allan K Hansen2,5 1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, 2Karbase, The Danish Vascular Registry, Aarhus, 3Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, 4Department of Vascular Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, 5Department of Vascular Surgery, Aalborg University Hospital, Aalborg, Denmark Aim: The Danish Vascular Registry (DVR, Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry for quality assessment and research. Study population: All patients undergoing vascular interventions (surgical and endovascular at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ~9,000 procedures are added. By January 2016, .180,000 procedures have been recorded. Since 2001, data completeness has been .90% (compared to the Danish National Patient Register. Main variables: Variables include information on descriptive patient data (ie, age, sex, height, and weight and comorbidity (ie, previous cardiovascular disease and diabetes. Process variable includes waiting time (time from event to medical contact and treatment and the type of procedures conducted. Outcome variables for in-hospital complications (ie, wound complications, myocardial infarction, stroke, amputation, respiratory complications, and renal insufficiency and 30-day patency are submitted. Variables for medical treatment (antithrombotic and statin treatment, amputation, and survival are extracted from nationwide, administrative registers. Conclusion: The DVR reports outcome on key indicators for

  14. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas Viviendo el accidente cerebrovascular agudo: significado de la enfermedad para personas hospitalizadas Experiencing acute stroke: the meaning of the illness for hospitalized patients

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    2013-04-01

    Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.Se objetivó comprender el significado de la experiencia de la persona que padeció accidente cerebrovascular agudo. Estudio cualitativo, fundamentado en los presupuestos teóricos del interaccionismo simbólico, realizado en unidad especializada en tratamiento de accidente cerebrovascular de un hospital terciario en Fortaleza-CE. Participaron diez pacientes. Datos recolectados mediante entrevista abierta, organizados y analizados según técnica de enunciación. Se cumplió con todos los aspectos éticos. El significado de la experiencia del padecimiento fue construido en base a la percepción de los sentimientos surgidos durante la internación, caracterizados por el miedo a la muerte y a las secuelas de la enfermedad; tristeza por alejarse del hogar; alivio al evidenciarse mejoras del cuadro clínico; e intención de cambio de hábitos de vida

  15. Diagnostic criteria for vascular dementia

    NARCIS (Netherlands)

    Scheltens, P.; Hijdra, A. H.

    1998-01-01

    The term vascular dementia implies the presence of a clinical syndrome (dementia) caused by, or at least assumed to be caused by, a specific disorder (cerebrovascular disease). In this review, the various sets of criteria used to define vascular dementia are outlined. The various sets of criteria

  16. Dynamic adaption of vascular morphology

    DEFF Research Database (Denmark)

    Okkels, Fridolin; Jacobsen, Jens Christian Brings

    2012-01-01

    The structure of vascular networks adapts continuously to meet changes in demand of the surrounding tissue. Most of the known vascular adaptation mechanisms are based on local reactions to local stimuli such as pressure and flow, which in turn reflects influence from the surrounding tissue. Here ...

  17. Caffeine's Vascular Mechanisms of Action

    Directory of Open Access Journals (Sweden)

    Darío Echeverri

    2010-01-01

    Full Text Available Caffeine is the most widely consumed stimulating substance in the world. It is found in coffee, tea, soft drinks, chocolate, and many medications. Caffeine is a xanthine with various effects and mechanisms of action in vascular tissue. In endothelial cells, it increases intracellular calcium stimulating the production of nitric oxide through the expression of the endothelial nitric oxide synthase enzyme. Nitric oxide is diffused to the vascular smooth muscle cell to produce vasodilation. In vascular smooth muscle cells its effect is predominantly a competitive inhibition of phosphodiesterase, producing an accumulation of cAMP and vasodilation. In addition, it blocks the adenosine receptors present in the vascular tissue to produce vasoconstriction. In this paper the main mechanisms of action of caffeine on the vascular tissue are described, in which it is shown that caffeine has some cardiovascular properties and effects which could be considered beneficial.

  18. The Danish Vascular Registry, Karbase

    DEFF Research Database (Denmark)

    Eldrup, Nikolaj; Cerqueira, Charlotte; de la Motte, Louise

    2016-01-01

    AIM: The Danish Vascular Registry (DVR), Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry...... for quality assessment and research. STUDY POPULATION: All patients undergoing vascular interventions (surgical and endovascular) at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ∼9,000 procedures are added. By January 2016, >180,000 procedures...... have been recorded. Since 2001, data completeness has been >90% (compared to the Danish National Patient Register). MAIN VARIABLES: Variables include information on descriptive patient data (ie, age, sex, height, and weight) and comorbidity (ie, previous cardiovascular disease and diabetes). Process...

  19. Social media in vascular surgery.

    Science.gov (United States)

    Indes, Jeffrey E; Gates, Lindsay; Mitchell, Erica L; Muhs, Bart E

    2013-04-01

    There has been a tremendous growth in the use of social media to expand the visibility of various specialties in medicine. The purpose of this paper is to describe the latest updates on some current applications of social media in the practice of vascular surgery as well as existing limitations of use. This investigation demonstrates that the use of social networking sites appears to have a positive impact on vascular practice, as is evident through the incorporation of this technology at the Cleveland Clinic and by the Society for Vascular Surgery into their approach to patient care and physician communication. Overall, integration of social networking technology has current and future potential to be used to promote goals, patient awareness, recruitment for clinical trials, and professionalism within the specialty of vascular surgery. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  20. Noninfarct vascular dementia and Alzheimer dementia spectrum.

    Science.gov (United States)

    Emery, V Olga; Gillie, Edward X; Smith, Joseph A

    2005-03-15

    Vascular dementia is an overarching superordinate category of which multiinfarct vascular dementia is only one subtype. To contribute to the definition of vascular dementia, method involved investigation of mental status, oral language and comprehension in 81 consecutive vascular patients comprising two vascular samples: cerebral infarct sample (n=43) and cerebral noninfarct sample (n=38). To determine baseline, method also involved investigation of 36 demographically equivalent normal elderly. Results indicate both vascular samples performed significantly worse than normal elderly. Results further indicate there were no robust, reliable, significant differences between cerebral infarct and cerebral noninfarct patients. The lack of significant differences between cerebral infarct and cerebral noninfarct vascular samples brings into focus the ambiguous transition between diffuse, generalized disease and the multifocality underlying the vascular dementia-Alzheimer dementia spectrum. Cross-cutting infarct and noninfarct vascular populations were vascular factors of arteriosclerosis, abnormal blood pressure, diabetes mellitus, abnormal electrocardiogram, peripheral vascular disease, and other variables implicated in the distal causality of both infarct and noninfarct vascular dementias. Results indicate cerebral infarction is not the only path to the final common phenotype of vascular dementia. Vascular dementia is reconceptualized so as to include noninfarct vascular dementia: vascular dementia caused by underlying vascular factors other than cerebral infarction. It is suggested that one form of the subtype of noninfarct vascular dementia is Alzheimer-type vascular dementia.

  1. Contemporary vascular smartphone medical applications.

    Science.gov (United States)

    Carter, Thomas; O'Neill, Stephen; Johns, Neil; Brady, Richard R W

    2013-08-01

    Use of smartphones and medical mHealth applications (apps) within the clinical environment provides a potential means for delivering elements of vascular care. This article reviews the contemporary availability of apps specifically themed to major vascular diseases and the opportunities and concerns regarding their integration into practice. Smartphone apps relating to major vascular diseases were identified from the app stores for the 6 most popular smartphone platforms, including iPhone, Android, Blackberry, Nokia, Windows, and Samsung. Search terms included peripheral artery (arterial) disease, varicose veins, aortic aneurysm, carotid artery disease, amputation, ulcers, hyperhydrosis, thoracic outlet syndrome, vascular malformation, and lymphatic disorders. Forty-nine vascular-themed apps were identified. Sixteen (33%) were free of charge. Fifteen apps (31%) had customer satisfaction ratings, but only 3 (6%) had greater than 100. Only 13 apps (27%) had documented medical professional involvement in their design or content. The integration of apps into the delivery of care has the potential to benefit vascular health care workers and patients. However, high-quality apps designed by clinicians with vascular expertise are currently lacking and represent an area of concern in the mHealth market. Improvement in the quality and reliability of these apps will require the development of robust regulation. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Depression in vascular dementia.

    Science.gov (United States)

    Naarding, Paul; de Koning, Inge; dan Kooten, Fop; Dippel, Diederik W J; Janzing, Joost G E; van der Mast, Rose C; Koudstaal, Peter J

    2003-04-01

    To study the presence of different dimensions of depression in subjects with vascular dementia. After a stroke, cognitive, affective and behavioural disturbances are common. It has been suggested that the nature of affective symptomatology can help to differentiate organic from psychological depression. Cognitive and affective symptoms were assessed in 78 stroke patients and a principal component analysis was performed on these symptoms. Also, a discriminant analysis was carried out to establish the contribution of different symptoms on the diagnosis 'depressive disorder' and 'dementia'. (1) Principal component analysis revealed three distinct sub-syndromes: one with predominantly mood symptoms, one with essentially psychomotor symptoms, and one with vegetative symptoms; (2) mood, psychomotor and vegetative symptoms were all independently and strongly related to a diagnosis of major depressive disorder according to DSM-III-R criteria; (3) the psychomotor factor was also firmly associated with dementia; and (4) discriminant analysis gave further support for our conclusion that some of the depressive features, in particular the psychomotor factor, are at least partly related to the organic brain damage from stroke. The results indicate that different dimensions of depression could be discerned in a group of stroke patients and that the symptom profile of depression in these patients can be affected by the presence of dementia. Copyright 2003 John Wiley & Sons, Ltd.

  3. Epigenetic Diabetic Vascular Complications

    Directory of Open Access Journals (Sweden)

    Ali Ahmadzadeh-Amiri

    2016-01-01

    Full Text Available Diabetic vascular complications (DVC influence several vital organ systems including cardiovascular, renal, ocular and nervous systems making it a major public health problem. Although extensive researches were performed in this field, the exact mechanisms responsible for these organ damages in diabetes remain obscure. Several metabolic disturbances have been involved in its complication and change in genes associated with these pathways occurred. Gene expression to produce a biologically active protein can be controlled by transcriptional and translational alteration on the head of genes without change in nucleotide composition. These epigenetic adjustments are steady, but possibly reversible and can be transmitted to future generation. Gene expression can be regulated by three epigenetic mechanisms including DNA methylation, histone modifications and noncoding microRNAs (miRNAs activity. Epigenetic studies must be directed to better realize the role of epigenetic changes to the etiology of DVC and knowledge of epigenetic would play a pivotal role in the application of individualized medicine. Application and development of high technology sequencing combined with more sensitive and advanced methodologies for epigenome studying help to determine specific epigenetic events that stimulate gene responses in patients with diabetes mellitus.

  4. [Extremity vascular traumas].

    Science.gov (United States)

    Angelini, Romeo; Rutolo, Ferdinando; Cozzolino, Giuseppe; D'Amario, Vanessa; Spigonardo, Francesca

    2005-01-01

    The Authors report on a series of 61 vascular traumas treated over a 7 years, separated in two groups. The first one includes 35 cases, that are street accidents, on the work and gunshot wounds. The second group includes 26 iatrogenic causes due to arterial catheterism. All patients underwent ecocolor Doppler directly in the operating theatre and, when this diagnostic procedure was not enough, pre-operating angiography was used (10 cases of complex traumas of the lower limb). One death was reported far each groups (3.27%). In 55 cases (90.1%), limb savage was achieved. In the others 4 (6.93%) of the first group, limb demolition was necessary for different causes. In the first group, severe neurological sequelaes were observed in 2 cases and motor deficits caused by tendon lesions in 1 case. The good results obtained are the result of the short ischemic interval between the acute event and treatment, thanks to a multidisciplinary approach of a specific equipe, that is rapid as possible.

  5. Propriedades psicométricas da versão brasileira da escala de qualidade de vida específica para acidente vascular encefálico: aplicação do modelo Rasch Psychometric properties of the Brazilian version of the Stroke Specific Quality of Life Scale: application of the Rasch model

    Directory of Open Access Journals (Sweden)

    RCM Lima

    2008-04-01

    Full Text Available CONTEXTUALIZAÇÃO: O acidente vascular encefálico (AVE produz déficits importantes na qualidade de vida (QV dos indivíduos. Medidas específicas de QV são necessárias para compreender e quantificar o impacto dessa patologia. OBJETIVO: O objetivo desse estudo foi adaptar transculturalmente o Stroke Specific Quality of Life Scale (SSQOL para o Português (Brasil e avaliar suas propriedades psicométricas. MATERIAIS E MÉTODOS: O SSQOL foi traduzido e adaptado seguindo instruções padronizadas e submetido a exame de confiabilidade teste-reteste (10 hemiplégicos. As propriedades psicométricas foram investigadas pela análise Rasch em 50 hemiplégicos. RESULTADOS: Foram detectados coeficientes de confiabilidade de 0,92 para itens e indivíduos. O índice de separação dos hemiplégicos foi 3,34 e dos itens, 3,36, ou seja, os itens separaram as pessoas em pelo menos três níveis de QV e em três níveis de QV - baixa, média e alta. Dos 49 itens, quatro não se enquadram no modelo, o que compromete a validade de constructo do instrumento, embora o padrão errático dos itens se justifique na amostra examinada. CONCLUSÕES: O instrumento mostrou-se clinicamente útil na população avaliada. Novos estudos em populações com outras características já estão em andamento.BACKGROUND: Stroke results in important deficits, which reduce individuals’ quality of life (QOL. Specific QOL measurements are necessary to understand and quantify the impact of this pathological condition. OBJECTIVE: The aim of this study was to make a transcultural adaptation of the Stroke Specific Quality of Life Scale (SSQOL into Brazilian Portuguese and to assess its psychometric properties. METHODS: The SSQOL was translated and adapted in accordance with standardized procedures and was subjected to test-retest reliability analysis with 10 hemiplegic subjects. The psychometric properties were investigated using Rasch analysis on 50 hemiplegics. RESULTS: Reliability

  6. Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

    Directory of Open Access Journals (Sweden)

    Marcello Barbosa Barros

    Full Text Available CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

  7. Trauma vascular, visión del cirujano vascular

    Directory of Open Access Journals (Sweden)

    Dr. D. Cristián Salas

    2011-09-01

    Full Text Available El 3% de todas las lesiones en trauma tiene un componente vascular. Con los conflictos armados del siglo pasado se lograron grandes avances en este campo. A partir de la Guerra de Vietnam gracias a las mejoras en el manejo prehospitalario, traslado de pacientes, y avances en técnica quirúrgica se lograron tasas de sobrevida y de amputaciones que se han mantenido estables hasta la fecha. El diagnóstico de lesiones vasculares en extremidades se realiza con el examen físico, sin embargo las lesiones de vasos torácicos y abdominales requieren de imágenes de apoyo, siempre que el paciente se encuentre estabilizado, generalmente tomografía axial computada. La mayoría de las lesiones vasculares son por trauma penetrante, comprometiendo principalmente las extremidades. Con el desarrollo de los procedimientos invasivos vasculares en los últimos años se ha observado un aumento de lesiones vasculares iatrogénicas. Hoy en día muchos pacientes con trauma vascular son manejados por vía endovascular.

  8. Role of preoperative vascular ultrasonography in hemodialysis vascular access operation.

    Science.gov (United States)

    Siribumrungwong, Boonying; Tomtitchong, Prakitpunthu; Kanpirom, Kitti

    2010-12-01

    Preoperative vascular mapping increase rate of successful hemodialysis vascular access operation. Several studies recommend using this procedure routinely. But some studies recommend using this procedure in selected patients. So this study aims to determine the impacts of preoperative vascular mapping in unfavorable-examined patients. 55 patients were studied retrospectively from August 2006 to October 2009. Before April 2008, the operative plans were based on physical examination (group 1). After April 2008, the surgeon did preoperative vascular mapping prior to the operation in unfavorable-examined patients (group 2). The results were compared. There were high maturation rates in favorable-examined patients. In unfavorable-examined patients, preoperative vascular mapping can identified nonpalpable favorable vein which successful maturation of 18.75%. Complementary duplex scan decrease rate of unsuccessful operation significantly (p = 0.037) but does not increase maturation rate. Careful physical examination is important part before operation. Preoperative vascular mapping has benefit only in patients with unfavorable-examined patients. It finds some nonpalpable favorable vein and decrease unsuccessful exploration.

  9. Diabetes and Retinal Vascular Dysfunction

    Directory of Open Access Journals (Sweden)

    Eui Seok Shin

    2014-01-01

    Full Text Available Diabetes predominantly affects the microvascular circulation of the retina resulting in a range of structural changes unique to this tissue. These changes ultimately lead to altered permeability, hyperproliferation of endothelial cells and edema, and abnormal vascularization of the retina with resulting loss of vision. Enhanced production of inflammatory mediators and oxidative stress are primary insults with significant contribution to the pathogenesis of diabetic retinopathy (DR. We have determined the identity of the retinal vascular cells affected by hyperglycemia, and have delineated the cell autonomous impact of high glucose on function of these cells. We discuss some of the high glucose specific changes in retinal vascular cells and their contribution to retinal vascular dysfunction. This knowledge provides novel insight into the molecular and cellular defects contributing to the development and progression of diabetic retinopathy, and will aid in the development of innovative, as well as target specific therapeutic approaches for prevention and treatment of DR.

  10. ( Elaeis guineensis Jacq ) vascular wilt

    African Journals Online (AJOL)

    Effet de la jachére sur l'expérimentation de la fusariose vasculaire du palmier à huile ( Elaeis guineensis Jacq ) : Effects of the fallow in the expression of oil-palm ( Elaeis guineensis Jacq ) vascular wilt.

  11. Heritability of Retinal Vascular Fractals

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Broe, Rebecca; Kessel, Line

    2017-01-01

    Purpose: To determine the genetic contribution to the pattern of retinal vascular branching expressed by its fractal dimension. Methods: This was a cross-sectional study of 50 monozygotic and 49 dizygotic, same-sex twin pairs aged 20 to 46 years. In 50°, disc-centered fundus photographs, the reti...... vasculature may affect the retinal response to potential vascular disease in later life....

  12. The Danish Vascular Registry, Karbase

    Science.gov (United States)

    Eldrup, Nikolaj; Cerqueira, Charlotte; de la Motte, Louise; Rathenborg, Lisbet Knudsen; Hansen, Allan K

    2016-01-01

    Aim The Danish Vascular Registry (DVR), Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry for quality assessment and research. Study population All patients undergoing vascular interventions (surgical and endovascular) at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ∼9,000 procedures are added. By January 2016, >180,000 procedures have been recorded. Since 2001, data completeness has been >90% (compared to the Danish National Patient Register). Main variables Variables include information on descriptive patient data (ie, age, sex, height, and weight) and comorbidity (ie, previous cardiovascular disease and diabetes). Process variable includes waiting time (time from event to medical contact and treatment) and the type of procedures conducted. Outcome variables for in-hospital complications (ie, wound complications, myocardial infarction, stroke, amputation, respiratory complications, and renal insufficiency) and 30-day patency are submitted. Variables for medical treatment (antithrombotic and statin treatment), amputation, and survival are extracted from nationwide, administrative registers. Conclusion The DVR reports outcome on key indicators for monitoring the quality at all vascular departments in Denmark for the purpose of quality improvement. Furthermore, data are available for research and are being used in international collaborations on changes in clinical practices. PMID:27822118

  13. [Cutaneous vascular anomalies in children].

    Science.gov (United States)

    Yilmaz, L; Kacenelenbogen, N

    2015-09-01

    Vascular anomalies, which are erroneously categorized under the term angiomas, are a highly heterogeneous group of lesions that are poorly understood and affect a mean of 5 to 10 % of children. The fortuitous discovery of propranolol's efficacy in one of these entities has made them a topical issue. The paper's main objective is to inform family doctors of the various types of vascular anomalies, clarify their classification, and provide a common terminology. Its secondary objective is to provide a decision tree that enables primary care doctors to avoid diagnostic pitfalls, successfully detect cases, and optimize management. Systematic review. According to a recent study, 71,3 % of publications use the term hemangioma erroneously, regardless of the authors' field. The key for family doctors is to use one international classification only, that of the International Society for the Study of Vascular Anomalies (ISSVA), in order to facilitate management and comprehension between the different healthcare levels. The diagnosis of vascular anomalies is clinical in 90 % of cases, so all family doctors can, whilst using a decision tree, diagnose a vascular anomaly and refer only those that are complex for specialist care. The most common vascular anomaly is infantile hemangioma in infants, which spontaneously regresses around the age of 5-7 years in 90 % of cases. Watchful waiting and regular follow-up suffice, therefore, in such settings.

  14. Vascular endothelial growth factor coordinates islet innervation via vascular scaffolding

    Science.gov (United States)

    Reinert, Rachel B.; Cai, Qing; Hong, Ji-Young; Plank, Jennifer L.; Aamodt, Kristie; Prasad, Nripesh; Aramandla, Radhika; Dai, Chunhua; Levy, Shawn E.; Pozzi, Ambra; Labosky, Patricia A.; Wright, Christopher V. E.; Brissova, Marcela; Powers, Alvin C.

    2014-01-01

    Neurovascular alignment is a common anatomical feature of organs, but the mechanisms leading to this arrangement are incompletely understood. Here, we show that vascular endothelial growth factor (VEGF) signaling profoundly affects both vascularization and innervation of the pancreatic islet. In mature islets, nerves are closely associated with capillaries, but the islet vascularization process during embryonic organogenesis significantly precedes islet innervation. Although a simple neuronal meshwork interconnects the developing islet clusters as they begin to form at E14.5, the substantial ingrowth of nerve fibers into islets occurs postnatally, when islet vascularization is already complete. Using genetic mouse models, we demonstrate that VEGF regulates islet innervation indirectly through its effects on intra-islet endothelial cells. Our data indicate that formation of a VEGF-directed, intra-islet vascular plexus is required for development of islet innervation, and that VEGF-induced islet hypervascularization leads to increased nerve fiber ingrowth. Transcriptome analysis of hypervascularized islets revealed an increased expression of extracellular matrix components and axon guidance molecules, with these transcripts being enriched in the islet-derived endothelial cell population. We propose a mechanism for coordinated neurovascular development within pancreatic islets, in which endocrine cell-derived VEGF directs the patterning of intra-islet capillaries during embryogenesis, forming a scaffold for the postnatal ingrowth of essential autonomic nerve fibers. PMID:24574008

  15. Vascular injuries of the upper extremity Lesões vasculares de membros superiores

    Directory of Open Access Journals (Sweden)

    Raafat Shalabi

    2006-12-01

    álise retrospectiva de 5 anos. De 01/01/2001 a 31/12/2005, 165 pacientes foram operados devido a lesões vasculares no King Fahd Hospital, Medina, Arábia Saudita. De todos os pacientes com trauma vascular periférico (115, trauma de membros superiores esteve presente em 58. O diagnóstico foi realizado por exame físico e Doppler manual isoladamente ou associado com ultra-som Doppler/angiografia. A restauração vascular primária foi realizada sempre que possível; do contrário, utilizou-se a interposição de veia. A fasciotomia foi considerada quando necessário. Pacientes com lesão de membro inferior não resgatável necessitando de amputação foram excluídos do estudo. RESULTADOS: Cinqüenta pacientes eram homens (86% e oito eram mulheres (14%, com idade entre 2,5 e 55 anos (média de 23 anos. A duração média de apresentação foi 8 h pós-lesão. O fator etiológico mais comum foi acidente em estradas, sendo responsável por 50,5% no grupo de trauma contuso e 33% entre as lesões penetrantes e por arma branca. A incidência de lesões ortopédicas concomitantes foi muito alta em nosso estudo (51%. A artéria braquial foi a mais afetada (51%. A interposição de veias foi utilizada em 53% dos casos. A taxa de preservação de membros foi de 100%. CONCLUSÃO: Pacientes que sofrem lesões vasculares de membros superiores devem ser transferidos para centros de cirurgia vascular o mais rápido possível. O tratamento imediato do trauma vascular periférico aumentará a sobrevida dos pacientes e a preservação dos membros. Devem-se estabelecer prioridades no tratamento de lesões associadas e evitar o atraso quando alterações isquêmicas estiverem presentes.

  16. Imaging of peripheral vascular disease

    Directory of Open Access Journals (Sweden)

    Mo Al-Qaisi

    2009-03-01

    Full Text Available Mo Al-Qaisi1, David M Nott1, David H King1, Sam Kaddoura2, Mo Hamady31Charing Cross Hospital, London, UK; 2Royal Brompton Hospital, London, UK; 3St. Mary’s Hospital, London, UKAbstract: This illustrated review article gives an evidence-based update on the different modalities used for imaging peripheral vascular disease (duplex ultrasound, computed tomography angiography, magnetic resonance angiography, and digital subtraction angiography. After discussing the latest technological developments for each modality, their limitations are also highlighted. The evidence is presented for the various modalities’ roles in the imaging of peripheral vascular disease, including problem-solving applications. The strengths and weaknesses of each modality are therefore critically appraised, including the salient technological, clinical, and financial aspects. This review allows the general and specialist practitioner to make an informed decision on how best to deploy imaging tests in peripheral vascular disease as part of an evidence-based approach. The article concludes with a rational imaging algorithm for the investigation of peripheral vascular disease.Keywords: imaging, peripheral, vascular, duplex, angiography, arterial 

  17. Optimal treatment of vascular birthmarks.

    Science.gov (United States)

    Werner, Jochen A; Dünne, Anja A; Lippert, Burkard M; Folz, Benedikt J

    2003-01-01

    Optimal functional and cosmetic outcomes for vascular lesions require a thorough preoperative diagnosis of vascular anomalies, since correct classification of each vascular lesion has a direct influence on the treatment of choice. Many different classification systems have been discussed controversially. Based on clinical practicality and significant accuracy of forecast with regard to the clinical course of a lesion, Mulliken and Glowacki's biologic classification gained most clinical relevance and has become accepted as the official classification scheme by the International Society for the Study of Vascular Anomalies (ISSVA). Based on comprehensive description of relevant literature results, the current communication shall give an overview of differing, internationally accepted treatments. Although conservative management can be proposed for uncomplicated hemangiomas occurring in infancy, the proliferative progression of these lesions provides an adequate indication for treatment, while vascular malformations, which usually persist throughout life, always require therapeutic intervention if they start to cause clinical symptoms. Based on individual parameters (such as diameter, location and growth dynamics), different treatments, including cryotherapy, corticosteroids, laser therapy, sclerotherapy, surgery, and/or embolization, can be performed successfully. Currently, however, none of these treatments represents the solitary treatment of choice.

  18. Vascular calcification: Inducers and inhibitors

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Donghyun, E-mail: dhlee@cau.ac.kr [Department of Biomedical Engineering, Division of Integrative Engineering, Chung-Ang University, 221 Heukseok-Dong, Dongjak-Gu, Seoul 156-756 (Korea, Republic of)

    2011-09-15

    Highlights: {center_dot} Types of vascular calcification processes. {center_dot} Inducers of vascular calcification. {center_dot} Inhibitors of vascular calcifications. {center_dot} Clinical utility for vascular calcification therapy. {center_dot} Implications for the development of new tissue engineering strategies. - Abstract: Unlike the traditional beliefs, there are mounting evidences suggesting that ectopic mineral depositions, including vascular calcification are mostly active processes, many times resembling that of the bone mineralization. Numbers of agents are involved in the differentiation of certain subpopulation of smooth muscle cells (SMCs) into the osteoblast-like entity, and the activation and initiation of extracellular matrix ossification process. On the other hand, there are factors as well, that prevent such differentiation and ectopic calcium phosphate formation. In normal physiological environments, activities of such procalcific and anticalcific regulatory factors are in harmony, prohibiting abnormal calcification from occurring. However, in certain pathophysiological conditions, such as atherosclerosis, chronic kidney disease (CKD), and diabetes, such balances are altered, resulting in abnormal ectopic mineral deposition. Understanding the factors that regulate the formation and inhibition of ectopic mineral formation would be beneficial in the development of tissue engineering strategies for prevention and/or treatment of such soft-tissue calcification. Current review focuses on the factors that seem to be clinically relevant and/or could be useful in developing future tissue regeneration strategies. Clinical utilities and implications of such factors are also discussed.

  19. Trauma vascular, visión del cirujano vascular

    OpenAIRE

    Dr. D. Cristián Salas

    2011-01-01

    El 3% de todas las lesiones en trauma tiene un componente vascular. Con los conflictos armados del siglo pasado se lograron grandes avances en este campo. A partir de la Guerra de Vietnam gracias a las mejoras en el manejo prehospitalario, traslado de pacientes, y avances en técnica quirúrgica se lograron tasas de sobrevida y de amputaciones que se han mantenido estables hasta la fecha. El diagnóstico de lesiones vasculares en extremidades se realiza con el examen físico, sin embargo las lesi...

  20. Heritability of Retinal Vascular Fractals

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Broe, Rebecca; Kessel, Line

    2017-01-01

    , the branching pattern of the retinal vessels demonstrated a higher structural similarity in monozygotic than in dizygotic twin pairs. The retinal vascular fractal dimension was mainly determined by genetic factors, which accounted for 54% of the variation. The genetically predetermination of the retinal......Purpose: To determine the genetic contribution to the pattern of retinal vascular branching expressed by its fractal dimension. Methods: This was a cross-sectional study of 50 monozygotic and 49 dizygotic, same-sex twin pairs aged 20 to 46 years. In 50°, disc-centered fundus photographs......, the retinal vascular fractal dimension was measured using the box-counting method and compared within monozygotic and dizygotic twin pairs using Pearson correlation coefficients. Falconer's formula and quantitative genetic models were used to determine the genetic component of variation. Results: The mean...

  1. Fetal origin of vascular aging

    Directory of Open Access Journals (Sweden)

    Shailesh Pitale

    2011-01-01

    Full Text Available Aging is increasingly regarded as an independent risk factor for development of cardiovascular diseases such as atherosclerosis and hypertension and their complications (e.g. MI and Stroke. It is well known that vascular disease evolve over decades with progressive accumulation of cellular and extracellular materials and many inflammatory processes. Metabolic syndrome, obesity and diabetes are conventionally recognized as risk factors for development of coronary vascular disease (CVD. These conditions are known to accelerate ageing process in general and vascular ageing in particular. Adverse events during intrauterine life may programme organ growth and favour disease later in life, popularly known as, ′Barker′s Hypothesis′. The notion of fetal programming implies that during critical periods of prenatal growth, changes in the hormonal and nutritional milieu of the conceptus may alter the full expression of the fetal genome, leading to permanent effects on a range of physiological.

  2. [Alzheimer's disease and vascular dementia].

    Science.gov (United States)

    Nagata, Ken

    2014-04-01

    Alzheimer's disease (AD) and vascular dementia (VaD) are the two major forms of dementia in the elderly, and they had been separated categorically on the basis of pathogenetic mechanisms and clinical operationalized criteria. However, it was claimed that this strict separation might steered toward the overdiagnosis of vascular dementia, this dichotomy has been reevaluated in the light of recent epidemiological and neuropathological knowledge. Cerebrovascular disease (CVD) is now considered as one of the vascular risk factors to the onset and evolution of Alzheimer's disease. Futhermore, the term "AD with CVD" has been used to classify patients fulfilling the clinical criteria for possible AD and who also present clinical or brain imaging evidence of relevant CVD.

  3. Vascular education and training in Asia.

    Science.gov (United States)

    Jirasiritham, Sopon

    2008-12-01

    Cardiovascular diseases have become more prevalent and threatening to the health of the population of Asia due to the rapidly growing number of aging people. The Asian Society for Vascular Surgery unites 13 member organizations: Japan, Korea, China, India, Hong Kong, Singapore, Malaysia, Taiwan, Bangladesh, Philippines, Saudi Arabia, Indonesia, and Thailand. The essential mission of the Asian Society for Vascular Surgery is to improve training in vascular surgery to increase the number of competent vascular surgeons in Asia. Almost every member country has its own vascular training program. Most curricula for vascular surgery training are composed of basic vascular research, clinical vascular medicine, vascular investigation, and open and endovascular surgery, with the period of training ranging from 2 to 4 years.

  4. Vascular Gene Expression: A Hypothesis

    Directory of Open Access Journals (Sweden)

    Angélica Concepción eMartínez-Navarro

    2013-07-01

    Full Text Available The phloem is the conduit through which photoassimilates are distributed from autotrophic to heterotrophic tissues and is involved in the distribution of signaling molecules that coordinate plant growth and responses to the environment. Phloem function depends on the coordinate expression of a large array of genes. We have previously identified conserved motifs in upstream regions of the Arabidopsis genes, encoding the homologs of pumpkin phloem sap mRNAs, displaying expression in vascular tissues. This tissue-specific expression in Arabidopsis is predicted by the overrepresentation of GA/CT-rich motifs in gene promoters. In this work we have searched for common motifs in upstream regions of the homologous genes from plants considered to possess a primitive vascular tissue (a lycophyte, as well as from others that lack a true vascular tissue (a bryophyte, and finally from chlorophytes. Both lycophyte and bryophyte display motifs similar to those found in Arabidopsis with a significantly low E-value, while the chlorophytes showed either a different conserved motif or no conserved motif at all. These results suggest that these same genes are expressed coordinately in non- vascular plants; this coordinate expression may have been one of the prerequisites for the development of conducting tissues in plants. We have also analyzed the phylogeny of conserved proteins that may be involved in phloem function and development. The presence of CmPP16, APL, FT and YDA in chlorophytes suggests the recruitment of ancient regulatory networks for the development of the vascular tissue during evolution while OPS is a novel protein specific to vascular plants.

  5. Angioembolisation in vaginal vascular malformation.

    Directory of Open Access Journals (Sweden)

    Srivastava D

    2001-01-01

    Full Text Available Vaginal arteriovenous malformations are rare entities and their most common presentation is vaginal haemorrhage. This case report describes a 22-year-old woman who presented at 20 weeks of gestation with slow growing soft and tender swelling at anterior vaginal wall. Diagnosis was confirmed as vaginal vascular malformation on contrast enhanced magnetic resonance imaging. The mass did not subside after delivery and patient developed dyspareunia. It was successfully treated by angioembolisation using polyvinyl alcohol particles. Angioembolisation being safe and effective should be the treatment of first choice for symptomatic vaginal vascular malformation.

  6. Vascular ultrasound for atherosclerosis imaging

    NARCIS (Netherlands)

    C.L. de Korte (Chris); H.H.G. Hansen (Hendrik); A.F.W. van der Steen (Ton)

    2011-01-01

    textabstractCardiovascular disease is a leading cause of death in the Western world. Therefore, detection and quantification of atherosclerotic disease is of paramount importance to monitor treatment and possible prevention of acute events. Vascular ultrasound is an excellent technique to assess the

  7. Signaling circuitry in vascular morphogenesis.

    Science.gov (United States)

    Warren, Carmen M; Iruela-Arispe, M Luisa

    2010-05-01

    In this mini-review, we have highlighted the recent breakthroughs in growth factor signaling that have made conceptual changes in our understanding of how blood vessels are formed. Studies conducted over the past few years have focused on understanding the cell biology of vascular morphogenesis. The major themes include characterization of the different cell types that comprise a vascular sprout, as well as the regulatory influence of cell-cell and cell-matrix interactions on signaling outcomes. In addition, novel trends have emerged, including nonconventional ways in which vascular endothelial growth factor contributes to cell survival and metabolic balance. The growth of new capillary sprouts from a preexisting vascular network requires a highly coordinated cellular response to both growth factors and morphogens. This response is sensed and triggered by cell surface receptors responsible for the activation of an intracellular cascade that efficiently initiates migration and proliferation programs. While the molecular players that coordinate these effects have been identified, recent findings have expanded our understanding of how context, in particular cell-cell and cell-matrix interactions, affects endothelial cell responses to growth factors.

  8. Vascular complications in orthopedic surgery.

    Science.gov (United States)

    Chervu, A; Quinones-Baldrich, W J

    1988-10-01

    Vascular complications may be seen secondary to trauma or in the perioperative period following elective surgery. Prompt recognition and correction of these problems are of utmost importance to assure functional viability of the affected extremity. Evaluation may be complicated by the presence of preexisting atherosclerotic occlusive disease in the elderly patient. Relevant points in the history and physical examination include mechanism of injury, preexisting disease, evaluation of motor and sensory function, and presence and character of pulses. Noninvasive vascular studies should be obtained in all patients. Absolute indications for angiography include absent pulses, signs and symptoms of ischemia, a bruit, and a posterior knee dislocation; decreased pulses, a significant hematoma, and proximity of the fracture fragment are relative indications. Controversial issues in the management of combined orthopedic and vascular injuries include the use of internal versus external fixation, the use of prosthetic versus autogenous material, and the need for venous reconstruction. Popliteal artery trauma is still associated with a high limb loss rate, and careful evaluation of knee injuries is necessary. Vascular compromise may also complicate joint replacement surgery. These complications are preventable, and management is greatly simplified by a detailed preoperative evaluation.

  9. Intestinal vascular anomalies in children.

    Science.gov (United States)

    Frémond, B; Yazbeck, S; Dubois, J; Brochu, P; Garel, L; Ouimet, A

    1997-06-01

    Vascular anomalies are an uncommon cause of gastrointestinal bleeding in childhood. Confusing nomenclature has made objective comparisons of published cases difficult and has interfered with an established consensus regarding diagnosis and therapeutic modalities. The purpose of this study was to clarify the situation by reviewing the records of all children who had intestinal vascular anomalies who were referred to our institution from 1975 to 1995. Thirteen lesions were identified in nine children (five boys and four girls). The median age at clinical onset was 8 years. Only two patients presented with a complex syndrome (Klippel-Trenaunay, 1; Osler-Rendu-Weber, 1). Diagnosis, location, and extension of these anomalies was only possible by angiography, which indicated that seven patients had isolated venous malformations and two had arteriovenous malformations. Because the lesions did not involve the serosa, intraoperative localization was a major problem. The main findings were a few slightly dilated mesenteric veins. Treatment was conservative in four children and surgical in five. Pathological findings on resected bowel demonstrated dilated and abnormal veins in the mucosa and submucosa. Selective angiography should not be delayed in patients with gastrointestinal bleeding if results of all other investigations are negative. Because these lesions are rarely recognizable on operative inspection, precise preoperative angiographic localization of intestinal vascular anomalies is essential to allow for a safe and limited resection of the involved bowel segment. Based on a better understanding of the natural history of these lesions, a classification of vascular anomalies of intestines in children is proposed.

  10. Silk Biomaterials with Vascularization Capacity.

    Science.gov (United States)

    Han, Hongyan; Ning, Hongyan; Liu, Shanshan; Lu, Qiang; Fan, Zhihai; Lu, Haijun; Lu, Guozhong; Kaplan, David L

    2016-01-20

    Functional vascularization is critical for the clinical regeneration of complex tissues such as kidney, liver or bone. The immobilization or delivery of growth factors has been explored to improve vascularization capacity of tissue engineered constructs, however, the use of growth factors has inherent problems such as the loss of signaling capability and the risk of complications such as immunological responses and cancer. Here, a new method of preparing water-insoluble silk protein scaffolds with vascularization capacity using an all aqueous process is reported. Acid was added temporally to tune the self-assembly of silk in lyophilization process, resulting in water insoluble scaffold formation directly. These biomaterials are mainly noncrystalline, offering improved cell proliferation than previously reported silk materials. These systems also have appropriate softer mechanical property that could provide physical cues to promote cell differentiation into endothelial cells, and enhance neovascularization and tissue ingrowth in vivo without the addition of growth factors. Therefore, silk-based degradable scaffolds represent an exciting biomaterial option, with vascularization capacity for soft tissue engineering and regenerative medicine.

  11. Markers of Early Vascular Ageing.

    Science.gov (United States)

    Kotsis, Vasilios; Antza, Christina; Doundoulakis, Ioannis; Stabouli, Stella

    2017-01-01

    Cardiovascular damage is clinically manifested as coronary artery disease, heart failure, stroke and peripheral artery disease. The prevalence of these adverse conditions is higher with advancing age. Although many patients present cardiovascular damage late in their life, it is common to see patients with early atherosclerosis in cardiovascular intensive care units at ages lower than 50 years in men and 55 for women. In this review of the literature we identified risk factors of early vascular damage. The classic risk factors such as age, gender, diabetes mellitus, dyslipidemia, smoking, alcohol, hypertension, obesity, family history and newer biomarkers such as hs-CRP, folic acid, homocysteine, fibrinogen are neither strong nor predictive of the individual patient's risk to present early cardiovascular disease. All these risk factors have been used to propose risk scores for possible future events but we still lack a single strong marker indicating new onset of disease that will predict the future independently of the classical factors. The role of vascular imaging techniques to identify patients with subclinical atherosclerotic vascular damage before clinical disease, including the effect of known and unknown risk factors on the vascular tree, seems to be very important for intensifying preventive measures in high risk patients. Early arteriosclerosis measured from pulse wave velocity is associated with reduced arterial elasticity and is associated with future cardiovascular events. Vascular measurements may better represent the continuum of cardiovascular disease from a young healthy to an aged diseased vessel that is going to produce adverse clinical events. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  12. Pediatric central nervous system vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Burch, Ezra A. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Orbach, Darren B. [Boston Children' s Hospital, Neurointerventional Radiology, Boston, MA (United States)

    2015-09-15

    Pediatric central nervous system (CNS) vascular anomalies include lesions found only in the pediatric population and also the full gamut of vascular lesions found in adults. Pediatric-specific lesions discussed here include infantile hemangioma, vein of Galen malformation and dural sinus malformation. Some CNS vascular lesions that occur in adults, such as arteriovenous malformation, have somewhat distinct manifestations in children, and those are also discussed. Additionally, children with CNS vascular malformations often have associated broader vascular conditions, e.g., PHACES (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies and sternal anomalies), hereditary hemorrhagic telangiectasia, and capillary malformation-arteriovenous malformation syndrome (related to the RASA1 mutation). The treatment of pediatric CNS vascular malformations has greatly benefited from advances in endovascular therapy, including technical advances in adult interventional neuroradiology. Dramatic advances in therapy are expected to stem from increased understanding of the genetics and vascular biology that underlie pediatric CNS vascular malformations. (orig.)

  13. Subclinical hypothyroidism after vascular complicated pregnancy

    NARCIS (Netherlands)

    Zanden, M. van der; Hop-de Groot, R.J.; Sweep, F.C.; Ross, H.A.; Heijer, M. den; Spaanderman, M.E.A.

    2013-01-01

    OBJECTIVE: Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions.

  14. ESRD QIP - Vascular Access - Payment Year 2018

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes facility details, performance rates, vascular access topic measure score, and the state and national average measure scores for the vascular...

  15. NEURO-VASCULAR INJURIES ASSOCIATED WITH LIMB ...

    African Journals Online (AJOL)

    hi-tech

    2000-12-01

    Dec 1, 2000 ... Results: Road traffic accidents were the main cause of fractures associated with neuro- vascular ... the patients with vascular or nerve injury associated with fractures .... of traumatic aorto-iliac dissection injury in a child with.

  16. Self-management of vascular risk factors

    OpenAIRE

    Sol-de Rijk, B.G.M.

    2009-01-01

    Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing vascular risk factors in patients with established vascular diseases. Patients with different manifestations of vascular diseases appeared to have high levels of self-efficacy concerning the self-ma...

  17. Vascular smooth muscle function: defining the diabetic vascular phenotype.

    Science.gov (United States)

    Bruno, Rosa Maria; Ghiadoni, Lorenzo

    2013-10-01

    In this issue of Diabetologia, a meta-analysis performed by Montero and co-authors (Diabetologia doi 10.1007/s00125-013-2974-1 ) demonstrates a significant impairment of vascular smooth muscle (VSM) function in type 2 diabetic patients. Endothelial function and VSM function between type 2 diabetic and healthy individuals were associated, especially in the microcirculation, confirming the hypothesis that unresponsiveness of VSM cells to NO may amplify the consequences of reduced NO availability. This study suggests a novel interpretation for endothelial dysfunction in diabetic patients, indicating VSM cells as key players. Causative mechanisms of VSM dysfunction, which seems to be a feature of the vascular phenotype of type 2 diabetes mellitus, are largely unexplored in humans. Future studies should also address the crucial issue of the prognostic significance of VSM dysfunction in diabetic patients, and possibly in other conditions characterised by high cardiovascular risk.

  18. Specificity of haemostasis abnormalities for vascular phenotypes.

    Science.gov (United States)

    Lowe, G D; Haverkate, F

    1998-01-01

    Atherothrombosis is a systemic disease, hence it is difficult to prove the specificity of haemostasis abnormality for any single vascular phenotype. Associations between haemostatic variables and any given phenotype, e.g. (vascular) dementia, should be interpreted with caution, given the overlaps of vascular disease phenotypes, risk factors, and haemostatic variables.

  19. 21 CFR 870.4450 - Vascular clamp.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vascular clamp. 870.4450 Section 870.4450 Food and... CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4450 Vascular clamp. (a) Identification. A vascular clamp is a surgical instrument used to occlude a blood vessel temporarily. (b) Classification. Class II...

  20. Hippocampal atrophy in subcortical vascular dementia

    NARCIS (Netherlands)

    van de Pol, L.A.; Gertz, H.J.; Scheltens, P.; Wolf, H

    2011-01-01

    Background and Purpose: New research criteria for subcortical vascular dementia (SVaD) have been suggested to define a more homogeneous subgroup of vascular dementia. Hippocampal (Hc) atrophy is a hallmark of Alzheimer's disease (AD), but it also occurs in other dementia disorders including vascular

  1. Near-infraread spectroscopy during peripheral vascular surgery

    DEFF Research Database (Denmark)

    Schroeder, Torben Veith; Eiberg, Jonas Peter; Vogt, Katja

    1997-01-01

    Original,Near-infraread spectroscopy,Vascular disease,Vascular by-pass surgery,Perioperative oxymetry......Original,Near-infraread spectroscopy,Vascular disease,Vascular by-pass surgery,Perioperative oxymetry...

  2. [Menopause: Hypertension and vascular disease].

    Science.gov (United States)

    Zilberman, J M

    2018-01-28

    Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Angiogenesis, Cancer, and Vascular Aging

    OpenAIRE

    Junji Moriya; Tohru Minamino

    2017-01-01

    Several lines of evidence have revealed that the angiogenic response to ischemic injury declines with age, which might account for the increased morbidity and mortality of cardiovascular disease (CVD) among the elderly. While impairment of angiogenesis with aging leads to delayed wound healing or exacerbation of atherosclerotic ischemic diseases, it also inhibits the progression of cancer. Age-related changes of angiogenesis have been considered to at least partly result from vascular aging o...

  4. Vascular Aging and Arterial Stiffness

    Directory of Open Access Journals (Sweden)

    Luana de Rezende Mikael

    Full Text Available Abstract Cardiovascular diseases (CVD account annually for almost one third of all deaths worldwide. Among the CVD, systemic arterial hypertension (SAH is related to more than half of those outcomes. Type 2 diabetes mellitus is an independent risk factor for SAH because it causes functional and structural damage to the arterial wall, leading to stiffness. Several studies have related oxidative stress, production of free radicals, and neuroendocrine and genetic changes to the physiopathogenesis of vascular aging. Indirect ways to analyze that aging process have been widely studied, pulse wave velocity (PWV being considered gold standard to assess arterial stiffness, because there is large epidemiological evidence of its predictive value for cardiovascular events, and it requires little technical knowledge to be performed. A pulse wave is generated during each cardiac contraction and travels along the arterial bed until finding peripheral resistance or any bifurcation point, determining the appearance of a reflected wave. In young individuals, arteries tend to be more elastic, therefore, the reflected wave occurs later in the cardiac cycle, reaching the heart during diastole. In older individuals, however, the reflected wave occurs earlier, reaching the heart during systole. Because PWV is an important biomarker of vascular damage, highly valuable in determining the patient’s global cardiovascular risk, we chose to review the articles on vascular aging in the context of cardiovascular risk factors and the tools available to the early identification of that damage.

  5. Vascularization regenerative medicine and tissue engineering

    CERN Document Server

    Brey, Eric M

    2014-01-01

    A Complex and Growing Field The study of vascularization in tissue engineering and regenerative medicine (TERM) and its applications is an emerging field that could revolutionize medical approaches for organ and tissue replacement, reconstruction, and regeneration. Designed specifically for researchers in TERM fields, Vascularization: Regenerative Medicine and Tissue Engineering provides a broad overview of vascularization in TERM applications. This text summarizes research in several areas, and includes contributions from leading experts in the field. It defines the difficulties associated with multicellular processes in vascularization and cell-source issues. It presents advanced biomaterial design strategies for control of vascular network formation and in silico models designed to provide insight not possible in experimental systems. It also examines imaging methods that are critical to understanding vascularization in engineered tissues, and addresses vascularization issues within the context of specific...

  6. Chronic Stress Improves NO- and Ca2+ Flux-Dependent Vascular Function: A Pharmacological Study.

    Science.gov (United States)

    Bruder-Nascimento, Thiago; Campos, Dijon Henrique Salome

    2015-01-23

    avaliada em anéis aórticos. Curvas de concentração-efeito foram realizadas para noradrenalina, na presença de L-NAME ou prazosina, cloreto de potássio (KCl), acetilcolina e nitroprussiato de sódio. Também foi efetuado um estudo para avaliação para fluxo de Ca2+. Resultados: Estresse crônico induziu hipertensão e resposta vascular diminuída para noradrenalina e KCl e aumentada para acetilcolina. A pré-incubação com L-NAME eliminou a diferença para noradrenalina. A resposta contrátil vascular para Ca2+ foi reduzida em animais estressados. Conclusão: Nossos dados sugerem que a resposta vascular ao estresse crônico seria uma adaptação aos efeitos deletérios do estresse, incluindo a hipertensão. Além disso, esses mecanismos adaptativos dependem de liberação de NO e fluxo de Ca2+. Esses resultados ajudam a esclarecer os mecanismos envolvidos nas alterações cardiovasculares associadas ao estresse. Entretanto, mais estudos são necessários para a melhor compreensão desses mecanismos.

  7. Ghrelin improves vascular autophagy in rats with vascular calcification.

    Science.gov (United States)

    Xu, Mingming; Liu, Lin; Song, Chenfang; Chen, Wei; Gui, Shuyan

    2017-06-15

    This study aimed to investigate whether ghrelin ameliorated vascular calcification (VC) through improving autophagy. VC model was induced by nicotine plus vitamin D 3 in rats and β-glycerophosphate in vascular smooth muscle cell (VSMC). Calcium deposition was detected by von Kossa staining or alizarin red S staining. ALP activity was also detected. Western blot was used to assess the protein expression. Ghrelin treatment attenuated the elevation of calcium deposition and ALP activity in VC model both in vivo and in vitro. Interesting, the protein levels of autophagy markers, LC3 and beclin1 were significantly upregulated by ghrelin in VC model. An autophagy inhibitor, 3-methyladenine blocks the ameliorative effect of ghrelin on VC. Furthermore, protein expressions of phosphate-AMPK were increased by ghrelin treatment both in calcified aorta and VSMC. The effect of ghrelin on autophagy induction and VC attenuation was prevented by AMPK inhibitor, compound C. Our results suggested that ghrelin improved autophagy through AMPK activation, which was resulted in VC amelioration. These data maybe throw light on prevention and therapy of VC. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Effect of vascular burden as measured by vascular indexes upon vascular dementia: a matched case-control study

    OpenAIRE

    Takahashi, Paul Y; Caldwell, Casey R; Targonski, Paul V

    2012-01-01

    Paul Y Takahashi, Casey R Caldwell, Paul V TargonskiPrimary Care Internal Medicine, Mayo Clinic, Rochester MN, USABackground: Vascular dementia (VaD) is a challenging illness that affects the lives of older adults and caregivers. It is unclear how multiple vascular risk factor exposures (polyvascular disease) affect VaD.Purpose: To determine the relationship between multiple vascular risk exposures, as counted on an index in cases with VaD, compared with healthy age-/gender-matched controls.M...

  9. Vascular dementia: Facts and controversies

    Directory of Open Access Journals (Sweden)

    Pavlović Aleksandra

    2013-01-01

    Full Text Available Vascular dementia (VaD is the second most frequent dementia after Alzheimer’s disease, and is diagnosed during lifetime in 20% of demented patients. Five­year survival rate in VaD is 39%, while it is estimated to be 75% in healthy persons of the same age. It is therefore important to make correct diagnosis of VaD early in the course of the disease. Risk factors for VaD are identical to stroke risk factors, and there are significant possibilities for the prevention of vascular cognitive decline. Cognitive decline develops acutely or step­by­step within three months after stroke, but more gradual progression of intellectual decline is also possible. Neurological examination can reveal pyramidal and extrapyramidal signs, pseudobulbar palsy, gait disturbance and urinary incontinence. Neuropsychological profile comprises the loss of cognitive set shifting, decline in word fluency, verbal learning difficulties, perseverations, difficulties in complex figure copying, and in patients with cortically located lesions also problems with speech and praxia. The basis of the diagnosis is, besides history, neurological examination and neuropsychological assessment, computed tomography and/ or magnetic resonance brain imaging. Vascular risk factors control is the most important measure in VaD prevention. Modern guidelines for the treatment of cognitive decline in VaD emphasize that donepezil can be useful in the improvement of cognitive status at the level of Class IIa recommendation at the level of evidence A, while memantine may be useful in patients with mixed VaD and Alzheimer’s disease dementia. [Projekat Ministarstva nauke Republike Srbije, br. 175022 i br. 175033

  10. MIGRAINE AND STROKE: VASCULAR COMORBIDITY

    Directory of Open Access Journals (Sweden)

    Donata eGuidetti

    2014-10-01

    Full Text Available Several comorbidities are associated to migraine.Recent meta-analyses have consistently demonstrated a relationship between migraine and stroke, which is well-defined for ischaemic stroke and migraine with aura, even stronger in females on oral contraceptives or smokers. However, there seems to be no clear-cut association between stroke in migraineurs and the common vascular risk factors, at least in the young adult population. Migraineurs also run an increased risk of hemorrhagic stroke, while the association between migraine and cardiovascular disease remains poorly defined.Another aspect is the relationship between migraine and the presence of silent brain lesions. It has been demonstrated that there is an increased frequency of ischaemic lesions in the white matter of migraineurs, especially silent infarcts in the posterior circulation territory in patients with at least 10 attacks per month. Although there is a higher prevalence of patent foramen ovale (PFO in migraineurs, the relationship between migraine and PFO remains controversial and PFO closure is not a recommended procedure to prevent migraine. As an increased frequency of cervical artery dissections has been observed in migrainous patients, it has been hypothesized that migraine may represent a predisposing factor for cervical artery dissection. There still remains the question as to whether migraine should be considered a true vascular disease or if the comorbidity between migraine and cerebrovascular disease may have underlying shared risk factors or pathophysiological mechanisms. Although further studies are required to clarify this issue, current evidence supports a clinical management where MA patients should be screened for other concomitant vascular risk factors and treated accordingly.

  11. El índice tobillo-brazo como predictor de mortalidad vascular Ankle brachial index as indicator for vascular mortality

    Directory of Open Access Journals (Sweden)

    Juan José Arévalo Manso

    2012-06-01

    Full Text Available El índice tobillo-brazo (ITB es un parámetro que muestra la relación entre la tensión arterial sistólica de la extremidad superior y la extremidad inferior. Este indicador, ampliamente estudiado y presente en la bibliografía, se ha mostrado como excelente predictor de mortalidad tanto vascular como por causas generales cuando presenta valores fuera del rango establecido como normal (0,90-1,30. En dichas situaciones la utilidad del ITB reside en detectar precozmente la existencia de enfermedad arterial periférica (EAP durante su fase asintomática y servir como parámetro de corte para el establecimiento de medidas preventivas más contundentes antes de que el daño vascular existente se haga sintomático. Para el profesional de enfermería este parámetro constituye una potente herramienta de valoración, objetiva y cuantitativa, que permite seleccionar aquellos pacientes en los que es preciso potenciar al máximo los cuidados preventivos.The ankle-brachial index (ABI is a simple test showing the relationship between systolic blood pressure in the upper and the lower limbs. This parameter widely studied in literature has been reported as an excellent vascular and all-cause death predictor when exceeds the normal values (0.90-1.30. In such situation the ABI can early detect periferic arterial disease (PAD in asymptomatic phase and be a cutoff parameter to consider more aggressive preventive interventions before the existing vascular damage becomes symptomatic. This test is a powerful assessment tool for nurses to select those patients needing to maximize preventive cares. The nursing staff training for ABI measurement, the provision of suitable equipment by the Health Institutions and the development of reliable and more simple measurement methods are key issues that would facilitate its routinely and systematically use to improve the preventive strategy in vascular diseases.

  12. Spinal vascular malformations; Spinale Gefaessmalformationen

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal vascular malformations are a group of rare diseases with different clinical presentations ranging from incidental asymptomatic findings to progressive tetraplegia. This article provides an overview about imaging features as well as clinical and therapeutic aspects of spinal arteriovenous malformations, cavernomas and capillary telangiectasia. (orig.) [German] Spinale Gefaessmalformationen sind eine Gruppe seltener Erkrankungen mit unterschiedlichen klinischen Praesentationen, die vom asymptomatischen Zufallsbefund bis zur progredienten Tetraparese reichen. Dieser Artikel gibt einen Ueberblick ueber radiologische Befunde sowie klinische und therapeutische Aspekte von spinalen arteriovenoesen Malformationen, Kavernomen und kapillaeren Teleangiektasien. (orig.)

  13. Vascular comorbidities in multiple sclerosis

    DEFF Research Database (Denmark)

    Thormann, Anja; Magyari, Melinda; Koch-Henriksen, Nils

    2016-01-01

    To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case–control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980–2005 were identified from the Danish Multiple Sclerosis Registry...... and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique...

  14. [Vascular depression, limits of the concept].

    Science.gov (United States)

    Lebert, Florence

    2004-09-01

    The concept of vascular depression has recently been reassessed and more clearly delineated. The diagnostic criteria for vascular depression require a major depression associated with evidence of confluent or diffuse vascular lesions in the subcortical regions on MRI. The clinical symptoms are not specific, but they are often associated with mild cognitive decline. Ischemia is probably the main factor for vascular depression, but the relationship between ischemic lesions and clinical symptoms remains not well explained. The apolipoproteine E genotype is not a risk factor for vascular depression, but it is associated with more severe hyperintensities on MRI. A pharmacological resistance has been described in vascular depression, but, in recent studies, clinical improvement has been observed with antidepressants in more than 80% of cases. A neuropsychological follow-up is recommended, because dementia may appear with 25% of patients.

  15. Protecting against vascular disease in brain

    Science.gov (United States)

    2011-01-01

    Endothelial cells exert an enormous influence on blood vessels throughout the circulation, but their impact is particularly pronounced in the brain. New concepts have emerged recently regarding the role of this cell type and mechanisms that contribute to endothelial dysfunction and vascular disease. Activation of the renin-angiotensin system plays a prominent role in producing these abnormalities. Both oxidative stress and local inflammation are key mechanisms that underlie vascular disease of diverse etiology. Endogenous mechanisms of vascular protection are also present, including antioxidants, anti-inflammatory molecules, and peroxisome proliferator-activated receptor-γ. Despite their clear importance, studies of mechanisms that underlie cerebrovascular disease continue to lag behind studies of vascular biology in general. Identification of endogenous molecules and pathways that protect the vasculature may result in targeted approaches to prevent or slow the progression of vascular disease that causes stroke and contributes to the vascular component of dementia and Alzheimer's disease. PMID:21335467

  16. Vascular adaption to physical inactivity in humans

    OpenAIRE

    Bleeker, M.W.P.

    2006-01-01

    This thesis presents studies on vascular adaptation to physical inactivity and deconditioning. Although it is clear that physical inactivity is an important risk factor for cardiovascular disease, the underlying physiological mechanisms have not yet been elucidated. In contrast to physical inactivity, exercise decreases the risk for cardiovascular disease. This beneficial effect of exercise is partly due to changes in vascular function and structure. However, far less is known about vascular ...

  17. Enhanced Recovery after Vascular Surgery

    Directory of Open Access Journals (Sweden)

    Milena D. Stojanovic

    2018-01-01

    Full Text Available The beginnings of the enhanced recovery after surgery (ERAS program were first developed for patients in colorectal surgery, and after it was established as the standard of care in this surgical field, it began to be applied in many others surgical areas. This is multimodal, evidence-based approach program and includes simultaneous optimization of preoperative status of patients, adequate selection of surgical procedure and postoperative management. The aim of this program is to reduce complications, the length of hospital stay and to improve the patients outcome. Over the past decades, special attention was directed to the postoperative management in vascular surgery, especially after major vascular surgery because of the great risk of multiorgan failure, such as: respiratory failure, myocardial infarction, hemodynamic instability, coagulopathy, renal failure, neurological disorders, and intra-abdominal complications. Although a lot of effort was put into it, there is no unique acceptable program for ERAS in this surgical field, and there is still a need to point out the factors responsible for postoperative outcomes of these patients. So far, it is known that special attention should be paid to already existing diseases, type and the duration of the surgical intervention, hemodynamic and fluid management, nutrition, pain management, and early mobilization of patients.

  18. Neuroradiological findings in vascular dementia

    Energy Technology Data Exchange (ETDEWEB)

    Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

    2007-01-15

    There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

  19. Proatherogenic pathways leading to vascular calcification

    Energy Technology Data Exchange (ETDEWEB)

    Mazzini, Michael J. [Department of Cardiology, Boston University Medical Center, Boston, MA (United States); Schulze, P. Christian [Department of Medicine, Boston University Medical Center, Boston, MA (United States)]. E-mail: christian.schulze@bmc.org

    2006-03-15

    Cardiovascular disease is the leading cause of morbidity and mortality in the western world and atherosclerosis is the major common underlying disease. The pathogenesis of atherosclerosis involves local vascular injury, inflammation and oxidative stress as well as vascular calcification. Vascular calcification has long been regarded as a degenerative process leading to mineral deposition in the vascular wall characteristic for late stages of atherosclerosis. However, recent studies identified vascular calcification in early stages of atherosclerosis and its occurrence has been linked to clinical events in patients with cardiovascular disease. Its degree correlates with local vascular inflammation and with the overall impact and the progression of atherosclerosis. Over the last decade, diverse and highly regulated molecular signaling cascades controlling vascular calcification have been described. Local and circulating molecules such as osteopontin, osteoprogerin, leptin and matrix Gla protein were identified as critical regulators of vascular calcification. We here review the current knowledge on molecular pathways of vascular calcification and their relevance for the progression of cardiovascular disease.

  20. Vascular tumors and malformations in children, Introduction.

    Science.gov (United States)

    Maguiness, Sheilagh M

    2016-03-01

    Over the past decade, I have been amazed at the growth in the field of vascular anomalies. The recognition of vascular birthmarks as a defined area of medicine is a relatively recent event. The International Society for the Study of Vascular Anomalies (ISSVA) was founded by Drs John Mulliken and Anthony Young in the late 1970s. Mulliken and Glowacki's sentinel 1982 paper on the biologic classification of vascular anomalies further established the field, by providing clarity of nomenclature and unifying concepts that had previously been lacking. ©2016 Frontline Medical Communications.

  1. [Diagnosis and management of vascular anomalies].

    Science.gov (United States)

    Philandrianos, C; Degardin, N; Casanova, D; Petit, P; Bartoli, J-M; Bardot, J; Magalon, G

    2011-06-01

    Vascular anomalies are a complex pathological group. They are especially difficult to study because of confusion in the terminology used. The classification developed by the International Society for the Study of Vascular Anomalies (ISSVA) in 1996 allows using a common scientific language. There are two groups of lesions: vascular tumor and vascular malformation. The management of these anomalies is difficult and must involve an interdisciplinary approach including specialists in plastic surgery, radiology, pediatry and dermatology. We propose a simplified approach for the management of these pathologies. This approach is coming from the experience of Marseille (France) multidisciplinary team. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  2. Tumor vascular disruption using various radiation types

    Directory of Open Access Journals (Sweden)

    JJ Bevelacqua

    2014-04-01

    Full Text Available The feasibility of disrupting a tumor’s vascular structure with various radiation types and radionuclides is investigated. Calculated absorbed dose profiles for photons and 4He ions suggest that low-energy beta-gamma and alpha emitting radionuclides can deposit sufficient absorbed dose to disrupt a tumor’s vascular structure while minimizing the dose outside the blood vessel. Candidate radionuclides uniformly distributed in microspheres are theoretically investigated with respect to their vascular disruption potential and to offer an alternative to 90Y microsphere therapy. Requisite activities of candidate low-energy beta-gamma and alpha emitting radionuclides to facilitate vascular disruption are calculated.

  3. Vascular function in health, hypertension, and diabetes

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Gliemann, Lasse; Hellsten, Ylva

    2015-01-01

    muscle, which can affect muscle function. Central aspects in the vascular impairments are alterations in the formation of prostacyclin, the bioavailability of NO and an increased formation of vasoconstrictors and reactive oxygen species (ROS). Regular physical activity effectively improves vascular...... to the formation of vasodilators such as nitric oxide (NO) and prostacyclin. In essential hypertension and type II diabetes, the endothelial function and regulation of vascular tone is impaired with consequent increases in peripheral vascular resistance and inadequate regulation of oxygen supply to the skeletal...

  4. Prótese vascular derivada do látex Latex-derived vascular prosthesis

    Directory of Open Access Journals (Sweden)

    Marcelo Luiz Brandão

    2007-06-01

    Full Text Available CONTEXTO: O desenvolvimento de prótese vascular tem sido vital para os avanços e realizações da cirurgia vascular reconstrutora durante as últimas 5 décadas. OBJETIVOS: Desenvolver um novo modelo de prótese vascular microperfurada, confeccionada em tecido recoberto com um composto derivado do látex natural da seringueira (Hevea brasiliensis e avaliar sua perviedade, trombogenicidade, biocompatibilidade e o processo de cicatrização, além de algumas propriedades mecânicas (adaptabilidade, elasticidade, impermeabilidade e possibilidade de sutura, utilizando como controle a prótese de politetrafluoretileno expandido no mesmo animal. MÉTODOS: Quinze cães foram separados em três grupos de cinco animais. Implantou-se a prótese de tecido e látex microperfurada e, no membro pélvico contralateral, a prótese de politetrafluoretileno expandido em todos os cães. O seguimento pós-operatório foi de 4, 8 e 12 semanas. A apreciação dos resultados foi feita segundo as avaliações clínicas dos pulsos, complicações (coleção líquida, deiscência, granuloma e infecção, arteriografias, análise macroscópica e elétron-micrografias de varredura. RESULTADOS: Os testes estatísticos aplicados não evidenciaram diferenças significativas (p > 0,05 em relação às complicações pós-operatórias e perviedade dos enxertos. Ambas as próteses integraram-se adequadamente aos tecidos circunvizinhos, com um tecido de incorporação formado por fibras colágenas. Constatou-se a presença de neoíntima recoberta por endotélio em toda a extensão da superfície luminal da prótese de tecido e látex microperfurada. Ao contrário, na prótese de politetrafluoretileno expandido, o desenvolvimento endotelial sobre a superfície neointimal limitou-se às regiões próximas às anastomoses. CONCLUSÕES: A prótese de tecido e látex microperfurada demonstrou qualidades estruturais (adaptabilidade, elasticidade, impermeabilidade e possibilidade de

  5. Implementation of a vascular access quality programme improves vascular access care

    NARCIS (Netherlands)

    van Loon, M.; van der Mark, W.; Beukers, N.; de Bruin, C.; Blankestijn, P. J.; Huisman, R. M.; Zijlstra, J. J.; van der Sande, F. M.; Tordoir, J. H. M.

    Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres

  6. Adiposity, adipocytokines & microvesicles in the etiology of vascular disease

    NARCIS (Netherlands)

    Kanhai, D.A.N.I.S.

    2013-01-01

    Vascular disease, in this thesis the terms vascular and cardiovascular are used interchangeably, is the number 1 cause of death worldwide. In 2008, 30% of all mortality had a vascular origin. Vascular mortality rates after a first manifestation of vascular disease are decreasing in Western society,

  7. FPGA controlled artificial vascular system

    Directory of Open Access Journals (Sweden)

    Laqua D.

    2015-09-01

    Full Text Available Monitoring the oxygen saturation of an unborn child is an invasive procedure, so far. Transabdominal fetal pulse oximetry is a promising method under research, used to estimate the oxygen saturation of a fetus noninvasively. Due to the nature of the method, the fetal information needs to be extracted from a mixed signal. To properly evaluate signal processing algorithms, a phantom modeling fetal and maternal blood circuits and tissue layers is necessary. This paper presents an improved hardware concept for an artificial vascular system, utilizing an FPGA based CompactRIO System from National Instruments. The experimental model to simulate the maternal and fetal blood pressure curve consists of two identical hydraulic circuits. Each of these circuits consists of a pre-pressure system and an artificial vascular system. Pulse curves are generated by proportional valves, separating these two systems. The dilation of the fetal and maternal artificial vessels in tissue substitutes is measured by transmissive and reflective photoplethysmography. The measurement results from the pressure sensors and the transmissive optical sensors are visualized to show the functionality of the pulse generating systems. The trigger frequency for the maternal valve was set to 1 per second, the fetal valve was actuated at 0.7 per second for validation. The reflective curve, capturing pulsations of the fetal and maternal circuit, was obtained with a high power LED (905 nm as light source. The results show that the system generates pulse curves, similar to its physiological equivalent. Further, the acquired reflective optical signal is modulated by the alternating diameter of the tubes of both circuits, allowing for tests of signal processing algorithms.

  8. Vascular permeability alterations induced by arsenic.

    Science.gov (United States)

    Chen, Shih-Chieh; Tsai, Ming-Hsien; Wang, Hsiu-Jen; Yu, Hsin-Su; Chang, Louis W

    2004-01-01

    The impact of arsenic on the integrity of blood vessels in vivo via in situ exposure (local injection) of arsenic was investigated. Vascular permeability changes were evaluated by means of the Evans blue assay and the India ink tracer techniques. Rats were intravenously injected with Evans blue followed by intradermal injections of various doses of sodium arsenite on the back skins of the animals. Evans blue at different time points was extracted and assayed as indices of vascular leakage. Skin at various time point injection sites was sampled for arsenic measurement via graphite furnace atomic absorption spectroscopy. Our time course study with Evans blue technique demonstrated a biphasic pattern of vascular permeability change: an early phase of permeability reduction and a later phase of permeability promotion at all dose levels tested. The India ink tracer technique also demonstrated a time-correlated increase in vascular labelling in the tissues examined, signifying an increase in vascular leakage with time. Moreover, we found that despite an early increase in tissue arsenic content at time of injection, tissue arsenic declined rapidly and returned to near control levels after 30-60 min. Thus, an inverse correlation between tissue arsenic content and the extent of vascular permeability was apparent. This study provides the first demonstration that in situ exposure to arsenic will produce vascular dysfunction (vascular leakage) in vivo.

  9. Functional preservation of vascular smooth muscle tissue

    Science.gov (United States)

    Alexander, W. C.; Hutchins, P. M.; Kimzey, S. L.

    1973-01-01

    The ionic and cellular feedback relationships operating to effect the vascular decompensatory modifications were examined to reveal procedures for implementing protective measures guarding against vascular collapse when returning from a weightless environment to that of the earth's gravity. The surgical procedures for preparing the rat cremaster, and the fixation methods are described. Abstracts of publications resulting from this research are included.

  10. VASCULAR EFFECTS OF KETAMINE IN ISOLATED RABBIT ...

    African Journals Online (AJOL)

    Daniel Owu

    Summary: The precise mechanism by which ketamine induces relaxation of vascular smooth muscle is not clear. The goal of this study was to further characterize the vascular actions of ketamine in rabbit aortic smooth muscles. Ring segments (2mm) of rabbit aortae were suspended in 20ml organ baths containing ...

  11. Arteriovenous Malformations and Other Vascular Malformation Syndromes

    Science.gov (United States)

    Whitehead, Kevin J.; Smith, Matthew C. P.; Li, Dean Y.

    2013-01-01

    Vascular malformations are a disruption of the normal vascular pattern in which it is expected that a capillary network of microscopic vessels lies interposed between high-pressure arteries that deliver blood and thin-walled veins that collect low-pressure blood for return to the heart. In the case of arteriovenous malformations, arteries or arterioles connect directly to the venous collection system, bypassing any capillary bed. Clinical consequences result from rupture and hemorrhage, from dramatically increased blood flow, or from the loss of capillary functions such as nutrient exchange and filtering function. These malformations can occur sporadically or as a component of inherited vascular malformation syndromes. In these and other hereditary vascular malformation syndromes, genetic studies have identified proteins and pathways involved in vascular morphogenesis and development. A common theme observed is that vascular malformations result from disruption in pathways involved in vascular stability. Here we review the vascular malformations and pathways involved in hereditary hemorrhagic telangiectasia, capillary malformation–arteriovenous malformation, cerebral cavernous malformations, and mucocutaneous venous malformations. PMID:23125071

  12. Non-suture methods of vascular anastomosis

    NARCIS (Netherlands)

    Zeebregts, CJ; Heijmen, RH; van den Dungen, JJ; van Schilfgaarde, R

    Background: The main aim of performing a vascular anastomosis is to achieve maximal patency rates. An important factor to achieve that goal is to minimize damage to the vessel walls. Sutures inevitably induce vascular wall damage, which influences the healing of the anastomosis. Over time, several

  13. Vascular birthmarks of infancy: resolving nosologic confusion.

    Science.gov (United States)

    Hand, Jennifer L; Frieden, Ilona J

    2002-04-01

    The terminology describing congenital vascular birthmarks has been a source of confusion in the medical literature. Mulliken and Glowacki [1982: Plas. Recons. Surg. 69:412-422] published a biologic classification system which has become the most widely accepted framework for classifying vascular birthmarks and is accepted as the official classification schema by the International Society for the Study of Vascular Anomalies (ISSVA). In this study, we evaluate the current nosology of vascular birthmarks used in standard medical genetics reference texts compared with the accepted Mulliken ISSVA framework. In five sources examined, a variety of terms were used to describe congenital vascular anomalies. The degree of agreement with accepted ISSVA classification varied both within and among texts, with agreement as low as 22% and as high as 75%. In all texts, hemangioma was the most commonly used term, appearing 79 times. Use of the term "hemangioma" had the lowest rate of agreement with the ISSVA classification criteria, with agreement in 23% of citations. The terms "vascular malformation" and "port-wine stain" were used less frequently, but with a much higher degree of agreement with the ISSVA classification: 82% and 66%, respectively. These results establish that nosologic confusion is widespread even in standard genetic reference texts. In particular, the term "hemangioma" is used imprecisely. The ISSVA classification system provides an extremely useful framework for geneticists to classify vascular birthmarks in their evaluation of infants and children with vascular anomalies in order to provide more accurate evaluation, prognosis, and genetic counseling. Copyright 2002 Wiley-Liss, Inc.

  14. Hemorrhage Control for Major Traumatic Vascular Injuries

    Science.gov (United States)

    2016-10-01

    and it is unclear if this contributed to the high (46%) mortality in OPEN patients with thoracic aortic injury. Intra- abdominal arterial hemorrhage...Endovascular therapy for overcoming challenges presented with blunt abdominal aortic injury. Vascular and endovascular surgery 2012;46:329-331. 23...systematically define the clinical and logistical issues surrounding traditional open vascular surgery and catheter-based hemorrhage control. The

  15. Vascular dementia | Connor | African Journal of Psychiatry

    African Journals Online (AJOL)

    Vascular dementia (VaD) is a common but heterogeneous condition in which there is a clear temporal relationship between the dementia and vascular disease. It may result from multiple large or small vessel strokes or a single strategic stroke. Subcortical ischaemic VaD includes multiple lacunes and subcortical ...

  16. Evaluation of Peripheral Vascular Calcification and Serum ...

    African Journals Online (AJOL)

    Introduction: Vascular calcification is a risk factor for cardiovascular mortality in the general population. It is highly prevalent in end stage renal disease (ESRD) patients. Low magnesium (Mg) levels have been reported to have a strong association with vascular calcification in hemodialysis (HD) patients. The aims of this ...

  17. Management Strategies in Hemodialysis Vascular Access

    NARCIS (Netherlands)

    J. van der Linden (Joke)

    2006-01-01

    textabstractSince the introduction of the AV fistula and the use of interposition graft little improvement has been made in the vascular access field. Still, vascular access related complications, are one of the most important reasons for patient hospitalization, morbidity and even mortality

  18. Reconstructive vascular surgery below the knee

    DEFF Research Database (Denmark)

    Rasmussen, L B; Jelnes, R; Sager, P

    1986-01-01

    In a series of 38 consecutive patients with advanced peripheral vascular disease (i.e. rest pain) reconstructive vascular surgery was performed with the distal anastomosis below the knee. Ankle/arm pressure index (AAI) was 0.28 (0.11-0.47) preoperatively; accumulated graft patency rate was 0.47 (SD...

  19. Percutaneous Treatment of Peripheral Vascular Malformations

    NARCIS (Netherlands)

    E. van der Linden (Edwin)

    2011-01-01

    textabstractVascular malformations arise from errors in the morphological processes that shape the embryonic vascular system during fetal development. These developmental errors result in abnormal clusters of blood vessels. Although these lesions are present at birth, they might not become visible

  20. PanVascular medicine. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Lanzer, Peter (ed.) [Health Care Center Bitterfeld (Germany). Division of Cardiovascular Disease

    2015-06-01

    Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established. Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.

  1. Fundamental principles of vascular network topology.

    Science.gov (United States)

    Kopylova, Veronika S; Boronovskiy, Stanislav E; Nartsissov, Yaroslav R

    2017-06-15

    The vascular system is arguably the most important biological system in many organisms. Although the general principles of its architecture are simple, the growth of blood vessels occurs under extreme physical conditions. Optimization is an important aspect of the development of computational models of the vascular branching structures. This review surveys the approaches used to optimize the topology and estimate different geometrical parameters of the vascular system. The review is focused on optimizations using complex cost functions based on the minimum total energy principle and the relationship between the laws of growth and precise vascular network topology. Experimental studies of vascular networks in different species are also discussed. © 2017 The Author(s); published by Portland Press Limited on behalf of the Biochemical Society.

  2. Stem/Progenitor cells in vascular regeneration.

    Science.gov (United States)

    Zhang, Li; Xu, Qingbo

    2014-06-01

    A series of studies has been presented in the search for proof of circulating and resident vascular progenitor cells, which can differentiate into endothelial and smooth muscle cells and pericytes in animal and human studies. In terms of pluripotent stem cells, including embryonic stem cells, iPS, and partial-iPS cells, they display a great potential for vascular lineage differentiation. Development of stem cell therapy for treatment of vascular and ischemic diseases remains a major challenging research field. At the present, there is a clear expansion of research into mechanisms of stem cell differentiation into vascular lineages that are tested in animal models. Although there are several clinical trials ongoing that primarily focus on determining the benefits of stem cell transplantation in ischemic heart or peripheral ischemic tissues, intensive investigation for translational aspects of stem cell therapy would be needed. It is a hope that stem cell therapy for vascular diseases could be developed for clinic application in the future.

  3. Using Polymeric Scaffolds for Vascular Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Alida Abruzzo

    2014-01-01

    Full Text Available With the high occurrence of cardiovascular disease and increasing numbers of patients requiring vascular access, there is a significant need for small-diameter (<6 mm inner diameter vascular graft that can provide long-term patency. Despite the technological improvements, restenosis and graft thrombosis continue to hamper the success of the implants. Vascular tissue engineering is a new field that has undergone enormous growth over the last decade and has proposed valid solutions for blood vessels repair. The goal of vascular tissue engineering is to produce neovessels and neoorgan tissue from autologous cells using a biodegradable polymer as a scaffold. The most important advantage of tissue-engineered implants is that these tissues can grow, remodel, rebuild, and respond to injury. This review describes the development of polymeric materials over the years and current tissue engineering strategies for the improvement of vascular conduits.

  4. Hedgehog and Resident Vascular Stem Cell Fate

    Directory of Open Access Journals (Sweden)

    Ciaran J. Mooney

    2015-01-01

    Full Text Available The Hedgehog pathway is a pivotal morphogenic driver during embryonic development and a key regulator of adult stem cell self-renewal. The discovery of resident multipotent vascular stem cells and adventitial progenitors within the vessel wall has transformed our understanding of the origin of medial and neointimal vascular smooth muscle cells (SMCs during vessel repair in response to injury, lesion formation, and overall disease progression. This review highlights the importance of components of the Hh and Notch signalling pathways within the medial and adventitial regions of adult vessels, their recapitulation following vascular injury and disease progression, and their putative role in the maintenance and differentiation of resident vascular stem cells to vascular lineages from discrete niches within the vessel wall.

  5. Vascular narrowing in pulmonary arterial hypertension is heterogeneous: rethinking resistance

    NARCIS (Netherlands)

    Rol, N.; Timmer, E.M.; Faes, T.J.; Noordegraaf, A.V.; Grunberg, K.; Bogaard, H.J.; Westerhof, N.

    2017-01-01

    In idiopathic pulmonary arterial hypertension (PAH), increased pulmonary vascular resistance is associated with structural narrowing of small (resistance) vessels and increased vascular tone. Current information on pulmonary vascular remodeling is mostly limited to averaged increases in wall

  6. Taking care of your vascular access for hemodialysis

    Science.gov (United States)

    ... below as a reminder. What Is a Vascular Access? A vascular access is an opening made in your skin ... access into your body. Know What Type of Vascular Access You Have There are 3 main types of ...

  7. Bypass materials in vascular surgery

    Directory of Open Access Journals (Sweden)

    Willich, Stephan N.

    2006-03-01

    Full Text Available Introduction: Arteriosclerotic changes can lead to circulatory disturbances in various areas of the human vascular system. In addition to pharmacological therapy and the management of risk factors (e. g. hypertension, diabetes, lipid metabolism disorders, and lifestyle, surgical interventions also play an important role in the treatment of arteriosclerosis. Long-segment arterial occlusions, in particular, can be treated successfully with bypass sur-gery. A number of different materials are available for this type of operation, such as autologous vein or pros-thetic grafts comprised of polytetrafluoroethylene (PTFE or Dacron®. Prosthetic materials are used especially in the treatment of peripheral artery disease, such as in aortoiliac or femoropopliteal bypass surgery. The present report will thus focus on this area in order to examine the effectiveness of different bypass materials. Among the efforts being made to refine the newly introduced DRG system in Germany, analysing the different bypass materials used in vascular surgery is particularly important. Indeed, in its current version the German DRG system does not distinguish between bypass materials in terms of reimbursement rates. Differences in cost structures are thus of especial interest to hospitals in their budget calculations, whereas both private and statutory health insurance funds are primarily interested in long-term results and their costs. Objectives: The goal of this HTA is to compare the different bypass materials used in vascular surgery in terms of their medical efficiency and cost-effectiveness, as well as with regard to their ethical, social and legal implications. In addition, this report aims to point out the areas in which further medical, epidemiological and health economic research is still needed. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information

  8. [Gastric vascular lesions in cirrhosis: gastropathy and antral vascular ectasia].

    Science.gov (United States)

    Casas, Meritxell; Calvet, Xavier; Vergara, Mercedes; Bella, Maria Rosa; Junquera, Félix; Martinez-Bauer, Eva; Campo, Rafael

    2015-02-01

    Portal hypertensive gastropathy (GHP) is a complication of portal hypertension usually associated with liver cirrhosis. The pathogenesis is unclear but the presence of portal hypertension is an essential factor for its development. GHP may be asymptomatic or present as gastrointestinal bleeding or iron deficiency anemia. Endoscopic lesions vary from a mosaic pattern to diffuse red spots; the most common location is the fundus. Treatment is indicated when there is acute or chronic bleeding, as secondary prophylaxis. There is insufficient evidence to recommend primary prophylaxis in patients who have never bled. Drugs that decrease portal pressure, such as non-cardioselective beta-blockers, and/or endoscopic ablative treatments, such as argon-beam coagulation, may be used. The role of transarterial intrahepatic portosystemic shunt) or bypass surgery has been insufficiently analyzed. Antral vascular ectasia (EVA) is a rare entity in liver cirrhosis, whose pathophysiology is still unknown. Clinical presentation is similar to that of GHP and endoscopy usually shows red spots in the antrum. Biopsy is often required to differentiate EVA from GHP. There is no effective medical therapy, so endoscopic ablative therapy and, in severe cases, antrectomy are recommended. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  9. Geração de clones de células HEK293 superprodutores de isoformas recombinantes de VEGF-A (Fator de Crescimento Endotelial Vascular A) humano visando à produção de biofármacos para terapia molecular e engenharia tecidual

    OpenAIRE

    Gustavo Gross Belchior

    2014-01-01

    Os primeiros vasos sanguíneos do embrião de vertebrados, formados de novo a partir de células originadas da mesoderme, originam os vasos linfáticos em um processo denominado vasculogênese. Já no adulto, novos vasos são formados principalmente através da angiogênese (ou linfoangiogênese) a partir da vasculatura pré-existente. Em indivíduos saudáveis, a arquitetura vascular é relativamente estática, sendo que o excesso ou a insuficiência de vasos são comumente relacionados à angiogênese patológ...

  10. Índices para estimar o tempo transcorrido entre o surto hemorrágico subaracnóideo e a colheita de líquido cefalorraqueano Appraisement of the time elapsed between cerebro-vascular accidents and cerebrospinal fluid examination. An experimental study

    Directory of Open Access Journals (Sweden)

    José M. Marlet

    1973-12-01

    Full Text Available O autor simulou, experimentalmente, acidente vascular cerebral hemorrágico em cães injetando sangue do próprio animal no espaço subaracnóideo, colhendo amostras diárias de LCR durante 14 dias, sendo estudada a evolução das concentrações de oxiemoglobina e de bilirrubina, empregando métodos espectrofotométricos. Define um coeficiente hemoglobínico como a relação entre a concentração de oxiemoglobina e o total de pigmentos do LCR e um índice hemoglobina-bilirrubina como a relação entre as concentrações de oxiemoglobina e bilirrubina. Depois do tratamento estatístico, chega à conclusão de que ambos permitem estimar o tempo transcorrido desde o surto hemorrágico subaracnóideo e a colheita de LCR. São apresentadas sugestões quanto à aplicabilidade prática destes indicadores em Neurologia e Medicina Preventiva.Hemorrhagic cerebro-vascular accidents were simulated in dogs by injecting their own blood in the subarachnoidal space. Gathering daily samples of cerebrospinal fluid during 14 days the evolution of the concentrations of oxyhemoglobin and bilirubin using the spectrosphotometric method was studied. The author defines hemoglobin coefficient as being the relatinship between the oxyhemoglobin concentration and the sum of the cerebrospinal fluid pigments and the hemoglobin-bilirubin index as the relationship between the oxyhemoglobin and the bilirubin concentration. After statistical treatment the author concludes that both permit to calculate the time span between the subarachnoidal hemorrhage and the examination of the cerebrospinal fluid. Some suggestions on the practical applicability of these indexes in Clinical Neurology and Preventive Medicine are discussed.

  11. Adiciones y revisiones al Atlas de la flora vascular silvestre de Burgos

    OpenAIRE

    Alejandre Sáez, Juan Antonio; Arán Redó, Vicente J.; Pablo BARBADILLO ESCRIVÁ DE ROMANÍ; Juan José BARREDO PÉREZ; Javier BENITO AYUSO; Escalante Ruiz, María Josefa; García López, Javier María; Luis MARÍN PADELLANO; Gonzalo MATEO SANZ; Moreno Moral, Gonzalo; Alberto RODRÍGUEZ GARCÍA; Sánchez Fernández, Rafael

    2016-01-01

    Se mencionan 31 táxones con citas y/o comentarios referidos a su existencia en la provincia de Burgos. De ellos 8 suponen una novedad para el catálogo provincial. Additions and revisions for the “Atlas de la flora vascular silvestre de Burgos”, IX. 31 Taxa with either quotations or remarks, related to their existence within the province of Burgos, are mentioned. 8 out of these aforementioned ones mean a novelty value for the provincial catalogue.

  12. [A new specialty is born: Vascular medicine].

    Science.gov (United States)

    Laroche, J-P

    2016-05-01

    On the 4th of December 2015, the French authorities officially recognized the birth of a specialty in vascular medicine entitled CO-DES cardiology-vascular/vascular Medicine. France is the 7th country to obtain this specialty after Switzerland, Germany, Austria, Czech Republic, Slovakia and Slovenia, six countries in the EEC. It has taken years to achieve a long but exciting experience: we went from hopes to disappointments, sometimes with the blues, but lobbying helping… with sustained confidence. This article tells the story of 30 years of struggle to achieve this vascular medicine specialty. Gaston Bachelard wrote: "Nothing is obvious, nothing is given, all is built." For the construction of vascular medicine, we had to overcome many obstacles, nothing was given to us, everything was conquered. Beware "The specialist is one who knows more and more things about an increasingly restricted field, up to 'knowing everything about nothing"' recalled Ralph Barton Ferry, philosopher; so there is room for modesty and humility but also convictions. The physical examination will remain the basis of our exercise. But let us recall the contributions of all those vascular physicians who practiced in the past, together with those currently active, who built day after day, year after year, a vascular medicine of quality. It is because of the trust of our colleagues and our patients that we can occupy the place that is ours today. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Microbleeds in vascular dementia: clinical aspects.

    Science.gov (United States)

    Van der Flier, Wiesje M; Cordonnier, Charlotte

    2012-11-01

    Microbleeds are small dot-like lesions which can be appreciated on gradient echo, T2*-weighted magnetic resonance images as hypointensities. They are considered as an expression of small vessel disease on MRI, next to lacunes and white matter hyperintensities (WMH). Microbleeds are relatively common in vascular dementia, with reported prevalences between 35% and 85%. In the context of vascular dementia, microbleeds are mainly thought to result from hypertensive vasculopathy, but the frequent co-occurrence of lobar microbleeds suggests that neurodegenerative pathology and/or cerebral amyloid angiopathy is also of importance. The presence of multiple microbleeds in vascular dementia or in patients with vascular cognitive impairment is related to worse performance on cognitive tests, mainly in psychomotor speed and executive functioning. They may have some predictive value in terms of predicting development of (vascular) dementia, mortality and disability. Data on the occurrence of stroke and post-stroke dementia in patients with microbleeds are to date not available. New definitions and diagnostic criteria for vascular dementia and vascular cognitive impairment are needed and should take into account microbleeds. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. XXXI LIAC Meeting on Vascular Research - Proceedings

    Directory of Open Access Journals (Sweden)

    L. Monteiro Rodrigues et al.

    2015-12-01

    Full Text Available LIAC MEETING ON VASCULAR RESEARCH 9 a 12 September | 9 a 12 Setembro Lisbon U. Lusofona's | Lisboa - Universidade Lusófona Scientific Commitee /Comissão Científica Luís Monteiro Rodrigues Philippe Charpiot, Brigida Bochicchio Alain-Pierre Gadeau Jacques Bonnet Julia Bujan Colette Lacabanne Fulvia Ortolani Organizing Commitee /Comissão Organizadora Luis Monteiro Rodrigues, CBIOS - ULHT Ana Sofia Fernandes, CBIOS - ULHT Catarina Pinto Reis, CBIOS - ULHT Henrique Silva, CBIOS - ULHT Hugo Ferreira, IBEB - FCUL Escola de Ciências e Tecnologias da Saúde (ECTS da U. Lusófona de Humanidades e Tecnologias ALIES – Associação Lusófona para o Desenvolvimento do Ensino e Investigação das Ciências da Saúde CBIOS – Centro de Investigação em Biociências e Tecnologias da Saúde Program /Programa 9 September | 9 de Setembro Open Session | Sessão de abertura António Tamburro Conference Lisboa's Wine & Cheese battle 10 September | 10 de Setembro 1st Session |Sessão 1 Molecular and Supramolecular Structure | Estrutura Molecular e Supramolecular Charmain | Moderador - Alain Pierre Gadeau Keynote lecture 1 | 1ª Conferência Keynote Speaker | Prelector Sylvie Ricard-Blum Free Comunications | Comunicações livres Speakers | Prelectores Brigida Bochicchio Vicenta Llorente-Cortés Zeinab El Dirani J Leal Monedero Keynote lecture 2 | 2ª Conferência Keynote Speaker | Prelector Valerie Samouillan Program /Programa (cont. 2st Session |Sessão 2 Cell Biology and Signaling | Biologia Celular e Sinalização Charmain | Moderador - Michel Spina Keynote lecture 3 | 3ª Conferência Keynote Speaker | Prelector Vicente Andrés Free Comunications | Comunicações livres Speakers | Prelectores Alain Gadeau Cristina Sena Filipe Paula Pascal Maurice 11 September | 11 de Setembro 3st Session |Sessão 3 Biomaterials and Tissue Engineering | Biomateriais e Engenharia de Tecidos Charmain | Moderador - Brigida Bochicchio Keynote lecture 4 | 4ª Confer

  15. Fascia and Primo Vascular System

    Directory of Open Access Journals (Sweden)

    Chun Yang

    2015-01-01

    Full Text Available The anatomical basis for the concept of acupuncture points/meridians in traditional Chinese medicine (TCM has not been resolved. This paper reviews the fascia research progress and the relationship among acupuncture points/meridians, primo vascular system (PVS, and fascia. Fascia is as a covering, with common origins of layers of the fascial system despite diverse names for individual parts. Fascia assists gliding and fluid flow and holds memory and is highly innervated. Fascia is intimately involved with nourishment of all cells of the body, including those of disease and cancer. The human body’s fascia network may be the physical substrate represented by the meridians of TCM. The PVS is a newly found circulatory system; recent increased interest has led to new research and new discoveries in the anatomical and functional aspects of the PVS. The fasciology theory provides new insights into the physiological effects of acupuncture needling on basic cellular mechanisms including connective tissue mechanotransduction and regeneration. This view represents a theoretical basis and means for applying modern biomedical research to examining TCM principles and therapies, and it favors a holistic approach to diagnosis and treatment.

  16. Vascular inflammatory cells in hypertension

    Directory of Open Access Journals (Sweden)

    David G. Harrison

    2012-05-01

    Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

  17. Dental infection and vascular disease.

    Science.gov (United States)

    Zoellner, Hans

    2011-04-01

    Periodontitis is a chronic inflammatory response to bacterial plaque in which the anchoring bone and soft tissues supporting teeth are destroyed, resulting in tooth mobility and loss. Dental caries involves the spread of infection from the dentine to the vascular dental pulp and periapical bony tissues, before involvement of adjacent soft tissues and spreading sepsis. Several case-controlled, cross-sectional, and cohort studies report correlation between periodontitis and increased cardiovascular, cerebrovascular, and peripheral artery disease, as determined by clinical disease, angiography, ultrasonography, and reduced flow-mediated dilation. Some studies report a similar relationship of atherosclerosis with periapical infection and potentially also with coronal caries, and this review identifies the need to investigate these associations further. Smoking and cadmium exposure are epidemiologically confounding environmental risk factors shared by atherosclerosis and periodontitis. Further complicating epidemiological studies are the risk factors for both atherosclerosis and periodontitis, with which periodontitis appears to have separate positive feedback relationships. These include diabetes, increased plasma lipid levels, hypertension, and white blood cell count. Animal and human intervention studies provide some direct support of a causal role for periodontitis in atherosclerosis, and possible mechanisms include bacterial invasion of arteries, specific atherogenic properties of oral bacteria, the acute phase response, and cytokine polymorphisms. © Thieme Medical Publishers.

  18. Intracranial Vascular Malformations and Epilepsy.

    Science.gov (United States)

    Josephson, Colin B; Rosenow, Felix; Al-Shahi Salman, Rustam

    2015-06-01

    Among the spectrum of intracranial vascular malformations (IVMs), arteriovenous malformations (AVMs), and cavernous malformations (CCMs) are of particular importance for epilepsy. Seizures are a common mode of presentation for both conditions. Seizures may occur de novo or secondary to intracerebral hemorrhage. Timely imaging is thus crucial for patients with seizures and AVMs or CCMs. Patients with a first-ever AVM- or CCM-related seizure can now be considered to have epilepsy according to the International League Against Epilepsy criteria. Observational studies and case series suggest that between 45 to 78% of patients with AVM-related epilepsy and 47 to 60% of patients with CCM-related epilepsy may achieve seizure freedom through antiepileptic drugs (AEDs) alone. Invasive procedures are available although current evidence suggests that epilepsy-specific preintervention evaluations are underused. Randomized controlled trials and population-based studies have demonstrated worse short-term functional outcomes after routine intervention on unruptured AVMs or CCMs when compared with conservative management. The role of invasive therapy for IVM-related epilepsy has yielded mixed results. Case series have reported high estimates of seizure freedom although these results have not been replicated in controlled observational studies. Randomized controlled trials of immediate invasive therapy versus conservative management, in addition to usual care with AEDs and of different types of treatment and their timing, are warranted for AVMs and CCM-related epilepsy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Oral vascular malformations: laser treatment and management

    Science.gov (United States)

    Romeo, U.; Rocchetti, F.; Gaimari, G.; Tenore, G.; Palaia, G.; Lo Giudice, G.

    2016-03-01

    Vascular malformations are a very heterogeneous group of circulatory system's diseases that can involve different kind of vessels: arterial, venous or lymphatic ones. Many treatments, such as conventional surgery, embolization, steroid therapy and laser therapy, are available for vascular lesions. The laser approach relies more therapeutic techniques: the transmucosal thermophotocoagulation, intralesional photocoagulation, the excisional biopsy. Today laser is demonstrated to be the gold standard technique to treat vascular lesions that allows a safe and efficient treatment and a lower post-operative healing time. The only disadvantage is the risk of carbonization that could be avoided by using the multiple-spot single pulsed wave technique.

  20. Imaging evaluation of fetal vascular anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Koch, Bernadette L.; Laor, Tal [MLC 5031 Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Adams, Denise M. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics and Hemangioma and Vascular Malformation Center, Cincinnati, OH (United States); Gupta, Anita [Cincinnati Children' s Hospital Medical Center, Department of Pathology, Cincinnati, OH (United States); Lim, Foong-Yen [Cincinnati Children' s Hospital Medical Center, Pediatric Surgery and Fetal Center of Cincinnati, Cincinnati, OH (United States)

    2015-08-15

    Vascular anomalies can be detected in utero and should be considered in the setting of solid, mixed or cystic lesions in the fetus. Evaluation of the gray-scale and color Doppler US and MRI characteristics can guide diagnosis. We present a case-based pictorial essay to illustrate the prenatal imaging characteristics in 11 pregnancies with vascular malformations (5 lymphatic malformations, 2 Klippel-Trenaunay syndrome, 1 venous-lymphatic malformation, 1 Parkes-Weber syndrome) and vascular tumors (1 congenital hemangioma, 1 kaposiform hemangioendothelioma). Concordance between prenatal and postnatal diagnoses is analyzed, with further discussion regarding potential pitfalls in identification. (orig.)

  1. Vascular pathology in the throwing athlete.

    Science.gov (United States)

    Dugas, J R; Weiland, A J

    2000-08-01

    Vascular pathology in the upper extremity of a throwing athlete comprises a spectrum of serious disorders apt to threaten the patient's career and the viability of the involved parts. Such pathology includes digital vessel thrombosis, proximal thrombosis with distal embolization, vessel aneurysm, and vessel compression, such as in thoracic outlet syndrome and quadrilateral space syndrome. This article provides a description of vascular disorders prone to result from sports activities and a review of published data relevant to throwing athletes. Recognition of vascular compromise as a cause for dead arm syndrome or painful digital dysfunction among athletes is essential to prevent the grave consequences of progressive ischemia.

  2. Retroperitoneal vascular malformation mimicking incarcerated inguinal hernia

    Directory of Open Access Journals (Sweden)

    Dubey Indu

    2011-01-01

    Full Text Available A 30-year-old man presented to the Department of Surgery with a painful groin swelling on right side. Exploration revealed a reddish-blue hemangiomatous mass in the scrotum extending through inguinal canal into the retroperitoneum. On further dissection swelling was found to be originating from right external iliac vein. The swelling was excised after ligating all vascular connections. The histopathological examination of excised mass confirmed the diagnosis of venous variety of vascular malformation. This is the first reported case of vascular malformation arising from retroperitoneum and extending into inguinoscrotal region, presenting as incarcerated inguinal hernia.

  3. Mechanisms of Vascular Aging: New Perspectives

    Science.gov (United States)

    Kaley, Gabor; de Cabo, Rafael; Sonntag, William E.; Csiszar, Anna

    2010-01-01

    This review focuses on molecular, cellular, and functional changes that occur in the vasculature during aging; explores the links between mitochondrial oxidative stress, inflammation, and development of vascular disease in the elderly patients; and provides a landscape of molecular mechanisms involved in cellular oxidative stress resistance, which could be targeted for the prevention or amelioration of unsuccessful vascular aging. Practical interventions for prevention of age-associated vascular dysfunction and disease in old age are considered here based on emerging knowledge of the effects of anti-inflammatory treatments, regular exercise, dietary interventions, and caloric restriction mimetics. PMID:20576649

  4. Subclinical hypothyroidism after vascular complicated pregnancy.

    Science.gov (United States)

    van der Zanden, Moniek; Hop-de Groot, Rianne J; Sweep, Fred C G J; Ross, H Alec; den Heijer, Martin; Spaanderman, Marc E A

    2013-01-01

    Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions. In 372 women with a history of vascular complicated pregnancy, we assessed thyroid function. Subclinical hypothyroidism was diagnosed in 73/372 women (19.6%). It occurred more often when pregnancy ended before 32 weeks of gestation (p = 0.008). In this cohort, subclinical hypothyroidism is more common after very preterm delivery. It may contribute to the elevated risk of remote cardiovascular disease.

  5. Maternal uterine vascular remodeling during pregnancy.

    Science.gov (United States)

    Osol, George; Mandala, Maurizio

    2009-02-01

    Sufficient uteroplacental blood flow is essential for normal pregnancy outcome and is accomplished by the coordinated growth and remodeling of the entire uterine circulation, as well as the creation of a new fetal vascular organ: the placenta. The process of remodeling involves a number of cellular processes, including hyperplasia and hypertrophy, rearrangement of existing elements, and changes in extracellular matrix. In this review, we provide information on uterine blood flow increases during pregnancy, the influence of placentation type on the distribution of uterine vascular resistance, consideration of the patterns, nature, and extent of maternal uterine vascular remodeling during pregnancy, and what is known about the underlying cellular mechanisms.

  6. Flora vascular de los Humedales de Chimbote, Perú

    Directory of Open Access Journals (Sweden)

    César Arana

    2013-06-01

    Full Text Available Los humedales de Chimbote (09°05’51"S; 78°32’52"O presentan una flora vascular compuesta por 41 especies en 18 familias. El 61% magnoliópsidas y el 39% liliópsidas. Las familias con mayor número de especies fueron Poaceae, Cyperaceae y Asteraceae. Las formas de crecimiento dominantes fueron las hierbas (85% seguidas de arbustos (10%. En comparación con los humedales costeros de Lima, en Chimbote se presenta mayor riqueza de especies que en Medio Mundo (16 especies y El Paraíso (25, aunque menos que en Los Pantanos de Villa (66. Un análisis de agrupamiento indica una mayor similitud con el humedal de Los Pantanos de Villa. En estos humedales se presentan cuatro tipos de comunidades vegetales. La mayor diversidad de especies es encontrada en la desembocadura del río Lacramarca.

  7. Vascular Complications During Catheter Ablation of Cardiac Arrhythmias: A Comparison Between Vascular Ultrasound Guided Access and Conventional Vascular Access.

    Science.gov (United States)

    Sharma, Parikshit S; Padala, Santosh K; Gunda, Sampath; Koneru, Jayanthi N; Ellenbogen, Kenneth A

    2016-10-01

    Vascular access related complications are the most common complications from catheter based EP procedures and have been reported to occur in 1-13% of cases. We prospectively assessed vascular complications in a large series of consecutive patients undergoing catheter based electrophysiologic (EP) procedures with ultrasound (US) guided vascular access versus conventional access. Consecutive patients undergoing catheter ablation procedures at VCU medical center were included. US guided access was obtained in all cases starting June 2015 (US group) while modified Seldinger technique without US guidance (non-US group) was used in cases prior to this date. All vascular complications were recorded for a 30-day period after the procedure. A total of 689 patients underwent 720 procedures. Ablations for ventricular tachyarrhythmias (ventricular tachycardia: VT, premature ventricular contractions: PVCs) accounted for 89 (12%) cases; atrial fibrillation (AF) ablations accounted for 328 procedures (46%) and other catheter based procedures accounted for 42% of cases. A significantly higher incidence of complications was noted in the non-US group compared with the US group (19 [5.3%] vs. 4 [1.1%], respectively, P = 0.002). Major complications were also higher among the non-US group (9 [2.5%] vs. 2 [0.6%], P = 0.03). Increasing age (P = 0.04) and non-US guided vascular access (P = 0.002) were associated with a higher risk of vascular access complications. In a large series of patients undergoing catheter based EP procedures for cardiac arrhythmias, US guided vascular access was associated with a significantly decreased 30-day risk of vascular complications. © 2016 Wiley Periodicals, Inc.

  8. Effect of vascular burden as measured by vascular indexes upon vascular dementia: a matched case-control study

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2012-01-01

    Full Text Available Paul Y Takahashi, Casey R Caldwell, Paul V TargonskiPrimary Care Internal Medicine, Mayo Clinic, Rochester MN, USABackground: Vascular dementia (VaD is a challenging illness that affects the lives of older adults and caregivers. It is unclear how multiple vascular risk factor exposures (polyvascular disease affect VaD.Purpose: To determine the relationship between multiple vascular risk exposures, as counted on an index in cases with VaD, compared with healthy age-/gender-matched controls.Methods: This was a matched case-control study of subjects living in Olmsted County, MN with documented VaD. Controls were selected by gender and age within 3 years from those who did not have dementia. The exposures included a total index (eleven exposure factors added together, along with indexes for cerebrovascular disease (two exposures, cardiovascular disease (four exposures, vascular disease (three exposures, and lifestyle (two exposures. Analysis used matched conditional univariable logistic regression for each index.Results: A total of 1736 potential subjects were identified, and 205 subjects were diagnosed with VaD. There was a significant association of the total score index with an odds ratio of 1.45 (95% confidence interval 1.21–1.74. The cerebrovascular index was also associated with VaD with an odds ratio of 12.18 (95% confidence interval 6.29–23.61. The cardiovascular and vascular indexes were also associated with VaD status. The lifestyle index was not associated with VaD.Conclusion: The cumulative role of multiple vascular risk factors or diseases increased the risk of VaD, as noted by the total vascular index. The lifestyle index did not reveal any significant differences. Further work is required for evaluation of these indexes.Keywords: polyvascular disease, elderly, vascular dementia

  9. Fisioterapia vascular no tratamento da doença venosa crônica

    Directory of Open Access Journals (Sweden)

    Flávia de Jesus Leal

    2015-09-01

    Full Text Available ResumoContextoA aplicação da fisioterapia vascular através dos exercícios terapêuticos e da drenagem linfática manual (DLM na Doença Venosa Crônica (DVC contribui para a minimização das alterações vasculares, com melhora do retorno venoso, diminuindo a estase sanguínea e contribuindo para a melhora do quadro clínico.ObjetivoVerificar a eficácia da fisioterapia vascular no tratamento da DVC.MétodosEstudo-piloto prospectivo longitudinal, que avaliou dez pacientes com DVC, com classificação CEAP (1-5, que responderam aos questionários de qualidade de vida (QV SF-36 e AVVQ, sendo submetidos a pletismografia a água e goniometria dos membros inferiores. Finalizada a avaliação inicial, receberam tratamento fisioterapêutico vascular, com exercícios terapêuticos e DLM, em dez sessões de 60 minutos. Após tratamento, foram novamente avaliadas pela aplicação dos questionários iniciais e realização dos métodos de mensuração volumétrica e de amplitude de movimento articular (ADM.ResultadosPacientes do gênero feminino, com idade média de 43,1 anos. Nas atividades de vida prática (AVPs, a posição predominante foi ortostatismo prolongado. Na classificação CEAP, a maioria das pacientes apresentou C3 e apenas 10% delas eram C2. Nos questionamentos sobre suas principais queixas, relataram sensação de peso e cansaço nos membros, dor nas pernas, prurido e edema. Após as sessões de fisioterapia vascular, todas as pacientes encontravam-se sem queixas. A ADM e a QV apresentaram melhora significativa após intervenção da fisioterapia vascular.ConclusãoA fisioterapia vascular contribui para o controle do quadro clínico da DVC, melhorando edema e ADM, e favorecendo a melhora da QV dos acometidos pela doença.

  10. Vascular malformations of the spine; Spinale Gefaessmalformationen

    Energy Technology Data Exchange (ETDEWEB)

    Thron, A.; Mull, M. [Universitaetsklinikum der RWTH Aachen (Germany). Abt. Neuroradiologie; Reith, W. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. fuer Neuroradiologie

    2001-11-01

    The vascular malformations of the spine and spinal cord are rare diseases. Possible symptoms may consist in a transient neurological deficit, a progressive sensorimotor transverse lesion or an acute para- or tetraplegia. Damage to the spinal cord occurs by bleeding, space-occupying effects and venous congestion, rarely by steal effects. Classification of the true inborn malformations differentiates between arteriovenous malformations (AVMs), cavernomas and capillary teleangiectasias. The more frequent spinal dural arteriovenous fistula (SDAVF) of the elderly patient is a probably acquired lesion which is presented in a separate paper. Capillary teleangiectasias are mostly incidental findings but may cause differential diagnostic problems. Cavernomas are important causes of hemorrhage and may initially be obscured within the bleeding. MRI is the most relevant imaging procedure in the early diagnostic workup. In case of an AVM selective spinal angiography is required to define the type of the lesion and to decide about the appropriate therapy which may be endovascular-interventional, neurosurgical, combined or attentive. (orig.) [German] Die Gefaessmalformationen des Spinalkanals und Rueckenmarks sind seltene Erkrankungen, deren moegliche Symptome von transienten neurologischen Ausfaellen bis zur akuten Querschnittlaehmung reichen. Eine Schaedigung des Rueckenmarks kann durch Blutungen, Raumforderungswirkung, venoese Kongestion oder ''Steal-Effekte'' entstehen. Haeufiger als die echten (angeborenen) Malformationen, wozu arteriovenoese Malformationen (AVMs), Kavernome und kapillaere Teleangiektasien gerechnet werden, sind die vermutlich erworbenen spinalen duralen arteriovenoesen Fisteln (SDAVF) des aelteren Patienten, die gesondert dargestellt werden. Die kapillaeren Teleangiektasien sind meist Zufallsbefunde, koennen aber differenzialdiagnostische Verwirrung verursachen. Kavernome sind eine wichtige Ursache fuer Blutungen, wobei sie sich

  11. Hydrogels for Engineering of Perfusable Vascular Networks

    Science.gov (United States)

    Liu, Juan; Zheng, Huaiyuan; Poh, Patrina S. P.; Machens, Hans-Günther; Schilling, Arndt F.

    2015-01-01

    Hydrogels are commonly used biomaterials for tissue engineering. With their high-water content, good biocompatibility and biodegradability they resemble the natural extracellular environment and have been widely used as scaffolds for 3D cell culture and studies of cell biology. The possible size of such hydrogel constructs with embedded cells is limited by the cellular demand for oxygen and nutrients. For the fabrication of large and complex tissue constructs, vascular structures become necessary within the hydrogels to supply the encapsulated cells. In this review, we discuss the types of hydrogels that are currently used for the fabrication of constructs with embedded vascular networks, the key properties of hydrogels needed for this purpose and current techniques to engineer perfusable vascular structures into these hydrogels. We then discuss directions for future research aimed at engineering of vascularized tissue for implantation. PMID:26184185

  12. Headache as Risk Factor for Vascular Disease

    OpenAIRE

    J Gordon Millichap

    2010-01-01

    The association of severe or recurrent headache or migraine with vascular disease in childhood or adolescence was examined by a National Health and Nutrition Survey at the National Institute of Neurological Disease and Stroke and of Mental Health, Bethesda, MD.

  13. Regulation of Vascular Function on Posttranscriptional Level

    Directory of Open Access Journals (Sweden)

    Andreas Eisenreich

    2013-01-01

    Full Text Available Posttranscriptional control of gene expression is crucial for regulating plurality of proteins and functional plasticity of the proteome under (pathophysiologic conditions. Alternative splicing as well as micro (miRNA-mediated mechanisms play an important role for the regulation of protein expression on posttranscriptional level. Both alternative splicing and miRNAs were shown to influence cardiovascular functions, such as endothelial thrombogenicity and the vascular tone, by regulating the expression of several vascular proteins and their isoforms, such as Tissue Factor (TF or the endothelial nitric oxide synthase (eNOS. This review will summarize and discuss the latest findings on the (pathophysiologic role of alternative splicing processes as well as of miRNAs on modulation of vascular functions, such as coagulation, thrombosis, and regulation of the vascular tone.

  14. Vascular tumors of bone : Imaging findings

    NARCIS (Netherlands)

    Vermaat, Marieke; Vanel, Daniel; Kroon, Herman M.; Verbeke, Sofie L. J.; Alberghini, Marco; Bovee, Judith V. M. G.; Bloem, Johan L.

    Purpose: To identify radiological features of malignant vascular tumors of bone, which can be used to avoid erroneously diagnosing metastases based on radiological multifocality, and histological epitheloid phenotype. Materials and methods: From the databases of the Bologna & Netherlands Committee

  15. Vascular adaption to physical inactivity in humans

    NARCIS (Netherlands)

    Bleeker, M.W.P.

    2006-01-01

    This thesis presents studies on vascular adaptation to physical inactivity and deconditioning. Although it is clear that physical inactivity is an important risk factor for cardiovascular disease, the underlying physiological mechanisms have not yet been elucidated. In contrast to physical

  16. Diagnosis and Management of Lymphatic Vascular Disease

    National Research Council Canada - National Science Library

    Rockson, Stanley G

    2008-01-01

    ... it. The most readily recognizable attribute of lymphatic vascular incompetence is the presence of the characteristic swelling of tissues, called lymphedema, which arises as a consequence of insufficient lymph transport...

  17. Extracellular Matrix Molecules Facilitating Vascular Biointegration

    Directory of Open Access Journals (Sweden)

    Martin K.C. Ng

    2012-08-01

    Full Text Available All vascular implants, including stents, heart valves and graft materials exhibit suboptimal biocompatibility that significantly reduces their clinical efficacy. A range of biomolecules in the subendothelial space have been shown to play critical roles in local regulation of thrombosis, endothelial growth and smooth muscle cell proliferation, making these attractive candidates for modulation of vascular device biointegration. However, classically used biomaterial coatings, such as fibronectin and laminin, modulate only one of these components; enhancing endothelial cell attachment, but also activating platelets and triggering thrombosis. This review examines a subset of extracellular matrix molecules that have demonstrated multi-faceted vascular compatibility and accordingly are promising candidates to improve the biointegration of vascular biomaterials.

  18. Evidence for a vascular factor in migraine

    DEFF Research Database (Denmark)

    Asghar, Mohammad S; Hansen, Adam E; Amin, Faisal Mohammad

    2011-01-01

    It has been suggested that migraine is caused by neural dysfunction without involvement of vasodilatation. Because dismissal of vascular mechanisms seemed premature, we examined diameter of extra- and intracranial vessels in migraine without aura patients....

  19. Hydrogels for Engineering of Perfusable Vascular Networks

    Directory of Open Access Journals (Sweden)

    Juan Liu

    2015-07-01

    Full Text Available Hydrogels are commonly used biomaterials for tissue engineering. With their high-water content, good biocompatibility and biodegradability they resemble the natural extracellular environment and have been widely used as scaffolds for 3D cell culture and studies of cell biology. The possible size of such hydrogel constructs with embedded cells is limited by the cellular demand for oxygen and nutrients. For the fabrication of large and complex tissue constructs, vascular structures become necessary within the hydrogels to supply the encapsulated cells. In this review, we discuss the types of hydrogels that are currently used for the fabrication of constructs with embedded vascular networks, the key properties of hydrogels needed for this purpose and current techniques to engineer perfusable vascular structures into these hydrogels. We then discuss directions for future research aimed at engineering of vascularized tissue for implantation.

  20. World Federation of Vascular Societies: presidential address

    DEFF Research Database (Denmark)

    Sillesen, Henrik Hegaard

    2010-01-01

    The presidential address describes briefly the history of the World Federation for Vascular Societies (WFVS) and its objectives. Vascular Surgery today includes interventional procedures (open surgical and endovascular) in addition to risk factor reduction and medical treatment. It is equally imp...... throughout the world. In addition, for introduction of new treatments, training issues and dissemination of science a global organisation like the WFVS is needed.......The presidential address describes briefly the history of the World Federation for Vascular Societies (WFVS) and its objectives. Vascular Surgery today includes interventional procedures (open surgical and endovascular) in addition to risk factor reduction and medical treatment. It is equally....... Similar, in order to be able to train with relevant case mix and numbers, and in order always to have both complex open and endovascular skills on call 24 hours per day, 365 days a year, centralisation into larger units is necessary. The WFVS is important simply looking at the huge demographic differences...

  1. Biomimicry, vascular restenosis and coronary stents.

    Science.gov (United States)

    Schwartz, R S; van der Giessen, W J; Holmes, D R

    1998-01-01

    Biomimicry is in its earliest stages and is being considered in the realm of tissue engineering. If arterial implants are to limit neointimal thickening, purely passive structures cannot succeed. Bioactivity must be present, either by pharmacologic intervention or by fabricating a 'living stent' that contains active cellular material. As tissue engineering evolves, useful solutions will emerge from applying this knowledge directly to vascular biologic problems resulting from angioplasty, stenting, and vascular prosthesis research.

  2. Standardized Definitions for Hemodialysis Vascular Access

    OpenAIRE

    Lee, Timmy; Mokrzycki, Michele; Moist, Louise; Maya, Ivan; Vazquez, Miguel; Lok, Charmaine

    2011-01-01

    Vascular access dysfunction is one of the leading causes of morbidity and mortality among end-stage renal disease patients 1,2. Vascular access dysfunction exists in all 3 types of available accesses: arteriovenous fistulas, arteriovenous grafts, and tunneled catheters. In order to improve clinical research and outcomes in hemodialysis access dysfunction, the development of a multidisciplinary network of collaborative investigators with various areas of expertise, and common standards for ter...

  3. Vascular Plaque Determination for Stroke Risk Assessment

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0608 TITLE: Vascular Plaque Determination for Stroke Risk Assessment PRINCIPAL INVESTIGATOR: Vince, David Geoffrey...TITLE AND SUBTITLE Vascular Plaque Determination for Stroke Risk Assessment 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-16-1-0608 5c. PROGRAM... plaques at high risk for initiating a cerebrovascular accident. The core of the current research project is a pilot clinical study to enroll 100 subjects

  4. 3D Bioprinting for Vascularized Tissue Fabrication.

    Science.gov (United States)

    Richards, Dylan; Jia, Jia; Yost, Michael; Markwald, Roger; Mei, Ying

    2017-01-01

    3D bioprinting holds remarkable promise for rapid fabrication of 3D tissue engineering constructs. Given its scalability, reproducibility, and precise multi-dimensional control that traditional fabrication methods do not provide, 3D bioprinting provides a powerful means to address one of the major challenges in tissue engineering: vascularization. Moderate success of current tissue engineering strategies have been attributed to the current inability to fabricate thick tissue engineering constructs that contain endogenous, engineered vasculature or nutrient channels that can integrate with the host tissue. Successful fabrication of a vascularized tissue construct requires synergy between high throughput, high-resolution bioprinting of larger perfusable channels and instructive bioink that promotes angiogenic sprouting and neovascularization. This review aims to cover the recent progress in the field of 3D bioprinting of vascularized tissues. It will cover the methods of bioprinting vascularized constructs, bioink for vascularization, and perspectives on recent innovations in 3D printing and biomaterials for the next generation of 3D bioprinting for vascularized tissue fabrication.

  5. Materials for engineering vascularized adipose tissue.

    Science.gov (United States)

    Chiu, Yu-Chieh; Cheng, Ming-Huei; Uriel, Shiri; Brey, Eric M

    2011-05-01

    Loss of adipose tissue can occur due to congenital and acquired lipoatrophies, trauma, tumor resection, and chronic disease. Clinically, it is difficult to regenerate or reconstruct adipose tissue. The extensive microvsacular network present in adipose, and the sensitivity of adipocytes to hypoxia, hinder the success of typical tissue transfer procedures. Materials that promote the formation of vascularized adipose tissue may offer alternatives to current clinical treatment options. A number of synthetic and natural biomaterials common in tissue engineering have been investigated as scaffolds for adipose regeneration. While these materials have shown some promise they do not account for the unique extracellular microenvironment of adipose. Adipose derived hydrogels more closely approximate the physical and chemical microenvironment of adipose tissue, promote preadipocyte differentiation and vessel assembly in vitro, and stimulate vascularized adipose formation in vivo. The combination of these materials with techniques that promote rapid and stable vascularization could lead to new techniques for engineering stable, vascularized adipose tissue for clinical application. In this review we discuss materials used for adipose tissue engineering and strategies for vascularization of these scaffolds. Materials that promote formation of vascularized adipose tissue have the potential to serve as alternatives or supplements to existing treatment options, for adipose defects or deficiencies resulting from chronic disease, lipoatrophies, trauma, and tumor resection. Copyright © 2009 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  6. [Management of vascular anomalies in children].

    Science.gov (United States)

    Elajmi, A; Clapuyt, P; Hammer, F; Bataille, A-C; Lengele, B; Boon, L M

    2016-10-01

    Vascular anomalies, which are broadly identified as "angiomas", are rare entities and often unknown by the medical sphere. They are divided in two different categories which carry different prognosis and management: "vascular tumors" and "vascular malformations". Their precise identification is crucial and involves a good knowledge of the biological classification published by Mulliken and Glowacki and that has recently been updated by the International Society for the Study of Vascular Anomalies (ISSVA). Vascular tumors are benign, common, inborn or not and most of the time disappear with growth. Vascular malformations are always congenital and growth with the child. They can involve type of vessels solely or combined with others. A rheologic differentiation between slow and fast flow malformations is essential in order to characterize the seriousness of the lesion. Frequently, their diagnosis is clinically established and the anamnesis is conducted to answer three questions that are the time of revelation of the lesion ("When?"), its aspect ("What?") and its evolution ("How?"). Further investigations are usually not required but a non-invasive imaging technique such as Doppler ultrasound could be useful if a doubt exists. Surgery is not mandatory and must always be well thought because its consequences might be disastrous. It must be left to cosmetic sequelae of these lesions or to lesions that are totally resectable without causing any unacceptable deformation. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Cardiopulmonary Manifestations of Collagen Vascular Diseases.

    Science.gov (United States)

    Jawad, Hamza; McWilliams, Sebastian R; Bhalla, Sanjeev

    2017-10-09

    The study aimed to illustrate the cardiopulmonary findings of the following collagen vascular diseases on cross-sectional imaging: rheumatoid arthritis, scleroderma (progressive systemic sclerosis), systemic lupus erythematosus, the inflammatory myopathies (polymyositis/dermatomyositis), and Sjögren's syndrome. Although collagen vascular diseases can affect any part of the body, interstitial lung disease and pulmonary hypertension are the two most important cardiopulmonary complications and are responsible for the majority of morbidity and mortality in this patient population. Interstitial pneumonia with autoimmune features (IPAF) is a newly described entity that encompasses interstitial lung disease in patients with clinical, serologic, or morphologic features suggestive of but not diagnostic of collagen vascular disease; these patients are thought to have better outcomes than idiopathic interstitial pneumonias. Interstitial lung disease and pulmonary hypertension determine the prognosis in collagen vascular disease patients. IPAF is a new term to label patients with possible collagen vascular disease-related interstitial lung disease. Collagen vascular disease patients are at increased risk for various malignancies.

  8. Vascular retraction driven by matrix softening

    Science.gov (United States)

    Valentine, Megan

    We recently discovered we can directly apply physical forces and monitor the downstream responses in a living organism in real time through manipulation of the blood vessels of a marine organism called, Botryllus schlosseri. The extracellular matrix (ECM) plays a key role in regulating vascular growth and homeostasis in Botryllus,a basal chordate which has a large, transparent extracorporeal vascular network that can encompass areas >100 cm2. We have determined that lysyl oxidase 1 (LOX1), which is responsible for cross-linking collagen, is expressed in all vascular cells and is critically important for vascular maintenance. Inhibition of LOX1 activity in vivo by the addition of a specific inhibitor, ß-aminopropionitrile (BAPN), caused a rapid, global regression of the entire vascular bed, with some vessels regressing >10 mm within 16 hrs. In this talk, I will discuss the molecular and cellular origins of this systemic remodeling event, which hinges upon the ability of the vascular cells to sense and respond to mechanical signals, while introducing this exciting new model system for studies of biological physics and mechanobiology. Collaborators: Anthony DeTomaso, Delany Rodriguez, Aimal Khankhel (UCSB).

  9. Stroke injury, cognitive impairment and vascular dementia☆

    Science.gov (United States)

    Kalaria, Raj N.; Akinyemi, Rufus; Ihara, Masafumi

    2016-01-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25–30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood–brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  10. Vascular Adventitia Calcification and Its Underlying Mechanism.

    Directory of Open Access Journals (Sweden)

    Na Li

    Full Text Available Previous research on vascular calcification has mainly focused on the vascular intima and media. However, we show here that vascular calcification may also occur in the adventitia. The purpose of this work is to help elucidate the pathogenic mechanisms underlying vascular calcification. The calcified lesions were examined by Von Kossa staining in ApoE-/- mice which were fed high fat diets (HFD for 48 weeks and human subjects aged 60 years and older that had died of coronary heart disease, heart failure or acute renal failure. Explant cultured fibroblasts and smooth muscle cells (SMCswere obtained from rat adventitia and media, respectively. After calcification induction, cells were collected for Alizarin Red S staining. Calcified lesions were observed in the aorta adventitia and coronary artery adventitia of ApoE-/-mice, as well as in the aorta adventitia of human subjects examined. Explant culture of fibroblasts, the primary cell type comprising the adventitia, was successfully induced for calcification after incubation with TGF-β1 (20 ng/ml + mineralization media for 4 days, and the phenotype conversion vascular adventitia fibroblasts into myofibroblasts was identified. Culture of SMCs, which comprise only a small percentage of all cells in the adventitia, in calcifying medium for 14 days resulted in significant calcification.Vascular calcification can occur in the adventitia. Adventitia calcification may arise from the fibroblasts which were transformed into myofibroblasts or smooth muscle cells.

  11. Nuevos términos clínicos, prevención y tratamiento del trastorno cognitivo vascular: revisión de literatura basada en la evidencia.

    OpenAIRE

    Custodio, Nilton; Montesinos, Rosa; Alva-Diaz, Carlos; Mejía-Rojas, Koni; Becerra-Becerra, Yahaira; Lira, David

    2016-01-01

    El trastorno cognitivo vascular agrupa todas las instancias donde el compromiso cognitivo puede ser atribuido a enfermedad vascular cerebral, es mayor que el esperado para el envejecimiento normal y que, cuando llega a afectar las actividades de la vida diaria, se denomina demencia vascular. En esta revisión, se actualizan los términos relacionados a trastorno cognitivo vascular y se plantean estrategias de prevención y tratamiento basadas en revisionessistemáticas y meta-análisis. En la prim...

  12. Hypertensive organ damage in patients with vascular disease

    NARCIS (Netherlands)

    Vlek, A.L.M.

    2009-01-01

    Hypertension is one of the most common vascular risk factors, and is an important cause of development of different vascular diseases. The main aim of this thesis was to determine the burden of hypertension-associated vascular diseases and end-organ damage in patients with manifest vascular disease.

  13. Lung irradiation induces pulmonary vascular remodelling resembling pulmonary arterial hypertension

    NARCIS (Netherlands)

    Ghobadi, G.; Bartelds, B.; van der Veen, S. J.; Dickinson, M. G.; Brandenburg, S.; Berger, R. M. F.; Langendijk, J. A.; Coppes, R. P.; van Luijk, P.

    Background Pulmonary arterial hypertension (PAH) is a commonly fatal pulmonary vascular disease that is often diagnosed late and is characterised by a progressive rise in pulmonary vascular resistance resulting from typical vascular remodelling. Recent data suggest that vascular damage plays an

  14. Vascular associated gene variants in patients with preeclampsia

    DEFF Research Database (Denmark)

    Lykke, Jacob A; Bare, Lance A; Olsen, Jørn

    2012-01-01

    Preeclampsia has been linked to subsequent vascular disease with many shared predisposing factors. We investigated the association between severe preeclampsia, and its subtypes, and specific vascular-related polymorphisms.......Preeclampsia has been linked to subsequent vascular disease with many shared predisposing factors. We investigated the association between severe preeclampsia, and its subtypes, and specific vascular-related polymorphisms....

  15. Cartilage oligomeric matrix protein prevents vascular aging and vascular smooth muscle cells senescence.

    Science.gov (United States)

    Wang, Meili; Fu, Yi; Gao, Cheng; Jia, Yiting; Huang, Yaqian; Liu, Limei; Wang, Xian; Wang, Wengong; Kong, Wei

    2016-09-16

    Aging-related vascular dysfunction contributes to cardiovascular morbidity and mortality. Cartilage oligomeric matrix protein (COMP), a vascular extracellular matrix protein, has been described as a negative regulatory factor for the vascular aging-related processes including atherosclerosis and vascular calcification. However, whether COMP is implicated in the process of vascular aging remains unclear. Here, we identified a novel function of COMP in preventing vascular aging and vascular smooth muscle cells (VSMCs) senescence. Firstly, vascular COMP expression was decreased in three different senescence-accelerated mouse models and was also declining with age. COMP(-/-) mice displayed elevated senescence-associated markers expression, including p53, p21 and p16, in the aortas compared with their wild type (WT) littermates. In accordance, COMP deficiency induced aging-related vascular dysfunction as evidenced by the significantly reduced phenylephrine-induced contraction and increased vascular stiffness as evaluated by pulse wave velocity. The aortic wall of COMP(-/-) mice was susceptible to senescence by displaying senescence-associated β-galactosidase (SA β-gal) activity induced by periadventitial application of CaCl2 to the abdominal aorta. In vitro, COMP knockdown by small interfering (si) RNA led to the elevation of p53, p21 and p16 as well as SA β-gal activity in VSMCs after H2O2 stimulation. VSMCs isolated from COMP(-/-) mice showed elevated senescence-associated markers expression and supplement of COMP adenovirus to COMP-deficient VSMCs greatly rescued cellular senescence. Taken together, these findings revealed the essential role of COMP in retarding the development of vascular aging and VSMC senescence. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Impact of Integrated Vascular Residencies on Academic Productivity within Vascular Surgery Divisions.

    Science.gov (United States)

    Kim, Bradford J; Valsangkar, Nakul P; Liang, Tiffany W; Murphy, Michael P; Zimmers, Teresa A; Bell, Teresa M; Davies, Mark G; Koniaris, Leonidas G

    2017-02-01

    Changing training paradigms in vascular surgery have been introduced to reduce overall training time. Herein, we sought to examine how shortened training for vascular surgeons may have influenced overall divisional academic productivity. Faculty from the top 55 surgery departments were identified according to National Institutes of Health (NIH) funding. Academic metrics of 315 vascular surgery, 1,132 general surgery, and 2,403 other surgical specialties faculty were examined using institutional Web sites, Scopus, and NIH Research Portfolio Online Reporting Tools from September 1, 2014, to January 31, 2015. Individual-level and aggregate numbers of publications, citations, and NIH funding were determined. The mean size of the vascular divisions was 5 faculty. There was no correlation between department size and academic productivity of individual faculty members (R(2) = 0.68, P = 0.2). Overall percentage of vascular surgery faculty with current or former NIH funding was 20%, of which 10.8% had major NIH grants (R01/U01/P01). Vascular surgery faculty associated with integrated vascular training programs demonstrated significantly greater academic productivity. Publications and citations were higher for vascular surgery faculty from institutions with both integrated and traditional training programs (48 of 1,051) compared to those from programs with integrated training alone (37 of 485) or traditional fellowships alone (26 of 439; P productivity was improved within vascular surgery divisions with integrated training programs or both program types. These data suggest that the earlier specialization of integrated residencies in addition to increasing dedicated vascular training time may actually help promote research within the field of vascular surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Imaging of vascular tumors with an emphasis on ISSVA classification.

    Science.gov (United States)

    Nozaki, Taiki; Matsusako, Masaki; Mimura, Hidefumi; Osuga, Keigo; Matsui, Mizuko; Eto, Hikaru; Ohtake, Naoyuki; Manabe, Atsushi; Kusakawa, Isao; Tsutsumi, Yoshiyuki; Nosaka, Shunsuke; Kamo, Minobu; Saida, Yukihisa

    2013-12-01

    The International Society for the Study of Vascular Anomalies (ISSVA) classification is becoming the international standard classification system for vascular tumors and vascular malformations. The ISSVA classification strictly distinguishes vascular tumors (neoplastic lesions) from vascular malformations (non-neoplastic lesions) based on whether there is a proliferation of vascular endothelial cells present, and it is an extremely useful classification system for determining therapeutic measures. For vascular tumors, it is clinically significant in terms of discriminating infantile hemangioma and rapidly involuting congenital hemangioma, which are expected to spontaneously regress, from other vascular tumors requiring treatment. Needless to say, clinical courses are important for diagnosis, and it is also important for radiologists to understand imaging findings on vascular tumors because such tumors have unique findings on diagnostic images. In this paper, vascular tumors are classified based on the ISSVA classification, and clinical and imaging findings are reviewed.

  18. Estudio vascular renal por TC multidetector de 64 canales 64-Multidetector row CT for the Renal Vascular Study

    Directory of Open Access Journals (Sweden)

    Daniela Stoisa

    2009-03-01

    Full Text Available Objetivo: Mostrar las diversas variantes anatómicas vasculares tanto arteriales como venosas en el estudio angiográfico renal por tomografìa computada multidetector (TCMD de 64 canales, dada su implicancia en un eventual planeamiento quirúrgico. Material y métodos: Evaluamos retrospectivamente 26 estudios realizados con tomógrafo Philips Brilliance de 64 canales. Se obtuvieron secuencias sin contraste y postcontraste e.v. en fases arterial y venosa, administrado con bomba inyectora doble cabezal. Para una fase arterial apropiada se utilizó técnica de bolus track. Las imágenes fueron posteriormente procesadas en Workstation Philips Brilliance 190P en un tiempo promedio de 30 minutos y reconstruidas con técnicas MIP y volumétrica. Resultados: Dentro de las variantes anatómicas arteriales, encontramos: bifurcaciones prehiliares (n=3, arterias accesorias (n=4 y arterias polares (n=9. Dentro de las variantes venosas fueron halladas: venas renales múltiples (n=5, venas circumaórticas (n=2, retroaórticas (n=2 y vena tributaria lumbar prominente (n=1. Conclusión: El estudio vascular renal adquiere importancia en el planeamiento quirúrgico en casos de nefrectomías parciales, laparoscópicas y en el transplante renal. Esto otorga suma utilidad al estudio de TCMD de 64 canales por su eficacia diagnóstica, dada la alta calidad de las reconstrucciones obtenidas, llegando a igualar a la angiografía digital, sin ser un método invasivo.Purpose: To show the wide range of anatomical vascular variants, arterial and venous, that can be seen in the angiographic renal study using 64-multidetector-row computed tomography (64-MDCT, due to its importance in an eventual surgical planning. Material and Methods: We have evaluated retrospectively 26 studies that have been done using a 64 channels Philips Brilliance CT scanner. We have obtained non enhanced and both in arterial and venous enhanced sequences. For the injection of the contrast material we

  19. Sirtuins, Cell Senescence, and Vascular Aging.

    Science.gov (United States)

    Kida, Yujiro; Goligorsky, Michael S

    2016-05-01

    The sirtuins (SIRTs) constitute a class of proteins with nicotinamide adenine dinucleotide-dependent deacetylase or adenosine diphosphate-ribosyltransferase activity. Seven SIRT family members have been identified in mammals, from SIRT1, the best studied for its role in vascular aging, to SIRT7. SIRT1 and SIRT2 are localized in the nucleus and cytoplasm. SIRT3, SIRT4, and SIRT5 are mitochondrial, and SIRT6 and SIRT7 are nuclear. Extensive studies have clearly revealed that SIRT proteins regulate diverse cell functions and responses to stressors. Vascular aging involves the aging process (senescence) of endothelial and vascular smooth muscle cells. Two types of cell senescence have been identified: (1) replicative senescence with telomere attrition; and (2) stress-induced premature senescence without telomere involvement. Both types of senescence induce vascular cell growth arrest and loss of vascular homeostasis, and contribute to the initiation and progression of cardiovascular diseases. Previous mechanistic studies have revealed in detail that SIRT1, SIRT3, and SIRT6 show protective functions against vascular aging, and definite vascular function of other SIRTs is under investigation. Thus, direct SIRT modulation and nicotinamide adenine dinucleotide stimulation of SIRT are promising candidates for cardiovascular disease therapy. A small number of pilot studies have been conducted to assess SIRT modulation in humans. These clinical studies have not yet provided convincing evidence that SIRT proteins alleviate morbidity and mortality in patients with cardiovascular diseases. The outcomes of multiple ongoing clinical trials are awaited to define the efficacy of SIRT modulators and SIRT activators in cardiovascular diseases, along with the potential adverse effects of chronic SIRT modulation. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  20. Adiposity, adipocytokines & microvesicles in the etiology of vascular disease

    OpenAIRE

    Kanhai, D.A.N.I.S.

    2013-01-01

    Vascular disease, in this thesis the terms vascular and cardiovascular are used interchangeably, is the number 1 cause of death worldwide. In 2008, 30% of all mortality had a vascular origin. Vascular mortality rates after a first manifestation of vascular disease are decreasing in Western society, which is attributable to better disease awareness, better preventive strategies and better healthcare systems. As mortality rates are decreasing, the number of patients surviving their first vascul...

  1. Desafio do cuidado domiciliar: avaliaÃÃo da sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefÃlico

    OpenAIRE

    Ana Railka de Souza Oliveira

    2010-01-01

    Estudar a sobrecarga dos cuidadores de pacientes acometidos por acidente vascular encefÃlico (AVE) contribui para a melhoria da assistÃncia de enfermagem ao tornÃ-la mais qualificada e orientada para as necessidades desta populaÃÃo. Objetivou-se avaliar a sobrecarga de cuidadores familiares principais de pacientes acometidos por acidente vascular encefÃlico. Estudo transversal, realizado no perÃodo de janeiro a abril de 2010, com cuidadores identificados dentro de Programas de AssistÃncia Do...

  2. Acidente vascular cerebral transitório como forma de apresentação de mixoma auricular

    Directory of Open Access Journals (Sweden)

    ROMEU PIRES

    2015-06-01

    Full Text Available Os autores apresentam o caso clínico de um doente de 71 anos, sem factores de risco vascular, admitido com clínica de acidente vascular cerebral transitório (AIT, cuja investigação etiológica veio revelar uma causa rara para esta faixa etária: um mixoma auricular esquerdo. The authors present a case of a patient of 71 years, without cardiovascular risk factors admitted by transient ischemic attack (TIA, whose diagnostic investigation led to the diagnosis of left atrial myxoma.

  3. Efecto del ejercicio aeróbico en la rigidez vascular en una población sana

    OpenAIRE

    Pizano, Alejandro; Echeverri, Darío; Montes, Félix R.

    2017-01-01

    Introducción: Un estilo de vida saludable es determinante para la salud cardiovascular. Existe controversia en los efectos vasculares benéficos del ejercicio físico. Objetivo: Evaluar el comportamiento de los parámetros de rigidez vascular en una población sana que practica ejercicio aeróbico rutinario en comparación con una población sana sedentaria. Métodos: Estudio de 32 sujetos sanos, pareados por edad y sexo: 12 hombres y 20 mujeres (46,3 ± 9,7 años), en el cual se evaluaron y comp...

  4. Design and development of multilayer vascular graft

    Science.gov (United States)

    Madhavan, Krishna

    2011-07-01

    Vascular graft is a widely-used medical device for the treatment of vascular diseases such as atherosclerosis and aneurysm as well as for the use of vascular access and pediatric shunt, which are major causes of mortality and morbidity in this world. Dysfunction of vascular grafts often occurs, particularly for grafts with diameter less than 6mm, and is associated with the design of graft materials. Mechanical strength, compliance, permeability, endothelialization and availability are issues of most concern for vascular graft materials. To address these issues, we have designed a biodegradable, compliant graft made of hybrid multilayer by combining an intimal equivalent, electrospun heparin-impregnated poly-epsilon-caprolactone nanofibers, with a medial equivalent, a crosslinked collagen-chitosan-based gel scaffold. The intimal equivalent is designed to build mechanical strength and stability suitable for in vivo grafting and to prevent thrombosis. The medial equivalent is designed to serve as a scaffold for the activity of the smooth muscle cells important for vascular healing and regeneration. Our results have shown that genipin is a biocompatible crosslinker to enhance the mechanical properties of collagen-chitosan based scaffolds, and the degradation time and the activity of smooth muscle cells in the scaffold can be modulated by the crosslinking degree. For vascular grafting and regeneration in vivo, an important design parameter of the hybrid multilayer is the interface adhesion between the intimal and medial equivalents. With diametrically opposite affinities to water, delamination of the two layers occurs. Physical or chemical modification techniques were thus used to enhance the adhesion. Microscopic examination and graft-relevant functional characterizations have been performed to evaluate these techniques. Results from characterization of microstructure and functional properties, including burst strength, compliance, water permeability and suture

  5. Preparation and features of polycaprolactone vascular grafts with the incorporated vascular endothelial growth factor

    Energy Technology Data Exchange (ETDEWEB)

    Sevostyanova, V. V., E-mail: sevostyanova.victoria@gmail.com; Khodyrevskaya, Y. I.; Glushkova, T. V.; Antonova, L. V.; Kudryavtseva, Y. A.; Barbarash, O. L.; Barbarash, L. S. [Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo (Russian Federation)

    2015-10-27

    The development of tissue-engineered small-diameter vascular grafts is an urgent issue in cardiovascular surgery. In this study, we assessed how the incorporation of the vascular endothelial growth factor (VEGF) affects morphological and mechanical properties of polycaprolactone (PCL) vascular grafts along with its release kinetics. Vascular grafts were prepared using two-phase electrospinning. In pursuing our aims, we performed scanning electron microscopy, mechanical testing, and enzyme-linked immunosorbent assay. Our results demonstrated the preservation of a highly porous structure and improvement of PCL/VEGF scaffold mechanical properties as compared to PCL grafts. A prolonged VEGF release testifies the use of this construct as a scaffold for tissue-engineered vascular grafts.

  6. Blood flow restricted exercise and vascular function.

    Science.gov (United States)

    Horiuchi, Masahiro; Okita, Koichi

    2012-01-01

    It is established that regular aerobic training improves vascular function, for example, endothelium-dependent vasodilatation and arterial stiffness or compliance and thereby constitutes a preventative measure against cardiovascular disease. In contrast, high-intensity resistance training impairs vascular function, while the influence of moderate-intensity resistance training on vascular function is still controversial. However, aerobic training is insufficient to inhibit loss in muscular strength with advancing age; thus, resistance training is recommended to prevent sarcopenia. Recently, several lines of study have provided compelling data showing that exercise and training with blood flow restriction (BFR) leads to muscle hypertrophy and strength increase. As such, BFR training might be a novel means of overcoming the contradiction between aerobic and high-intensity resistance training. Although it is not enough evidence to obtain consensus about impact of BFR training on vascular function, available evidences suggested that BFR training did not change coagulation factors and arterial compliance though with inconsistence results in endothelial function. This paper is a review of the literature on the impact of BFR exercise and training on vascular function, such as endothelial function, arterial compliance, or other potential factors in comparison with those of aerobic and resistance training.

  7. Cytoskeleton, cytoskeletal interactions, and vascular endothelial function

    Directory of Open Access Journals (Sweden)

    Wang J

    2012-12-01

    Full Text Available Jingli Wang,1 Michael E Widlansky1,21Department of Medicine, Cardiovascular Medicine Division, 2Department of Pharmacology, Medical College of Wisconsin, Milwaukee, Wisconsin, USAAbstract: Far from being inert, the vascular endothelium is a critical regulator of vascular function. While the endothelium participates in autocrine, paracrine, and endocrine signaling, it also transduces mechanical signals from the cell surface involving key cell structural elements. In this review, we discuss the structure of the vascular endothelium and its relationship to traditional cardiovascular risk factors and clinical cardiovascular events. Further, we review the emerging evidence that cell structural elements, including the glycocalyx, intercellular junctions, and cytoskeleton elements, help the endothelium to communicate with its environment to regulate vascular function, including vessel permeability and signal transduction via nitric oxide bioavailability. Further work is necessary to better delineate the regulatory relationships between known key regulators of vascular function and endothelial cell structural elements.Keywords: endothelium, shear stress, eNOS, cardiovascular risk factors, glycocalyx

  8. Toward a pathological definition of vascular dementia.

    Science.gov (United States)

    Grinberg, Lea Tenenholz; Heinsen, Helmut

    2010-12-15

    To date, there are no widely accepted neuropathological criteria for vascular dementia, although creating such a standard is ranked high on the wish list of all the researchers in this field. Such criteria would make it possible to perform large multicentre clinicopathological studies and, consequently, to better understand which, how, and where vascular brain lesions lead to cognitive decline, as it is possible to do in Alzheimer's disease or Parkinson's disease. However, a major obstacle in the standardization of diagnosis is the fact that vascular brain lesions are a large group comprising heterogeneous changes that have different pathogeneses. Although it is accepted that some kinds of vascular changes cause cognitive impairment, it is not uncommon to find reports of the assumed same histological changes in control subjects. An indispensable first step in the unequivocal establishment of neuropathological criteria is to uniform the definitions used for each one of the lesions, preferably based on its pathogenesis. In the present, non-standardized state of ambiguity, a given lesion is designated by different names between and within the clinical, radiological, and pathological settings, and several definitions simply overlap. Before attempting to create new criteria, a multidisciplinary group-task is urged to identify and minimize the uncontrolled proliferation of definitions. Only then, it will be possible to advance the understanding of how vascular brain changes affect cognition. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Blood Flow Restricted Exercise and Vascular Function

    Directory of Open Access Journals (Sweden)

    Masahiro Horiuchi

    2012-01-01

    Full Text Available It is established that regular aerobic training improves vascular function, for example, endothelium-dependent vasodilatation and arterial stiffness or compliance and thereby constitutes a preventative measure against cardiovascular disease. In contrast, high-intensity resistance training impairs vascular function, while the influence of moderate-intensity resistance training on vascular function is still controversial. However, aerobic training is insufficient to inhibit loss in muscular strength with advancing age; thus, resistance training is recommended to prevent sarcopenia. Recently, several lines of study have provided compelling data showing that exercise and training with blood flow restriction (BFR leads to muscle hypertrophy and strength increase. As such, BFR training might be a novel means of overcoming the contradiction between aerobic and high-intensity resistance training. Although it is not enough evidence to obtain consensus about impact of BFR training on vascular function, available evidences suggested that BFR training did not change coagulation factors and arterial compliance though with inconsistence results in endothelial function. This paper is a review of the literature on the impact of BFR exercise and training on vascular function, such as endothelial function, arterial compliance, or other potential factors in comparison with those of aerobic and resistance training.

  10. Neuropsychological profiles of vascular disease and risk of dementia: implications for defining vascular cognitive impairment no dementia (VCI-ND)

    OpenAIRE

    Stephan, BCM; Minett, T.; Muniz-Terrera, G.; Harrison, SL; Matthews, FE; Brayne, C.

    2017-01-01

    $\\textbf{Background}$ vascular cognitive impairment no dementia (VCI-ND) defines a preclinical phase of cognitive decline associated with vascular disorders. The neuropsychological profile of VCI-ND may vary according to different vascular conditions. $\\textbf{Objective}$ to determine the neuropsychological profile of individuals with no dementia and vascular disorders, including hypertension, peripheral vascular disease (PVD), coronary heart disease (CHD), diabetes and stroke. Ri...

  11. Avaliação do ácido lático em indivíduos com hemiparesia pós-acidente vascular encefálico após estimulação elétrica para fortalecimento muscular Lactic acid assessment in post-stroke hemiparetic subjects following electrical stimulation for muscle strengthening

    Directory of Open Access Journals (Sweden)

    Fernanda Ishida Corrêa

    2009-06-01

    Full Text Available O fortalecimento da musculatura parética promove melhora da capacidade funcional, o que pode ser obtido pela estimulação elétrica funcional (EEF, porém são necessários parâmetros específicos para evitar fadiga muscular. Este estudo visou verificar, em indivíduos com hemiparesia pós-AVE, o tempo de repouso (time off necessário para reabsorção do ácido lático durante a EEF, de modo a evitar a fadiga - detectada por lactacidemia (concentração excessiva de ácido lático. Foram coletadas amostras de sangue de 18 indivíduos portadores de hemiparesia em sete momentos, antes, durante e após a EEF. A corrente quadrada bifásica, de 50 Hz, foi usada com time on de 10 segundos (s e o time off variou de 10 s (protocolo 1 a 30 s (protocolo 2, sobre o ponto motor do músculo tibial anterior. Na análise do sangue coletado, não foi encontrada diferença estatisticamente significante (p>0,05 entre os dois protocolos; tampouco foi registrada diferença no período imediatamente pós-terapia. Pode-se pois afirmar que a ferramenta utilizada para mensurar lactacidemia não se mostrou eficaz na detecção da fadiga muscular, inviabilizando verificar o tempo ideal de repouso (time off, sendo necessários mais estudos em busca de protocolos seguros. Sugere-se a continuidade deste estudo, com alteração do músculo e atividade funcional eliciada pela estimulação elétrica, bem como uma ferramenta alternativa na mensuração e detecção da fadiga muscular.Strengthening paretic muscles improves functional capacity, which can be achieved by functional electric stimulation (FES, but specific parameters are needed in order to prevent muscle fatigue. The purpose of this study was to assess, in post-stroke hemiparetic patients, the necessary time of rest (time off for re-absorption of lactic acid during FES, so as to prevent fatigue - detected by lactic acid testing. Blood samples of 18 hemiparetic subjects were collected at seven moments: pre

  12. Vascular effects of maternal alcohol consumption.

    Science.gov (United States)

    Ramadoss, Jayanth; Magness, Ronald R

    2012-08-15

    Maternal alcohol consumption during pregnancy is a significant field of scientific exploration primarily because of its negative effects on the developing fetus, which is specifically defined as fetal alcohol spectrum disorders. Though the effects on the mother are less explored compared with those on the fetus, alcohol produces multiple effects on the maternal vascular system. Alcohol has major effects on systemic hemodynamic variables, endocrine axes, and paracrine factors regulating vascular resistance, as well as vascular reactivity. Alcohol is also reported to have significant effects on the reproductive vasculature including alterations in blood flow, vessel remodeling, and angiogenesis. Data presented in this review will illustrate the importance of the maternal vasculature in the pathogenesis of fetal alcohol spectrum disorders and that more studies are warranted in this field.

  13. Roles of xenobiotic receptors in vascular pathophysiology.

    Science.gov (United States)

    Xiao, Lei; Zhang, Zihui; Luo, Xiaoqin

    2014-01-01

    The pregnane X receptor (PXR) and constitutive androstane receptor (CAR), 2 closely related and liver-enriched members of the nuclear receptor superfamily, and aryl hydrocarbon receptor (AhR), a nonnuclear receptor transcription factor (TF), are major receptors/TFs regulating the expression of genes for the clearance and detoxification of xenobiotics. They are hence defined as "xenobiotic receptors". Recent studies have demonstrated that PXR, CAR and AhR also regulate the expression of key proteins involved in endobiotic responses such as the metabolic homeostasis of lipids, glucose, and bile acid, and inflammatory processes. It is suggested that the functions of PXR, CAR and AhR may be closely implicated in the pathogeneses of metabolic vascular diseases, such as hyperlipidemia, atherogenesis, and hypertension. Therefore, manipulation of the activities of these receptors may provide novel strategies for the treatment of vascular diseases. Here, we review the pathophysiological roles of PXR, CAR and AhR in the vascular system.

  14. Nonsurgical management of vascular malformation of masseter

    Directory of Open Access Journals (Sweden)

    Venkatesh Jayaraman

    2015-01-01

    Full Text Available Intramuscular vascular anomalies are rare congenital hamartomatous lesions. Less than 1% of these occur in skeletal muscle out of which 15% arise in head and neck musculature. In the head and neck region, masseter muscle is the most common site. It accounts for about 5% of intramuscular vascular malformations. They are present from birth but are clinically apparent during infancy and childhood and occasionally during adulthood. Due to its location it is often mistaken for a parotid swelling. The usual treatment of choice is surgical excision with a margin. This is associated with loss of motor function, hemorrhage, nerve damage. Intralesional sclerotherapy, embolization are nonsurgical alternatives for treatment of slow flow venous malformations. Sclerotherapy can be used solely in multiple sittings or as an adjunct to surgery. This article presents a case report of a 28-year-old male with recurrent intramuscular vascular malformation in the masseter muscle, which was successfully treated by ethanol sclerotherapy.

  15. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao

    2015-01-01

    -controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability...... vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy....... correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive...

  16. Impaired Pulmonary Vascular Development in Bronchopulmonary Dysplasia

    Science.gov (United States)

    Baker, Christopher D.; Abman, Steven H.

    2015-01-01

    Bronchopulmonary dysplasia (BPD), the chronic lung disease associated with preterm birth, results from disruption of normal pulmonary vascular and alveolar growth. Though BPD was once described as primarily due to postnatal injury from mechanical ventilation and oxygen therapy after preterm birth, it is increasingly appreciated that BPD results from antenatal and perinatal factors that interrupt lung development in infants born at the extremes of prematurity. The lung in BPD consists of a simplified parenchymal architecture that limits gas exchange and leads to increased cardiopulmonary morbidity and mortality. This review outlines recent advances in the understanding of pulmonary vascular development and describes how disruption of these mechanisms results in BPD. We point to future therapies that may augment postnatal vascular growth to prevent and treat this severe chronic lung disease. PMID:26044102

  17. Calcificaciones vasculares en pacientes con insuficiencia renal crónica

    Directory of Open Access Journals (Sweden)

    Jara C. Aquiles, DRA.

    2012-11-01

    Full Text Available En enfermedad renal crónica (ERC el riesgo aumentado de muerte por causa cardiovascular se relaciona con calcificaciones vasculares precoces y progresivas. Estas calcificaciones ocurren por un proceso altamente regulado. En los vasos de los pacientes con ERC coexisten calcificaciones en la íntima vascular asociadas a ateroesclerosis, pero además hay calcificaciones en la túnica media del vaso. Estos dos tipos de calcificaciones tienen distintas consecuencias fisiopatológicas cardiovasculares. Los principales componentes que interactúan para producir calcificación de la matriz extracelular son la célula muscular lisa vascular (CMLV, factores que inician el proceso de transformación osteocondrogénica, inductores e inhibidores de la calcificación, factores que regulan a estos últimos. Como respuesta al proceso de calcificación, el vaso expresa inhibidores que disminuyen la diferenciación osteoblástica, amplificando la lesión ósea adinámica. Así, el conocimiento del proceso patológico bidireccional del eje Hueso-Vaso ayuda a explicar la estrecha correlación entre pérdida de masa ósea y calcificación vascular.

  18. Ultrasound for vascular access in pediatric patients.

    Science.gov (United States)

    Schindler, Ehrenfried; Schears, Gregory J; Hall, Stuart R; Yamamoto, Tomohiro

    2012-10-01

    In pediatric patients vascular access is often more difficult than in adults because of the smaller size of the vessels and the inability of the patient to cooperate without deep sedation or general anesthesia. Therefore Ultrasound has already become an invaluable tool for vascular access, but the full potential of ultrasound has yet to be fully realized. Improvements in image quality and a better understanding of optimal insertion techniques continue to help clinicians safely and efficiently place catheters with fewer complications. The probes used for the vascular access are mainly linear and convex type. Higher- frequency ultrasound provides a vivid image; however, the signals are remarkably attenuated. Therefore, the choice of the probe with appropriate frequency is essential. As blood vessels are relatively easily identified with ultrasound, ultrasound-guided vascular access does not require as sharp images as ultrasound-guided nerve block. For pediatric vascular access, the linear probe with 5-15 MHz, 2-5 cm depth is ideal and adequate for almost all cases. Ultrasound-guided vascular access has two main approaches: 'long-axis' or 'in-plane approach' and 'short-axis' or 'transverse approach'. The long-axis approach visualizes the vessel along the insertion pathway and is commonly used to monitor the entire approach of the needle into the vessel. The short-axis approach is easier to show the positional relationship and depth of target vessels, but it is much harder to follow the needle tip within the tissues. The use of 'real-time' ultrasound has been shown to increase first insertion success, reduce access time, have a higher overall success, and reduce arterial puncture. As the technology continues to improve the use of ultrasound will become as ubiquitous as the lines themselves. © 2012 Blackwell Publishing Ltd.

  19. Oxidative stress and vascular inflammation in aging.

    Science.gov (United States)

    El Assar, Mariam; Angulo, Javier; Rodríguez-Mañas, Leocadio

    2013-12-01

    Vascular aging, a determinant factor for cardiovascular disease and health status in the elderly, is now viewed as a modifiable risk factor. Impaired endothelial vasodilation is a early hallmark of arterial aging that precedes the clinical manifestations of vascular dysfunction, the first step to cardiovascular disease and influencing vascular outcomes in the elderly. Accordingly, the preservation of endothelial function is thought to be an essential determinant of healthy aging. With special attention on the effects of aging on the endothelial function, this review is focused on the two main mechanisms of aging-related endothelial dysfunction: oxidative stress and inflammation. Aging vasculature generates an excess of the reactive oxygen species (ROS), superoxide and hydrogen peroxide, that compromise the vasodilatory activity of nitric oxide (NO) and facilitate the formation of the deleterious radical, peroxynitrite. Main sources of ROS are mitochondrial respiratory chain and NADPH oxidases, although NOS uncoupling could also account for ROS generation. In addition, reduced antioxidant response mediated by erythroid-2-related factor-2 (Nrf2) and downregulation of mitochondrial manganese superoxide dismutase (SOD2) contributes to the establishment of chronic oxidative stress in aged vessels. This is accompanied by a chronic low-grade inflammatory phenotype that participates in defective endothelial vasodilation. The redox-sensitive transcription factor, nuclear factor-κB (NF-κB), is upregulated in vascular cells from old subjects and drives a proinflammatory shift that feedbacks oxidative stress. This chronic NF-κB activation is contributed by increased angiotensin-II signaling and downregulated sirtuins and precludes adequate cellular response to acute ROS generation. Interventions targeted to recover endogenous antioxidant capacity and cellular stress response rather than exogenous antioxidants could reverse oxidative stress-inflammation vicious cycle in

  20. [Sonography of vascular and biliary epigastric structures].

    Science.gov (United States)

    Triller, J; Haertel, M; Zaunbauer, W; Fuchs, W A

    1981-04-01

    Ultrasonic devices with rapid image build-up and high power of resolution enable detailed assessment of the vascular and biliary structures. Visualisation of the biliary tract of normal lumen in the extrahepatic region enables identification of a biliary obstruction at a time where dilatation of the intrahepatic biliary tract has not yet taken place. The identification of small visceral branches of the aorta abdominalis as well as of portal and systemic veins yields sonographically reliable vascular points of reference which enable, apart from the exact localisation of the biliary tract and of the pancreas, accurate topographic identification of abdominal mass lesions.

  1. Genealogy of training in vascular neurosurgery.

    Science.gov (United States)

    Chowdhry, Shakeel A; Spetzler, Robert F

    2014-02-01

    Remarkable advances and changes in the landscape of neurovascular disease have occurred recently. Concurrently, a paradigm shift in training and resident education is underway. This crossroad of unique opportunities and pressures necessitates creative change in the training of future vascular neurosurgeons to allow incorporation of surgical advances, new technology, and supplementary treatment modalities in a setting of reduced work hours and increased public scrutiny. This article discusses the changing landscape in neurovascular disease treatment, followed by the recent changes in resident training, and concludes with our view of the future of training in vascular neurosurgery.

  2. Laser speckle analysis of retinal vascular dynamics

    DEFF Research Database (Denmark)

    Neganova, Anastasiia Y.; Postnov, Dmitry D.; Jacobsen, Jens Christian B.

    2016-01-01

    Studies of vascular responses are usually performed on isolated vessels or on single vessels in vivo. This allows for precise measurements of diameter or blood flow. However, dynamical responses of the whole microvascular network are difficult to access experimentally. We suggest to use full......-field laser speckle imaging to evaluate vascular responses of the retinal network. Image segmentation and vessel recognition algorithms together with response mapping allow us to analyze diameter changes and blood flow responses in the intact retinal network upon systemic administration of the vasoconstrictor...

  3. Gastric antral vascular ectasia: a case report

    Directory of Open Access Journals (Sweden)

    Amir Cehajic

    2014-09-01

    Full Text Available Gastric antral vascular ectasia is a vascular gastric malformation which represents a rare cause of upper gastrointestinal system bleeding. It is usually presented with a significant anemia and it is diagnosed with an endoscopic examination of the upper gastrointestinal system. It is often associated with other chronic illnesses such as liver cirrhosis, sclerodermia, diabetes mellitus and arterial hypertension. It is treated symptomatically in terms of anemia correction with blood transfusions and iron supplements, proton pump inhibitors, beta-blockers and endoscopic procedures such as argon plasma coagulation which currently represents the treatment of choice in Sy. GAVE cases.

  4. Prediction of Major Vascular Events after Stroke

    DEFF Research Database (Denmark)

    Ovbiagele, Bruce; Goldstein, Larry B.; Amarenco, Pierre

    2014-01-01

    BACKGROUND: Identifying patients with recent stroke or transient ischemic attack (TIA) at high risk of major vascular events (MVEs; stroke, myocardial infarction, or vascular death) may help optimize the intensity of secondary preventive interventions. We evaluated the relationships between...... were analyzed. Hazard ratios (HRs) from Cox regression models were used to determine the risk of subsequent MVEs based on the FCRS predicting 20% or more 10-year coronary heart disease risk. The novel risk model was derived based on multivariable modeling with backward selection. Model discrimination...

  5. Engineering the mechanical and biological properties of nanofibrous vascular grafts for in situ vascular tissue engineering.

    Science.gov (United States)

    Henry, Jeffrey J D; Yu, Jian; Wang, Aijun; Lee, Randall; Fang, Jun; Li, Song

    2017-08-17

    Synthetic small diameter vascular grafts have a high failure rate, and endothelialization is critical for preventing thrombosis and graft occlusion. A promising approach is in situ tissue engineering, whereby an acellular scaffold is implanted and provides stimulatory cues to guide the in situ remodeling into a functional blood vessel. An ideal scaffold should have sufficient binding sites for biomolecule immobilization and a mechanical property similar to native tissue. Here we developed a novel method to blend low molecular weight (LMW) elastic polymer during electrospinning process to increase conjugation sites and to improve the mechanical property of vascular grafts. LMW elastic polymer improved the elasticity of the scaffolds, and significantly increased the amount of heparin conjugated to the micro/nanofibrous scaffolds, which in turn increased the loading capacity of vascular endothelial growth factor (VEGF) and prolonged the release of VEGF. Vascular grafts were implanted into the carotid artery of rats to evaluate the in vivo performance. VEGF treatment significantly enhanced endothelium formation and the overall patency of vascular grafts. Heparin coating also increased cell infiltration into the electrospun grafts, thus increasing the production of collagen and elastin within the graft wall. This work demonstrates that LMW elastic polymer blending is an approach to engineer the mechanical and biological property of micro/nanofibrous vascular grafts for in situ vascular tissue engineering.

  6. Assessment of risk of peripheral vascular disease and vascular care capacity in Ghana

    Science.gov (United States)

    Gyedu, Adam; Stewart, Barclay T; Nakua, Emmanuel; Quansah, Robert; Donkor, Peter; Mock, Charles; Hardy, Mark A; Yangni-Angate, Koffi Herve

    2015-01-01

    Introduction This study aimed to describe national peripheral vascular disease (PVD) risk and health burden and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in a low- and middle-income country (LMIC) is defined and capacity improvement priorities identified. Methods Data to estimate PVD risk factor burden were obtained from: i) World Health Organization’s Study on Global Ageing and Health (SAGE), Ghana; and ii) Institute of Health Metrics and Evaluation Global Burden of Disease database (IHME GBD). In addition, a novel nationwide assessment of vascular care capacity was performed, with 20 vascular care items assessed at 40 hospitals in Ghana. Factors contributing to specific item deficiency were also described. Results From the SAGE database, there were 4,305 respondents aged at least 50 years with data to estimate PVD risk. Out of these 57% were at moderate to high PVD risk with ≥3 risk factors, thus giving 1,654,557 persons when extrapolated nationally. Using IHME GBD data, the estimated disability-adjusted life years incurred from PVD increased 5-fold from 1990 to 2010 (1.3 to 3.2 per 100,000 persons, respectively). Vascular care capacity assessment demonstrated marked deficiencies in items for diagnosis, perioperative and vascular surgical care. Deficiencies were most often due to absence of equipment, lack of training and technology breakage. Conclusion Risk factor reduction and management as well as optimization of current resources are paramount to avoid the large burden of peripheral vascular disease falling on healthcare systems in low- and middle-income countries that are not well equipped to handle vascular surgical care, and for which rapid development of such capacity would be difficult and expensive. PMID:26560502

  7. Vascular Anomalies Classification: Recommendations From the International Society for the Study of Vascular Anomalies.

    Science.gov (United States)

    Wassef, Michel; Blei, Francine; Adams, Denise; Alomari, Ahmad; Baselga, Eulalia; Berenstein, Alejandro; Burrows, Patricia; Frieden, Ilona J; Garzon, Maria C; Lopez-Gutierrez, Juan-Carlos; Lord, David J E; Mitchel, Sally; Powell, Julie; Prendiville, Julie; Vikkula, Miikka

    2015-07-01

    Vascular anomalies represent a spectrum of disorders from a simple "birthmark" to life- threatening entities. Incorrect nomenclature and misdiagnoses are commonly experienced by patients with these anomalies. Accurate diagnosis is crucial for appropriate evaluation and management, often requiring multidisciplinary specialists. Classification schemes provide a consistent terminology and serve as a guide for pathologists, clinicians, and researchers. One of the goals of the International Society for the Study of Vascular Anomalies (ISSVA) is to achieve a uniform classification. The last classification (1997) stratified vascular lesions into vascular malformations and proliferative vascular lesions (tumors). However, additional disease entities have since been identified that are complex and less easily classified by generic headings, such as capillary malformation, venous malformation, lymphatic malformation, etc. We hereby present the updated official ISSVA classification of vascular anomalies. The general biological scheme of the classification is retained. The section on tumors has been expanded and lists the main recognized vascular tumors, classified as benign, locally aggressive or borderline, and malignant. A list of well-defined diseases is included under each generic heading in the "Simple Vascular Malformations" section. A short definition is added for eponyms. Two new sections were created: one dealing with the malformations of individually named vessels (previously referred to as "truncular" malformations); the second groups lesions of uncertain or debated nature (tumor versus malformation). The known genetic defects underlying vascular anomalies are included in an appendix. This classification is meant to be a framework, acknowledging that it will require modification as new scientific information becomes available. Copyright © 2015 by the American Academy of Pediatrics.

  8. Vascular plugs - A key companion to Interventionists - 'Just Plug it'.

    Science.gov (United States)

    Ramakrishnan, Sivasubramanian

    2015-01-01

    Vascular plugs are ideally suited to close extra-cardiac, high flowing vascular communications. The family of vascular plugs has expanded. Vascular plugs in general have a lower profile and the newer variants can be delivered even through a diagnostic catheter. These features make them versatile and easy to use. The Amplatzer vascular plugs are also used for closing intracardiac defects including coronary arterio-venous fistula and paravalvular leakage in an off-label fashion. In this review, the features of currently available vascular plugs are reviewed along with tips and tricks of using them in the cardiac catheterization laboratory. Copyright © 2015. Published by Elsevier B.V.

  9. Demência vascular: dificuldades diagnósticas e tratamento Vascular dementia: a critical review of diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    CHARLES ANDRÉ

    1998-09-01

    Full Text Available JUSTIFICATIVA: O tratamento dos pacientes com síndrome demencial depende do diagnóstico correto de sua etiologia e da utilização de critérios objetivos de avaliação do curso da doença. O diagnóstico preciso da demência vascular (Dva é difícil e nossos conhecimentos sobre a organização neuropsicológica do cérebro em estados de doença e a evolução da doença são precários, tornando penosa a avaliação das respostas a diferentes intervenções. MÉTODOS: São discutidos os critérios diagnósticos, os instrumentos de avaliação do curso da Dva e as diferentes intervenções terapêuticas atualmente em estudo. RESULTADOS: O uso de critérios diagnósticos estritos e a otimização dos métodos de avaliação evolutiva são passos importantes para otimizar o tratamento dos pacientes com DVa. A prevenção de novos eventos cerebrovasculares é a única medida comprovadamente eficaz para promover estabilização e talvez regressão das alterações cognitivas e comportamentais nestes pacientes. As evidências de possível benefício de estimulantes inespecíficos do metabolismo cerebral e de drogas neuroprotetoras não são suficientes para indicar seu uso rotineiro. Medidas de estruturação do ambiente, o uso racional e parcimonioso de medicamentos em geral, e a definição através de testes neuropsicológicos de rotas terapêuticas adaptadas às necessidades de cada paciente são também importantes. CONCLUSÕES: Critérios diagnósticos e de acompanhamento evolutivo da DVa são ainda inadequados. A prevenção de novos episódios cerebrovasculares é a base do tratamento dos pacientes com DVa. O uso criterioso de drogas psiquiátricas, uma abordagem neurocognitiva dirigida aos déficits de cada paciente e a estruturação do ambiente para reduzir demandas desnecessárias e cansaço são importantes medidas complementares, mas deixam grande margem para otimização do tratamento.BACKGROUND: Treatment of vascular dementia

  10. Oscillation of Angiogenesis and Vascular Dropout in Progressive Human Vascular Disease. [Vascular Pattern as Useful Read-Out of Complex Molecular Signaling

    Science.gov (United States)

    Parsons-Wingerter, Patricia

    2010-01-01

    When analyzed by VESsel GENeration Analysis (VESGEN) software, vascular patterns provide useful integrative read-outs of complex, interacting molecular signaling pathways. Using VESGEN, we recently discovered and published our innovative, surprising findings that angiogenesis oscillated with vascular dropout throughout progression of diabetic retinopathy, a blinding vascular disease. Our findings provide a potential paradigm shift in the current prevailing view on progression and treatment of this disease, and a new early-stage window of regenerative therapeutic opportunities. The findings also suggest that angiogenesis may oscillate with vascular disease in a homeostatic-like manner during early stages of other inflammatory progressive diseases such as cancer and coronary vascular disease.

  11. General versus vascular surgeon: impact of a vascular fellowship on clinical practice, surgical case load, and lifestyle.

    Science.gov (United States)

    Franz, Randall W

    2010-02-01

    An applicant shortage for vascular surgery (VS) residencies exists despite an increase in available training positions created to meet the growing demands for vascular surgeons. After 3 years of practice as an American Board of Surgery (ABS)-certified/board-eligible general surgeon, the author of this study attended an accredited 1-year VS training fellowship and received an ABS certificate of Added Qualifications in VS. The purpose of this review was to investigate the implications completing a vascular fellowship has had on VS procedure patterns, vascular procedure competency, clinical practice, career, and lifestyle with the aim of attracting trainees to the field of VS. The author's operative logs were reviewed retrospectively to summarize vascular procedures performed before and after the vascular fellowship. Statistical analysis was performed comparing the types and volume of vascular procedures before and after the vascular fellowship. Changes in professional career and personal life also were examined. The author performed 401 vascular procedures during 2.8 years as a general surgeon. In the first 3.4 years after the vascular fellowship, vascular procedure volume increased to 1563. The mean number of vascular procedures performed per year increased from 143.2 as a general surgeon to 459.7 as a vascular surgeon. The three major differences in vascular procedures occurring after the vascular fellowship were (1) a threefold increase in the number of vascular procedures performed, (2) a shift from major open to venous and endovascular procedures, and (3) an increase in case complexity. Specializing in VS also has resulted in increased career opportunities, more career satisfaction, a direct financial benefit, and more flexibility for lifestyle and family. Because of these positive changes, the author encourages medical students and residents interested in VS to explore the specialty early, seek vascular surgeons to serve as mentors, and enter one of the new VS

  12. Riesgo de disfagia en pacientes con accidente cerebro vascular isquémico

    OpenAIRE

    Machado, Daniela

    2015-01-01

    La disfagia es un trastorno para tragar alimentos sólidos, semisólidos y/o líquidos debido a una deficiencia en cualquiera de las etapas de la deglución. Se asocia a un gran número de afectaciones neurológicas, entre ellas el accidente cerebro vascular. Objetivo: Determinar la presencia de disfagia en la etapa oral de la deglución y la sintomatología presente en los pacientes entre 40 y 70 años que sufrieron accidente cerebro vascular isquémico, con un tiempo de evolución de 1 a 6 me...

  13. Estudo da evolução de úlceras vasculares sob a ação de carboxterapia

    OpenAIRE

    Piazzolla,Luciana Paganini

    2012-01-01

    As úlceras vasculares são grande causa de isolamento social, depressão e redução das atividades de vida diária e instrumentais. Uma opção terapêutica para pacientes com úlcera vascular é a carboxiterapia. Trabalhos científicos comprovam melhora da cicatrização e menor custo, porém são poucos os estudos que exploram tal técnica. O objetivo desta pesquisa é estudar o efeito da carboxiterapia na redução do diâmetro e área das úlceras vasculares e intensidade da dor. Foi estudada uma série de ...

  14. Maternal homocystinuria and Moebius syndrome? Vascular aetiology

    OpenAIRE

    Gupta, N.; Anthony, M Y

    2011-01-01

    A case of Moebius syndrome is reported in an infant of a mother known to have pyridoxine-unresponsive homocystinuria. The authors suggest that Moebius syndrome could result from early vascular insufficiency or disruption occurring early in development related to maternal homocystinuria.

  15. Membrane-mediated regulation of vascular identity.

    Science.gov (United States)

    Hashimoto, Takuya; Tsuneki, Masayuki; Foster, Trenton R; Santana, Jeans M; Bai, Hualong; Wang, Mo; Hu, Haidi; Hanisch, Jesse J; Dardik, Alan

    2016-03-01

    Vascular diseases span diverse pathology, but frequently arise from aberrant signaling attributed to specific membrane-associated molecules, particularly the Eph-ephrin family. Originally recognized as markers of embryonic vessel identity, Eph receptors and their membrane-associated ligands, ephrins, are now known to have a range of vital functions in vascular physiology. Interactions of Ephs with ephrins at cell-to-cell interfaces promote a variety of cellular responses such as repulsion, adhesion, attraction, and migration, and frequently occur during organ development, including vessel formation. Elaborate coordination of Eph- and ephrin-related signaling among different cell populations is required for proper formation of the embryonic vessel network. There is growing evidence supporting the idea that Eph and ephrin proteins also have postnatal interactions with a number of other membrane-associated signal transduction pathways, coordinating translation of environmental signals into cells. This article provides an overview of membrane-bound signaling mechanisms that define vascular identity in both the embryo and the adult, focusing on Eph- and ephrin-related signaling. We also discuss the role and clinical significance of this signaling system in normal organ development, neoplasms, and vascular pathologies. © 2016 Wiley Periodicals, Inc.

  16. Vascular factors in dementia and apathy

    NARCIS (Netherlands)

    Eurelings, L.S.M.

    2016-01-01

    The number of individuals suffering from dementia is expected to rise significantly in the future. Because so far no curative treatment exists, prevention remains paramount. A large body of evidence points to the direction of an important role of vascular risk factors in the aetiology of dementia

  17. Self-management of vascular risk factors

    NARCIS (Netherlands)

    Sol-de Rijk, B.G.M.

    2009-01-01

    Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing

  18. Angiogenesis: the genetic regulation of vascular development

    NARCIS (Netherlands)

    R.A. Haasdijk (Remco Anton)

    2014-01-01

    markdownabstract__Abstract__ For centuries, many scientists are fascinated by the organisation of the vascular network. The Greek philosopher and polymath Aristotle (384 BC) was one of the first man who described the vasculature. He wrote: “the system of blood vessels in the body may

  19. Vascular risk factors, cognitve decline, and dementia

    Directory of Open Access Journals (Sweden)

    E Duron

    2008-04-01

    Full Text Available E Duron, Olivier HanonBroca Hospital, Paris, FranceAbstract: Dementia is one of the most important neurological disorders in the elderly. Aging is associated with a large increase in the prevalence and incidence of degenerative (Alzheimer’s disease and vascular dementia, leading to a devastating loss of autonomy. In view of the increasing longevity of populations worldwide, prevention of dementia has turned into a major public health challenge. In the past decade, several vascular risk factors have been found to be associated with vascular dementia but also Alzheimer’s disease. Some longitudinal studies, have found significant associations between hypertension, diabetus mellitus, and metabolic syndrome, assessed at middle age, and dementia. Studies assessing the link between hypercholesterolemia, atrial fibrillation, smoking, and dementia have given more conflicting results. Furthermore, some studies have highlighted the possible protective effect of antihypertensive therapy on cognition and some trials are evaluating the effects of statins and treatments for insulin resistance. Vascular risk factors and their treatments are a promising avenue of research for prevention of dementia, and further long-term, placebo-controlled, randomized studies, need to be performed.Keywords: dementia, hypertension, diabetus mellitus, hypercholesterolemia, metabolic syndrome

  20. Dynamics of nephron-vascular network

    DEFF Research Database (Denmark)

    Postnov, Dmitry; Postnov, D E; Marsh, D J

    2012-01-01

    to learn about processes not directly amenable to experimentation. We demonstrate that: (i) the nearest nephrons are synchronized in-phase due to a vascular propagated electrical coupling, (ii) the next few branching levels display a formation of phase-shifted patterns due to hemodynamic coupling and mode...

  1. Cerebral dysplastic vascular malformation: a developmental arrest

    Energy Technology Data Exchange (ETDEWEB)

    Wortzman, G.; Sima, A.A.F.; Morley, T.P.

    1983-08-01

    A cryptic malformation of the brain was found to represent an arrest in vascular development. Microscopy showed plump endothelium of blood vessels, which did not have a normal lumen and consisted of solid cords of cells. The microscopic, angiographic, and computed tomographic appearance of this anomaly are discussed and compared with cavernous angiomas, arteriovenous malformations, and venous angiomas.

  2. Biodegradable Microfluidic Scaffolds for Vascular Tissue Engineering

    Science.gov (United States)

    2005-01-01

    bonding multiple microfluidic layers. Introduction Overcoming the problems of nutrient transport is critical in the design of tissue engineering...an intrinsic vascular network within these scaffolds. More specifically, the application of microfabrication and BioMEMS technology has been focused

  3. [High flow vascular malformations in children].

    Science.gov (United States)

    López Gutiérrez, J C; Ros, Z; Martínez, L; Díaz, M; Leal, N; Rivas, S; Hernández, F

    2002-10-01

    Unlike hemangiomas and low-flow vascular malformations which are very common in children, arterial anomalies have small incidence. Differential diagnosis is difficult, and needs a physician familiarized with vascular anomalies. Appropriate treatment must be planned by multidisciplinary team considering the patient's age, and anatomical location. Twenty-eight children with high flow vascular malformations have been treated since 1990 at La Paz Children's Hospital Vascular Anomalies Program. We excluded of the study group patients with central nervous system lesions. 85% of the patients had malformation in stage I or II (according the ISSVA accepted Schöbinger stating) and most of them were erroneously diagnosed as hemangioms with a variety of inappropriate treatments previously performed. Doppler Ultrasound and Magnetic Resonance confirmed malformation flow and extension. Angiography and selective embolization was only considered as therapeutic approach in candidates to surgical resection. 16 patients underwent complete resection of the malformation including one foot and two fingers amputation and five more incomplete resection of the ulcerate area. In conclusion, we did not find age at onset, sex and symptoms relationship. Laser, radiotherapy, surgical ligation or partial resection must be considered inappropriate therapies which may stimulate AVM exacerbation. Only radical surgical procedure after selective endovascular embolization will be successful but then reconstructive surgery should be performed to achieve good aesthetic and functional results.

  4. SAJS 1050 - Vascular surgery.indd

    African Journals Online (AJOL)

    Vascular Surgery. SAJS. Three randomised controlled trials have shown a significant reduction in peri-operative mortality when comparing endovascular aneurysm repair (EVAR) with ... surgery poses an unacceptably high risk to them, but unfavourable ... All patients who underwent elective AUI with FFBP for abdominal.

  5. Vascular aspects of cognitive impairment and dementia

    NARCIS (Netherlands)

    Wiesmann, M.; Kiliaan, A.J.; Claassen, J.A.H.R.

    2013-01-01

    Hypertension and stroke are highly prevalent risk factors for cognitive impairment and dementia. Alzheimer's disease (AD) and vascular dementia (VaD) are the most common forms of dementia, and both conditions are preceded by a stage of cognitive impairment. Stroke is a major risk factor for the

  6. Vascular determinants of epilepsy: The Rotterdam study

    NARCIS (Netherlands)

    X. Li (Xinhua); M.M.B. Breteler (Monique); M.C. de Bruyne (Martine); H. Meinardi; W.A. Hauser (W. Allen); A. Hofman (Albert)

    1997-01-01

    textabstractPurpose: To investigate the relation between vascular determinants and epilepsy in an elderly population. Methods: This is a cross-sectional, community-based, case-control study. The total study population was comprised of 4,944 subjects, 65 of whom had epilepsy which conformed to

  7. Early vascular complications after pediatric liver transplantation

    NARCIS (Netherlands)

    Sieders, E; Peeters, PMJG; Ten Vergert, EM; de Jong, KP; Porte, RJ; Zwaveling, JH; Bijleveld, CMA; Slooff, MJH

    Vascular complications have a detrimental effect on the outcome after liver transplantation. Most studies focus exclusively on hepatic artery thrombosis (HAT), The current study analyzed the incidence, consequences, and risk factors for HAT, portal vein thrombosis (PVT), and venous outflow tract

  8. Clinical presentations and epidemiology of vascular dementia.

    Science.gov (United States)

    Smith, Eric E

    2017-06-01

    Cerebrovascular and cardiovascular diseases cause vascular brain injury that can lead to vascular cognitive impairment (VCI). VCI is the second most common neuropathology of dementia and mild cognitive impairment (MCI), accounting for up to one-third of the population risk. It is frequently present along with other age-related pathologies such as Alzheimer's disease (AD). Multiple etiology dementia with both VCI and AD is the single most common cause of later life dementia. There are two main clinical syndromes of VCI: post-stroke VCI in which cognitive impairment is the immediate consequence of a recent stroke and VCI without recent stroke in which cognitive impairment is the result of covert vascular brain injury detected only on neuroimaging or neuropathology. VCI is a syndrome that can result from any cause of infarction, hemorrhage, large artery disease, cardioembolism, small vessel disease, or other cerebrovascular or cardiovascular diseases. Secondary prevention of further vascular brain injury may improve outcomes in VCI. © 2017 The Author(s); published by Portland Press Limited on behalf of the Biochemical Society.

  9. Venous Thromboembolism in Pediatric Vascular Anomalies

    Directory of Open Access Journals (Sweden)

    Taizo A. Nakano

    2017-07-01

    Full Text Available The presence of a vascular anomaly suggests that capillaries, veins, arteries, and/or lymphatic vessels have demonstrated abnormal development and growth. Often dilated and misshaped, these vessels augment normal flow of blood and lymphatic fluids that increases the overall risk to develop intralesional thrombosis. Abnormal endothelial and lymphoendothelial cells activate hemostasis and hyperfibrinolytic pathways through poorly understood mechanisms, which contribute to the development of localized intravascular coagulopathy. Vascular malformations, tumors, and complex combined syndromes demonstrate varying degrees of prothrombotic activity and consumptive coagulopathy depending on the vessels involved and the pattern and extent of abnormal growth. The clinical impact of venous thromboembolism in pediatric vascular anomalies varies from painful syndromes that disrupt quality of life to life-threatening embolic disease. There remains little literature on the study, evaluation, and treatment of thrombosis in pediatric vascular anomalies. However, there have been great advances in our ability to image complex lesions, to surgically and interventionally augment disease, and to provide enhanced supportive care including patient education, compression therapy, and strategic use of anticoagulation.

  10. Vascular patterning in human heterotopic ossification.

    Science.gov (United States)

    Cocks, Margaret; Mohan, Aditya; Meyers, Carolyn A; Ding, Catherine; Levi, Benjamin; McCarthy, Edward; James, Aaron W

    2017-05-01

    Heterotopic ossification (HO, also termed myositis ossificans) is the formation of extra-skeletal bone in muscle and soft tissues. HO is a tissue repair process gone awry, and is a common complication of surgery and traumatic injury. Medical strategies to prevent and treat HO fall well short of addressing the clinical need. Better characterization of the tissues supporting HO is critical to identifying therapies directed against this common and sometimes devastating condition. The physiologic processes of osteogenesis and angiogenesis are highly coupled and interdependent. However, few efforts have been made to document the vascular patterning within heterotopic ossification. Here, surgical pathology case files of 29 human HO specimens were examined by vascular histomorphometric analysis. Results demonstrate a temporospatial patterning of HO vascularity that depends on the "maturity" of the bony lesion. In sum, human HO demonstrates a time- and space-dependent pattern of vascularization suggesting a coupled pathophysiologic process involving the coordinate processes of osteogenesis and angiogenesis. Further imaging studies may be used to further characterize vasculogenesis within HO and whether anti-angiogenic therapies are a conceivable future therapy for this common condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Audit of the Danish national vascular database

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Jensen, L P; Schroeder, T V

    1996-01-01

    The accuracy of data contained in the Danish vascular database was compared with the case notes. A total of 100 case notes were reviewed for 11 pertinent variables in the database. A high error rate ranging from 2 to 34% was found. Also, approximately 10% of patients had never been entered into t...

  12. Circulating Progenitor Cells in Diabetic Vascular Disease

    NARCIS (Netherlands)

    van Oostrom, O.

    2009-01-01

    Patients with diabetes have altered levels and function of (bone marrow-derived) vascular progenitor cells (endothelial progenitor cells-EPC, smooth muscle progenitor cells-SPC) which may contribute to their accelerated atherosclerosis. The results from clinical and experimental studies in this

  13. Electrotonic vascular signal conduction and nephron synchronization

    DEFF Research Database (Denmark)

    Marsh, D.J.; Toma, I.; Sosnovtseva, Olga

    2009-01-01

    frequencies of both pair members to converge to a common value. The myogenic oscillations also synchronized, and the synchronization between the TGF and the myogenic oscillations showed an increased stability against parameter perturbations. Electronic vascular signal propagation is a plausible mechanism...

  14. [Vascular injuries in joint replacement surgery].

    Science.gov (United States)

    Novotný, K; Pádr, R; Landor, I; Sosna, A

    2011-01-01

    Iatrogenic injuries to blood vessels in joint replacement surgery are rare events that occur as few per thousand. However, their sequelae are serious. The patient may either bleed to death, because vascular injury is not obvious and therefore difficult to diagnose, or lose the limb due to ischaemia. The highest risk of vascular injury is associated with repeat surgery and loosening of the acetabular component. We distinguish sharp and blunt force injuries. The former are caused by implants, sharp instruments, bone fragments or bone cement debris. The latter arise from stretching over a part of implanted material. Bleeding can be inapparent or apparent. Inapparent bleeding is difficult to diagnose and is recognized from the dynamics of blood losses. Haemodynamic instability or, in a worse case, even hypovolaemic shock may be the only signs of bleeding. Occlusion of an artery is manifested by limb ischaemia. The seriousness and progression of ischaemia depends on the rate of arterial occlusion, potential pathways for collateral circulation and the degree of atherosclerotic vascular disease. The patient with conduction anaesthesia does not feel pain and therefore the diagnosis must primarily be based on arterial pulsation in the limb and its skin colour. A pseudoaneurysm can develop due to a partially weakened vascular wall and its rupture is a life-threatening complication. Its presence is recognized as a pulsating mass in the groin. An arterio- venous fistula which arises from traumatic communication between the two vessels may lead to cardiac failure. The diagnosis is based on examination by sonography and digital subtraction angiography. The results of CT angiography and MR angiography are difficult to evaluate because of the presence of metal implants. In apparent bleeding it is sometimes difficult to locate the source. It is recommended to perform digital compression and gain access to the vessels from the extraperitoneal approach. When an expanding haematoma or

  15. Vascular Contributions to Cognitive Impairment and Dementia

    Science.gov (United States)

    Gorelick, Philip B.; Scuteri, Angelo; Black, Sandra E.; DeCarli, Charles; Greenberg, Steven M.; Iadecola, Costantino; Launer, Lenore J.; Laurent, Stephane; Lopez, Oscar L.; Nyenhuis, David; Petersen, Ronald C.; Schneider, Julie A.; Tzourio, Christophe; Arnett, Donna K.; Bennett, David A.; Chui, Helena C.; Higashida, Randall T.; Lindquist, Ruth; Nilsson, Peter M.; Roman, Gustavo C.; Sellke, Frank W.; Seshadri, Sudha

    2013-01-01

    Background and Purpose This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed. This statement serves as an overall guide for practitioners to gain a better understanding of VCI and dementia, prevention, and treatment. Methods Writing group members were nominated by the writing group co-chairs on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council Scientific Statement Oversight Committee, the Council on Epidemiology and Prevention, and the Manuscript Oversight Committee. The writing group used systematic literature reviews (primarily covering publications from 1990 to May 1, 2010), previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and, when appropriate, formulate recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. After peer review by the American Heart Association, as well as review by the Stroke Council leadership, Council on Epidemiology and Prevention Council, and Scientific Statements Oversight Committee, the statement was approved by the American Heart Association Science Advisory and Coordinating Committee. Results The construct of VCI has been introduced to capture the entire spectrum of cognitive disorders associated with all forms of cerebral vascular brain injury—not solely stroke—ranging from mild cognitive impairment through fully developed

  16. [Cell biology of intraocular vascular diseases].

    Science.gov (United States)

    Ishibashi, T

    1999-12-01

    Diabetic retinopathy (DR) still remains the leading cause of blindness in the working population of Japan and western world, though therapies such as retinal photocoagulation and vitrectomy can be remarkably effective when administered at an appropriate stage in the disease process. Consequently, there is a need for further investigation of the pathogenesis of DR to develop better therapy. DR is characterized by gradually progressive alterations in the retinal microvasculature, leading to three fundamental morbidities: 1. vascular hyperpermeability, 2. vascular occlusion, and 3. neovascularization. Recent studies have revealed that hyperglycemia causes several metabolic disorders which cause DR directly or indirectly through the abnormal expression of cytokines including vascular endothelial growth factor (VEGF). In this study, we performed precise tests of the correlation between intraocular VEGF and the three fundamental changes in the diabetic retina mentioned above. Ultrastructural study of the human retina revealed that two major pathways are responsible for hyperpermeability of diabetic retinal vessels, i.e., intercellular or paracellular transport (opening of the tight junctions) and intracellular or transcellular transport (caveolae, intracytoplasmic vesicles, and fenestration). All these pathways were induced by intravitreal injection of VEGF. The major trigger of VEGF overexpression is tissue ischemia caused by vascular occlusion. However, the retinas from the eyes with background DR revealed increased expression of VEGF without apparent incidence of vascular occlusion. We have identified accumulation of advanced glycation end products (AGEs) in these retinas, and found that AGEs are a major stimulus for VEGF overexpression in background DR. Retinal vascular occlusion was caused by thrombus formation primarily in the capillary vessels. Thrombi mainly consisted of fibrin, platelets, and leucocytes in the early stage of their formation, and glial cells and

  17. Herramienta para hacer cuestionarios para Moodle

    OpenAIRE

    Muñoz Garcia, jesus

    2010-01-01

    Herramienta de creación de cuestionarios remotos de cuestiones SQL para Moodle. Permite también, el Aprendizaje colaborativo, para que los estudiantes puedan hacer cuestionarios de forma conjunta y desarrollar habilidades de trabajo en equipo. / Tool for Moodle to create remote quiz with SQL question. It also allows collaborative learning, so students can do together remote quiz and develop teamwork and social skills.

  18. Coexistence of pheochromocytoma with uncommon vascular lesions

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Kota

    2012-01-01

    Full Text Available Background: Pheochromocytoma/paragangliomas have been described to be associated with rare vascular abnormalities like renal artery stenosis. Coexistence of physiologically significant renal artery lesions is a compounding factor that alters management and prognosis of pheochromocytoma patients. Apart from individual case reports, data on such association in Indian population is not available. The aim of this study is to find the nature and prevalence of associated vascular abnormalities. Materials and Methods: From 1990 to 2010, a total of 50 patients were diagnosed with pheochromocytoma/paragangliomas. Hospital charts of these patients were reviewed retrospectively to identify those with unusual vascular abnormalities. Available literature was also reviewed. Results: Of the 50 patients with pheochromocytoma, 7 (14% had coexisting vascular lesions including renal artery stenosis in 4, aortoarteritis in 1, aortic aneurysm in 1 and inferior vena cava thrombosis in 1. Pheochromocytoma was adrenal in 42 and extra adrenal in 8. Laparoscopic adrenalectomy was done in the patients. One patient with renal artery stenosis due to intimal fibrosis was subjected to percutaneous balloon angioplasty; the other three improved after adrenalectomy and lysis of fibrous adhesive bands. The patient with aortoarteritos was treated with oral steroids. Inferior vena cava thrombosis was reversed with anticoagulants. The patient with abdominal aortic aneurysm was advised for annual follow-up on account of its size of 4.5 cm and asymptomatic presentation. Conclusion: There are multiple mechanisms that can lead to renal artery stenosis and other vascular abnormalities in a case of pheochromocytoma. A high index of suspicion is necessary to enable both entities to be diagnosed preoperatively and allow proper planning of surgical therapy. Incomplete diagnosis may lead to persistent hypertension postoperatively in a case of associated renal artery stenosis.

  19. The making of indigenous vascular prosthesis

    Directory of Open Access Journals (Sweden)

    Madathipat Unnikrishnan

    2016-01-01

    Full Text Available Background & objectives: Vascular illnesses are on the rise in India, due to increase in lifestyle diseases and demographic transition, requiring intervention to save life, organ or limbs using vascular prosthesis. The aim of this study was to develop indigenous large diameter vascular graft for treatment of patients with vascular pathologies. Methods: The South India Textile Research Association, at Coimbatore, Tamil Nadu, India, developed seamless woven polyester (Polyethylene terephthalate graft at its research wing. Further characterization and testing followed by clinical trials were conducted at Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. Fifteen in vivo experiments were carried out in 1992-1994 in pigs as animal model. Controlled (phase I clinical trial in ten patients was performed along with control graft. Thereafter, phase II trial involved 22 patients who underwent multi-centre clinical trial in four centres across India. Results: Laboratory testing showed that polyester graft was non-toxic, non-leeching and non-haemolytic with preserved long-term quality, further confirming in pigs by implanting in thoracic aorta, comparable to control Dacron grafts. Perigraft incorporation and smooth neointima formation which are prime features of excellent healing characteristics, were noted at explantation at planned intervals. Subsequently in the phase I and II clinical trials, all patients had excellent recovery without mortality or device-related adverse events. Patients receiving the test graft were followed up for 10 and 5 years, respectively. Serial clinical, duplex scans and CT angiograms performed periodically confirmed excellent graft performance. Interpretation & conclusions: Indigenously developed Chitra vascular graft was comparable to commercially available Dacron graft, ready for clinical use at affordable cost to patients as against costly imported grafts.

  20. Homocysteine, vitamins, and prevention of vascular disease.

    Science.gov (United States)

    McCully, Kilmer S

    2004-04-01

    Within the past four decades, the efforts of investigators worldwide have established the amino acid homocysteine as an important factor in arteriosclerosis and diseases of aging. After its discovery in 1932, homocysteine was demonstrated to be an important intermediate in the metabolism of amino acids. However, little was known about the broader biomedical significance of homocysteine until 1962, when children with mental retardation, accelerated growth, dislocated ocular lenses, and frequent vascular thrombosis were found to excrete homocysteine in the urine. My study of two patients with homocystinuria caused by different inherited enzymatic disorders in 1968 disclosed advanced widespread arteriosclerotic plaques in both cases. This discovery led to the conclusion that homocysteine causes vascular disease by a direct effect on the cells and tissues of the arteries. This interpretation suggests that homocysteine is important in the pathogenesis of arteriosclerosis in persons with hereditary, dietary, environmental, hormonal, metabolic, and other factors predisposing them to hyperhomocysteinemia. Within the past decade, many major clinical and epidemiological studies have proven that hyperhomocysteinemia is a potent independent risk factor for vascular disease. According to the homocysteine theory of arteriosclerosis, insufficient dietary intake of the B vitamins, folic acid and pyridoxine, caused by losses of these nutrients during processing of foods, leads to elevation of blood homocysteine and vascular disease in the general population. The dramatic decline in cardiovascular mortality since the 1960s in the United States is attributed to fortification of the food supply by synthetic pyridoxine and folic acid. The recent Swiss Heart Study showed that B vitamins slowed restenosis in patients with coronary arteriosclerosis treated with angioplasty. Currently, more than 20 prospective, worldwide, interventional trials involving at least 100,000 participants are

  1. (-)-DEPRENYL INHIBITS VASCULAR HYPERPERMEABILITY FOLLOWING HEMORRHAGIC SHOCK

    Science.gov (United States)

    J., Binu Tharakan; Whaley, Greg; Hunter, Felicia A.; Smythe, W. Roy; Childs, Ed W.

    2010-01-01

    Recent studies from our laboratory demonstrated the involvement of endothelial cell reactive oxygen species (ROS) formation and activation of apoptotic signaling in vascular hyperpermeability following hemorrhagic shock (HS). The objective of this study was to determine if (-)-deprenyl, an antioxidant with anti-apoptotic properties would attenuate HS-induced vascular hyperpermeability. In rats, HS was induced by withdrawing blood to reduce the MAP to 40 mmHg for 60 minutes followed by resuscitation for 60 minutes. To study hyperpermeability, the rats were injected with FITC-albumin (50 mg/kg) and the changes in integrated optical intensity of the mesenteric post-capillary venules were obtained intra and extra vascularly utilizing intravital microscopy. Mitochondrial ROS formation and mitochondrial transmembrane potential (ΔΨm) were studied using dihydrorhodamine 123 and JC-1 respectively. Mitochondrial release of cytochrome c was determined using ELISA and caspase-3 activity by a fluorometric assay. Parallel studies were performed in rat lung microvascular endothelial cells (RLMEC) utilizing pro-apoptotic BAK as inducer of hyperpermeability. Hemorrhagic shock induced vascular hyperpermeability, mitochondrial ROS formation, decrease in ΔΨm, release of cytochrome c and caspase-3 activation (p < 0.05). (-)-Deprenyl (0.15 mg/Kg) attenuated all these effects (p < 0.05). Similarly in RLMEC, (-)-deprenyl attenuated BAK peptide induced monolayer hyperpermeability (p < 0.05), ROS formation, decrease in ΔΨm, cytochrome c release (p < 0.05) and activation of caspase-3 (p < 0.05). The protective effects of (-)-deprenyl on vascular barrier functions may be due to its protective effects on ΔΨm thereby preventing mitochondrial release of cytochrome c and caspase-3 mediated disruption of endothelial adherens junctions. PMID:19373132

  2. Vascular endothelial growth factor and vascular endothelial growth factor receptor-2 expression in mdx mouse brain.

    Science.gov (United States)

    Nico, Beatrice; Corsi, Patrizia; Vacca, Angelo; Roncali, Luisa; Ribatti, Domenico

    2002-10-25

    Recent data have demonstrated that vascular endothelial growth factor (VEGF) is expressed by subsets of neurons, coincident with angiogenesis within its developing cerebral cortex. In this study, with the aim of elucidating the mechanisms of vascular involvement during brain impairment in Duchenne muscular distrophy (DMD), we have correlated the vascular density with VEGF and VEGF receptor-2 (VEGFR-2) expression in the brain cortex of normal and mdx mouse, an animal model with a genetic defect in a region homologous with the human DMD gene. Results showed that in mdx mouse, tissue area occupied by microvessels positive to factor VIII related antigen and VEGFR-2 increased in parallel to the tissue area occupied by neurons positive to VEGF. Our data suggest that increased vascularity in the brain of mdx mouse may be due, at least in part, to proliferation of endothelial cells in response to VEGF secreted by neuronal cells.

  3. Estudio comparativo de microsutura vascular en ratas: punto simple y punto de colchonero horizontal Comparative study about vascular microsurgery on rats: classic interrupted suture versus horizontal mattress suture

    Directory of Open Access Journals (Sweden)

    C. Casado Sánchez

    2009-09-01

    Full Text Available La Microcirugía es la técnica empleada para la realización de la microanastomosis vascular. El objetivo del presente estudio es comparar dos tipos de técnicas de microsutura: los puntos simples clásicos, de empleo habitual en la microcirugía vascular, y los puntos de colchonero horizontales, no evaluados habitualmente para este tipo de cirugía. Fueron intervenidas 20 ratas albinas de la cepa Wistar (peso medio de 250 - 300 gr. bajo anestesia general; realizamos sección transversal en la arteria femoral, procediendo a su reparación microquirúrgica inmediata. Se establecieron 2 grupos de animales: en el grupo A (n=10, la microsutura se hizo mediante 6 puntos sueltos simples, y en el grupo B (n=10, empleando 3 puntos de colchonero horizontal. Comprobamos la patencia en el desclampado inmediato y tras una hora del desclampado (para ambas técnicas fue positiva en el 100% de los casos, y la hemorragia en ambos tiempos (se registró un único caso de sangrado en el postoperatorio inmediato en el grupo B, que requirió la revisión de la microsutura. El tiempo medio de ejecución de la sutura en el grupo B, 15 minutos aproximadamente, fue más corto que en el grupo A, 21 minutos aproximadamente, diferencia estadísticamente significativa (p Microsurgery is the procedure of choice for vascular microanastamoses. The objective of this study was to compare two types of suture techniques: classic interrupted suture anastomoses, commonly used for vascular anastamoses in microsurgery, and another technique using horizontal mattress sutures, rarely evaluated in this type of surgery. Twenty albino Wistar rats were operated (average weight: 250 - 300 gr. under general anaesthesia. A transverse section of the femoral artery was performed and immediately followed by an anastamoses. The animals were placed into two groups of ten. The classic 6 interrupted suture anastomoses technique was performed in group A (n = 10 and another technique using 3

  4. Vascular surgery research in the Gulf Cooperation Council countries

    Directory of Open Access Journals (Sweden)

    Ali Jawas

    2014-04-01

    Conclusion: The quality and quantity of vascular surgery research in the GCC countries should be improved to answer important local questions related to vascular diseases. This needs better strategic planning and more collaboration between various institutions.

  5. Vascular effects of a single high salt meal

    Directory of Open Access Journals (Sweden)

    Mohamed Abdel Kader Abdel Wahab

    2016-09-01

    Conclusion: High salt intake may acutely impair vascular function in different vascular beds independent of the increase of blood pressure. Plasma sodium increase may be one of the underlying mechanisms.

  6. Elevated Plasma Homocysteine Level in Vascular Dementia Reflects the Vascular Disease Process

    OpenAIRE

    Karin Nilsson; Lars Gustafson; Björn Hultberg

    2013-01-01

    Background: Patients with vascular dementia (VaD) exhibit particularly elevated levels of plasma total homocysteine (tHcy) compared to patients with other psychogeriatric diseases. Methods: We investigated the main determinants (age, renal impairment, cobalamin/folate status and presence of extracerebral vascular disease) of plasma tHcy in 525 patients with VaD. Furthermore, 270 patients with depression were used as a reference group to reveal the potential specificity of elevated plasma tHcy...

  7. Trauma vascular periférico em urgência: impacto após implantação de bundle

    OpenAIRE

    Krempser, Paula

    2014-01-01

    Pesquisa quantitativa que objetivou criar e aplicar na prática clínica um “bundle de prevenção de trauma vascular periférico” para abordagem do processo de punção vascular periférica em serviço de urgência e emergência nas situações em que o vaso foi utilizado para fins de infusão de volumes e fármacos intravasculares e analisar sua efetividade na prática clínica comparando a incidência de trauma vascular antes e após intervenção educativa. O cenário da investigação foi um serviço de urgência...

  8. Possible role of vascular risk factors in Alzheimer's disease and vascular dementia.

    Science.gov (United States)

    Hasnain, Mehrul; Vieweg, W Victor R

    2014-01-01

    The contribution of vascular risk factors to Alzheimer-vascular spectrum dementias is increasingly being recognized. We provide an overview of recent literature on this subject. Overweight and obesity as well as underweight during midlife predict cognitive decline and dementia later in life. Hypertension during midlife is also associated with dementia later in life and the association is stronger for untreated hypertension. Calcium channel blockers, angiotensin converting enzyme inhibitors, and angiotensin-1 receptor-blockers may be particularly beneficial in diminishing the risk of dementia associated with hypertension. Studies have fairly consistently shown that type 2 diabetes is a risk factor for dementia. Episodes of hypoglycemia add to this risk. Regular physical exercise during any point in the lifespan protects against cognitive decline and dementia. Most benefit is realized with physical exercise during early and midlife. Dyslipidemia also increases the risk of dementia but the findings are less consistent. Findings on the possible benefit of lipid-lowering agents (statins) are conflicting. Earlier studies identified smoking as protective of dementia but recent better designed studies have consistently shown that smoking increases the risk of dementia. The association of vascular risk factors with dementia is more robust for vascular dementia than Alzheimer's disease. Heterogeneity of studies and lack of trials specifically designed to assess cognition as an endpoint make firm conclusions difficult. But considering the expected global burden of dementia and projected attributable risk of vascular risk factors to it, there is sufficient evidence to promote vascular risk factor reduction strategies as dementia prevention interventions.

  9. Vascular smooth muscle cells derived from inbred swine induced pluripotent stem cells for vascular tissue engineering.

    Science.gov (United States)

    Luo, Jiesi; Qin, Lingfeng; Kural, Mehmet H; Schwan, Jonas; Li, Xia; Bartulos, Oscar; Cong, Xiao-Qiang; Ren, Yongming; Gui, Liqiong; Li, Guangxin; Ellis, Matthew W; Li, Peining; Kotton, Darrell N; Dardik, Alan; Pober, Jordan S; Tellides, George; Rolle, Marsha; Campbell, Stuart; Hawley, Robert J; Sachs, David H; Niklason, Laura E; Qyang, Yibing

    2017-12-01

    Development of autologous tissue-engineered vascular constructs using vascular smooth muscle cells (VSMCs) derived from human induced pluripotent stem cells (iPSCs) holds great potential in treating patients with vascular disease. However, preclinical, large animal iPSC-based cellular and tissue models are required to evaluate safety and efficacy prior to clinical application. Herein, swine iPSC (siPSC) lines were established by introducing doxycycline-inducible reprogramming factors into fetal fibroblasts from a line of inbred Massachusetts General Hospital miniature swine that accept tissue and organ transplants without immunosuppression within the line. Highly enriched, functional VSMCs were derived from siPSCs based on addition of ascorbic acid and inactivation of reprogramming factor via doxycycline withdrawal. Moreover, siPSC-VSMCs seeded onto biodegradable polyglycolic acid (PGA) scaffolds readily formed vascular tissues, which were implanted subcutaneously into immunodeficient mice and showed further maturation revealed by expression of the mature VSMC marker, smooth muscle myosin heavy chain. Finally, using a robust cellular self-assembly approach, we developed 3D scaffold-free tissue rings from siPSC-VSMCs that showed comparable mechanical properties and contractile function to those developed from swine primary VSMCs. These engineered vascular constructs, prepared from doxycycline-inducible inbred siPSCs, offer new opportunities for preclinical investigation of autologous human iPSC-based vascular tissues for patient treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. A Diagnostic Program of Vascular Tumor and Vascular Malformations in Children According to Modern Classification.

    Science.gov (United States)

    Benzar, Iryna

    The aim of the study was to analyze the cohort of inpatient children with vascular anomalies according to the globally accepted classification introduced by the ISSVA. The study included 205 inpatient children within the time period of the years 2010-2015. Types of vascular anomalies (VAs), age of patients, diagnostic procedures, and anatomical localization of VAs were analyzed. 65 patients of first year of life had vascular tumors, with prevalence of infantile hemangiomas (IHs) in 57 (87.7%) patients. 45 children had IHs localized within soft tissues, whereas 7 patients suffered from IHs of the liver, and 5 children from IHs of the respiratory tract. Most patients with soft tissue IHs were diagnosed only with ultrasound; СT or MRI diagnostics were performed on 5 (8.8%) patients, and biopsy was carried out in 2 (4.4%) children. Vascular malformations (VM) were diagnosed in 140 (68.3%) patients. Ultrasound investigation (US) was the screening method. MRI was performed to confirm the diagnosis of low-flow VM, whereas for high-flow VM CT angiography and selective angiography were useful. Venous malformations were diagnosed in 17 (12.1%) patients, and 112 (80.0%) had cystic LM, among them children under the age of 2 years prevailed. Arteriovenous malformations were diagnosed in 5 (3.8%) patients, ages 2-14 years. Clinical manifestations of vascular anomalies have clear age features. Among hospitalized children vascular tumors add up to 31.7% and VM - up to 68.3%.

  11. Deficiency of superoxide dismutase promotes cerebral vascular hypertrophy and vascular dysfunction in hyperhomocysteinemia.

    Directory of Open Access Journals (Sweden)

    Sanjana Dayal

    Full Text Available There is an emerging consensus that hyperhomocysteinemia is an independent risk factor for cerebral vascular disease and that homocysteine-lowering therapy protects from ischemic stroke. However, the mechanisms by which hyperhomocysteinemia produces abnormalities of cerebral vascular structure and function remain largely undefined. Our objective in this study was to define the mechanistic role of superoxide in hyperhomocysteinemia-induced cerebral vascular dysfunction and hypertrophy. Unlike previous studies, our experimental design included a genetic approach to alter superoxide levels by using superoxide dismutase 1 (SOD1-deficient mice fed a high methionine/low folate diet to produce hyperhomocysteinemia. In wild-type mice, the hyperhomocysteinemic diet caused elevated superoxide levels and impaired responses to endothelium-dependent vasodilators in cerebral arterioles, and SOD1 deficiency compounded the severity of these effects. The cross-sectional area of the pial arteriolar wall was markedly increased in mice with SOD1 deficiency, and the hyperhomocysteinemic diet sensitized SOD1-deficient mice to this hypertrophic effect. Analysis of individual components of the vascular wall demonstrated a significant increase in the content of smooth muscle and elastin. We conclude that superoxide is a key driver of both cerebral vascular hypertrophy and vasomotor dysfunction in this model of dietary hyperhomocysteinemia. These findings provide insight into the mechanisms by which hyperhomocysteinemia promotes cerebral vascular disease and ischemic stroke.

  12. Using biplanar fluoroscopy to guide radiopaque vascular injections: a new method for vascular imaging.

    Directory of Open Access Journals (Sweden)

    Haley D O'Brien

    Full Text Available Studying vascular anatomy, especially in the context of relationships with hard tissues, is of great interest to biologists. Vascular studies have provided significant insight into physiology, function, phylogenetic relationships, and evolutionary patterns. Injection of resin or latex into the vascular system has been a standard technique for decades. There has been a recent surge in popularity of more modern methods, especially radiopaque latex vascular injection followed by CT scanning and digital "dissection." This technique best displays both blood vessels and bone, and allows injections to be performed on cadaveric specimens. Vascular injection is risky, however, because it is not a standardizable technique, as each specimen is variable with regard to injection pressure and timing. Moreover, it is not possible to view the perfusion of injection medium throughout the vascular system of interest. Both data and rare specimens can therefore be lost due to poor or excessive perfusion. Here, we use biplanar video fluoroscopy as a technique to guide craniovascular radiopaque latex injection. Cadaveric domestic pigs (Sus scrofa domestica and white-tailed deer (Odocoileus virginianus were injected with radiopaque latex under guidance of fluoroscopy. This method was found to enable adjustments, in real-time, to the rate, location, and pressure at which latex is injected in order to avoid data and specimen loss. In addition to visualizing the injection process, this technique can be used to determine flow patterns, and has facilitated the development of consistent markers for complete perfusion.

  13. Vascularized fibular graft in infected tibial bone loss

    OpenAIRE

    C Cheriyan Kovoor; R Jayakumar; V V George; Vinod Padmanabhan; A J Guild; Sabin Viswanath

    2011-01-01

    Background : The treatment options of bone loss with infections include bone transport with external fixators, vascularized bone grafts, non-vascularized autogenous grafts and vascularized allografts. The research hypothesis was that the graft length and intact ipsilateral fibula influenced hypertrophy and stress fracture. We retrospectively studied the graft hypertrophy in 15 patients, in whom vascularized fibular graft was done for post-traumatic tibial defects with infection. Materials...

  14. Critical issues in vascular surgery: Education in Brazil.

    Science.gov (United States)

    Moreira, Ricardo C R

    2008-12-01

    Vascular surgery practice and education vary widely across the globe. In Brazil, the largest and most populated country of South America, vascular surgery is an independent specialty, with >3000 practicing specialists. Vascular surgery education in Brazil consists of 6 years of medical school, followed by a 4-year residency in vascular surgery. Endovascular surgery training is provided by part-time mini-fellowships after a residency program has been completed. The author of this report, who represents the Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) or Brazilian Society of Angiology and Vascular Surgery, presents the critical issues in vascular surgery education in Brazil. An informal survey was conducted among residency program directors and members of the SBACV National Board to identify the critical issues in vascular surgical education in Brazil. The 25 responders pointed to two issues as the most critical. The first is funding for vascular surgical education. Currently, 73 vascular residency programs are accredited, with 142 first-year positions and 288 residents in training. Vascular surgery residents are paid a meager stipend, but instructors receive no pay. Endovascular fellows have to pay for their training. This has led to endovascular training being financed by the industry, despite the potential conflicts of interest created by this situation. The second critical issue is endovascular surgery training. The vascular surgical community in Brazil faces the huge task of how to offer training in endovascular techniques to the 140 or so young vascular surgeons coming out of residency programs every year, as well as how to teach endovascular techniques to several hundred certified vascular surgeons already in practice. Funding vascular surgery educational programs and training surgeons in the new endovascular techniques are the critical issues faced by vascular surgical educators in Brazil.

  15. Vascular access complications and risk factors in hemodialysis ...

    African Journals Online (AJOL)

    Tarek A. Ghonemy

    2015-08-18

    Aug 18, 2015 ... Abstract Background: Morbidity related to vascular access is the leading cause of hospitalization for chronic hemodialysis patients and is associated with high cost. Since data on vascular access complications are scarce, this study was designed to focus on vascular access complications in hemodialysis ...

  16. Outcomes for cervicomediastinal vascular trauma managed by a ...

    African Journals Online (AJOL)

    Background: The management of cervicomediastinal vascular trauma is challenging. We report on our experience with the condition in a newly established vascular trauma service unit, and compare the outcomes to those reported in our parent vascular surgery department. Method: The details of patients with ...

  17. Peripheral False Aneurysms: An Evolution Of Precedent Vascular ...

    African Journals Online (AJOL)

    With the rise in armed conflicts in Nigeria, major vascular injuries are seen more commonly. Unfortunately it is not well appreciated that securing haemostasis at the site of injury is not tantamount to adequate handling of the vascular situation. Occasioned by misdiagnosis of the extent and type of vascular damage, false ...

  18. Patterns of peripheral vascular diseases at Muhimbili National hospital

    African Journals Online (AJOL)

    Background: Vascular diseases are emerging as a major health burden worldwide and vascular surgery is the major treatment of choice for these diseases. The treatment results in cosmetic and functional improvement. Purpose of the report is to show the commonly seen peripheral vascular disorders and treatment options ...

  19. Vascular access complications and risk factors in hemodialysis ...

    African Journals Online (AJOL)

    Background: Morbidity related to vascular access is the leading cause of hospitalization for chronic hemodialysis patients and is associated with high cost. Since data on vascular access complications are scarce, this study was designed to focus on vascular access complications in hemodialysis patients. Methods: 119 ...

  20. Colour-flow ultrasound in the detection of penetrating vascular ...

    African Journals Online (AJOL)

    Purpose. To determine the sensitivity of colour-flow ultrasound in the detection of penetrating vascular injuries of the neck when compared with conventional angiography. Method. We prospectively imaged the neck arteries of all patients with suspected vascular injuries who were referred for angiography by the vascular ...

  1. The evolution of development of vascular cambia and secondary growth

    Science.gov (United States)

    Andrew Groover; Rachel Spicer

    2010-01-01

    Secondary growth from vascular cambia results in radial, woody growth of stems. The innovation of secondary vascular development during plant evolution allowed the production of novel plant forms ranging from massive forest trees to flexible, woody lianas. We present examples of the extensive phylogenetic variation in secondary vascular growth and discuss current...

  2. colour-flow ultrasound in the detection of penetrating vascular ...

    African Journals Online (AJOL)

    Purpose. To determine the sensitivity of colour-flow ultrasound in the detection of penetrating vascular injuries of the neck when compared with conventional angiography. Method. We prospectively imaged the neck arteries of all patients with suspected vascular injuries who were referred for angiography by the vascular ...

  3. Cierre percutáneo del conducto arterioso permeable utilizando el Amplatzer vascular Plug II

    OpenAIRE

    Parra-Bravo,Rafael; Beirana-Palencia,Luisa; Corona-Rodríguez,Antonio; Alarcón-Elguera,Laura; Tejeda-Hernández,Norma; Aguilar-Segura,Perla; Lazo-Cárdenas,César; Arellano-Llamas,Abril

    2011-01-01

    Amplatzer vascular Plug II (AVP II) es un dispositivo oclusor autoexpandible, indicado para oclusiones arteriales o venosas en la vasculatura periférica. Objetivo: Describir nuestra experiencia clínica inicial con el AVP II, en el cierre percutáneo del conducto arterioso permeable pequeño. Métodos: Analizamos retrospectivamente, siete pacientes sometidos a oclusión percutánea del conducto arterioso. El AVP II se eligió con un diámetro mayor a 50% del diámetro mínimo del conducto arterioso. Re...

  4. Expresión de dos genes candidatos a resistencia contra la bacteriosis vascular en yuca

    OpenAIRE

    LOPEZ CAMILO; CONTRERAS NIETO ELIZABETH

    2008-01-01

    La yuca (Manihot esculenta Crantz, Euphorbiaceae) es el cuarto cultivo en importancia a nivel mundial como fuente de calorías para la población humana y cuya producción se ve afectada por la bacteriosis vascular, enfermedad ocasionada por Xanthomonas axonopodis pv. manihotis (Xam). La resistencia a enfermedades en plantas depende de la presencia de genes de resistencia (<...

  5. Pediatric vascular trauma in Manaus, Amazon - Brazil.

    Science.gov (United States)

    Costa, Cleinaldo DE Almeida; Souza, José Emerson Dos Santos; Araújo, Antônio Oliveira DE; Melo, Flávio Augusto Oliva; Costa, Isabelle Nascimento; Klein, Paulo Henrique

    2016-01-01

    to assess the incidence of pediatric vascular injuries in patients treated at the Emergency Room of the Eastern Children's Hospital, in Manaus. we conducted a retrospective study of pediatric patients who suffered vascular injuries treated between February 2001 to February 2012. we studied 71 patients, predominantly male (78.87%), with a mean age of 7.63 years. The predominant mechanism of injury was stab wound in 27 patients (38.03%). The average hospital stay was 10.18 days; 16 patients required care in intensive care unit, with average stay of 8.81 days. The main injuries occurred in the extremities, the upper limb being the most affected, with lesions of the ulnar artery in 13 (15.66%) and radial in 10 (12.04%). The mostly applied procedure was vascular exploration 35 (32.4%). Complications occurred in nine patients (12.68%). Mortality was 1.4%, in one patient with a lesion of the common iliac vein and the inferior vena cava due fall from height. pediatric vascular injury occurred predominantly in the extremities. The dimensions of the injured vessels made surgical correction more complex and increased complication rates, particularly amputations. avaliar a incidência de traumatismos vasculares pediátricos em doentes atendidos no Hospital Pronto Socorro da Criança Zona Leste, na cidade de Manaus. estudo retrospectivo de doentes pediátricos vítimas de traumatismos vasculares atendidos no período de fevereiro de 2001 a fevereiro de 2012. foram estudados 71 doentes com predominância do sexo masculino (78,87%) com média de idade de 7,63 anos. O mecanismo de trauma predominante foi o ferimento por arma branca em 27 pacientes (38,03%). A média de internação foi 10,18 dias, com 16 doentes necessitando de cuidados em unidade de tratamento intensivo com permanência média de 8,81 dias. As principais lesões ocorreram em extremidades, com predomínio do membro superior, com lesões das artérias ulnar em 13 (15,66%) e radial em dez (12,04%). O procedimento

  6. Cocoa, Blood Pressure, and Vascular Function

    Science.gov (United States)

    Ludovici, Valeria; Barthelmes, Jens; Nägele, Matthias P.; Enseleit, Frank; Ferri, Claudio; Flammer, Andreas J.; Ruschitzka, Frank; Sudano, Isabella

    2017-01-01

    Cardiovascular disease (CVD) represents the most common cause of death worldwide. The consumption of natural polyphenol-rich foods, and cocoa in particular, has been related to a reduced risk of CVD, including coronary heart disease and stroke. Intervention studies strongly suggest that cocoa exerts a beneficial impact on cardiovascular health, through the reduction of blood pressure (BP), improvement of vascular function, modulation of lipid and glucose metabolism, and reduction of platelet aggregation. These potentially beneficial effects have been shown in healthy subjects as well as in patients with risk factors (arterial hypertension, diabetes, and smoking) or established CVD (coronary heart disease or heart failure). Several potential mechanisms are supposed to be responsible for the positive effect of cocoa; among them activation of nitric oxide (NO) synthase, increased bioavailability of NO as well as antioxidant, and anti-inflammatory properties. It is the aim of this review to summarize the findings of cocoa and chocolate on BP and vascular function. PMID:28824916

  7. Treatment of hemobilia by transcatheter vascular occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Vaughan, R.; Roesch, J.; Keller, F.S.; Antonovic, R.

    1984-08-01

    Four cases of hemobilia treated by transcatheter arterial occlusion are presented and reviewed with 30 similar cases reported in the literature. Transcatheter vascular occlusion successfully controlled hemorrhage in all 34 patients. No obvious liver parenchymal damage appeared in 26 patients; transient elevation of liver enzymes occurred in 6 patients (18%) including one in our series; two of the patients reviewed died of acute hepatic insufficiency following nonselective hepatic artery embolization. Hemobilia should be considered when gastrointestinal hemorrhage occurs after abdominal trauma, liver biopsy or other manipulative liver procedures. Hepatic angiography establishes the diagnosis and selective vascular occlusion is the treatment of choice for control of intractable or recurrent hemorrhage. Techniques and precautions for the diagnosis and transcatheter therapy of hemobilia are discussed.

  8. Pulmonary vascular complications of hereditary haemorrhagic telangiectasia.

    Science.gov (United States)

    Circo, Sebastian; Gossage, James R

    2014-09-01

    The purpose of this study is to present the latest advances and recommendations in the diagnosis and treatment of pulmonary vascular complications associated with hereditary haemorrhagic telangiectasia (HHT): pulmonary arteriovenous malformations (PAVMs), pulmonary arterial hypertension (PAH), pulmonary hypertension associated with high output cardiac failure or liver vascular malformations, haemoptysis, haemothorax and thromboembolic disease. Transthoracic contrast echocardiography has been validated as a screening tool for PAVM in patients with suspected HHT. Advancements in genetic testing support its use in family members at risk as a cost-effective measure. Therapy with bevacizumab in patients with high output cardiac failure and severe liver AVMs showed promising results. PAH tends to be more aggressive in HHT type 2 patients. Patients suffering from this elusive disease should be referred to HHT specialized centres to ensure a standardized and timely approach to diagnosis and management.

  9. [Vascular complications associated with lumbar spinal surgery].

    Science.gov (United States)

    Riedemann-Wistuba, M; Alonso-Pérez, M; Llaneza-Coto, J M

    2016-01-01

    Although there are currently less invasive techniques available for the treatment of spinal injuries, open surgery is still required in many cases. Vascular injuries occurring during lumbar spine surgery, although uncommon, are of great importance due to their potential gravity. Clinical manifestations vary from an acute hemorrhagic shock that needs urgent treatment to save the patient's life, to insidious injuries or an asymptomatic evolution, and should be studied to choose the best therapeutic alternative. Four cases are reported that represent this range of possibilities and emphasize the importance of a careful surgical technique during lumbar spine interventions, and the need for high clinical suspicion, essential for the early diagnosis of these vascular complications. The current therapeutic options are also discussed. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  10. Alzheimer and vascular brain disease: Senile dementia

    Directory of Open Access Journals (Sweden)

    Eliasz Engelhardt

    Full Text Available Alois Alzheimer is best known for his description of a novel disease, subsequently named after him. However, his wide range of interests also included vascular brain diseases. He described Senile dementia, a highly heterogeneous condition, and was able not only to distinguish it from syphilitic brain disease, but also to discriminate two clinicopathological subtypes, that may be labeled a "arteriosclerotic subtype", comparable to the present clinicopathological continuum of "Vascular cognitive impairment", and another as a "neurodegenerative subtype", characterized by primary [cortical] ganglion cell [nerve cells] degeneration, possibly foreshadowing a peculiar presenile disease that he was to describe some years later and would carry his name. He also considered the possibility of a senile presentation of this disease subtype, which was described by Oskar Fischer a short time later. Considering the clinicopathological overlapping features of the "arteriosclerotic subtype" of Senile dementia with Arteriosclerotic atrophy of the brain, it might be possible to consider that both represent a single condition.

  11. Alzheimer and vascular brain disease: Senile dementia.

    Science.gov (United States)

    Engelhardt, Eliasz; Grinberg, Lea T

    2015-01-01

    Alois Alzheimer is best known for his description of a novel disease, subsequently named after him. However, his wide range of interests also included vascular brain diseases. He described Senile dementia, a highly heterogeneous condition, and was able not only to distinguish it from syphilitic brain disease, but also to discriminate two clinicopathological subtypes, that may be labeled a "arteriosclerotic subtype", comparable to the present clinicopathological continuum of "Vascular cognitive impairment", and another as a "neurodegenerative subtype", characterized by primary [cortical] ganglion cell [nerve cells] degeneration, possibly foreshadowing a peculiar presenile disease that he was to describe some years later and would carry his name. He also considered the possibility of a senile presentation of this disease subtype, which was described by Oskar Fischer a short time later. Considering the clinicopathological overlapping features of the "arteriosclerotic subtype" of Senile dementia with Arteriosclerotic atrophy of the brain, it might be possible to consider that both represent a single condition.

  12. Perioperative smoking cessation in vascular surgery

    DEFF Research Database (Denmark)

    Kehlet, M.; Heesemann, Sabine; Tonnesen, H.

    2015-01-01

    Background: The effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery. Methods: A single-blinded randomized clinical trial conducted at two vascular surgery...... departments in Denmark. The intervention group was offered the Gold Standard Program (GSP) for smoking cessation intervention. The control group was offered the departments' standard care. Inclusion criteria were patients with planned open peripheral vascular surgery and who were daily smokers. According...... intervention and 21 as controls. There was no difference in 30-day complication rates or 6-week abstinence rates between the two groups. Conclusions: A trial assessing the effect of smoking cessation on postoperative complications on the day of soft tissue surgery is still needed. If another trial...

  13. Acidic Fibroblast Growth Factor Promotes Vascular Repair

    Science.gov (United States)

    Bjornsson, Thorir D.; Dryjski, Maciej; Tluczek, John; Mennie, Robert; Ronan, John; Mellin, Theodore N.; Thomas, Kenneth A.

    1991-10-01

    Intravascular injury to arteries can result in thickening of the intimal smooth muscle layer adjacent to the lumen by migration and proliferation of cells from the underlying medial smooth muscle layer accompanied by deposition of extracellular matrix. This pathological response, which decreases lumen diameter, might, in part, be the result of the access of smooth muscle cells to plasma and platelet-derived growth factors as a consequence of denudation of the overlying confluent monolayer of vascular endothelial cells. Injured rat carotid arteries were treated by i.v. administration of acidic fibroblast growth factor, a heparin-binding protein that is chemotactic and mitogenic for vascular endothelial cells. The growth factor treatment resulted in dose-dependent inhibition of intimal thickening with parallel promotion of endothelial regeneration over the injured area. Therefore, acidic fibroblast growth factor might be efficacious in the prevention of restenosis caused by intimal thickening following angioplasty in humans.

  14. Biophysical Regulation of Vascular Differentiation and Assembly

    CERN Document Server

    Gerecht, Sharon

    2011-01-01

    The ability to grow stem cells in the laboratory and to guide their maturation to functional cells allows us to study the underlying mechanisms that govern vasculature differentiation and assembly in health and disease. Accumulating evidence suggests that early stages of vascular growth are exquisitely tuned by biophysical cues from the microenvironment, yet the scientific understanding of such cellular environments is still in its infancy. Comprehending these processes sufficiently to manipulate them would pave the way to controlling blood vessel growth in therapeutic applications. This book assembles the works and views of experts from various disciplines to provide a unique perspective on how different aspects of its microenvironment regulate the differentiation and assembly of the vasculature. In particular, it describes recent efforts to exploit modern engineering techniques to study and manipulate various biophysical cues. Biophysical Regulation of Vascular Differentiation and Assembly provides an inter...

  15. Visfatin and cardio-cerebro-vascular disease.

    Science.gov (United States)

    Wang, Pei; Vanhoutte, Paul M; Miao, Chao-Yu

    2012-01-01

    Nicotinamide phosphoribosyltransferase is the rate-limiting enzyme that catalyzes the first step in the biosynthesis of nicotinamide adenine dinucleotide from nicotinamide. This protein was originally cloned as a putative pre-B cell colony-enhancing factor and also found to be a visceral fat-derived adipokine (visfatin). As a multifunctional protein, visfatin plays an important role in immunity, metabolism, aging, inflammation, and responses to stress. Visfatin also participates in several pathophysiological processes contributing to cardio-cerebro-vascular diseases, including hypertension, atherosclerosis, ischemic heart disease, and ischemic stroke. However, whether visfatin is a friend or a foe in these diseases remains uncertain. This brief review focuses on the current understanding of the complex role of visfatin in the cardio-cerebro-vascular system under normal and pathophysiological conditions.

  16. Vascular anomalies of the upper limb

    Directory of Open Access Journals (Sweden)

    G Balakrishnan

    2011-01-01

    Full Text Available Vascular anomalies of the upper extremity are a surgical challenge to the hand surgeons. The treatment modality varies with respect to the presentation, extent of the lesion, progression and their complications. Based on our experience in treating patients with vascular malformations, a protocol has been formulated for their management, which we have found to be very useful and successful. With the use of the tumescent technique and good planning, haemangiomas are best excised in infancy or early childhood. Investigations like contrast computed tomography and magnetic resonance imaging have been found to be a useful tool in the diagnosis and planning of surgery for venous malformations. Embolisation seems to be a safe option in arteriovenous malformations.

  17. Vascular endothelium receptors and transduction mechanisms

    CERN Document Server

    Gillis, C; Ryan, Una; Proceedings of the Advanced Studies Institute on "Vascular Endothelium: Receptors and Transduction Mechanisms"

    1989-01-01

    Beyond their obvious role of a barrier between blood and tissue, vascular endothelial cells are now firmly established as active and essential participants in a host of crucial physiological and pathophysiological functions. Probably the two most important factors responsible for promoting the current knowledge of endothelial functions are 1) observations in the late sixties-early seventies that many non-ventilatory properties of the lung could be attributed to the pulmonary endothelium and 2) the establishment, in the early and mid-seventies of procedures for routine culture of vascular endothelial cells. Many of these endothelial functions require the presence of receptors on the surface of the plasma membrane. There is now evidence for the existence among others of muscarinic, a-and /3-adrenergic, purine, insulin, histamine, bradykinin, lipoprotein, thrombin, paf, fibronectin, vitronectin, interleukin and albumin receptors. For some of these ligands, there is evidence only for the existence of endothelial ...

  18. Pathophysiology of Vascular Remodeling in Hypertension

    Directory of Open Access Journals (Sweden)

    Nicolás F. Renna

    2013-01-01

    Full Text Available Vascular remodeling refers to alterations in the structure of resistance vessels contributing to elevated systemic vascular resistance in hypertension. We start with some historical aspects, underscoring the importance of Glagov’s contribution. We then move to some basic concepts on the biomechanics of blood vessels and explain the definitions proposed by Mulvany for specific forms of remodeling, especially inward eutrophic and inward hypertrophic. The available evidence for the existence of remodeled resistance vessels in hypertension comes next, with relatively more weight given to human, in comparison with animal data. Mechanisms are discussed. The impact of antihypertensive drug treatment on remodeling is described, again with emphasis on human data. Some details are given on the three mechanisms to date which point to remodeling resistance arteries as an independent predictor of cardiovascular risk in hypertensive patients. We terminate by considering the potential role of remodeling in the pathogenesis of endorgan damage and in the perpetuation of hypertension.

  19. Vascular dementia: Pharmacological treatment approaches and perspectives

    Directory of Open Access Journals (Sweden)

    Andrius Baskys

    2007-10-01

    Full Text Available Andrius Baskys1,3, Anthony C Hou21Department of Psychiatry and Human Behavior; 2Program in Geriatrics, University of California at Irvine, Irvine, California; 3Memory Disorders Program, VA Health Care System Long Beach, Long Beach, California, USAAbstract: Vascular dementia is a common condition for which there are no effective approved pharmacological treatments available. Absence of effective treatments creates a difficult situation for those suffering from the disease, their caregivers, and healthcare providers. This review will address our current understanding of the mechanisms of nerve cell damage due to ischemia and summarize available clinical trial data on several commonly used compounds including memantine, donepezil, galantamine, rivastigmine, nimodipine, hydergine, nicergoline, CDPcholine, folic acid, as well as such nonpharmacological approaches as validation therapy.Keywords: vascular dementia, excitotoxicity, treatment, NMDA, memantine, donepezil, galantamine, rivastigmine, nimodipine, hydergine, nicergoline, CDP-choline, folic acid

  20. Magnesium and Vascular Changes in Hypertension

    Directory of Open Access Journals (Sweden)

    Ana Rosa Cunha

    2012-01-01

    Full Text Available Many factors have been implicated in the pathogenesis of hypertension, including changes in intracellular concentrations of calcium, sodium, potassium, and magnesium. There is a significant inverse correlation between serum magnesium and incidence of cardiovascular diseases. Magnesium is a mineral with important functions in the body such as antiarrhythmic effect, actions in vascular tone, contractility, glucose metabolism, and insulin homeostasis. In addition, lower concentrations of magnesium are associated with oxidative stress, proinflammatory state, endothelial dysfunction, platelet aggregation, insulin resistance, and hyperglycemia. The conflicting results of studies evaluating the effects of magnesium supplements on blood pressure and other cardiovascular outcomes indicate that the action of magnesium in the vascular system is present but not yet established. Therefore, this mineral supplementation is not indicated as part of antihypertensive treatment, and further studies are needed to better clarify the role of magnesium in the prevention and treatment of cardiovascular diseases.

  1. Protein Kinase C Inhibitors as Modulators of Vascular Function and Their Application in Vascular Disease

    Directory of Open Access Journals (Sweden)

    Raouf A. Khalil

    2013-03-01

    Full Text Available Blood pressure (BP is regulated by multiple neuronal, hormonal, renal and vascular control mechanisms. Changes in signaling mechanisms in the endothelium, vascular smooth muscle (VSM and extracellular matrix cause alterations in vascular tone and blood vessel remodeling and may lead to persistent increases in vascular resistance and hypertension (HTN. In VSM, activation of surface receptors by vasoconstrictor stimuli causes an increase in intracellular free Ca2+ concentration ([Ca2+]i, which forms a complex with calmodulin, activates myosin light chain (MLC kinase and leads to MLC phosphorylation, actin-myosin interaction and VSM contraction. Vasoconstrictor agonists could also increase the production of diacylglycerol which activates protein kinase C (PKC. PKC is a family of Ca2+-dependent and Ca2+-independent isozymes that have different distributions in various blood vessels, and undergo translocation from the cytosol to the plasma membrane, cytoskeleton or the nucleus during cell activation. In VSM, PKC translocation to the cell surface may trigger a cascade of biochemical events leading to activation of mitogen-activated protein kinase (MAPK and MAPK kinase (MEK, a pathway that ultimately increases the myofilament force sensitivity to [Ca2+]i, and enhances actin-myosin interaction and VSM contraction. PKC translocation to the nucleus may induce transactivation of various genes and promote VSM growth and proliferation. PKC could also affect endothelium-derived relaxing and contracting factors as well as matrix metalloproteinases (MMPs in the extracellular matrix further affecting vascular reactivity and remodeling. In addition to vasoactive factors, reactive oxygen species, inflammatory cytokines and other metabolic factors could affect PKC activity. Increased PKC expression and activity have been observed in vascular disease and in certain forms of experimental and human HTN. Targeting of vascular PKC using PKC inhibitors may function in

  2. Tratamiento endovascular del accidente vascular encefálico agudo

    Directory of Open Access Journals (Sweden)

    Dr. G. Francisco Mena

    2013-01-01

    Full Text Available La alternativa de terapia neuroendovascular para un tratamiento del accidente vascular encefálico agudo es una área de la medicina en rápida expansión. El rescate endovascular del infarto cerebral agudo tiene como principal objetivo la rápida reperfusión del vaso ocluido utilizando la trombolisis intra-arterial cerebral y distintos métodos de trombectomía mecánica o colocación permanente de neurostent. El tratamiento neuro-endovascular de la hemorragia subaracnoidea aguda aneurismática también se ha establecido como la terapia de elección e incluye la embolización convencional con coils del aneurisma cerebral roto o utilizando técnica de embolización balón o stent asistido o colocación primaria de stent con tecnología de divertidor de flujo. Además, con la terapia endovascular se puede efectuar angioplastía farmacológica y mecánica del vasoespasmo cerebral.

  3. Vascular anomalies in pediatric patients: updated classification, imaging, and therapy.

    Science.gov (United States)

    Kollipara, Ramya; Odhav, Ashika; Rentas, Kenny E; Rivard, Douglas C; Lowe, Lisa H; Dinneen, Laura

    2013-07-01

    Recent advances in knowledge regarding histopathology, cause, and treatment of pediatric vascular anomalies have led to substantial changes in classification and terminology. Over the past two decades, various subspecialists have adopted a new classification system proposed by the International Society for the Study of Vascular Anomalies (ISSVA). The ISSVA classification of vascular anomalies divides vascular anomalies into two categories: vascular neoplasms and malformations. It has been widely adopted by various pediatric subspecialists, because it reliably correlates patient presentation and disease progression, with more accurate histology, diagnosis, imaging, and treatment. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Maternal homocystinuria and Moebius syndrome? Vascular aetiology.

    Science.gov (United States)

    Gupta, N; Anthony, M Y

    2011-02-14

    A case of Moebius syndrome is reported in an infant of a mother known to have pyridoxine-unresponsive homocystinuria. The authors suggest that Moebius syndrome could result from early vascular insufficiency or disruption occurring early in development related to maternal homocystinuria. Moebius syndrome consists of congenital complete or partial facial nerve palsy with or without paralysis of other cranial nerves and often in association with other malformations of the limbs and orofacial structures, but usually without gross structural brain abnormalities.

  5. Vascular Dysfunction in Horses with Endocrinopathic Laminitis.

    Directory of Open Access Journals (Sweden)

    Ruth A Morgan

    Full Text Available Endocrinopathic laminitis (EL is a vascular condition of the equine hoof resulting in severe lameness with both welfare and economic implications. EL occurs in association with equine metabolic syndrome and equine Cushing's disease. Vascular dysfunction, most commonly due to endothelial dysfunction, is associated with cardiovascular risk in people with metabolic syndrome and Cushing's syndrome. We tested the hypothesis that horses with EL have vascular, specifically endothelial, dysfunction. Healthy horses (n = 6 and horses with EL (n = 6 destined for euthanasia were recruited. We studied vessels from the hooves (laminar artery, laminar vein and the facial skin (facial skin arteries by small vessel wire myography. The response to vasoconstrictors phenylephrine (10-9-10-5M and 5-hydroxytryptamine (5HT; 10-9-10-5M and the vasodilator acetylcholine (10-9-10-5M was determined. In comparison with healthy controls, acetylcholine-induced relaxation was dramatically reduced in all intact vessels from horses with EL (% relaxation of healthy laminar arteries 323.5 ± 94.1% v EL 90.8 ± 4.4%, P = 0.01, laminar veins 129.4 ± 14.8% v EL 71.2 ± 4.1%, P = 0.005 and facial skin arteries 182.0 ± 40.7% v EL 91.4 ± 4.5%, P = 0.01. In addition, contractile responses to phenylephrine and 5HT were increased in intact laminar veins from horses with EL compared with healthy horses; these differences were endothelium-independent. Sensitivity to phenylephrine was reduced in intact laminar arteries (P = 0.006 and veins (P = 0.009 from horses with EL. Horses with EL exhibit significant vascular dysfunction in laminar vessels and in facial skin arteries. The systemic nature of the abnormalities suggest this dysfunction is associated with the underlying endocrinopathy and not local changes to the hoof.

  6. Desktop Database Management in Vascular Surgery

    OpenAIRE

    Lewis, H. Michael; Wheeler, Jock R.; Gregory, Roger T.

    1980-01-01

    A low-cost patient database management system has been developed using a microcomputer for use in a vascular surgery practice. The system is self-instructional, and is designed for use by physicians and/or clerical personnel without specialized training. Although the program is written in BASIC major modifications in the database as well as user-defined database searches are made in English. The database represents over 4100 operations on 2500 patients over 13 years. Factors influencing the s...

  7. Vascular effects of maternal alcohol consumption

    OpenAIRE

    Ramadoss, Jayanth; Magness, Ronald R.

    2012-01-01

    Maternal alcohol consumption during pregnancy is a significant field of scientific exploration primarily because of its negative effects on the developing fetus, which is specifically defined as fetal alcohol spectrum disorders. Though the effects on the mother are less explored compared with those on the fetus, alcohol produces multiple effects on the maternal vascular system. Alcohol has major effects on systemic hemodynamic variables, endocrine axes, and paracrine factors regulating vascul...

  8. NF1 Signal Transduction and Vascular Dysfunction

    Science.gov (United States)

    2014-05-01

    the effects of losing a second allele of NF1 in the vascular endothelium of the adult mouse. This will be the first model of NF1 loss in the... adult endothelium and can serve as a model system for investigation of both cardiovascular effects and the tumor microenvironment. Body: Aim 1...would be to try and determine if there were defects in TGF-b signaling (Smad activation/EndMT) prior to doing a wholesale catalog of all the

  9. Advancing and Translating Knowledge in Vascular Medicine.

    Science.gov (United States)

    Husmann, Marc; Barton, Matthias

    2014-01-01

    For centuries, physicians have depended on the use of written information to gain knowledge. Book printing and binding introduced by Gutenberg in the fifteenth century revolutionized and accelerated the distribution of information. Advancing medical knowledge and progress is not only linked to the scientific quality of a discovery determining it will be accepted by the peers but also by its communication and sharing of new findings with the medical community. All these factors determine whether new knowledge will advance and improve clinical practice, medical education, and ultimately, patient care, and human health. In the past decade medical publishing has witnessed a revolution with regard to the instant, online availability of published "open access" information, which can be accessed and printed from any computer connected to the internet. As an example, how language and availability of printed information may affect distribution of knowledge, we discuss the publication of the first results of balloon angioplasty in patients with peripheral vascular disease 40 years ago by Andreas Grüntzig, M.D. at the University of Zürich. Vascular Medicine, as part of Frontiers in Cardiovascular Medicine, will provide open access provided to all published content for sharing and distributing new and most up-to-date information on clinical practice and medical knowledge in vascular medicine. We anticipate that the ongoing transformation of scientific publishing through open access will further accelerate this process and make new knowledge available even faster. Immediate, unrestricted, and rapid access to the most current knowledge published will play a role in maintaining and advancing human vascular health across the globe.

  10. Endothelial microparticles: Sophisticated vesicles modulating vascular function

    Science.gov (United States)

    Curtis, Anne M; Edelberg, Jay; Jonas, Rebecca; Rogers, Wade T; Moore, Jonni S; Syed, Wajihuddin; Mohler, Emile R

    2015-01-01

    Endothelial microparticles (EMPs) belong to a family of extracellular vesicles that are dynamic, mobile, biological effectors capable of mediating vascular physiology and function. The release of EMPs can impart autocrine and paracrine effects on target cells through surface interaction, cellular fusion, and, possibly, the delivery of intra-vesicular cargo. A greater understanding of the formation, composition, and function of EMPs will broaden our understanding of endothelial communication and may expose new pathways amenable for therapeutic manipulation. PMID:23892447

  11. Magnesium and Vascular Changes in Hypertension

    OpenAIRE

    Ana Rosa Cunha; Bianca Umbelino; Margarida L. Correia; Mario Fritsch Neves

    2012-01-01

    Many factors have been implicated in the pathogenesis of hypertension, including changes in intracellular concentrations of calcium, sodium, potassium, and magnesium. There is a significant inverse correlation between serum magnesium and incidence of cardiovascular diseases. Magnesium is a mineral with important functions in the body such as antiarrhythmic effect, actions in vascular tone, contractility, glucose metabolism, and insulin homeostasis. In addition, lower concentrations of magnesi...

  12. Equipamiento para exhibiciones itinerantes

    OpenAIRE

    Montemurro, Florencia

    2012-01-01

    El trabajo consiste en el diseño de un equipamiento para muestras itinerantes para el Museo de Ciencias Naturales de la ciudad de La Plata. Para su desarrollo se tomó como concepto la desestructuración de la imagen del Museo. El objetivo era generar una imagen más actual y renovada de este establecimiento como estrategia para atraer diferentes tipos de visitantes. (Párrafo extraído del texto a modo de resumen) Facultad de Bellas Artes

  13. Permanent vascular access in patients with end-stage renal disease, Brazil Acceso vascular permanente en pacientes renales crónicos terminales en Brasil Acesso vascular permanente em pacientes renais crônicos terminais no Brasil

    Directory of Open Access Journals (Sweden)

    Gisele Macedo da Silva

    2011-04-01

    renal crónica anterior a la entrada en hemodiálisis OBJETIVO: Analisar fatores associados à provisão de acesso vascular arteriovenoso no Brasil. MÉTODOS: Estudo transversal, nacionalmente representativo, com pacientes com doença renal crônica terminal acompanhados em serviços de diálise ou em centros transplantadores no ano de 2007. A amostra incluiu apenas pacientes que tiveram a hemodiálise como primeira modalidade de tratamento e que sabiam com que tipo de acesso vascular haviam iniciado o tratamento (N = 2.276. Os dados são oriundos do Projeto TRS - "Avaliação econômico-epidemiológica das modalidades de Terapia Renal Substitutiva no Brasil". Regressão logística múltipla foi utilizada. RESULTADOS: Aproximadamente 30% dos pacientes tinham acesso vascular arteriovenoso. Os fatores associados à baixa probabilidade de ter acesso vascular arteriovenoso como primeiro tipo de acesso foram: tempo de diagnóstico de doença renal crônica anterior à entrada em hemodiálise < 1 ano, menor tempo de tratamento dialítico, não possuir cobertura de plano de saúde, residir na região Centro-Oeste, Nordeste e Sudeste, e residir na região Norte e ao mesmo tempo não possuir cobertura de plano de saúde. No modelo final não foi observada associação do desfecho com variáveis socioeconômicas e comorbidades, mas sim com cuidados pré-diálise. CONCLUSÕES: Os resultados mostram que, para aumentar a provisão de acesso vascular arteriovenoso antes do início da hemodiálise no Brasil, os esforços devem ser focados no cuidado pré-diálise.

  14. VASCULAR REMODELING IN HYPERTENSION: ANGIOGENESIS FEATURES

    Directory of Open Access Journals (Sweden)

    L. A. Haisheva

    2014-07-01

    Full Text Available Aim — cross-sectional study of changes in various segments of the vascular bed in arterial hypertension (AH, defining the role of inducers and inhibitors of angiogenesis in these processes.Materials and methods. The study included 99 patients with arterial hypertension of I–II degree, average age of 63.2 ± 2.6 years, diseaseduration 9.2 ± 7.2 years.Results. It was found that patients with arterial hypertension have disorders in all segments of vascular bed: endothelial dysfunction (highvWF, microcirculatory disorders, and increased pulse wave velocity (PWV of elastic-type vessels. The level of angioginesis factors doesnot depend on such parameters as gender, age, body mass index. Smoking and duration of hypertension influence on vascular endothelialgrowth factor raise and endostatin levels are higher in patients with family history of cardiovascular diseases. Duration of disease is directlycorrelated with microcirculatory disorders and the PWV, correlation between microcirculatory disorders and pulse wave velocity indicatetheir common processes.

  15. Vascular permeability in cerebral cavernous malformations.

    Science.gov (United States)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik B W; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-10-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.

  16. Biophysical Cueing and Vascular Endothelial Cell Behavior

    Directory of Open Access Journals (Sweden)

    Joshua A. Wood

    2010-03-01

    Full Text Available Human vascular endothelial cells (VEC line the vessels of the body and are critical for the maintenance of vessel integrity and trafficking of biochemical cues. They are fundamental structural elements and are central to the signaling environment. Alterations in the normal functioning of the VEC population are associated with a number of vascular disorders among which are some of the leading causes of death in both the United States and abroad. VECs attach to their underlying stromal elements through a specialization of the extracellular matrix, the basement membrane. The basement membrane provides signaling cues to the VEC through its chemical constituents, by serving as a reservoir for cytoactive factors and through its intrinsic biophysical properties. This specialized matrix is composed of a topographically rich 3D felt-like network of fibers and pores on the nano (1–100 nm and submicron (100–1,000 nm size scale. The basement membrane provides biophysical cues to the overlying VECs through its intrinsic topography as well as through its local compliance (relative stiffness. These biophysical cues modulate VEC adhesion, migration, proliferation, differentiation, and the cytoskeletal signaling network of the individual cells. This review focuses on the impact of biophysical cues on VEC behaviors and demonstrates the need for their consideration in future vascular studies and the design of improved prosthetics.

  17. Transradial approach for challenging vascular access interventions.

    Science.gov (United States)

    Rahmatzadeh, Mitra; Vijayan, Vikram; Ritter, Carsten J; Hockley, Joseph; Leong, Benjamin Dk; Sandford, Monique; Mwipatayi, Bibombe P

    2015-08-01

    Percutaneous interventional procedures for vascular access are usually performed using the draining cephalic or basilic vein. The transradial approach, which has been extensively investigated for coronary angiography and intervention, could be an attractive new technique for peri-anastomotic arteriovenous fistula stenosis. From June 2012 to February 2013, 30 patients with end-stage renal failure were evaluated for transradial vascular access intervention. A 4-French (Fr) micropuncture kit was used to access the radial artery and then subsequently upgraded to a 5-Fr sheath. Fourteen patients required an upgrade to a 6-Fr sheath for the final intervention. Primary technical success (residual stenosis access was achieved in all patients. There were no peri-procedural complications. The post-interventional primary patency was calculated as 100%, 100%, 88.4% and 32.8% at 1, 6, 9 and 12 months, respectively. The post-interventional primary assisted patency was calculated as 100%, 100%, 100% and 63.3% at 1, 6, 9 and 12 months, respectively. Based on colour-coded Duplex scan and/or photoelectric plethysmography, all access-site arteries showed normal perfusion; however, the freedom from significant radial artery restenosis was 92.4% at 12-month follow-up. The transradial approach for vascular access endovascular interventions is technically feasible and safe. It allows simultaneous treatment of peri-anastomotic lesions in fistulas with complex venous anatomy as well as lesions in the arterial inflow and central outflow. © The Author(s) 2014.

  18. Vascular parkinsonism: analysis of seven cases

    Directory of Open Access Journals (Sweden)

    Silva Elton Gomes da

    2006-01-01

    Full Text Available INTRODUCTION: Neuroimaging studies of elderly individuals reveal alterations in the white matter that are incompatible with the patient?s parkinsonism, mistakenly classified as vascular parkinsonism (VP. METHOD: This study was conducted on a population composed of 20 patients with Parkinson?s disease (PD whose neuroimaging exams revealed vascular alterations in the white matter and seven patients with VP in order to compare diagnostic criteria. RESULTS: Age at disease onset of patients with PD was 55±12 years and patients with VP it was 62±13 years. Twelve patients with PD and five patients with VP presented arterial hypertension; three patients with VP and two patients with PD presented gait impairment; all patients with VP presented rigidity and bradykinesia, six of them presented resting tremor; 19 patients with PD presented tremor and 19 of them presented rigidity, while 17 presented bradykinesia. When the symptoms and evolution of both diseases were compared, the vascular alterations in the white matter were considered unspecific. CONCLUSION: Since clinical symptoms are unspecific, a differential diagnosis requires neuroimaging, good response to levodopa and clinical evolution.

  19. Vascular Access Guidelines: Summary, Rationale, and Controversies.

    Science.gov (United States)

    Sequeira, Adrian; Naljayan, Mihran; Vachharajani, Tushar J

    2017-03-01

    Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population. The implementation of guidelines and FFBI has led to a significant increase in the arteriovenous fistula use in the prevalent dialysis population. The guidelines are criticized for being opinion based and often impractical. Over the past 2 decades, the patient population undergoing dialysis has become older with complex comorbidities and challenges for creating an ideal vascular access. Advancing knowledge about access pathophysiology, improved treatment options, and improved process of care with team approach model point toward diminishing relevance of few of the existing guidelines. Moreover, several guidelines remain controversial and may be leading to clinical decisions that may be unfavorable to the patients. The review discusses the historical aspect of vascular access care in the United States and evolution of current practice standards and controversies surrounding few of these guidelines in the current time. Published by Elsevier Inc.

  20. Pancreatic transplantation: Radiologic evaluation of vascular complications

    Energy Technology Data Exchange (ETDEWEB)

    Snider, J.F.; Hunter, D.W.; Kuni, C.C.; Castaneda-Zuniga, W.R.; Letourneau, J.G. (Univ. of Minnesota Hospital and Clinic, Minneapolis (USA))

    1991-03-01

    Transplantation of the pancreas is an increasingly common therapeutic option for preventing or delaying complications of type I diabetes mellitus. The authors studied the relative roles of various radiologic examinations in diagnosing vascular complications in these grafts including arterial and venous thrombosis, stenosis, and anastomotic leak (the most common vascular factors that necessitate pancreatectomy of the transplant), as defined with pathologic or arteriographic data. The results of 78 scintigraphic flow studies, 40 abdominal and pelvic computed tomographic (CT) scans, 27 sonograms, and eight color Doppler studies were evaluated in 52 patients who received a total of 27 cadaveric and 26 living-donor grafts over a 12-year period. These results were correlated with the data from 45 gross and microscopic pathologic studies and 37 arteriograms to determine their relative value in enabling detection of graft thrombosis and other vascular complications. Scintigraphy, CT, sonography, and color Doppler were all sensitive in detection of generalized graft abnormalities but lacked specificity in defining the underlying etiologic factors.

  1. Stem cell function during plant vascular development.

    Science.gov (United States)

    Elo, A; Immanen, J; Nieminen, K; Helariutta, Y

    2009-12-01

    While many regulatory mechanisms controlling the development and function of root and shoot apical meristems have been revealed, our knowledge of similar processes in lateral meristems, including the vascular cambium, is still limited. Our understanding of even the anatomy and development of lateral meristems (procambium or vascular cambium) is still relatively incomplete, let alone their genetic regulation. Research into this particular tissue type has been mostly hindered by a lack of suitable molecular markers, as well as the fact that thus far very few mutants affecting plant secondary development have been described. The development of suitable molecular markers is a high priority in order to help define the anatomy, especially the location and identity of cambial stem cells and the developmental phases and molecular regulatory mechanisms of the cambial zone. To date, most of the advances have been obtained by studying the role of the major plant hormones in vascular development. Thus far auxin, cytokinin, gibberellin and ethylene have been implicated in regulating the maintenance and activity of cambial stem cells; the most logical question in research would be how these hormones interact during the various phases of cambial development.

  2. Connective tissue: Vascular and hematological (blood) support.

    Science.gov (United States)

    Calvino, Nick

    2003-01-01

    Connective Tissue (CT) is a ubiquitous component of all major tissues and structures of the body (50% of all body protein is CT), including that of the blood, vascular, muscle, tendon, ligament, fascia, bone, joint, IVD's (intervertebral discs) and skin. Because of its ubiquitous nature, CT is an often overlooked component of any essential nutritional program that may address the structure, and/or function of these tissues. The central role of CT in the health of a virtually all cells, tissues, organs, and organ systems, is discussed. General nutritional CT support strategies, as well as specific CT support strategies that focus on blood, vascular, structural system (eg, muscles, tendons, ligaments, fascia, bone, and joints), integument (skin) and inflammatory and immune mediation will be discussed here and will deal with connective tissue dynamics and dysfunction. An overview of the current scientific understanding and possible options for naturally enhancing the structure and function of CT through the application of these concepts will be discussed in this article, with specific attention on the vascular and hematological systems.

  3. Vascular permeability in cerebral cavernous malformations

    Science.gov (United States)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik BW; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-01-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy. PMID:25966944

  4. Vascular development in the vertebrate pancreas.

    Science.gov (United States)

    Azizoglu, D Berfin; Chong, Diana C; Villasenor, Alethia; Magenheim, Judith; Barry, David M; Lee, Simon; Marty-Santos, Leilani; Fu, Stephen; Dor, Yuval; Cleaver, Ondine

    2016-12-01

    The vertebrate pancreas is comprised of a highly branched tubular epithelium, which is intimately associated with an extensive and specialized vasculature. While we know a great deal about basic vascular anatomy of the adult pancreas, as well as islet capillaries, surprisingly little is known about the ontogeny of its blood vessels. Here, we analyze development of the pancreatic vasculature in the mouse embryo. We show that pancreatic epithelial branches intercalate with the fine capillary plexus of the surrounding pancreatic mesenchyme. Endothelial cells (ECs) within this mesenchyme are heterogeneous from the onset of organogenesis. Pancreatic arteries take shape before veins, in a manner analogous to early embryonic vessels. The main central artery forms during mid-gestation, as a result of vessel coalescence and remodeling of a vascular plexus. In addition, we show that vessels in the forming pancreas display a predictable architecture that is dependent on VEGF signaling. Over-expression of VEGF disrupts vascular patterning and arteriovenous differentiation within the developing pancreas. This study constitutes a first-time in-depth cellular and molecular characterization of pancreatic blood vessels, as they coordinately grow along with the pancreatic epithelium. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Epoxygenated Fatty Acids Inhibit Retinal Vascular Inflammation.

    Science.gov (United States)

    Capozzi, Megan E; Hammer, Sandra S; McCollum, Gary W; Penn, John S

    2016-12-14

    The objective of the present study was to assess the effect of elevating epoxygenated fatty acids on retinal vascular inflammation. To stimulate inflammation we utilized TNFα, a potent pro-inflammatory mediator that is elevated in the serum and vitreous of diabetic patients. In TNFα-stimulated primary human retinal microvascular endothelial cells, total levels of epoxyeicosatrienoic acids (EETs), but not epoxydocosapentaenoic acids (EDPs), were significantly decreased. Exogenous addition of 11,12-EET or 19,20-EDP when combined with 12-(3-adamantane-1-yl-ureido)-dodecanoic acid (AUDA), an inhibitor of epoxide hydrolysis, inhibited VCAM-1 and ICAM-1 expression and protein levels; conversely the diol product of 19,20-EDP hydrolysis, 19,20-DHDP, induced VCAM1 and ICAM1 expression. 11,12-EET and 19,20-EDP also inhibited leukocyte adherence to human retinal microvascular endothelial cell monolayers and leukostasis in an acute mouse model of retinal inflammation. Our results indicate that this inhibition may be mediated through an indirect effect on NFκB activation. This is the first study demonstrating a direct comparison of EET and EDP on vascular inflammatory endpoints, and we have confirmed a comparable efficacy from each isomer, suggesting a similar mechanism of action. Taken together, these data establish that epoxygenated fatty acid elevation will inhibit early pathology related to TNFα-induced inflammation in retinal vascular diseases.

  6. Efectividad de los ácidos grasos hiperoxigenados en la prevención de las úlceras vasculares: Una revisión sistemática Hyperoxygenated fatty acid effectiveness in the prevention of the vascular ulcers

    Directory of Open Access Journals (Sweden)

    Eva Vives Sánchez

    2011-09-01

    Full Text Available Objetivos: conocer la eficacia de los ácidos grasos hiperoxigenados (AGHO en la prevención de las úlceras vasculares. Determinar el nivel de evidencia existente sobre el uso de ácidos grasos hiperoxigenados en la prevención de las úlceras vasculares. Material y método: se realizó una búsqueda bibliográfica en la The Cochrane Library, The Joanna Briggs Institute, PubMed-Medline y CUIDEN. Para su evaluación se han seguido las recomendaciones del sistema GRADE para la valoraciún de la evidencia y la fuerza de las recomendaciones. Resultados: en The Cochrane Library y en The Joanna Briggs Institute no aparece ningún documento que haga referencia a los AGHO. En el resto de bases de datos encontramos estudios observacionales que hacen referencia a las úlceras vasculares y AGHO. Conclusiones: aun no disponiendo de ensayos clínicos que evidencien su uso, se han venido utilizando durante los últimos años, con resultados satisfactorios, en el cuidado de la piel de las personas con alteraciones vasculares en los miembros inferiores. De acuerdo con la clasificación GRADE, todos los estudios arrojan una calidad de evidencia baja, por lo cual estimamos necesario la puesta en marcha de investigaciones que aporten mayor evidencia científica.Objectives: to determine the effectiveness of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Determine the level of existing evidence the use of hyper-oxygenated fatty acids in the prevention of vascular ulcers. Material and Method: we performed a literature search of Cochrane Library, The Joanna Briggs Institute, PubMed, Medline and CUIDEN. For the evaluation, have followed the recommendations of the GRADE system for assessing evidence and strength of recommendations. Results: The Cochrane Library and The Joanna Briggs Institute does not see any document referring to AGHO. In all other databases are observational studies that relate to vascular ulcers and AGHO. Conclusions: although

  7. Repito para recordar : Recuerdo para religar

    OpenAIRE

    Juárez, Horacio Eduardo

    2015-01-01

    Tanto la repitencia y el abandono escolar continúan generando importantes desafíos para el sistema educativo, a pesar de los grandes esfuerzos realizados en los últimos años en la Argentina para mejorar la inclusión y la calidad educativa. El presente proyecto de investigación de tipo cualitativo, se propone explorar a través de conceptos psicológicos como la transferencia, la influencia del profesor de educación física en el rendimiento académico del alumno de escuela secundaria. El vínculo ...

  8. Improving cost efficiency on a vascular surgery service.

    Science.gov (United States)

    Skillman, J J; Paras, C; Rosen, M; Davis, R B; Kim, D; Kent, K C

    2000-03-01

    A vascular task force (VTF) consisting of two vascular surgeons and other key personnel was established to reduce costs and improve efficiency in the management of patients on a vascular surgery service. The VTF met monthly beginning in 1994 to study and implement changes in the management of patients with (1) abdominal vascular, (2), carotid endarterectomy (3) distal bypass, and (4) other vascular procedures, including amputations. Length of stay, and fixed and variable costs were assessed for change over time using Pearson correlation coefficients. Improvements in efficiency (length of stay) and decreases in costs (fixed and variable costs) from fiscal year 1993 to fiscal year 1996 were significant for the total group of vascular patients (P Management of distal bypass and other vascular surgery patients showed less striking improvement. Vascular surgeons in collaboration with other dedicated personnel involved in the care of vascular patients can improve efficiency and reduce costs. Advances were greatest in patients who required operations for carotid and abdominal vascular disorders and least for patients who required distal bypasses and other vascular procedures.

  9. Syndromes associated with vascular tumors and malformations: a pictorial review.

    Science.gov (United States)

    Nozaki, Taiki; Nosaka, Shunsuke; Miyazaki, Osamu; Makidono, Akari; Yamamoto, Asako; Niwa, Tetsu; Tsutsumi, Yoshiyuki; Aida, Noriko; Masaki, Hidekazu; Saida, Yukihisa

    2013-01-01

    Use of the International Society for the Study of Vascular Anomalies (ISSVA) classification system has been strongly recommended in recent years because of the need for separate therapeutic measures for patients with vascular tumors and malformations. In the ISSVA classification system, vascular tumors, which are neoplastic, are distinguished from vascular malformations, which are caused by vascular structural anomalies and are not neoplastic, on the basis of the presence or absence of neoplastic proliferation of vascular endothelial cells. It is important that radiologists be familiar with the development, diagnosis, and treatment of vascular tumors and malformations, especially the imaging features of low- and high-flow vascular malformations. Some vascular tumors and malformations develop in isolation, whereas others develop within the phenotype of a syndrome. Syndromes that are associated with vascular tumors include PHACE syndrome. Syndromes that are associated with vascular malformations include Sturge-Weber, Klippel-Trénaunay, Proteus, blue rubber bleb nevus, Maffucci, and Gorham-Stout syndromes, all of which demonstrate low flow, and Rendu-Osler-Weber, Cobb, Wyburn-Mason, and Parkes Weber syndromes, all of which demonstrate high flow. Because imaging findings may help identify such syndromes as systemic, it is important that radiologists familiarize themselves with these conditions.

  10. FACTORES DE RIESGO VASCULAR: REGISTRO EXTRAINSTITUCIONAL EN LA LOCALIDAD DE ENCRUCIJADA / Vascular Risk factors: extra-institutional registry in Encrucijada municipality

    Directory of Open Access Journals (Sweden)

    Gerardo Álvarez Álvarez

    2010-09-01

    Full Text Available Resumen Introducción y objetivos: El conocimiento de los factores de riesgo vascular es de gran importancia para la preservación de la salud poblacional, ellos contribuyen al desarrollo de la aterosclerosis, sustrato necesario para ocasionar daños en el corazón, cerebro, riñón y vasos periféricos. El objetivo de esta investigación fue realizar un pesquisaje de un segmento poblacional en la búsqueda de estos factores de riesgo. Métodos: Se realizó una investigación de carácter analítico-transversal, de forma extrainstitucional a las unidades médicas, sobre factores de riesgo vascular en la localidad de Encrucijada, Villa Clara, en mayo del 2009. Resultados: Se habilitaron 10 puntos de registros en lugares concurridos por la población; en un lapso de 4 horas se alcanzó una casuística de 697 personas, con un predominio de mujeres y de personas con color de la piel blanca. La talla media poblacional fue de 1,64 cm, los valores promedios de peso corporal, índice de masa corporal y de la cintura abdominal fueron de: 67 kg, 25 kg/m2 y 86,3 cm. La hipertensión arterial fue encontrada en el 16 % de los casos, con mayor porcentaje en individuos con poca actividad física, en los de mayor índice de masa corporal y cintura abdominal, y con color negro de la piel. La adicción tabáquica fue superior en hombres. Se constató una notable aceptación poblacional. Conclusiones: Nuestro estudio demuestra la presencia de factores de riesgo vascular en un segmento de la población del municipio Encrucijada y nos alertan sobre la necesidad de fortalecer la medicina comunitaria (promoción y prevención para mejorar la salud de todos. / Abstract Introduction and objectives: The knowledge of vascular risk factors is of great importance in the preservation of the population's health as they contribute to the development of atherosclerosis which is a necessary substratum to produce damages in the heart, brain, kidney and peripheral vessels. This

  11. Nox, Reactive Oxygen Species and Regulation of Vascular Cell Fate

    Directory of Open Access Journals (Sweden)

    Denise Burtenshaw

    2017-11-01

    Full Text Available The generation of reactive oxygen species (ROS and an imbalance of antioxidant defence mechanisms can result in oxidative stress. Several pro-atherogenic stimuli that promote intimal-medial thickening (IMT and early arteriosclerotic disease progression share oxidative stress as a common regulatory pathway dictating vascular cell fate. The major source of ROS generated within the vascular system is the nicotinamide adenine dinucleotide phosphate (NADPH oxidase family of enzymes (Nox, of which seven members have been characterized. The Nox family are critical determinants of the redox state within the vessel wall that dictate, in part the pathophysiology of several vascular phenotypes. This review highlights the putative role of ROS in controlling vascular fate by promoting endothelial dysfunction, altering vascular smooth muscle phenotype and dictating resident vascular stem cell fate, all of which contribute to intimal medial thickening and vascular disease progression.

  12. Skin integrated with perfusable vascular channels on a chip.

    Science.gov (United States)

    Mori, Nobuhito; Morimoto, Yuya; Takeuchi, Shoji

    2017-02-01

    This paper describes a method for fabricating perfusable vascular channels coated with endothelial cells within a cultured skin-equivalent by fixing it to a culture device connected to an external pump and tubes. A histological analysis showed that vascular channels were constructed in the skin-equivalent, which showed a conventional dermal/epidermal morphology, and the endothelial cells formed tight junctions on the vascular channel wall. The barrier function of the skin-equivalent was also confirmed. Cell distribution analysis indicated that the vascular channels supplied nutrition to the skin-equivalent. Moreover, the feasibility of a skin-equivalent containing vascular channels as a model for studying vascular absorption was demonstrated by measuring test molecule permeation from the epidermal layer into the vascular channels. The results suggested that this skin-equivalent can be used for skin-on-a-chip applications including drug development, cosmetics testing, and studying skin biology. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The role of the vascular dendritic cell network in atherosclerosis

    Science.gov (United States)

    Alberts-Grill, Noah; Denning, Timothy L.; Rezvan, Amir

    2013-01-01

    A complex role has been described for dendritic cells (DCs) in the potentiation and control of vascular inflammation and atherosclerosis. Resident vascular DCs are found in the intima of atherosclerosis-prone vascular regions exposed to disturbed blood flow patterns. Several phenotypically and functionally distinct vascular DC subsets have been described. The functional heterogeneity of these cells and their contributions to vascular homeostasis, inflammation, and atherosclerosis are only recently beginning to emerge. Here, we review the available literature, characterizing the origin and function of known vascular DC subsets and their important role contributing to the balance of immune activation and immune tolerance governing vascular homeostasis under healthy conditions. We then discuss how homeostatic DC functions are disrupted during atherogenesis, leading to atherosclerosis. The effectiveness of DC-based “atherosclerosis vaccine” therapies in the treatment of atherosclerosis is also reviewed. We further provide suggestions for distinguishing DCs from macrophages and discuss important future directions for the field. PMID:23552284

  14. Elevated Plasma Homocysteine Level in Vascular Dementia Reflects the Vascular Disease Process

    Directory of Open Access Journals (Sweden)

    Karin Nilsson

    2013-02-01

    Full Text Available Background: Patients with vascular dementia (VaD exhibit particularly elevated levels of plasma total homocysteine (tHcy compared to patients with other psychogeriatric diseases. Methods: We investigated the main determinants (age, renal impairment, cobalamin/folate status and presence of extracerebral vascular disease of plasma tHcy in 525 patients with VaD. Furthermore, 270 patients with depression were used as a reference group to reveal the potential specificity of elevated plasma tHcy in patients with VaD. Results: Elevated plasma tHcy levels in patients with VaD could only partly be attributed to cobalamin/folate deficiency or renal impairment. Plasma tHcy might also be related to the vascular disease process since patients with depression and vascular disease exhibited similar plasma tHcy levels to patients with VaD. Conclusion: Our findings suggest that elevated plasma tHcy might be a sensitive marker for the vascular disease process in patients with VaD and that the level also is a reflection of changes in the other main determinants of plasma tHcy.

  15. Vascular AMPK as an attractive target in the treatment of vascular complications of obesity.

    Science.gov (United States)

    García-Prieto, C F; Gil-Ortega, M; Aránguez, I; Ortiz-Besoain, M; Somoza, B; Fernández-Alfonso, M S

    2015-01-01

    The key for the survival of all organisms is the regulation and control of energy metabolism. Thus, several strategies have evolved in each tissue in order to balance nutrient supply with energy demand. Adenosine monophosphate-activated protein kinase (AMPK) is now recognized as a key participant in energy metabolism. It ensures an appropriate energetic supply by promoting energy conserving pathways in detriment of anabolic processes not essential for cell survival. Vascular AMPK plays a critical role in the regulation of blood flow and vascular tone through several mechanisms, including vasodilation by stimulating nitric oxide release in endothelial cells. Since obesity leads to endothelial damage and AMPK dysregulation, AMPK activation might be an important strategy to restore vascular function in cardiometabolic alterations. In the present review we focus on the role of vascular AMPK in both endothelial and smooth muscle cells, paying special attention to its dysregulation in obesity- and high-fat diet-related complications, as well as to the mechanisms and benefits of vascular AMPK activation. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Retinal vascular tortuosity in obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Mohsenin A

    2013-04-01

    Full Text Available Amir Mohsenin,1 Vahid Mohsenin,2 Ron A Adelman1 1Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA; 2Yale Center for Sleep Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA Purpose: Endothelial dysfunction and vascular disease are common in obstructive sleep apnea (OSA. We sought to examine the retinal vascular manifestations of OSA. Methods: Nine consecutive patients with OSA underwent ophthalmic examination regardless of any ocular complaints. Seven patients without OSA matched for demographics were used as controls. Fundus photographs from both eyes were used to quantitate retinal vascular tortuosity of the temporal arterial and venous arcades using ImageJ digital analysis software. The tortuosity of each vessel from the optic disc rim to the crossing point of a 5 disc diameter (5DD circle and 10 disc diameter (10DD circle centered on the optic disc were quantitated. Results: The mean age of patients with OSA in the study was 52 years ± SD of 10 years and 67 years ± SD of 10 years in the control group. The apnea-hypopnea index in patients with OSA ranged from 12 to 102 events/hr of sleep. The nadir oxyhemoglobin saturation during sleep in patients with OSA ranged from 60% to 87%. There was no significant difference in the frequency of diabetes or hypertension between the groups. Total tortuosity was increased at the 5DD (P = 0.011 and 10DD (P = 0.004 marks. Arterial tortuosity was significantly increased at the 10DD mark (P = 0.016. Venular tortuosity was increased at both the 5DD (P = 0.001 and 10DD (P = 0.028 marks. Conclusion: Patients with OSA have increased retinal vascular tortuosity as compared to matched controls. Increased tortuosity of the retinal vasculature may be a novel association with OSA. A larger prospective study will be necessary to further explore this relationship and its clinical significance. Keywords

  17. [Vascular tumours and malformations, classification, pathology and imaging].

    Science.gov (United States)

    Wassef, M; Vanwijck, R; Clapuyt, P; Boon, L; Magalon, G

    2006-01-01

    The understanding of vascular anomalies (vascular tumours and vascular malformations) was obscured, for a long time, by confusion and uncertainties in nosology and terminology. The International Society for the Study of Vascular Anomalies (ISSVA) recently adopted a classification scheme, clearly separating vascular tumours (hemangiomas of different types) which result from active cell proliferation, from vascular malformations, which are inborn defects in vascular morphogenesis. These two types of lesions have different clinical behaviour and require different diagnostic and therapeutic strategies. The most frequent vascular tumour is infantile hemangioma. Its clinical aspects and evolution are well-known. New data have been recently obtained concerning the phenotype of tumour cells and its histogenesis. Of the numerous new vascular tumours, which have been recently described, only the congenital hemangiomas, the vascular tumours associated with the Maffucci syndrome and the tumours that may be complicated by a profound thrombocytopenia (Kasabach and Merritt phenomenon) will be considered. Vascular malformations can be classified according to the vessel(s) types they are composed of. A classification table is presented, separating the malformations of vascular trunks from tissular malformations which are more intimately embedded in the surrounding tissues. The different syndromes associated with vascular anomalies take also place in this table. The clinical, imaging and histological aspects of the most frequent malformations (capillary, venous, lymphatic and arteriovenous) are presented. This classification intend to clarify the nosology and terminology of the complex field of vascular tumours and malformation and to offer a common language to the different physicians and specialists contributing, preferably with a interdisciplinary approach, to the diagnosis and treatment of these difficult lesions.

  18. CARACTERIZACIÓN DE LOS FACTORES DE RIESGO VASCULAR EN PACIENTES ADULTOS / Characterization of vascular risk factors in adult patients

    Directory of Open Access Journals (Sweden)

    Estrella M. Hernández Hurtado

    2013-07-01

    Full Text Available Resumen: Introducción: La elevada prevalencia de factores de riesgo vascular en la población y su relación con el desarrollo de la cardiopatía isquémica representan un problema de salud pública. Objetivo: Caracterizar estos factores en adultos. Método: Se realizó un estudio observacional, descriptivo, transversal en pacientes que asistieron a la consulta de riesgo vascular del municipio de Ranchuelo, en Villa Clara, entre abril de 2010 y abril de 2011. La información se procesó con el programa SPSS versión 15.0. Se estimaron estadígrafos de tendencia central y dispersión para variables cuantitativas, y las cualitativas se resumieron mediante frecuencias absolutas y porcentajes. Resultados: Los principales factores de riesgo identificados fueron: hipertensión arterial (85,7 %, obesidad (81,1 %, diabetes mellitus (61,9 % y hábito de fumar (52,4 %. El 42,9 % presentó cuatro factores de riesgo asociados al momento del diagnóstico. El hábito de fumar fue el que mostró asociación significativa con la cardiopatía isquémica (p=0.04. Conclusiones: Los principales factores de riesgo identificados fueron: hipertensión arterial, obesidad, diabetes mellitus y hábito de fumar. Predominó la tendencia de asociación entre ellos, y fue frecuente la presencia de varios factores en un mismo paciente. Se encontró una asociación significativa entre el hábito de fumar y la presencia de cardiopatía isquémica. / Abstract: Introduction: The high prevalence of vascular risk factors in the population and its relationship to the development of ischemic heart disease represent a public health problem. Objective: To characterize these risk factors in adults. Method: An observational, descriptive, transversal study was conducted in patients who were treated at the outpatient vascular risk consultation in the municipality of Ranchuelo, Villa Clara, from April 2010 to April 2011. The information was processed using SPSS software, version 15

  19. Resección laparoscópica de tumor del estroma gástrico

    Directory of Open Access Journals (Sweden)

    Norkys Martín Bourricaudy

    Full Text Available Los tumores estromales gastrointestinales son los tumores mesenquimales más frecuentes del tracto digestivo. La mayor prevalencia de esta enfermedad se presenta en el estómago. El tratamiento de elección es la resección del área tumoral con márgenes histológicos sin linfadenectomia. Las técnicas de mínimo acceso muestran una alternativa muy favorable para el tratamiento de los tumores estromales gastrointestinales. Existen reportes aislados en la literatura de estos tumores tratados quirúrgica y oncológicamente. Por la escasa frecuencia con que se presenta la patología y los beneficios que brinda el acceso laparoscópico para su tratamiento, hemos realizado el presente trabajo con el objetivo de describir los aspectos clínicos del diagnóstico y tratamiento de un paciente que presenta tumor de páncreas versus tumor estromal gástrico. Se realiza laparoexploración donde se constata tumor de fundus gástrico, curvatura mayor y realiza resección tumoral laparoscópica. Con evolución favorable, confirmación inmunohistoquímica de tumores estromales gastrointestinales y seguimiento oncológico.

  20. Cytoglobin regulates blood pressure and vascular tone through nitric oxide metabolism in the vascular wall

    Science.gov (United States)

    Liu, Xiaoping; El-Mahdy, Mohamed A.; Boslett, James; Varadharaj, Saradhadevi; Hemann, Craig; Abdelghany, Tamer M.; Ismail, Raed S.; Little, Sean C.; Zhou, Danlei; Thuy, Le Thi Thanh; Kawada, Norifumi; Zweier, Jay L.

    2017-04-01

    The identity of the specific nitric oxide dioxygenase (NOD) that serves as the main in vivo regulator of O2-dependent NO degradation in smooth muscle remains elusive. Cytoglobin (Cygb) is a recently discovered globin expressed in fibroblasts and smooth muscle cells with unknown function. Cygb, coupled with a cellular reducing system, efficiently regulates the rate of NO consumption by metabolizing NO in an O2-dependent manner with decreased NO consumption in physiological hypoxia. Here we show that Cygb is a major regulator of NO degradation and cardiovascular tone. Knockout of Cygb greatly prolongs NO decay, increases vascular relaxation, and lowers blood pressure and systemic vascular resistance. We further demonstrate that downregulation of Cygb prevents angiotensin-mediated hypertension. Thus, Cygb has a critical role in the regulation of vascular tone and disease. We suggest that modulation of the expression and NOD activity of Cygb represents a strategy for the treatment of cardiovascular disease.

  1. Sobrecarga de cuidadores familiares de idosos com acidente vascular encefálico

    Directory of Open Access Journals (Sweden)

    Tatiana Ferreira da Costa

    2015-06-01

    Full Text Available Objetivo: Investigar a prevalência e associação da sobrecarga com características do indivíduo com sequela de acidente vascular encefálico e do cuidador. Métodos: Estudo descritivo, transversal, com abordagem quantitativa, realizado na cidade de João Pessoa - PB. Os participantes foram 136 cuidadores familiares. Para a coleta de dados, aplicou-se a escala de Barthel e Zarit Burden Interview. Resultados: Evidencia-se alta prevalência de sobrecarga entre os cuidadores (77,2%, a qual apresentou associação estatisticamente significativa com as seguintes características: indivíduos com sequela de acidente vascular encefálico com 65 anos ou mais, com grau de dependência muito grave, cuidadores do sexo feminino, com faixa etária adulta e com baixo grau de escolaridade. Conclusão: Destaca-se a importância prática de intervenções realizadas por enfermeiros e demais profissionais de saúde com relação às orientações e supervisões referentes ao cuidado dispensado ao cuidador familiar de indivíduos com sequela de acidente vascular encefálico.

  2. Depressão vascular no idoso: resposta ao tratamento antidepressivo associado a inibidor das colinesterases Vascular depression in elderly: response to treatment with antidepressant associated to cholinesterase inhibitor

    Directory of Open Access Journals (Sweden)

    Ricardo Barcelos

    2007-01-01

    Full Text Available CONTEXTO: Entre os transtornos neuropsiquiátricos ocasionados por eventos cerebrovasculares, a depressão vascular é pouco diagnosticada por médicos não especialistas, causando aumento da morbimortalidade de pacientes idosos. CASO CLÍNICO: Trata-se de um paciente com 67 anos que apresentou resposta parcial a tratamento com inibidores da recaptura de serotonina e efeitos adversos autonômicos graves com outros antidepressivos. A adição de rivastigmina ao citalopram promoveu sucesso terapêutico, com redução de 23 para 7 pontos, na escala de Hamilton para depressão. DISCUSSÃO: O resultado obtido traz novas perspectivas para o tratamento da depressão vascular, sendo necessários ensaios clínicos controlados que evidenciem o benefício da adição dos inibidores das colinesterases aos antidepressivos no tratamento destes pacientes.CONTEXT: Among neuropsychiatric disorders caused by cerebrovascular factors, vascular depression is diagnosed in a small degree by general practitioners, causing morbid-mortality increase in elderly. CASE REPORT: That is a case of a 67 year-old-man with partial response after treatment with a Selective Serotonin Receptors Inhibitor, and severe autonomic adverse effects with other antidepressants. The addition of rivastigmine to citalopram resulted in a therapeutic success, with a reduction of 23 to 7 points on the Hamilton Depressive Scale (HAM-D. DISCUSSION: The result obtained brings new perspectives to the treatment of vascular depression, providing that randomized controlled trials with larger sample sizes confirm the positive effect of the addition of a cholinesterase inhibitor to antidepressants in the treatment of these patients.

  3. Protein Kinase C as Regulator of Vascular Smooth Muscle Function and Potential Target in Vascular Disorders.

    Science.gov (United States)

    Ringvold, H C; Khalil, R A

    2017-01-01

    Vascular smooth muscle (VSM) plays an important role in maintaining vascular tone. In addition to Ca2+-dependent myosin light chain (MLC) phosphorylation, protein kinase C (PKC) is a major regulator of VSM function. PKC is a family of conventional Ca2+-dependent α, β, and γ, novel Ca2+-independent δ, ɛ, θ, and η, and atypical ξ, and ι/λ isoforms. Inactive PKC is mainly cytosolic, and upon activation it undergoes phosphorylation, maturation, and translocation to the surface membrane, the nucleus, endoplasmic reticulum, and other cell organelles; a process facilitated by scaffold proteins such as RACKs. Activated PKC phosphorylates different substrates including ion channels, pumps, and nuclear proteins. PKC also phosphorylates CPI-17 leading to inhibition of MLC phosphatase, increased MLC phosphorylation, and enhanced VSM contraction. PKC could also initiate a cascade of protein kinases leading to phosphorylation of the actin-binding proteins calponin and caldesmon, increased actin-myosin interaction, and VSM contraction. Increased PKC activity has been associated with vascular disorders including ischemia-reperfusion injury, coronary artery disease, hypertension, and diabetic vasculopathy. PKC inhibitors could test the role of PKC in different systems and could reduce PKC hyperactivity in vascular disorders. First-generation PKC inhibitors such as staurosporine and chelerythrine are not very specific. Isoform-specific PKC inhibitors such as ruboxistaurin have been tested in clinical trials. Target delivery of PKC pseudosubstrate inhibitory peptides and PKC siRNA may be useful in localized vascular disease. Further studies of PKC and its role in VSM should help design isoform-specific PKC modulators that are experimentally potent and clinically safe to target PKC in vascular disease. © 2017 Elsevier Inc. All rights reserved.

  4. A Diagnostic Program of Vascular Tumor and Vascular Malformations in Children According to Modern Classification

    Directory of Open Access Journals (Sweden)

    Iryna Benzar

    2017-06-01

    Full Text Available The aim of the study was to analyze the cohort of inpatient children with vascular anomalies according to the globally accepted classification introduced by the ISSVA. Methods: The study included 205 inpatient children within the time period of the years 2010–2015. Types of vascular anomalies (VAs, age of patients, diagnostic procedures, and anatomical localization of VAs were analyzed. Results: 65 patients of first year of life had vascular tumors, with prevalence of infantile hemangiomas (IHs in 57 (87.7% patients. 45 children had IHs localized within soft tissues, whereas 7 patients suffered from IHs of the liver, and 5 children from IHs of the respiratory tract. Most patients with soft tissue IHs were diagnosed only with ultrasound; СT or MRI diagnostics were performed on 5 (8.8% patients, and biopsy was carried out in 2 (4.4% children. Vascular malformations (VM were diagnosed in 140 (68.3% patients. Ultrasound investigation (US was the screening method. MRI was performed to confirm the diagnosis of low-flow VM, whereas for high-flow VM CT angiography and selective angiography were useful. Venous malformations were diagnosed in 17 (12.1% patients, and 112 (80.0% had cystic LM, among them children under the age of 2 years prevailed. Arteriovenous malformations were diagnosed in 5 (3.8% patients, ages 2–14 years. Conclusions: Clinical manifestations of vascular anomalies have clear age features. Among hospitalized children vascular tumors add up to 31.7% and VM – up to 68.3%.

  5. Novel paradigms for dialysis vascular access: upstream hemodynamics and vascular remodeling in dialysis access stenosis.

    Science.gov (United States)

    Remuzzi, Andrea; Ene-Iordache, Bogdan

    2013-12-01

    Failure of hemodialysis access is caused mostly by venous intimal hyperplasia, a fibro-muscular thickening of the vessel wall. The pathogenesis of venous neointimal hyperplasia in primary arteriovenous fistulae consists of processes that have been identified as upstream and downstream events. Upstream events are the initial events producing injury of the endothelial layer (surgical trauma, hemodynamic shear stress, vessel wall injury due to needle punctures, etc.). Downstream events are the responses of the vascular wall at the endothelial injury that consist of a cascade of processes including leukocyte adhesion, migration of smooth muscle cells from the media to the intimal layer, and proliferation. In arteriovenous fistulae, the stenoses occur in specific sites, consistently related to the local hemodynamics determined by the vessel geometry and blood flow pattern. Recent findings that the localization of these sites matches areas of disturbed flow may add new insights into the pathogenesis of neointimal hyperplasia in the venous side of vascular access after the creation of the anastomosis. The detailed study of fluid flow motion acting on the vascular wall in anastomosed vessels and in the arm vasculature at the patient-specific level may help to elucidate the role of hemodynamics in vascular remodeling and neointimal hyperplasia formation. These computational approaches may also help in surgical planning for the amelioration of clinical outcome. This review aims to discuss the role of the disturbed flow condition in acting as upstream event in the pathogenesis of venous intimal hyperplasia and in producing subsequent local vascular remodeling in autogenous arteriovenous fistulae used for hemodialysis access. The potential use of blood flow analysis in the management of vascular access is also discussed.

  6. Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement.

    Science.gov (United States)

    Dencker, Ditte; Taudorf, Mikkel; Luk, N H Vincent; Nielsen, Michael B; Kofoed, Klaus F; Schroeder, Torben V; Søndergaard, Lars; Lönn, Lars; De Backer, Ole

    2016-10-15

    Vascular access and closure remain a challenge in transcatheter aortic valve replacement (TAVR). This single-center study aimed to report the incidence, predictive factors, and clinical outcomes of access-related vascular injury and subsequent vascular intervention. During a 30-month period, 365 patients underwent TAVR and 333 patients (94%) were treated by true percutaneous transfemoral approach. Of this latter group, 83 patients (25%) had an access-related vascular injury that was managed by the use of a covered self-expanding stent (n = 49), balloon angioplasty (n = 33), or by surgical intervention (n = 1). In 16 patients (5%), the vascular injury was classified as a major vascular complication. Absence of a preprocedural computed tomography angiography (CTA) of the iliofemoral arteries (OR 2.04, p = 0.007) and female gender (OR 2.18, p = 0.004) were independent predictors of the need for access-related vascular intervention. In addition, a high sheath/common femoral artery ratio as measured on preoperative CTA was associated with a higher rate of post-TAVR vascular intervention. The radiation dose, iodine contrast volume, transfusion need, length of hospitalization, and 30-day mortality were not significantly different between patients with versus without access-related vascular intervention. In conclusion, access-related vascular intervention in patients who underwent transfemoral-TAVR is not uncommon. Female gender and a high sheath/common femoral artery ratio are risk factors for access-related vascular injury, whereas preprocedural planning with CTA of the access vessels may reduce the risk of vascular injury. Importantly, most access-related vascular injuries may be treated by percutaneous techniques with similar clinical outcomes to patients without vascular injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for Alzheimer's disease.

    Science.gov (United States)

    Kalaria, Raj N

    2016-05-01

    Vascular dementia (VaD) is recognised as a neurocognitive disorder, which is explained by numerous vascular causes in the general absence of other pathologies. The heterogeneity of cerebrovascular disease makes it challenging to elucidate the neuropathological substrates and mechanisms of VaD as well as vascular cognitive impairment (VCI). Consensus and accurate diagnosis of VaD relies on wide-ranging clinical, neuropsychometric and neuroimaging measures with subsequent pathological confirmation. Pathological diagnosis of suspected clinical VaD requires adequate postmortem brain sampling and rigorous assessment methods to identify important substrates. Factors that define the subtypes of VaD include the nature and extent of vascular pathologies, degree of involvement of extra and intracranial vessels and the anatomical location of tissue changes. Atherosclerotic and cardioembolic diseases appear the most common substrates of vascular brain injury or infarction. Small vessel disease characterised by arteriolosclerosis and lacunar infarcts also causes cortical and subcortical microinfarcts, which appear to be the most robust substrates of cognitive impairment. Diffuse WM changes with loss of myelin and axonal abnormalities are common to almost all subtypes of VaD. Medial temporal lobe and hippocampal atrophy accompanied by variable hippocampal sclerosis are also features of VaD as they are of Alzheimer's disease. Recent observations suggest that there is a vascular basis for neuronal atrophy in both the temporal and frontal lobes in VaD that is entirely independent of any Alzheimer pathology. Further knowledge on specific neuronal and dendro-synaptic changes in key regions resulting in executive dysfunction and other cognitive deficits, which define VCI and VaD, needs to be gathered. Hereditary arteriopathies such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy or CADASIL have provided insights into the mechanisms of

  8. Paravertebral vascular hamartoma - radiological findings; Hamartoma vascular paravertebral - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Maria Cristina Soares dos; Dinoa, Vanessa de Albuquerque; Borges, Aurea Valeria Rosa Mohana; Teixeira, Sonia [Hospital Universitario Antonio Pedro (HUAP), Niteroi, RJ (Brazil). Secao de Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Monteiro, Elio [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Cirurgia

    1997-01-01

    Hamartomas are benign tumours that can occur in different organs and tissues. They consist of an abnormal increase of cells and tissues common to the organ from which they arise. When they occur in lymphatic and blood vessels they are called vascular hamartomas. These tumours are frequent in the central nervous system, giving rise to hemorrhages. The authors report a case of vascular hamartoma in the right paravertebral gutter with an intradural component that caused a spinal cord compression and paraplegia. A malignant lesion was suggested based on the clinical and radiological findings. (author) 14 refs., 4 figs.

  9. Vascular dysfunction in the diabetic placenta: causes and consequences.

    Science.gov (United States)

    Leach, Lopa; Taylor, Alice; Sciota, Flavia

    2009-07-01

    The development and functioning of the human fetoplacental vascular system are vulnerable to the maternal diabetic milieu. These vessels are in direct continuum with the fetal vascular system and are therefore also vulnerable to fetal endocrine derangements. Increased angiogenesis, altered junctional maturity and molecular occupancy, together with increased leakiness, constitute a well-described phenotype of vessels in the Type 1 diabetic human placenta and can be related to increased levels of placental vascular endothelial growth factor. The causes of these observed changes, whether maternal hyperglycaemia or fetal hyperinsulinaemia, still remain to be shown in the human placenta. Mechanistic studies using different vascular systems have shown high glucose and insulin to have profound vascular effects, with elevations in vascular endothelial growth factor, nitric oxide and protein kinase C being behind alterations in junctional adhesion molecules such as occludin and vascular endothelial-cadherin and vascular leakage of albumin. The role of advanced glycation products and oxidative stress in this vascular pathology is also discussed. The altered molecular mechanisms underlying the vascular changes in the diabetic human placenta may reflect similar consequences of high glucose and hyperinsulinaemia.

  10. Stromal vascular fraction improves deep partial thickness burn wound healing.

    Science.gov (United States)

    Atalay, Sibel; Coruh, Atilla; Deniz, Kemal

    2014-11-01

    The practice of early burn wound excision and wound closure by immediate autologous skin or skin substitutes is the preferred treatment in extensive deep partial and full-thickness burns. To date there is no proven definite medical treatment to decrease burn wound size and accelerate burn wound healing in modern clinical practice. Stromal vascular fraction is an autologous mixture that has multiple proven beneficial effects on different kinds of wounds. In our study, we investigated the effects of stromal vascular fraction on deep partial-thickness burn wound healing. In this study, 20 Wistar albino rats were used. Inguinal adipose tissue of the rats was surgically removed and stromal vascular fraction was isolated. Thereafter, deep second-degree burns were performed on the back of the rats by hot water. The rats were divided into two groups in a randomized fashion. The therapy group received stromal vascular fraction, whereas the control group received only physiologic serum by intradermal injection. Assessment of the burn wound healing between the groups was carried out by histopathologic and immuno-histochemical data. Stromal vascular fraction increased vascular endothelial growth factor, proliferating cell nuclear antigen index, and reduced inflammation of the burn wound. Furthermore, vascularization and fibroblastic activity were achieved earlier and observed to be at higher levels in the stromal vascular fraction group. Stromal vascular fraction improves burn wound healing by increasing cell proliferation and vascularization, reducing inflammation, and increasing fibroblastic activity. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  11. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement.

    Science.gov (United States)

    Sachdev, Perminder; Kalaria, Raj; O'Brien, John; Skoog, Ingmar; Alladi, Suvarna; Black, Sandra E; Blacker, Deborah; Blazer, Dan G; Chen, Christopher; Chui, Helena; Ganguli, Mary; Jellinger, Kurt; Jeste, Dilip V; Pasquier, Florence; Paulsen, Jane; Prins, Niels; Rockwood, Kenneth; Roman, Gustavo; Scheltens, Philip

    2014-01-01

    Several sets of diagnostic criteria have been published for vascular dementia since the 1960s. The continuing ambiguity in vascular dementia definition warrants a critical reexamination. Participants at a special symposium of the International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2009 critiqued the current criteria. They drafted a proposal for a new set of criteria, later reviewed through multiple drafts by the group, including additional experts and the members of the Neurocognitive Disorders Work Group of the fifth revision of Diagnostic and Statistical Manual (DSM-5) Task Force. Cognitive disorders of vascular etiology are a heterogeneous group of disorders with diverse pathologies and clinical manifestations, discussed broadly under the rubric of vascular cognitive disorders (VCD). The continuum of vascular cognitive impairment is recognized by the categories of Mild Vascular Cognitive Disorder, and Vascular Dementia or Major Vascular Cognitive Disorder. Diagnostic thresholds are defined. Clinical and neuroimaging criteria are proposed for establishing vascular etiology. Subtypes of VCD are described, and the frequent cooccurrence of Alzheimer disease pathology emphasized. The proposed criteria for VCD provide a coherent approach to the diagnosis of this diverse group of disorders, with a view to stimulating clinical and pathologic validation studies. These criteria can be harmonized with the DSM-5 criteria such that an international consensus on the criteria for VCD may be achieved.

  12. Lung irradiation induces pulmonary vascular remodelling resembling pulmonary arterial hypertension.

    Science.gov (United States)

    Ghobadi, G; Bartelds, B; van der Veen, S J; Dickinson, M G; Brandenburg, S; Berger, R M F; Langendijk, J A; Coppes, R P; van Luijk, P

    2012-04-01

    Pulmonary arterial hypertension (PAH) is a commonly fatal pulmonary vascular disease that is often diagnosed late and is characterised by a progressive rise in pulmonary vascular resistance resulting from typical vascular remodelling. Recent data suggest that vascular damage plays an important role in the development of radiation-induced pulmonary toxicity. Therefore, the authors investigated whether irradiation of the lung also induces pulmonary hypertension. Different sub-volumes of the rat lung were irradiated with protons known to induce different levels of pulmonary vascular damage. Early loss of endothelial cells and vascular oedema were observed in the irradiation field and in shielded parts of the lung, even before the onset of clinical symptoms. 8 weeks after irradiation, irradiated volume-dependent vascular remodelling was observed, correlating perfectly with pulmonary artery pressure, right ventricle hypertrophy and pulmonary dysfunction. The findings indicate that partial lung irradiation induces pulmonary vascular remodelling resulting from acute pulmonary endothelial cell loss and consequential pulmonary hypertension. Moreover, the close resemblance of the observed vascular remodelling with vascular lesions in PAH makes partial lung irradiation a promising new model for studying PAH.

  13. Mononuclear Cells and Vascular Repair in HHT

    Directory of Open Access Journals (Sweden)

    Calinda eDingenouts

    2015-03-01

    Full Text Available Hereditary hemorrhagic telangiectasia (HHT or Rendu-Osler-Weber disease is a rare genetic vascular disorder known for its endothelial dysplasia causing arteriovenous malformations and severe bleedings. HHT-1 and HHT-2 are the most prevalent variants and are caused by heterozygous mutations in endoglin and ALK1, respectively. An undervalued aspect of the disease is that HHT patients experience persistent inflammation. Although endothelial and mural cells have been the main research focus trying to unravel the mechanism behind the disease, wound healing is a process with a delicate balance between inflammatory and vascular cells. Inflammatory cells are part of the mononuclear cells (MNCs fraction, and can, next to eliciting an immune response, also have angiogenic potential. This biphasic effect of MNC can hold a promising mechanism to further elucidate treatment strategies for HHT patients. Before MNC are able to contribute to repair, they need to home to and retain in ischemic and damaged tissue. Directed migration (homing of mononuclear cells following tissue damage is regulated by the stromal cell derived factor 1 (SDF1. MNCs that express the C-X-C chemokine receptor 4 (CXCR4 migrate towards the tightly regulated gradient of SDF1. This directed migration of monocytes and lymphocytes can be inhibited by dipeptidyl peptidase 4 (DPP4. Interestingly, MNC of HHT patients express elevated levels of DPP4 and show impaired homing towards damaged tissue. Impaired homing capacity of the MNCs might therefore contribute to the impaired angiogenesis and tissue repair observed in HHT patients. This review summarizes recent studies regarding the role of MNCs in the etiology of HHT and vascular repair, and evaluates the efficacy of DPP4 inhibition in tissue integrity and repair.

  14. Extraglandular and intraglandular vascularization of canine prostate.

    Science.gov (United States)

    Stefanov, Miroslav

    2004-03-01

    The literature on the vascularization of the canine prostate is reviewed and the clinical significance of prostate morphology is described. Scanning Electron Microscopy (SEM), combined with improved corrosion casting methods, reveal new morphological details that promise better diagnostics and treatment but also require expansion of clinical nomenclature. A proposal is made for including two previously unnamed veins in Nomina Anatomica Veterinaria (NAV). The canine prostate has two lobes with independent vascularization. Each lobe is supplied through the left and right a. prostatica, respectively. The a. prostatica sprouts three small vessels (cranial, middle, and caudal) towards the prostate gland. A. prostatica is a small-size artery whose wall structure is similar to the arteries of the muscular type. V. prostatica is a small-size valved vein. The canine prostate has capsular, parenchymal, and urethral vascular zones. The surface vessels of the capsule are predominantly veins and the diameter of arterial vessels is larger than that of the veins. The trabecular vessels are of two types: direct and branched. The prostate parenchyma is supplied by branches of the trabecular vessels. The periacinary capillaries are fenestrated and form a net in a circular pattern. The processes of the myoepithelial cells embrace both the acins and the periacinar capillaries. In the prostate ductal system. there are spermatozoa. The prostatic part of the urethra is supplied by an independent branch of a. prostatica. The prostatic urethral part is drained by v. prostatica, the vein of the urethral bulb and the ventral prostate veins. M. urethralis begins as early as the urethral prostatic part. The greater part of the white muscle fibers in m. urethralis suggest an enhanced anaerobic metabolism. Copyright 2004 Wiley-Liss, Inc.

  15. Diagnostic criteria of vascular dementia in CADASIL.

    Science.gov (United States)

    Benisty, Sarah; Hernandez, Karen; Viswanathan, Anand; Reyes, Sonia; Kurtz, Annie; O'Sullivan, Michael; Bousser, Marie-Germaine; Dichgans, Martin; Chabriat, Hugues

    2008-03-01

    Subcortical ischemic vascular dementia (SIVD) is a major subtype of vascular dementia (VaD). Recently, the diagnostic criteria of VaD have been modified to encompass this entity. Application of these criteria in CADASIL, a genetic model of SIVD, may help to better assess their significance. The aim of this study was to compare different sets of diagnostic criteria of VaD in a population of CADASIL patients. Different sets of diagnostic criteria of VaD (DSMIV, ICD10, standard NINDS-AIREN, modified NINDS-AIREN for SIVD) were applied to 115 CADASIL patients. Diagnosis of VaD was made through 2 steps: (1) diagnosis of dementia and (2) association of dementia to lesions of vascular origin. The percentage of patients satisfying the different sets and the concordance between these criteria was analyzed. At least 1 set of criteria was satisfied for diagnosis in 29 subjects with dementia. In this group of patients, the sensitivity of the DSM IV, ICD 10, and standard NINDS-AIREN criteria for VaD was, respectively, 79%, 72%, and 45%. In contrast, the sensitivity of the NINDS-AIREN criteria for SIVD was 90%. The incomplete sensitivity of these last criteria was related to the absence of focal signs in some patients. The neuroimaging criteria were satisfied in all patients with dementia. The modified NINDS-AIREN criteria of SIVD are the most sensitive VaD criteria in CADASIL. Among these criteria, the neuroimaging criteria, although poorly specific to dementia, have a complete sensitivity. In contrast, focal signs were inconstant in CADASIL patients with dementia.

  16. Cytokines in Alzheimer's disease and vascular dementia.

    Science.gov (United States)

    Angelopoulos, P; Agouridaki, H; Vaiopoulos, H; Siskou, E; Doutsou, K; Costa, V; Baloyiannis, S I

    2008-12-01

    The levels of interleukin 1beta, interleukin 6, and interleukin 10 were elevated in the serum of patients with dementia. No statistically significant correlation was recorded in the interleukin levels among patients with Alzheimer's disease and vascular dementia. Also, no significant correlation was observed in the interleukin levels in the serum and the severity of dementia. However, a significant correlation was found between IL-6 and tumor necrosis factor-alpha (TNF-alpha) levels and age. The levels of IL-1beta and IL-6 were positively correlated with hypertension, and IL-2 levels were negatively correlated. No correlation was found between depressive symptoms and levels of cytokines in the serum.

  17. Abdominal vascular syndromes: characteristic imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D' Ippolito, Giuseppe, E-mail: leandrocleite@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Mediciana. Departmento de Diagnostico por Imagem

    2016-07-15

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital - including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome) - compressive - including 'nutcracker' syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. (author)

  18. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis, F., E-mail: francoiscornelis@hotmail.com [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)

    2013-06-15

    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  19. Endogenous pancreatic polypeptide in different vascular beds

    DEFF Research Database (Denmark)

    Henriksen, J H; Schwartz, Tania; Bülow, J B

    1986-01-01

    The plasma concentration of pancreatic polypeptide (PP-like immunoreactivity) was measured in different vascular beds in order to determine regional kinetics of endogenous PP in fasting, supine subjects with normal or moderately decreased kidney function. Patients with kidney disease (n = 10) had...... concentration (r = 0.70, P less than 0.01). Hepatic venous PP was significantly higher than systemic PP in both controls and patients with kidney disease (P less than 0.001, n = 15). The values were positively correlated (r = 0.98, P less than 0.001; slope = 1.37 +/- 0.05, P less than 0.001), indicating...

  20. Vascular complications after splenectomy for hematologic disorders

    Science.gov (United States)

    Buchanan, George R.

    2009-01-01

    The most widely recognized long-term risk of splenectomy is overwhelming bacterial infection. More recently, thrombosis has become appreciated as another potential complication of the procedure. Because of these long-term risks, the indications for and timing of splenectomy are debated in the medical community. Accordingly, the adverse effects and benefits of splenectomy for hematologic disorders and other conditions demand further study. This comprehensive review summarizes the existing literature pertaining to vascular complications after splenectomy for hematologic conditions and attempts to define the potential pathophysiologic mechanisms involved. This complex topic encompasses diverse underlying conditions for which splenectomy is performed, diverse thrombotic complications, and multiple pathophysiologic mechanisms. PMID:19636061

  1. Interação entre sistema nervoso autônomo e função vascular na hipertensão arterial resistente = : Interaction between autonomic nervous system and vascular function in resistant hypertension

    OpenAIRE

    Wladimir Mignone Gordo

    2014-01-01

    Resumo: Em pacientes hipertensos resistentes, frequentemente obesos, tanto a pressão arterial elevada como a obesidade contribuem para a disfunção vascular. Além disso, resultados prévios demonstraram que distúrbios autonômicos estão relacionados com a obesidade e hipertensão e que a redução da variabilidade da frequência cardíaca (VFC) pode representar um fator de risco para a hipertensão. Para melhor entender a relação entre a disfunção autonômica e a hipertensão arterial resistente (HAR), ...

  2. Influencia de las medias de compresión en la aparición de úlceras vasculares en pacientes con insuficiencia venosa

    OpenAIRE

    Montejo García, María Teresa

    2013-01-01

    Introducción: Las úlceras vasculares constituyen un gran reto profesional para el personal sanitario dada su elevada incidencia (3-5 nuevos casos/mil personas/año), prevalencia (0,1-0,3% de la población) e índice de recidivas (alrededor de un 40% en los doce meses posteriores a la curación de la úlcera). De todas las úlceras vasculares, las úlceras venosas (UV), o de éstasis, son las más frecuentes, representando entre 75-80% del total de las úlceras de pierna. Objetivo: Evaluar si la aplicac...

  3. Polimorfismos de proteínas de la matriz extracelular y perfil de expresión diferencial en la calcificación vascular

    OpenAIRE

    Tuñón Le Poultel, Diego

    2013-01-01

    Objetivo: Con el fin de esclarecer el efecto que las proteínas de la matriz extracelular tienen en el proceso de la calcificación vascular, así como para profundizar en el papel que determinados factores ejercen sobre el desarrollo de la calcificación vascular se propusieron los siguientes objetivos: En primer lugar, analizar la posible asociación de polimorfismos en algunos genes de proteínas de la matriz extracelular sobre la calcificación aórtica y la densidad mineral ósea. En segundo lug...

  4. Modelo basado en SIG para el estudio de la mortalidad por enfermedad cerebro-vascular

    National Research Council Canada - National Science Library

    Carlos Alberto Tangarife Villa; Libardo Londoño Ciro

    2013-01-01

    ... estadístico bivariado y multivariado orientadas a identificar su composición según variables de persona y explorar relaciones con sus determinantes pero sin impactar significativamente su ocurrencia, sin embargo, en el presente...

  5. Autotaxin overexpression causes embryonic lethality and vascular defects.

    Directory of Open Access Journals (Sweden)

    Hiroshi Yukiura

    Full Text Available Autotaxin (ATX is a secretory protein, which converts lysophospholipids to lysophosphatidic acid (LPA, and is essential for embryonic vascular formation. ATX is abundantly detected in various biological fluids and its level is elevated in some pathophysiological conditions. However, the roles of elevated ATX levels remain to be elucidated. In this study, we generated conditional transgenic (Tg mice overexpressing ATX and examined the effects of excess LPA signalling. We found that ATX overexpression in the embryonic period caused severe vascular defects and was lethal around E9.5. ATX was conditionally overexpressed in the neonatal period using the Cre/loxP system, which resulted in a marked increase in the plasma LPA level. This resulted in retinal vascular defects including abnormal vascular plexus and increased vascular regression. Our findings indicate that the ATX level must be carefully regulated to ensure coordinated vascular formation.

  6. Autotaxin Overexpression Causes Embryonic Lethality and Vascular Defects

    Science.gov (United States)

    Yukiura, Hiroshi; Kano, Kuniyuki; Kise, Ryoji; Inoue, Asuka; Aoki, Junken

    2015-01-01

    Autotaxin (ATX) is a secretory protein, which converts lysophospholipids to lysophosphatidic acid (LPA), and is essential for embryonic vascular formation. ATX is abundantly detected in various biological fluids and its level is elevated in some pathophysiological conditions. However, the roles of elevated ATX levels remain to be elucidated. In this study, we generated conditional transgenic (Tg) mice overexpressing ATX and examined the effects of excess LPA signalling. We found that ATX overexpression in the embryonic period caused severe vascular defects and was lethal around E9.5. ATX was conditionally overexpressed in the neonatal period using the Cre/loxP system, which resulted in a marked increase in the plasma LPA level. This resulted in retinal vascular defects including abnormal vascular plexus and increased vascular regression. Our findings indicate that the ATX level must be carefully regulated to ensure coordinated vascular formation PMID:25992708

  7. Cell based therapeutic approach in vascular surgery: application and review

    Directory of Open Access Journals (Sweden)

    Rocca Aldo

    2017-10-01

    Full Text Available Multipotent stem cells - such as mesenchymal stem/stromal cells and stem cells derived from different sources like vascular wall are intensely studied to try to rapidly translate their discovered features from bench to bedside. Vascular wall resident stem cells recruitment, differentiation, survival, proliferation, growth factor production, and signaling pathways transduced were analyzed. We studied biological properties of vascular resident stem cells and explored the relationship from several factors as Matrix Metalloproteinases (MMPs and regulations of biological, translational and clinical features of these cells. In this review we described a translational and clinical approach to Adult Vascular Wall Resident Multipotent Vascular Stem Cells (VW-SCs and reported their involvement in alternative clinical approach as cells based therapy in vascular disease like arterial aneurysms or peripheral arterial obstructive disease.

  8. [Vascular malformations (I). Concept, classification, pathogenesis and clinical features].

    Science.gov (United States)

    Redondo, P

    2007-04-01

    Vascular malformations are anomalies always present at birth that, contrary to hemangiomas, never regress and may grow during lifetime. Clinical presentation of vascular malformations is extremely variable and ranges from asymptomatic spots of mere aesthetic concern to lesions with high blood flow or located in critical sites that may be life-threatening. Given the low incidence of these disorders it is difficult to establish therapeutic guidelines. In addition to a correct classification of vascular anomalies, it is necessary a multidisciplinary approach for the follow-up and management of these patients. The first part of this review focuses on the different classifications of vascular anomalies, maintaining as reference the one proposed by the International Society for the Study of Vascular Anomalies (ISSVA). Additionally, clinical features of the different subtypes of vascular anomalies as well as their association in certain syndromes are reviewed.

  9. Structural and functional imaging for vascular targeted photodynamic therapy

    Science.gov (United States)

    Li, Buhong; Gu, Ying; Wilson, Brian C.

    2017-02-01

    Vascular targeted photodynamic therapy (V-PDT) has been widely used for the prevention or treatment of vascular-related diseases, such as localized prostate cancer, wet age-related macular degeneration, port wine stains, esophageal varices and bleeding gastrointestinal mucosal lesions. In this study, the fundamental mechanisms of vascular responses during and after V-PDT will be introduced. Based on the V-PDT treatment of blood vessels in dorsal skinfold window chamber model, the structural and functional imaging, which including white light microscopy, laser speckle imaging, singlet oxygen luminescence imaging, and fluorescence imaging for evaluating vascular damage will be presented, respectively. The results indicate that vessel constriction and blood flow dynamics could be considered as the crucial biomarkers for quantitative evaluation of vascular damage. In addition, future perspectives of non-invasive optical imaging for evaluating vascular damage of V-PDT will be discussed.

  10. Local Augmented Angiotensinogen Secreted from Apoptotic Vascular Endothelial Cells Is a Vital Mediator of Vascular Remodelling.

    Directory of Open Access Journals (Sweden)

    Shyh-Jong Wu

    Full Text Available Vascular remodelling is a critical vasculopathy found in atheromatous diseases and allograft failures. The local renin angiotensin system (RAS has been implicated in vascular remodelling. However, the mechanisms by which the augmented local RAS is associated with the initial event of endothelial cell apoptosis in injured vasculature remain undefined. We induced the apoptosis of human umbilical vein endothelial cells (HUVECs and vascular smooth muscle cells (VSMCs through serum starvation (SS. After the cells were subjected to SS, we found that the mRNA expression of angiotensinogen (AGT was increased by >3-fold in HUVECs and by approximately 2.5-fold in VSMCs. In addition, the expression of angiotensin-converting enzyme (ACE mRNA was increased in VSMCs but decreased to 50% in HUVECs during the same apoptotic process. Increases in the expression of AGT protein and angiotensin II (Ang II were found in a serum-free medium conditioned by HUVECs (SSC. The increased Ang II was suppressed using lisinopril (an ACE inhibitor treatment. Moreover, the activation of ERK1/2 induced by the SSC in VSMCs was also suppressed by losartan. In conclusion, we first demonstrated that the augmented AGT released from apoptotic endothelial cells acts as a vital progenitor of Ang II to accelerate vascular remodelling, and we suggest that blocking local augmented Ang II might be an effective strategy for restraining intimal hyperplasia.

  11. Total hepatectomy model in pigs: Revised method for vascular reconstruction using a rigid vascular prosthesis

    NARCIS (Netherlands)

    Sosef, M. N.; van Gulik, T. M.

    2004-01-01

    Total hepatectomy in animals provides an irreversible model of acute liver failure. Vascular reconstruction in this model of acute liver failure was modified and characterized for the use of assessment of liver support systems. Pigs underwent total hepatectomy and a rigid three-way transparent

  12. The vascular bed in COPD: pulmonary hypertension and pulmonary vascular alterations

    Directory of Open Access Journals (Sweden)

    Seiichiro Sakao

    2014-09-01

    Full Text Available The loss of pulmonary vessels has been shown to be related to the severity of pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD. The severity of hypoxaemia is also related to pulmonary hypertension and pulmonary vascular resistance in these patients, suggesting that the hypoxic condition probably plays an important role in this form of pulmonary hypertension. However, pulmonary hypertension also develops in patients with mild COPD without hypoxaemia. Oxygen supplementation therapy often fails to reverse the pulmonary hypertension in these COPD patients, thus suggesting that the pulmonary vascular alterations in those patients may involve different sites of the pulmonary vasculature or a different form of vascular remodelling. It has recently been demonstrated that pulmonary vascular remodelling, resulting in pulmonary hypertension in COPD patients, can develop independently from parenchymal destruction and loss of lung vessels. We wonder whether the changes in the lung microenvironment due to hypoxia and vessel loss have a causative role in the development of pulmonary hypertension in patients with COPD. Herein we review the pathobiological features of the pulmonary vasculature in COPD patients and suggest that pulmonary hypertension can occur with and without emphysematous lung tissue destruction and with and without loss of lung vessels.

  13. Mussel-inspired immobilization of vascular endothelial growth factor (VEGF) for enhanced endothelialization of vascular grafts.

    Science.gov (United States)

    Shin, Young Min; Lee, Yu Bin; Kim, Seok Joo; Kang, Jae Kyeong; Park, Jong-Chul; Jang, Wonhee; Shin, Heungsoo

    2012-07-09

    Most polymeric vascular prosthetic materials have low patency rate for replacement of small diameter vessels (polydopamine-mediated immobilization of growth factors on the surface of polymeric materials as a versatile tool to modify surface characteristics of vascular grafts potentially for accelerated endothelialization. Polydopamine was deposited on the surface of biocompatible poly(L-lactide-co-ε-caprolactone) (PLCL) elastomer, on which vascular endothelial growth factor (VEGF) was subsequently immobilized by simple dipping. Surface characteristics and composition were investigated by using scanning electron microscopy, atomic force microscopy, and X-ray photoelectron spectroscopy. Immobilization of VEGF on the polydopamine-deposited PLCL films was effective (19.8 ± 0.4 and 197.4 ± 19.7 ng/cm(2) for DPv20 and DPv200 films, respectively), and biotin-mediated labeling of immobilized VEGF revealed that the fluorescence intensity increased as a function of the concentration of VEGF solution. The effect of VEGF on adhesion of HUVECs was marginal, which may have been masked by polydopamine layer that also enhanced cell adhesion. However, VEGF-immobilized substrate significantly enhanced proliferation of HUVECs for over 7 days of in vitro culture and also improved their migration. In addition, immobilized VEGF supported robust cell to cell interactions with strong expression of CD 31 marker. The same process was effective for immobilization of basic fibroblast growth factor, demonstrating the robustness of polydopamine layer for secondary ligation of growth factors as a simple and novel surface modification strategy for vascular graft materials.

  14. Anatomía Vascular de Plántulas de Cicer Arietinum: Genotipo M x WR-315-14 (Fabaceae Vascular anatomy of seedlings of Cicer aretinum M x WR-315-14 genotype (Fabaceae

    Directory of Open Access Journals (Sweden)

    N. S. Ateca

    2009-07-01

    Full Text Available Se estudiaron los caracteres anatómicos de la vascularización de plántulas de Cicer arietinum L. (Fabaceae, Faboideae, Cicereae pertenecientes al genotipo M x WR-315-14. La anatomía vascular de la raíz, hipocótilo, nudo cotiledonar, epicótilo, segundo y tercer entrenudo de plántulas normales con el protofilo desplegado, fueron analizados para determinar la localización y detalles sobre las variaciones en el desarrollo de los elementos conductores. Estos datos serán de interés para la identificación en estados juveniles de genotipos de la especie.We studied the vascular anatomy in seedlings of Cicer aretinum L. M x WR-315-14 genotype (Fabaceae, Faboideae, Cicereae, with the aim of determining the localization and development of conducting elements. We analyzed the vascular anatomy of roots, hypocotyls, cotyledonal nudes, epicotyls, second and third internodes of standard seedlings with unfolded protophylls. These data will contribute to the identification of different genotypes of the species in juvenile stages.

  15. Vascular disease and stroke risk in atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y.H.; Lane, Deirdre A

    2012-01-01

    Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial fibri...... fibrillation and whether adding vascular disease improves Congestive heart failure, Hypertension, Age 75 years, Diabetes, previous Stroke (CHADS(2)) risk stratification....

  16. Pathophysiology of Headaches with a Prominent Vascular Component

    Directory of Open Access Journals (Sweden)

    Juan A Pareja

    1996-01-01

    Full Text Available Vascular changes, whether preliminary or secondary, seem to accompany most headaches. The literature concerning pathophysiological mechanisms in headaches where vascular phenomena are a major, integral part, ie, migraine and cluster headache syndrome, is reviewed and the most common forms of headache associated with cerebrovascular disease are discussed. Emphasis is placed on the vascular phenomena and on the abundant hypotheses and theories regarding headache mechanisms. This review also presents alternative explanatory models, and compares the available anatomical, physiological and biochemical results.

  17. Bases anatómicas vasculares de los colgajos perforantes cutáneos Vascular anatomical basis of perforator skin flaps

    Directory of Open Access Journals (Sweden)

    S. Morris

    2006-12-01

    Full Text Available En las ultimas dos décadas, el uso de colgajos perforantes musculocutaneos se ha incrementado a medida que los microcirujanos se han familiarizado con la técnica y estos colgajos se han convertido en una parte de la evolución de la Microcirugía. Como se basan en perforantes musculocutaneas o septocutaneas individuales, el microcirujano reconstructivodebe tener la información anatómica detallada para planificar la transferencia de colgajos perforantes. El fin de este trabajo es la revisión de las diversas técnicas angiográficas disponibles para estudiar la anatomía vascular del cuerpo humano y presentar nuestra técnica habitual de inyección vascular. Exhibiremos ejemplos ilustrativos utilizando la técnica de la inyección de gelatina de oxido de plomo para visualizar la anatomía relevante de los sitios donantes de colgajos perforantes. La técnica de la inyección de gelatina de óxido descrita por Salmon y Rees y Taylor, puede ser utilizada para inyecciones arteriales o venosas, pero la hemos utilizado primariamente para inyección arterial. Los pasos para la inyección se describen detalladamente en el trabajo. En los pasados 5 años hemos disecado un total de 21 cadáveres frescos tras estudios de inyección arterial de gelatina de oxido de plomo. Se han revisado un total de 7000 radiografías. Presentamos los resultados de la búsqueda anatómica en las áreas de cabeza, cuello, miembros superiores, torso y miembros inferiores. La técnica de la inyección de gelatina de oxido de plomo es simple y económica a su vez; la técnica de análisis computarizado es barata y las técnicas de análisis informático son directas y proveen excelente visualización de la arquitectura de la piel humana. Los delicados detalles identificados utilizando esta técnica de inyección proveen información útil a los cirujanos para planificar transferencias de piel, músculo, hueso y nervio, y por tanto favorecen nuestra comprensión de la anatom

  18. Vascular access profile in maintenance hemodialysis patients.

    Science.gov (United States)

    Gowda, Anoop; Pavan, Malleshappa; Babu, Kishore

    2014-05-01

    The aims of this study was to evaluate maintenance hemodialysis population in a tertiary care hospital based dialysis unit for vascular access (VA) types, to compare native arteriovenous fistula (AVF) and arteriovenous graft (AVG) survival, and to assess risk factors for access failure. A total of 182 patients on maintenance hemodialysis were evaluated and followed up in terms of VA type and VA outcomes. Among 103 prevalent patients, 15.5% initiated dialysis with AVF. At the time of the study, 67.9% of the prevalent patients had an AVF and 29.1% had AVG. Of 79 incident patients, 64% were followed up for more than 3 months by nephrologists before initiation of dialysis. Among these patients, 13.6% were initiated with AVF. There were 25 primary failures and 50 secondary failure episodes. Of the 50 secondary failures, 15 were AVF failures and 31 AVG failures. Vascular access survival was significantly superior with AVF as compared with AVG (P = .03). With longer dialysis periods, failure rates were higher. Follow-up with nephrologists prior to initiation of dialysis had a major influence on VA. Arteriovenous fistula is the best VA for maintenance hemodialysis. However, when the vasculature is not ideal for AVF, AVG should be constructed. A small percentage of our patients had fistula at initiation of dialysis. This is mainly due to late nephrology referrals and also due to reluctance of patients to undergo surgical access placement when they are relatively asymptomatic.

  19. Regulation of vascular tone by adipocytes

    Directory of Open Access Journals (Sweden)

    Van de Voorde Johan

    2011-03-01

    Full Text Available Abstract Recent studies have shown that adipose tissue is an active endocrine and paracrine organ secreting several mediators called adipokines. Adipokines include hormones, inflammatory cytokines and other proteins. In obesity, adipose tissue becomes dysfunctional, resulting in an overproduction of proinflammatory adipokines and a lower production of anti-inflammatory adipokines. The pathological accumulation of dysfunctional adipose tissue that characterizes obesity is a major risk factor for many other diseases, including type 2 diabetes, cardiovascular disease and hypertension. Multiple physiological roles have been assigned to adipokines, including the regulation of vascular tone. For example, the unidentified adipocyte-derived relaxing factor (ADRF released from adipose tissue has been shown to relax arteries. Besides ADRF, other adipokines such as adiponectin, omentin and visfatin are vasorelaxants. On the other hand, angiotensin II and resistin are vasoconstrictors released by adipocytes. Reactive oxygen species, leptin, tumour necrosis factor α, interleukin-6 and apelin share both vasorelaxing and constricting properties. Dysregulated synthesis of the vasoactive and proinflammatory adipokines may underlie the compromised vascular reactivity in obesity and obesity-related disorders.

  20. Brain vascular changes in Cockayne syndrome.

    Science.gov (United States)

    Hayashi, Masaharu; Miwa-Saito, Naho; Tanuma, Naoyuki; Kubota, Masaya

    2012-04-01

    Cockayne syndrome (CS) and xeroderma pigmentosum (XP) are caused by deficient nucleotide excision repair. CS is characterized by cachectic dwarfism, mental disability, microcephaly and progeria features. Neuropathological examination of CS patients reveals dysmyelination and basal ganglia calcification. In addition, arteriosclerosis in the brain and subdural hemorrhage have been reported in a few CS cases. Herein, we performed elastica van Gieson (EVG) staining and immunohistochemistry for collagen type IV, CD34 and aquaporin 4 to evaluate the brain vessels in autopsy cases of CS, XP group A (XP-A) and controls. Small arteries without arteriosclerosis in the subarachnoid space had increased in CS cases but not in either XP-A cases or controls. In addition, string vessels (twisted capillaries) in the cerebral white matter and increased density of CD34-immunoreactive vessels were observed in CS cases. Immunohistochemistry findings for aquaporin 4 indicated no pathological changes in either CS or XP-A cases. Hence, the increased subarachnoid artery space may have caused subdural hemorrhage. Since such vascular changes were not observed in XP-A cases, the increased density of vessels in CS cases was not caused by brain atrophy. Hence, brain vascular changes may be involved in neurological disturbances in CS. © 2011 Japanese Society of Neuropathology.

  1. Vascular hemichorea: case report and review

    Directory of Open Access Journals (Sweden)

    Bárbara Martínez Alfonzo

    2014-04-01

    Full Text Available Chorea rarely complicates ischemic or hemorrhagic cerebral vascular lesions. Clinical symptoms usually involve one side of the body while the injury is situated on the contralateral cerebral hemisphere. Spontaneous remission is the norm, but sometimes symptomatic treatment is required. A 58-year-old male patient who suffers from untreated high blood pressure, type II obesity, smokes 6 packs of cigarettes per year and has a moderate intake of alcohol is presented. The patient’s recent history began three days before he appeared at the Emergency Department. His symptoms were ceaseless, involuntary movements in his left arm and foot during day and night with no restriction of voluntary movements. Physical examination and laboratory tests revealed no other findings. Magnetic resonance imaging of the brain showed hyperintensity in the right posterolateral thalamic region consistent with ischemic cerebrovascular disease. Symptomatic therapy was indicated and his underlying conditions were addressed. The importance of this case lies on the low prevalence as well as the scarcity of publications regarding vascular causes of hemichorea, including diagnosis, therapy and prognosis.

  2. Vascular Extracellular Matrix and Arterial Mechanics

    Science.gov (United States)

    WAGENSEIL, JESSICA E.; MECHAM, ROBERT P.

    2009-01-01

    An important factor in the transition from an open to a closed circulatory system was a change in vessel wall structure and composition that enabled the large arteries to store and release energy during the cardiac cycle. The component of the arterial wall in vertebrates that accounts for these properties is the elastic fiber network organized by medial smooth muscle. Beginning with the onset of pulsatile blood flow in the developing aorta, smooth muscle cells in the vessel wall produce a complex extracellular matrix (ECM) that will ultimately define the mechanical properties that are critical for proper function of the adult vascular system. This review discusses the structural ECM proteins in the vertebrate aortic wall and will explore how the choice of ECM components has changed through evolution as the cardiovascular system became more advanced and pulse pressure increased. By correlating vessel mechanics with physiological blood pressure across animal species and in mice with altered vessel compliance, we show that cardiac and vascular development are physiologically coupled, and we provide evidence for a universal elastic modulus that controls the parameters of ECM deposition in vessel wall development. We also discuss mechanical models that can be used to design better tissue-engineered vessels and to test the efficacy of clinical treatments. PMID:19584318

  3. [Central blood pressure and vascular damage].

    Science.gov (United States)

    Pérez-Lahiguera, Francisco; Rodilla, Enrique; Costa, José Antonio; Pascual, José María

    2015-07-20

    The aim of this study was to assess the relationship between central blood pressure and vascular damage. This cross-sectional study involved 393 never treated hypertensive patients (166 women). Clinical blood pressure (BP), 24h blood pressure (BP24h) and central blood pressure (CBP) were measured. Vascular organ damage (VOD) was assessed by calculating the albumin/creatinine ratio (ACR), wave pulse pressure velocity and echocardiographic left ventricular mass index (LVMI). Patients with VOD had higher values of BP, BP24h, and CBP than patients without ACR. When comparing several systolic BP, systolic BP24h had a higher linear correlation with CBP (Z Steiger test: 2.26; P=.02) and LVMI (Z Steiger test: 3.23; P=.01) than PAC. In a multiple regression analysis corrected by age, sex and metabolic syndrome, all pressures were related with VOD but systolic BP24h showed the highest correlation. In a logistic regression analysis, having the highest tercile of systolic BP24h was the stronger predictor of VOD (multivariate odds ratio: 3.4; CI 95%: 2.5-5.5, P=.001). CBP does not have more correlation with VOD than other measurements of peripheral BP. Systolic BP24h is the BP measurement that best predicts VOD. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. [Skillful care for chronic vascular wounds].

    Science.gov (United States)

    Goullet de Rugy, C; Lazareth, I; You, C; Stansal, A; Priollet, P

    2016-09-01

    In vascular medicine, wound care requires pluridisciplinary expertise and nursing skill. Care must be perfectly adapted to each individual patient, the specificities of each particular wound, and the underlying vascular disease. The goal is to achieve wound healing. Inappropriate care can retard healing or even aggravate the wound. The skin should be cleaned with water a non-allergic detergent and should concern the entire limb in addition to the wound itself. Fibrin or necrosis detersion is an important step that can be painful. Different tools are available. The skin around the wound should be hydrated and protected, focusing on fragile areas, such as the tibial crest and heals, in order to prevent the development of new wounds. Other more complex interventions include tenosynovectomy, bone gouging and reduction of the necrotic toe that when properly performed can prevent a new passage in the operating room. If the ischemia becomes critical, the foot should be held warm with a carded cotton, taking care to separate the toes with dry dressings in order to preserve the healthy tissue and avoid induced wounds. Finally, compression bands are indispensable in cases with edema or venous hyperpressure. A skillful banding technique is essential, especially for legs with complex morphology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Lower Extremity Permanent Dialysis Vascular Access.

    Science.gov (United States)

    Parekh, Vishal B; Niyyar, Vandana D; Vachharajani, Tushar J

    2016-09-07

    Hemodialysis remains the most commonly used RRT option around the world. Technological advances, superior access to care, and better quality of care have led to overall improvement in survival of patients on long-term hemodialysis. Maintaining a functioning upper extremity vascular access for a prolonged duration continues to remain a challenge for dialysis providers. Frequently encountered difficulties in clinical practice include (1) a high incidence of central venous catheter-related central vein stenosis and (2) limited options for creating a functioning upper extremity permanent arteriovenous access. Lack of surgical skills, fear of complications, and limited involvement of the treating nephrologists in the decision-making process are some of the reasons why lower extremity permanent dialysis access remains an infrequently used option. Similar to upper extremity vascular access options, lower extremity arteriovenous fistula remains a preferred access over arteriovenous synthetic graft. The use of femoral tunneled catheter as a long-term access should be avoided as far as possible, especially with the availability of newer graft-catheter hybrid devices. Our review provides a summary of clinical evidence published in surgical, radiology, and nephrology literature highlighting the pros and cons of different types of lower extremity permanent dialysis access. Copyright © 2016 by the American Society of Nephrology.

  6. Two barriers for sodium in vascular endothelium?

    Science.gov (United States)

    Oberleithner, Hans

    2012-01-01

    Vascular endothelium plays a key role in blood pressure regulation. Recently, it has been shown that a 5% increase of plasma sodium concentration (sodium excess) stiffens endothelial cells by about 25%, leading to cellular dysfunction. Surface measurements demonstrated that the endothelial glycocalyx (eGC), an anionic biopolymer, deteriorates when sodium is elevated. In view of these results, a two-barrier model for sodium exiting the circulation across the endothelium is suggested. The first sodium barrier is the eGC which selectively buffers sodium ions with its negatively charged prote-oglycans.The second sodium barrier is the endothelial plasma membrane which contains sodium channels. Sodium excess, in the presence of aldosterone, leads to eGC break-down and, in parallel, to an up-regulation of plasma membrane sodium channels. The following hypothesis is postulated: Sodium excess increases vascular sodium permeability. Under such con-ditions (e.g. high-sodium diet), day-by-day ingested sodium, instead of being readily buffered by the eGC and then rapidly excreted by the kidneys, is distributed in the whole body before being finally excreted. Gradually, the sodium overload damages the organism. PMID:22471931

  7. Vascular access: the impact of ultrasonography.

    Science.gov (United States)

    Almeida, Carlos Eduardo Saldanha de

    2016-01-01

    Vascular punctures are often necessary in critically ill patients. They are secure, but not free of complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts, complications and costs. This study reviews important publications and the puncture technique using ultrasound, bringing part of the experience of the intensive care unit of the Hospital Israelita Albert Einstein, São Paulo (SP), Brazil, and discussing issues that should be considered in future studies. RESUMO Punções vasculares são muitas vezes necessárias em pacientes gravemente enfermos. São seguras, mas não isentas de complicações. A ultrassonografia associada à técnica de punção gera diminuição do número de tentativas, de complicações e de custos. O presente artigo revisou importantes publicações sobre o tema, bem como técnicas de punções, trazendo parte da experiência do centro de terapia intensiva de adultos do Hospital Israelita Albert Einstein, em São Paulo (SP) e discutindo tópicos que devem ser melhor explorados em estudos futuros.

  8. Neuroprotection in vascular dementia: a future path.

    Science.gov (United States)

    Skoog, Ingmar; Korczyn, Amos D; Guekht, Alla

    2012-11-15

    The burden of cognitive disorders is likely to increase over the coming years due to both increased longevity and altered risk factor patterns, arising from changes in lifestyle, healthcare and society. Vascular dementia with its underlying heterogeneous pathology, is a challenge for clinicians, and is frequently further aggravated by overlap with other neurodegenerative processes. Current Alzheimer's disease drugs have had limited clinical efficacy in treating vascular dementia and none have been approved by major regulatory authorities specifically for this disease. Moving forward, a valid choice may be a multimodal therapy, as has already been successfully proven in Alzheimer's disease. Actovegin, a hemodialysate derived from calf blood, has been shown to have effects on a variety of cellular processes and a recent experimental study has revealed its neuroprotective mechanisms of action. These data, coupled with positive results from clinical trials in mixed dementia populations, have served as a foundation for the design of a new trial investigating the efficacy and disease-modifying effects of Actovegin in post-stroke cognitive impairment. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Acute regional vascular insufficiency after jellyfish envenomation.

    Science.gov (United States)

    Williamson, J A; Burnett, J W; Fenner, P J; Hach-Wunderle, V; Hoe, L Y; Adiga, K M

    Three cases of jellyfish envenomation which occurred in the Indian Ocean and the Andaman Sea are reported. In each instance the stinging occurred on the upper extremities, and impaired the circulation to the stung limb(s), with absent distal arterial pulses, regional cyanosis, and the threat of distal gangrene. One of the patients is seriously and permanently handicapped, with bilateral upper-limb numbness and paresis; another patient has permanent sensory loss; the third patient, who also had brachial-artery narrowing that was demonstrated by angiography, made an uneventful recovery. The first two patients underwent surgical fasciotomy, whereas surgical exploration was performed on the third patient. Reduced blood flow in the major arteries of the limbs was observed directly in each case. Further, the arterial segment that primarily was affected, in each case, appeared to be that which underlay the actual site of the sting. All patients were young persons with no previous history of vascular disease. These cases corroborate the vascular and neurogenic injury, which previously have been reported in experimental animals and in human patients, that may result from jellyfish venoms.

  10. Apolipoprotein E pathology in vascular dementia.

    Science.gov (United States)

    Rohn, Troy T; Day, Ryan J; Sheffield, Colin B; Rajic, Alexander J; Poon, Wayne W

    2014-01-01

    Vascular dementia (VaD) is the second most common form of dementia and is currently defined as a cerebral vessel vascular disease leading to ischemic episodes. Apolipoprotein E (apoE) gene polymorphism has been proposed as a risk factor for VaD, however, to date there are few documented post-mortem studies on apoE pathology in the VaD brain. To investigate a potential role for the apoE protein, we analyzed seven confirmed cases of VaD by immunohistochemistry utilizing an antibody that specifically detects the amino-terminal fragment of apoE. Application of this antibody, termed N-terminal, apoE cleavage fragment (nApoECF) revealed consistent labeling within neurofibrillary tangles (NFTs), blood vessels, and reactive astrocytes. Labeling occurred in VaD cases that had confirmed APOE genotypes of 3/3, 3/4, and 4/4, with respect to NFTs, staining of the nApoECF co-localized with PHF-1 and was predominantly localized to large, stellate neurons in layer II of the entorhinal cortex. Quantitative analysis indicated that approximately 38.4% of all identified NFTs contained the amino-terminal fragment of apoE. Collectively, these data support a role for the proteolytic cleavage of apoE in the VaD and support previous reports that APOE polymorphism is significantly associated with susceptibility in this disease.

  11. Vascular aspects of cognitive impairment and dementia

    Science.gov (United States)

    Wiesmann, Maximilian; Kiliaan, Amanda J; Claassen, Jurgen AHR

    2013-01-01

    Hypertension and stroke are highly prevalent risk factors for cognitive impairment and dementia. Alzheimer's disease (AD) and vascular dementia (VaD) are the most common forms of dementia, and both conditions are preceded by a stage of cognitive impairment. Stroke is a major risk factor for the development of vascular cognitive impairment (VCI) and VaD; however, stroke may also predispose to AD. Hypertension is a major risk factor for stroke, thus linking hypertension to VCI and VaD, but hypertension is also an important risk factor for AD. Reducing these two major, but modifiable, risk factors—hypertension and stroke—could be a successful strategy for reducing the public health burden of cognitive impairment and dementia. Intake of long-chain omega-3 polyunsaturated fatty acids (LC-n3-FA) and the manipulation of factors involved in the renin–angiotensin system (e.g. angiotensin II or angiotensin-converting enzyme) have been shown to reduce the risk of developing hypertension and stroke, thereby reducing dementia risk. This paper will review the research conducted on the relationship between hypertension, stroke, and dementia and also on the impact of LC-n3-FA or antihypertensive treatments on risk factors for VCI, VaD, and AD. PMID:24022624

  12. Anesthesia for free vascularized tissue transfer.

    Science.gov (United States)

    Hagau, Natalia; Longrois, Dan

    2009-01-01

    Anesthesia may be an important factor in maximizing the success of microsurgery by controlling the hemodynamics and the regional blood flow. The intraanesthetic basic goal is to maintain an optimal blood flow for the vascularized free flap by: increasing the circulatory blood flow, maintaining a normal body temperature to avoid peripheral vasoconstriction, reducing vasoconstriction resulted from pain, anxiety, hyperventilation, or some drugs, treating hypotension caused by extensive sympathetic block and low cardiac output. A hyperdynamic circulation can be obtained by hypervolemic or normovolemic hemodilution and by decrease of systemic vascular resistance. The importance of proper volume replacement has been widely accepted, but the optimal strategy is still open to debate. General anesthesia combined with various types of regional anesthesia is largely preferred for microvascular surgery. Maintenance of homeostasis through avoidance of hyperoxia, hypocapnia, and hypovolemia (all factors that can decrease cardiac output and induce local vasoconstriction) is a well-established perioperative goal. As the ischemia-reperfusion injury could occur, inhalatory anesthetics as sevoflurane (that attenuate the consequences of this process) seem to be the anesthetics of choice. (c) 2008 Wiley-Liss, Inc.

  13. Amaurosis fugax associated with congenital vascular defect

    Directory of Open Access Journals (Sweden)

    Giltner JW

    2016-07-01

    Full Text Available John W Giltner,1 Edward R Thomas,2 William K Rundell3 1Boonshoft School of Medicine, Wright State University, Dayton, OH, USA; 2Ohio Eyecare Institute, Premier Health Specialists, Dayton, OH, USA; 3Department of Surgery, Miami Valley Hospital, Dayton, OH, USA Abstract: A 68-year-old female with no significant past medical history presented with loss of vision in the lower half of her left eye that lasted <5 minutes. No abnormalities were found on ocular or physical exam. Computed tomography angiography and carotid ultrasound were performed, which confirmed the diagnosis as amaurosis fugax with two abnormalities leading to the transient retinal vessel occlusion. First, it was found that the patient has a congenital vascular anomaly, which consisted most notably of a right-sided aortic arch. This vascular anomaly also consisted of abnormal branching of the left subclavian and common carotid arteries, predisposing the patient to turbulent blood flow and increased risk of the formation of an atherosclerotic plaque at the origin of the common carotid artery. This is an abnormal location for a plaque leading to amaurosis fugax compared to the most common location at the carotid bifurcation. Endarterectomy was not performed because of the difficult location of the plaque and tortuosity of the vessel. Rather, medical intervention with antiplatelet and lipid-lowering therapy was initiated to lower the risk of future retinal or cerebral thromboembolic events. Keywords: amaurosis fugax, aorta, carotid, congenital, defect

  14. Hypertension in Metabolic Syndrome: Vascular Pathophysiology

    Directory of Open Access Journals (Sweden)

    Yolanda Mendizábal

    2013-01-01

    Full Text Available Metabolic syndrome is a cluster of metabolic and cardiovascular symptoms: insulin resistance (IR, obesity, dyslipemia. Hypertension and vascular disorders are central to this syndrome. After a brief historical review, we discuss the role of sympathetic tone. Subsequently, we examine the link between endothelial dysfunction and IR. NO is involved in the insulin-elicited capillary vasodilatation. The insulin-signaling pathways causing NO release are different to the classical. There is a vasodilatory pathway with activation of NO synthase through Akt, and a vasoconstrictor pathway that involves the release of endothelin-1 via MAPK. IR is associated with an imbalance between both pathways in favour of the vasoconstrictor one. We also consider the link between hypertension and IR: the insulin hypothesis of hypertension. Next we discuss the importance of perivascular adipose tissue and the role of adipokines that possess vasoactive properties. Finally, animal models used in the study of vascular function of metabolic syndrome are reviewed. In particular, the Zucker fatty rat and the spontaneously hypertensive obese rat (SHROB. This one suffers macro- and microvascular malfunction due to a failure in the NO system and an abnormally high release of vasoconstrictor prostaglandins, all this alleviated with glitazones used for metabolic syndrome therapy.

  15. Drinking Citrus Fruit Juice Inhibits Vascular Remodeling in Cuff-Induced Vascular Injury Mouse Model

    Science.gov (United States)

    Ohnishi, Arika; Asayama, Rie; Mogi, Masaki; Nakaoka, Hirotomo; Kan-no, Harumi; Tsukuda, Kana; Chisaka, Toshiyuki; Wang, Xiao-Li; Bai, Hui-Yu; Shan, Bao-Shuai; Kukida, Masayoshi; Iwanami, Jun; Horiuchi, Masatsugu

    2015-01-01

    Citrus fruits are thought to have inhibitory effects on oxidative stress, thereby attenuating the onset and progression of cancer and cardiovascular disease; however, there are few reports assessing their effect on vascular remodeling. Here, we investigated the effect of drinking the juice of two different citrus fruits on vascular neointima formation using a cuff-induced vascular injury mouse model. Male C57BL6 mice were divided into five groups as follows: 1) Control (water) (C), 2) 10% Citrus unshiu (CU) juice (CU10), 3) 40% CU juice (CU40), 4) 10% Citrus iyo (CI) juice (CI10), and 5) 40% CI juice (CI40). After drinking them for 2 weeks from 8 weeks of age, cuff injury was induced by polyethylene cuff placement around the femoral artery. Neointima formation was significantly attenuated in CU40, CI10 and CI40 compared with C; however, no remarkable preventive effect was observed in CU10. The increases in levels of various inflammatory markers including cytokines such as monocyte chemotactic protein-1, interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α in response to vascular injury did not differ significantly between C, CU10 and CI10. The increases in cell proliferation and superoxide anion production were markedly attenuated in CI10, but not in CU10 compared with C. The increase in phosphorylated ERK expression was markedly attenuated both in CU10 and CI10 without significant difference between CU10 and CI10. Accumulation of immune cells did not differ between CU10 and CI10. These results indicate that drinking citrus fruit juice attenuates vascular remodeling partly via a reduction of oxidative stress. Interestingly, the preventive efficacy on neointima formation was stronger in CI than in CU at least in part due to more prominent inhibitory effects on oxidative stress by CI. PMID:25692290

  16. Vascular Anomalies Encountered During Pancreatoduodenectomy: Do They Influence Outcomes?

    National Research Council Canada - National Science Library

    Shukla, Parul J; Barreto, Savio G; Kulkarni, Aniruddha; Nagarajan, Ganesh; Fingerhut, Abe

    2010-01-01

    .... Other vascular abnormalities such as replaced common hepatic artery with a hepatomesenteric trunk and celiomesenteric trunk and arcuate ligament syndrome leading to celiac artery stenosis are also...

  17. A Role for the Endothelium in Vascular Calcification

    Science.gov (United States)

    Yao, Yucheng; Jumabay, Medet; Ly, Albert; Radparvar, Melina; Cubberly, Mark R.; Boström, Kristina I.

    2013-01-01

    Rationale Vascular calcification is a regulated process that involves osteoprogenitor cells and frequently complicates common vascular disease such as atherosclerosis and diabetic vasculopathy. However, it is not clear if the vascular endothelium has a role in contributing osteoprogenitor cells to the calcific lesions. Objective To determine if the vascular endothelium contributes osteoprogenitor cells to vascular calcification. Methods and Results In this study, we use two mouse models of vascular calcification, mice with gene deletion of matrix Gla protein (MGP), a BMP-inhibitor, and Ins2Akita/+ mice, a diabetes model. We show that enhanced bone morphogenetic protein (BMP) signaling in both types of mice stimulates the vascular endothelium to contribute osteoprogenitor cells to the vascular calcification. The enhanced BMP signaling results in endothelial-mesenchymal transitions and the emergence of multipotent cells, followed by osteoinduction. Endothelial markers co-localize with multipotent and osteogenic markers in calcified arteries by immunostaining and fluorescence-activated cell sorting. Lineage tracing using Tie2-Gfp transgenic mice supports an endothelial origin of the osteogenic cells. Enhancement of MGP expression in Ins2Akita/+ mice, as mediated by an Mgp transgene limits the generation of multipotent cells. Moreover, MGP-depleted human aortic endothelial cells in vitro acquire multipotency rendering the cells susceptible to osteoinduction by BMP and high glucose. Conclusions Our data suggest that the endothelium is a source of osteoprogenitor cells in vascular calcification that occurs in disorders with high BMP activation such as deficiency of BMP inhibitors and diabetes. PMID:23852538

  18. Vascular adaptation in athletes: is there an 'athlete's artery'?

    National Research Council Canada - National Science Library

    Green, D.J; Spence, A; Rowley, N; Thijssen, D.H.J; Naylor, L.H

    2012-01-01

    Whilst the existence of a specific phenotype characterized as 'athlete's heart' is generally acknowledged, the question of whether athletes exhibit characteristic vascular adaptations has not been specifically addressed...

  19. Rho kinase as a target for cerebral vascular disorders

    Science.gov (United States)

    Bond, Lisa M; Sellers, James R; McKerracher, Lisa

    2015-01-01

    The development of novel pharmaceutical treatments for disorders of the cerebral vasculature is a serious unmet medical need. These vascular disorders are typified by a disruption in the delicate Rho signaling equilibrium within the blood vessel wall. In particular, Rho kinase overactivation in the smooth muscle and endothelial layers of the vessel wall results in cytoskeletal modifications that lead to reduced vascular integrity and abnormal vascular growth. Rho kinase is thus a promising target for the treatment of cerebral vascular disorders. Indeed, preclinical studies indicate that Rho kinase inhibition may reduce the formation/growth/rupture of both intracranial aneurysms and cerebral cavernous malformations. PMID:26062400

  20. Management of vascular anomalies: Review of institutional management algorithm

    Directory of Open Access Journals (Sweden)

    Lalit K Makhija

    2017-01-01

    Full Text Available Introduction: Vascular anomalies are congenital lesions broadly categorised into vascular tumour (haemangiomas and vascular dysmorphogenesis (vascular malformation. The management of these difficult problems has lately been simplified by the biological classification and multidisciplinary approach. To standardise the treatment protocol, an algorithm has been devised. The study aims to validate the algorithm in terms of its utility and presents our experience in managing vascular anomalies. Materials and Methods: The biological classification of Mulliken and Glowacki was followed. A detailed algorithm for management of vascular anomalies has been devised in the department. The protocol is being practiced by us since the past two decades. The data regarding the types of lesions and treatment modality used were maintained. Results and Conclusion: This study was conducted from 2002 to 2012. A total of 784 cases of vascular anomalies were included in the study of which 196 were haemangiomas and 588 were vascular malformations. The algorithmic approach has brought an element of much-needed objectivity in the management of vascular anomalies. This has helped us to define the management of particular lesion considering its pathology, extent and aesthetic and functional consequences of ablation to a certain extent.

  1. Application study of medical robots in vascular intervention.

    Science.gov (United States)

    Lu, Wang-sheng; Xu, Wu-yi; Zhang, Jing; Liu, Da; Wang, Da-min; Jia, Po; Li, Zhi-cao; Wang, Tian-miao; Zhang, Da-peng; Tian, Zeng-min; Zeng, Yanjun

    2011-09-01

    Based on the background of minimally invasive surgery and applications of medical robots, a vascular interventional robotic system has been developed that can be used in the field of vascular intervention. The robotic system comprises a propulsion system, an image navigation system and a virtual surgery training system. Integration of the three systems constitutes a vascular intervention prototype robotic system used to carry out in vitro vascular intervention and animal experiments. On a transparent glass vascular model, a catheter was shown to enter an arbitrary branch of the vascular model with catheter motion meeting the requirements of clinical vascular intervention surgery (VIS); i.e. error band of catheter motion experiments, 1.33-2.00 mm (4F-6F) diameter catheters were selectively inserted successfully into predefined targets in the animal, such as the renal, cardiovascular and cerebrovascular artery. Compared with conventional manual surgery, the time for robotic surgery is a little longer. There were no operative complications in the animal experiments. These simulation and animal study results demonstrate that this vascular interventional robotic system allows doctors to perform angiography remotely and prevents them from radiation exposure. The system may be the basis for further clinical applications of vascular intervention. Copyright © 2011 John Wiley & Sons, Ltd.

  2. Evaluating Peripheral Vascular Injuries: Is Color Doppler Enough for Diagnosis?

    Directory of Open Access Journals (Sweden)

    Mohd Lateef Wani

    2014-03-01

    Full Text Available Background:: Vascular injury poses a serious threat to limb and life. Thus, diagnosis should be made immediately with minimally invasive methods. Doppler is a good aid in diagnosis of vascular injury. Methods:: The present prospective study was conducted on 150 patients who presented with soft signs (the signs which are suggestive but not confirmatory of vascular injury. They were subjected to color Doppler examination before exploration. The patients with the features of vascular injury on color Doppler were subjected to exploration. On the other hand, those who had normal Doppler were subjected to CT- angiography. Then, the findings of the exploration were matched with those of color Doppler. The data were analyzed using the SPSS statistical software. Results:: Out of the 150 Doppler examinations, 110 (73.33% were reported as positive, while 40 were reported as negative for vascular injury. These were subjected to CT-angiography and seven of them had the features of vascular injury on CT-angiography. All the patients with positive Doppler or CT angiography findings were subjected to exploration. Doppler had a sensitivity of 94% and specificity of 82.5% in diagnosis of vascular injury using Binary classification test. Conclusions:: Color Doppler is an easily available, reliable, and handy method of diagnosing a vascular injury. It has a very high sensitivity and specificity in diagnosis of vascular injuries.

  3. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement

    Science.gov (United States)

    Sachdev, Perminder; Kalaria, Raj; O’Brien, John; Skoog, Ingmar; Alladi, Suvarna; Black, Sandra E; Blacker, Deborah; Blazer, Dan; Chen, Christopher; Chui, Helena; Ganguli, Mary; Jellinger, Kurt; Jeste, Dilip V.; Pasquier, Florence; Paulsen, Jane; Prins, Niels; Rockwood, Kenneth; Roman, Gustavo; Scheltens, Philip

    2014-01-01

    Background Several sets of diagnostic criteria have been published for vascular dementia (VaD) since the 1960s. The continuing ambiguity in VaD definition warrants a critical re-examination. Methods Participants at a special symposium of the International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2009 critiqued the current criteria. They drafted a proposal for a new set of criteria, later reviewed through multiple drafts by the group, including additional experts and the members of the Neurocognitive Disorders Work Group of the DSM-5 Task Force. Results Cognitive disorders of vascular etiology are a heterogeneous group of disorders with diverse pathologies and clinical manifestations, discussed broadly under the rubric of vascular cognitive disorders (VCD). The continuum of vascular cognitive impairment is recognized by the categories of Mild Vascular Cognitive Disorder, and Vascular Dementia or Major Vascular Cognitive Disorder. Diagnostic thresholds are defined. Clinical and neuroimaging criteria are proposed for establishing vascular etiology. Subtypes of VCD are described, and the frequent co-occurrence of Alzheimer’s disease pathology emphasized. Conclusions The proposed criteria for VCD provide a coherent approach to the diagnosis of this diverse group of disorders, with a view to stimulating clinical and pathological validation studies. These criteria can be harmonized with the DSM-5 criteria such that an international consensus on the criteria for VCD may be achieved. PMID:24632990

  4. 3D Multiscale Modelling of Angiogenesis and Vascular Tumour Growth

    KAUST Repository

    Perfahl, H.

    2012-11-01

    We present a three-dimensional, multiscale model of vascular tumour growth, which couples nutrient/growth factor transport, blood flow, angiogenesis, vascular remodelling, movement of and interactions between normal and tumour cells, and nutrient-dependent cell cycle dynamics within each cell. We present computational simulations which show how a vascular network may evolve and interact with tumour and healthy cells. We also demonstrate how our model may be combined with experimental data, to predict the spatio-temporal evolution of a vascular tumour.

  5. Evolution of development of vascular cambia and secondary growth.

    Science.gov (United States)

    Spicer, Rachel; Groover, Andrew

    2010-05-01

    Secondary growth from vascular cambia results in radial, woody growth of stems. The innovation of secondary vascular development during plant evolution allowed the production of novel plant forms ranging from massive forest trees to flexible, woody lianas. We present examples of the extensive phylogenetic variation in secondary vascular growth and discuss current knowledge of genes that regulate the development of vascular cambia and woody tissues. From these foundations, we propose strategies for genomics-based research in the evolution of development, which is a next logical step in the study of secondary growth.

  6. Frequency and Effect of Access-Related Vascular Injury and Subsequent Vascular Intervention After Transcatheter Aortic Valve Replacement

    DEFF Research Database (Denmark)

    Dencker, Ditte; Taudorf, Mikkel; Luk, N H Vincent

    2016-01-01

    Vascular access and closure remain a challenge in transcatheter aortic valve replacement (TAVR). This single-center study aimed to report the incidence, predictive factors, and clinical outcomes of access-related vascular injury and subsequent vascular intervention. During a 30-month period, 365...... patients underwent TAVR and 333 patients (94%) were treated by true percutaneous transfemoral approach. Of this latter group, 83 patients (25%) had an access-related vascular injury that was managed by the use of a covered self-expanding stent (n = 49), balloon angioplasty (n = 33), or by surgical...... for access-related vascular intervention. In addition, a high sheath/common femoral artery ratio as measured on preoperative CTA was associated with a higher rate of post-TAVR vascular intervention. The radiation dose, iodine contrast volume, transfusion need, length of hospitalization, and 30-day mortality...

  7. Estrategias para negociaciones exitosas.

    Directory of Open Access Journals (Sweden)

    José B. Parra V

    2010-01-01

    Full Text Available Las estrategias de negociación son herramientas para disminuir conflictos o para intercambiar bienes y servicios. Una negociación exitosa crea relaciones de solidaridad y propicia reciprocidad, cooperación y confianza para quienes tendrán relaciones permanentes de negociación con beneficios para ambas partes. Una estrategia de negociación exitosa requiere manejar el desarrollo del ambiente social del grupo de personas, con la finalidad de tener presente las fronteras que no pueden irrumpirse. Otro aspecto importante, es el lenguaje corporal utilizado por las personas y las tácticas que se practican. El manejo de esta información permite diseñar diferentes modelos de negociaciones para cada caso específico. Este documento propone la utilización de la herramienta MONACO, diseñada por los autores, que es un software útil para encontrar los mejores tácticas posibles dentro de una negociación; basándose en el lenguaje corporal que muestra el negociante oponente durante cada oferta monetaria. El uso de este software da al negociador la oportunidad de manejar las negociaciones con mayor control, el negociador que usa el software puede elegir una estrategia de acuerdo a las relaciones que espera mantener con el negociador oponente.

  8. Nrf2/Keap1 system regulates vascular smooth muscle cell apoptosis for vascular homeostasis: role in neointimal formation after vascular injury.

    Science.gov (United States)

    Ashino, Takashi; Yamamoto, Masayuki; Numazawa, Satoshi

    2016-05-20

    Abnormal increases in vascular smooth muscle cells (VSMCs) in the intimal region after a vascular injury is a key event in developing neointimal hyperplasia. To maintain vascular function, proliferation and apoptosis of VSMCs is tightly controlled during vascular remodeling. NF-E2-related factor 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1) system, a key component of the oxidative stress response that acts in maintaining homeostasis, plays an important role in neointimal hyperplasia after a vascular injury; however, the role of Nrf2/Keap1 in VSMC apoptosis has not been clarified. Here we report that 14 days after arterial injury in mice, TUNEL-positive VSMCs are detected in both the neointimal and medial layers. These layers contain cells expressing high levels of Nrf2 but low Keap1 expression. In VSMCs, Keap1 depletion induces features of apoptosis, such as positive TUNEL staining and annexin V binding. These changes are associated with an increased expression of nuclear Nrf2. Simultaneous Nrf2 depletion inhibits Keap1 depletion-induced apoptosis. At 14 days after the vascular injury, Nrf2-deficient mice demonstrated fewer TUNEL-positive cells and increased neointimal formation in the neointimal and medial areas. The results suggest that the Nrf2/Keap1 system regulates VSMC apoptosis during neointimal formation, thereby inhibiting neointimal hyperplasia after a vascular injury.

  9. Metabolic acidosis and vascular calcification: using blueprints from bone to map a new venue for vascular research.

    Science.gov (United States)

    Al-Aly, Z

    2008-02-01

    Vascular calcification is an important problem in patients with chronic kidney disease. The pathobiology of vascular calcification is complex and is intricately related to bone remodeling. Mendoza et al. report that experimental metabolic acidosis prevents calcitriol-induced vascular calcification in uremic animals. To fully understand the effect of acidosis on the vasculature, a comprehensive and integrated approach that simultaneously examines the effect of metabolic acidosis on bone and vasculature is needed.

  10. Vascular training in Scotland and Northern Ireland: The trainee perspective prior to introduction of the new vascular curriculum.

    Science.gov (United States)

    Guthrie, G J K; Hussey, K K; Wilson, A M; Jamieson, R W; Marron, C D; Suttie, S A

    2015-06-01

    The last decade has seen the evolution of vascular surgery from a sub-specialty of general surgery to that of an independent, stand-alone specialty. The introduction of a vascular-only curriculum is anticipated to require significant change from the current provision for vascular surgical training to allow vascular trainees to acquire the specialist skills in elective, emergency, and endovascular surgery to provide endovascular services in the future. To provide an insight into current vascular training in Scotland and Northern Ireland. Specialty trainees in general surgery, with a sub-specialty interest in vascular in Scotland and Northern Ireland were asked to carry out a voluntary online survey between May 2012 and July 2012. 22 specialty trainees/specialist registrars who have declared a sub-specialty interest in vascular surgery were identified and polled. 20 trainees completed the survey. 13 trainees still participated in general surgical on-call rotas. Formal teaching opportunities were readily available but only 10 trainees could attend regularly. All trainees worked in units offering endovascular treatment for aneurysm and occlusive disease, but few had dedicated training sessions in endovascular skills. All endovascular simulation-based training was industry sponsored. The majority of trainees report a good overall training experience and are keen to see the implementation of a vascular-specific curriculum. 15 trainees had undertaken a dedicated period of research towards a higher degree, with only 50% based on a vascular topic. The majority of trainees reported a positive training experience with Scotland and Northern Ireland having great potential as vascular training deaneries. The survey identifies specific areas that could be improved by the development of the new curriculum in vascular surgery to provide excellent vascular training in Scotland and Northern Ireland. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC

  11. VEGFR tyrosine kinase inhibitor II (VRI) induced vascular insufficiency in zebrafish as a model for studying vascular toxicity and vascular preservation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Shang; Dang, Yuan Ye; Oi Lam Che, Ginny [State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macao (China); Kwan, Yiu Wa [School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong (China); Chan, Shun Wan [State Key Laboratory of Chinese Medicine and Molecular Pharmacology, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong (China); Leung, George Pak Heng [Pharmacology and Pharmacy, Faculty of Medicine, The University of Hong Kong, Hong Kong (China); Lee, Simon Ming Yuen, E-mail: simonlee@umac.mo [State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macao (China); Hoi, Maggie Pui Man, E-mail: maghoi@umac.mo [State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macao (China)

    2014-11-01

    In ischemic disorders such as chronic wounds and myocardial ischemia, there is inadequate tissue perfusion due to vascular insufficiency. Besides, it has been observed that prolonged use of anti-angiogenic agents in cancer therapy produces cardiovascular toxicity caused by impaired vessel integrity and regeneration. In the present study, we used VEGFR tyrosine kinase inhibitor II (VRI) to chemically induce vascular insufficiency in zebrafish in vivo and human umbilical vein endothelial cells (HUVEC) in vitro to further study the mechanisms of vascular morphogenesis in these pathological conditions. We also explored the possibility of treating vascular insufficiency by enhancing vascular regeneration and repair with pharmacological intervention. We observed that pretreatment of VRI induced blood vessel loss in developing zebrafish by inhibiting angiogenesis and increasing endothelial cell apoptosis, accompanied by down-regulation of kdr, kdrl and flt-1 genes expression. The VRI-induced blood vessel loss in zebrafish could be restored by post-treatment of calycosin, a cardiovascular protective isoflavone. Similarly, VRI induced cytotoxicity and apoptosis in HUVEC which could be rescued by calycosin post-treatment. Further investigation of the underlying mechanisms showed that the PI3K/AKT/Bad cell survival pathway was a main contributor of the vascular regenerative effect of calycosin. These findings indicated that the cardiovascular toxicity in anti-angiogenic therapy was mainly caused by insufficient endothelial cell survival, suggesting its essential role in vascular integrity, repair and regeneration. In addition, we showed that VRI-induced blood vessel loss in zebrafish represented a simple and effective in vivo model for studying vascular insufficiency and evaluating cancer drug vascular toxicities. - Highlights: • In vivo VRI model • Rescue effects of calycosin • Calycosin EC survival pathways.

  12. [Extracranial vascular anomalies (hemangiomas and vascular malformations) in children and adolescents--diagnosis, clinic, and therapy].

    Science.gov (United States)

    Eivazi, B; Werner, J A

    2014-03-01

    The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be

  13. Extracranial vascular malformations (hemangiomas and vascular malformations) in children and adolescents - diagnosis, clinic, and therapy.

    Science.gov (United States)

    Eivazi, Behfar; Werner, Jochen A

    2014-01-01

    The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be

  14. Extracranial vascular malformations (hemangiomas and vascular malformations) in children and adolescents – diagnosis, clinic, and therapy

    Science.gov (United States)

    Eivazi, Behfar; Werner, Jochen A.

    2014-01-01

    The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be

  15. Deep dorsal vein arterialisation in vascular impotence.

    Science.gov (United States)

    Wespes, E; Corbusier, A; Delcour, C; Vandenbosch, G; Struyven, J; Schulman, C C

    1989-11-01

    A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre-operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow-up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno-venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.

  16. Gait and Equilibrium in Subcortical Vascular Dementia

    Directory of Open Access Journals (Sweden)

    Rita Moretti

    2011-01-01

    Full Text Available Subcortical vascular dementia is a clinical entity, widespread, even challenging to diagnose and correctly treat. Patients with this diagnosis are old, frail, often with concomitant pathologies, and therefore, with many drugs in therapy. We tried to diagnose and follow up for three years more than 600 patients. Study subjects were men and women, not bedridden, aged 68–94 years, outpatients, recruited from June, 1st 2007 to June, 1st 2010. We examined them clinically, neurologically, with specific consideration on drug therapies. Our aim has been to define gait and imbalance problem, if eventually coexistent with the pathology of white matter and/or with the worsening of the deterioration. Drug intake interference has been detected and considered.

  17. Digital image processing of vascular angiograms

    Science.gov (United States)

    Selzer, R. H.; Beckenbach, E. S.; Blankenhorn, D. H.; Crawford, D. W.; Brooks, S. H.

    1975-01-01

    The paper discusses the estimation of the degree of atherosclerosis in the human femoral artery through the use of a digital image processing system for vascular angiograms. The film digitizer uses an electronic image dissector camera to scan the angiogram and convert the recorded optical density information into a numerical format. Another processing step involves locating the vessel edges from the digital image. The computer has been programmed to estimate vessel abnormality through a series of measurements, some derived primarily from the vessel edge information and others from optical density variations within the lumen shadow. These measurements are combined into an atherosclerosis index, which is found in a post-mortem study to correlate well with both visual and chemical estimates of atherosclerotic disease.

  18. Hemothorax in vascular Ehlers-Danlos syndrome.

    Science.gov (United States)

    Álvarez, Kevin; Jordi, López; Jose Angel, Hernández

    2017-10-16

    Vascular Ehlers-Danlos syndrome (EDS IV) is a rare genetic disorder characterized by an alteration in the COL3A1 gene which encodes type III collagen. It is the most common type of collagen in vessels of medium size and certain organs such as the intestines and the uterus. The alteration of this type of collagen produces aneurisms and ruptures of vessels and organs. A high level of clinical suspicion is required for diagnosis. It is a complex disease whose management requires a multidisciplinary team to treat the different complications that may occur. We report the case of a 50-year-old man diagnosed with EDS IV detected incidentally after hemothorax secondary to a coughing spell. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  19. Rheumatic diseases and autoimmune vascular dementia.

    Science.gov (United States)

    Atzeni, Fabiola; Pipitone, Nicolò; Iaccarino, Luca; Masala, Ignazio Francesco; Weiss, Ronen; Alciati, Alessandra; Doria, Andrea; Chapmanand, Joab; Sarzi-Puttini, Piercarlo

    2017-10-13

    Vascular dementia (VD) comes second after Alzheimer's disease (AD) as a cause of impaired cognition. VD is not a specific nosological entity, but rather a syndrome encompassing a number of diseases caused by impaired supply of blood to the brain. Systemic autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis and antiphospholipid syndrome (APS) can be associated with dementia. VD is often related to the presence of traditional cardiovascular risk factors, but it may also be associated with a host of disorders affecting the brain blood vessels, neuronal cells, or both. It is important to entertain in the differential diagnosis of VD, to recognize and to cure them accurately in order to preserve life's quality of our patients. Copyright © 2017. Published by Elsevier B.V.

  20. [Nocardia farcinica infection of a vascular prosthesis].

    Science.gov (United States)

    Babilas, P; Scherer, K; Landthaler, M; Ehrenstein, B; Szeimies, R-M

    2007-04-01

    A 61-year-old woman presented with purple-red subcutaneous nodules on her right leg. She had experienced fever up to 40 degrees C for the past 10 days and felt generally weak over the last two months. Four months earlier, a vascular graft had been implanted in her right femoral artery. Based on the diagnosis of skin infection due to implantation of an infected prosthesis, she was hospitalized and treated with an antibiotic regime. During the initial antibiotic treatment, the symptoms deteriorated, and she developed joint, hepatic and CNS abscesses. Finally, a microbiologic culture with an extended incubation time revealed the diagnosis of an infection with the slowly growing bacterium Nocardia ssp. Hereupon the patient was treated purposefully with Meropenem over six months. This treatment resulted in complete recovery.

  1. Vascular medicine and surgery in ancient Egypt.

    Science.gov (United States)

    Barr, Justin

    2014-07-01

    Lauded alike by ancient civilizations and modern society, pharaonic Egyptian medicine remains an object of fascination today. This article discusses its surprisingly sophisticated understanding of a cardiovascular system. The term "cardiovascular system," however, carries assumptions and meanings to a modern audience, especially readers of this journal, which simply do not apply when considering ancient conceptions of the heart and vessels. For lack of better language, this article will use "cardiovascular" and similar terms while recognizing the anachronistic inaccuracy. After briefly summarizing ancient Egyptian medicine generally, it will review the anatomy, pathology, and treatment of the vasculature. The practice of mummification in ancient Egypt provides a unique opportunity for paleopathology, and the conclusion will explore evidence of arterial disease from a modern scientific perspective. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  2. Diabetic Retinopathy: Vascular and Inflammatory Disease

    Science.gov (United States)

    Semeraro, F.; Cancarini, A.; dell'Omo, R.; Rezzola, S.; Romano, M. R.; Costagliola, C.

    2015-01-01

    Diabetic retinopathy (DR) is the leading cause of visual impairment in the working-age population of the Western world. The pathogenesis of DR is complex and several vascular, inflammatory, and neuronal mechanisms are involved. Inflammation mediates structural and molecular alterations associated with DR. However, the molecular mechanisms underlying the inflammatory pathways associated with DR are not completely characterized. Previous studies indicate that tissue hypoxia and dysregulation of immune responses associated with diabetes mellitus can induce increased expression of numerous vitreous mediators responsible for DR development. Thus, analysis of vitreous humor obtained from diabetic patients has made it possible to identify some of the mediators (cytokines, chemokines, and other factors) responsible for DR pathogenesis. Further studies are needed to better understand the relationship between inflammation and DR. Herein the main vitreous-related factors triggering the occurrence of retinal complication in diabetes are highlighted. PMID:26137497

  3. [Vascular complications after pelvic rami fracture].

    Science.gov (United States)

    Fernández-Lombardía, J; Paz-Aparicio, A; Hernández-Vaquero, D

    2014-01-01

    The case is presented of a 78 year-old patient who suffered a right ileo- and ischiopubic rami fracture after a casual fall. A few hours later, she presented with sudden abdominal pain and hypotension. Imaging test showed extraperitoneal hemorrhage with active bleeding and hemodynamic compromise. The progressive worsening, with anemia and hemodynamic instability, required her being sent to the reference hospital for selective embolization of the bleeding point. After embolization, the patient́s situation stabilized, and she was then able to sit down one week later. The fracture consolidated 3 months later. Although low-energy pelvic fractures by lateral compression do not usually present with complications, sometimes they require a strict control due to the potential risk of vascular injuries. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Urologic surgery laparoscopic access: vascular complications.

    Science.gov (United States)

    Branco, Anibal Wood

    2017-01-01

    Vascular injury in accidental punctures may occur in large abdominal vessels, it is known that 76% of injuries occur during the development of pneumoperitoneum. The aim of this video is to demonstrate two cases of vascular injury occurring during access in laparoscopic urologic surgery. The first case presents a 60-year old female patient with a 3cm tumor in the superior pole of the right kidney who underwent a laparoscopic partial nephrectomy. After the Verres needle insertion, output of blood was verified. During the evaluation of the cavity, a significant hematoma in the inferior vena cava was noticed. After the dissection, a lesion in the inferior vena cava was identified and controlled with a prolene suture, the estimated bloos loss was 300ml. The second case presents a 42-year old female live donor patient who had her right kidney selected to laparoscopic live donor nephrectomy. After the insertion of the first trocar, during the introduction of the 10mm scope, an active bleeding from the mesentery was noticed. The right colon was dissected and an inferior vena cava perforation was identified; a prolene suture was used to control the bleeding, the estimated blood loss was 200mL, in both cases the patients had no previous abdominal surgery. Urologists must be aware of this uncommon, serious, and potentially lethal complication. Once recognized and in the hands of experienced surgeons, some lesions may be repaired laparoscopically. Whenever in doubt, the best alternative is the immediate conversion to open surgery to minimize morbidity and mortality. Copyright® by the International Brazilian Journal of Urology.

  5. Vascular Burden and Cognitive Function in Late-Life Depression

    NARCIS (Netherlands)

    Zuidersma, Marij; Izaks, Gerbrand J.; Naarding, Paul; Comijs, Hannie C.; Oude Voshaar, Richard C.

    OBJECTIVE: To evaluate the relation of vascular risk factors, subclinical, and manifest vascular disease with four domains of cognitive functioning in a large sample of clinically depressed older persons. METHODS: A cross-sectional analysis was used, and depressed patients were recruited from

  6. Experimental autologous substitute vascular graft for transplantation surgery

    NARCIS (Netherlands)

    Kobori, L; Dallos, G; Gouw, ASH; Nemeth, T; Nemes, B; Fehervari, I; Tegzess, Adam; Slooff, MJH; Perner, F; De Jong, KP

    2000-01-01

    Vascular complications in fiver transplantation are a major cause of graft failure and mortality. The aim of the study was to create autologous vascular graft without risk of rejection. Posterior rectus fascia sheath lined with peritoneum was used for iliac artery replacement in seven mongrel dogs.

  7. The role of microRNA-126 in vascular homeostasis

    NARCIS (Netherlands)

    Solingen, Coen van

    2012-01-01

    This thesis details our studies assessing the role of the endothelial-enriched miRNA-126 in the regulation of vascular homeostasis. In Chapter 2 the current insight in the role of miRNA-126 in vascular homeostasis is reviewed. Chapter 3 focuses on the role of miRNA-126 in ischemia induced

  8. Insertional mutagenesis in the vascular wilt pathogen Verticillium dahliae

    NARCIS (Netherlands)

    Santhanam, P.

    2014-01-01

    Vascular wilt diseases caused by soil-borne pathogens are among the most devastating plant diseases worldwide. The ascomycete fungus Verticillium dahliae causes vascular wilt diseases in hundreds of dicotyledonous plant species, including important crops such as eggplant, lettuce, olive, spinach

  9. Diagnosis and treatment of vascular damage in dementia

    NARCIS (Netherlands)

    Biessels, GJ|info:eu-repo/dai/nl/165576367

    2016-01-01

    This paper provides an overview of cognitive impairment due to vascular brain damage, which is referred to as vascular cognitive impairment (VCI). Over the past decades, we have seen marked progress in detecting VCI, both through maturation of diagnostic concepts and through advances in brain

  10. Monozygotic twins discordant for vascular malformations and dysregulated growth

    NARCIS (Netherlands)

    Oduber, Charlène E. U.; Bliek, Jet; van der Horst, Chantal M. A. M.; van Steensel, Maurice A. M.; Hennekam, Raoul C. M.

    2010-01-01

    There is a large group of disorders characterized by non-cranial vascular malformations and a dysregulated growth, of which the prototype may be Klippel-Trenaunay syndrome (KTS). The aetiology of KTS and vascular malformations-dysregulated growth (VM-DG) syndromes resembling KTS is obscure, but

  11. Altered extracellular magnesium and variations in vascular smooth ...

    African Journals Online (AJOL)

    Background: There is a paucity of information on the heterogeneity of vascular smooth muscles in their responses to agonists following exposure to varying extracellular magnesium, [Mg2+]0. The present study was designed to examine, comparatively, the influence of variations in [Mg2+]0 on vascular smooth muscles of ...

  12. Vascular malformations of the lower limb with osseous involvement

    NARCIS (Netherlands)

    Breugem, C. C.; Maas, M.; Breugem, S. J. M.; Schaap, G. R.; van der Horst, C. M. A. M.

    2003-01-01

    Vascular malformations are rare congenital lesions which often have associated skeletal changes. Over a period of ten years, 90 patients at our clinic had a vascular anomaly of the lower limb, examined by either CT or MRI. Of these, 18 (20%) had bony involvement. A questionnaire was sent to these

  13. Annotated checklist of the vascular plants of Kakamega Forest ...

    African Journals Online (AJOL)

    ... 527 genera are recorded. This represents about 15.2% of the total number of 6506 Kenyan vascular plant species. For each taxon documented, a short description of its habit and distribution is given. Also 181 synonyms are listed. Keywords: Kakamega Forest, vascular plants, pteridophytes, gymnosperms, angiosperms, ...

  14. Lesion-symptom mapping in vascular cognitive impairment

    NARCIS (Netherlands)

    Biesbroek, J.M.

    2016-01-01

    Cerebral vascular disease (CVD) is an important cause of cognitive decline and dementia, either alone or in combination with neurodegenerative diseases, such as Alzheimer's Disease (AD). The contribution of CVD to cognitive decline and dementia is referred to as Vascular Cognitive Impairment (VCI).

  15. Macrophage migration inhibitory factor induces vascular leakage via autophagy

    Directory of Open Access Journals (Sweden)

    Hong-Ru Chen

    2015-01-01

    Full Text Available Vascular leakage is an important feature of acute inflammatory shock, which currently has no effective treatment. Macrophage migration inhibitory factor (MIF is a pro-inflammatory cytokine that can induce vascular leakage and plays an important role in the pathogenesis of shock. However, the mechanism of MIF-induced vascular leakage is still unclear. In this study, using recombinant MIF (rMIF, we demonstrated that MIF induced disorganization and degradation of junction proteins and increased the permeability of human endothelial cells in vitro. Western blotting analysis showed that rMIF treatment induced LC3 conversion and p62 degradation. Inhibition of autophagy with a PI3K inhibitor (3-MA, a ROS scavenger (NAC or autophagosomal-lysosomal fusion inhibitors (bafilomycin A1 and chloroquine rescued rMIF-induced vascular leakage, suggesting that autophagy mediates MIF-induced vascular leakage. The potential involvement of other signaling pathways was also studied using different inhibitors, and the results suggested that MIF-induced vascular leakage may occur through the ERK pathway. In conclusion, we showed that MIF triggered autophagic degradation of endothelial cells, resulting in vascular leakage. Inhibition of MIF-induced autophagy may provide therapeutic targets against vascular leakage in inflammatory shock.

  16. Vascular pattern in enchondroma and chondrosarcoma: clinical and immunohistologic study.

    Science.gov (United States)

    Cintra, Francisco F; Etchebehere, Mauricio; Gonçalves, Jose C B; Cassone, Alejandro E; Amstalden, Eliane M I

    2014-09-01

    Although cartilaginous tumors have low microvascular density, vessels are important for the provision of nutrition so that the tumor can grow and generate metastasis. The aim of this study was to assess the value of the vascular pattern classification as a prognostic tool in chondrosarcomas (CSs) and its relation with vascular endothelial growth factor (VEGF) expression. This was a retrospective study of 21 enchondromas and 57 conventional CSs. Clinical data and outcome were retrieved from medical files. CSs histologic grades (on a scale of 1 to 3) were determined according to the World Health Organization classification. The vascular pattern (on a scale of A to C) was assessed through CD34, according to Kalinski. CD105 and VEGF were also evaluated. Poor outcome was significantly associated with vascular pattern groups B and C. Higher vascular pattern were 6.5 times more frequent in moderate-grade and high-grade CSs than in grade 1 CS. On multivariate analysis, a clear correlation was found between VEGF overexpression and B/C vascular patterns. Only 18 (benign and malignant) tumors stained for CD105. The results point to the use of the vascular pattern classification as a prognostic tool in CSs and to differentiate low-grade from moderate-grade/high-grade CSs. Vascular pattern might be also used to complement histologic grade, VEGF immunostaining, and microvascular density, for indicating a patient's prognosis. Low-grade CSs develop under low neoangiogenesis, which conforms to the slow growth rate of these tumors.

  17. Surveillance of Hemodialysis Vascular Access with Ultrasound Vector Flow Imaging

    DEFF Research Database (Denmark)

    Brandt, Andreas Hjelm; Olesen, Jacob Bjerring; Lindskov Hansen, Kristoffer

    2015-01-01

    -functioning vascular access with as few complications as possible and preferred vascular access is an AVF. Dysfunction due to stenosis is a common complication, and regular monitoring of volume flow is recommended to preserve AVF patency. UDT is considered the gold standard for volume flow surveillance, but VFI has...

  18. An Audit of the Clinicopathological Spectrum of Benign Vascular ...

    African Journals Online (AJOL)

    Background: Vascular tumors of the female genital tract (FGT) are very rare. The aim of this study was to analyze the spectrum of vascular tumors in FGT and to correlate their clinicopathological features. Materials and Methods: A retrospective study of 15years, including clinical features, imaging studies, gross and ...

  19. Prevalence, pattern and risk factors for retinal vascular occlusions in ...

    African Journals Online (AJOL)

    Introduction: Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. They are associated with several systemic and ocular pathologies and are significant causes of visual loss. Objective: This study aims to determine the prevalence, pattern and risk factors for retinal ...

  20. Review: Vascular Effects of Histamine | Ebeigbe | Nigerian Journal ...

    African Journals Online (AJOL)

    Four subtypes of receptors (HFour subtypes of receptors (H1, H2, H3 and H4) mediate the actions of histamine. In the vascular wall, the effects of histamine are mediated via H1 and H2 receptors and the actions are modulated by H3 receptor subtype located on presynaptic neurones. Alterations in vascular responses to ...