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1.
Nat Commun ; 11(1): 4950, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009377

RESUMO

Necrotizing enterocolitis (NEC) is a devastating disease of premature infants with high mortality rate, indicating the need for precision treatment. NEC is characterized by intestinal inflammation and ischemia, as well derangements in intestinal microcirculation. Remote ischemic conditioning (RIC) has emerged as a promising tool in protecting distant organs against ischemia-induced damage. However, the effectiveness of RIC against NEC is unknown. To address this gap, we aimed to determine the efficacy and mechanism of action of RIC in experimental NEC. NEC was induced in mouse pups between postnatal day (P) 5 and 9. RIC was applied through intermittent occlusion of hind limb blood flow. RIC, when administered in the early stages of disease progression, decreases intestinal injury and prolongs survival. The mechanism of action of RIC involves increasing intestinal perfusion through vasodilation mediated by nitric oxide and hydrogen sulfide. RIC is a viable and non-invasive treatment strategy for NEC.


Assuntos
Enterocolite Necrosante/patologia , Intestinos/irrigação sanguínea , Intestinos/patologia , Isquemia/patologia , Microcirculação , Animais , Enterócitos/patologia , Humanos , Hipóxia , Mucosa Intestinal/patologia , Camundongos Endogâmicos C57BL , Microvilosidades/patologia , Microvilosidades/ultraestrutura
2.
Vestn Oftalmol ; 136(4. Vyp. 2): 226-234, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32880144

RESUMO

The article describes a clinical case of acute macular neuroretinopathy and «chronic¼ paracentral acute middle maculopathy in a patient with atypical hemolytic-uremic syndrome - an orphan disease characterized by systemic thrombosis in the vessels of the microcirculatory bed due to chronic uncontrolled activation of the alternative complement pathway. Optical coherence tomography angiography data confirm the ischemic nature of the disease with localization in the deep vascular plexus of the retina in acute macular neuroretinopathy and in the superficial vascular plexus of the retina in «chronic¼ paracentral acute middle maculopathy. The use of modern diagnostic methods, including optical coherence tomography angiography, can help improve detection of the pathology and expand its understanding in severe microangiopathic syndromes, which include atypical hemolytic-uremic syndrome.


Assuntos
Síndrome Hemolítico-Urêmica Atípica , Doenças Retinianas , Angiofluoresceinografia , Humanos , Microcirculação , Retina , Tomografia de Coerência Óptica
4.
Clin Exp Rheumatol ; 38 Suppl 125(3): 132-136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865167

RESUMO

OBJECTIVES: Nailfold videocapillaroscopy (NVC) is the current gold standard for detection and quantification of capillary abnormalities in Raynaud's phenomenon (RP). The objective of this study is to evaluate the role of dermatoscopy as a further screening tool in RP. METHODS: Nailfold capillaries of RP patients were examined by a hand-held non-contact polarised dermatoscope connected to the digital camera (D1) and connected to an iPad (D2). Both dermatoscopic images were marked with an arrowhead. NVC examination was evaluated at the arrowhead. Single blinded reader performed all examinations. NVC was graded as per standard of European League against Rheumatism (EULAR) study group on microcirculation in rheumatic diseases. Consensus evaluation of dermatoscopy characteristics/grade was determined and each dermatoscopic image was given a final impression of 'normal', 'non-specific' or 'scleroderma' pattern. The final interpretation by both techniques was compared after completion of the blinded reading. RESULTS: Classification of 100 consecutive dermatoscopic images resulted in 37 (wide view) 'non-interpretable', 2 'normal', 48 'non-specific' and 13 'scleroderma' pattern with D1; 23 'non-interpretable', 4 'normal', 52 'non-specific' and 21 'scleroderma' pattern by the experts with D2; 0 non-interpretable, 4 normal, 13 non-specific and 83 'scleroderma' pattern with NVC. CONCLUSIONS: Overall, 50% of dermatoscopic images were classified as non-specific and 30% were classified as non-interpretable in RP patients. However, all images classified by dermatoscopy as "normal" or as overt "scleroderma" pattern were confirmed by concomitant NVC analysis. These findings demonstrate tenuous promise for dermatoscopy as a tool for the initial screening of nailfold capillaries in RP. Further regular work up with NVC is needed to further clarify non-interpretable and non-specific findings possibly related to non-scleroderma patterns.


Assuntos
Doença de Raynaud , Doenças Reumáticas , Escleroderma Sistêmico , Capilares , Consenso , Dermoscopia , Europa (Continente) , Humanos , Microcirculação , Angioscopia Microscópica , Unhas
6.
Clin Exp Rheumatol ; 38 Suppl 125(3): 148-153, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865175

RESUMO

OBJECTIVES: To evaluate the prevalence of skin ulcers (SUs) and their association with clinical phenotype in a monocentric cohort of patients affected with systemic sclerosis (SSc). METHODS: Patients affected with SSc (ACR/EULAR 2013 criteria) in regular follow-up at the Rheumatology Unit of Padova University Hospital, Italy, were considered and retrospectively evaluated. Demographic, clinical and laboratory data, organ involvement and therapy were recorded. We analysed the occurrence, timing (single episode, recurrent/chronic) and site of SUs. The association between SUs and demographic and clinical variables was assessed by logistic regression analysis. RESULTS: We evaluated 211 SSc patients, aged 60.8±12.4 years, 187 (89%) females, 147 (70%) affected with limited cutaneous SSc. During a median follow-up of 120 months (50-216), 105 (50%) patients experienced at least one episode of SU; among them, 66% had recurrent or persistent SUs. Patients with a history of SUs compared with those never affected were younger at SSc diagnosis (p=0.009), had more frequently a diffuse cutaneous form (p=0.001), chronic anaemia (p<0.001), systemic inflammation (p=0.001), lung (p=0.002) and cardiac (p=0.004) involvement, and calcinosis (p=0.001). At multivariate analysis a younger age at SSc diagnosis (p=0.031), articular involvement (p=0.005) and telangiectasia (p=0.003) were independently associated with SUs. Telangiectasia, articular involvement, chronic anaemia and inflammatory state were found to be associated with the recurrence/chronicisation of SUs. CONCLUSIONS: SUs represent a common complication in our cohort of patients with a long-term follow-up. The association of SUs with some clinical manifestations of SSc suggests a combined role of microcirculatory damage and inflammation in their origin.


Assuntos
Escleroderma Sistêmico , Úlcera Cutânea , Idoso , Feminino , Humanos , Itália , Microcirculação , Pessoa de Meia-Idade , Fenótipo , Estudos Retrospectivos
7.
Medicine (Baltimore) ; 99(38): e22126, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957332

RESUMO

INTRODUCTION: Coronary microvascular disease (CMVD) can affect the structure, function, and metabolism of the heart, and has an important impact on the occurrence, development and prognosis of coronary artery disease (CAD). Shexiang Tongxin dropping pill (STDP) can dilate blood vessels, alleviate inflammation, reduce endothelial damage, and improve coronary microvascular function in mice with myocardial infarction. This study aims to assess the impact of STDP on stable coronary artery disease (SCAD) patients with normal FFR and CMVD. METHODS AND ANALYSIS: This is a single-center, prospective randomized trial that will enroll 64 SCAD patients, CAD with normal FFR and CMVD. Patients will be randomly divided into study group and control group in a 1:1 fashion. On the basis of conventional drug treatment, the former will receive STDP while the latter will not. The follow-up period of the subjects is 12 months, and clinical follow-up will be conducted before discharge, 30 days, 3 months, 6 months, and 12 months after procedure to complete the detection of relevant indicators. The primary endpoint is the change of index of microcirculatory resistance (ΔIMR) at 12-month follow-up. DISCUSSION: The present study will be the first randomized control study to evaluate the efficacy and safety of STDP on SCAD patients, CAD with normal FFR and CMVD, which will provide a broader idea and more experimental basis for improving the treatment of CMVD. TRIAL REGISTRATION: This is a protocol for the randomized clinical trial which has been registered in the Chinese clinical Trial Registry with an identifier: ChiCTR2000032429.


Assuntos
Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/patologia , Medicamentos de Ervas Chinesas , Microvasos/patologia , Circulação Coronária , Reserva Fracionada de Fluxo Miocárdico , Humanos , Microcirculação , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Vasc Health Risk Manag ; 16: 331-341, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32982262

RESUMO

Purpose: Physiological tests may aid in diagnosing median arcuate ligament syndrome (MALS). MALS is a symptomatic compression of the celiac artery causing symptoms similar to chronic mesenteric ischemia (CMI) of atherosclerotic etiology. Simultaneous use of visible light spectroscopy (VLS) and laser doppler flowmetry (LDF) during upper endoscopy may detect microcirculatory changes in these patients. Patients and Methods: In a single-center, prospective comparative cohort, 25 patients were evaluated for MALS. Patients with a consensus diagnosis of MALS (n=15) underwent a gastroscopy assisted, transmucosal microcirculatory assessment with LDF and VLS. Results were compared to individuals with normal intestinal circulation (n=38) evaluated with duplex ultrasonography, and to patients with chronic mesenteric ischemia (n=32). Treatment response was evaluated clinically at 1, 3, 6, and 12 months, and with ultrasound, VLS and LDF at three months. Health-related quality of life (QoL) was assessed with Euroqol (EQ-5D-5L), preoperatively, and 12 months postoperatively. Results: Preoperative mean transmucosal oxygen saturation was significantly lower in patients with MALS (SO2 76±6), as compared to healthy individuals (SO2 81±4), p=0.02. An overall significant improvement in SO2 after surgical decompression of the celiac artery was found (SO2 81±3.7, p=0.05). Eleven (92%) patients with clinical improvement after laparoscopic decompression had a definitive diagnosis of MALS. Median follow-up was 18 months (4-24 months). Four of the five dimensions investigated with EQ-5D-5L improved. Conclusion: VLS detected a significantly lower baseline transmucosal SO2 in patients with MALS as compared to control subjects with normal intestinal circulation. An improvement in SO2 after laparoscopic decompression was found, supporting a possible ischemic etiology in our patient population.


Assuntos
Artéria Celíaca/fisiopatologia , Duodeno/irrigação sanguínea , Gastroscopia , Fluxometria por Laser-Doppler , Síndrome do Ligamento Arqueado Mediano/diagnóstico , Microcirculação , Circulação Esplâncnica , Estômago/irrigação sanguínea , Adulto , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo , Estudos de Casos e Controles , Descompressão Cirúrgica , Feminino , Humanos , Laparoscopia , Masculino , Síndrome do Ligamento Arqueado Mediano/fisiopatologia , Síndrome do Ligamento Arqueado Mediano/cirurgia , Isquemia Mesentérica/diagnóstico , Isquemia Mesentérica/fisiopatologia , Oclusão Vascular Mesentérica/diagnóstico , Oclusão Vascular Mesentérica/fisiopatologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Qualidade de Vida , Recuperação de Função Fisiológica , Análise Espectral , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(6): 899-906, 2020 Jun 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895211

RESUMO

OBJECTIVE: To investigate the mechanism by which Shexiang Tongxin dripping pills (STDP) improves coronary microcirculation disorder (CMD) and cardiac dysfunction in a porcine model of myocardial ischemia-reperfusion injury. METHODS: Fourteen minipigs were randomly selected for interventional balloon occlusion of the middle left anterior descending branch to induce CMD, and another 7 pigs received sham operation. The pig models of CMD were randomized equally into the model group and STDP-treated group. All the animals were fed with common feed for 8 weeks, and in STDP-treated group, the pigs were given STDP at the daily dose of 3 mg/kg (mixed with feed) for 8 weeks. Before and at the 8th week after the operation, the pigs underwent coronary angiography and echocardiography to determine the vessel lumen diameter and TIMI frame count (CTFC). The pathologies of the myocardium and the microvessels were examined with HE staining at the 8th week. Western blotting was used to detect the expression of silencing information regulator (Sirt1), peroxidase proliferator-activated receptor-γ coactivator-1α (PGC-1α), peroxisome proliferator-activated receptor α (PPARα), extracellular signal-regulated kinase1/2 (ERKI/2), Toll-like receptor 4 (TLR4), and uncoupling protein 2 (UCP2) in myocardial tissue. RESULTS: Before and at the 8th week after the operation, the diameter of the anterior descending vessel in the 3 groups did not differ significantly (P > 0.05). At the 8th week, the number of CTFC frames in the model group increased significantly compared with that in the sham-operated group, but was obviously lowered by treatment with STDP (P < 0.05). Myocardial ischemia-reperfusion injury significantly increased the interventricular septal thickness at end-diastole, left ventricular end-diastole dimension, end-diastole volume, interventricular septal thickness at end-systole and left ventricular mass at 8 weeks after the modeling (P < 0.05), but such changes were significantly alleviated by treatment with STDP (P < 0.05). STDP treatment markedly alleviated myocardial microvascular congestion, thrombosis and peripheral inflammatory cell infiltration induced by myocardial ischemia-reperfusion, but atrophy of the myocardial muscle fiber remained distinct. STDP obviously suppressed the down-regulation of Sirt1, PGC-1α, and PPARα and the up-regulation of ERK1/ 2, TLR4, and UCP2 in the myocardial tissues induced by myocardial ischemia-reperfusion injury. CONCLUSIONS: STDP has anti-inflammatory effects and regulates energy metabolism in the myocardium through modulating Sirt1, PGC-1α, PPARα, ERKI/2, TLR4, and UCP2 to improve CMD and cardiac dysfunction after myocardial ischemia-reperfusion.


Assuntos
Medicamentos de Ervas Chinesas , Traumatismo por Reperfusão Miocárdica , Animais , Microcirculação , Miocárdio , Ratos , Ratos Sprague-Dawley , Suínos
11.
Am J Chin Med ; 48(6): 1315-1330, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32907362

RESUMO

Critical care medicine is a medical specialty engaging the diagnosis and treatment of critically ill patients who have or are likely to have life-threatening organ failure. Sepsis, a life-threatening condition that arises when the body responds to infection, is currently the major cause of death in intensive care units (ICU). Although progress has been made in understanding the pathophysiology of sepsis, many drawbacks in sepsis treatment remains unresolved. For example, antimicrobial resistance, controversial of glucocorticoids use, prolonged duration of ICU care and the subsequent high cost of the treatment. Recent years have witnessed a growing trend of applying traditional Chinese medicine (TCM) in sepsis management. The TCM application emphasizes use of herbal formulation to balance immune responses to infection, which include clearing heat and toxin, promoting blood circulation and removing its stasis, enhancing gastrointestinal function, and strengthening body resistance. In this paper, we will provide an overview of the current status of Chinese herbal formulations, single herbs, and isolated compounds, as an add-on therapy to the standard Western treatment in the sepsis management. With the current trajectory of worldwide pandemic eruption of newly identified Coronavirus Disease-2019 (COVID-19), the adjuvant TCM therapy can be used in the ICU to treat critically ill patients infected with the novel coronavirus.


Assuntos
Anti-Inflamatórios/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Medicina Tradicional Chinesa , Pneumonia Viral/tratamento farmacológico , Sepse/tratamento farmacológico , Artemisininas/uso terapêutico , Astragalus propinquus , Berberina/uso terapêutico , Betacoronavirus , Estado Terminal , Emodina/uso terapêutico , Humanos , Unidades de Terapia Intensiva , Mucosa Intestinal , Microcirculação , Pandemias , Permeabilidade , Rheum , Salvia miltiorrhiza
12.
Wiad Lek ; 73(7): 1465-1469, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32759438

RESUMO

OBJECTIVE: The aim: Improvement of early diagnostics quality and efficiency of chronic pharyngeal diseases (CPD) treatment in children with DM-1 by studying the clinical and laboratory features of the disease course and complex therapy administration. PATIENTS AND METHODS: Materials and methods: A comprehensive examination of 707 children with diabetes mellitus-1, aged 3 to 18, was conducted, which determined clinical and laboratory features of their state in the presence and absence of chronic tonsillitis (CT). RESULTS: Results: Using microbiological and cytological examination of the palatine tonsils (PT) crypts, the leading role of microbial associations in the pathogenesis of HT in the formation of immune inflammation was determined, their influence on the local immunity indices was defined. Significant disturbances of the microcirculatory bed (MCB) in the presence of HT in children with DM-1, direct correlation between CPD and the presence of vascular glomeruli, changes in the retinal capillary structure (r = 0,332; p <0,05) according to biomicroscopy bulbar conjunctiva (BMBC) data were determined. The study of psycho-emotional state in children with CT and DM-1 was conducted, along with applied psycho-corrective program, which significantly reduces the manifestations of aggressiveness, aggression, and frustration reactions in them. CONCLUSION: Сonclusions: A non-invasive complex of the study of PT state on changes of local immunity indices, microbiocenosis and cytological data for correction of CPD course was developed, which allows to obtain faster compensation of CT and contributes to patients' quality of life improvment.


Assuntos
Diabetes Mellitus Tipo 1 , Tonsilite , Adolescente , Criança , Pré-Escolar , Doença Crônica , Humanos , Microcirculação , Tonsila Palatina , Qualidade de Vida
13.
Vestn Oftalmol ; 136(4): 57-65, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32779457

RESUMO

PURPOSE: To assess the progression of primary open-angle glaucoma (POAG) and to study the role of retinal microcirculation in its progression. MATERIAL AND METHODS: In this 2-year prospective study, the rate of POAG progression was determined using perimetry (ROP1) and spectral domain optical coherence tomography (SD-OCT) by thinning of retinal nerve fiber layer (RNFL) (ROP2) and ganglion cell complex (GCC) (ROP3). The vessel density of parafoveal superficial plexus (VD parafovea) and peripapillary retina (VD ppr) was assessed using OCT angiography, peripheral resistance index (RI), and blood flow velocity in the posterior short ciliary arteries (PSCA) and central retinal artery (CRA) with the use of color Doppler mapping. The predictive properties of each parameter were calculated using the area under receiver operating curve (AUC). RESULTS: Progression was detected in 9.8% cases by perimetry and in 19.7% cases by OCT. The combination of these two methods increased the detection up to 32.8%. Circulatory parameters - VD parafovea (AUC 0.70±0.07), VD ppr (0.715±0.07), PSCA RI (0.801±0.12), CRA RI (0.798±0.11) - had similar high predictive properties as IOP max (0.79±0.05), corneal hysteresis (0.755±0.07), thickness of inner parafoveal layers (0.728±0.07) and RNFL (0.692±0.06). The study revealed the following correlations: ROP1 with maximum IOP (p=0.01), ROP2 with blood flow velocity in PSCA (p=0.01), VD parafovea with corneal hysteresis (p=0.01), and GCC thickness with ocular perfusion pressure (p=0.01). CONCLUSION: The obtained data demonstrates the importance of combining perimetry with OCT for detecting the progression of glaucoma and indicates its relationship with reduced ocular hemoperfusion.


Assuntos
Pressão Intraocular , Doenças do Nervo Óptico , Antígenos de Neoplasias , Proteínas Ligadas por GPI , Humanos , Microcirculação , Proteínas de Neoplasias , Estudos Prospectivos , Retina , Tomografia de Coerência Óptica
14.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(8): 974-978, 2020 Aug 15.
Artigo em Chinês | MEDLINE | ID: mdl-32794664

RESUMO

Objective: To evaluate the treatment results of Ilizarov microcirculation reconstruction technique for chronic wounds in the post-traumatic ischemia limbs. Methods: Between January 2016 and July 2019, 7 cases of chronic wounds in the post-traumatic ischemia limbs were treated. There were 5 males and 2 females, with an average age of 42.4 years (range, 29-66 years). The duration of the wound ranged from 1 month to 2 years (mean, 7.7 months). The wounds located in the leg (3 cases) or in the foot and ankle (4 cases). The wound sizes ranged from 4.0 cm×2.2 cm to 12.0 cm×7.1 cm. There were 1 case of tibial varus, 3 cases of equinovarus, 1 case of scleroderma, and 2 cases of Volkmann's ischemic contracture. After debridement, external fixators were used for tibial transverse transport, or correction of tibial varus and correction of equinovarus. Results: All patients were followed up 8-20 months, with an average of 13 months. The infection of wound surface was all controlled in 7 cases and the granulation tissue grew well; the wound surface healed directly in 5 cases and healed after skin grafting in 2 cases, and the wound healing time was 1-3 months (mean, 1.7 months). During the follow-up, there was no recurrence of the wound. Six cases of limb deformity were corrected. Conclusion: For the chronic wounds in the post-traumatic ischemia limbs, Ilizarov microcirculation reconstruction technique can effectively improve local circulation and facilitate the fresh granule growth and wound healing.


Assuntos
Pé Torto Equinovaro/cirurgia , Técnica de Ilizarov , Adulto , Idoso , Fixadores Externos , Feminino , Humanos , Masculino , Microcirculação , Pessoa de Meia-Idade , Transplante de Pele , Resultado do Tratamento
15.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(8): 964-968, 2020 Aug 15.
Artigo em Chinês | MEDLINE | ID: mdl-32794662

RESUMO

Objective: To explore the biological mechanisms of tibial transverse transport (TTT) for promoting microcirculation and tissue repair. Methods: The clinical application and animal model study of TTT were reviewed. Results: The possible biological mechanisms of TTT for promoting microvascular network formation and tissue repair: ① Tibial corticotomy reduces intramedullary pressure and improves microcirculation; ② Tension stress stimulation promotes microvascular regeneration and accelerates the formation of new "transcortical vessels" network; ③ Systemic mobilization of stem cells, mediating local inflammation, etc. Conclusion: TTT has been clinically proven to be effective for the management of lower limb ischemia and diabetic foot ulcers. The surgical procedure is relatively easy with little adverse effects on bone structures. The TTT has good application prospects despite the biological mechanisms of which still need further exploration.


Assuntos
Pé Diabético , Animais , Isquemia , Microcirculação , Tíbia , Cicatrização
16.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(7): 885-889, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32788031

RESUMO

Acute myocardial infarction with cardiogenic shock (AMI-CS) refers to the rapid decrease in cardiac output in a short period of time, and it leads to severe insufficient perfusion of various organs and causes systemic microcirculatory dysfunction, which is the most common cause of the death of patients with acute myocardial infarction (AMI). At present, the main strategy for clinical treatment of AMI-CS is revascularization, which reduces the mortality of AMI-CS. However, myocardial ischemia and reperfusion can cause ischemia/reperfusion (I/R) injury, induce myocardial mitochondrial dysfunction, and a large amount of reactive oxygen species (ROS) accumulation. Mitochondrial-mediated apoptosis of cardiomyocytes is the main reason of cardiomyocyte death during reperfusion injury. This article summarizes the role of mitochondrial in AMI-CS, which focus on three aspects of mitochondrial permeability transition pore (mPTP) opening, mitochondrial autophagy and mitochondrial fusion/division. It is expected to provide new ideas for clinical AMI-CS and identify potential complications targets.


Assuntos
Infarto do Miocárdio , Traumatismo por Reperfusão Miocárdica , Humanos , Microcirculação , Miócitos Cardíacos , Choque Cardiogênico
17.
Zhen Ci Yan Jiu ; 45(6): 513-6, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32643891

RESUMO

The therapeutic effect of acupuncture is often closely related to the improvement of microcirculation. Acupuncture stimulation can adjust pathophysiological changes of microcirculation in the human body through multiple ways, multiple links and multiple levels, healing disorders at last. Laser speckle contrast imaging (LSCI), an emerging technology, can be used to study the effect of acupuncture on microcirculation. In this paper, retrieving the related literature published in recent years, we found that LSCI technology has already been applied to the following aspects 1) acupoint-viscera and microcirculation, 2) stimulation-induced transmission of sensations along the meridian and microcirculation, 3) non-meridians or non-acupoints and microcirculation, 4) specific acupoints and microcirculation, as well as 5) different acupuncture needle manipulations and microcirculation. However, most of the studies focused on animal experiments and healthy subjects, observing microcirculatory effects under normal physiological conditions, and the sample size of participants was smaller. In the future, we highly recommend that increasing the sample size and further studying the local microcirculation are necessary in the pathological state of diseases.


Assuntos
Terapia por Acupuntura , Microcirculação , Animais , Humanos
18.
Rev Cardiovasc Med ; 21(2): 157-162, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32706205

RESUMO

Cardiovascular disease, and in particular coronary artery disease (CAD), remains an important contributor of morbidity and mortality among patients with chronic kidney disease (CKD). Classic symptomatology of CAD and effectiveness of established therapeutic measures is less frequent in patients with CKD. This suggests unique characteristics of CAD among patients with CKD. Two important features of CAD in CKD include increased calcific density of atherosclerotic plaques and of the vessels themselves (coronary artery calcification -- CAC), as well as a decrease in microcirculatory function -- or coronary microcirculatory dysfunction. A multitude of pathophysiologic pathways have been identified that contribute to CAC in CKD; less is known about the pathophysiology of microcirculatory dysfunction. It is not well established if these two processes are directly related to each other, but the combination results in a greater severity of effect on overall myocardial function and may in part explain the greater preponderance of silent myocardial infarction. Further investigation is needed to better understand these unique aspects of CAD in CKD as well as the role they play in overall CVD in this group, and ultimately therapeutics that may lessen the burden of disease.


Assuntos
Doença da Artéria Coronariana/fisiopatologia , Circulação Coronária , Vasos Coronários/fisiopatologia , Rim/fisiopatologia , Microcirculação , Insuficiência Renal Crônica/fisiopatologia , Calcificação Vascular/fisiopatologia , Animais , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/terapia , Vasos Coronários/diagnóstico por imagem , Progressão da Doença , Taxa de Filtração Glomerular , Hemodinâmica , Humanos , Placa Aterosclerótica , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/terapia , Medição de Risco , Fatores de Risco , Fatores de Tempo , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/epidemiologia , Calcificação Vascular/terapia
19.
Methodist Debakey Cardiovasc J ; 16(2): 114-121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670471

RESUMO

Coronary artery disease (CAD), also known as ischemic heart disease, is a major cause of morbidity and mortality worldwide, and timely noninvasive diagnosis of clinical and subclinical CAD is imperative to mitigate its burden on individual patients and populations. Positron emission tomography (PET) is a versatile tool that can perform relative myocardial perfusion imaging (MPI) with high accuracy; furthermore, it provides valuable information about the coronary microvasculature using rest and stress myocardial blood flow (MBF) and coronary flow reserve (CFR) measurements. Several radiotracers are approved by the US Food and Drug Administration to help with MPI, MBF, and CFR evaluation. A large body of evidence indicates that evaluation of the coronary microcirculation using MBF and CFR provides strong diagnostic and prognostic data in a multitude of patient populations. This review describes the technical aspects of PET compared to other modalities and discusses its clinical uses for diagnosis and prognosis of coronary arterial epicardial and microcirculatory disease.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Reserva Fracionada de Fluxo Miocárdico , Microcirculação , Imagem de Perfusão do Miocárdio/métodos , Tomografia por Emissão de Pósitrons , Doença da Artéria Coronariana/fisiopatologia , Humanos , Valor Preditivo dos Testes
20.
Stomatologiia (Mosk) ; 99(4): 9-14, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32692513

RESUMO

THE AIM: Of the study was to establish the relationship of hemodynamic parameters of periodontal tissues and lipid peroxidation products in adolescents with arterial hypertension (AH). METHODS: The study included 132 adolescents (average age 14.51±1.91 years), from which 2 clinical groups (1 - the group with AH without periodontal disease (n=19, average age - 15±1.53 years) and 2 - the group with AH with periodontal diseases (n=57, average age - 14.7±1.89 years)) and 2 comparison groups (3 - the comparison group without AH and periodontal diseases (n=19, average age - 13.82±1.89 years) and 4 - comparison group without AH and with periodontal diseases (n=37, mean age - 14.57±2.01 years)) were formed. Hemodynamic analysis of the periodontal microcirculatory bed using the Doppler ultrasound method and the level of lipid peroxidation products using spectrophotometric and fluorometric methods was performed. RESULTS: In adolescents with hypertension without and with inflammatory periodontal diseases as a whole, unidirectional changes in the hemodynamics of the vascular bed of the periodontium were observed in the form of increased values of the maximum blood flow velocity in systole and an increase in the peripheral resistance index. At the same time, the group with hypertension and periodontal disease was distinguished by lower values of these indicators. In the system of lipid peroxidation, increased values of ketodienes and conjugated trienes occurred in patients with hypertension without periodontal disease and end products that actively reacting with thiobarbituric acid in patients with hypertension and periodontal disease. Correlation analysis showed the presence of intersystem relationships between the hemodynamic parameters of the vascular bed of periodontal adolescents with hypertension without periodontal disease. In the group of adolescents with arterial hypertension and periodontal disease, there was a decrease in the correlation coefficients between intersystem parameters by almost two times, as well as the appearance of pathological dependencies between toxic metabolites of the lipid peroxidation process - products that actively reacting with thiobarbituric acid and vascular blood flow indicators. CONCLUSION: It has been noted that in adolescent patients with hypertension and periodontal diseases on the background of lower vascular blood flow and accumulation of end toxic metabolites, pathological dependencies occur between them, which may contribute to more intense damage to the tissues of the periodontal complex in the presence of hypertension.


Assuntos
Hipertensão , Doenças Periodontais , Adolescente , Criança , Hemodinâmica , Humanos , Peroxidação de Lipídeos , Microcirculação
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