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Les ulcères digitaux (UD) correspondent à une perte de substance de l'épiderme et du derme profond d'évolution chronique au niveau des doigts. Il s'agit d'une complication sévère et fréquente de la sclérodermie systémique. La physiopathologie des UD est complexe et peut dépendre de différents mécanismes, au sein desquels la vasculopathie joue toujours un rôle dominant. Les UD cicatrisent lentement, peuvent se compliquer et surtout récidiver. Le retentissement fonctionnel et douloureux est majeur pour les patients, d'où la nécessité d'un dépistage et d'un traitement précoces. Ils entraînent en outre un impact économique majeur et sont responsables d'une grande partie de l'invalidité liée à la sclérodermie systémique. Il est capital de cibler la population à risque d'UD pour favoriser la prévention et un traitement précoce. Pour prendre en charge un ulcère digital chez un patient sclérodermique il faut d'abord en préciser le mécanisme puis proposer la prise en charge la plus adaptée selon les circonstances. Les mesures non spécifiques peuvent être prophylactiques (limiter les traitements vasoconstricteurs, les toxiques, les traumatismes, lutter contre le froid, favoriser la rééducation), ou curatives (antalgiques et soins locaux). Plus spécifiquement, les traitements des ulcères cherchent à favoriser la vasodilatation périphérique. Différents types de médicaments seront discutés dans cette revue (inhibiteurs calciques, dérivés de la prostacycline, bosentan, sildénafil). Le traitement doit toujours être adapté au mécanisme dominant et ajusté à la tolérance et à l'évolution du patient. Il doit s'accompagner d'un suivi rapproché et multidisciplinaire. Digital ulcers (DU) are a chronically progressive loss of epidermal and deep dermal tissue in the fingers. It is a severe and frequent complication of systemic sclerosis. The pathophysiology of DU is complex and may depend on different mechanisms, in which vasculopathy always plays a dominant role. DUs heal slowly, can become complicated and above all can have recurrences. The functional and painful repercussions are major for patients, hence the need for early detection and treatment. They also have a major economic impact and are responsible for much of the disability associated with systemic sclerosis. Targeting the population at risk of DU is crucial for prevention and early treatment. The management of a digital ulcer in a scleroderma patient requires first clarifying the mechanism and then suggesting the most appropriate management according to the circumstances. Non-specific measures can be prophylactic (limit vasoconstrictor treatments, toxic substances, trauma, fight against cold, favor rehabilitation), or curative (analgesics and local care). More specifically, ulcer treatments seek to promote peripheral vasodilation. Different types of drugs will be discussed in this review (calcium channel blockers, prostacyclin derivatives, bosentan, sildenafil). Treatment must always be adapted to the dominant mechanism and adjusted to the patient's tolerance. Patients must be accompanied by close multidisciplinary monitoring. [ABSTRACT FROM AUTHOR]

Clinical manifestations of COVID-19 have changed a lot, ranging from respiratory and Ear, Nose and Throat (ENT) symptoms to extra pulmonary thrombotic, neurological, cardiac and renal complications. We here report the case of two patients with SARS-CoV-2 pneumonia whose course was marked by prolonged upper limb ischaemia. The association between venous, but also arterial, thrombotic complications and viral infection is now well established, and appears to be related to hypercoagulability. [ABSTRACT FROM AUTHOR]

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Prostate artery embolization is a new minimal invasive technic to combat benign prostate hyperplasia. This new technic also comes with new complications. In this case report, we look at four patients in whom a necrosis of the glans penis occurred after the embolization of their prostate arteries. The cause of this complication is not yet clear in all of the patients and further research is still necessary. Patients who are considering an embolization of their prostate arteries need to be informed about this complication because of the drastic aesthetic outcomes that can sometimes be seen. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Nous rapportons deux cas d'ischémies des membres inférieurs survenant après une vaccination contre la Covid-19, chez deux patients sans aucun étiologie diagnostiquée pour cette ischémie. L'infection au SRAS-CoV-2 semble impliquée, dont plusieurs mécanismes physiopathologiques vasculaires ont été décrits dans plusieurs travaux. En outre, la vaccination contre la Covid-19 apparaît comme un facteur de risque indépendant de la survenue de l'ischémie des membres inférieurs. Les D-dimères étaient élevés chez les deux patients. Un patient a subi une thrombectomie à la sonde de Fogarty ; l'autre patient a bénéficié d'une amputation de jambe d'emblée avec une bonne cicatrisation du moignon. We report two cases of ischemia of the lower limbs occurring after vaccination against Covid-19, in two patients without etiology for the ischemia. SARS-CoV-2 infection appears to be involved, for which several vascular physiopathological mechanisms have been identified in several studies. In addition, the vaccination against Covid-19 appears to be a risk of occurrence of ischemia of the lower limbs. Dimers were elevated in both patients. One patient underwent a Fogarty catheter thrombectomy; the other patient received an immediate leg amputation with good healing of the stump. [ABSTRACT FROM AUTHOR]

Copyright of Military Medical Science Letters / Vojenské zdravotnické Listy is the property of University of Defence, Faculty of Military Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There is growing attention to paradoxic embolism in association with ischemic stroke in recent times. It can be perceived as a fashion trend but inclination towards this unusual clinical unit has its fairly strong basis in accindental autopsy findings in adults, even for different reasons then association with significant arterial embolism. Current high standard of imaging methods for sure contributes in fast and accurate diagnostics but on the other hand, the knowledge of imaging methods and clinical symptoms is a need from indicating physician. [ABSTRACT FROM AUTHOR]

Résumé: L'ischémie chronique des membres inférieurs (MI) est une présentation inhabituelle de la périartérite noueuse (PAN), qui est très peu rapportée. Nous décrivons le cas d'une patiente, âgée de 25 ans, présentant une PAN révélée par une ischémie chronique des MI, aboutissant à une amputation. Chronic limb-threatening ischaemia is a rare presentation of the periarteritis nodosa (PAN). We report a case of a 25 year old patient who has a periarteritis nodosa revelead by chronic leg ischaemia. Evolution was bad, resulting in amputation. [ABSTRACT FROM AUTHOR]

Aim: Assessment of all brain MRIs in our hospital done during one-year period and finding out the frequency of each diagnosis with the image of diffusion restriction. Methods: We found 324 examinations, that shown diffusion restriction out of 6.001 brain MRIs. In those we assessed size, localisation and in ischemia the time passed from the onset of a stroke and correlation of changes on FLAIR. Results: Acute ischemia was diagnosed in 189 patients (58%), haemorrhage (mostly postoperative) in 68 (21%), tumour in 50 (15%) and other etiology in 17 patients (5%). Patients with acute ischemia and tumours were significantly older than patients in remaining groups. Conclusion: In everyday practise we encounter diffusion restriction in acute ischemia, but there are more diagnoses with these finding, and it is good to know them (list of them is in the discussion of this article). MR should be always described with the knowledge of patients' clinical status and findings on remaining MRI sequences. [ABSTRACT FROM AUTHOR]

Background - The use of stress myocardial perfusion scintigraphy, Single-photon Emission Computed Tomography (SPECT), is nowadays revived in the evaluation of patients with suspected ischemic heart disease in order to indirectly assess blood fl ow and myocardial fl ow reserve. Aim of the study - To identify clinical, electrocardiographic (ECG) and echocardiographic features associated with SPECT abnormalities in myocardial perfusion. Materials and methods - We conducted an observational, prospective study, on 17 successively enrolled patients, 58.83% men, aged 35-79 years (57.47+/-13.18 years), admitted in a cardiology clinic of an academic, general, non-coronarography capable hospital, where every resource to identify and quantify myocardial ischemia must be used. The following data was collecting: cardiovascular risk factors, myocardial ischemia on ECG, echocardiographic quantification of cardiac chamber size and left ventricular ejection fraction (LVEF) and perfusion defects on stress myocardial SPECT. Results - Perfusion defects on 99mTc-MIBI SPECT were detected on the majority of patients (76.47%) while ECG was suggestive for ischemia in only 52.94% of the total included patients. There were no significant differences on the cardiovascular risk factors between the subgroup of patients with or without defects in myocardial perfusion SPECT. Anterior wall perfusion defects have been closely and directly correlated with right ventricular telediastolic diameter (p < 0.05, r = 0.730) and indirectly with BNP level (p < 0.01, r = -0.891) and inferior vena cava diameter (p < 0.05, r = -0.651). Lateral wall perfusion defects have been closely and directly correlated with creatinkinase, CK-MB level (p < 0.01, r = 0.711; p < 0.05, r = 0.607, respectively) and left ventricular posterior wall thickness (p < 0.01, r = 0.765) and indirectly with LVEF-echo (p < 0.051, r = -0.498). Inferior wall perfusion defects have been closely and directly correlated with BNP level (p < 0.05, r = 0.735) and indirectly with smoker status (p < 0.01, r = -0.683). Conclusion - We provide an early insight into SPECT parameters versus ECG/echocardiographic in patients with IHD assessed in Northeastern Romania, revealing some clinical, ECG and echocardiographic features, opening the perspectives for a larger prospective study. [ABSTRACT FROM AUTHOR]

Résumé L'épreuve d'effort fait-elle encore partie des examens utiles dans la détection des cardiopathies à risque chez des sujets sportifs ? Doit-on continuer à l'utiliser comme examen de surveillance chez des patients sportifs coronariens ? Les méta-analyses, considérant un sous-décalage ST de plus de 1 mm comme critère de positivité, soulignent la faible prévalence d'examens anormaux et un taux important de faux-positifs. Mais pour le diagnostic de la maladie coronaire, ce sont surtout l'évolution du segment ST à l'effort ou en récupération et la survenue d'arythmies à l'effort qui permettent de détecter les vrais positifs. Lorsque le risque coronarien est plus important (présence de facteurs de risque, reprise du sport, efforts intenses et prolongés), il paraît licite de recommander un tel examen de manière régulière chez les hommes de plus de 40 ans avec deux facteurs de risque mais également chez les vétérans reprenant le sport après une période d'inactivité prolongée. Pour le sportif coronarien asymptomatique l'épreuve d'effort reste au centre de la décision finale d'autorisation de reprise d'un sport en compétition quelle que soit le mode de revascularisation. Bien sûr l'épreuve d'effort, même incontournable reste imparfaite dans le dépistage d'une coronaropathie chez le sportif asymptomatique. Elle apporte cependant d'autres renseignements à la condition d'être maximale, et d'attacher de l'importance aux arythmies, au profil tensionnel et à la puissance maximale développée en complément de la seule étude du segment ST. Abstract Is the stress test still part of the useful examinations in the detection of risk heart disease in sports subjects? Should we continue to use it as a surveillance examination in coronary sports patients? Meta-analysis, considering a ST subshift of more than 1 mm as a criterion for positivity, underline the low prevalence of abnormal examinations and a significant rate of false-positives. But for the diagnosis of coronary artery disease, it is mainly the evolution of the ST segment to effort or recovery and the occurrence of stress arrhythmias that detect true positivity. When coronary risk is more important (presence of risk factors, resumption of sport, intense and prolonged efforts), it seems lawful to recommend such a review on a regular basis among men over 40 years of age with two risk factors but Also among veterans taking up sport after a period of prolonged inactivity. For the asymptomatic coronary athlete the stress test remains at the centre of the final decision for the resumption of a sport in competition irrespective of the method of revascularization. Of course the stress test, even inevitable, remains flawed in the detection of coronary artery disease in the asymptomatic athlete. However, it provides additional information on the condition of being maximal, and attaching importance to arrhythmias, the tensional profile and the maximum power developed in addition to the ST segment's only study. [ABSTRACT FROM AUTHOR]

Three cases of bilateral paramedian thalamus ischemia consistent with the occlusion of the artery of Percheron were indentified in our department between 11/2016 and 11/2017. In the first case, it was a 48-year-old woman investigated for mild alteration of conciousness and desorientation in place and time. In the second case, it was a 51-year-old man presenting with uncousciousness and intermittent tonic-clonic seizures. In the third case, it was a 56-year-old man primary examined for subarachnoid haemorrhage (SAH) with known aneurysm at the tip of the basilar artery. Patient was treated by stenting of the left posterior cerebral artery and sac embolisation. In the last patient, mydriasis of left eye, alternating disturbance of consciousness and CT finding of bilateral medial thalamic ischemia developed on the following day after the endovascular intervention. [ABSTRACT FROM AUTHOR]

In approximately one in ten patients undergoing major non-cardiac surgery, abnormal increases in plasma levels of high sensitivity cardiac troponin occur during the first postoperative days, suggesting postoperative myocardial injury. Most of these patients have no signs or symptoms of myocardial ischaemia or infarction. Nonetheless, they are at increased risk of both 30-day and long-term all-cause mortality as well as higher incidence of major cardiovascular adverse events, comparable to type 2 postoperative myocardial infarction. The myocardial injury is deemed to result from critical imbalance of myocardial O2 demand and supply. The pathophysiology, clinical implications and prevention of this condition are reviewed, and an alternative interpretation of the mechanisms causing cardiomyocyte necrosis – inflammation – is presented. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery disease remains (CAD) a major cause of morbidity and mortality worldwide1 . However, the mortality rates of CAD have declined over the past decades, mainly due to improvements in the treatment of acute coronary syndromes, therapies for heart failure or revascularization for chronic angina2 , but also because of awareness-raising and prevention strategies. [ABSTRACT FROM AUTHOR]

Peripheral artery disease is a severe medical condition commonly characterized by critical or acute limb ischemia. Gradual accumulation of thrombotic plaques in peripheral arteries of the lower limb may lead to intermittent claudication or ischemia in muscle tissue. Ischemic muscle tissue with lesions may become infected, resulting in a non-healing wound. Stable progression of the non-healing wound associated with severe ischemia might lead to functional deterioration of the limb, which, depending on the severity, can result in amputation. Immediate rescue of ischemic muscles through revascularization strategies is considered the gold standard to treat critical limb ischemia. Growth factors offer multiple levels of protection in revascularization of ischemic tissue. In this review, the basic mechanism through which growth factors exert their beneficial properties to rescue the ischemic limb is extensively discussed. Moreover, clinical trials based on growth factor and stem cell therapy to treat critical limb ischemia are considered. The clinical utility of stem cell therapy for the treatment of limb ischemia is explained and recent advances in nanocarrier technology for selective growth factor and stem cell supplementation are summarized. [ABSTRACT FROM AUTHOR]

Irradiation of normal tissues leads to acute increase in reactive oxygen/nitrogen species that serve as intra- and inter-cellular signaling to alter cell and tissue function. In the case of chest irradiation, it can affect the heart, blood vessels, and lungs, with consequent tissue remodelation and adverse side effects and symptoms. This complex process is orchestrated by a large number of interacting molecular signals, including cytokines, chemokines, and growth factors. Inflammation, endothelial cell dysfunction, thrombogenesis, organ dysfunction, and ultimate failing of the heart occur as a pathological entity - 'radiation-induced heart disease' (RIHD) that is major source of morbidity and mortality. The purpose of this review is to bring insights into the basic mechanisms of RIHD that may lead to the identification of targets for intervention in the radiotherapy side effect. Studies of authors also provide knowledge about how to select targeted drugs or biological molecules to modify the progression of radiation damage in the heart. New prospective studies are needed to validate that assessed factors and changes are useful as early markers of cardiac damage. [ABSTRACT FROM AUTHOR]

Résumé But de l’étude La sténose des artères carotides augmente avec l’âge et peut précipiter une ischémie cérébrale pendant une hypotension artérielle. Dans une étude pilote monocentrique, nous avons investigué sa prévalence à l’âge avancé et évalué son influence sur le but tensionnel et le traitement antihypertensif. Patients et méthodes Tous les patients âgés de ≥ 90 ans de l’unité médicale d’un hôpital de soins primaires ont été étudiés prospectivement pendant 15 mois à l’exception de cas avec choc circulatoire et les réadmissions. L’examen ultrasonographique des artères précérébrales a été offert à tous les patients âgés. Ont été analysées la fréquence des sténoses de l’artère carotide commune, interne et externe (ACC, ACI, ACE), la pression artérielle (PA) et les médicaments antihypertenseurs. Résultats Soixante-trois patients (92 ± 3 ans, 78 % femmes) avec une hospitalisation médiane de 11 jours ont été inclus. À l’admission, 76 % avaient des antihypertenseurs et 86 % à la sortie. La PA moyenne était à 149/77 (admission) comparé à 129/72 mmHg (sortie) ; systolique < 140 mmHg 36 % et 64 % ( p < 0,05). L’épaisseur intima-média moyen (ACC) était 8,7/9,4 mm (droite/gauche). Une plaque ou sténose < 60 % était présente (ACC/ICA/ECA) chez 19,0/19,0/31,7 % (bifurcation 74,6 %) et une sténose ≥ 60 % chez 0/7,9/19,0 % (ACI bilatérale 1,6 % ; occlusion unilatérale 3,1 %). La probabilité d’une PA systolique < 120 mmHg coïncidant avec une sténose significative de l’ACI était 1–2 %. Conclusion Concernant le risque d’ischémie cérébrale par une sténose carotidienne, un objectif tensionnel < 140 mmHg semble tolérable pour la plupart des nonagénaires. La recherche d’une sténose significative pourrait être utile si l’objectif tensionnel était plus bas. Aim Carotid artery stenosis increases with age and may cause brain ischemia if arterial hypotension occurs. We performed a monocentric pilot study to investigate its prevalence in the very elderly and to assess its potential influence on blood pressure (BP) goals during antihypertensive treatment. Methods All patients ≥ 90 years of a primary care medical ward were prospectively included over 15 months. Ultrasound exams of the precerebral arteries were offered to all elderly patients for routine evaluation of their cardiovascular risk. Frequencies of stenosed common, internal and external carotid arteries (CCA, ICA, ECA) were analyzed together with clinical BP and antihypertensive therapy. Patients with circulatory shock and readmissions were excluded. Results Sixty-three patients aged 92 ± 3 years (78% female) hospitalized for a median of 11 days were included. On admission, 76% were on antihypertensive drugs vs. 86% at discharge. Mean admission BP was 149/77 vs. 129/72 mmHg at discharge; systolic BP < 140 mmHg 36% vs 64% ( P < 0.05). Mean intima-media thickness (ACC, right/left) was 8.7/9.4 mm. Prevalence of plaque or stenosis < 60% was: CCA 19.0%, ICA 19.0%, ECA 31.7%, bulb 74.6%; of stenosis ≥ 60%: CCA 0%, ICA 7.9%, ECA 19.0%, ICA bilateral 1.6% (unilateral occlusion 3.1%, no bilateral). Coincidence of systolic BP < 120 mmHg and ACI stenosis ≥ 60% had a probability of 1–2%. Conclusion Concerning the risk of brain ischemia due to carotid artery stenosis, a BP goal < 140 mmHg should be safe for most nonagenarians. If individual BP goals are lower, searching for significant stenosis by ultrasound may be useful. [ABSTRACT FROM AUTHOR]

In premenopausal women, ovarian steroids are felt to play a role in the prevention of cardiovascular disease. We aimed to assess whether menstrual cycle variations in estrogen can modify the response to ischemia-reperfusion (IR) injury in humans. In an investigator-blinded crossover study, 10 healthy premenopausal women with regular menstrual cycles were studied. They had flow-mediated dilatation (FMD) measured by ultrasound in the radial artery before and after IR (15 min of brachial artery ischemia, 15 min of reperfusion) during both the early and late follicular phases of the menstrual cycle. The order of these visits was not randomized. IR significantly blunted FMD in the early follicular phase (pre-IR: 7.1% ± 1.0%; post-IR: 3.6% ± 1.0%, P = 0.01) when estradiol levels were low (148.4 ± 19.8 pmol/L). Conversely, FMD was preserved after IR during the late follicular phase (pre-IR: 7.2% ± 0.9%; post-IR: 7.0% ± 0.8%, P = NS, P = 0.03 compared with early follicular) when estradiol levels were high (825.7 ± 85.8 pmol/L, P < 0.001 compared with early follicular). There was a significant inverse relationship between estradiol concentration and IR-induced endothelial dysfunction (i.e., change in FMD after IR) ( r = 0.59, r2 = 0.36, P < 0.01). These findings demonstrate, for the first time in humans, a clear relationship between the cyclical changes in serum concentrations of estradiol and the endothelium's response to IR. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Minocycline belongs to the family of tetracyclines, which are drugs traditionally approved as antibiotics. Based on preclinical animal cardiac models and clinical neurology trials, this drug has gained special attention as a promising cardiovascular therapeutic agent given its anti-inflammatory, antiapoptotic, antioxidant, and antienzymatic properties. This review focuses on the available evidence for minocycline as a cardioprotective drug, with special attention to mechanisms of action. Ongoing cardiovascular clinical trials are briefly discussed. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Physiology & Pharmacology is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The objective of this literature review was to summarize clinical and experimental evidence of the renal responses to warm and cold ischemia. The study compared different surgical procedures and options for dealing with renal ischemia during partial nephrectomy. The article is a summary of the current literature data. Results: There are three main mechanisms of ischemic renal injury -- vascular, persistent vasoconstriction with an abnormal endothelial cell compensatory response, and tubular obstruction, with backflow of urine, and injury due to reperfusion. Controversy regarding the maximal kidney tolerability to warm ischemia continues. This communication summarizes literary data regarding available surgical techniques used to diminish the effects of warm ischemia. Conclusion: If ischemia is required, the tumour should be removed within 25 minutes of warm ischemia, regardless of the surgical approach. If this longer time of resection is expected, we have to start immediately with cold ischemia. Cold ischemia, depending on the cooling method, can be tolerated for up to 2 hours (autotransplantation). The cold ischemia technique includes in situ cold arterial perfusion, ice slush placed around the kidney, retrograde caliceal perfusion or ex situ cold arterial perfusion with autotransplantation. The technique depends on preoperative findings, surgical technique (open, laparoscopic or robotic) and institutional experience. [ABSTRACT FROM AUTHOR]

Although radial artery cannulation is a common procedure, in rare cases, it can cause thrombosis leading to severe ischemia of the hand and potentially subsequent gangrene resulting in tissue loss. In this case report, a patient who developed a severely ischemic left hand subsequent to radial artery cannulation is presented. Doppler ultrasound studies showed adequate flow in the patient's hand, however complete thrombosis of the radial artery and significant low flow of the ulnar artery were found using arterial angiogram. The ischemia progressed and surgical intervention to revascularize the hand was unsuccessful, which led to the ultimate amputation of the patient's hand. In cases such as these, where Doppler ultrasound findings show flow but the hand ischemia continues to progress, further diagnostic studies and surgical intervention should be performed as soon as possible to minimize the amount of tissue loss. [ABSTRACT FROM AUTHOR]

Decreased oxygen availability impairs cellular energy production and, without a coordinated and matched decrease in energy consumption, cellular and whole organism death rapidly ensues. Of particular interest are mechanisms that protect brain from low oxygen injury, as this organ is not only the most sensitive to hypoxia, but must also remain active and functional during low oxygen stress. As a result of natural selective pressures, some species have evolved molecular and physiological mechanisms to tolerate prolonged hypoxia with no apparent detriment. Among these mechanisms are a handful of responses that are essential for hypoxia tolerance, including ( i) sensors that detect changes in oxygen availability and initiate protective responses; ( ii) mechanisms of energy conservation; ( iii) maintenance of basic brain function; and ( iv) avoidance of catastrophic cell death cascades. As the study of hypoxia-tolerant brain progresses, it is becoming increasingly apparent that mitochondria play a central role in regulating all of these critical mechanisms. Furthermore, modulation of mitochondrial function to mimic endogenous neuroprotective mechanisms found in hypoxia-tolerant species confers protection against otherwise lethal hypoxic stresses in hypoxia-intolerant organs and organisms. Therefore, lessons gleaned from the investigation of endogenous mechanisms of hypoxia tolerance in hypoxia-tolerant organisms may provide insight into clinical pathologies related to low oxygen stress. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Zoology is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: This review outlines the skin, vascular and musculoskeletal symptoms affecting the hand during systemic inflammatory diseases other than rheumatoid arthritis. Skin lesions are diagnosed clinically and their symptomatology is documented through an extensive series of photographs. These conditions may require specific care before a surgical procedure can be performed. Vascular lesions are also diagnosed clinically and their symptomatology is described in detail. It is important to recognize that acrocyanosis is always benign. The surgeon should be able to distinguish between primary, but benign Raynaud's disease and secondary Raynaud's syndrome, which has a high risk of finger necrosis. Current preventative and curative treatments for finger necrosis are described. The clinical, radiological, progressive and therapeutic features of musculoskeletal lesions are reviewed, namely those associated with psoriatic arthritis, systemic sclerosis and lupus. [Copyright &y& Elsevier]

Les complications thromboemboliques associées à l´infection par less than i greater than Mycobacterium tuberculosis less than/i greater than ont été rapportées dans la littérature et ont eu lieu dans 1,5 à 3,4% de l´infection tuberculeuse. Nous rapportons le cas dune fill'ette âgée de 4ans suivie pour spondylodiscite tuberculeuse, admise dans notre formation pour prise en charge d'une ischémie aigue des deux membres inférieurs consommée, ayant nécessité une amputation trans-tibiale d'un coté et trans-fémorale du coté contro-latéral. Nous discutons les aspects cliniques, physiopathologiques et le lien de causalité.

Résumé: L'ischémie critique est le stade ultime de l'évolution de l'artériopathie des membres inférieurs (AOMI) ; les alternatives thérapeutiques chirurgicales épuisées, il reste peu d'options et l'évolution est alors rapidement très péjorative, surtout chez le patient diabétique. Pour ces raisons, l'AOMI est l'une des maladies qui font l'objet de nombreux essais de thérapie génique et cellulaire visant à améliorer la perfusion des extrémités des membres inférieurs. Dans cette revue, nous évoquons les différents essais de thérapie génique qui ont été menés et, pour l'essentiel abandonnés pour des raisons d'effets secondaires et de risques majeurs. Les différents types de cellules souches utilisés pour les thérapies cellulaires des AOMI sont ensuite évoqués : cellules progénitrices endothéliales (CPE) précoces ou tardives, préconditionnées ou non ; cellules souches mésenchymateuses, cellules souches embryonnaires (CSE) et cellules souches pluripotentes induites (induced pluripotent stem cells [iPS]) humaines. Les problèmes de caractérisation et d'utilisation de ces cellules sont abordés et les résultats obtenus dans les principaux essais cliniques disponibles sont rapportés. [ABSTRACT FROM AUTHOR]

Repeated cycles of vascular occlusion followed by reperfusion initiate a protective mechanism that acts to mitigate future cell injury. Such ischemic episodes are known to improve vasodilation, oxygen utilization, muscle function, and have been demonstrated to enhance exercise performance. Thus, the use of occlusion cuffs represents a novel intervention that may improve subsequent exercise performance. Fourteen participants performed an exercise protocol that involved lower-body strength and power tests followed by repeated sprints. Occlusion cuffs were then applied unilaterally (2 × 3-min per leg) with a pressure of either 220 (intervention) or 15 mm Hg (control). Participants immediately repeated the exercise protocol, and then again 24 h later. The intervention elicited delayed beneficial effects (24 h post-intervention) in the countermovement jump test with concentric (effect size (ES) = 0.36) and eccentric (ES = 0.26) velocity recovering more rapidly compared with the control. There were also small beneficial effects on 10- and 40-m sprint times. In the squat jump test there were delayed beneficial effects of occlusion on eccentric power (ES = 1.38), acceleration (ES = 1.24), and an immediate positive effect on jump height (ES = 0.61). Thus, specific beneficial effects on recovery of power production and sprint performance were observed both immediately and 24 h after intermittent unilateral occlusion was applied to each leg. [ABSTRACT FROM AUTHOR]

Dexrazoxane (DEX), an inhibitor of topoisomerase II and intracellular iron chelator, is believed to reduce the formation of reactive oxygen species (ROS) and protects the heart from the toxicity of anthracycline antineoplastics. As ROS also play a role in the pathogenesis of cardiac ischaemia/reperfusion (I/R) injury, the aim was to find out whether DEX can improve cardiac ischaemic tolerance. DEX in a dose of 50, 150, or 450 mg·(kg body mass)-1 was administered intravenously to rats 60 min before ischaemia. Myocardial infarct size and ventricular arrhythmias were assessed in anaesthetized open-chest animals subjected to 20 min coronary artery occlusion and 3 h reperfusion. Arrhythmias induced by I/R were also assessed in isolated perfused hearts. Only the highest dose of DEX significantly reduced infarct size from 53.9% ± 4.7% of the area at risk in controls to 37.5% ± 4.3% without affecting the myocardial markers of oxidative stress. On the other hand, the significant protective effect against reperfusion arrhythmias occurred only in perfused hearts with the dose of DEX of 150 mg·kg-1, which also tended to limit the incidence of ischaemic arrhythmias. It is concluded that DEX in a narrow dose range can suppress arrhythmias in isolated hearts subjected to I/R, while a higher dose is needed to limit myocardial infarct size in open-chest rats. [ABSTRACT FROM AUTHOR]

The article offers information on a study on the blood-brain barrier (BBB), and its dysfunction during ischaemia. It informs that pharmacological thrombolysis is the only therapy for brain ischaemic stroke and is limited to a small percentage of the admitted patients since thrombolytics have toxical effects. It also informs that since promising neuroprotectants could not satisfy the clinical trials, the study had to be conducted with physiopathological and pharmacological approaches.

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