Clinical Hemorheology and Microcirculation - Volume 68, issue 4
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Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research.
The endeavour of the Editors-in-Chief and publishers of
Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of
Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process.
Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.
The following professionals and institutions will benefit most from subscribing to
Clinical Hemorheology and Microcirculation: medical practitioners in all fields including hematology, cardiology, geriatrics, angiology, surgery, obstetrics and gynecology, ophthalmology, otology, and neurology. Pharmacologists, clinical laboratories, blood transfusion centres, manufacturing firms producing diagnostic instruments, and the pharmaceutical industry will also benefit.
Important new topics will increasingly claim more pages of
Clinical Hemorheology and Microcirculation: the role of hemorheological and microcirculatory disturbances for epidemiology and prognosis, in particular regarding cardiovascular disorders, as well as its significance in the field of geriatrics. Authors and readers are invited to contact the editors for specific information or to make suggestions.
Abstract: Rheological blood parameters of neonates are different form those of adults. Many authors have studied changes in blood rheology in neonates in different clinical disorders. To-date, no one set the normal values for blood rheological parameters in healthy neonates. The aim of this study is to set the norm for rheological blood parameters in healthy newborns and to describe the changes in those parameters in common clinical disorders that affect the newborns. We recruited all the neonates born to mothers experiencing un eventful pregnancies, blood was taken from the umbilical cord right after the delivery. In this time period we…recruited 4985 neonate. From this huge database we were able to set the standards for blood rheology in neonates, namely plasma viscosity of 1.06±0.072 mPa, erythrocyte aggregation at stasis of 2.41±2.74 s-1 and erythrocyte aggregation under low shear forces of 8.51±6.38 s-1 . These values changed significantly in some diseased neonates. This is the largest study investigating normal rheological parameters and deviations from the norm in common clinical disorders occurring in this early stage of life.
Abstract: INTRODUCTION: Although microcirculation dysfunction plays unique role in septic shock, translation of microcirculation to clinical practices is limited by current semi-quantities analysis and unclear clinical relevance of microcirculation monitoring. Our aim was to critically evaluate the characteristic nature and relevant clinical important of microcirculation. EVIDENCE ACQUISITION: Pubmed (2000 to August 2015) were searched to identify observation, case-control, intervention and randomized clinical studies evaluating the relationship between microcirculation alterations and mortality, morbidity and drug responses. The STROBE and CONSORT Statement for assessment of the quality of included studies. EVIDENCE SYNTHESIS: We examined results from 17 observations, 4…randomized controlled trials and one case report published studies. This data set comprised of 637 patients. Early septic shock is associated with hypoperfusion and heterogeneous microcirculation that is associated with hyperlactemia and metabolic acidosis. The evidence on clinical relevance of microcirculation is less striking, mainly due to the limited number of studies and problems related to the methodological protocol of the studies and currently semi-quantitative analysis technique. In particular the baseline and time course of microcirculation alteration appears to be controversial. CONCLUSION: There is lack of evidences of clinical importance of early microcirculation monitoring and mechanism of microcirculation dysfunction in septic shock patients. This could be due to the methodological protocol of the studies and currently semi-quantitative analysis technique.
Keywords: Septic shock, tissue perfusion, organ dysfunction, drug response, hemodynamic
Abstract: BACKGROUND: Veterans with Gulf War Illness (GWI) experience chronic symptoms that include fatigue, pain, and cognitive impairment. This symptom cluster may be the consequence of impaired tissue oxygen delivery due to red blood cell (RBC) dysfunction. OBJECTIVE: The purpose of this preliminary study was to determine whether the microrheological behavior of RBCs is altered in GWI. METHODS: We recruited 17 cases of GWI (GWI+) and 10 age matched controls (GWI–), and examined RBC deformability and aggregation via ektacytometry along with measurement of complete blood counts. RESULTS: RBCs were more deformable in GWI+, as indicated…by higher elongation indices particularly at higher shear stress values (5.33, 9.49, and 16.89) when compared to GWI–. Aggregation formation, stability and kinetics were similar between GWI+and GWI–. Complete blood counts were also similar, with the exception of mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and RBC distribution width (RDW) which was elevated in GWI+. CONCLUSIONS: In this preliminary study, we observed increased deformability along with increased MCH, MCHC and RDW in veterans with GWI+, which may contribute to the symptomatology of GWI. Further research is required to confirm our findings and the role of RBC microrheology in GWI.
Keywords: Persian Gulf Syndrome, hemorheology, rheology, fatigue, blood cell count
Abstract: BACKGROUND: Chronic venous disease of the lower limbs is a common public health problem worldwide with negative impact on quality of life and results with drugs used to treat it are sparse, probably due to lack of good experimental models. OBJECTIVE: In this investigation we have tested the effects of two commonly used venotonic substances, Ruscus extract and micronized diosmine, on the microcirculation in vivo . METHODS: These substances were given orally, by gavage, during two weeks, twice daily and observations were made using the hamster cheek pouch preparation. RESULTS: The drugs elicited…a dose-dependent inhibition of (1) macromolecular permeability increase induced by histamine or ischemia followed by reperfusion, being the Ruscus extract more active on both and (2) leukocyte-endothelium interaction, again being the Ruscus extract more effective in the inhibition of the number of adherent and rolling leukocytes. About the duration of the effect after the end of the treatment, both drugs had similar effects but Ruscus extract showed greater permanence of its effect on all observed parameters. CONCLUSIONS: Our results suggest that both drugs have antioxidant and anti-inflammatory properties being Ruscus extract more active. It should be added that only Ruscus extract showed a significant venular constriction.
Abstract: It is proposed that the specific reversal by serum albumin of the erythrocyte echinocytosis in an inorganic phosphate buffer saline or in a saline, either after 24 h in blood or after a storage of 6-7 weeks in SGAM or PAGGSM media, is due to a cell dehydration by a decrease of the total NaCl and KCl concentrations favoring the stomatocytogenic slow outward transport of inorganic phosphate with a hydrogen ion by band 3 anion exchanger, which was previously proposed to control the erythrocyte shape. This proposal would indicate that the opposition of the erythrocyte echinocytosis by serum albumin is not…limited to binding to echinocytogenic amphiphiles, supported by the ability of the band 3-based mechanism of control of the erythrocyte shape to explain a variety of observations on the erythrocyte shape. It would also imply that this mechanism is a determinant of the erythrocyte rheological properties since influenced by cell shape and volume. It is shown that the above process of stomatocytosis can explain stomatocytoses by different agents as well as a knizocytosis induced in vitro and occurring in acquired and inherited disorders and other situations. Lastly, it can also explain the opposition of hemolysis by mannitol in SGAM and PAGGSM media.
Keywords: Band 3, echinocytosis, erythrocyte, serum albumin, stomatocytosis
Abstract: BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with thrombotic events due to platelets’ defects. OBJECTIVE: The aim of this study was to investigate the effects of endurance training on expressions of platelet hsa-miR-223 and P2RY12 receptor, as well as platelet function in T2DM patients. METHODS: Twenty female T2DM patients (age, 62.25±3.81 yr; weight, 73.53±9.04 kg; height, 154.7±4.3 cm) were randomly divided into two groups (Control (CONT) and endurance training (ET)). Subjects in ET group performed eight weeks of running on treadmill at 60–75% of VO2 peak (moderate intensity), 3 sessions per week, while, the subjects in…control group were not involved in any kind of exercise training. Two blood samples were taken before and 48 h after the training and were analyzed for platelet aggregation, and hsa-miR-223 and P2RY12 expressions. RESULTS: Although platelet aggregation decreased significantly in ET group (P < 0.05), these changes were not significantly different between two groups. Expression of platelet hsa-miR-223 increased and P2RY12 mRNA reduced following ET non-significantly. However, decreases in fasting blood glucose, glycated hemoglobin and body weight, and increases in VO2 peak following ET were significantly different when compared to control group (P < 0.05). CONCLUSIONS: Short-term endurance training dose not induce up-regulation of hsa-miR-223 and down-regulation of P2RY12, while it has a positive impact on platelet function, glycemic indices, physical fitness and body composition in female T2DM patients.
Abstract: OBJECTIVES: This study aimed to describe the computed tomography (CT), magnetic resonance imaging (MRI) imaging features of adrenal schwannoma and to correlate imaging findings with histopathologic findings. METHODS: The findings from multiphase CT or MRI examinations of seventeen patients with histopathologically confirmed adrenal schwannoma were reviewed. The imaging criteria included shape, size, margin, attenuation, signal intensity, secondary degeneration, and internal mass enhancement pattern. RESULTS: All cases were unilateral, round or oval solitary tumors, with diameters ranging from approximately 2.5 to 8.8 cm (median = 4.5 cm). Of the twelve cases assessed using CT, adrenal schwannoma appeared as well-circumscribed round or…oval low-density suprarenal masses with a mean attenuation values of 30.1 HU of solid portions during unenhanced phase. Ten cases exhibited heterogeneous cyst formation, and one case showed calcification. Internal septa were noted in 5 cases. All solid areas displayed early mild heterogeneous enhancement and delayed progressive enhancement. Regarding MRI, solid portions of five masses were hypointense to the liver parenchyma on T1-weighted imaging (T1WI) and were heterogeneously hyperintense on T2-weighted imaging (T2WI). The enhanced pattern of solid areas of adrenal schwannoma on MRI is similar to that of CT. Cystic or hemorrhagic changes were noted in 4 cases and internal septa were noted in 3 cases. CONCLUSION: Although schwannoma is a rare entity in the adrenal gland, we believe that the following signs may suggest the diagnosis of this entity: a non-lipid containing mass, a well-defined border, a unilateral mass with cystic or hemorrhagic degeneration, septa with delayed enhancement and a characteristic progressive contrast enhancement pattern of the solid portions.
Abstract: BACKGROUND: In the absence of trauma, hematologic disease and anti-platelet use, no attention has been paid to elucidate the mechanism of ecchymosis. It has taken our attention that ecchymosis on lower limb might be a sign of varicose vein. Accordingly, we aimed to analyze and describe the frequency of leg symptoms and presence of ecchymosis in patients with varicose vein. MATERIALS AND METHODS: Four hundred and ninety four patients who had been diagnosed as having varicose vein or chronic venous insufficiency either by clinical examination or Doppler ultrasonography were included in the study. Leg symptoms were defined as…pain, itching, muscle cramps, throbbing, and swelling. Ulcers, pigmentations and ecchymosis were recorded as signs of varicose vein. Ecchymosis was defined as a hemorrhagic lesions, larger than >3 mm on the skin of lower extremities, forming a flat, rounded or irregular, blue or purplish patch. RESULTS: Leg pain was the most common symptom in our study population. Ecchymosis was observed in 24 patients (5%). Logistic regression analysis showed that ecchymosis was significantly and positively associated with muscle cramps (Odds ratio: 5.82, p = 0.001) and female gender (Odds ratio: 5.17 p = 0,019 but negatively associated with age (Odds ratio: 0.94, p = 0.004). CONCLUSION: We have documented for the first time that the frequency of ecchymosis and its association with muscle cramps in a relatively large patient population with peripheral varicose vein or chronic venous insufficiency. Ecchymosis on lower limbs should be considered as a novel sign of varicose vein.
Keywords: Ecchymosis, varicose vein, muscle cramps, venous leg symptoms