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Distal Hypoperfusion Ischemic Syndrome in a Patient With End-Stage Renal Disease.
Cureus
November 2024
Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA.
Distal hypoperfusion ischemic syndrome (DHIS), also known as dialysis access steal syndrome (DASS), is a rare but significant complication in patients with end-stage renal disease (ESRD) undergoing hemodialysis through arteriovenous fistulas (AVFs). This case report presents a female patient in her 40s with a complex medical history, including peripheral arterial disease, coronary artery disease, and recurrent cellulitis affecting her right hand, who developed DHIS following the placement of a brachiobasilic AVF. Despite optimal medical management, the patient exhibited persistent ischemic symptoms, including hand coolness and necrosis, ultimately requiring surgical ligation of the AVF.
View Article and Find Full Text PDFA retrospective review of sildenafil in the Australia and New Zealand Fontan registry: indications and treatment responses.
Int J Cardiol Congenit Heart Dis
June 2024
University of Sydney, Sydney, Australia.
Introduction: Rates of morbidity and mortality are high in the setting of Fontan physiology and effective medical therapies are not well-established. Clinical trials assessing phosophodiesterase-5-inhibitors, such as sildenafil, have not demonstrated major benefit in patients with a Fontan-type circulation but have only included stable, well-functioning people.
Methods: We sought to retrospectively characterize the people followed by the ANZ Fontan Registry prescribed sildenafil >30 days post Fontan-surgery.
A Case of Pulmonary Arteriovenous Shunt Diagnosed by Microbubble Test via a Swan-Ganz Catheter.
Cureus
December 2024
Department of Cardiology, Japanese Red Cross Maebashi Hospital, Maebashi, JPN.
When encountering severe hypoxemia that does not respond to oxygen supplementation, it is essential to consider underlying right-to-left shunting. Among various diagnostic approaches, the microbubble test via transthoracic echocardiography (TTE) is a simple, noninvasive method for detecting pulmonary arteriovenous shunts, particularly in hepatopulmonary syndrome (HPS). Although microbubbles are usually administered peripherally, using a Swan-Ganz (SG) catheter to inject microbubbles directly into the pulmonary artery may provide even more definitive diagnostic information.
View Article and Find Full Text PDFDifferent sensitivities of porcine coronary arteries and veins to BAY 60-2770, a soluble guanylate cyclase activator.
J Pharmacol Sci
January 2025
Department of Pathological and Molecular Pharmacology, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-1094, Japan.
Nitric oxide (NO)-donor drugs, which stimulate reduced form of soluble guanylate cyclase (sGC), have different efficacy to the arteries and veins. This study examined whether sGC activators, which activate oxidized/apo sGC, also have arteriovenous selectivity similar to that of NO-donor drugs. The mechanical responses of the isolated blood vessels were assessed using the organ chamber technique and protein expression was verified using western blotting.
View Article and Find Full Text PDFInterplay between Netrin-1 and Norrin controls arteriovenous zonation of blood-retina barrier integrity.
Proc Natl Acad Sci U S A
December 2024
Paris Cardiovascular Research Center, Université Paris Cité, Inserm U970, Paris F-75015, France.
The integrity of the blood-retina barrier (BRB) is crucial for phototransduction and vision, by tightly restricting transport of molecules between the blood and surrounding neuronal cells. Breakdown of the BRB leads to the development of retinal diseases. Here, we show that Netrin-1/Unc5b and Norrin/Lrp5 signaling establish a zonated endothelial cell gene expression program that controls BRB integrity.
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