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1
Kornerup, Tore. "CAPILLARY FRAGILITY AND DIABETIC RETINOPATHY." Acta Ophthalmologica 33, no. 5 (2009): 583–98. http://dx.doi.org/10.1111/j.1755-3768.1955.tb03332.x.
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Forster, PJG, and AD Wright. "Capillary Fragility at High Altitude." Clinical Science 75, s19 (1988): 14P. http://dx.doi.org/10.1042/cs075014pc.
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3
West, John B. "Fragility of pulmonary capillaries." Journal of Applied Physiology 115, no. 1 (2013): 1–15. http://dx.doi.org/10.1152/japplphysiol.00229.2013.
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Although the pulmonary capillaries were discovered in 1661, the ultrastructure of the wall was not elucidated until 60 years ago. Electron micrographs then showed that only 0.2 μm of tissue separated the capillary endothelium from the alveolar space over much of the area. In retrospect this vanishingly small protective layer should have alerted physiologists to the potential fragility of the capillaries, but this was not appreciated until almost 40 years later. This predicament is unique to pulmonary capillaries. No other capillaries in the body are shielded from the outside environment by such a minute amount of tissue. Reasons why the fragility of the capillaries was not recognized earlier include an inappropriate comparison with the properties of systemic capillaries, the mistaken view that the pulmonary capillary pressure is always low, and a misleading use of the Laplace equation. Evidence for the fragility comes from physiological, pathological, and laboratory observations. As expected from evolutionary considerations, the fragility only becomes evident in the normal lung under exceptional conditions. These include elite human athletes at maximal exercise and animals that have developed the capacity for extreme aerobic activity. However, lung and heart diseases frequently cause capillary disruption. Remodeling of pulmonary capillaries occurs in humans in whom the capillary pressure rises over a long period. Neonatal capillaries are extremely fragile, presumably because they have never been exposed to increased transmural pressures. The capillaries conform to the general biological rule that tissue adapts its structure to carry out its required function.
4
Hunter, D. J., J. R. Smart, and L. Whitton. "Increased capillary fragility at high altitude." BMJ 292, no. 6513 (1986): 98. http://dx.doi.org/10.1136/bmj.292.6513.98.
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5
Kulkarni, Shradha A., Evan Strobelt, and Zaven Sargsyan. "Capillary Fragility in Zika Virus Infection." American Journal of Medicine 130, no. 2 (2017): e59. http://dx.doi.org/10.1016/j.amjmed.2016.10.008.
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6
Feinstein, A. R. "Tourniquet test for capillary fragility in diabetes." JAMA: The Journal of the American Medical Association 255, no. 3 (1986): 323b—323. http://dx.doi.org/10.1001/jama.255.3.323b.
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7
Feinstein, A. R. "Tourniquet Test for Capillary Fragility in Diabetes." JAMA: The Journal of the American Medical Association 255, no. 3 (1986): 323. http://dx.doi.org/10.1001/jama.1986.03370030041014.
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8
Wienert, Volker. "Efficacy of aescin on the capillary fragility in men." International Journal of Angiology 6, no. 02 (2011): 115–17. http://dx.doi.org/10.1007/bf01616680.
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9
Wiwanikit, Viroj. "Capillary Fragility, Zika Virus Infection, and Basic Screening Test." American Journal of Medicine 130, no. 6 (2017): e277. http://dx.doi.org/10.1016/j.amjmed.2017.01.047.
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de Godoy, Lívia Maria Pereira, Ana Carolina Pereira de Godoy, Henrique Jose Pereira de Godoy, and Jose Maria Pereira de Godoy. "Control of ochre dermatitis with aminaphtone in an adolescent." Our Dermatology Online 14, no. 3 (2023): 301–3. http://dx.doi.org/10.7241/ourd.20233.15.
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The aim of this manuscript is to report the case of a 22-year-old adolescent who presented with brownish patches on the skin of her lower legs persistent since the age of eleven years. She was treated by a dermatologist since the age of twelve years with a clinical diagnosis of ochre dermatitis confirmed by a biopsy. The patient was treated for two years without a success and was sent to a vascular surgeon at fourteen years of age. The diagnosis was confirmed, and the venous duplex scan discarded the possibility of a macrocirculation abnormality. The patient was treated with aminaphtone with the normalization of the skin for two years, after which the patches returned and were controlled again with the same medication. As ochre dermatitis may be associated with capillary fragility, the use of aminaphtone is a therapeutic option. Key words: Ochre Dermatitis; Hyperpigmentation; Capillary Fragility; Aminaphtone; Adolescent
11
Kitchens, CS, and JF Pendergast. "Human thrombocytopenia is associated with structural abnormalities of the endothelium that are ameliorated by glucocorticosteroid administration." Blood 67, no. 1 (1986): 203–6. http://dx.doi.org/10.1182/blood.v67.1.203.203.
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Abstract Capillary fragility is characteristic of severe thrombocytopenia. This mechanical weakness may not be solely accounted for by decreased ability of platelets to repair endothelial breaks. Platelets may have a role in maintaining endothelial hemostasis. This laboratory has demonstrated thinning of capillary endothelium in experimental thrombocytopenia. We now report similar findings in human thrombocytopenia. Capillary endothelium supplying either skin or skeletal muscle was found to have a mean thickness only half that of normal as well as frequent very thinned areas, including some fenestrations. All findings reverted toward normal after four days of prednisone administration at a time the degree of thrombocytopenia was equally severe. These findings are consistent with the hypothesis that platelets are necessary for normal structure and function of endothelial cells and that glucocorticosteroid administration may ameliorate the pathophysiology of thrombocytopenia.
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Kitchens, CS, and JF Pendergast. "Human thrombocytopenia is associated with structural abnormalities of the endothelium that are ameliorated by glucocorticosteroid administration." Blood 67, no. 1 (1986): 203–6. http://dx.doi.org/10.1182/blood.v67.1.203.bloodjournal671203.
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Capillary fragility is characteristic of severe thrombocytopenia. This mechanical weakness may not be solely accounted for by decreased ability of platelets to repair endothelial breaks. Platelets may have a role in maintaining endothelial hemostasis. This laboratory has demonstrated thinning of capillary endothelium in experimental thrombocytopenia. We now report similar findings in human thrombocytopenia. Capillary endothelium supplying either skin or skeletal muscle was found to have a mean thickness only half that of normal as well as frequent very thinned areas, including some fenestrations. All findings reverted toward normal after four days of prednisone administration at a time the degree of thrombocytopenia was equally severe. These findings are consistent with the hypothesis that platelets are necessary for normal structure and function of endothelial cells and that glucocorticosteroid administration may ameliorate the pathophysiology of thrombocytopenia.
13
Cantero, A., and L. C. Simard. "A Study of the Tumor Necrotizing Effects with S. Marcenscens Polysaccharide in Mice Transplanted Sarcomas (S-37)." Revista Brasileira de Cancerologia 4, no. 7 (2023): 48–50. http://dx.doi.org/10.32635/2176-9745.rbc.1951v4n7.4247.
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Mice bearing sarcoma implants (S.37) obtained from the National Câncer Institute received sublethal dosage of Serrata Marcenscens polysaccharide (as obtained from Dr. Shear). The cytotoxic like action, characterized by hemorrhage and necrosis in the tumor mass has been investigated, as to its relationship to an anaphylactic action, or as due to an increased capillary fragility. Results are herewith reported.
14
West, John B. "Role of the fragility of the pulmonary blood-gas barrier in the evolution of the pulmonary circulation." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 304, no. 3 (2013): R171—R176. http://dx.doi.org/10.1152/ajpregu.00444.2012.
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In 1953 Frank Low published the first high-resolution electron micrographs of the human pulmonary blood-gas barrier. These showed that a structure only 0.3-μm thick separated the capillary blood from the alveolar gas, immediately suggesting that the barrier might be vulnerable to mechanical failure if the capillary pressure increased. However, it was 38 years before stress failure was recognized. Initially it was implicated in the pathogenesis of High Altitude Pulmonary Edema, but it was soon clear that stress failure of pulmonary capillaries is common. The vulnerability of the blood-gas barrier is a key factor in the evolution of the pulmonary circulation. As evolution progressed from the ancestors of fishes to amphibians, reptiles, and finally birds and mammals, two factors challenged the integrity of the barrier. One was the requirement for the barrier to become increasingly thin because of the greater oxygen consumption. The other was the high pulmonary capillary pressures that were inevitable before there was complete separation of the pulmonary and systemic circulations.
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Cesarone, M. R., A. Ricci, A. Di Renzo, G. Belcaro, and M. Dugall. "Efficacy of Topical Treatment with Aescin + Essential Phospholipids Gel on Capillary Fragility." Angiology 55, no. 6_suppl (2004): S23—S25. http://dx.doi.org/10.1177/000331970405500606.
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Iriti, Marcello, Elena Maria Varoni, and Sara Vitalini. "Bioactive Compounds in Health and Disease – Focus on Rutin." Bioactive Compounds in Health and Disease 6, no. 10 (2023): 235. http://dx.doi.org/10.31989/bchd.v6i10.1145.
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The flavonoid rutin was first isolated from rue (Ruta graveolens L.) and is used therapeutically as a capillary stabilizing and vasoprotective agent to reduce capillary fragility, although no health claims have been approved in the EU. This article briefly focuses on physicochemical properties, occurrence in foods and oral bioavailability of rutin, with emphasis on human studies. According to the available information, rutin can be considered a promising bioactive compound, despite the paucity of clinical trials. In addition to its therapeutic relevance in pathological and pathophysiological conditions, dietary rutin can also contribute to improve the physiological status of the organism in healthy subjects, thus preventing the onset of non-communicable chronic degenerative diseases.Keywords: Flavonoids; polyphenols; phenylpropanoids; bioactive phytochemicals; biological activity; oral bioavailability pharmacokinetics; safety; rutin
17
Fu, Zhenxing, Gregory P. Heldt, and John B. West. "Increased fragility of pulmonary capillaries in newborn rabbit." American Journal of Physiology-Lung Cellular and Molecular Physiology 284, no. 5 (2003): L703—L709. http://dx.doi.org/10.1152/ajplung.00276.2002.
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The pulmonary capillaries of neonatal lungs are potentially vulnerable to stress failure because of the complex changes in the pulmonary circulation that occur at birth. We perfusion fixed the lungs from nine anesthetized newborn rabbits at capillary transmural pressures (Ptm) of 5 ± 5, 10 ± 5, and 15 ± 5 cmH2O. Normal microscopic appearances were seen at Ptm values of 5 ± 5 and 10 ± 5 cmH2O, but massive airway edema was observed in lungs perfused at a Ptm of 15 ± 5 cmH2O. Consistent with this, no disruptions of the alveolar epithelium were observed at Ptm values of 5 ± 5 cmH2O, but mean values of 0.11 and 1.22 breaks/mm epithelium were found at Ptm of 10 ± 5 and 15 ± 5 cmH2O, respectively ( P < 0.05 for 5 ± 5 vs. 15 ± 5 cmH2O). These pressures are in striking contrast to those in the adult rabbit in which, by a similar procedure, a Ptm of 52.5 cmH2O, is required before stress failure is consistently seen. We conclude that stress failure of pulmonary capillaries in newborn rabbit lungs can occur at Ptm values of less than one-third of those that are required in adult lungs.
18
Doughty, H. A., and C. Beardmore. "Bleeding Time at Altitude." Journal of the Royal Society of Medicine 87, no. 6 (1994): 317–19. http://dx.doi.org/10.1177/014107689408700605.
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Disorders of coagulation during ascent to high altitude in the unacclimatized are well recognized. In order to document the sequence of haematological changes, the bleeding time was estimated weekly in six climbers during a six week climb. The median bleeding time was shown to increase by 50% between the first and fourth week, it then plateaued during continued ascent to 5700 m. During the sixth week the bleeding time rapidly reverted to baseline levels whilst still at altitude. The observations might be explained by the compensatory changes in coagulation factors following the initial prothrombotic phase, compounded by increased capillary fragility. Acclimatization to altitude is accompanied by a series of complex haematological changes. The temporal sequence should be considered when devising a strategy to reduce the risk of thrombosis.
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Fu, Jack B., and Shinichiro Morishita. "Inpatient Rehabilitation of Hematopoietic Stem Cell Transplant Patients." American Journal of Physical Medicine & Rehabilitation 103, no. 3S (2024): S46—S51. http://dx.doi.org/10.1097/phm.0000000000002408.
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Abstract Hematopoietic stem cell transplants play an important role in the treatment of cancer, particularly hematologic malignancies. These patients can encounter functional impairments unique to hematopoietic stem cell transplant, including deconditioning, cancer-related fatigue, steroid myopathy, graft versus host disease, and capillary leak syndrome. Medical fragility and increased risk of infection may make rehabilitation challenging on the acute care and postacute care settings. Patients admitted to acute inpatient rehabilitation experience a high rate of transfer to the primary acute service and high rate of mortality after transfer back. Physical medicine and rehabilitation physicians can use a number of strategies to mitigate these patients’ risk of medical complications including evidence-based predictive models to assist with postacute rehabilitation triage, physiatry-led consult-based rehabilitation, and oncology hospitalist comanagement on inpatient rehabilitation.
20
Guolo, E., P. Romagnoni, and F. Peron. "Capillary rising damp in Venetian context: state of the art and numerical simulation." Journal of Physics: Conference Series 2069, no. 1 (2021): 012046. http://dx.doi.org/10.1088/1742-6596/2069/1/012046.
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Abstract The fragility of Venice and its buildings are linked to the floods, observed since ancient times and emphasized in recent years: the periodic sea level rise, accompanied by rising damp, are the main causes of the alteration. In particular, the rising damp causes a series of complex diseases in the historic buildings, such as physical decay, chemical or biological, with loss of aesthetic and economic value. In addition, greater heat dispersion and reduced thermal comfort can also occur in interior spaces, with consequent risks for human health. This is a sign of “Sick Building Syndrome”. It is very important to develop models for assessing the vulnerability of assets and to manage sustainable plans related to maintenance processes and activities, satisfying the requirements of effectiveness and compatibility. Basing on numerical models performed with the WUFI 2D software, the paper analyses the different behavior of rising damp in relation to materials or masonry structures. In particular, the construction techniques and typical materials used in Venetian buildings were investigated, such as clay brick walls, lime plaster, Marmorino and Cocciopesto, adopted mainly to limit the capillary rise also caused by the phenomenon of “acqua alta”.
21
Tomson, C. R. V., S. M. Channon, I. S. Parkinson, et al. "Correction of subclinical ascorbate deficiency in patients receiving dialysis: Effects on plasma oxalate, serum cholesterol, and capillary fragility." Clinica Chimica Acta 180, no. 3 (1989): 255–64. http://dx.doi.org/10.1016/0009-8981(89)90007-7.
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22
Pinto, Thiago Maurício de Souza, Fabrini Luiz Alves Almeida, Julianna Oliveira de Lucas Xavier, et al. "Biopharmacotechnical and physical properties of solid pharmaceutical forms containing rutin commercially acquired in Juiz de Fora city, Brazil." Acta Scientiarum. Health Sciences 42 (July 9, 2020): e52212. http://dx.doi.org/10.4025/actascihealthsci.v42i1.52212.
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Rutin is a flavonoid used in clinical practice to treat capillary fragility and prevent bleeding due to its wide variety of pharmacological actions, including antioxidant, anti-inflammatory, anti-allergic, antiproliferative, and anticarcinogenic activities. In this study, the biopharmacotechnical and physical properties of film-coated tablets containing rutin marketed in drugstores were evaluated. Using samples from three batches called A, B and C, we determined the average weight, disintegration time, hardness, content and dissolution profile, and kinetics of the tablets. The samples demonstrated average weight of 457.45 ± 12.32 to 449.15 ± 8.95 mg; disintegration time, 30.17 ± 2.14 to 15.17 ± 2.14 min; hardness, 1.92 ± 0.55 to 1.69 ± 0.36 Kgf; and rutin content, 18.34 ± 1.21 to 15.66 ± 1.29 mg. After 90 min, the dissolution profile showed 52.65, 41.80, and 79.2% for A, B, and C, respectively. The results imply that the non-conformities of the tested products can significantly compromise the drug’s therapeutic efficacy.
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Torrente, Y., M. Belicchi, C. Marchesi, et al. "Autologous Transplantation of Muscle-Derived CD133+ Stem Cells in Duchenne Muscle Patients." Cell Transplantation 16, no. 6 (2007): 563–77. http://dx.doi.org/10.3727/000000007783465064.
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Duchenne muscular dystrophy (DMD) is a lethal X-linked recessive muscle disease due to defect on the gene encoding dystrophin. The lack of a functional dystrophin in muscles results in the fragility of the muscle fiber membrane with progressive muscle weakness and premature death. There is no cure for DMD and current treatment options focus primarily on respiratory assistance, comfort care, and delaying the loss of ambulation. Recent works support the idea that stem cells can contribute to muscle repair as well as to replenishment of the satellite cell pool. Here we tested the safety of autologous transplantation of muscle-derived CD133+ cells in eight boys with Duchenne muscular dystrophy in a 7-month, double-blind phase I clinical trial. Stem cell safety was tested by measuring muscle strength and evaluating muscle structures with MRI and histological analysis. Timed cardiac and pulmonary function tests were secondary outcome measures. No local or systemic side effects were observed in all treated DMD patients. Treated patients had an increased ratio of capillary per muscle fibers with a switch from slow to fast myosin-positive myofibers.
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Mansur, Fadlul Azim Fauzi, and Nurul Azmawati Mohamed. "Islands of White in a Sea of Red: A Cutaneous Manifestation of Dengue Fever in a Pregnant Woman." Malaysian Journal of Science Health & Technology 7, no. 3 (2021): 64–66. http://dx.doi.org/10.33102/mjosht.v7i3.203.
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Dengue fever is a significant public health problem in Asia, resulting in serious morbidity and even mortality. It is mainly known for causing severe constitutional symptoms and bleeding, often resulting in haemorrhagic shock. Dengue fever may manifest cutaneously in several forms. These include petechial rash, maculopapular rash and what has been termed as islands of white in a sea of red. Most can be attributed to capillary fragility, which led to tests such as the tourniquet test. This case highlights the dengue fever cutaneous presentation of islands of white in a sea of red in a multigravida woman during her first trimester. Her husband and son who was infected at the same time did not develop similar skin condition but developed the more common maculopapular and petechial rashes. The pathophysiology of such lesions is not well understood, and its relation to pregnancy is not known. Blood investigations were typical of dengue fever. The outcome of the patient’s pregnancy was also normal. This case highlights the need for doctors to look out for such lesions in dengue patients.
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Kimak, Agnieszka, and Agnieszka Żebrowska. "Therapeutic Approach in Pigmented Purpuric Dermatoses—A Scoping Review." International Journal of Molecular Sciences 25, no. 5 (2024): 2644. http://dx.doi.org/10.3390/ijms25052644.
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Pigmented purpuric dermatoses (PPD) encompass a group of chronic skin conditions characterized by the presence of petechiae, purpura, and pigmentation changes. While generally benign, these dermatoses can be persistent and aesthetically bothersome. Key clinical features include red to brownish patches with a distinctive “cayenne pepper” appearance, predominantly localized on the lower extremities, particularly the shins. Subtypes include Schamberg disease, Majocchi’s disease, Gougerot–Blum disease, Ducas and Kapetanakis pigmented purpura, and lichen aureus. Diagnosis relies primarily on clinical evaluation of skin lesions, with biopsy as a confirmatory tool. Although the exact cause of PPD remains unclear, capillary fragility and red blood cell extravasation are implicated. Treatment strategies for PPD aim to alleviate symptoms, considering the generally benign and chronic nature of the condition. As there is no standardized treatment, various methods with varying efficacy are employed. After searching SCOPUS and PubMed databases, we assessed 42 original articles to present current knowledge regarding therapy of PPD. This review will compare treatment approaches specifically in Schamberg disease and other manifestations of pigmented purpuric dermatoses.
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Napolitano, Angela, Laura De Michieli, Giulio Sinigiani, Tamara Berno, Alberto Cipriani, and Luca Spiezia. "Thromboembolic and Bleeding Events in Transthyretin Amyloidosis and Coagulation System Abnormalities: A Review." Journal of Clinical Medicine 12, no. 20 (2023): 6640. http://dx.doi.org/10.3390/jcm12206640.
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Transthyretin amyloidosis (ATTR) is a group of diseases caused by the deposition of insoluble fibrils derived from misfolded transthyretin, which compromises the structure and function of various organs, including the heart. Thromboembolic events and increased bleeding risk are among the most important complications of ATTR, though the underlying mechanisms are not yet fully understood. Transthyretin plays a complex role in the coagulation cascade, contributing to the activation and regulation of the coagulation and fibrinolytic systems. The prevalence of atrial fibrillation, cardiac mechanical dysfunction, and atrial myopathy in patients with ATTR may contribute to thrombosis, though such events may also occur in patients with a normal sinus rhythm and rarely in properly anticoagulated patients. Haemorrhagic events are modest and mainly linked to perivascular amyloid deposits with consequent capillary fragility and coagulation anomalies, such as labile international-normalised ratio during anticoagulant therapy. Therefore, it is paramount to carefully stratify the thrombotic and haemorrhagic risks, especially when initiating anticoagulant therapy. Our review aims to ascertain the prevalence of thromboembolic and haemorrhagic events in ATTR and identify potential risk factors and predictors and their impact on antithrombotic therapy.
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Shekhar, Neema, Ranjan Eeshaan, Durga Madhab Tripathy, Mani Siddharth, and Oberoi Bhavni. "Pigmented purpuric dermatoses: A review." Pigment International 11, no. 1 (2024): 1–11. http://dx.doi.org/10.4103/pigmentinternational.pigmentinternational_53_23.
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Pigmented purpuric dermatosis (PPD) comprises a group of skin conditions characterized by flat, nonpalpable petechiae and purpura as a result of capillaritis. Although the precise cause of PPD is as yet unknown, increased vascular permeability and capillary fragility are key factors in its pathophysiology. PPD has diverse clinical presentations, but the histopathology of all these variants essentially remains the same. The initial purpuric lesions develop a golden-brown hue owing to hemosiderin absorption and eventually progress to chronic pigmentary changes. These lesions, which often affect the lower limbs, are either asymptomatic or accompanied by moderate pruritus, and can be difficult to diagnose and treat. There are several subtypes of clinical presentations that have been documented over the years. In order to accurately diagnose PPD, a thorough clinical evaluation and, occasionally, a biopsy may be required. It is essential to identify the condition and reassure patients of its benign nature. Treatment is usually necessary due to the chronic nature of the condition, its consequences on physical and mental well-being, and the presence of significant lesions or itching. In this review, we outline the various prevalent PPDs and discuss their etiopathogenesis, clinical features, and diagnostic and treatment modalities.
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Arafa Musa, Ehab M. Mostafa, Mohammad M. Al-Sanea, Shaimaa R. Ahmed, Gomaa Mostafa-Hedeab, and Mohamed A. Abdelgawad. "Insights Studies for Certain Natural FDA Approved Polyphenolics and Repurposing for COVID-19." International Journal of Research in Pharmaceutical Sciences 11, SPL1 (2020): 1390–95. http://dx.doi.org/10.26452/ijrps.v11ispl1.3667.
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Natural polyphenolic drugs were approved for treatment of various diseases. Diosmin, rutin, quercetin, aesculin, genistein, hesperidin and silybin are known for their safety and have been applied for several human disorders including cancer, cardiovascular disorders, atherosclerosis, oxidative stress, capillary fragility, liver and pancreatic disorders and others. As the structures of the selected polyphenolic compounds possess variable chemical moieties with diverse chemical and electronic characters, these properties have been employed for further insights studies to predict new applications concerning the newly occurred pandemic. COVID-19 is a terrible disease that attacked millions of human populations at the end of year 2019. As the number of death cases has increased to exceed one million of humans, the early discovery of new treatment from previously approved and safe drugs is the main target of this study. Employing the putative docking studies for the selected polyphenolic drugs were done and the results were promising, all tested drugs exhibited high affinity with the selected five proteins of protease enzyme, the docking score ranged from -8.4461 to -26.1691 kcal/mol with 3-7 variable interaction bonds. Among the tested drugs, diosmin appeared as the most promising drug as it exhibited the highest energy score and interaction bonds with the most of proteins.
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Troуan, Vyacheslav, and Bogdan Kindras. "Increasing the crack resistance of high-strength self-compacting concrete." Technology audit and production reserves 1, no. 1(57) (2021): 17–24. http://dx.doi.org/10.15587/2706-5448.2021.225500.
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The object of research is high-strength self-compacting concrete, which does not require additional vibration during laying. One of the most problematic issues of high-strength self-compacting concretes is increased cracking, associated with large shrinkage deformations of such concretes and their fragile destruction.
 A decrease in shrinkage deformations of concrete was established when part of the cement was replaced to mineral additives. This effect is explained by a decrease of the cement content and, accordingly, a decrease of the chemical component of the autogenous shrinkage of concrete, and an increase of the adsorptive binding of capillary moisture by mineral additives, with reduces the physical drying shrinkage of concrete. In this case, the type and dispersion of the used mineral additive can affect to the shrinkage deformations of concrete. A significant decrease in shrinkage deformations when using metakaolin is explained by an increase the amount of ettringite as a result of the reaction of active metakaolin Al2O3 with two-water gypsum of cement. It was found that the replacement of cement to 10 % of mineral additives leads to a decrease in the value of the critical stress intensity factor (SIF), which is compensated by a decrease of the fragility of concrete fracture (an increase of the area of microplastic deformations). At the same time, the type of mineral additive used does not affect to the value of the critical stress intensity factor, but significantly affects to the fragility of fracture of concrete samples. The introduction of 10 % mineral additives (to replace cement) had a positive effect on the retention of flow of self-compacting concrete mixes; the best results according to this criterion were observed when using silica fume, fly ash and limestone. All mineral modifiers, except for silica fume, led to a decrease of the compressive strength of high-strength concretes on all terms of hardening. In the case of the tensile strength of concrete at bending and splitting, with the introduction of silica fume, metakaolin and fly ash, a positive effect was observed compared to the base composition without additives.
 Comprehensive accounting of the results obtained will allow a reasonable approach to the design of high-strength self-compacting concretes with increased crack resistance.
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Ebrahim, Hanan S., Nourhan M. Deyab, Basamat S. Shaheen, Ahmed M. M. Gabr, and Nageh K. Allam. "In Vitro: The Extraordinary Enhancement in Rutin Accumulation and Antioxidant Activity in Philodendron “Imperial Red” Plantlets Using Ti-Mo-Ni-O Nanotubes as a Novel Elicitor." BioTech 13, no. 3 (2024): 24. http://dx.doi.org/10.3390/biotech13030024.
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Rutin, a flavonoid phytochemical compound, plays a vital role in human health. It is used in treating capillary fragility and has anti-Alzheimer, anti-inflammatory, and antioxidant effects. In this study, Ti-Mo-Ni-O nanotubes (NTs) were used, for the first time, in an unprecedented plant biotechnology application, wherein in vitro Philodendron shoots (Philodendron erubescens) known as “Imperial Red” were targeted for rutin accumulation. The antioxidant responses and the accumulation of rutin were evaluated in treated Philodendron erubescens (P. erubescens) shoots using 5.0 mg/L of Ti-Mo-Ni-O NTs. The total phenolic content and total flavonoid content were estimated, and an ABTS+ assay, FRAP assay, and iron metal chelation assay were performed. The application of Ti-Mo-Ni-O NTs enhanced the rutin content considerably from 0.02 mg/g to 2.96 mg/g for dry-weight shootlet extracts. Therefore, the use of Ti-Mo-Ni-O NTs is proposed to be a superior alternative to elevate the rutin content. The aim of the current study is to target P. erubescens shoots grown in vitro for the accumulation of rutin compounds using Ti-Mo-Ni-O NT powder, to determine the quantitative and qualitative accumulation of rutin via HPLC–DAD analysis, and to estimate the antioxidant activity of P. erubescens shoot extract. This study presents a novel methodology for utilizing nano-biotechnology in the synthesis of plant secondary metabolites.
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Rezazadeh, Arash, Sandra C. Hollensead, Damian A. Laber, and Goetz H. Kloecker. "Intracranial Hemorrhage in a Patient with Osteogenesis Imperfecta Due to Inherited and Acquired Platelet Dysfunction." Blood 108, no. 11 (2006): 3960. http://dx.doi.org/10.1182/blood.v108.11.3960.3960.
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Abstract A 42 year-old man with Osteogenesis Imperfecta (OI) had three episodes of spontaneous Subdural Hematoma (SH) after binge drinking. There is no remote history of abnormal bleeding or easy bruising despite multiple fractures. Medications included Aspirin (ASA). The first and second SH occurred within the preceding year and were treated conservatively. The third SH occurred while on ASA and drinking more than 500cc liquor/day. The Platelet Function Assay (PFA-100) was significantly abnormal (see table). After platelet transfusions the SH was surgically evacuated without complications. An MRA of the head showed no vascular abnormality. CBC, serum chemistries, PT, PTT, factor VIII and von Willebrand factor were normal. The patient stopped taking ASA, but continued to drink. The PFA-100, although abnormal, had improved. After a month-long alcohol abstinence his PFA-100 normalized. He has been without SH ever since. However the platelet aggregation study still shows a lack of second wave response to ADP. EVENT ASA ETOH Collagen/Epi Collagen/ADP Platelet Count SH3 (+) (+) &gt;300 112 266 Plt transfusion n/a n/a 122 51 347 Follow up (−) (+) 219 108 231 Follow up (−) (−) 117 80 276 Reference Range 118–162 Seconds 59–103 Seconds 140–370 Discussion: Both OI and ETOH are known factors of causing intrinsic platelet defect. The Framingham Offspring Study showed that alcohol consumption is inversely associated with both platelet activation and aggregation, particularly in men. ETOH is capable of inhibiting collagen induced platelet aggregation, secretion, arachidonate mobilization, and TXA2 formation. Also it has been suggested that intracellular Ca2+ homeostasis and aggregation in platelets are impaired by ethanol through the generation of H2O2 and oxidation of sulphydryl groups. OI causes vascular fragility and intrinsic platelet defect. In one study the most frequent abnormalities were increased capillary fragility (35%), decreased platelet retention (33%) and reduced factor VIII R:Ag (23%). Reduced ristocetin cofactor, deficient platelet aggregation induced by collagen and prolonged bleeding time were less common findings. The combination of vascular, platelet related and plasmatic defects may reflect that OI is a heterogeneous group of disorders with common clinical expression. Conclusion: Patients with OI are at risk for intracranial bleeding due to vascular fragility and intrinsic platelet defect. Our patient had a normal PFA-100, off ASA and ETOH. The platelet aggregation study -a more sensitive test- was able to detect a platelet secretion defect in our patient. The abnormal platelet aggregation study was likely due to his OI, which never caused abnormal bleeding by itself. The additional affect of ASA and ETOH on his platelets led to recurrent episodes of SH. Many OI patients are on NSAID/ASA due to chronic bone pain. Special attention should be paid to alcohol abuse in this group of patients. Normal platelet counts and coagulation tests may not be sufficient to evaluate the risk of bleeding. We suggest performing a PFA-100 or a platelet aggregation study, when platelet dysfunction is suspected.
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Jørgensen, J. O. L., S. A. Pedersen, J. Ingerslev, F. J. Møller, and J. S. Christiansen. "Growth hormone (GH) therapy in GH-deficient patients, the plasma Factor VIII-von Willebrand factor complex, and capillary fragility. A double-blind, placebo-controlled crossover study." Scandinavian Journal of Clinical and Laboratory Investigation 50, no. 4 (1990): 417–20. http://dx.doi.org/10.3109/00365519009091600.
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Espinoza, Betty Manrique, Ana Rivera Almaraz, and Aaron Salinas Rodriguez. "HYPERGLYCEMIA AND INCIDENCE OF FRAILTY IN OLDER MEXICAN ADULTS LIVING IN RURAL AREAS." Innovation in Aging 3, Supplement_1 (2019): S680. http://dx.doi.org/10.1093/geroni/igz038.2511.
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Abstract Hyperglycemia is the main characteristic of diabetes and is the result of an absolute or partial deficit in the production or action of insulin. Recent evidence suggests that hyperglycemia increases the risk of frailty. This issue is of great importance for the Mexican population given the high prevalence of diabetes, particularly in older adults. Our objective was to analyze the association between hyperglycemia and the incidence of frailty in a cohort of rural older adults in Mexico. Prospective cohort study with 600 rural older adults, with measurements made in 2009, 2013 and 2018. Fragility was defined using the proposal of Fried and colleagues. The determination of glycosylated hemoglobin was performed through the A1CNow® device, with capillary blood; hyperglycemia was defined considering the recommendation of the American Diabetes Association; where values greater than 6.5% (140 mg / dL) of glycosylated hemoglobin were considered hyperglycemia. We used an ordinal logistic regression model to analyze the relationship between hyperglycemia and incidence of frailty. In the baseline measurement (2009), 8.6% of older adults presented frailty. The incidence of frailty was 6.9%. After adjusting for health and sociodemographic characteristics, hyperglycemia was significantly associated with the incidence of frailty (RR = 2.24 P = 0.018). These findings allow us to determine that hyperglycemia is a prognostic factor of the incidence of frailty. Because frailty is preventable, future interventions for the prevention of frailty should consider the presence of hyperglycemia.
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Anand, Siddharth, Pratibha Pawal-Aute, Shashikant Gunale, and Meenal Agarwal. "A Rare Pathogenic Variant in the SERPINF1 Gene in Association with Early-Onset Severe Presentation of Autosomal Recessive Type of Osteogenesis Imperfecta VI: A Case Report." Case Reports in Orthopedic Research 5, no. 3 (2023): 108–14. http://dx.doi.org/10.1159/000527988.
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Osteogenesis imperfecta (OI) refers to a group of genetic disorders with the typical clinical presentation of increased bone fragility. More than 90% of OI cases have an underlying genetic mutation in the collagen genes COL1A1 or COL1A2. However, there are now 22 different recognized OI subtypes based on the underlying gene implicated. OI type VI is caused by pathogenic variants in the serine proteinase inhibitor clade F (SERPINF1) gene. In this case study, the patient was a 4-year-old female, born in a consanguineous family, with a history of delayed gross motor milestones and recurrent fractures after trivial trauma since the age of 8 months. The results of skeletal surveys and bone scans indicated that the patient suffered from OI. To confirm the diagnosis, we performed a next-generation sequencing (NGS) analysis of genes implicated in OI using the TruSight One NGS Panel. Bioinformatics analysis showed the presence of a rare pathogenic variant in exon 7 of the SERPINF1 gene in a homozygous state (NM_002615.5:c.907C>T; NP_002606.3:p.Arg303Ter; ClinVar submission ID: SUB10491966). The variant results in the termination of the polypeptide chain at position 303. Targeted capillary sequencing confirmed the presence of this variant in a homozygous state in the patient and in heterozygous state for both parents. Additionally, the patient’s younger sibling, aged 10 months, harbored the variant in a homozygous state. The sibling started bisphosphonate therapy and did not suffer any fractures in over 2 years after initiating the therapy. The etiological genetic diagnosis helped provide genetic counseling to the family. This highlights the utility of NGS for the confirmation of a clinical analysis in cases where alterations in multiple genes can result in similar clinical presentation.
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Nizamov, F. Kh. "Chronic venous insufficiency after COVID-19: management of edema and pain syndromes." Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) 18, no. 2 (2021): 151–53. http://dx.doi.org/10.21518/1995-1477-2021-18-2-151-153.
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Introduction. COVID-19 infection raises many questions regarding the health condition of patients after they have had COVID-19. The aim of this study is to examine the characteristic symptoms of chronic venous insufficiency in the postcovid period.Materials and methods. The materials that were used for work included the results of studying the medical aid appealability, characteristic symptoms, diagnosis and treatment of symptoms of chronic venous insufficiency in persons who have had the coronavirus infection. 47 patients presented with complaints about deterioration of their condition after they had had COVID-19 over March to September 2021 period. Methods: general clinical examiniation, ultrasound angioscanning of veins of the lower extremities, laboratory coagulation tests.Results and discussion. Before deterioration, calf circumference was measured 22–24 cm at a typical measurement site in most patients (89%), after covid infection it reached 26–27 cm. Varicose veins remained soft, without intravascular formations, edema was often bilateral, asymmetric, pain was described as constant (5–6 VAS scores), patients had prominent signs of lymphostasis. 35 out of 47 people received diosmin-based venotonic drug of Russian manufacture at a dose of 1000 mg/day (one tablet twice a day), the course of treatment lasted one to two months. After that period, the edema subsided in 85% of patients, the severity of pain syndrome significantly reduced (up to 2–3 VAS scores). With regard to chronic venous insufficiency in patients with chronic diseases of lower extremity veins (mostly varicose and post-thrombotic diseases), the significant progress of disease was observed in almost 94% of follow-up cases. Diosmin is the main drug that is prescribed to treat chronic venous insufficiency. The drug has an angioprotective and venotonic effect, reduces the vein wall elasticity, increases venous tone, and decreases venous stasis, reduces capillary permeability and fragility, and increases their resistance, improves microcirculation and lymphatic drainage.Сonclusions. In the postcovid period, clinical symptoms of some chronic diseases occur/worsen, including clinical manifestations of chronic venous insufficiency. The use of Russian diosmin-based drug for the management of edema and pain syndrome is very promising.
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Alkindi, Nour, Abdurahman Andijani, Samara Zavalkoff, and Karl Muchantef. "C4 (Clinical Case) Vascular Ehlers-Danlos Syndrome in the Paediatric Population: A Case Report of an Internal Bleed Caused by Ruptured Pseudoaneurysm." Paediatrics & Child Health 28, Supplement_1 (2023): e50-e51. http://dx.doi.org/10.1093/pch/pxad055.105.
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Abstract Introduction/Background Ehlers-Danols syndrome (EDS) is a connective tissue disease characterized by joint hypermobility, skin hyperextensibility and tissue fragility. EDS has six types. Type IV EDS: vascular EDS (vEDS), is rare but also the most malignant. Case Description We report a 15-year-old boy with a previous history of spontaneous colon perforation and two left shoulder dislocations. He presented with sudden onset abdominal pain, vomiting, dizziness, and lethargy with a Glasgow coma scale of 13. His abdomen was soft but mildly tender. He had a capillary refill of 3 seconds with cold extremities, was found to be in a hypotensive shock state requiring resuscitation with fluids and inotropes, as well as intubation and mechanical ventilation. His hemoglobin dropped by 30 g/L in 6 hours. Therefore, an abdominal ultrasound was done, revealing an intrabdominal hematoma. CT scan of the abdomen confirmed a ruptured fusiform pseudoaneurysm of the accessory left hepatic artery. This was successfully managed by coil embolization, see F1 and F2, below. Genetic workup was positive for the pathogenic COL3A1 gene that presents phenotypically as Ehlers-Danlos syndrome, particularly type IV. Discussion COL3A1 encodes pro-alpha1 chains of type III collagen. Inheritance is autosomal-dominant. It can present as a de novo variant with a negative family history, as was the situation for our patient. Estimated affected people with de novo variant vEDS is 33%-50%. Clinical diagnosis of vEDS involves one major and several minor criteria (2017). Major criteria include arterial aneurysms, dissection, or rupture; intestinal rupture; uterine rupture during pregnancy; family history of vEDS. Minor criteria include easy bruising; thin skin and visible veins; facial characteristics including prominent eyes, narrow nasal bridge, thin lips; club foot, congenital hip dislocation; inguinal hernia and pneumothorax. Our patient had two elements from the major criteria: arterial pseudoaneurysm and intestinal rupture. Conclusion vEDS has high morbidity and mortality due to the risk of spontaneous internal organ/vessel injury. This can be mitigated by increased awareness of systemic manifestations of vEDS and a high index of suspicion by both primary care and emergency physicians. Once diagnosed, surveillance is crucial, including regular blood pressure monitoring, frequent non-invasive imaging to identify emerging vascular lesions, and pregnancy counselling for potential uterine rupture and avoiding trauma, collision sports, and lifting heavy items.
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Gutiérrez, Lorena Suárez. "Iatrogenic Cushing Syndrome and Secondary Adrenal Insufficiency Due to an Interaction Between Fluticasone and Ritonavir." Journal of the Endocrine Society 5, Supplement_1 (2021): A136. http://dx.doi.org/10.1210/jendso/bvab048.274.
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Abstract Introduction: The interaction between corticosteroids and protease inhibitors (PIs) is a clearly described drug interaction. Several case series have been described.-Fluticasone is the one with the greatest potential risk of producing iatrogenic adrenal insufficiency given its pharmacokinetic characteristics. Clinical Case: 44-year-old woman diagnosed with HIV (human immunodeficiency virus) category B3 diagnosed in 1989; multiple antiretroviral treatments. Severe lipodystrophy Also HCV genotype IA. Bronchial asthma since 2000. A treatment with fluticasone 1 inh / 24h, salbutamol on demand, darunavir 800 mg / day and ritonavir 100 mg / day. He had known lipodystrophy since 2001 and the abdominal perimeter was controlled, showing an increase in it. Likewise, she presented progressive proximal weakness in the lower limbs, with increased hair, capillary fragility and alopecia, which is why she was referred to Endocrinology. Moderate hirsutism, muscle atrophy were observed and in the analytical study: normal FSH and LH. Testosterone 0.05 ng / ml (0.1–0.9), ACTH 1.0 pg / ml (7.2–63.3), Cortisol am 0.65 µg / dl (4.30–22.40). Urinary free cortisol 3.74 µg / 24h (36–137). A Synacten Test is performed: Basal 0.52; 30 min 2.33; 60 min 2.84 with ACTH 1 and a diagnosis of iatrogenic independent ACTH Cushing Syndrome associated with secondary adrenal insufficiency. With this diagnosis, he was referred to the pulmonology clinic for a change from inhaled corticosteroid to beclomethasone and replacement treatment with hydroaltenesone was started. Three months later, he was admitted for a fever after stopping hydroaltesone. It was restarted, antibiotic treatment was prescribed, and she was discharged home with a new regimen of antiretrovirals (raltegravir, tenofovir, and abacavir). Clinical Lesson: Fluticasone is a synthetic steroid that is cleared by the cytochrome P450 enzyme CYP3A4, which is inhibited or enhanced by a multitude of drugs, including ritonavir. As it is not metabolized, there is an increase in circulating levels, causing a decrease in ACTH secretion and therefore a suppression of the adrenal gland with its insufficiency and cushing syndrome. In our case and usually, the initial signs are difficult to detect due to their overlap with lipodystrophy associated with protease inhibitors. Although there is no agreement in the literature: the options are the replacement of fluticasone with another corticosteroid that is not a CYP3A4 substrate such as beclomethasone and the replacement of ritonavir with another antiretroviral (as in our case) or the reduction of the dose of fluticasone. It is recommended to avoid the initiation of fluticasone in patients receiving ritonavir. Substitution treatment with a progressive reduction in dose is performed with hydroaltesona. Most cases resolve in 9–12 months.
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Fridriksdottir, Halla, Andreas Ørslev Rasmussen, Jens Lykkesfeldt, Maria Rossing, and Eva Birgitte Leinoe. "Reduced Vitamin C Levels in Patients with Bleeding of Unknown Cause and Generalized Joint Hypermobility." Blood 142, Supplement 1 (2023): 25. http://dx.doi.org/10.1182/blood-2023-173361.
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Introduction Vitamin C is essential for the synthesis of collagen. Ehler-Danlos syndrome (EDS) is a group of collagen disorders associated with generalized joint hypermobility (HM), bleeding and bruising. The genetic cause of the HM EDS subtype (hEDS) is unknown. Referral to haematology clinics may result in the diagnosis: bleeding of unknown cause (BUC), where no specific haemostatic treatment is available. However, it is a clinical experience, published in many textbooks, that bleeding, and bruising associated with EDS improve by oral intake of vitamin C. No previous studies examined vitamin C levels in patients with BUC. The aim of the study is to investigate the association of vitamin C levels with HM and vascular fragility in patients with BUC. Methods Patients with bleeding tendency are referred to our Haemophilia Center. Following ISTH-BAT score, normal coagulation test (INR, APTT, fibrinogen, F8, F9, F11, F13, VWFAg, VWFRist) and inconclusive results of flow cytometry analysis of platelet function, patients are diagnosed with BUC. Patients with a high ISTH-BAT score &gt; 10 were included in this study. We performed clinical examinations by a tourniquet test for capillary fragility and a Beighton score for generalized HM. A skin extensibility test was performed by pulling on the skin off the forearm and the lateral side of the throat until resistance was met. The test was considered positive (abnormal) if the skin extended more than 2 cm in both sites when pulled. Germline DNA was analyzed by whole genome sequencing (WGS) analysis and an in silico panel of 170 genes associated with bleeding and generalized HM was examined. Additionally, homozygous polymorphism in vitamin C genes ( GULOP, SLC23A1, SLC23A2, SVCT1, HP, GST and SOD2) known to cause reduced vitamin C levels, were assessed Vitamin C analysis: The participants received oral and written guidelines regarding intake of vitamin C in relation to the blood sample. The guidelines included no vitamin C supplements for 3 days before the blood sampling and no intake of vitamin C rich food on the day of the appointment. Plasma samples were immediately acidified by addition of 10% meta-phosphoric acid to ensure the stability of ascorbic acid, and subsequently analyzed by high-performance liquid chromatography. Severe vitamin C deficiency was defined as &lt;11µM, deficiency as &lt; 23 µM, suboptimal status as 23-49 µM and adequate status as &gt;49 µM. Results Sixty probands and 20 healthy age- and gender-matched controls (HC) were included. Most patients were women (56/60, 93%), median age 48 (range 21- 75) and median BAT score 13 (range 10-21). By WGS a 67-year woman with Beighton score 7 was diagnosed with Noonan syndrome due to a pathogenic variant in PTPN11 (c.922A&gt;G). Also, a 62-year woman without HM was diagnosed with mild FV deficiency due to a heterozygous variant in F5 (c.449A&gt;G). No other causal variants were identified. In a patient with a homozygous variant in SLC23A1, vitamin C level was suboptimal 42µM.Suboptimal vitamin C levels were found in 19/60 patients and 2/20 HC. One patient was severely vitamin C deficient (7µM). Vitamin C levels were significantly lower in patients compared to HC (median 56 µM vs 76 µM; p = 0.012). Beighton score was positive in 29/60 patients and 1/20 HC (p&lt;0.001). In 18/60 patients versus 0/20 HC the skin extensibility test was abnormal (p = 0.01). In 12/29 patients with a positive Beighton score the test for skin extensibility was also positive indicating a diagnosis of hEDS. Tourniquet test was positive (&gt; 10 petechiae) in 18/60 patients and 4/20 HC (p&gt;0.5). Patients with positive Beighton scores had significantly higher BAT scores than patients without HM (P= 0.014). No significant associations were found between vitamin C levels, a positive Beighton score, a positive Tourniquet test or a high BAT score respectively. Conclusions We found that a high proportion of patients with BUC have generalized HM, abnormal skin extensibility and positive tourniquet test. Indeed, patients with HM had increased ISTH-BAT scores compared to patients with negative Beighton scores. Our data support that hEDS may be an underlying cause of BUC. Further studies are needed to determine the genetic background of hEDS. Levels of vitamin C were reduced in patients with BUC compared to age and sex matched control. Our results could pave the way for a randomized study of vitamin C supplements versus placebo for bleeding and bruising in patients with generalized HM and BUC.
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Chami, Ariana de Sousa, Ellen Marcia Peres, Helena Ferraz Gomes, Dayana Carvalho Leite, Bruna Maiara Ferreira Barreto Pires, and Ariane da Silva Pires. "Cateteres venosos utilizados em adolescentes hospitalizados: estudo descritivo." Revista Recien - Revista Científica de Enfermagem 12, no. 38 (2022): 60–67. http://dx.doi.org/10.24276/rrecien2022.12.38.60-67.
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Avaliar os tipos de cateteres venosos utilizados por adolescentes hospitalizados. Estudo descritivo, documental, quantitativo, desenvolvido numa enfermaria de saúde do adolescente. A amostra constituiu-se de 30 prontuários de adolescentes submetidos à cateterização venosa. Os dados foram analisados através de estatística descritiva simples. Dos 85 dispositivos inseridos 78,8% (n=67) foram cateteres intravenosos periféricos e 9,4% (n=8) cateter central de inserção periférica. Quanto ao tempo da terapêutica 85,9% (n=73) destinaram-se àquelas com tempo < que 21 dias. Em relação à farmacologia 35,29% (n=30) referem-se à antibioticoterapia, seguido da quimioterapia em 17,65% (n=15), hidratação venosa com 16,47% (n=14) e pulsoterapia com 16,47% (n=14). A despeito das comorbidades que levam, não raras vezes, à associação de drogas, as quais promovem fragilidade capilar, e o tempo de administração das mesmas, a principal escolha para os acessos vasculares recaiu sobre os Cateteres Intravenosos Periféricos.
 Descritores: Enfermagem, Adolescente, Dispositivo Venoso, Cateteres Venosos.
 
 Venous catheters used in hospitalized adolescents: a descriptive study
 Abstract: To evaluate the types of venous catheters used by hospitalized adolescents. Descriptive, documentary, quantitative study, developed in an adolescent health ward. The sample consisted of 30 medical records of adolescents undergoing venous catheterization. Data were analyzed using simple descriptive statistics. Of the 85 inserted devices, 78.8% (n=67) were peripheral intravenous catheters and 9.4% (n=8) peripherally inserted central catheters. As for the duration of therapy, 85.9% (n=73) were aimed at those with a time <21 days. Regarding pharmacology, 35.29% (n=30) refer to antibiotic therapy, followed by chemotherapy in 17.65% (n=15), intravenous hydration with 16.47% (n=14) and pulse therapy with 16. 47% (n=14). Despite the comorbidities that often lead to the association of drugs, which promote capillary fragility, and their administration time, the main choice for vascular access was Peripheral Intravenous Catheters.
 Descriptors: Nursing, Adolescent, Venous Device, Venous Catheters.
 
 Catéteres venosos utilizados en adolescentes hospitalizados: estudio descriptivo
 Resumen: Evaluar los tipos de catéteres venosos que utilizan los adolescentes hospitalizados. Estudio descriptivo, documental, cuantitativo, desarrollado en un servicio de salud de adolescentes. La muestra estuvo constituida por 30 historias clínicas de adolescentes sometidos a cateterismo venoso. Los datos se analizaron mediante estadística descriptiva simple. De los 85 dispositivos insertados, el 78,8% (n=67) fueron catéteres intravenosos periféricos y el 9,4% (n=8) catéteres centrales insertados periféricamente. En cuanto a la duración de la terapia, el 85,9% (n=73) se dirigió a aquellos con un tiempo <21 días. Respecto a la farmacología, el 35,29% (n=30) se refieren a antibioticoterapia, seguido de quimioterapia en 17,65% (n=15), hidratación intravenosa con 16,47% (n=14) y pulsoterapia con 16,47% (n=14). A pesar de las comorbilidades que muchas veces conducen a la asociación de fármacos, que promueven la fragilidad capilar, y su tiempo de administración, la principal opción para el acceso vascular fueron los catéteres intravenosos periféricos.
 Descriptores: Enfermería, Adolescente, Dispositivo Venoso, Catéteres Venosos.
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Franco, Katty Manrique, and Helard Manrique. "ODP521 THYROID HORMONE RESISTANCE SYNDROME." Journal of the Endocrine Society 6, Supplement_1 (2022): A783—A784. http://dx.doi.org/10.1210/jendso/bvac150.1620.
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Abstract Introduction The Thyroid hormone resistance syndrome is characterized by decreased tissue sensitivity to thyroid hormones. The incidence is about 1/50,000. We present two clinical cases of this disease. Clinical case 1A 59-year-old woman was evaluated for presenting palpitations for more than one year during exercise and rest. Also, she noticed heat even in the winter. Headache, hair loss, dry skin, capillary fragility were other complaints. She denies trembling in the hands, diarrhea and subcutaneous edemas. Cardiologist didn't find any cardiac alterations. Holter showed sinus tachycardia with average heart rate 84/min (59-135/min). No evidence of ectopic beats. Bisoprolol 5mg/day was indicated. Three years ago, in routine control "high thyroid hormones" was found. A year ago, one doctor said her "that she had altered thyroid hormones". Her daughter has hyperthyroidism recentely diagnosed. The physical exam showed uniform goiter. Not acanthosis. Slight distal tremor. Soft skin, no edemas. No exophthalmos. Her first blood profile showed: Total T3 1.15 (0.8-2), Total T4 14.34 (5.1-14.1) TSH 5.43 (0.27-4.2) Free T4 1.81 (0.93-1.7). The second one showed Free T3 3.25 (2-4.4), Free T4 1.94 (0.93-1.7), TSH 4.78 (0.27-4.2). The thyroid antibodies: TSI, AbTG and AbTPO were negative. Pituitary hormone profile was normal and according to the age. Pituitary MRI was normal. Clinical case 2 A 15-year-old male was evaluated for tachycardia, weight loss, nervousness, anxiety, and sweaty hands. Evaluated by Cardiology, the Holter monitor shows sinus tachycardia. In endocrinology department, the clinical evaluation showed only goiter and sweaty hands. Hepatic and renal profile were normal. Urinary and blood catecholamines and norepinephrine were normal. His first blood profile showed: Total T3 1.54 (0.8-2), Total T4 14.56 (5.1-14.1) Free T4 1.79 (0.93-1.7), TSH 0.54 (0.27-4.2). The second profile: Total T4 14.37 (5.1-14.1), Free T4 1.8 (0.93-1.7), TSH 0.48 (0.27-4.2). The thyroid antibodies: TSI, AbTG and AbTPO were negative. The thyroid ultrasound showed diffuse goiter. The pituitary MRI didn't show any lesions. He started treatment with Metoprolol every 24 hours. In both patients, we can´t made genetic testing because is not available in country. Discussion The thyroid profile in patients with thyroid hormone resistance syndrome is very characteristic: they present with elevated free thyroid hormones and normal or slightly elevated TSH. It is important to rule out alterations in transporter proteins, the presence in serum of a factor that interferes with hormonal determination, or a TSH-producing pituitary tumor. The diagnosis requires a high degree of suspicion. BibliographyMARBAN CALZON, Mercedes; GONZALEZ JIMENO, Alicia; GARCIA BERMEJO, Alba, BELMONTE PINTRE, Zaira. Perfil hormonal tiroideo poco frecuente. Síndrome de resistencia a hormonas tiroideas. Rev Pediatr Aten Primaria[online]. 2019, vol.21, n.81BERNAL J. Sindromes de resistencia a las hormonas tiroideas. Endocrinología y Nutrición. 2011. Vol 58, Num 4.1 Presentation: No date and time listed
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Mazzolini, Anna, Valeria Fedeli, and Grazia Concilio. "Fragilità urbane, mobilità e politiche di contrasto al Covid in Africa." TERRITORIO, no. 97 (February 2022): 61–66. http://dx.doi.org/10.3280/tr2021-097-supplementooa12928.
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Alcuni contesti urbani necessitano di una mobilit&agrave; permanente e flessibile di beni e persone come condizione per la vita collettiva e il sostentamento di base. Per questi contesti la pandemia ha concretizzato sfide che non possono essere analizzate con paradigmi cognitivi di origine americo-euro-centrica.Per la citt&agrave; di Maputo, l'articolo riflette sulle fragilit&agrave; urbane dell'Africa subsahariana, analizzando le misure di prevenzione della pandemia in relazione alla mobilit&agrave; come fattore di co-produzione della citt&agrave;. In tal senso si ridefiniscono i concetti di urbano e dimobilit&agrave; e si propongono strategie di analisi e strumenti di osservazione capillari da supportare con una oculata governance dei dati.
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Valentina KIEFFER. "Aspect clinique et traitement des troubles trophiques d’origine veineuse avec peau intacte." Les pathologies vasculaires (anciennement ANGEIOLOGIE) 71, no. 02 (2019): 5. http://dx.doi.org/10.54695/mva.71.02.2182.
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Les maladies veineuses aiguës et chroniques font partiedes manifestations cliniques les plus répandues dans lapopulation, elles sont souvent mésestimées voir négligéeset seules les complications, fréquentes, invalidantes attirentl’attention.Les troubles trophiques sont un motif fréquent de consultation. Elles touchent près d’un individu sur deux.Dans cet ouvrage, nous allons traiter, les troubles trophiques d’origine veineuse sans lésion ouverte de la peau,caractéristiques des stades C1EAP à C5EAP de la maladieveineuse.Nous parlerons des télangiectasies qui correspondent àdes dilations intradermiques du plexus veineux post-capillaire, consécutives à une hyperpression veineuse localisée età une fragilité capillaire constitutionnelle. Elles deviennentvisibles lorsque leur diamètre atteint 0,1 mm.L’eczéma est souvent observé sur un terrain d’insuffisanceveineuse chronique, initialement localisée aux deux jambes,parfois en regard d’une varice ou d’une perforante.La dermite ocre correspond à des taches brunâtres del’épiderme résultant de l’extravasation du sang qui se situele plus souvent à la cheville, mais pouvant s’étendre aupied ou à la jambe.
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Marassiro, Mateus João, Marcelo Leles Romarco de Oliveira, and Sergio Feliciano Come. "Three Decades of Agricultural Extension in Mozambique: Between Advances and Setbacks." Journal of Agricultural Studies 8, no. 2 (2020): 418. http://dx.doi.org/10.5296/jas.v8i2.16647.
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This article aims to analyze the intervention in the area of public agrarian extension in Mozambique, taking into consideration the trajectory of this policy in this country. The methodology used is the literature review and consultation of documents that guide the agrarian extension in the country. Documentary analysis of plans and programs that address the theme was performed, as well as the consultation of articles available on Google scholar published between 2000 and 2019, which brought discussions about agrarian extension. The results suggest that the intervention of extension technicians is still low. This reality may be associated with the fragility of agricultural extension sector policies and agricultural policies that support the area. The verified data demonstrate that the number of extensionists tends to increase, but the rate of farmers who benefit from these services tends to reduce. Low coverage of extension services and poor consideration of farmers’ social economic conditions at ultimately contribute to low rates of agricultural productivity. Therefore, agrarian extension services should be taken as a fundamental support instrument for farmers, contributing to the increase of agricultural production and productivity and to the improvement of economic social and commercial conditions in Mozambican agriculture. Therefore, it is considered relevant for Mozambique to develop land extension policies and implement them to enable greater capillarity with farmers.
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Núñez, Paula Gabriela, and Ana Inés Barelli. "Marcas urbanas y sentidos sociales en disputa. San Carlos de Bariloche, Argentina, 1966-1983." HiSTOReLo. Revista de Historia Regional y Local 5, no. 10 (2013): 164–96. http://dx.doi.org/10.15446/historelo.v5n10.38530.
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San Carlos de Bariloche es la principal localidad turística de la Patagonia argentina. Representa, por su dimensión, a la ciudad más poblada de la provincia de Río Negro y es la tercera en tamaño en la Patagonia. Su crecimiento demográfico ha estado nutrido por diferentes migraciones nacionales y extranjeras. De estas últimas las principales provienen de países latinoamericanos. El artículo apunta a indagar en la desvalorización de su migración más importante, la chilena, durante la segunda mitad del siglo XX. Esta exclusión se fortaleció entre 1966 y 1983, por las iniciativas estatales que exacerbaron la xenofobia, las persecuciones políticas, la precarización de las condiciones laborales y los cambios en la organización espacial durante los gobiernos dictatoriales del período, esto es, los que se desarrollaron de 1966 a 1973 y de 1976 a 1983. El presente artículo analiza cómo algunos espacios de Bariloche se constituyeron en marcas urbanas que representaron intereses de los sectores más visibles en nombre de la “nación”, al tiempo que revisa dispositivos de resistencia de sectores excluidos de migrantes chilenos, que tuvieron, paralelamente, componentes de construcción espacial. Para este último punto se aborda la construcción de la Capilla Nuestra Señora del Carmen en 1966, construida en el área conocida como “barrio de los chilenos”, que se levantó como una marca alternativa, tanto material como simbólica, para disputar pertenencia, reconocimiento y visibilidad.Palabras clave: urbanización simbólica, xenofobia, turismo, religión, San Carlos de Bariloche.Urban Marks and Social Senses at Issue. San Carlos de Bariloche, 1966-1983AbstractSan Carlos de Bariloche is the main tourist town in the Argentinean Patagonia. It is also the biggest city in the Province of Río Negro, and the third largest in Patagonia. Its demographic growth has been nurtured by national and international migrations, the most important influence of the foreign population is from Latin-American. This article studies the underestimate that covered the central migration of the city, the Chilean, during the second half of Twentieth Century. This exclusion growth between 1966 and 1983, because of State initiatives that increased local xenophobia, adding political persecutions, fragility in labor conditions, and changes in spatial organization, in the context of the coup d´etat during 1966 to 1973 and 1976 to 1983. This article analyzed the urban marks in Bariloche, that were built taking into account the interests of the hegemonic sectors in the name of "Nation". At the same time, this construction was crossed by forms of resistance designed by different social sectors. Inside them, the activity of Chilean migrants involved the construct of a chapel in 1966, in a place known as “the Chilean neighborhood”, in devotion of the Patron of Chile, the Virgin of Carmen. The chapel and the devotion were erected in order to discuss the logics of pertinence, the ways of recognition and the social visibility. Keywords: symbolic urbanization, xenophobia, tourism, religion, San Carlos de Bariloche.
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Sulli, A., E. Hysa, A. Cere, et al. "AB1517 NAILFOLD CAPILLAROSCOPIC STATUS IN HYPERMOBILE EHLERS DANLOS SYNDROME PATIENTS: PILOT INVESTIGATION." Annals of the Rheumatic Diseases 82, Suppl 1 (2023): 1990.2–1991. http://dx.doi.org/10.1136/annrheumdis-2023-eular.4886.
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BackgroundHypermobile Ehlers Danlos syndrome (hEDS) is the most common subtype among the EDS syndromes and is a rare inherited connective tissue disease characterized mostly by hyperextensible skin and generalized joint hypermobility. Microvascular assessment has been documented only by one case report in the “vascular type” of EDS, despite vascular manifestations may occur also in other EDS subtypes [1,2]. A reduced skin thickness has been previously reported in hEDS patients [3].ObjectivesTo investigate, for the first time, nailfold microvascular status in hEDS patients in comparison with healthy controls (HCs). Peripheral blood perfusion (PBP) and dermal thickness (DT) were also assessed.MethodsTwelve hEDS patients (75% females, mean age 41±16, classified with the 2017 International Classification Criteria of EDS [4]) and twelve age- and sex-matched HCs were observed from 2018 to 2022. Beighton score was calculated for both patients and HCs. Main nailfold videocapillaroscopy (NVC) parameters (dilated capillaries, giant capillaries, microhemorrhages, abnormal shapes and number of capillaries) were analysed and compared between the two groups to assess morphological features [5]. To assess the microvascular functional status, laser speckled contrast analysis (LASCA) was used to measure PBP in several region of interests. DT was also measured by cross-sectional B-mode scans obtained by a high-frequency 22 MHz ultrasound probe in 17 different areas of the body (including upper arms, lower arms, trunk and forehead).ResultsNo statistically significant differences were observed in this small cohort between hEDS and HCs concerning the microvascular findings detected by NVC, even if microhemorrages were more prevalent in hEDS patients (33% vs 0 %) (seeTable 1). Also, PBP assessed by LASCA was found similar in hEDS patients and HCs (178.12 ± 49.76 perfusional units vs 157.81 ± 67.15 at fingertips, p = 0.43). The mean DT did not significantly differ from hEDS patients and HCs in all skin areas (mean total DT of 18.44 ± 2.21 mm in hEDS patients vs 18.49 ± 2.13 mm in HCs, p = 0.96). As expected, the mean Beighton score was significantly higher in hEDS patients than in HCs (5.54±1.75 vs 1.25±1.58), but no significant correlation was detected between DT and Beighton score (r = 0.1, p = 0.76).ConclusionMicrohemorrages seem more prevalent in hEDS patients than in ECs, suggesting a subclinical microvascular fragilility also in this subgroup of EDS patients. Skin ultrasound and PBP findings did not detect significant differences between hEDS patients and HCs, which might be due to the small sample size. These findings will be followed by further research including cases of the vascular EDS phenotype [6].References[1]D’hondt S et al. Genet Med 2018.[2]Superti-Furga A et al. Int J Microcirc Clin Exp 1992.[3]Eisenbeiss C et al. Br J Dermatol 2003.[4]Malfait F et al. Am J Med Genet C Semin Med Genet 2017.[5]Sulli A et al. Ann Rheum Dis 2014.[6]Sulli A et al. RMD Open. 2018.Table 1.NVC in hEDS vs HCs. See text for abbreviationsNVC findingshEDS (n = 12)HCs (n = 12)p -valuesMean capillary number9.4±0.88.8±0.480.08Dilations n (%)10 (83%)10 (83%)0.97Giant capillaries n (%)001Microhaemorrages n (%)4 (33%)00.09Abnormal shapes n (%)3 (25%)4 (33%)0.65Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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"Rutin Treatment of Capillary Fragility." Nutrition Reviews 6, no. 10 (2009): 301–3. http://dx.doi.org/10.1111/j.1753-4887.1948.tb01932.x.
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C, Romano, Costa M, Rapisarda M, Messina M, and Bertini M. "Treatment of Capillary Fragility in Subjects with Spontaneous Hematomas." Journal of Clinical Case Reports 08, no. 07 (2018). http://dx.doi.org/10.4172/2165-7920.10001152.
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"5116617 Pharmaceutical composition for topical use in the treatment of the capillary fragility." General Pharmacology: The Vascular System 23, no. 6 (1992): vi. http://dx.doi.org/10.1016/0306-3623(92)90374-s.
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Dipti Rao, Roeland F. Stolk, Maaike H. de Blauw, Marcel M.C. Hovens, and Robert-Jan Hassing. "Ancient Bruises: a Case of Skin Lesions due to Vitamin C Deficiency." European Journal of Case Reports in Internal Medicine 2, LATEST ONLINE (2015). http://dx.doi.org/10.12890/2015_000297.
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Scurvy was a common 18th century disease caused by vitamin C deficiency. It presents with multiple non-specific symptoms and can lead to capillary fragility due to impaired collagen synthesis. We report the case of a 63-year-old woman who presented with fatigue, nausea and progressive skin lesions consisting of multiple ecchymoses on the legs as also described in the diary drawings of a navy doctor in the 19th century. The ascorbic acid level was undetectable low in the patient’s serum. However, treatment with 500 mg ascorbic acid daily dramatically improved the skin lesions within 5 days.
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Pirtle, Floyd A., Dylan Maldonado, Pitchaporn Yingchoncharoen, et al. "Rumpel-Leede phenomenon following radial artery catheterisation." European Journal of Case Reports in Internal Medicine, July 14, 2023. http://dx.doi.org/10.12890/2023_003990.
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Rumpel-Leede phenomenon is a rarely diagnosed entity that can be seen in patients following the application of tourniquet-like forces to the extremities. This phenomenon describes petechiae and purpura secondary to venous compression and congestion, with its underlying aetiology involving the fragility of capillary vessels within the dermis. This condition is associated with chronic medical conditions such as diabetes mellitus, hypertension, dyslipidemia, peripheral vascular disease and systemic inflammatory diseases, including infections. In addition, patients with coagulopathy including thrombocytopenia or platelet dysfunction from antiplatelet use, or those with thrombotic thrombocytopenic purpura and idiopathic thrombocytopenic purpura, are predisposed to capillary haemorrhage and petechiae formation. In this report, we present a case of a patient who developed Rumpel-Leede phenomenon following catheterisation of the right radial artery with spontaneous resolution – where only five cases have been reported to date – with the aim to make clinicians aware of this condition and to avoid unnecessary interventions.