Safe and strategic vascular access
Peter A. Schneider in Endovascular Skills: Guidewire and Catheter Skills for Endovascular Surgery, 2019
A poorly chosen or conducted access can make case complicated and possibly make a complicated case impossible. Use of the vascular system itself to assist the therapist in arriving at the site of the lesion for treatment has tremendous appeal. The retrograde femoral puncture is the most commonly used since it is safest and offers the highest degree of versatility. Consider the need for access as a breach of the vascular system, a necessary evil that should be minimized as far as possible. The most important maneuver for successful vascular access occurs prior to the procedure, and that is choosing the puncture site. A puncture of the mid-common femoral artery is desirable. Ultrasound guidance is extremely helpful in achieving this goal. Puncture of the artery proximal to femoral head is likely to be too far proximal and to enter the external iliac artery. A right-handed operator stands on the patient’s left side for forehand delivery of the needle and guidewire.
Menopausal symptoms
Myra Hunter, Melanie Smith in Managing Hot Flushes and Night Sweats, 2020
Hot flushes and night sweats are typically described as sensations of intense heat, accompanied by sweating and sometimes shivering and palpitations. They are also called ‘vasomotor’ symptoms because they are associated with changes in the vascular system that affects blood flow in the body; for example, when hot flushes occur, there is an initial (vaso) dilation and subsequent (vaso) constriction of blood vessels. The menopause at work has become a ‘hot topic’! Recent research suggests that many women find menopausal symptoms more difficult to deal with at work, partly due to aspects of the work environment. Most women who develop breast cancer have already gone through the menopause— the risk of developing breast cancer increases with age— and they may well have been experiencing menopausal symptoms when their cancer was first discovered. Women undergoing treatment for gynaecological cancers can also experience menopausal symptoms following medical intervention.
Radiation Damage of Other Organ Systems
Kedar N. Prasad in Handbook of RADIOBIOLOGY, 2020
The radiation response of the heart is called radiation carditis. The myocardial cells are highly radioresistant on the criterion of morphological changes. The structural changes in the myocardium are seen only after high-radiation therapeutic doses. The pericardial cells are relatively more radiosensitive; the damage to the pericardium is produced with more frequency at lower radiation doses. The fine vasculatures are relatively radiosensitive; therefore, acute and chronic effects of irradiation of the heart are primarily due to the damage of the vascular system.
Effects of dydrogesterone on the vascular system
Published in Gynecological Endocrinology, 2007
Harald Seeger, Alfred O. Mueck
Estrogens exert beneficial effects on the vascular system, while progestogens generally have a negative impact (e.g. vasoconstrictor effects on the arterial system). In contrast, dydrogesterone appears to be largely neutral in terms of biochemical markers and indirect clinical endpoints, such as blood pressure, that act as surrogate markers for vascular function. Studies on lipid and carbohydrate metabolism, which can also influence vascular function, demonstrate that the addition of dydrogesterone intensifies rather than attenuates beneficial estrogenic effects. Dydrogesterone also has largely neutral effects on hemostasis. Since there are relatively few data available on clinical parameters such as blood flow measurements, especially in women with pre-existing cardiovascular diseases, increased risks cannot be excluded for a combination of estrogen replacement with dydrogesterone. Further studies should focus on this open question since dydrogesterone, with its largely neutral properties, might be a suitable option, including for older women already at increased cardiovascular risk.
Effects of radiation and MediPort placement on the development of thoracic outlet syndrome
Published in Baylor University Medical Center Proceedings, 2020
Clara Grimsley, Robert Corn, Stephen Hohmann, John Eidt, Bertram Smith, Gregory Pearl, Bradley R. Grimsley
We present a patient who exemplifies the interplay of factors contributing to the development of venous-type thoracic outlet syndrome. The patient was treated with both radiation and chemotherapy for squamous cell carcinoma in the head and neck region; radiation and chemotherapy have been known to damage the vascular system. Multimodality treatment is necessary to achieve good long-term results in these complex patients.
Diabetes management in older people: a focus on cardiovascular risk reduction
Published in Postgraduate Medicine, 2017
Emily McNicholas, Ahmed H. Abdelhafiz
Cardiovascular disease remains the most common cause of death in persons with diabetes regardless of age. Increasing age combined with diabetes exert a synergistic effect on the vascular system increasing the atherosclerosis burden in older people with diabetes. Due to their high baseline risk, they stand to benefit most from interventions to reduce cardiovascular risk. Older people with diabetes are functionally heterogeneous and their management is challenging. Fit and independent individuals are likely to benefit from tight targets while a relaxed approach putting quality of life at the heart of management plans is more appropriate in the frail and dependent individuals with limited life expectancy.
Related Knowledge Centers
- Lymph
- Thermoregulation
- Lymphatic System
- Blood
- Homeostasis
- Electrolyte
- Hormone