Oscillatory pattern of acral skin blood flow within thermoneutral zone in healthy humans

The acral skin contains arteriovenous anastomoses, which probably is the main part of skin microcirculation for blood flow adjustments and thermoregulation in the thermoneutral zone. The objective was to investigate if an increase in sympathetic activation during cooling influences the oscillatory pattern of acral skin blood flow. We had measurements of bilateral acral skin blood flow (n??=??12) during lowering of ambient temperature from 32 °C to 18 °C. We quantified the oscillatory pattern as the time averaged wavelet spectral powers, coherence and phase angles in three frequency intervals (0.01–0.02 Hz, 0.02–0.05 Hz and 0.05–0.08 Hz). The differences were tested by Wilcoxon signed rank sum method between adjacent intervals. The absolute fluctuations in laser Doppler flux at 0.01–0.02 Hz, 0.02–0.05 Hz and 0.05–0.08 Hz were similar at 32 °C and 25 °C, and decreased at 18 °C (p????0.89) at 25 °C, and lower at 32 °C and at 18 °C.The median phase angles between the flux signals from right and left finger tips were close to 0 radians. We found that the relative fluctuations in acral skin blood flow increased during vasoconstriction due to cooling. Wavelet analysis of acral skin blood flow oscillations could serve as a future clinical tool. © 2017 IOP Publishin

Contact allergy in patients with chronic venous leg ulcers

Contact allergy (CA) is prevalent in patients with chronic leg ulcers (CLUs) due to venous stasis1 and may delay wound healing. Exposure to different ointments and wound dressings over time, combined with occlusive bandaging, may predispose to contact sensitization.2 The spectrum of allergens depends on wound care practices.3, 4 Studies on CA in patients with CLUs from Norway are lacking. To determine the occurrence of CA in patients with CLUs, patch testing was performed with the Leg Ulcer Series (LUS) containing 27 chemicals and five additional substances relevant to wound treatment: Caine mix III and V, hydrocortisone, IntraSite gel (propylene glycol 20%, Smith & Nephew), and Brulidine (dibrompropamidine 0.15%, Sanofi‐Aventis) (Table S1). Fifty‐two of the 97 patients were also tested with the European Baseline Series (EBS) (Table S2)

Cardiovascular rEmodelling in living kidNey donorS with reduced glomerular filtration rate: rationale and design of the CENS study

Purpose: Until recently, it has been believed that donating a kidney not represents any risk for development of cardiovascular disease. However, a recent Norwegian epidemiological study suggests that kidney donors have an increased long-term risk of cardiovascular mortality. The pathophysiological mechanisms linking reduced kidney function to cardiovascular disease are not known. Living kidney donors are screened for cardiovascular morbidity before unilateral nephrectomy, and are left with mildly reduced glomerular filtration rate (GFR) after donation. Therefore, they represent an unique model for investigating the pathogenesis linking reduced GFR to cardiovascular disease and cardiovascular remodelling. We present the study design of Cardiovascular rEmodelling in living kidNey donorS with reduced glomerular filtration rate (CENS), which is an investigator-initiated prospective observational study on living kidney donors. The hypothesis is that living kidney donors develop cardiovascular remodelling due to a reduction of GFR. Materials and methods: 60 living kidney donors and 60 age and sex matched healthy controls will be recruited. The controls will be evaluated to fulfil the Norwegian transplantation protocol for living kidney donors. Investigations will be performed at baseline and after 1, 3, 6 and 10 years in both groups. The investigations include cardiac magnetic resonance imaging, echocardiography, bone density scan, flow mediated dilatation, laser Doppler flowmetry, nailfold capillaroscopy, office blood pressure, 24-h ambulatory blood pressure, heart rate variability and investigation of microbiota and biomarkers for inflammation, cardiovascular risk and the calcium-phosphate metabolism. Conclusions: The present study seeks to provide new insight in the pathophysiological mechanisms linking reduced kidney function to cardiovascular disease. In addition, we aim to enlighten predictors of adverse cardiovascular outcome in living kidney donors