Nalazi CDFI i PDI kod ekstrakranijske arterijske bolesti

The development of duplex ultrasound instrumentation combining high-resolution B-mode imaging with Doppler flow analysis represents a major advancement in ultrasound cerebrovascular diagnosis. Duplex sonography enables not only estimation of arterial stenosis, but allows for visualization of the plaque morphology. The principal arterial abnormality detectable with B-mode sonography is plaque, which appears as echogenic material that thickens the arterial wall and obliterates the lucent zone between the intimal reflection and the adventitia. When an atherosclerotic plaque is detected, its severity, extent, morphology and location must be analyzed. The most common site of atherosclerotic plaque formation is at the carotid bifurcation. The European Carotid Surgery Trial (ECST) and North American Symptomatic Carotid Endarterectomy Trial (NASCET) have shown that the degree of internal carotid artery stenosis is a major predictor of ipsilateral ischemic stroke in patients presenting with transient ischemic attack or minor ischemic stroke. The main location of vertebral stenosis or occlusion is the origin (V0 segment), less commonly more distally in the cervical region (V1 segment) or intracranially (V4 segment). The left subclavian artery is more often affected by atherosclerosis than truncus brachiocephalicus. The main characteristic of occlusion or stenosis of truncus brachiocephalicus are spectral changes in the right subclavian, carotid and vertebral artery. Cerebral ischemia is the most serious consequence of cervical artery dissection. Internal carotid artery is the most commonly affected vessel. In extreme cases, artery dissections can extend from the aorta to the subclavian, carotid and vertebral arteries. The term ‘vasculitis’ encompasses a heterogeneous group of multisystemic disorders; CDFI examination demonstrates thickening of the arterial wall, usually circumferential, stenosis or occlusion of the arteries.Razvoj ultrazvučnih dupleks uređaja koji ujedinjuju B-prikaz visoke rezolucije sa spektralnom krivuljom pridonio je značajnom napretku u dijagnostici cerebrovaskularnih bolesti. Dupleks ultrasonografija omogućuje ne samo procjenu stupnja stenoze, nego i prikaz morfologije plaka. Najčešći poremećaj krvnih žila vidljiv pomoću B-prikaza je plak koji se prikazuje kao ehogena struktura koja zadebljava stjenku arterije i obliterira prostor između intimalne refleksije i adventicije. Kada se prikaže aterosklerotski plak, treba analizirati njegov položaj, prostiranje, morfologiju i stupanj stenoze. Najčešće mjesto stvaranja aterosklerotskog plaka je karotidna bifurkacija. Studije European Carotid Surgery Trial (ECST) i North American Symptomatic Carotid Endarterectomy Trial (NASCET) pokazale su da je stupanj stenoze unutarnje karotidne arterije najvažniji predskazatelj istostranog ishemijskog udara u bolesnika s prolaznim ishemijskim napadajem ili blažim oblikom moždanog udara. Najčešće mjesto stenoze ili okluzije vertebralnih arterija je polazište (segment V0), a rjeđe distalno u cervikalnom dijelu(segment V1) ili intrakranijski (segment V4). Lijeva subklavijska arterija češće je zahvaćena aterosklerotskim promjenama nego brahiocefalni trunkus. Glavno obilježje okluzije ili stenoze brahiocefalnog trunkusa je promjena spektra u desnoj subklavijskoj, karotidnoj i vertebralnoj arteriji. Moždana ishemija je najozbiljnija posljedica disekcije vratnih arterija. Najčešće je zahvaćena unutarnja karotidna arterija. U krajnjim slučajevima disekcija se može protezati od aorte do subklavijskih, karotidnih i vertebralnih arterija. Pojam vaskulitis obuhvaća heterogenu skupinu multisistemskih poremećaja. Ultrazvučnom (dupleks) pretragom prikazuje se zadebljanje stijenki arterija, najčešće cirkumferentno, stenoza ili okluzija arterija

Hepatoprotective effects of BPC-157 - paracetamol overdose

Paracetamol, also known as acetaminophen, is a widely used medication to treat pain and fever. As it’s one of the over-the-counter medications, it’s easily accessible to everyone. Its mechanism of action is the inhibition of prostaglandin synthesis in the CNS to reduce hyperalgesia. It also influences the thermoregulatory center in the hypothalamus and lowers fever. 90-95% of paracetamol is metabolized in the liver where it’s conjugated with glucuronic acid and sulfates into inactive metabolites, and the rest via cytochrome-p450. Its main side effect is hepatotoxicity and acute liver injury. Here we investigate the hepatoprotective effects of BPC-157 while administering a toxic dose of paracetamol intraperitoneally in rats

ISOSORBIDE-5-MONONITRATE INDUCED PERIPHERAL AND CENTRAL VASCULAR DYSFUNCTION IN RATS AND TRETMENT WITH STABLE GASTRIC PENTADECAPEPTIDE BPC 157

Introduction: Although the understanding of migraine pathophysiology is incomplete, it is now well accepted that this neurovascular syndrome is mainly due to cranial vasodilation. Several experimental migraine models have been developed, including the use of a nitric oxide (NO) donor, such as isosorbide-5-mononitrate (IS-5-MN). Nitric oxide regulates cerebral and extracerebral cranial blood flow and arterial diameters. We observed the therapeutic effects of stable gastric pentadecapeptide BPC 157 on peripheral and central vascular dysfunction caused by IS-5- MN administration

Znanstveni pristup migreni

Migraine is a common episodic headache disorder; prevalence of migraine in most western countries is 10-12%. The mechanism of migraine pain development is not fully understood. The theory of neurogenic inflammation proposes that the main event is the inflammation in the vessel wall which leads to leakage of nociceptive substances, causing thickening of the vessel wall and dilatation of vascular smooth muscles. The release of vasoactive neuropeptides causes depolarization of trigeminal perivascular axons, thus causing pain. Triptans are recommended for acute migraine attacks; studies have shown that their use increases productivity at work and improves the quality of life. Preventive therapy is recommended in migraine patients with frequent, severe, long-lasting attacks, in cases where acute therapy is not efficient, if there is a contraindication to the drug, failure or unbearable side-effects from acute treatments, overuse of acute medications or in special cases such as hemiplegic migraine. Beta-blockers and tricyclic antidepressants were often used as first line therapy for migraine prevention. Other p reventive drugs include pizotifen, flunarizine, and anticonvulsives. Migraine is often associated with a number of commorbid diseases: allergies, hypotension, epilepsy, fatigue sy, gastritis, iritabile colon disease, vertigo; therefore, preventive and acute therapy should be tailored individually.Migrena je česta glavobolja čija se prevalencija kreće u zapadnim zemljama između 10- 12%. Mehanizam boli kod migrene nije sasvim razjašnjen. Po teoriji neurogene upale glavno zbivanje je upala stijenki krvnih žila koja dovodi do istjecanja nociceptivnih supstanci što uzrokuje zadebljanje zida arterija te dilataciju glatkih mišićnih stanica. Otpuštanje vazoaktivnih neuropeptida uzrokuje depolarizaciju trigeminalnih aksona što dovodi do pojave boli. Triptani se preporučaju u akutnim napadajima migrene; istraživanja su pokazala da se njihovom upotrebom u akutnom napadaju migrene povećava produktivnost na poslu i poboljšava kvaliteta života. Preventivna terapija se preporuča kod osoba s učestalim jakim i dugotrajnim napadajima, te u slučajevima kada akutna terapija nije učinkovita, ukoliko postoji kontraindikacija ili su izražene nuspojave za primjenu akutne terapije, te u slučajevima kada se radi o obiteljskoj hemiplegijskoj migreni. U preventivnoj terapiji preporučaju se beta blokatori i triciklički antidepresivi a od ostalih lijekova se preporučaju pizotifen, flunarizin te antiepileptici. Migrena je često udružena s komorbidnim bolestima poput alergija, hipotenzije, epilepsija, sindromom kroničnog umora, iritabilnim kolonom, gastritisom i vertigom; stoga se akutna i profilaktička terapija moraju individualno određivati

Microembolus Detection by Transcranial Doppler Sonography: Review of the Literature

Transcranial Doppler can detect microembolic signals which are characterized by unidirectional high intensity increase, short duration, random occurrence, and a “whistling” sound. Microembolic signals have been detected in a number of clinical settings: carotid artery stenosis, aortic arch plaques, atrial fibrillation, myocardial infarction, prosthetic heart valves, patent foramen ovale, valvular stenosis, during invasive procedures (angiography, percutaneous transluminal angioplasty), surgery (carotid, cardiopulmonary bypass, orthopedic), and in certain systemic diseases. Microembolic signals are frequent in large artery disease, less commonly detected in cardioembolic stroke, and infrequent in lacunar stroke. This article provides an overview about the current state of technical and clinical aspects of microembolus detection