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Abstract: Introduction: Acrocyanosis is the most common form of angiodystonic vascular acrosyndrome, characterized by functional microcirculatory alterations without structural vessel damage. It is traditionally classified as either primary or secondary, the latter often associated with underlying conditions. Methods: Some observations suggest a frequent association between acrocyanosis and connective tissue diseases (CTDs). To investigate this, we conducted a study on 53 patients diagnosed with acrocyanosis: 45 females and eight males, 15 to 82 years old, with a mean age of 35 years. Secondary acrocyanosis was identified in 24 patients (45.3%). Results: Advanced age (≥ 40 years) was a significant risk factor for secondary acrocyanosis (relative risk = 2.5, 95% confidence interval: 1.4–4.5, p = 0.002). No significant differences were observed between sexes. CTDs were the most common conditions associated with acrocyanosis (32% of the study population and 71% of the secondary forms). Conclusions: Although generally considered benign, acrocyanosis may indicate an underlying systemic disease. Clinical examination remains essential for the diagnosis of acrocyanosis. Our findings reveal a high prevalence of secondary acrocyanosis associated with CTDs. Patients with strong clinical suspicion should be referred to specialized centers for capillaroscopy and antinuclear antibody testing.
Keywords: acrocyanosis, capillaroscopy, connective tissue diseases, microcirculation, non-invasive diagnosis
Published in DiRROS: 15.06.2026; Views: 240; Downloads: 146
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Abstract: Acute elevations in blood glucose can influence microvascular function and autonomic nervous system (ANS) reactivity, both implicated in cardiometabolic risk. We assessed the effects of oral glucose tolerance test (OGTT) on microvascular and ANS physiological responses in healthy young individuals. Using laser Doppler flowmetry (LDF), we measured basal skin microcirculatory blood flow and responses to post-occlusive reactive hyperemia, iontophoresis of acetylcholine (ACh), and sodium nitroprusside (SNP) in 28 participants before and 45 and 120 min after OGTT or water loading. LDF spectral components were analyzed using wavelet analysis (WA). ANS reactivity was evaluated from electrocardiogram recordings by analyzing heart rate variability (HRV). OGTT caused time-dependent changes in microvascular and HRV parameters. Endothelial nitric oxide-independent vasodilation transiently decreased during SNP response (p = 0.014), while myogenic component transiently increased (p = 0.029; two-way repeated measures ANOVA), with no significant change in the endothelial nitric oxide-dependent component. HRV measures RMSSD (p = 0.009) and SDNN (p = 0.008) decreased. Oral glucose loading affects microcirculation in healthy individuals, likely through modulation of endothelial nitric oxide-independent signaling, vascular smooth muscle responsiveness, and ANS reactivity. WA may offer a sensitive method for detecting microvascular dysfunction associated with physiological changes following oral glucose loading.
Keywords: acute hyperglycemia, endothelial function, heart rate variability, microcirculation, nitric oxide, oral glucose loading, oral glucose tolerance test, wavelet analysis
Published in DiRROS: 20.04.2026; Views: 298; Downloads: 279
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Abstract: Most women with epithelial ovarian cancer (EOC) suffer from peritoneal carcinomatosis upon first clinical presentation. Extensive peritoneal carcinomatosis has a poor prognosis and its pathophysiology is not well understood. Although treatment with systemic intravenous chemotherapy is often initially successful, peritoneal recurrences occur regularly. We hypothesized that insufficient or poorly-perfused microvasculature may impair the therapeutic efficacy of systemic intravenous chemotherapy but may also limit expansive and invasive growth characteristic of peritoneal EOC metastases. In 23 patients with advanced EOC or suspicion thereof, we determined the angioarchitecture and perfusion of the microvasculature in peritoneum and in peritoneal metastases using incident dark field (IDF) imaging. Additionally, we performed immunohistochemical analysis and 3-dimensional (3D) whole tumor imaging using light sheet fluorescence microscopy of IDF-imaged tissue sites. In all metastases, microvasculature was present but the angioarchitecture was chaotic and the vessel density and perfusion of vessels was significantly lower than in unaffected peritoneum. Immunohistochemical analysis showed expression of vascular endothelial growth factor and hypoxia inducible factor 1α, and 3D imaging demonstrated vascular continuity between metastases and the vascular network of the peritoneum beneath the elastic lamina of the peritoneum. We conclude that perfusion of the microvasculature within metastases is limited, which may cause hypoxia, affect the behavior of EOC metastases on the peritoneum and limit the response of EOC metastases to systemic treatment.
Keywords: microvasculature, microcirculation, EOC, peritoneal carcinomatosa, incident dark feld imaging
Published in DiRROS: 23.07.2024; Views: 1454; Downloads: 820
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