Endothelins are potent peptide vasoconstrictors which were discovered two decades back. Their role in cardiovascular diseases, cancer, glaucoma, diabetes mellitus and many other diseases have been studied. Inspite of a lot of research many questions regarding their pathophysiological roles still remain unanswered. Though many endothelin receptor antagonists showed promising results in animal st...

Neurogenic shock is a type of distributive shock that describes the sudden loss of autonomic tone due to spinal cord injury often characterized by hypotension and relative bradycardia. Loss of sympathetic tone occurs with injuries above T6 and results in decreased systemic vascular resistance. Peripheral vasoconstrictors, chronotropes, and inotropes may be needed in cases of neurogenic shock. A...

• Hyponatremia and hepatorenal syndrome are complications that occur in patients with cirrhosis and ascites and represent a stage of “further” decompensation of cirrhosis • Worsened vasodilatation with consequent non-osmotic release of arginine-vasopressin and renal vasoconstriction are the main pathogenic mechanism for hyponatremia and hepatorenal syndrome, respectively • Both hyponatremia and...

Hepatopulmonary syndrome consists of a clinical triad: arterial blood deoxygenation, intrapulmonary vasodilation, and liver disease. Both acute and chronic cases of this syndrome have been reported, and the most common cause is cirrhosis. The principle disease mechanism is dilation of the pulmonary blood vessels causing alterations in gas exchange. Increased pulmonary production of nitric acid ...

Acute variceal bleeding (AVB) is a milestone event for patients with portal hypertension. Esophageal varices bleed because of an increase in portal pressure that causes the variceal wall to rupture. AVB in a patient with cirrhosis and portal hypertension is associated with significant morbidity and mortality. The initial management of these patients includes proper resuscitation, antibiotic pro...

Liver cirrhosis is complicated by a hyperdynamic circulation characterized by a generalized arterial vasodilatation. This vasodilatation occurs despite high plasma concentration of several potent vasoconstrictive substances like angiotensin, vasopressin, endothelin and norepinephrine. The experimental evidence available shows that compensatory adrenergic and vasoconstrictive signals are not nor...

Intradialytic hypotension continues to play a significant role in the morbidity and in some cases the mortality associated with maintenance hemodialysis. Greater precision in the determination of dry weight using bioimpedance technology and biofeedback systems designed to prevent rapid fluctuations in blood volume have recently been shown to decrease the frequency of this complication. Pharmaco...

This study aimed to describe the structure of oral health services in primary care Brazil with centers participating second cycle ‘National Program for Improving Access and Quality Primary Care’ (PMAQ-AB), largest service evaluation program ever instituted country. cross-sectional evaluated 16,202 services, regarding 22 pieces dental equipment 25 supplies. The presence each piece equipment/dent...