The shear complexity of insulin-stimulated vasodilatation

Comparison of the acute effects of ankle bathing versus moderate-intensity aerobic exercise on vascular function in young adults

We examined the efficacy of ankle bathing versus aerobic exercise to improve vascular function in young adults who were randomized to aerobic exercise (AE) (n = 13, 40%-60% of heart rate reserve), ankle bathing (AB) (n = 15, 43 °C), or a control condition (CON) (n = 14, ankle bathing, 36 °C) for 40 min. Conduit vessel function [brachial artery flow-mediated dilation (FMD)], carotid and femoral artery blood flow and shear rate (SR), and arterial stiffness [carotid-to-femoral pulse wave velocity (cf-PWV), augmentation index (AIx@75), β-stiffness index, and arterial compliance] were evaluated. Compared with CON, AE and AB increased FMD at 30 min and 90 min (interaction: p < 0.05); AB decreased carotid artery blood flow and SR at 30 min, while both AE and AB increased femoral artery blood flow and SR at 30 min and 90 min (interaction: p < 0.05); AE and AB decreased cf-PWV and AIx@75 at 30 min and 90 min (interaction: p < 0.05); and AE improved both carotid and femoral β-stiffness index and arterial compliance, while AB reduced β-stiffness index and increased arterial compliance only in the femoral artery (interaction: p < 0.05). These findings suggest that ankle bathing may serve as an alternative strategy for enhancing vascular function. Novelty: We observed similar improvements in conduit vessel function, femoral artery blood flow and shear rate, and arterial stiffness following ankle bathing and acute aerobic exercise in young adults. These findings have identified ankle bathing as a potential therapeutic strategy for enhancing vascular function, which may be particularly relevant for those with limited ability to engage in regular aerobic exercise.

Drug-induced peripheral oedema: An aetiology-based review

Many drugs are responsible, through different mechanisms, for peripheral oedema. Severity is highly variable, ranging from slight oedema of the lower limbs to anasarca pictures as in the capillary leak syndrome. Although most often noninflammatory and bilateral, some drugs are associated with peripheral oedema that is readily erythematous (eg, pemetrexed) or unilateral (eg, sirolimus). Thus, drug-induced peripheral oedema is underrecognized and misdiagnosed, frequently leading to a prescribing cascade. Four main mechanisms are involved, namely precapillary arteriolar vasodilation (vasodilatory oedema), sodium/water retention (renal oedema), lymphatic insufficiency (lymphedema) and increased capillary permeability (permeability oedema). The underlying mechanism has significant impact on treatment efficacy. The purpose of this review is to provide a comprehensive analysis of the main causative drugs by illustrating each pathophysiological mechanism and their management through an example of a drug.