Jose Antonio Diaz

Purpose Basic science contributes to knowledge and advances the field. This is not an exception in Phlebology. This manuscript highlights the latest contributions to the basic science on varicose veins. Methods A brief non-systematic review of the literature in the area of basic science and varicose veins was performed using PubMed. We found critical articles that are discussed in this work. In addition, we discussed all the scientific method steps, the importance of each of them, and its application to the field of Phlebology. The basic science and varicose veins' articles were discussed as basic science findings on vein wall, blood flow disturbances, and vein valve changes. Results Altered vein wall in varicose veins results from the remodeling phenomenon, led by modifications at the vein wall cellular level and in the intercellular space. Smooth Muscle Cells are involved in this process, and a shift between contractile to secretory phenotype has been described. MMPs are actively engaged in the remodeling stage, contributing to the final modification of the vein wall observed in varicose veins. Finally, the blood flow characteristics and the vein valve functionality demonstrated an integrated system. Conclusions The Scientific Method is the cornerstone of the basic science approach. Varicose veins result from altered blood flow and vein wall remodeling phenomenon.

Thermal therapies have strong potential for improving outcomes for patients suffering from cardiac arrest, neonatal hypoxic-ischemic encephalopathy, or medically refractory intracranial hypertension. We propose a novel tool to manipulate blood temperature through extravascular thermoelectric heat exchange of blood vessel walls and flowing blood. This tool is a concentrated cooling probe with several thermoelectric units combined to focus cooling at the application site. Using this tool, we aim to achieve desired levels of temperature control and potentially reduce complications associated with traditional intravascular or systemic thermal therapies. Leveraging the feedback control, speed, and reversible operation of thermoelectric cooling modules, the device can adapt to cool or heat as desired. Preclinical testing on rodent models confirmed rapid, significant reduction of intravenous jugular blood temperature when a prototype device was brought in contact with the left carotid artery (change in blood temperature of −4.74 ± 2.9 °C/h and −4.29 ± 1.64 °C/h for 0 °C and −5 °C cooling trials, respectively). Declines in rectal temperature were also noted, but at lesser magnitudes than for jugular blood (0 °C: −3.09 ± 1.29 °C/h; −5 °C: −2.04 ± 1.08 °C/h), indicating proof-of-concept of thermoelectric extravascular blood cooling within a relatively localized region of the body. With further improvements in the technique, there is potential for selective organ cooling via a reduction in the temperature of flowing blood.

In this issue of Blood, Zirka et al1 investigated the role of Slc44a2 in thrombosis. Specifically, they focused on determining how Slc44a2 expressing either the