International Newsletter

In February, I attended the 8th Congress of the Endothelium in Caracas, Venezuela. It made a lot of sense. Neurologists along with cardiologists, vascular surgeons, internists, endocrinologists, and basic scientists discussed the trials and tribulations of the endothelium. This is the most extensive organ of the body; if displayed, the endothelial lining of an adult would cover two tennis fields. The most salient pathology of the endothelium is atherosclerosis, but there are other processes that disrupt global functions such as selective permeability, vascular tone, antiadhesion, antiaggregation, fibrinolysis, and tissue growth attributed to the interior lining of arteries, capillaries, and veins. I guess one could talk of endothelioses as alterations of the endothelium and name the discipline that studies such disruptions endotheliology. It becomes a bit more complicated when referring a patient to the endotheliologist, and I do not ever expect to see a patient in my office complaining of pain in the endothelium. But that is where the fallacy lies; because the endothelium does not cause pain, patients and insurance companies do not pay attention to it. Stay tuned!

I also learned that in Venezuela one needs a medical prescription to buy aspirin. As I was praising this evidence-based, clinically rational action, calculating to myself how many intracerebral bleeds could be spared in a population of 20 million, someone snapped me back to reality. “No,” she said, “the action was not stroke-related. It had to do with dengue fever.” This mosquito-borne viral infection is common in the Caribbean region and causes a flu-like syndrome. The knee-jerk reaction …