Central Cardiovascular System Research Articles

Practical aspects of anaesthetic monitoring, part 2: respiratory system and temperature monitoring

In practice, anaesthetic monitoring is normally carried out by trained veterinary nurses, although veterinary surgeons are ultimately responsible for the safety of their patients and should be fully aware of the monitoring methods available. This two-part review article considers the evidence for monitoring anaesthetised small animals in a clinical setting and highlights the current veterinary recommendations, comparing them to the human anaesthesia standards of care. The monitoring modalities are considered in light of the physiological parameters they are intended to measure, highlighting the relevance to anaesthesia and their usefulness in clinical practice. Practical examples are given throughout, emphasising how monitors can warn of physiological and equipment deterioration. Part one outlined the available approaches to basic and advanced central nervous system and cardiovascular system monitoring, emphasising the practical aspects, as well as introducing more advanced concepts. Part two considers respiratory system and temperature monitoring.

Practical aspects of anaesthetic monitoring, part 1: central nervous system and cardiovascular system

In practice, anaesthetic monitoring is normally carried out by trained veterinary nurses, although veterinary surgeons are ultimately responsible for the safety of their patients and should be fully aware of the monitoring methods available. This two-part review article considers the evidence for monitoring anaesthetised small animals in a clinical setting and highlights the current veterinary recommendations, comparing them to the human anaesthesia standards of care. The monitoring modalities are considered in light of the physiological parameters they are intended to measure, highlighting the relevance to anaesthesia and their usefulness in clinical practice. Practical examples are given throughout, emphasising how monitors can warn of physiological and equipment deterioration. Part one outlines the available approaches to basic and advanced central nervous system and cardiovascular system monitoring, emphasising the practical aspects as well as introducing more advanced concepts. Part two will consider respiratory system and temperature monitoring.

The results of allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimen doses in patients with Hurler syndrome

Background. Hurler syndrome is the most severe type of mucopolysaccharidosis with central nervous system, cardio-vascular system and musculoskeletal system involvement. A unique method of radical therapy is allogenic stem cell transplantation (allo-HSCT). A question on high toxicity of HSCT is still unsolved for these patients. Aim – to estimate effectiveness and toxicity of conditioning regimen with reduce intensity in patients with Hurler syndrome. Materials and methods. Eight patients were enrolled to the investigation. Follow-up median was 20 (1–60) months. 6 patients received allo-HSCT from full HLA-matched unrelated donors, 2 patients received HSCT from partially HLA-matched unrelated donors with mismatch in A locus. The following conditioning regimens with reduce intensity were used as preparative therapy: Fludarabine – 150 mg/m2, Melphalan – 140 mg/m2, Antithymocyte Immunoglobulin (ATGAM) – 60 mg/kg. For graft-versus-host disease (GvHD) prevention Cyclosporine A in dose 1.5 mg/kg2 time per day with a combination with Methotrexate (10 mg/m2 in days +1, +3, +6) or Mycophenolate mofetil (MMF) (15 mg/kg 2 times per day during 30 days) was used. The most common transplant source were peripheral blood stem cells (PBSC) – 6 (75 %) patients, in 2 cases bone marrow was used. Due to high level of T-cells in PBSC at 3 patients, the immunomagnetic CD3/CD19-depletion or CD34+-cells depletion with the help CliniMACs device was performed. The following transplantation of CD3/CD19+-cells in dose 1.0 × 107/ kg of recipients weight in case of full-matched unrelated donor or 1.0 × 106/ kg of recipients weight in case of mismatched unrelated donor was performed. Results. Six patients are alive on a moment of analysis (median follow-up 20 (1–60) months). Overall survival of patients with Hurler syndrome after allo-HSCT is 75 %. All patients engrafted with complete donors chimerism on day +30. Alpha-L-iduronidase activity in leukocytes achieved normal level (average 61.3 nM/mg/18 h) on day +30. Activity was normal till day +100 – 77.6 nM/mg/18 h (normal indicator –61.0–175.5 nM/mg/18 h). Mixed donor’s chimerism was revealed on days +60 and +180 at two patients. No incidence of severe mucosytis III–IV gr. revealed. Two patients died due to transplant related causes. Causes of deaths: 1st patient – acute intestinal GvHD IV gr., III gr. skin GvHD, II gr. liver GvHD on day +69 from allo-HSCT, 2nd patient – TRALI-syndrome after packed red cells transfusion on day +45after allo-HSCT. Conclusion. Allo-HSCT with reduced intensity conditioning regimen for the patients with Hurler syndrome is effective method of treatment without severe toxic complication. Immunoadoptive therapy can be used for rejection prevention in case of mixed donor’s chimerism.

Do your patients with bipolar disorder use dietary supplements?

It is increasingly evident that physicians should routinely ask patients with bipolar disorder about the use of dietary supplements. In our recent study of 348 patients with bipolar disorder, about 3 out of 10 patients used dietary supplements in addition to prescribed drugs, with 2 in 10 of these taking supplements for the long term (Bauer et al. 2015). The patients tried about 40 different supplements, with fish oil, vitamin B preparations, multivitamins, and melatonin taken most frequently. Dietary supplements have the potential to interfere with the treatment of bipolar disorder due to patient misconceptions, and the safety and quality of some products. Patients may turn to dietary supplements to counteract side effects of prescribed drugs or because of a poor outcome. The majority of dietary supplements are self-selected, rather than recommended by a physician, and product choice is primarily influenced by friends, testimonials, aggressive marketing claims, price, and traditions (OIG 2012; New York State 2005). Many patients have misconceptions about dietary supplements, such as that “natural” is synonymous for safe, that supplements are safer than prescribed drugs, that megadoses are safe, and that the products and advertisements are pre-approved by the FDA. Dietary supplements may interact with prescription drugs or with other dietary supplements (Izzo and Ernst 2009). Most interactions with dietary supplements reported in the literature involve prescription drugs that affect the central nervous system or cardiovascular system (Tsai et al. 2012). Patients with bipolar disorder may also be at increased risk of interactions because they often take multiple prescription drugs. Another concern is that some dietary supplements may potentially cause psychiatric adverse reactions such as anxiety, panic attack, confusion, hallucinations, or mania (Ernst 2003). The FDA estimates that there is extensive underreporting of adverse events from dietary supplements (GAO 2013). Many quality problems have been reported for dietary supplements, including product contamination, ingredients not matching those listed on the label, and dosage strength inconsistencies. Between 2004 and 2012, of all FDA drug recalls due to risk of serious adverse consequences or death, over half were for dietary supplements (Harel et al. 2013). Analytical testing of the ingredients in many dietary supplements manufactured in the US found the strength varied widely from that listed on the label (Lockwood 2011). In 2015, an investigation by the New York State Attorney General’s office found that 80 % of store brand herbal dietary supplements at 4 large national chain stores did not contain the herbs listed on the label (O’Connor 2015). In addition, enforcement of current good manufacturing practices by the FDA is limited, with only 11 % of the dietary supplement manufacturing facilities inspected in fiscal year 2013 (Long 2014). The evidence suggests that physicians should assume that patients will not volunteer information on the use of supplements and that this may not be included in a patient's electronic medical record. To provide optimal treatment of bipolar disorder, physicians need to understand patient use of dietary supplements.

Differential Diagnostic Consideration of the Syndrome of Psychomotor Agitation in Geriatric Population

Syndrome of dementia, which appears as a result of deterioration of brain structure that is caused by different factors, together with syndrome of psychomotor restlessness, represents one of the most common psychiatric conditions at patients of the geriatric population (older than 75 years). Our clinical experience shows that these conditions, in this age group, at the moment of admission to hospital treatment, are much more frequent than relapse of chronic endogenous psychosis. Many somatic condition, activation of chronic diseases and subclinical disorders, consequences of previous head trauma (that patient don’t even remember), side effects of most commonly used drugs in the general and internal medicine (benzodiazepines, hypnotics, anticholinergics, antihypertensives, and drugs used in the treatment of arthritis), can cause mental confusion, anxiety and psychomotor agitation – which are conditions similar to dementia. It is very often that mild dehydration is sufficient to cause deterioration in mental status, accompanied by the emergence of nocturnal agitation, confusion, and delirious clouded consciousness. The risk of the manifestation of side effects of psychomotor drugs in geriatric patients becomes much higher due to the exhaustion of adaptive reserves of the central nervous system and cardiovascular system, and due to the delayed liver and kidney function. Implementation of antipsychotics with simpler pharmacodynamic effect is justified to calm the patient. However, later treatment should be directed to compensate the volume of fluid, to correct the electrolyte imbalance, and to treat the root causes that led to the manifestation of psychopathological phenomenology.

Characteristics of fetal anomalies detected on the third trimester ultrasound scan

Objective To investigate the categories of fetal anomalies detected by ultrasound scan in the third trimester. Methods From January 1, 2012 to December 31, 2013, 492 singleton fetuses were found to have structural abnormalities on the first, second or third trimester ultrasound scan in the Peking University First Hospital, only 50 (10.2%) fetuses were detected on the third trimester (≥28 weeks of gestation) with no abnormalities detected on the first and second trimester scan, were enrolled. The categories of the fetal structural abnormalities were analyzed. Results The age of the mothers of the 50 fetuses with structural abnormalities was (35.7±5.2) years (26–43 years) with an average gestation of (32.4±2.8) weeks (28.6–36.8 weeks). These abnormalities were seen in the central nervous system (42%, 21/50), digestive system (28%, 14/50), urinary system (16%, 8/50), cardiovascular system (8%, 4/50), respiratory system (4%, 2/50) and facial structures (2%, 1/50). Intrauterine death occurred in one case and 49 mothers had a live birth. After birth, 14 neonates were normal, five needed further treatment, three cases were complicated by other abnormalities, 23 had no dysfunction but need follow–up and four were lost to follow–up. Six of the 20 (30%) fetuses with central nervous system abnormalities and 2/4 fetuses with cardiovascular system abnormalities had an adverse prognosis, while 1/12 and 2/7 fetuses with digestive and urinary system abnormalities had an adverse prognosis. Conclusions The central nervous system and cardiovascular system should be examined in priority during the third trimester ultrasound scan. Key words: Congenital abnormalities; Ultrasonography, prenatal; Pregnancy trimester, third; Malformation of cortical development; Cardiovascular abnormalities; Retrospective studies

Does levobupivacaine have a benefit over bupivacaine in our practice?

Background The well-known toxic effects of bupivacaine on central nervous system and cardiovascular system were a base for the development of new long-acting local anesthetics. Levobupivacaine is the pure S(-)-enantiomer of racemic bupivacaine. This study compares the efficacy of levobupivacaine as against bupivacaine by epidural clinical study and by different routes in animal study. Materials and methods Evaluation of the analgesic activities by the hot plate method was carried out in nine groups of mice. Each four groups were injected intraperitoneally with either levobupivacaine or bupivacaine. The control group received saline. The hemodynamic effects of levobupivacaine and bupivacaine were carried out on the isolated rabbit's heart and anesthetized cats for carotid blood pressure and ECG. Thirty patients undergoing limb surgery were randomized to receive 15 ml of 0.5% levobupivacaine or bupivacaine through epidural needle. Intraoperative blood pressure and heart rate were recorded. Onset time of sensory and motor block, time to T 10 sensory block, complete motor block, quality of analgesia, and times for two segment regressions were detected. Results Experimentally, the intensity and duration of analgesia produced by levobupivacaine was more than that of bupivacaine. Both drugs induced significant dose-dependent negative inotropic effect, but it was lesser in levobupivacaine than in bupivacaine. An amount of 2 mg/kg levobupivacaine produced a significant rise in blood pressure and 4 mg/kg significantly decreased it, whereas 1 and 2 mg/kg bupivacaine produced a significant decrease in blood pressure. The ECG pattern of levobupivacaine showed no abnormalities, but bupivacaine at a dose of 2 mg/kg produced significant bradycardia and ECG changes. Cardiac arrest and death of cats occurred when 4 mg/kg of bupivacaine was injected. Clinically, the onset time of sensory block, time to T 10 sensory block and time to complete motor block are lower with bupivacaine than with levobupivacaine. Conclusion We found, based on the current pharmacodynamics evidence from this experimental and clinical study, that levobupivacaine has good analgesic activity and less cardiodepressant effect, and it offers advantages over bupivacaine.

Nitrous Oxide

*Department of Anaesthetics and Critical Care, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal; and †Department of Anaesthetics and Critical Care, King Edward VIII Hospital, Durban, South Africa; and ‡Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, United Kingdom.

P66 Characterization of wild type and patient-described mutant forms of Human Persulfide Dioxygenase, ETHE1

Hydrogen sulfide (H 2 S) is an endogenously produced gaseous signaling molecule with beneficial effects in various cellular processes in the central nervous system, cardiovascular system and gastrointestinal tract. The biogenesis of H 2 S involves the enzymes of the transsulfuration pathway cystathionine b-synthase and g-cystathionase. H 2 S oxidation and removal occurs in the mitochondria and the electrons from this oxidation are used in electron transfer chain to generate energy. Steady-state levels of H 2 S are controlled by its biogenesis in the transsulfuration pathway and its efficient oxygen-dependent catabolism in the mitochondria by a 3-enzyme pathway including sulfide quinone oxidoreductase, persulfide dioxygenase (ETHE1) and a sulfur transferase. Mutations in the persulfide dioxgenase, ETHE1, result in ethylmalonic encephalopathy, an inborn error of metabolism. In this study, we report the biochemical characterization and kinetic properties of human persulfide dioxygenase and describe the biochemical penalties associated with two patient mutations, T152I and D196N. Steady-state kinetic analysis reveals that the T152I mutation results in a 3-fold lower activity, which is correlated with a 3-fold lower iron content compared to the wild-type enzyme. The D196N mutation results in a 2-fold higher K M for the substrate, glutathione persulfide (GSSH).

A pharmacovigilance study in chest diseases outpatient clinic

Introduction Adverse drug reactions is an important healthcare issue, it causes excess morbidity and mortality. The aim of this study was to determine the adverse drug reactions in patients who admitted to the outpatient clinic of respiratory diseases and to improve some clinical strategies if they are preventable. Patients and methods This study is a prospective observational study which was performed to determine adverse drug reaction in patients who admitted to the outpatient clinic of respiratory diseases. Results During the 15 months of study period a total of 114 adverse reactions were reported in 92 out of 18.130 patients. Most of the adverse reactions were related with gastrointestinal system, central nervous system and cardiovascular system. The most of the adverse events were associated with fixed inhaled formoterol-budesonide combination and inhaled tiotropium. The most frequently reported reactions were hoarseness, xerostomia, headache and dizziness. Poliuri and cough were less frequently reported reactions. Conclusion Most of the adverse reactions were of limited intensity but some of these side effects might effect patients compliance. Serious adverse events were not detected.

Study of time reversibility/irreversibility of cardiovascular data: theoretical results and application to laser Doppler flowmetry and heart rate variability signals

Time irreversibility can be qualitatively defined as the degree of a signal for temporal asymmetry. Recently, a time irreversibility characterization method based on entropies of positive and negative increments has been proposed for experimental signals and applied to heart rate variability (HRV) data (central cardiovascular system (CVS)). The results led to interesting information as a time asymmetry index was found different for young subjects and elderly people or heart disease patients. Nevertheless, similar analyses have not yet been conducted on laser Doppler flowmetry (LDF) signals (peripheral CVS). We first propose to further investigate the above-mentioned characterization method. Then, LDF signals, LDF signals reduced to samples acquired during ECG R peaks (LDF_RECG signals) and HRV recorded simultaneously in healthy subjects are processed. Entropies of positive and negative increments for LDF signals show a nonmonotonic pattern: oscillations—more or less pronounced, depending on subjects—are found with a period matching the one of cardiac activity. However, such oscillations are not found with LDF_RECG nor with HRV. Moreover, the asymmetry index for LDF is markedly different from the ones of LDF_RECG and HRV. The cardiac activity may therefore play a dominant role in the time irreversibility properties of LDF signals.

Unusual manifestations of Mycoplasma pneumoniae infection in children

Abstract Mycoplasma pneumoniae (MP) infection is no longer a benign condition it was originally thought to be. Many atypical pulmonary & extrapulmonary manifestations affecting major organ systems like the central nervous system, cardiovascular system, haematological system, gastrointestinal system, musculoskeletal system and renal system have been described. Early recognition of these symptoms is often difficult and serologic diagnosis may not be helpful.

Molecular Bases of Osteoporosis in HIV: The Role of the Virus and Antiretroviral Therapy

In addition to immune system, HIV infection can determine the onset of functional dysfunctions of several organs and tissues such as central nervous system, cardiovascular system, kidney, and bone. It is noteworthy that HIV-infected individuals show an increased risk of bone mass loss with subsequent osteopenia and osteoporosis development. Interestingly, antiretroviral therapy is not able to tackle the bone derangement but, on the contrary, it can induce a progressive bone mass loss, especially when specific antiretroviral drugs are used. In this report, we summarized the HIV and antiretroviral-related mechanisms involved in the osteopenia and osteoporosis induction.

First-year medical students’ conceptual understanding of and resistance to conceptual change concerning the central cardiovascular system

Medical students often have initial understanding concerning medical domains, such as the central cardiovascular system (CCVS), when they enter the study programme. These notions may to some extent be in conflict with scientific understanding, which can be seen as a challenge for medical teaching. Hence, the purpose of this study was to analyse what kind of initial mental models students have about the CCVS and how these models change after a course. Further, we were interested in how medical students evaluate the role of problem-based learning (PBL)-enriched conventional instruction in their learning of the CCVS. Pre- and posttests consisting of a drawing task were conducted with 60 Finnish medical students. Additionally, problem-based learning and course evaluation questionnaires were administered. Results show that one-third of the students had misconceptions such as single-loop concepts in understanding the CCVS before the course. Although the instruction seems to support conceptual change, 10 % of the students did not reach a scientific model. In their evaluations of the learning environment, the students appreciated working in small groups in addition to lectures. Sixty-five percent of the students considered PBL an effective learning method, whereas the rest of the students found it ineffective. In sum, although most of the first-year medical students reached an adequate representation of the central cardiovascular system, too many seem to have resistant misconceptions. Hence, in developing learning environments that support students’ conceptual change in the medical domain, students’ prior knowledge and perceptions of learning environments need to be taken into account.

Acute pathophysiological influences of conducted electrical weapons in humans: A review of current literature

Conducted electrical weapons (CEWs) deliver short high-voltage, low current energy pulses to temporarily paralyze a person by causing muscular contraction. The narrative of this article is a methodical analysis on acute pathophysiological changes within the central nervous system, cardiovascular, neuroendocrine, sympatho-adrenergic and muskuloskeletal system which can occur after application of conducted electrical weapons on human subjects. The results are based on wide-ranging literature analysis and source studies. The majority of the recent scientific publications on humans classify the health risks of an appropriate use of the CEWs device as minor. However, there still is an uncertainty about possible side-effects of these devices. Therefore medical supervision with human application is advised.

Multifractal Analysis of Laser Doppler Flowmetry Signals: Partition Function and Generalized Dimensions of Data Recorded before and after Local Heating

Laser Doppler flowmetry (LDF) signals - that reflect the peripheral cardiovascular system - are now widespread in blood microcirculation research. Over the last few years, the central cardiovascular system has been the subject of many fractal and multifractal works. However, only very few multifractal studies of LDF signals have been published. Such multifractal analyses have shown that LDF data can be weakly multifractal but the origin of such characteristics are still unknown. We therefore herein propose a multifractal analysis of LDF signals recorded on the forearm of twelve healthy subjects, before and after skin local heating. The results show that the partition functions for all the signals have power-law characteristics. Moreover, generalized dimensions present very few variations with q for the signals recorded before heating; these variations are larger 20 minutes after local heating. Physiological activities may therefore play a role in the weak multifractal properties of LDF data.

Reposição hormonal e exercício físico no tratamento da insuficiência cardíaca: revisão sistemática

FUNDAMENTAÇÃO: A despeito do pleno uso da terapia farmacológica e não farmacológica, persistem as expressivas morbidade e mortalidade decorrentes da insuficiência cardíaca (IC). No contexto terapêutico é relevante a inibição das inadequadas adaptações neuro-hormonais e metabólicas, sendo bem conhecida a deficiência anabólica que se instala na IC. Mas somente recentemente surgiram alguns estudos sobre os benefícios que adviriam da terapia de reposição ou suplementação de testosterona (TRT). OBJETIVOS: Pesquisar estudos que abordem a TRT na insuficiência cardíaca (IC), em especial os desenvolvidos no cenário ideal de tratamento clínico, que inclui programa de exercício físico. MÉTODOS: Foram consultadas as bases de dados SciELO e PubMed, a base de dados Cochrane de Revisões Sistemáticas e o Registro de Ensaios Controlados da Colaboração Cochrane. RESULTADOS: Os poucos estudos sobre TRT em pacientes com IC evidenciaram melhora da função hemodinâmica, da resistência à insulina, da capacidade funcional e das respostas neuro-hormonal e neuromuscular, evidenciaram as controvérsias quanto à influência sobre o perfil inflamatório, e não constataram mudanças na função e na estrutura cardiovascular central. Entretanto, não foi encontrado nenhum estudo sobre TRT concomitante ao programa de exercícios físicos. CONCLUSÕES: O estágio atual de conhecimento, embora baseado em poucos estudos, permite considerar a TRT no tratamento de pacientes com IC. Não está bem definida a forma ideal da TRT, no que diz respeito à duração do tratamento, critérios de inclusão e exclusão etc. Existe uma grande lacuna na literatura, chamando atenção à inexistência de estudos sobre a TRT concomitante ao tratamento clínico pleno, que inclui um programa de exercícios físicos.

Investigation of Pharmacodynamics, Pharmacology, and Toxicology of Domestic Human Prourokinase

The comparison of the effect of fibrinolytic activity of recombinant human prourokinase (rhpro-UK) and urokinase(UK) with rabbits indicated rhpro-UK and UK all decreased resolution time of globular proteins, and the affect of rhpro-UK on parameter of fibrinolysis of rabbits was less than UK. The solution of thrombin of rhpro-UK in vitro was increased with dosage of rhpro-UK, and when rhpro-UK was compared with isodose UK, the difference is significant. Both rhpro-UK and UK all was marked solution of thrombin from Chinese piglets, and it were not evident effect on fibrinogen, plasminogen, and a2-antiplasmin of the piglets. The affect of rhpro-UK on bleeding time, clotting time, bleeding amount of unit time was less than UK. It indicated that the side effect of rhpro-UK was distinguished less than UK. The investigation of pharmacology of ileums of mice, rats, dogs, and guinea pigs indicated that rhpro-UK was not marked affect on behavior, state, central nervous system, cardiovascular system, respiratory system, and digestive system of the tested animals. But tested dogs were bleeding at location of operation, and the blood of the animal was heparinized. The studis of toxicology of rhpro-UK indicated that rhpro-UK was median lethal dose of 97.5 mg/kg in mice. When The Beagle dogs was administed rhpro-UK of 2, 8, 28 mg/kg, the toxic reaction was not observed, except for temporal hyperemia of gum, extend of clotting time, increasing of total cholerythrin, total proteins, albumin of the dogs, the direct damage of organs for the medicine was not observed in examination of pathology in the dosages of 8 and 28 mg/kg, any toxic reaction was not observed in dosage of 2 mg/kg. The special toxic experiments proved that rhpro-UK was not of mutagenesis and teratogenesis.

Progress in research of adenosine and its biological products in ophthalmology

Adenosine is an important biological substance in the body. It exists extensively in intracellular and extracellular tissues. In physiological condition, adenosine remains at very low level intissue. However, under stress such as inflammation, ischemia, hypoxia, trauma, or pain etc. the adenosine concentration will be elevated dramatically,indicating that adenosine participates in multiple histopathological processes. Adenosine is a natural chemical messenger that binds to four subtypes( A1, A2A, A2B, A3 ) of adenosine receptors and by that, it regulates multiple kinds of physiological functions. Studies found that adenosine plays an important role in the central nervous system, cardiovascular system and coagulation system. In recent years, adenosine has been seen as an attractive option to improve the treatment of glaucoma and retinal diseases. The effects of adenosine in ophthalmology were as follows: adjusting intraocular pressure, inhibiting retinal angiogenesis, dilating retinal blood vessels, regulating retinal nerve conduction, protecting retinal photoreceptors and ganglion cells, arresting the inflammatory response. This article discusses the research progress in adenosine and its receptors as well as biological products of adenosine and projects the application of adenosine in ophthalmology. Key words: Adenosine; Receptor; Biological agent; Ophthalmology

Multiscale Analysis of Microvascular Blood Flow: A Multiscale Entropy Study of Laser Doppler Flowmetry Time Series

Processes regulating the cardiovascular system (CVS) are numerous. Each possesses several temporal scales. Their interactions lead to interdependences across multiple scales. For the CVS analysis, different multiscale studies have been proposed, mostly performed on heart rate variability signals (HRV) reflecting the central CVS; only few were dedicated to data from the peripheral CVS, such as laser Doppler flowmetry (LDF) signals. Very recently, a study implemented the first computation of multiscale entropy for LDF signals. A nonmonotonic evolution of multiscale entropy with two distinctive scales was reported, leading to a markedly different behavior from the one of HRV. Our goal herein is to confirm these results and to go forward in the investigations on origins of this behavior. For this purpose, 12 LDF signals recorded simultaneously on the two forearms of six healthy subjects are processed. This is performed before and after application of physiological scales-based filters aiming at isolating previously found frequency bands linked to physiological activities. The results obtained with signals recorded simultaneously on two different sites of each subject show a probable central origin for the nonmonotonic behavior. The filtering results lead to the suggestion that origins of the distinctive scales could be dominated by the cardiac activity.