Extra-Thoracic Aneurysms in Marfan Syndrome: A Systematic Review of the Literature

INTRODUCTION

Marfan syndrome (MS) most often shows as thoracic aortic aneurysm (TAA) or aortic dissection, but it may also involve other vascular territories.

OBJECTIVE

To identify those extra-thoracic vascular manifestations most frequently associated with MS.

METHODOLOGY

Systematic review of the literature with PRISMA criteria. The following databases were included: Medline, Embase, Web of Science (WOS), Cumulative Index of Nursing and Health Sciences Literature (CINHAL); Spanish database MEDESY Cochrane Central Register of Controlled Trials (CENTRAL).

RESULTS

10,008 articles were identified, leaving 155 for the first stage of data analysis (total incidence of aneurysms) and 83 for the second (descriptive data analysis). Overall, 518 aneurysms were identified: 149 in the head and neck, 94 in the extremities 275 in the aortic, iliac and visceral sectors. Mostly, they were simultaneously discovered during studies of the AAT. In the abdominal aorta, the presentation with rupture in 11 of 32 patients stands out. Resection and bypass was the most frequently used method for repair in the treated cases.

CONCLUSIONS

Although its frequency in the general population is unknown, this systematic review suggests that extra-thoracic aneurysmal arterial involvement in the MS may be more frequent than expected. We believe screening for aneurysms in other vascular sectors may be advisable, especially in patients with MS and AAT.

Simulating the city traffic complexity induced by traffic light periods

We revisited the global traffic light optimization problem through a cellular automata model, which allows us to address the relationship between the traffic lights and car routing. We conclude that both aspects are not separable. Our results show that a good routing strategy weakens the importance of the traffic light period for mid-densities, thus limiting the parameter space where such optimization is relevant. This is confirmed by analyzing the travel time normalized by the shortest path between the origin and destination. As an unforeseen result, we report what seems to be a power-law distribution for such quantities, indicating that the travel time distribution slowly decreases for long travel times. The power-law exponent depends on the density, traffic light period, and routing strategy, which in this case is parametrized by the tendency of agents to abandon a route if it becomes stagnant. These results could have relevant consequences on how to improve the overall traffic efficiency in a particular city, thus providing insight into useful measurements, which are often counter-intuitive, which may be valuable to traffic controllers that operate through traffic light periods and phases.

Pilot-scale phycoremediation using Muriellopsis sp. for wastewater reclamation in the Atacama Desert: microalgae biomass production and pigment recovery

Municipal wastewater phycoremediation represents a promising circular economy-based process for wastewater reclamation used to recover water and produce biomass. This study aimed to evaluate a pilot-scale phycoremediation system, using the most efficient strain of microalgae for wastewater reclamation in the Atacama Desert. Nitrogen and phosphorus removal, as well as biomass growth, were compared in different microalgae treatments, namely Muriellopsis sp., Scenedesmus almeriensis, Chlamydomonas segnis, Chlorella pyrenoidosa and Chlorella vulgaris. The most efficient treatments, Muriellopsis sp. and S. almeriensis, were scaled up to 20-L bubble column reactors to evaluate nutrient removal and biomass biochemical profile for potential biotechnological application. Finally, Muriellopsis sp. was selected for a pilot-scale phycoremediation experiment (800-L raceway), which removed 84% of nitrogen, 93% of phosphorus and other chemical compounds after 4 days of treatment to meet most of the Chilean standards for irrigation water (NCh. 1333. DS. MOP No. 867/78). Faecal coliforms count was reduced by 99.9%. Furthermore, biomass productivity reached 104.25 mg·L^-1·day^-1 value with 51% protein, and pigment content of 0.6% carotenoid, with 0.3% lutein. These results indicate the potential of wastewater phycoremediation at an industrial scale for the production of irrigation water and carotenoid using Muriellopsis sp.

Oxidative and Nitrosative Pattern in Circulating Leukocytes of Very Early/Early Hepatocellular Carcinoma Patients

BACKGROUND/AIM

In chronic liver disease, various immune cell subsets exert pro or anti-tumour effects by releasing reactive oxygen and nitrogen species (ROS, RNS). Here, we evaluated the oxidative and nitrosative pattern in peripheral blood leukocyte subpopulations of early hepatocellular carcinoma (HCC) patients compared with HCC-free cirrhotic patients.

MATERIALS AND METHODS

Venous blood samples from 18 HCC-free cirrhotic patients and 17 early stage HCC patients were collected to determine ROS, RNS and reduced glutathione levels in isolated leukocytes analyzed by flow cytometry.

RESULTS

Intracellular levels of ROS and glutathione were higher in lymphocytes, monocytes, and neutrophils from HCC patients as well as mitochondrial superoxide in neutrophils and monocytes whereas intracellular levels of nitric oxide were lower in lymphocytes, monocytes, and neutrophils.

CONCLUSION

Early HCC alters intracellular levels of ROS and RNS of some circulating leukocytes subsets. This finding may represent a potential area of interest concerning the development of new treatments and prognostic markers.

AB1014 CLINICAL AND LABORATORY PHENOTYPES IN PATIENTS DIAGNOSED WITH SARCOIDOSIS IN A VETERAN’S HOSPITAL

Background:

Sarcoidosis is a disease which affect any organ or tissue in the body, but is predisposed to lung involvement in up to 90% of cases. Its cause is not yet established, although a multicausal model with genetic, environmental and infectious factors is proposed.

Objectives:

Determine the clinical, paraclinical characteristics and survival of patients diagnosed with Sarcoidosis treated at the Central Military Hospital.

Methods:

Historical cohort study of patients who were diagnosed with Sarcoidosis at the Central Military Hospital in the last 5 years. A review of medical records, laboratory results and radiological studies was performed and verification of survival status free of mortality was documented by independent outcomes group. A descriptive analysis was done using standard methods and non-parametric survival was calculated using the Kaplan Meyer method with confidence interval in STATA 15.

Results:

Twenty patients with confirmatory biopsy of sarcoidosis. Average age 44 ± 15.3 years, 55% (11/20) of the patients were men. Dyspnea was the most frequent reason for consultation 50% (10/20), S. Löfgren 10% (2/20), the lung was the most frequent location 65% (13/20), mild hypercalcemia and normal enzyme converting angiotensin levels were found. 60% of patients had grade 1 commitment on the chest radiograph. 60% (12/20) of the patients received immunosuppressive treatment. The overall survival at 5 years was 92% (95% CI 57-99).

Conclusion:

Sarcoidosis is a disease of young patients with a slight predominance in men. Pulmonary involvement is the most frequent, followed by mediastinal nodal involvement. Most patients received steroid treatment at some time in their life. The long-term survival of the disease is more than 90%, which indicates its benign course.

References:

[1]Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis.N Engl J Med. 2007 Nov 22;357(21):2153-65.

[2]Arkema EV, Grunewald J, Kullberg S, Eklund A, Askling J. Sarcoidosis incidence and prevalence: a nationwide register-based assessment in Sweden. Eur Respir J 2016; 48: 1690–1699.

Acknowledgments:

Not aply

Disclosure of Interests:

None declared

Does following optimized routes for single cars improve car routing?

We study the impact of deserting a pre-established path, determined by a navigation software, on the overall city traffic. To do so, we consider a cellular automaton model for vehicular traffic, where the cars travel between two randomly assigned points in the city following three different navigation strategies based on the minimization of the individual paths or travel times. We found, in general, that, above a critical car density, the transport improves in all strategies if we decrease the time that the vehicles persist in trying to follow a particular strategy when a route is blocked, namely, the mean flux increases, the individual travel times decrease, and the fluctuations of density in the streets decrease; consequently, deserting helps prevent traffic jams.

Application of electrocoagulation for the efficient pollutants removal to reuse the treated wastewater in the dyeing process of the textile industry

The possibility of using electrocoagulation for efficient removal of pollutants in the industrial liquid waste of a textile industry was studied. The performance of the process was evaluated through the analysis of color, turbidity, and chemical oxygen demand (COD). The analysis was first done with the wastewater coming from the process of dyeing linen, which is the most polluting of all effluents that reach the residual effluent pool (REP). For the analysis, the MODDE 7.0 software was used to construct a statistical model. With the results obtained from this model and the experimental measurements, response surfaces were obtained. These response surfaces predicted the behavior of electrocoagulation for different values of the studied variables (pH, current density, and treatment time). Based on the obtained results, the wastewater coming from the REP was treated using the optimum values for the operational variables. After the treatment it was possible to remove 86% color, 82% turbidity, and 59% COD. It was demonstrated that reusing the treated water in the process of wool dyeing does not have a negative effect on the quality of the dyed fabric. Thus, it is possible to implement the process in the textile industry to reduce the consumption of water.

Effects of asymmetric dimethylarginine on renal arteries in portal hypertension and cirrhosis

AIM

To evaluate the effects of asymmetric dimethylarginine (ADMA) in renal arteries from portal hypertensive and cirrhotic rats.

METHODS

Rat renal arteries from Sham (n = 15), pre-hepatic portal hypertension (PPVL; n = 15) and bile duct ligation and excision-induced cirrhosis (BDL; n = 15) were precontracted with norepinephrine, and additional contractions were induced with ADMA (10^-6-10^-3 mol/L), an endogenous inhibitor of nitric oxide (NO) synthase. Concentration-response curves to acetylcholine (1 × 10^-9-3 × 10^-6 mol/L) were determined in precontracted renal artery segments with norepinephrine in the absence and in the presence of ADMA. Kidneys were collected to determine the protein expression and activity of dimethylarginine dimethylaminohydrolase (DDAH), an enzyme that catabolizes ADMA.

RESULTS

In renal arteries precontracted with norepinephrine, ADMA caused endothelium-dependent contractions. The pD₂ values to ADMA were similar in the Sham and PPVL groups (4.20 ± 0.08 and 4.11 ± 0.09, P > 0.05, respectively), but were lower than those of the BDL group (4.79 ± 0.16, P < 0.05). Acetylcholine-induced endothelium-dependent relaxation that did not differ, in terms of pD₂ and maximal relaxation, among the 3 groups studied. Treatment with ADMA (3 × 10^-4 mol/L) inhibited acetylcholine-induced relaxation in the 3 groups, but the inhibition was higher (P < 0.05) in the BDL group compared with that for the Sham and PPVL groups. The mRNA and protein expression of DDAH-1 were similar in kidneys from the three groups. Conversely, DDAH-2 expression was increased (P < 0.05) in PPVL and further enhanced (P < 0.05) in the BDL group. However, renal DDAH activity was significantly decreased in the BDL group.

CONCLUSION

Cirrhosis increased the inhibitory effect of ADMA on basal- and induced-release of NO in renal arteries, and decreased DDAH activity in the kidney.

Accumulation of Symmetric Dimethylarginine in Hepatorenal Syndrome

In patients with cirrhosis, nitric oxide (NO), asymmetric dimethylarginine (ADMA), and possibly symmetric dimethylarginine (SDMA) have been linked to the severity of the disease. We investigated whether plasma levels of dimethylarginines and NO are elevated in patients with hepatorenal syndrome (HRS), compared with patients with cirrhosis without renal failure (no-HRS). Plasma levels of NO, ADMA, SDMA, and l-arginine were measured in 11 patients with HRS, seven patients with no-HRS, and six healthy volunteers. SDMA concentration in HRS was higher than in no-HRS and healthy subjects (1.47 ± 0.25 vs. 0.38 ± 0.06 and 0.29 ± 0.04 μM, respectively; P < 0.05). ADMA and NOx concentrations were higher in HRS and no-HRS patients than in healthy subjects (ADMA, 1.20 ± 0.26, 1.11 ± 0.1, and 0.53 ± 0.06 μM, respectively; P < 0.05; NOx, 94 ± 9.1, 95.5 ± 9.54, and 37.67 ± 4.62 μM, respectively; P < 0.05). In patients with HRS there was a positive correlation between serum creatinine and plasma SDMA (r2 = 0.765, P < 0.001) but not between serum creatinine and ADMA or NOx. The results suggest that renal dysfunction is a main determinant of elevated SDMA concentration in HRS. Accumulation of ADMA as a result of impaired hepatic removal may be the causative factor initiating renal vasoconstriction and SDMA retention in the kidney.

Decreased bioavailability of nitric oxide in aorta from ovariectomized senescent mice. Role of cyclooxygenase

This study investigates the effects of aging and/or ovariectomy on vascular reactivity to thromboxane A2 (TXA2) receptor stimulation with U46619, and the modulation by nitric oxide (NO) and cyclooxygenase (COX) in aorta from female senescence-accelerated mice (SAMP8) and from senescence resistant mice (SAMR1). Five-month-old female SAMR1 and SAMP8 were divided into three groups: sham-operated, ovariectomized and ovariectomized plus estradiol. Twenty-eight days after surgery, thoracic aortic rings were mounted for isometric recording of tension and concentration-response curves for U46619 (10(-10)-3 × 10(-7) M) were performed in the absence and in the presence of the NO synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME, 10(-4) M) and/or COX inhibitor indomethacin (10(-5)M). Vascular superoxide production was detected by dihydroethidium staining on sections of thoracic aorta. NO bioavailability in response to U46619 was suppressed by estrogen withdrawn in young and senescent mice and was restored by the administration of estradiol. In the presence of indomethacin, contractions to U46619 decreased in all groups indicating an aging- and estrogen-dependent modulation of contractile prostanoids. The simultaneous incubation of L-NAME and indomethacin did not change the maximal responses and sensitivities to TXA2 in any group in comparison with untreated aortic segments. The superoxide generation induced by TXA2 was greater in aorta from SAMP8 than in SAMR1. Moreover, in ovariectomized groups superoxide production was further increased and treatment with 17β-estradiol reverted the effects of the ovariectomy. Inhibition of COX with indomethacin prevented the U46619-induced increase in superoxide formation. Our results indicate that NO bioavailability in response to TP receptor activation is both estrogen- and aging-dependent. TXA2 induced contractions are partially mediated by COX activation. Both aging and ovariectomy enhanced COX-dependent component of the TXA2-induced contraction. It is noteworthy that in the absence of estrogen, COX inhibition induces an increase of NO bioavailability. Therefore, in senescent female mice with an experimental menopause, TP-receptor stimulation is responsible for COX activation and enhanced superoxide generation, which may result in reduced NO bioavailability. These effects were reversed by estrogen administration.

Development and Reproduction of Chrysoperla externa (Hagen) (Neuroptera: Chrysopidae) Fed on Myzus persicae (Sulzer) (Hemiptera: Aphididae) Vectoring Potato leafroll virus (PLRV)

The aim of this study was to evaluate the biological parameters of Chrysoperla externa (Hagen) while feeding on Myzus persicae (Sulzer) acting as a vector of potato leafroll virus (PLRV). In laboratory experiments, three different diets were offered ad libitum to C. externa during the larval period: M. persicae fed on PLRV-infected potato leaves, M. persicae fed on uninfected potato leaves, and eggs of the factitious prey Anagasta kuehniella (Zeller) as the control. The following parameters were studied: the developmental time and survival rate of the larval and pupal stages, the sex ratio, the proportion of fertile females, female fecundity and egg viability, and the survival curve of the first 30 days after adult emergence. PLRV-infected aphids influenced the C. externa larval developmental time and survival compared to PLRV-uninfected aphids and A. kuehniella eggs. The pupal developmental time of C. externa was shorter when fed on aphids compared to A. kuehniella eggs, but no differences were recorded between the PLRV-infected and uninfected aphid diets. Additionally, no differences were observed for pupal survival and reproduction. However, adult survival was affected by the prey type, as 75% of C. externa control adults remained alive at an age of 30 days compared to 51 and 54% for those fed on PLRV-uninfected and infected aphids, respectively.

Asymmetric dimethylarginine as a mediator of vascular dysfunction in cirrhosis

Cirrhosis is associated with marked abnormalities in the circulatory function that involve a reduction in systemic vascular resistance. An important cause of this vasodilatation is the increased production or activity of nitric oxide (NO) in the splanchnic circulation. During portal hypertension and cirrhosis an increased endothelial NO synthase (eNOS) activity is demonstrated in splanchnic vessels. In contrast, the activity of eNOS in the cirrhotic liver is decreased, which suggests a different regulation of eNOS in the liver and in the splanchnic vessels. Asymmetric dimethylarginine (ADMA) is an endogenous NO inhibitor and higher plasma levels of ADMA are related to increased cardiovascular risk in both the general population and among patients with cirrhosis. It has been demonstrated that the liver is a key player in the metabolism of ADMA. This observation was further supported by investigations in human patients, showing a close correlation between ADMA plasma levels and the degree of hepatic dysfunction. ADMA is degraded to citrulline and dimethylamine by dimethylarginine dimethylaminohydrolases (DDAHs). DDAHs are expressed as type 1 and 2 isoforms and are widely distributed in various organs and tissues, including the liver. In this review, we discuss experimental and clinical data that document the effects of dimethylarginines on vascular function in cirrhosis. Our increasing understanding of the routes of synthesis and metabolism of methylarginines is beginning to provide insights into novel mechanisms of liver disease and allowing us to identify potential therapeutic opportunities.

Toxicity and sublethal effects of six insecticides to last instar larvae and adults of the biocontrol agents Chrysoperla carnea (Stephens) (Neuroptera: Chrysopidae) and Adalia bipunctata (L.) (Coleoptera: Coccinellidae)

To further develop Integrated Pest Management (IPM) strategies against crop pests, it is important to evaluate the effects of insecticides on biological control agents. Therefore, we tested the toxicity and sublethal effects (fecundity and fertility) of flonicamid, flubendiamide, metaflumizone, spirotetramat, sulfoxaflor and deltamethrin on the natural enemies Chrysoperla carnea and Adalia bipunctata. The side effects of the active ingredients of the insecticides were evaluated with residual contact tests for the larvae and adults of these predators in the laboratory. Flonicamid, flubendiamide, metaflumizone and spirotetramat were innocuous to last instar larvae and adults of C. carnea and A. bipunctata. Sulfoxaflor was slightly toxic to adults of C. carnea and was highly toxic to the L4 larvae of A. bipunctata. For A. bipunctata, sulfoxaflor and deltamethrin were the most damaging compounds with a cumulative larval mortality of 100%. Deltamethrin was also the most toxic compound to larvae and adults of C. carnea. In accordance with the results obtained, the compounds flonicamid, flubendiamide, metaflumizone and spirotetramat might be incorporated into IPM programs in combination with these natural enemies for the control of particular greenhouse pests. Nevertheless, the use of sulfoxaflor and deltamethrin in IPM strategies should be taken into consideration when releasing either of these biological control agents, due to the toxic behavior observed under laboratory conditions. The need for developing sustainable approaches to combine the use of these insecticides and natural enemies within an IPM framework is discussed.

The effect of Chrysoperla carnea (Neuroptera: Chrysopidae) and Adalia bipunctata (Coleoptera: Coccinellidae) on the spread of cucumber mosaic virus (CMV) by Aphis gossypii (Hemiptera: Aphididae)

The effects of two aphidophagous predators, the larvae of Chrysoperla carnea and adults of Adalia bipunctata, on the spread of cucumber mosaic virus (CMV) transmitted in a non-persistent manner by the cotton aphid Aphis gossypii were studied under semi-field conditions. Natural enemies and aphids were released inside insect-proof cages (1 m × 1 m × 1 m) with a central CMV-infected cucumber plant surrounded by 48 healthy cucumber seedlings, and the spatiotemporal dynamics of the virus and vector were evaluated in the short and long term (1 and 5 days) in the presence and absence of the natural enemy. The spatial analysis by distance indices methodology together with other indices measuring the dispersal around a single focus was used to assess the spatial pattern and the degree of association between the virus and its vector. Both natural enemies significantly reduced the number of aphids in the CMV-source plant after 5 days but not after 1 day. The CMV transmission rate was generally low, especially after 1 day, due to the limited movement of aphids from the central CMV-source plant, which increased slightly after 5 days. Infected plants were mainly located around the central virus-infected source plant, and the percentage of aphid occupation and CMV-infected plants did not differ significantly in absence and presence of natural enemies. The distribution patterns of A. gossypii and CMV were only coincident close to the central plant. The complexity of multitrophic interactions and the role of aphid predators in the spread of CMV are discussed.