Who Discovered the Binary System and Arithmetic? Did Leibniz Plagiarize Caramuel?

Gottfried Wilhelm Leibniz (1646-1716) is the self-proclaimed inventor of the binary system and is considered as such by most historians of mathematics and/or mathematicians. Really though, we owe the groundwork of today's computing not to Leibniz but to the Englishman Thomas Harriot and the Spaniard Juan Caramuel de Lobkowitz (1606-1682), whom Leibniz plagiarized. This plagiarism has been identified on the basis of several facts: Caramuel's work on the binary system is earlier than Leibniz's, Leibniz was acquainted-both directly and indirectly-with Caramuel's work and Leibniz had a natural tendency to plagiarize scientific works.

[Association between type 2 diabetes and physical activity in individuals with family history of diabetes]

OBJECTIVE

To investigate whether the association between type 2 diabetes (T2D) and family history of diabetes is modified by the levels of physical activity in the Chilean population.

METHOD

In this study were included 5129 participants from the cross-sectional 2009-2010 National Health Survey. Physical activity level was assessed using the Global Physical Activity Questionnaire and family history of T2D, through self-reporting. The association between diabetes, family history of diabetes and physical activity was determined using logistic regression.

RESULTS

The odds of developing T2D in people with family history of this pathology is high, independent of their levels of physical activity and adiposity. Both men and women with family history of T2D have a higher probability of developing T2D. The odds ratio for having T2D was 5,49 (95%CI: 3,85-7,84; p <0,0001) in women, and 8,16 (95%CI: 4,96-13,4; p <0,0001) in men with family history of T2D and low levels of physical activity in comparison to those with high levels of physical activity and without a family history.

CONCLUSION

Given the elevated risk of developing T2D presented by individuals with a family history of this pathology, and the effect of physical activity in reducing such risk, people with family history of diabetes may need higher levels of physical activity to attenuate their susceptibility to T2D.

[Risk factors associated with hypertension. Analysis of the 2009-2010 Chilean health survey]

BACKGROUND

High blood pressure is one of the major risk factors for the development of cardiovascular disease, affecting 27% of the Chilean population in 2010.

AIM

To determine the risk factors associated with the development of hypertension.

MATERIAL AND METHODS

Analysis of the database of the 2009-2010 National Health Survey in which 4,901 participants were included. Socio-demographic factors, physical activity, eating habits, well-being and comorbidities were analyzed.

RESULTS

Women had a lower risk of developing hypertension than men (Odds ratio (OR): 0.69, 95% confidence intervals (CI): 0.59-0.81, p < 0.01). In both men and women, the risk is greater over the age of 25 years (OR: 2.90, 95% CI: 1.55-5.43, p < 0.01). The risk is greater in subjects who were overweight (OR: 1.61, 95% CI: 1.31-1.98, p < 0.01), obese (OR: 3.18, 95% CI: 2.56-3.95, p < 0.01), or had central obesity (OR: 2.25, 95% CI: 1.85-2.72, p < 0.01). Subjects with a family history of hypertension and diabetes also have a higher risk.

CONCLUSIONS

Identifying the risk factors associated with hypertension allows public health policies to be tailored to its prevention.

[Effects of a lower body weight or waist circumference on cardiovascular risk]

BACKGROUND

Overall and central obesity are important risk factors for cardiovascular disease.

AIM

To investigate the association of body weight, body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors in Chile.

MATERIAL AND METHODS

We included 5,157 participants from the National Health Survey 2009-2010. Prevalence of type 2 diabetes, hypertension, metabolic syndrome and dyslipidemia (high total cholesterol and triglyceride levels and low HDL-cholesterol) were defined using international recommendations. BMI and WC were measured using standardized protocols.

RESULTS

A five percent lower body weight, BMI and WC were associated with a significant reduction in cardiovascular risk factors. For each 5% reduction in body weight, the risk for hypertension decreased by 8 and 9% in women and men respectively. Similar risk reductions were observed for diabetes (9 and 11% respectively), metabolic syndrome (23 and 30% respectively), low HDL cholesterol (13 and 13% respectively), high triglyceride levels (16 and 18% respectively) and total cholesterol (8 and 10% respectively). Similar findings were observed for BMI and WC.

CONCLUSIONS

Lower body weight, BMI or WC are associated with important reductions in cardiovascular risk factors. A 5% reduction in these adiposity markers could be a perfectly feasible goal for lifestyle interventions.

Prenatal exposure estimation of BPA and DEHP using integrated external and internal dosimetry: A case study

Prenatal exposure to Endocrine disruptors (EDs), such as Bisphenol A (BPA) and di (2-ethylhexyl) phthalate (DEHP), has been associated with obesity and diabetes diseases in childhood, as well as reproductive, behavioral and neurodevelopment problems. The aim of this study was to estimate the prenatal exposure to BPA and DEHP through food consumption for pregnant women living in Tarragona County (Spain). Probabilistic calculations of prenatal exposure were estimated by integrated external and internal dosimetry modelling, physiologically based pharmacokinetic (PBPK) model, using a Monte-Carlo simulation. Physical characteristic data from the cohort, along with food intake information from the questionnaires (concentrations of BPA and DEHP in different food categories and the range of the different food ratios), were used to estimate the value of the total dietary intake for the Tarragona pregnancy cohort. The major contributors to the total dietary intake of BPA were canned fruits and vegetables, followed by canned meat and meat products. In turn, milk and dairy products, followed by ready to eat food (including canned dinners), were the most important contributors to the total dietary intake of DEHP. Despite the dietary variations among the participants, the intakes of both chemicals were considerably lower than their respective current tolerable daily intake (TDI) values established by the European Food Safety Authority (EFSA). Internal dosimetry estimates suggest that the plasma concentrations of free BPA and the most important DEHP metabolite, mono (2-ethylhexyl) phthalate (MEHP), in pregnant women were characterized by transient peaks (associated with meals) and short half-lives (< 2h). In contrast, fetal exposure was characterized by a low and sustained basal BPA and MEHP concentration due to a lack of metabolic activity in the fetus. Therefore, EDs may have a greater effect on developing organs in young children or in the unborn child.

[Sedentary lifestyle is associated with metabolic and cardiovascular risk factors independent of physical activity]

BACKGROUND

Sedentary behavior is a main risk factor for cardiovascular disease and mortality.

AIM

To investigate the association between sedentary behavior and metabolic and cardiovascular risk factors.

MATERIAL AND METHODS

We assessed 322 participants aged between 18 to 65 years. Physical activity and sedentary behavior were measured with accelerometers (Actigraph®). Body mass index (BMI), waist circumference, percentage of body fat, diet and blood markers (glucose, lipid profile, insulin and HOMA-IR) were measured with standardized protocols.

RESULTS

Thirty four percent of participants were physically inactive and spent on average 8.7 h/day on sedentary activities. Per one hour increase in sedentary behavior there were significant adverse changes in glucose (4.79 mg/dl), insulin (2.73 pmol/l), HOMA-IR (0.75), BMI (0.69 kg/m²), waist circumference (1.95 cm), fat mass (1.03%), total cholesterol (9.73 mg/dl), HDL-cholesterol (-3.50 mg/dl), LDL-cholesterol (10.7 mg/dl) and triglycerides (12.4 mg/dl). These findings were independent of main confounding factors including total physical activity, dietary factors, BMI and socio-demographics.

CONCLUSIONS

The detrimental effect of sedentary behaviors on cardiometabolic and obesity-related traits is independent of physical activity levels. Therefore, reducing sedentary time should be targeted in the population apart from increasing their physical activity levels.

[Being physically active modifies the detrimental effect of sedentary behavior on obesity and cardiometabolic markers in adults]

BACKGROUND

Sedentary behavior is a major risk factor for cardiovascular disease and mortality.

AIM

To investigate whether the associations between sedentary behavior and cardiometabolic markers differs across physical activity levels.

MATERIALS AND METHODS

Cross sectional study of 314 participants aged 18 to 65 years. Body mass index (BMI) and waist circumference were measured, and body fat was derived from the sum of four skinfolds. Physical activity was measured objectively using accelerometers (Actigraph GT1M, USA®). A fasting blood sample was obtained to measure glucose, insulin, HOMA-IR, lipid profile and high sensitive C reactive protein (hsCRP). Those participants with an activity level > 600 MET.min-1.week-1 were classified as physically active.

RESULTS

Thirty four percent of participants were physically inactive and spent an average of 8.7 h.day-1 in sedentary pursuits. Physically inactive individuals had poorer cardiometabolic health than their physically active counterparts. Per one hour decrease in overall sedentary behavior, there was a significant improvement in glucose (-8.46 and -4.68 mg.dl-1), insulin (-2.12 and -1.77 pmol.l-1), HOMA-IR (-0.81 and -0.56) BMI (-0.93 and -0.62 kg.m-2) and waist circumference (-2.32 and -1.65 cm) in physically active and inactive participants, respectively.

CONCLUSIONS

Being physically active may modify the detrimental effects of sedentary behavior on cardiometabolic and obesity-related traits.

[Inverse association of cardiorespiratory fitness with cardiovascular risk factors in Chilean adults]

BACKGROUND

A high level of cardiorespiratory fitness (CRF) is an important protector against cardiovascular and metabolic diseases.

AIM

To explore the association of CRF with several metabolic markers and estimate the variation of these parameters by an increase of 1 MET change in CRF.

MATERIAL AND METHODS

Cross-sectional study of 447 adults (56% women) without medical history of cardiometabolic diseases. Physical activity evaluated using accelerometry, body mass index (BMI), blood pressure, blood glucose and insulin and lipid profile were measured. HOMA-IR was calculated with fasting glucose and insulin levels. The submaximal Chester Step Test was used to measure CRF.

RESULTS

CRF was significantly associated with the level and intensity of physical activity, and all metabolic markers (p-trend < 0.05), except with diastolic blood pressure. It was estimated that 1-MET increase in CRF is associated with waist circumference (β -0.32 cm), fat mass (β -0.22%), insulin (β -0.67 pmol.l-1), HOMA-IR (β -0.17) and HDL cholesterol (β +1.46 mg.dl-1). All these associations were independent of main covariates such as age, sex, education, smoking and body mass index.

CONCLUSIONS

A higher level of CRF is inversely associated with several metabolic markers that are risk factors for cardiovascular disease.

Statin-associated autoimmune myopathy: A distinct new IFL pattern can increase the rate of HMGCR antibody detection by clinical laboratories

BACKGROUND AND OBJECTIVE

Statin-associated autoimmune myopathy (SAAM) with anti-HMGCR antibodies has recently been described. Several specific immunoassays are in use to detect HMGCR antibodies. In the course of systematic autoantibody screening we recognized a new distinct IFL staining pattern on rat liver sections that regularly coincided with anti-HMGCR antibodies. In this study we investigated whether this new IFL pattern is specifically associated to statin-associated autoimmune myopathy and corresponds to anti-HMGCR antibodies.

PATIENTS AND METHODS

Twenty-three patients positive for anti-HMGCR antibodies (14 diagnosed with SAAM) were investigated for anti-HMGCR antibodies by two ELISA assays and confirmed by immmunoblot. HMGCR associated liver IFL pattern (HALIP) was detected by indirect IFL and the reactivity against HMGCR was confirmed by immunoabsorption using purified human HMGCR antigen. 90 patients with other autoimmune diseases and 45 non-autoimmune statin treated patients were studied as controls.

RESULTS

21 out of 23 (91%) anti-HMGCR positive patients were HALIP positive. The staining was completely and specifically removed by immunoabsorption with human purified HMGCR. None of the control sera from autoimmune patients or non-autoimmune statin treated subjects was positive for HALIP. Statistical concordance between HALIP and anti-HMGCR antibody specific tests was 98.7%, kappa 0.95.

CONCLUSIONS

A new and distinct IFL staining pattern (HALIP) is associated to HMGCR associated myopathy. Absorption and concordance studies indicate that the antigen recognized in the liver by HALIP is HMGCR or a closely related protein. Awareness of this new pattern can help to detect HMGCR autoantibodies in statin treated patients tested for autoimmune serology.

Sacral nerve stimulation lead implantation in partial sacral agenesis using intra-operative computerized tomography

AIM

Sacral nerve stimulation (SNS) lead implantation is a straightforward procedure for individuals with intact spinal vertebrae. When sacral anomalies are present, however, the anatomical and radiological reference points used for the accurate placement of the electrode may be absent or difficult to identify.

METHOD

We describe an innovative surgical procedure of percutaneous nerve evaluation for SNS in a patient with faecal incontinence secondary to a congenital imperforate anus and partial sacral agenesis using a surgical imaging platform (O-arm system) under neurophysiological control.

RESULTS

Using intra-operative CT and neuronavigation, the insertion point at the skin was identified. The lead was introduced into the right-sided S3 foramen and placed at the correct depth. An appropriate motor response was obtained after stimulation and neurophysiological control confirmed that the right S3 root was being stimulated.

CONCLUSION

Our experience showed that O-arm guided navigation can be used to overcome the difficulty of SNS lead placement in patients with partial sacral agenesis who have faecal incontinence.

[Higher physical activity levels are associated with lower prevalence of cardiovascular risk factors in Chile]

BACKGROUND

Little is known about the relationship between physical activity (PA) and cardiovascular risk factors in the Chilean population.

AIM

To investigate the association between different levels and intensities of PA and the prevalence of cardiovascular (CV) risk factors in Chilean adults.

MATERIAL AND METHODS

Data from the National Health Survey 2009-10 including 5157 participants, provided by the Epidemiology Department of the Ministry of Health, was analyzed in this study. The prevalence of type 2 diabetes mellitus, hypertension, metabolic syndrome and dyslipidemia were determined using international criteria. PA levels were determined using the Global Physical Activity Questionnaire (GPAQ v2) and different levels of PA were derived from it (transport-related, moderate and vigorous PA). Quartiles of PA were determined to investigate the association between PA and cardiovascular risk factors.

RESULTS

Twenty three percent of women and 17.1% of men did not meet the PA recommendation (≥ 600 METs.min.week-1). When prevalence of CV risk factors were compared between inactive individuals (< 600 METs.min.week-1) and active individuals (≥ 9500 METs.min.week-1) a significantly lower prevalence of diabetes mellitus (6.2% and 10%), hypertension (18.0% and 12.4%) and metabolic syndrome (8.9% and 12.1%) for women and men, respectively, was found in the active participants. Similar results were found for high versus low transport-related PA.

CONCLUSIONS

Increasing levels of PA are associated with a significantly lower frequency of cardiovascular risk factors in Chilean adults.

Fipronil sulfone induced higher cytotoxicity than fipronil in SH-SY5Y cells: Protection by antioxidants

Fipronil is a broad spectrum insecticide from the phenyl pyrazole family, which targets GABA receptor. Limited information is available about the metabolite fipronil sulfone cytotoxic actions. This study examined in vitro neurotoxicity of fipronil and fipronil sulfone and evaluated Trolox (vitamin E analog) (0.3, 1μM), N-acetyl-cysteine (0.5, 1mM), melatonin (0.1, 1μM) and Tempol (superoxide dismutase analog) (0.3, 0.5mM) protective role in SH-SY5Y cells. MTT and LDH assays were carried out to assess the cytotoxicity of fipronil and fipronil sulfone at 3-100μM concentrations. Fipronil sulfone was more toxic than fipronil. Tempol showed the best neuroprotectant profile against fipronil (50 and 150μM) and fipronil sulfone (3 and 10μM) reaching control levels. Fipronil (100μM) and fipronil sulfone (3μM) treatments induced a 4.7- and 5-fold increases in lipid peroxides measured as malondialdehyde (MDA) and a 2.2- and 2.0-fold increases in the levels of nitric oxide (NO). These results suggest that oxidative stress observed may be one of the major mechanisms of fipronil-induced neurotoxicity and it may be attributed in part to fipronil disposition and metabolism. Our results led us postulate that metabolite fipronil sulfone might be responsible for the fipronil-induced toxicity rather than fipronil itself.

Effects of exposure to pyrethroid cyfluthrin on serotonin and dopamine levels in brain regions of male rats

The effects of cyfluthrin oral exposure (1, 5, 10 and 20mg/kg bw, 6 days) on brain region monoamine levels of male rats were examined. Cyfluthrin-treated rats (1, 5 and 10mg/kg bw, orally 6 days), had no visible injury, i.e., no clinical signs of dysfunction were observed. However, rats treated with cyfluthrin at the highest dose (20mg/kg bw, orally 6 days) showed skeletal muscle contraction in the hind limbs, slight movement incoordination without any signs of dyskinesia and tremor after 1-2h of treatment. These signs were reversible at 6h after dose. After last dose of cyfluthrin, dopamine (DA) and serotonin (5-HT) and its metabolites levels were determined in brain regions hypothalamus, midbrain, hippocampus, striatum and prefrontal cortex by HPLC. Cyfluthrin (1mg/kg bw, orally 6 days) did not affect the DA, 5-HT and metabolites levels in the brain regions studied. Cyfluthrin (5, 10 and 20mg/kg bw, orally 6 days) caused a statistically significant decrease in DA and its metabolites DOPAC and HVA levels and in 5-HT and its metabolite 5-HIAA levels in a brain region- and dose-related manner. Moreover, cyfluthrin (20mg/kg bw, orally 6 days) evoked a statistically significant increase in 5-HT turnover in striatum and midbrain, and in DA turnover in striatum and prefrontal cortex. These findings indicate that serotoninergic and dopaminergic neurotransmission is affected by exposure to cyfluthrin and may contribute to the overall spectrum of neurotoxicity caused by this pyrethroid.

Pharmacokinetics, efficacy prediction indexes, and residue depletion of ribavirin in Atlantic salmon's (Salmo salar) muscle after oral administration in feed

Ribavirin is an antiviral used in human medicine, but it has not been authorized for use in veterinary medicine although it is effective against infectious salmon anemia (ISA) virus, between others. In this study, we present a pharmacokinetic profile of ribavirin in Atlantic salmon (Salmo salar), efficacy prediction indexes, and the measure of its withdrawal time. To determine the pharmacokinetic profile, fishes were orally administered with a single ribavirin dose of 1.6 mg/kg bw, and then, plasma concentrations were measured at different times. From the time-vs.-concentration curve, Cmax = 413.57 ng/mL, Tmax  = 6.96 h, AUC = 21394.01 μg·h/mL, t1/2  = 81.61 h, and K10  = 0.0421/h were obtained. Ribavirin reached adequate concentrations during the pharmacokinetic study, with prediction indexes of Cmax /IC50  = 20.7, AUC/IC50  = 1069.7, and T>IC50  = 71 h, where IC is the inhibitory concentration 50%. For ribavirin depletion study, fishes were orally administered with a dairy dose of 1.6 mg/kg bw during 10 days. Concentrations were measured on edible tissue on different days post-treatment. A linear regression of the time vs. concentration was conducted, obtaining a withdrawal time of 1966 °C days. Results obtained reveal that the dose of 1.6 mg/kg bw orally administered is effective for ISA virus, originating a reasonable withdrawal period within the productive schedules of Atlantic salmon.

Efficacy and safety of switching to abacavir/lamivudine (ABC/3TC) plus rilpivirine (RPV) in virologically suppressed HIV-infected patients on HAART

We analysed the efficacy and safety of switching from a regimen based on nonnucleoside reverse transcriptase inhibitors (NNRTI) or integrase inhibitors (INI) to ABC/3TC + RPV in virologically suppressed HIV-infected patients. This multicentre, retrospective study comprised asymptomatic HIV-infected patients who switched from 2 NRTI + NNRTI or 2 NRTI + INI to ABC/3TC + RPV between February 2013 and December 2013; all had undetectable HIV viral load prior to switching. Efficacy and safety, and changes in lipids and cardiovascular risk (CVR) were analysed at 48 weeks. Of 85 patients (74.1 % men, mean age 49.5 years), 83 (97.6 %) switched from a regimen based on NNRTI (EFV 74, RPV 5, ETV 2, NVP 2), and 45 (53 %) switched from TDF/FTC to ABC/3TC. The main reasons for switching were toxicity (58.8 %) and convenience (29.4 %). At 48 weeks, 78 (91.8 %) patients continued taking the same regimen; efficacy was 88 % by intention to treat, and 96 % by per protocol. Two patients were lost to follow-up and five ceased the new regimen (4 due to adverse effects and 1 virologic failure). Mean CD4 cell counts increased (744 vs. 885 cells/μL; p = 0.0001), and there were mean decreases in fasting total cholesterol (-15.9 mg/dL; p < 0.0001) and LDL-cholesterol (-11.0 mg/dL; p < 0.004), with no changes in HDL-cholesterol, triglycerides, total cholesterol:HDL-cholesterol ratio, and CVR. ABC/3TC + RPV is effective and safe in virologically-suppressed patients on antiretroviral therapy (ART). Forty-eight weeks after switching the lipid profile improved with decreases in total and LDL cholesterol.

Socio-demographic patterns of physical activity and sedentary behaviour in Chile: results from the National Health Survey 2009-2010

BACKGROUND

Surveillance of physical activity (PA) is essential for the development of health promotion initiatives. The aim of the present study was to examine the prevalence of PA and sedentary behaviour with respect to socio-demographic factors in Chile.

METHODS

A representative sample of 5434 adults aged ≥15 years (59% women) who participated in the Chilean National Health Survey (2009-2010) were included. Socio-demographic data (age, sex, environment, education level, income level and smoking status) were collected for all participants. PA levels were assessed using the Global Physical Activity Questionnaire.

RESULTS

19.8% [95% CI: 18.1-21.6] of the Chilean population did not meet PA recommendations (≥600 MET min week(-1)). The prevalence of physical inactivity was higher in participants aged ≥65 years, compared with the youngest age groups and was higher in women than in men. However, it was lower for participants with high, compared with low, education or income levels. The overall prevalence of sedentary risk behaviour (spending >4 h sitting per day) was 35.9% [95% CI: 33.7-38.2].

CONCLUSION

Physical inactivity correlates strongly with socio-demographic factors such as age, gender and educational level. Results identify social and economic groups to which future public health interventions should be aimed to increase PA in the Chilean population.

Evidence for dose-additive effects of a type II pyrethroid mixture. In vitro assessment

Despite the widespread use of pyrethroid insecticides that led to common exposure in the population, few studies have been conducted to quantitatively assess dose-additive effects of pyrethroids using a funcional measure involved in the common toxic mode of action. The aim of this study was to evaluate the potency and efficacy of 6 Type II pyretroids (α-cypermethrin, cyfluthrin, λ-cyhalothrin, deltamethrin, cyphenothrin and esfenvalerate) to evoke induction of both nitric oxide and lipid peroxides levels measured as malondialdehyde in three in vitro models (SH-SY5Y, HepG2 and Caco-2 human cells) as well as to test the hypothesis of dose additivity for mixtures of these same 6 pyrethroids. Concentration-responses for 6 pyrethroids were determined as well as the response to mixtures of all 6 pyrethroids. Additivity was tested assuming a dose-additive model. The human neuroblastoma SH-SY5Y cell line was the most sensitive in vitro model. The rank order of potency for cell SH-SY5Y viability MTT assay was deltamethrin>cyphenothrin>λ-cyhalothrin>cyfluthrin>esfenvalerate>α-cypermethrin. When 6 pyrethroids were present in the mixture at an equitoxic mixing ratio, the action on nitric oxide (NO) and lipid peroxides measured as malondialdehyde (MDA) production was consistent with a dose-additive model. The results of the present study are consistent with previous reports of additivity of pyrethroids in vivo e in vitro.

Computational model of collagen turnover in carotid arteries during hypertension

It is well known that biological tissues adapt their properties because of different mechanical and chemical stimuli. The goal of this work is to study the collagen turnover in the arterial tissue of hypertensive patients through a coupled computational mechano-chemical model. Although it has been widely studied experimentally, computational models dealing with the mechano-chemical approach are not. The present approach can be extended easily to study other aspects of bone remodeling or collagen degradation in heart diseases. The model can be divided into three different stages. First, we study the smooth muscle cell synthesis of different biological substances due to over-stretching during hypertension. Next, we study the mass-transport of these substances along the arterial wall. The last step is to compute the turnover of collagen based on the amount of these substances in the arterial wall which interact with each other to modify the turnover rate of collagen. We simulate this process in a finite element model of a real human carotid artery. The final results show the well-known stiffening of the arterial wall due to the increase in the collagen content.

[Rupture of a superior mesenteric artery aneurysm in pediatric age: case report and literature review]

INTRODUCTION

Splanchnic artery aneurysms are rare in children. High mortality from rupture justifies its treatment, with various therapeutic options among which stand out surgery and recently, endovascular treatment.

CASE REPORT

A 11 year old girl presented with abdominal pain and sudden drop in hematocrit. The urgent abdominal CT angiography showed a saccular aneurysm of the superior mesenteric artery (SMA) at 4 cm from the ostium with dissection and active bleeding. A selective angiography was performed which confirmed the dissection. A self-expanding stent was placed in the main trunk of the SMA and a transcatheter coil and onyx embolization of the aneurysm was performed. The control angiogram showed no evidence of residual perfusion of the false lumen and demonstrated proper vascularization of the distal jejunum-ileal branches. Dual antiplatelet therapy with aspirin and dipyridamole was begun. After 24 months of follow-up the patient is asymptomatic.

COMMENTS

Endovascular treatment of a SMA aneurysm is effective in the pediatric patient, even in emergency situations.