Clinical Efficacy Of Infra Popliteal Angioplasty For Below The Knee Peripheral Vascular Occlusive Disease

BACKGROUND

Peripheral arterial disease (PAD) affects a substantial proportion of the global population, particularly older individuals, affecting around 200 million people worldwide highlighting its significant impact on human health. Critical limb ischemia (CLI) is the most severe clinical presentation of PAD characterized by ischemic rest pain tissue ulceration or gangrene. The objective of the study is to assess the efficacy of infra popliteal angioplasty (in terms of wound healing and limb salvage) in patients with below-the-knee total chronic occlusion (TCO).

METHODS

In this cross-sectional study, all consecutive patients in one year with TCO and fulfilling the inclusion criteria were included.

RESULTS

A total of 64 limbs underwent angioplasty. The mean age was 55.38 ± 13.12 (Range 22-88) years and there were 73% (n=47) males. Diabetes mellitus was the most prevalent risk factor in 59.4% (n=38) of patients. 48.4 % (n=31) of patients had below-knee TCO in all three arteries. Technical Success was achieved in 95.3% (n=61/64). All 3 patients who had technical failure ended up with below-the-knee amputation. Furthermore, 2 more patients who had technical success also ended up with below-the-knee amputation. The difference between these two rates was significant (100% vs 3.3%; p-value =0.004). In terms of wound healing, statistically significant improvement was noted within the first 6 months (p-value = 0.05). The limb salvage rate was 90.6% (n=59/64). The primary patency rate was 81.3% (n=52) and 76.6% (n=49) at 6 and 12 months respectively.

CONCLUSIONS

Angioplasty results in statistically significant wound healing leading to a higher limb salvage rate, in patients with TCO of infrapopliteal arteries.

Efficacy of Revision Using Distal Inflow in Patients with Symptomatic Dialysis Access-Associated Steal Syndrome

Objectives: In this study, we aim to assess the efficacy of revision using distal inflow (RUDI) in patients with symptomatic dialysis access-associated steal syndrome (DASS). Materials and Methods: All consecutive patients who were diagnosed with grade 3 or 4 DASS and have undergone RUDI in 4 years were included in this study. Results: In total, 35 patients were included in this study; participants had a mean age of 47.5±7.52 years and 54% (n=19) were males. As per our findings, significant improvement was noted in terms of paresthesia (81.2%, p-value: 0.012), coolness (79.4%, p-value: 0.006), pain (78.1%, p-value: 0.006), discoloration (76.4%, p-value: 0.044), paresis (71.4%, p-value: 0.016), and ulcer healing (50%, p-value: 0.044). Gangrene did not further progress in all patients (n=35). Reduction in fistula flow rate after RUDI was 57.5% (682±121 ml/min, p-value: 0.001). Digital systolic pressure was noted to improve by 71.4% (60±9.2 mmHg, p-value: 0.002) after RUDI. Peak systolic velocity increased in both ulnar (66.1±8.2 cm/s, p-value: 0.04) and radial (64.2±7.6 cm/s, p-value: 0.024) arteries of the wrist. Cumulative patency of RUDI graft was 100%, 91.4%, and 85.7% at 3, 6, and 12 months, respectively. Conclusion: RUDI has resulted in significant improvements in terms of DASS symptoms. Using a native vein as conduit, RUDI should be considered a procedure of choice for patients with high-flow DASS.

Hidradenitis suppurativa in Black and White patients - a clinical study

OBJECTIVE

It is suggested that hidradenitis suppurativa (HS) is more prevalent and causes greater morbidity in Black patients than in White. Clinical data are however lacking.

PATIENTS AND METHODS

We therefore describe HS risk factors, disease severity and clinical phenotypes in the Blacks and Whites. Patients referred for HS between 1984 and 2019 at the Johns Hopkins Hospital were identified using the Pathology Data System (PDS). Clinical and sociodemographic characteristics were extracted and the van der Zee & Jemec HS clinical phenotypes were recovered.

RESULTS

A total of 278 patients were identified. Ethnically, 108 (38.8%) were White, and 170 (61.2%) Black. The following HS phenotypes were found: Regular (n=193, 69.4%), scarring folliculitis (n=40, 1.4%) frictional furuncle (11.2%), conglobata (n=9, 3.2%), syndromic (n=3, 1.1%) and ectopic (n=2, 0.7%). No statistically significant ethnic differences in clinical presentation were found. Blacks however had more severe diseases than Whites (p= 0.024 for trend). With multivariate logistic regression analysis, we found that male sex, disease duration, and smoking were independent predictors of regular HS phenotype. Major limitations are the limited number of cases studied and the lack of data regarding response to therapies.

CONCLUSIONS

Demographics and phenotypical presentation of HS patients do not seem to be associated with Black ethnicity. However, there is a significant trend for Blacks to present with more Hurley stage 2 and 3 disease compared to White patients. It is speculated that ethnic differences are epiphenomena to social factors, highlighting the broader importance of ethnicity.

Iron–manganese–titanium (1 : 1 : 2) oxide composite thin films for improved photocurrent efficiency

Fe₂MnTi₃O₁₀–MnTiO₃ composite thin films with a photocurrent density of 1.88 mA cm⁻² at 0.2 V have been deposited through AACVD.

Effects of dietary chromium chloride, nicotinic acid and copper sulphate on meat of broilers

1. Combinations of chromium and copper were added to the diet to assess their effects on broiler meat characteristics. 2. For this purpose 175 one-day-old broiler chicks were divided into 7 equal groups and were given treatment feeds containing copper sulphate, chromium chloride and nicotinic acid in different combinations. 3. The study was carried out for 5 weeks and samples were collected at the end of 15, 29 and 35 d of treatment and at 42 d after a withdrawal period of one week. 4. Cholesterol content had decreased significantly in breast meat at d 29 in all treatment groups. In thigh meat, it decreased significantly at d 29 in groups receiving two concentrations of chromium + two concentrations of copper. Cholesterol content remained lower even after withholding the treatment for one week. 5. Crude fat content decreased significantly in breast meat in all treatment groups. In thigh meat, at d 29, a significant reduction in crude fat was observed only in birds receiving low chromium and high copper. 6. Crude protein at d 29 increased significantly in breast meat of birds receiving low chromium and high copper, and low or high chromium, while it decreased significantly in treatment groups after withholding the treatment. In thigh meat, at d 29, it increased significantly in treatment groups but decreased significantly after withholding the treatment. 7. It was concluded that chromium and copper, along with nicotinic acid, have modulating effects on broiler meat under tropical conditions.

Trimetallic supported catalyst for renewable source of energy and environmental control through CO2 conversion

A supported catalyst and a catalytic process have been developed for the conversion of carbgas (CO2 + (100 ppm) H2O + 1% H2) as a renewable source of energy and as a measure for the control of carbon dioxide -- a greenhouse gas. The carbgas was passed over a trimetallic supported catalyst consisting of ruthenium (Ru), manganese (Mn) and cobalt (Co) dispersed on a high surface area titanium dioxide support at 673 K and at atmospheric pressure with a gas space velocity of 6000-7200/h. The catalytic reaction produces methanol and propyne in a fixed bed reactor system. The catalyst simultaneously splits water into hydrogen and oxygen, and carbon dioxide into carbon and oxygen under very mild reaction conditions and at atmospheric pressure. The oxygen generated during the reaction and the addition of hydrogen during the catalytic reaction not only generates a considerable amount of energy for the reaction to proceed but also sustains the oxidation states of Ru, Mn and Co. This process maintains the specific active oxidation states of the metals during the catalytic run -- a key step in the process.

Lower homologues (methyl, ethyl) of diorganotin derivatives of germyl (substituted) propanoic acids: spectroscopic elucidations and biological studies

Some novel lower homologues of diorganotin derivatives of germyl substituted propanoic acids with general formula [Ar(3)GeCH(R(1))CH(R(2))COO](2)SnR(2)(3), where Ar = p-CH(3)C(6)H(4), C(6)H(5), R(1) = p-CH(3)C(6)H(4), p-CH(3)OC(6)H(4), o-CH(3)OC(6)H(4), C(6)H(5), R(2) = H, CH(3), R(3) = CH(3), C(2)H(5) have been prepared by the condensation reaction of dialkyltin oxide and triarylgermyl(substituted) propanoic acid in 1 : 2 M ratio, respectively, and were characterized by IR, multinuclear ((1)H, (13)C, (119)Sn) NMR, (119 m)Sn Mössbauer spectroscopy. The synthesized compounds were also screened for their toxicity and possible antibacterial, antifungal activities and found some encouraging results.

Spectrum of gestational exposure to illicit drugs and other xenobiotic agents in newborn infants by meconium analysis

OBJECTIVE

To detect the spectrum of gestational exposure to illicit drugs and other xenobiotic agents in neonates by meconium analysis.

METHOD

Meconium was collected from 98 neonates and analyzed for illicit drugs and other xenobiotic agents by high-performance liquid chromatography and gas chromatography/mass spectrometry.

RESULTS

Eighty-one (82.7%) infants tested positive for xenobiotic agents, and each infant had from 1 to 9 drugs present. These included local anesthetics (30%) such as lidocaine and mepivacaine; food additives (25%) such as ionol (butylated hydroxytoluene); illicit drugs (11%), especially cocaine and morphine; analgesics (10%) such as meperidine; and fewer (< 10%) other drugs such as antihistamines, antidepressants, adrenergics, anticonvulsants, cough medications, analeptics, hypnosedatives, and cardiotonics.

CONCLUSION

We demonstrated substantial exposure of neonates to xenobiotic agents, ranging from exposure to food additives, prescribed or over-the-counter medications, and drugs of abuse.

Cyclophosphamide in the treatment of toxic epidermal necrolysis

A patient with non-small cell lung carcinoma and recent radiotherapy for brain metastases developed toxic epidermal necrolysis (TEN) shortly after therapy with phenytoin was initiated for a seizure. Exfoliation progressed to involve 90% of her body surface despite treatment with high-dose corticosteroids for 5 days, but sloughing and systemic toxicity ceased within 2 days of initiating therapy with intravenous cyclophosphamide (300 mg/day). Reepithelialization rapidly followed. This experience and the reports of others suggest that intravenous cyclophosphamide is helpful in the treatment of TEN.

Analysis of benzodiazepines and tricyclic antidepressants in serum using a common solid-phase clean-up and a common mobile phase

A single, rapid and specific solid-phase clean-up procedure was developed for the analysis of benzodiazepines and tricyclic antidepressants using a carefully selected wash step and specific sequential elution. Benzodiazepines were eluted from the solid-phase column using as mixture of water-methanol-acetonitrile (2:3:3) followed by the elution of tricyclic antidepressants with methanol containing 0.6% diethylamine. A 30% solution of acetonitrile in phosphate buffer containing dimethyloctylamine was used as a common isocratic mobile phase for the analysis of benzodiazepines and tricyclic antidepressants on a reversed-phase column and detection was carried out at 242 nm. The sensitivity limit of the assay for benzodiazepines and tricyclic antidepressants was 25 ng/ml in serum with recoveries of 95-105% for benzodiazepines and 76-95% for tricyclic antidepressants. The results were linear for benzodiazepines over the range 50-2000 ng/ml and for tricyclic antidepressants over the range 25-500 ng/ml. Analysis for benzodiazepines and tricyclic antidepressants gave good precision, with a coefficient of variation of less than 5.0%. The method described here will be suitable for use in a clinical setting, where there is a concomitant use of benzodiazepines and tricyclic antidepressants.