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Karbasion N, Xu Y, Snider JC, Bersi MR. Primary Mouse Aortic Smooth Muscle Cells Exhibit Region- and Sex-Dependent Biological Responses In Vitro. J Biomech Eng 2024; 146:060904. [PMID: 38421345 PMCID: PMC11005860 DOI: 10.1115/1.4064965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/02/2024]
Abstract
Despite advancements in elucidating biological mechanisms of cardiovascular remodeling, cardiovascular disease (CVD) remains the leading cause of death worldwide. When stratified by sex, clear differences in CVD prevalence and mortality between males and females emerge. Regional differences in phenotype and biological response of cardiovascular cells are important for localizing the initiation and progression of CVD. Thus, to better understand region and sex differences in CVD presentation, we have focused on characterizing in vitro behaviors of primary vascular smooth muscle cells (VSMCs) from the thoracic and abdominal aorta of male and female mice. VSMC contractility was assessed by traction force microscopy (TFM; single cell) and collagen gel contraction (collective) with and without stimulation by transforming growth factor-beta 1 (TGF-β1) and cell proliferation was assessed by a colorimetric metabolic assay (MTT). Gene expression and TFM analysis revealed region- and sex-dependent behaviors, whereas collagen gel contraction was consistent across sex and aortic region under baseline conditions. Thoracic VSMCs showed a sex-dependent sensitivity to TGF-β1-induced collagen gel contraction (female > male; p = 0.025) and a sex-dependent proliferative response (female > male; p < 0.001) that was not apparent in abdominal VSMCs. Although primary VSMCs exhibit intrinsic region and sex differences in biological responses that may be relevant for CVD presentation, several factors-such as inflammation and sex hormones-were not included in this study. Such factors should be included in future studies of in vitro mechanobiological responses relevant to CVD differences in males and females.
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Affiliation(s)
- Niyousha Karbasion
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
| | - Yujun Xu
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
- Washington University in St. Louis
| | - J. Caleb Snider
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
- Washington University in St. Louis
| | - Matthew R. Bersi
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
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Ogino H, Isogai N, Kume N, Shibutani S, Yashiro H, Takahara M, Fujimura N. Evaluating the Effectiveness and Clinical Outcomes of Endovascular Aneurysm Repair-First Approach for Ruptured Abdominal Aortic Aneurysm in Japan. J Endovasc Ther 2024:15266028241248337. [PMID: 38659330 DOI: 10.1177/15266028241248337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
PURPOSE To verify the validity of an endovascular aneurysm repair (EVAR)-first strategy for treating patients with ruptured abdominal aortic aneurysm (rAAA) in Japan. MATERIALS AND METHODS This study was conducted on 2 groups of patients with rAAA who underwent surgical treatment at 3 hospitals in the Kanagawa Prefecture, Japan, between January 2007 and September 2016. The open surgical treatment group comprised patients with rAAA who underwent open surgical treatment before January 2012; their data were retrospectively collected from their medical records. The EVAR-first strategy group comprised patients with rAAA who underwent treatment based on the Shonan rAAA protocol (SRAP; the standard protocol-based EVAR-first strategy) in or after February 2012; their data were collected prospectively. The short- and long-term treatment outcomes of both groups were compared. In addition, a risk score-based sensitivity analysis (one-to-one matching) was conducted on both groups using a caliper with 0.2 standard deviations of the score. RESULTS Of the 163 patients with rAAA, the open surgical and EVAR-first strategy groups comprised 53 and 110 patients, respectively (EVAR: 91.8%, open repair: 8.2%). The 30-day postoperative mortality rate differed significantly, being 42% for the open surgery group and 25% for the EVAR-first strategy group (odds ratio: 0.44, 95% confidence interval: 0.20-0.97). The postoperative survival rates at 6 months, 1 year, and 3 years were 66%, 48%, and 58% for the EVAR-first group, respectively, and 51%, 66%, and 48% for the open surgery group, respectively (p=0.072). In a matched cohort analysis (n=50), the 30-day postoperative mortality rate was 22% for the EVAR-first group and 44% for the open surgery group (odds ratio: 0.35, 95% confidence interval: 0.14-0.90). The postoperative survival rates at 6 months, 1 year, and 3 years were 76%, 76%, and 63% for the EVAR-first group, respectively, and 48%, 45%, and 45% for the open surgery group, respectively (p=0.003). CONCLUSION The SRAP-based EVAR-first strategy for rAAA yielded significantly better treatment outcomes than the open surgical strategy. These findings suggest that EVAR should be considered the primary treatment option for rAAA, given its potential to reduce early mortality rates. CLINICAL IMPACT Multicenter retrospective analysis of prospectively collected registry data was done to compare treatment outcomes of two groups of ruptured abdominal aortic aneurysm patients open surgery and endovascular-aneurysm-repair (EVAR)-first strategy (Shonan ruptured abdominal aortic aneurysm protocol). EVAR-first group showed better outcomes: lower 30-day mortality (25% vs. 42%), higher survival rates at 6 months, 1 year, and 3 years. Take home Message: The study supports the use of the EVAR-first strategy with the Shonan Protocol for treating ruptured abdominal aortic aneurysms in Japan, showing improved outcomes, reduced 30-day postoperative mortality, and better long-term survival rates compared to the conventional approach.
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Affiliation(s)
- Hidemitsu Ogino
- Department of Vascular Surgery, Narita Tomisato Tokushukai Hospital, Chiba, Japan
| | - Naoko Isogai
- Department of Vascular Surgery, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Nao Kume
- Department of Vascular Surgery, Narita Tomisato Tokushukai Hospital, Chiba, Japan
| | - Shintaro Shibutani
- Department of Vascular Surgery, Kawasaki Tsurumi Vascular Surgery Clinic, Kawasaki, Japan
| | - Hideki Yashiro
- Department of Radiology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Naoki Fujimura
- Division of Vascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
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Geraedts AC, Zuidema R, Schuurmann RC, Kwant AN, Mulay S, Balm R, de Vries JPP. Shortest Apposition Length at the First Postoperative Computed Tomography Angiography Identifies Patients at Risk for Developing a Late Type Ia Endoleak After Endovascular Aneurysm Repair. J Endovasc Ther 2024; 31:274-281. [PMID: 36113063 PMCID: PMC10938489 DOI: 10.1177/15266028221120514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
PURPOSE Imaging surveillance following endovascular aneurysm repair (EVAR) is strictly recommended. This study investigates the value of endograft apposition and position relative to the aortic neck on the first postoperative computed tomography angiography (CTA) in determining patients at risk for a late type Ia endoleak (T1aEL). MATERIALS AND METHODS Patients with a T1aEL after the first postoperative CTA were selected from a consecutive database and matched with uncomplicated controls. Endograft apposition and position, including the shortest apposition length (SAL), were determined on the first postoperative CTA. The SAL is the shortest distance between the proximal endograft fabric and the first slice where circumferential apposition with the aortic wall is lost. Differences in endograft apposition at the first postoperative CTA were compared between groups. Logistic regression analysis identified independent predictors for late T1aEL. RESULTS A total of 32 patients with a late T1aEL were included and matched with 32 uncomplicated controls. Median follow-up after primary EVAR was 62.0 (interquartile range [IQR]: 36.8, 83.5) months in the T1aEL group compared with 47.5 (IQR: 34.0, 79.3) months in the control group; p=0.265. Median preoperative neck diameter was significantly larger in the T1aEL group than in the control group (26.6 [IQR: 24.9, 29.6] mm versus 23.4 [IQR: 22.5, 25.3] mm); p<0.001. Patients in the T1aEL group had a median SAL of 11.6 (IQR: 4.3, 20.5) mm compared with 20.7 (IQR: 13.1, 24.9) mm in the control group; p=0.002. SAL <10mm on the first postoperative CTA (odds ratio [OR]: 9.63, 95% confidence interval [CI]: 1.60-57.99) and larger neck diameter (OR: 1.80, 95% CI: 1.26-2.57) were independent predictors for developing a late T1aEL. CONCLUSION Preoperative neck diameter and SAL on the first postoperative CTA following EVAR are important predictors for the development of a late T1aEL. Patients with a SAL of <10mm had a significantly higher risk of developing a late T1aEL. Future research should determine whether these patients would benefit from reintervention before an actual T1aEL is present. CLINICAL IMPACT Understanding the mechanisms of endovascular aneurysm repair failure is essential to further enhance clinical outcomes. Adequate proximal sealing is necessary to foster freedom from type 1a endoleak. This study demonstrates that the shortest apposition length (SAL) at the first postoperative computed tomography angiography (CTA) is able to identify patients at risk for a late type 1a endoleak. Especially patients with a SAL <10mm are at high risk. Currently, the guidelines advice repeated imaging with CTA in patients with a seal <10mm. Future research should determine whether these patients would benefit from re-intervention before an actual type 1a endoleak is present.
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Affiliation(s)
- Anna C.M. Geraedts
- Department of Surgery, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Roy Zuidema
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Richte C.L. Schuurmann
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Ayla N. Kwant
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Sana Mulay
- Department of Surgery, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Ron Balm
- Department of Surgery, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jean-Paul P.M. de Vries
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
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Shi H, Wu Q, Guo N, Liu L, Widjaja J, Yang J, Gu Y. Causal relationship of obesity and adiposity distribution on risk of ventral hernia. World J Surg 2024. [PMID: 38520680 DOI: 10.1002/wjs.12137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/05/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE Ventral hernia (VH) is a common surgical disease. Previous studies suggested that obesity is an important risk factor for VH. However, the causal relationship between fat distribution and the risk of VH is still unclear. This study used Mendelian randomization (MR) to evaluate their causal relationship. METHODS We used the body mass index (BMI), body fat percentage, and body fat mass to represent general obesity and utilized the volume of abdominal subcutaneous adiposity tissue, visceral adiposity tissue, waist circumference, hip circumference, and waist-to-hip ratio to represent abdominal adiposity. The data were extracted from the large-scale genome-wide association study of European ancestry. We used two-sample MR to infer causality, using multivariate MR to correct the effects of confounding factors. RESULTS Increased BMI, body fat percentage, body fat mass, visceral adiposity tissue, waist circumference, and hip circumference rather than subcutaneous adiposity tissue or waist-to-hip ratio, were causally associated with a higher risk of VH. The results of multivariate MR suggested that body fat percentage was causally associated with a higher risk of VH after adjusting for body mass index, diabetes, and smoking. CONCLUSION General obesity, increased visceral adiposity tissue, waist circumference, and hip circumference rather than subcutaneous adiposity tissue or the waist-to-hip ratio were causally associated with a higher risk of VH. These findings provided a deeper understanding of the role that the distribution of adiposity plays in the mechanism of VH.
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Affiliation(s)
- Hekai Shi
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, China
| | - Qian Wu
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, China
| | - Nuojin Guo
- Department of Endocrinology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Ligang Liu
- Institute of Therapeutic Innovations and Outcomes, College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
| | - Jason Widjaja
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, China
| | - Jianjun Yang
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, China
| | - Yan Gu
- Department of General Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, China
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Chen Z, Liu C, Wang Y, Guo R, Chen W, Wang H, Song X. Free-breathing abdominal chemical exchange saturation transfer imaging using water presaturation and respiratory gating at 3.0 T. NMR Biomed 2024:e5134. [PMID: 38459747 DOI: 10.1002/nbm.5134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/06/2024] [Accepted: 02/06/2024] [Indexed: 03/10/2024]
Abstract
Free-breathing abdominal chemical exchange saturation transfer (CEST) has great potential for clinical application, but its technical implementation remains challenging. This study aimed to propose and evaluate a free-breathing abdominal CEST sequence. The proposed sequence employed respiratory gating (ResGat) to synchronize the data acquisition with respiratory motion and performed a water presaturation module before the CEST saturation to abolish the influence of respiration-induced repetition time variation. In vivo experiments were performed to compare different respiratory motion-control strategies and B0 offset correction methods, and to evaluate the effectiveness and necessity of the quasi-steady-state (QUASS) approach for correcting the influence of the water presaturation module on CEST signal. ResGat with a target expiratory phase of 0.5 resulted in a higher structural similarity index and a lower coefficient of variation on consecutively acquired CEST S0 images than breath-holding (BH) and respiratory triggering (all p < 0.05). B0 maps derived from the abdominal CEST dataset itself were more stable for B0 correction, compared with the separately acquired B0 maps by a dual-echo time scan and B0 maps derived from the water saturation shift referencing approach. Compared with BH, ResGat yielded more homogeneous magnetization transfer ratio asymmetry maps at 3.5 ppm (standard deviation: 3.96% vs. 3.19%, p = 0.036) and a lower mean squared difference between scan and rescan (27.52‱ vs. 16.82‱, p = 0.004). The QUASS approach could correct the water presaturation-induced CEST signal change, but its necessity for in vivo scanning needs further verification. The proposed free-breathing abdominal CEST sequence using ResGat had an acquisition efficiency of approximately four times that using BH. In conclusion, the proposed free-breathing abdominal CEST sequence using ResGat and water presaturation has a higher acquisition efficiency and image quality than abdominal CEST using BH.
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Affiliation(s)
- Zhensen Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Chuyu Liu
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine Tsinghua University, Beijing, China
| | | | - Rui Guo
- School of Medical Technology, Beijing Institute of Technology, Beijing, China
| | | | - He Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Xiaolei Song
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine Tsinghua University, Beijing, China
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Antono AC, Najar J, Wong SYW, Junn J, Knowlton LM. Large uterine fibroids causing a closed loop small bowel obstruction following uterine fibroid embolization. Trauma Surg Acute Care Open 2024; 9:e001425. [PMID: 38464551 PMCID: PMC10921493 DOI: 10.1136/tsaco-2024-001425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Amanda C Antono
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Julie Najar
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Sunnie Y W Wong
- Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Justin Junn
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Lisa Marie Knowlton
- General Surgery, Stanford University, Stanford, California, USA
- Stanford University Medical Center, Palo Alto, California, USA
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Mantalovas S, Paschou E, Kountouri I, Sevva C, Papadopoulos K, Roulia P, Dagher M, Laskou S, Lagopoulos V, Koulouris C, Louloudopoulou F, Kopsidas P, Sapalidis K, Kesisoglou I, Kosmidis C. A Unique Case of Appendiceal Intussusception (Inversion): A Case in Bloom. Diagnostics (Basel) 2024; 14:555. [PMID: 38473027 DOI: 10.3390/diagnostics14050555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/18/2024] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
A 40-year-old female patient presented to a secondary facility with dull lower abdominal pain and a persistent low-grade fever. Her laboratory results showed elevated inflammation markers. A CT scan revealed two abscesses in the lesser pelvic region in direct contact with the apex of the appendix, the posterior wall of the uterus, and the right-side appendages. The patient responded well to intravenous antibiotics, and an MRI scan revealed the cause to be an appendiceal rupture. The patient was scheduled for an appendectomy. The procedure started laparoscopically but had to be converted to an open one with a midline infra-umbilical incision in order to protect the right appendages. A standard appendectomy was conducted, and the histology report revealed rupture of the appendix with concomitant wall inversion in the context of fibrous adhesions as well as obstruction due to a fecalith. Patient recovery and follow-up were excellent. Acute appendicitis, while frequently encountered in surgical practice, can present a diagnostic conundrum when it manifests in an atypical manner. This unique form of inversion appeared to confer a protective role against peritonitis, primarily through the mechanism of obstruction occurring centrally to the rupture. We suggest that this case should be included in current classifications as a partial inversion of the appendix after rupture and inflammation.
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Affiliation(s)
- Stylianos Mantalovas
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Eleni Paschou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Ismini Kountouri
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Christina Sevva
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Konstantinos Papadopoulos
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Panagiota Roulia
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Marios Dagher
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Styliani Laskou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Vasileios Lagopoulos
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Charilaos Koulouris
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Fedra Louloudopoulou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Periklis Kopsidas
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Isaak Kesisoglou
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
| | - Christoforos Kosmidis
- Third Surgical Department, "AHEPA" University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece
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Duchesne G, Xia D, Waller JL, Bollag WB, Mohammed A, Padala S, Kheda M, Taskar V, Weintraub NL, Young L, Baer SL. Risk factors and mortality in dialysis patients with abdominal aortic aneurysm: A retrospective cohort study. J Investig Med 2024; 72:287-293. [PMID: 38183213 DOI: 10.1177/10815589241226729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
In the general population, abdominal aortic aneurysm (AAA) is synonymous with vascular disease and associated with increased mortality. Vascular disease is common in end-stage renal disease (ESRD) patients on dialysis, but there is limited information on AAA in this population. To address this issue, we queried the United States Renal Data System for risk factors associated with a diagnosis of AAA as well as the impact of AAA on ESRD patient survival. Incident dialysis patients from 2005 to 2014 with AAA and other clinical comorbidities were identified using ICD-9 and ICD-10 codes. Time to death was defined using the time from the start of dialysis to the date of death or to December 31, 2015. Cox proportional hazards (CPH) modeling was used to determine the adjusted hazard ratio (aHR) and 95% confidence intervals (CI) for death. From a total cohort of 820,826, we identified 21,631 subjects with a diagnosis of AAA. When compared to patients without AAA, AAA patients were older and more likely to be of white race and male gender, have a higher mean Charlson comorbidity index (CCI), have hypertension as the ESRD etiology, and use tobacco. Although a bivariate CPH model showed that AAA patients had an increased mortality risk compared to patients without the diagnosis, in the final CPH model, AAA patients had a decreased risk of mortality (aHR = 0.83, 95% CI 0.81-0.84) due to confounding with age. These results suggest that AAA is not associated with increased risk of death in ESRD patients after controlling for various demographic and clinical risk factors.
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Affiliation(s)
- Gabriela Duchesne
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Di Xia
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Department of Family and Community Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Mufaddal Kheda
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Varsha Taskar
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Neal L Weintraub
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA, USA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
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Yong PSA, Ke Y, Kok EJY, Tan BPY, Kadir HA, Abdullah HR. Preoperative anemia in older individuals undergoing major abdominal surgery is associated with early postoperative morbidity: a prospective observational study. Can J Anaesth 2024; 71:353-366. [PMID: 38182829 DOI: 10.1007/s12630-023-02676-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE Preoperative anemia is associated with poor postoperative outcomes. Older patients have limited physiologic reserves, which renders them vulnerable to the stress of major abdominal surgery. We aimed to determine if the severity of preoperative anemia is associated with early postoperative morbidity among older patients undergoing major abdominal surgery. METHODS Ethics approval was obtained from SingHealth Centralized Institutional Review Board. This is a prospective observational study conducted in the preoperative anesthesia clinic of a tertiary Singapore hospital from 2017 to 2021. Patient demographic data, comorbidities, and intraoperative details were collected. Outcome measures included blood transfusions, complications according to the Postoperative Morbidity Survey, days alive and out of hospital (DaOH), length of hospital stay, and mortality. RESULTS A total of 469 patients were analyzed, 37.5% of whom had preoperative anemia (serum hemoglobin of < 13 g·dL-1 in males and < 12 g·dL-1 in females). Anemia was significantly associated with older age, a higher age-adjusted Comprehensive Complication Index score, a higher incidence of diabetes mellitus, and a higher proportion of patients with an American Society of Anesthesiologists Physical Status of III or IV. The severity of anemia was associated with the presence of early postoperative morbidity at day 5, increased blood transfusions, longer length of hospital stay, and fewer DaOH at 30 days and six months. CONCLUSION Anemia is significantly associated with poorer postoperative outcomes in the older population. The impact of anemia on postoperative outcomes could be further evaluated with quality of life indicators, patient-reported outcome measures, and health economic tools.
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Affiliation(s)
- Phui S Au Yong
- Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Yuhe Ke
- Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Eunice J Y Kok
- Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore
| | - Brenda P Y Tan
- Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore
| | - Hanis Abdul Kadir
- Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore
- Health Services Research Unit, Singapore General Hospital, Singapore, Singapore
| | - Hairil R Abdullah
- Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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Kim SH, Park JH, Kim DH, Mun JH, Chung JH, Lee SS. A novel animal model of abdominal aortic aneurysm by mechanical injury. Exp Ther Med 2024; 27:103. [PMID: 38356672 PMCID: PMC10865458 DOI: 10.3892/etm.2024.12391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/06/2023] [Indexed: 02/16/2024] Open
Abstract
The present study established a novel and reproducible animal model to study abdominal aortic aneurysms. In total, 22 adult Lewis rats underwent a procedure to produce mechanical injuries at the infrarenal aorta which was opened temporarily. The aortas were injured 6 times and repaired. Those rats were divided into 2 groups and the aortic aneurysm tissue was harvested after 42 (6-week group) or 63 (9-week group) days and evaluated for the progression of aortic aneurysms. In the 6-week group, changes in the aneurysm were observed in 6/10 (60%) rats and the mean maximum diameter of the aorta demonstrated a 119% increase in size from the baseline measurement. In the 9-week group, changes in the aneurysm were observed in 8/11 (88%) rats and the mean maximum diameter of aorta demonstrated a 133% increase in size. Additional findings from the aortic aneurysm tissue were found microscopically, including the destruction of the tunica media and the elastic fiber. The present study demonstrated that this novel animal model for the development of abdominal aortic aneurysms (AAAs) produced by mechanical injury may have high reproducibility and similar gross and microscopic morphology to humans. This model could be helpful to investigate the treatment of AAAs.
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Affiliation(s)
- Soo-Hong Kim
- Department of Surgery, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam 50612, Republic of Korea
| | - Je-Hyung Park
- Department of Surgery, Bongseng Memorial Hospital, Busan 48775, Republic of Korea
| | - Dong Hyun Kim
- Department of Surgery, Division of Endovascular and Vascular Surgery, School of Medicine, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Gyeongsangnam 50612, Republic of Korea
| | - Jin-Ho Mun
- Department of Surgery, Division of Endovascular and Vascular Surgery, School of Medicine, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Gyeongsangnam 50612, Republic of Korea
| | - Jae Hun Chung
- Department of Surgery, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam 50612, Republic of Korea
| | - Sang Su Lee
- Department of Surgery, Division of Endovascular and Vascular Surgery, School of Medicine, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Gyeongsangnam 50612, Republic of Korea
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Aboelnaga M, Elkadi MS, Abdelhady IE, Elwan YH. Small Bowel Obstruction Due to Abdominal Cocoon Syndrome in Post-COVID-19 Patients. Cureus 2024; 16:e53564. [PMID: 38445118 PMCID: PMC10914080 DOI: 10.7759/cureus.53564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Abdominal cocoon syndrome, also recognized as encapsulating peritoneal sclerosis, is an exceedingly rare medical condition characterized by an anomalous membranous envelopment of the small bowel. Despite its clinical rarity, the precise etiology and pathogenic mechanisms of this syndrome remain elusive. METHODS This comprehensive discussion presents a case series encompassing six patients who sought medical attention in the Emergency Room, all sharing a common presentation: severe abdominal distension and persistent constipation. Intriguingly, these symptoms manifested following recent severe coronavirus disease 2019 (COVID-19) infections. Remarkably, none of these patients had significant medical histories or had undergone prior surgical interventions, rendering their cases even more enigmatic. RESULTS The defining feature across all six cases emerged during exploratory laparotomy, where a consistent finding stunned the surgical team: the discovery of a thick, fibrous membrane enveloping segments of the small bowel. The surgical procedure entailed meticulous dissection and subsequent removal of this membrane, with tissue samples dispatched for histopathological evaluation. This diagnostic approach conclusively confirmed the presence of abdominal cocoon syndrome in each of these patients. DISCUSSION The focal point of our discussion revolves around a potential connection between recent severe COVID-19 infection, intensive care unit admissions, and the subsequent development of abdominal cocoon syndrome. This intriguing association compels further inquiry to unveil the precise pathogenesis of this syndrome, particularly within the context of COVID-19. Given the diagnostic complexities associated with abdominal cocoon syndrome, this report underscores the indispensability of maintaining a heightened clinical suspicion and the significance of rigorous intraoperative assessments to ensure timely diagnosis and effective management. CONCLUSION Abdominal cocoon syndrome represents a rare and enigmatic medical condition characterized by its uncertain etiology. Our case series tantalizingly suggests a link between recent severe COVID-19 infection and the development of this syndrome. Nevertheless, comprehensive research endeavors are warranted to unravel the intricate mechanisms that underlie this intriguing association. In light of the diagnostic challenges associated with abdominal cocoon syndrome, this report underscores the pivotal role of exploratory surgery, in the absence of definitive radiological imaging, as the cornerstone for both diagnosis and therapeutic intervention. The pursuit of further investigations into the intricate relationship between COVID-19 and abdominal cocoon syndrome may ultimately yield the critical insights needed to demystify this complex medical enigma.
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Affiliation(s)
| | | | | | - Yomna H Elwan
- General Surgery, Mansoura International Hospital, Mansoura, EGY
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12
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Załuski M, Makara-Studzińska M. Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis. Inquiry 2024; 61:469580241229642. [PMID: 38400723 PMCID: PMC10894537 DOI: 10.1177/00469580241229642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 02/26/2024]
Abstract
Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.
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Masmoudi A, Zouari A, Bouzid A, Fourati K, Baklouti S, Ben Amar M, Boujelben S. Predicting Waist Circumference From a Single Computed Tomography Image Using a Mobile App (Measure It): Development and Evaluation Study. JMIRx Med 2023; 4:e38852. [PMID: 38234160 PMCID: PMC10958995 DOI: 10.2196/38852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/27/2023] [Accepted: 10/11/2023] [Indexed: 01/19/2024]
Abstract
Background Despite the existing evidence that waist circumference (WC) provides independent and additive information to BMI when predicting morbidity and mortality, this measurement is not routinely obtained in clinical practice. Using computed tomography (CT) scan images, mobile health (mHealth) has the potential to make this abdominal obesity parameter easily available even in retrospective studies. Objective This study aimed to develop a mobile app as a tool for facilitating the measurement of WC based on a cross-sectional CT image. Methods The development process included three stages: determination of the principles of WC measurement from CT images, app prototype design, and validation. We performed a preliminary validity study in which we compared WC measurements obtained both by the conventional method using a tape measurement in a standing position and by the mobile app using the last abdominal CT slice not showing the iliac bone. Pearson correlation, student t tests, and Q-Q and Bland-Altman plots were used for statistical analysis. Moreover, to perform a diagnostic test evaluation, we also analyzed the accuracy of the app in detecting abdominal obesity. Results We developed a prototype of the app Measure It, which is capable of estimating WC from a single cross-sectional CT image. We used an estimation based on an ellipse formula adjusted to the gender of the patient. The validity study included 20 patients (10 men and 10 women). There was a good correlation between both measurements (Pearson R=0.906). The student t test showed no significant differences between the two measurements (P=.98). Both the Q-Q dispersion plot and Bland-Altman analysis graphs showed good overlap with some dispersion of extreme values. The diagnostic test evaluation showed an accuracy of 83% when using the mobile app to detect abdominal obesity. Conclusions This app is a simple and accessible mHealth tool to routinely measure WC as a valuable obesity indicator in clinical and research practice. A usability and validity evaluation among medical teams will be the next step before its use in clinical trials and multicentric studies.
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Affiliation(s)
| | - Amine Zouari
- Surgery Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Ahmed Bouzid
- Surgery Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Kais Fourati
- Surgery Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | | | - Mohamed Ben Amar
- Surgery Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Salah Boujelben
- Surgery Department, Habib Bourguiba University Hospital, Sfax, Tunisia
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Guy EFS, Clifton JA, Knopp JL, Holder-Pearson LR, Chase JG. Non-Invasive Assessment of Abdominal/Diaphragmatic and Thoracic/Intercostal Spontaneous Breathing Contributions. Sensors (Basel) 2023; 23:9774. [PMID: 38139620 PMCID: PMC10747041 DOI: 10.3390/s23249774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
(1) Background: Technically, a simple, inexpensive, and non-invasive method of ascertaining volume changes in thoracic and abdominal cavities are required to expedite the development and validation of pulmonary mechanics models. Clinically, this measure enables the real-time monitoring of muscular recruitment patterns and breathing effort. Thus, it has the potential, for example, to help differentiate between respiratory disease and dysfunctional breathing, which otherwise can present with similar symptoms such as breath rate. Current automatic methods of measuring chest expansion are invasive, intrusive, and/or difficult to conduct in conjunction with pulmonary function testing (spontaneous breathing pressure and flow measurements). (2) Methods: A tape measure and rotary encoder band system developed by the authors was used to directly measure changes in thoracic and abdominal circumferences without the calibration required for analogous strain-gauge-based or image processing solutions. (3) Results: Using scaling factors from the literature allowed for the conversion of thoracic and abdominal motion to lung volume, combining motion measurements correlated to flow-based measured tidal volume (normalised by subject weight) with R2 = 0.79 in data from 29 healthy adult subjects during panting, normal, and deep breathing at 0 cmH2O (ZEEP), 4 cmH2O, and 8 cmH2O PEEP (positive end-expiratory pressure). However, the correlation for individual subjects is substantially higher, indicating size and other physiological differences should be accounted for in scaling. The pattern of abdominal and chest expansion was captured, allowing for the analysis of muscular recruitment patterns over different breathing modes and the differentiation of active and passive modes. (4) Conclusions: The method and measuring device(s) enable the validation of patient-specific lung mechanics models and accurately elucidate diaphragmatic-driven volume changes due to intercostal/chest-wall muscular recruitment and elastic recoil.
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Affiliation(s)
- Ella F. S. Guy
- Centre for Bioengineering, Mechanical Engineering, University of Canterbury, Christchurch 8041, New Zealand (J.L.K.); (J.G.C.)
| | - Jaimey A. Clifton
- Centre for Bioengineering, Mechanical Engineering, University of Canterbury, Christchurch 8041, New Zealand (J.L.K.); (J.G.C.)
| | - Jennifer L. Knopp
- Centre for Bioengineering, Mechanical Engineering, University of Canterbury, Christchurch 8041, New Zealand (J.L.K.); (J.G.C.)
| | - Lui R. Holder-Pearson
- Electrical and Computer Engineering, University of Canterbury, Christchurch 8041, New Zealand;
| | - J. Geoffrey Chase
- Centre for Bioengineering, Mechanical Engineering, University of Canterbury, Christchurch 8041, New Zealand (J.L.K.); (J.G.C.)
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Yoshida A, Nakamura S, Oh RJ, Shiomi H, Yamazaki H, Yoshida K, Tanigawa N. The Dosimetric Analysis of Duodenal and Intestinal Toxicity After a Curative Dose Re-irradiation Using the Intensity-Modulated Radiotherapy for Abdominopelvic Lymph Node Lesions. Cureus 2023; 15:e50920. [PMID: 38259406 PMCID: PMC10803104 DOI: 10.7759/cureus.50920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION This study aimed to examine the influence of dosimetric factors on gastrointestinal toxicity after radical re-irradiation for lymph node recurrence in the abdominopelvic region using a composite plan. METHODS Between January 2008 and March 2017, 33 patients underwent radical re-irradiation for lymph node recurrence in the abdominopelvic region with a complete overlap with previous radiation therapy (RT) with the median prescription dose of the second RT of 71.7 Gy10. Re-irradiation planning protocol for target volume and organs at risk (OARs) (duodenum, small and large intestines) was decided as follows: more than equal to 97% of the prescription dose was administered to the D95 (percentage of the minimum dose that covered 95% of the target volume) of planning target volume (PTV); minimal dose to the maximally irradiated doses delivered to 1cc [D1 cc] and 5cc [D5 cc] of OARs was set below 70 Gy3 and 50 Gy3, respectively; and D1 cc and D5 cc in the cumulative plans to OARs were 120 Gy3 and 100 Gy3. Kaplan-Meier analyses were performed to evaluate overall survival (OS) and univariate log-rank and multivariate Cox proportional hazards model analyses were performed to explore predictive factors. Using dose summation of the first and re-irradiation plans, we conducted a dosimetric analysis for grade ≥ 3 toxicities of the duodenum and intestine. RESULTS With a median follow-up of 18 months, the two-year OS rate was 45.5%. The number of RT fields (localized or multiple) was a significant predisposing factor for OS rate with a hazard ratio of 0.23 (95% confidence interval 0.07-0.73). The two-year OS of the patients with a localized RT field was 63.6% and 9.1% for multiple RT fields (p= 0.00007). Four patients experienced grade ≥3 gastrointestinal toxicity related to re-irradiation (4/33=12.1%). We could not find any predisposing dosimetric value in the comparisons with and without toxicity. CONCLUSIONS The dose constraints presented in this study are relatively low rates of toxicity, which may be useful when planning re-irradiation. Especially, for the patients who could be treated with localized RT field, radical re-irradiation with a high curative dose is a good option. No dosimetric predisposing factor was found for radical re-irradiation of abdominopelvic lesions in the composite plan.
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Affiliation(s)
- Asami Yoshida
- Radiation Oncology, Kansai Medical University, Hirakata, JPN
| | | | - Ryoong-Jin Oh
- Radiation Oncology, Miyakojima Image Guided Radiation Therapy (IGRT) Clinic, Osaka, JPN
| | - Hiroya Shiomi
- Radiation Oncology, Miyakojima Image Guided Radiation Therapy (IGRT) Clinic, Osaka, JPN
| | - Hideya Yamazaki
- Radiology, Kyoto Prefectural University of Medicine, Kyoto, JPN
| | - Ken Yoshida
- Radiation Oncology, Kansai Medical University, Hirakata, JPN
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Lee J, Jung JH, Kim J, Jeong C, Ha J, Kim MH, Lee JM, Chang SA, Baek KH, Han K, Lim DJ. Associations between body composition and the risk of fracture according to bone mineral density in postmenopausal women: a population-based database cohort study. Eur J Endocrinol 2023; 189:527-536. [PMID: 37995142 DOI: 10.1093/ejendo/lvad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE We aimed to investigate the associations of body composition and the risk of fracture in postmenopausal women, stratified based on bone mineral density. METHODS A population-based cohort study using the database of the National Screening Program for Transitional Ages with women aged 66 years was performed. Bone mineral density was categorized as normal, osteopenia, and osteoporosis. The following body mass index (BMI) categories for general obesity were used: underweight (<18.5), normal (18.5-22.9), overweight (23-24.9), obese (25-29.9), and severely obese (≥30 kg/m2). Waist circumference (WC) used for central obesity assessment was categorized into 5 groups. Newly diagnosed fracture during the follow-up period defined based on ICD-10 codes was the primary outcome. RESULTS During 7.7 ± 1.4 years of follow-up, 41 672 (17.9%) participants experienced any fracture, 20 326 (8.7%) experienced vertebral fractures (VFs), and 2883 (1.2%) experienced hip fractures (HFs). The adjusted hazard ratios (aHRs) for any fracture showed a progressive increase with higher BMI and WC categories in individual with osteopenia and osteoporosis. Regarding VF, aHR was highest in severely obese individuals with osteoporosis (aHR [95% CI], 3.45 [2.99-3.97]) and in individuals with WC ≥ 95 cm with osteoporosis (4.79 [4.09-5.60]). The aHR [95% CI] for HF was highest in the underweight group with osteopenia (1.94 [1.16-3.27]) and osteoporosis (2.96 [2.15-4.10]). In central obesity individuals with WC ≥ 95 cm, aHR [95% CI] for HF was 2.80 [1.91-4.91]. CONCLUSIONS General obesity and central obesity are not protective against any fracture, VF and HF in postmenopausal women with osteopenia or osteoporosis.
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Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Jin-Hyung Jung
- Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Jinyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Chaiho Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Republic of Korea
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Jung-Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Sang-Ah Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Boer GJ, Larbi N, Bekken JA, Kuijper TM, Vroegindeweij D, Fioole B. A Ratio Between Infrarenal and Suprarenal Aortic Diameters Corrects for Absolute Aortic Diameter Variations due to Patients' Sex and Body Size. J Endovasc Ther 2023:15266028231204812. [PMID: 37850720 DOI: 10.1177/15266028231204812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVES Aortic diameters may differ significantly between patients with different gender and body size. The aim of this study was to relate absolute aortic diameters to age, sex, height, and weight of the patients and to correct for these factors by calculating the ratio between the infrarenal and the suprarenal aortic diameters. METHODS A total of 458 patients who underwent elective endovascular aneurysm repair (EVAR) between 2004 and 2018 were included. The aortic anatomy in this group of elective EVAR patients was compared with a control group of 75 patients without an abdominal aortic aneurysm (AAA). The aortic diameter was measured at 4 suprarenal points and 4 infrarenal points. Ratios were calculated by dividing the mean infrarenal neck diameter by 4 suprarenal measurements. RESULTS Patients in the aneurysm group had significantly larger suprarenal and infrarenal aortic diameters. The ratios between the mean infrarenal neck diameter and all 4 suprarenal measurements were larger in the AAA group than in the control group. In both groups, there was a significant correlation between the mean infrarenal neck diameter and sex, height, weight, and body surface area (BSA). However, in both groups, all 4 ratios between the mean infrarenal neck diameter and suprarenal aortic diameters were not correlated with age, sex, height, weight, or BSA, except for the ratio between the mean infrarenal neck diameter and the aortic diameter measurement proximal to the upper renal artery, which was correlated to weight and BSA in the control group. CONCLUSION The mean infrarenal neck diameter is correlated with sex, height, weight, and BSA. However, when the suprarenal aortic diameter was used as an internal control for the mean infrarenal neck diameter, we were able to correct for these variations in aortic diameters due to sex and body size. The clinical relevance of this ratio in patients treated by EVAR has yet to be assessed in future research. CLINICAL IMPACT In the assessment for EVAR suitability the absolute diameter of the aneurysm neck is taken into account. We believe that using absolute diameters is not the appropriate way to assess this suitability, but that patient characteristics such as age, gender and body size, should be factored into this assessment. In this paper, we show that suprarenal and infrarenal aortic diameters are both significantly increased in patients with an aneurysm compared with patients without an aneurysm. Besides, we found that mean infrarenal aortic diameter is correlated with sex, height, weight, and body surface area. Finally, we propose a new ratio system, using suprarenal diameters as an internal control, to correct for aortic diameter variations due to sex and body size.
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Affiliation(s)
- Gert Jan Boer
- Department of Vascular Surgery, Maasstad Hospital, Rotterdam, The Netherlands
| | - Nora Larbi
- Department of Vascular Surgery, Maasstad Hospital, Rotterdam, The Netherlands
| | - Joost A Bekken
- Department of Vascular Surgery, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | | | | | - Bram Fioole
- Department of Vascular Surgery, Maasstad Hospital, Rotterdam, The Netherlands
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Ioannidis O, Symeonidis S, Ouzounidis N, Foutsitzis V, Anestiadou E, Christidis P, Loutzidou L, Fesatidou V, Kerasidou O, Tsalis K, Aggelopoulos S. Two case reports of mesenteric and retroperitoneal actinomycosis and a narrative review of the relevant literature. Med Pharm Rep 2023; 96:441-446. [PMID: 37970198 PMCID: PMC10642741 DOI: 10.15386/mpr-2073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 11/13/2022] [Accepted: 01/22/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction Actinomycosis is an uncommon subacute or chronic suppurative bacterial granulomatous infectious disease with clinical heterogeneity. The majority of actinomycosis cases were of extra-abdominal origin, with oro-cervico-facial cases representing 55%, abdominopelvic representing 20%, and thoracic representing 15% of total reports. Currently, abdominal actinomycosis incidence is approximately 1 case per 119,000 people, being found three times more frequently among males. We report two rare clinical presentations of abdominal actinomycosis affecting the mesentery and the retroperitoneum, respectively. Case Report 1 A 58-year-old Caucasian male presented to our clinic with abdominal pain in the right upper quadrant. Pre-operative evaluation, although inconclusive, showed a mesocolic mass infiltrating the right and transverse colon. The patient underwent exploratory laparotomy. After partial resection of the mass, the histopathology report demonstrated mesenteric actinomycosis. Case Report 2 A 40-year-old Caucasian male presented to our clinic complaining about a mucopurulent material from an orifice at the right inguinal region. After appropriate work-up, a large abdominopelvic, stellate mass (75 x 22.8 mm) in the retroperitoneum was revealed. Surgery along with the appropriate antibiotics was used to treat the patient. Conclusion Preoperative suspicion and diagnosis of actinomycosis are very challenging, with a high rate of misdiagnosis often resulting in delayed treatment. Our case reports highlight that abdominal actinomycosis should always be part of differential diagnosis, especially when there is involvement of multiple organs. The gold standard treatment of actinomycosis is surgical excision with prolonged antibiotic treatment.
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Affiliation(s)
- Orestis Ioannidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Savvas Symeonidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Ouzounidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Vasilis Foutsitzis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Elissavet Anestiadou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Panagiotis Christidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Lydia Loutzidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Vasiliki Fesatidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ourania Kerasidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Tsalis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Stamatios Aggelopoulos
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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Guo H, Yang B, Kiryu S, Wang Q, Yu D, Sun Z, Chen Y, Li X, Wang F, Ba X. Evaluation of the relations between reproduction-related pituitary and ovarian hormones and abdominal fat area-related variables determined with computed tomography in overweight or obese women who have undergone bariatric surgery: a cross-sectional study. Quant Imaging Med Surg 2023; 13:7065-7076. [PMID: 37869350 PMCID: PMC10585523 DOI: 10.21037/qims-22-1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 08/22/2023] [Indexed: 10/24/2023]
Abstract
Background An understanding of the associations between midregion fat depots and systemic hormone levels will be crucial for developing health-promotion messages aimed at overweight or obese women. However, related research in this area is rare. The present study was performed to identify and quantify fat-related reproduction pituitary and ovarian hormones in overweight or obese women. Methods A total of 250 eligible overweight or obese women scheduled to undergo laparoscopic sleeve gastrectomy (LSG) from a single center were retrospectively included in this study. Computed tomography (CT) images at the level of the umbilicus were selected, and abdominal fat areas were measured and calculated. The reproduction-related pituitary and ovarian hormones were also measured. The correlations among the parameters were examined using Spearman correlation test. Multiple linear regression analysis was performed after log and β-transformation of the hormone levels and fat area-related variables. Results Positive correlations were detected for prolactin (PRL) with total fat area (TFA) [β=0.045; P=0.029; 95% confidence interval (CI): 0.004-0.085] and subcutaneous fat area (SFA) (β=0.066; P=0.023; 95% CI: 0.009-0.123), whereas estradiol showed a negative correlation with visceral fat area (VFA) (β=-0.056, P=0.005; 95% CI: -0.096 to -0.017) and relative VFA (rVFA) (β=-0.068; P=0.001; 95% CI: -0.109 to -0.027) and a positive correlation with SFA (β=0.036; P=0.042; 95% CI: 0.001-0.071). Progesterone (PROG) was negatively correlated with both VFA (β=-0.037; P=0.002; 95% CI: -0.061 to -0.013) and rVFA (β=-0.039; P=0.002; 95% CI: -0.063 to -0.014). The final results revealed that TFA was increased by 3.1% and SFA was increased by 4.7% with a doubling of PRL concentration; VFA was reduced by 2.5% and rVFA was reduced by 2.6% with a doubling of PROG concentration; and VFA was reduced by 3.8%, rVFA was reduced by 4.6%, and SFA was increased by 2.5% with a doubling of estradiol concentration. Conclusions There exist certain associations between some reproduction-related pituitary and ovarian hormones and fat areas. Our findings provide new insights into the associations between midregion fat depots and systemic hormone levels in overweight or obese women.
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Affiliation(s)
- Hao Guo
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, China
| | - Bo Yang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
- Department of Radiology, Qingzhou People’s Hospital, Qingzhou, China
| | - Shigeru Kiryu
- Department of Radiology, Narita Hospital, International University of Health and Welfare, Narita City, Chiba, Japan
| | - Qing Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Dexin Yu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Zehua Sun
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, China
| | - Yang Chen
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, China
- Department of Medical Imaging, Weifang Medical University, Weifang, China
| | - Xin Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
- Department of Radiology, Tengzhou Central People’s Hospital, Tengzhou, China
| | - Fang Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Xinru Ba
- Department of Radiology, Yantaishan Hospital, Yantai, China
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20
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van Zutphen M, Beeren I, Aben KKH, van der Heijden AG, Witjes JA, Kiemeney LALM, Vrieling A. Body mass index and waist circumference in relation to risk of recurrence and progression after non-muscle invasive bladder cancer. Cancer Med 2023; 12:20459-20469. [PMID: 37800635 PMCID: PMC10652337 DOI: 10.1002/cam4.6620] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/25/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Obesity may be associated with increased risk of recurrence and progression in patients with non-muscle invasive bladder cancer (NMIBC), but evidence is limited and inconsistent. We examined the associations of body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) with risk of recurrence and progression among patients with NMIBC. METHODS This prospective study included 1029 patients diagnosed with primary NMIBC between 2014 and 2017. Patients reported weight 2 years before diagnosis at baseline, and weight, waist and hip circumference at 3 months postdiagnosis. Associations were quantified using Cox proportional hazard analyses, adjusted for clinical and lifestyle characteristics. RESULTS More than half of patients were overweight (49%) or obese (19%) after diagnosis. During a median follow-up time of 3.6 years, 371 patients developed ≥1 recurrence and 53 experienced progression. No associations with recurrence were observed for BMI (HRper 5 kg/m2 0.94; 95% CI 0.82, 1.07), waist circumference (HRper 10 cm 0.95; 95% CI 0.86, 1.05), or WHR (HRper 0.1 unit 0.90; 95% CI 0.76, 1.06). In contrast, higher BMI was associated with a 40% increased risk of progression, with only the 2-year prediagnosis association reaching statistical significance (HRper 5 kg/m2 1.42; 95% CI 1.09, 1.84). No associations for pre-to-postdiagnosis weight change were found. CONCLUSION General and abdominal obesity were not associated with recurrence risk among patients with NMIBC, but might be associated with increased risk of progression. Studies with sufficient sample size to stratify by tumor stage and treatment are needed to better understand whether and how obesity could influence prognosis.
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Affiliation(s)
- Moniek van Zutphen
- Department for Health EvidenceRadboud University Medical CenterNijmegenThe Netherlands
| | - Ivy Beeren
- Department for Health EvidenceRadboud University Medical CenterNijmegenThe Netherlands
| | - Katja K. H. Aben
- Department for Health EvidenceRadboud University Medical CenterNijmegenThe Netherlands
- Netherlands Comprehensive Cancer OrganisationUtrechtThe Netherlands
| | | | - J. Alfred Witjes
- Department of UrologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Lambertus A. L. M. Kiemeney
- Department for Health EvidenceRadboud University Medical CenterNijmegenThe Netherlands
- Department of UrologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Alina Vrieling
- Department for Health EvidenceRadboud University Medical CenterNijmegenThe Netherlands
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21
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Faust TF, Schnittka E, Steadman MB, Cail GM, Rice BS. Management of Laparoscopic Adjustable Gastric Band Erosion: A Case Report. Cureus 2023; 15:e47718. [PMID: 38021841 PMCID: PMC10675987 DOI: 10.7759/cureus.47718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Gastric banding was one of the first operations to gain popularity within the field of bariatric surgery. This case details one patient's presentation and subsequent management of gastric band erosion with the hope of guiding other physicians and supporting the decreased use of gastric banding. The patient, a 61-year-old Caucasian female, presented to the bariatric clinic complaining of a multiyear history of epigastric pain and acid reflux, which was refractory to treatment with proton pump inhibitors. She had a history of laparoscopic adjustable gastric band (LAGB) placement in 2007. She was initially successful in achieving weight loss and maintained regular band adjustments but was lost to follow-up and regained a body mass index (BMI) of 41.59 kg/m2. Evaluation with upper gastrointestinal (GI) endoscopy was recommended and performed. This revealed a LAGB in its entirety with tubing within the gastric fundus. Removal with dual endoscopy and abdominal laparoscopy was recommended and scheduled. During attempts to remove the band using an endoscopic snare, significant difficulty was encountered. Ultimately, an endoscopic rat-tooth grasper was used to lyse the band and tubing into four sections for complete removal. The subcutaneous port of the band was successfully removed laparoscopically, and the patient was discharged from the operating room. She reported limited pain in the postoperative suite but was lost to follow-up regarding long-term symptom relief. This report describes the presentation and management of one patient's experience with a known complication of LAGB-band erosion. This complication necessitated two additional procedures with anesthesia and placed the patient at increased risk for esophageal perforation, complications related to sedation, and the development of abdominal adhesions. Her case aims to support the decreasing prevalence of LAGBs within bariatric surgery and hopes to guide other physicians challenged with the management of similar cases.
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Affiliation(s)
- Taylor F Faust
- Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Emma Schnittka
- Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Michael B Steadman
- Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Garrett M Cail
- Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Bradley S Rice
- Department of Gastroenterology, Crestwood Medical Center, Huntsville, USA
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22
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McComb K, Barghash M, Eltayef S. Idiopathic Spontaneous Intraperitoneal Haemorrhage (ISIH): A Diagnostic Dilemma and Its Conservative Management. Cureus 2023; 15:e44879. [PMID: 37814746 PMCID: PMC10560380 DOI: 10.7759/cureus.44879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/11/2023] Open
Abstract
Idiopathic spontaneous intraperitoneal haemorrhage (ISIH) is a rare cause of acute abdominal pain. It refers to haemoperitoneum resulting from the rupture of an intra-abdominal vessel without the preceding trauma or underlying pathology. Here, we present the case of a 17-year-old boy with acute abdominal pain. Initially, acute appendicitis was the primary differential diagnosis. Imaging demonstrated a significant volume of intra-abdominal fluid that was haemorrhagic in nature, but no active bleeding or source was identified. A conservative management approach was adopted due to the patient's clinical improvement during his admission. This case highlights the high index of clinical suspicion required to diagnose and investigate ISIH. In contrast to the historical opinion that stipulates management with a surgical intervention, this case demonstrates the possibility of conservative management in stable patients.
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Affiliation(s)
- Katie McComb
- General Surgery, North Manchester General Hospital, Manchester, GBR
| | - Mohammed Barghash
- General and Colorectal Surgery, North Manchester General Hospital, Manchester, GBR
| | - Saleh Eltayef
- General and Colorectal Surgery, North Manchester General Hospital, Manchester, GBR
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23
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Pereira LDN, Pegorari MS, Patrizzi LJ, de Walsh IAP, Silva CDFR, da Silva JDS, Matos AP, Pinto ACPN, Ohara DG. Cross-Sectional Study on the Association Between Respiratory Muscle Strength and Dynapenic Abdominal Obesity in Community-Dwelling Older Adults. Clin Interv Aging 2023; 18:1351-1359. [PMID: 37605751 PMCID: PMC10440087 DOI: 10.2147/cia.s411170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023] Open
Abstract
Purpose Impaired respiratory muscle strength has been associated with some geriatric syndromes. However, no studies have previously evaluated the relationship between respiratory muscle strength and dynapenic abdominal obesity. This study aimed to analyze whether there is an association between respiratory muscle strength and abdominal obesity, dynapenia and dynapenic abdominal obesity (DAO) in community-dwelling older adults. Patients and Methods Cross-sectional study conducted with community-dwelling older adults (n=382 / 70.03 ± 7.3 years) from Macapá, Amapá, Brazil. Respiratory muscle strength was assessed by measuring maximal inspiratory and expiratory pressures (MIP and MEP, respectively), using an analog manovacuometry. DAO was defined as the combination of dynapenia (grip strength < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). We performed descriptive and inferential statistical analyses using the student's t-test for independent and related samples and linear regression model. Results Older adults with abdominal obesity, dynapenia, and DAO presented lower mean values (obtained and obtained versus predicted; except abdominal obesity versus MIP) for maximal respiratory pressures compared to individuals without these conditions. However, the adjusted analysis only indicated an association between MIP and the following conditions: dynapenia (MIP - β =-0.171; p<0.001), abdominal obesity (MIP - β=0.102; p=0.042), and DAO (MIP - β=-0.101; p=0.028). Conclusion Older adults with abdominal obesity, dynapenia, and DAO showed impaired maximal respiratory pressures. The results of the adjusted analysis indicate that inspiratory muscle strength may require greater attention by health professionals aiming at preventing respiratory complications and improving respiratory health care in older people with these conditions.
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Affiliation(s)
| | - Maycon Sousa Pegorari
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Macapá, AP, Brazil
| | - Lislei Jorge Patrizzi
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Isabel Aparecida Porcatti de Walsh
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | | | - Areolino Pena Matos
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, AP, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Macapá, AP, Brazil
| | - Ana Carolina Pereira Nunes Pinto
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, AP, Brazil
- Iberoamerican Cochrane Centre - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Cochrane Brazil, Center for Evidence-Based Health Studies and Health Technology Assessment, Sao Paulo, Brazil
- Department of Medicine, Evidence-Based Health Post-Graduation Program, Federal University of São Paulo, Sao Paulo, Brazil
| | - Daniela Gonçalves Ohara
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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24
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Wang Y, Zhou M, Ding Y, Li X, Zhou Z, Xie T, Shi Z, Fu W. A radiomics model for predicting the outcome of endovascular abdominal aortic aneurysm repair based on machine learning. Vascular 2023; 31:654-663. [PMID: 35440250 DOI: 10.1177/17085381221091061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to develop a radiomics model to predict the outcome of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), based on machine learning (ML) algorithms. METHODS We retrospectively reviewed 711 patients with infra-renal AAA who underwent elective EVAR procedures between January 2016 and December 2019 at our single center. The radiomics features of AAA were extracted using Pyradiomics. Pearson correlation analysis, analysis of variance (ANOVA), least absolute shrinkage, and selection operator (LASSO) regression were applied to determine the predictors for EVAR-related severe adverse events (SAEs). Eighty percent of patients were classified as the training set and the remaining 20 percent of patients were classified as the test set. The selected features were used to build a radiomics model in training set using different ML algorithms. The performance of each model was assessed using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve in the test set. RESULTS A total of 493 patients were enrolled in this study, the mean follow-up time was 32 months. During the follow-up, 156 (31.6%) patients experienced EVAR-related SAEs. A total of 1223 radiomics features were extracted from each patient, of which 30 radiomics features were finally identified. The quantitative performance assessment and the ROC curves indicated that the logistics regression (LR) model had better predictive value than others, with accuracy, 0.86; AUC, 0.93; and F1 score, 0.91. The Rad-score waterfall plot showed that the overall amount of error was small both in the training set and in the test set. Calibration curve showed that the calibration degree of the training set and the test set were good (p > 0.05). Decision curve analysis (threshold 0.32) demonstrated that the model had good clinical applicability. CONCLUSION Our radiomics model could be used as an efficient and adjunctive tool to predict the outcome after EVAR.
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Affiliation(s)
- Yonggang Wang
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Min Zhou
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yong Ding
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xu Li
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhenyu Zhou
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tianchen Xie
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhenyu Shi
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weiguo Fu
- Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
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25
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ZHANG X, LI Q, YI R, XING C, JIN Y, MENG J, FENG J, ZHAO S, LIANG F, GUO T. Effect of catgut embedding at acupoints versus non-acupoints in abdominal obesity: a randomized clinical trial. J TRADIT CHIN MED 2023; 43:780-786. [PMID: 37454263 PMCID: PMC10320439 DOI: 10.19852/j.cnki.jtcm.20230608.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/18/2022] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To explore the difference of catgut embedding effect between acupoints and non-acupoints in patients with abdominal obesity (AO). METHODS In this multicenter, double-blind, randomized controlled trial, all subjects were randomly assigned into the acupoint catgut embedding (ACE) group and control group (catgut embedding at non-acupoints). With a 12-week actual intervention period and a 4-week period of follow-up. Waist circumference (WC), body weight, body mass index (BMI), hip circumference (HC) and appetite were applied and assessed at baseline and after 6, 12 and 16 weeks. RESULTS After the total intervention phase (12 weeks), the WC, body weight, BMI, HC and visual analogue scale scores of appetite, decreased significantly in the two groups as compared to the baseline (0.001). Meanwhile, after the 4-week follow-up, the indicators still decreased significantly in the ACE group (0.001). At 12 and 16 weeks, catgut embedding at acupoints showed significantly advantages to non-acupoints in WC and appetite (0.05). No serious adverse events were observed in ACE group and control group. CONCLUSIONS Catgut embedding at acupoints and non-acupoints are all effective and safe for AO. ACE can effectively treat AO as expected and deliver lasting results.
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Affiliation(s)
- Xinghe ZHANG
- 1 School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Qifu LI
- 1 School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Rong YI
- 2 Department of Acupuncture and Moxibustion, Kunming Hospital of Traditional Chinese Medicine, Kunming 650200, China
| | - Chonghui XING
- 3 Department of Acupuncture and Moxibustion, the Sports Trauma Specialist Hospital of Yunnan Province, Kunming 650051, China
| | - Yuhao JIN
- 1 School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Jiangqiong MENG
- 1 School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Jialei FENG
- 4 Institute for History of Medicine and Medical Literature, China Academy of Chinese Medical Sciences, Beijing 100027, China
| | - Siwen ZHAO
- 1 School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Fanrong LIANG
- 5 School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Taipin GUO
- 1 School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
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26
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Klucniks A, Kerner V. Anaesthesia for intestinal transplantation. BJA Educ 2023; 23:312-319. [PMID: 37465232 PMCID: PMC10350554 DOI: 10.1016/j.bjae.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 07/20/2023] Open
Affiliation(s)
| | - V. Kerner
- Anuradhapura Teaching Hospital, Anuradhapura, Sri Lanka
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27
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Jiang T, Zhao Z, Cai Z, Shen C, Zhang B. Case Report: Giant abdominal hemangioma originating from the liver. Front Oncol 2023; 13:1165195. [PMID: 37588097 PMCID: PMC10425808 DOI: 10.3389/fonc.2023.1165195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
Background Hepatic hemangioma is among the most common benign liver lesions. However, giant pedunculated hepatic hemangiomas are exceptionally rare and associated with additional risks, such as torsion. Case presentation We present the case of a 63-year-old female patient who presented with abdominal distension and pain. Barium meal examination and gastroscopy revealed a large, smooth-surfaced submucosal bulge located at the fundus of the stomach. Subsequent MRI examination identified a mass measuring approximately 6.4 x 7 cm in the left upper abdomen. Surgical intervention was planned for mass removal. However, intraoperative exploration revealed the origin of the mass to be the liver, and subsequent histopathological examination confirmed it as a hemangioma. Conclusion We systematically summarized the characteristics of our case along with 31 previously reported cases. Giant pedunculated hepatic hemangiomas typically occur in the left lobe of the liver. Due to their atypical presentation, a combination of imaging methods such as ultrasound, CT, and/or MRI is essential for accurate diagnosis. Furthermore, surgical intervention is recommended due to the potential risks of bleeding, rupture, and torsion.
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Affiliation(s)
- Tianxiang Jiang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhou Zhao
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaolun Cai
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Chaoyong Shen
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Zhang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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28
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Mavropoulou X, Psoma E, Papachristodoulou A, Pyrrou N, Spanou E, Alexandratou M, Sidiropoulou M, Theocharidou A, Rafailidis V, Chrysanthidis T, Prassopoulos P. Gastrointestinal Imaging Findings in the Era of COVID-19: A Pictorial Review. Medicina (Kaunas) 2023; 59:1332. [PMID: 37512143 PMCID: PMC10385728 DOI: 10.3390/medicina59071332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
The potentially fatal COVID-19 pandemic has been associated with a largespectrum of clinical presentations. Beyond the classical pulmonary manifestations, gastrointestinal tract-related symptoms suchas nausea, diarrhea, abdominal distention and pain have been observed in patients, as a consequence of the binding of SARS-CoV-19 to Angiotensin-converting Enzyme 2 (ACE2) receptors in the gastrointestinal (GI) tract. The early recognition ofspecific imaging features, including hepatobiliary involvement, pancreatic involvement, development of solid organ infarcts, ischemic bowel changes and vascular occlusion, plays a key role through the course of the disease. Also, suspicious symptoms, especially in critically ill patients with clinical and biochemical markers of hypovolemia, necessitate timely imaging for bleeding complications. The aim of this pictorial review is to illustrate the spectrum of the GIimaging findings in patients with COVID-19. Awareness of diagnostic imaging hallmarks is crucial to optimize the management of these patients.
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Affiliation(s)
- Xanthippi Mavropoulou
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Elisavet Psoma
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Angeliki Papachristodoulou
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Nikoletta Pyrrou
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Ekaterini Spanou
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Maria Alexandratou
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Maria Sidiropoulou
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Anastasia Theocharidou
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Vasileios Rafailidis
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Theofilos Chrysanthidis
- Infectious Diseases Division, First Internal Medicine Department, School of Medicine, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
| | - Panos Prassopoulos
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece
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Zuidema R, Geraedts ACM, van Veldhuizen WA, Mulay S, de Vries JPPM, Schuurmann RCL, Balm R. Diminishing Endograft Apposition during Follow-Up Is an Important Indicator of Late Type 1a Endoleak after Endovascular Aneurysm Repair. J Clin Med 2023; 12:3969. [PMID: 37373662 PMCID: PMC10299238 DOI: 10.3390/jcm12123969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Late type 1a endoleaks (T1aELs) after endovascular aneurysm repair (EVAR) are hazardous complications which should be avoided. This study investigated the evolution of the shortest apposition length (SAL) post-EVAR and hypothesised that a declining apposition during follow-up may be an indicator of T1aEL development. Patients with a late T1aEL were selected from a consecutive multicentre database. For each T1aEL patient, the preoperative computed tomography angiography (CTA), first postoperative CTA, and pre-endoleak CTA were analysed. T1aEL patients were matched 1:1 to uncomplicated controls, based on endograft type and follow-up duration. Anatomical characteristics and endograft dimensions, including the post-EVAR SAL, were measured. Included were 28 patients with a late T1aEL and 28 matched controls. The SAL decreased from 11.2 mm (5.6-20.6 mm) to 3.9 mm (0.0-11.4 mm) in the T1aEL group (p = 0.006), whereas an increase in SAL was seen in the control group from 21.3 mm (14.1-25.8 mm) to 25.4 mm (19.0-36.2 mm; p = 0.015). On the pre-endoleak CTA, 18 patients (64%) in the T1aEL group had a SAL < 10 mm, and one (4%) patient in the control group had a SAL < 10 mm on the matched CTAs. Moreover, three mechanisms of decreasing sealing zone were identified, which might be used to determine optimal imaging or reintervention strategies. Diminishing SAL < 10 mm is an indicator for T1aEL during follow-up, it is imperative to include apposition analysis during follow-up.
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Affiliation(s)
- Roy Zuidema
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (W.A.v.V.); (J.-P.P.M.d.V.); (R.C.L.S.)
| | - Anna C. M. Geraedts
- Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, 1081 HV Amsterdam, The Netherlands; (A.C.M.G.); (S.M.); (R.B.)
| | - Willemina A. van Veldhuizen
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (W.A.v.V.); (J.-P.P.M.d.V.); (R.C.L.S.)
| | - Sana Mulay
- Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, 1081 HV Amsterdam, The Netherlands; (A.C.M.G.); (S.M.); (R.B.)
| | - Jean-Paul P. M. de Vries
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (W.A.v.V.); (J.-P.P.M.d.V.); (R.C.L.S.)
| | - Richte C. L. Schuurmann
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (W.A.v.V.); (J.-P.P.M.d.V.); (R.C.L.S.)
| | - Ron Balm
- Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Cardiovascular Sciences, 1081 HV Amsterdam, The Netherlands; (A.C.M.G.); (S.M.); (R.B.)
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Meloni A, Cademartiri F, Pistoia L, Degiorgi G, Clemente A, De Gori C, Positano V, Celi S, Berti S, Emdin M, Panetta D, Menichetti L, Punzo B, Cavaliere C, Bossone E, Saba L, Cau R, La Grutta L, Maffei E. Dual-Source Photon-Counting Computed Tomography-Part III: Clinical Overview of Vascular Applications beyond Cardiac and Neuro Imaging. J Clin Med 2023; 12:jcm12113798. [PMID: 37297994 DOI: 10.3390/jcm12113798] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Photon-counting computed tomography (PCCT) is an emerging technology that is expected to radically change clinical CT imaging. PCCT offers several advantages over conventional CT, which can be combined to improve and expand the diagnostic possibilities of CT angiography. After a brief description of the PCCT technology and its main advantages we will discuss the new opportunities brought about by PCCT in the field of vascular imaging, while addressing promising future clinical scenarios.
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Affiliation(s)
- Antonella Meloni
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
- Department of Bioengineering, Fondazione Monasterio/CNR, 56124 Pisa, Italy
| | | | - Laura Pistoia
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
| | - Giulia Degiorgi
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
| | - Alberto Clemente
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
| | - Carmelo De Gori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
| | - Vincenzo Positano
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
- Department of Bioengineering, Fondazione Monasterio/CNR, 56124 Pisa, Italy
| | - Simona Celi
- BioCardioLab, Department of Bioengineering, Fondazione Monasterio/CNR, 54100 Massa, Italy
| | - Sergio Berti
- Cardiology Unit, Ospedale del Cuore, Fondazione Monasterio/CNR, 54100 Massa, Italy
| | - Michele Emdin
- Department of Cardiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
| | - Daniele Panetta
- Institute of Clinical Physiology, National Council of Research, 56124 Pisa, Italy
| | - Luca Menichetti
- Institute of Clinical Physiology, National Council of Research, 56124 Pisa, Italy
| | - Bruna Punzo
- Department of Radiology, IRCCS SynLab-SDN, 80131 Naples, Italy
| | - Carlo Cavaliere
- Department of Radiology, IRCCS SynLab-SDN, 80131 Naples, Italy
| | - Eduardo Bossone
- Department of Cardiology, Ospedale Cardarelli, 80131 Naples, Italy
| | - Luca Saba
- Department of Radiology, University Hospital, 09042 Monserrato, CA, Italy
| | - Riccardo Cau
- Department of Radiology, University Hospital, 09042 Monserrato, CA, Italy
| | - Ludovico La Grutta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties-ProMISE, Department of Radiology, University Hospital "P. Giaccone", 90127 Palermo, Italy
| | - Erica Maffei
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy
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Garcia-Aguilar P, Maiz N, Rodó C, Garcia-Manau P, Arévalo S, Molino JA, Guillen G, Carreras E. Fetal abdominal cysts: Predicting adverse outcomes. Acta Obstet Gynecol Scand 2023. [PMID: 37194337 DOI: 10.1111/aogs.14584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/17/2023] [Accepted: 04/12/2023] [Indexed: 05/18/2023]
Abstract
INTRODUCTION The primary aim of the study was to identify risk factors associated with fetal or neonatal loss, neonatal morbidity, and the need for surgery in fetuses diagnosed with an abdominal cyst. The secondary aim was to compare the characteristics of the cyst according to trimester at diagnosis. MATERIAL AND METHODS This was an observational retrospective study performed at Vall d'Hebron University Hospital. The study included pregnant women aged 18 years or older with diagnosis of a fetal abdominal cyst from 2008 to 2021. RESULTS A total of 82 women with a median gestational age of 31+1 weeks (12+0-39+4) were included in the analysis. Seven (8.5%) cases were diagnosed in the first trimester, 28 (34.1%) in the second trimester, and 47 (57.3%) in the third trimester. Fetal or neonatal loss occurred in 10 (12.2%) cases; significant predictors were diagnosis in the first trimester (OR 36.67, 95% CI: 4.89-274.79), male gender (OR 4.75, 95% CI: 1.13-19.9), and associated abnormalities (OR 15.2, 95% CI: 2.92-79.19). A total of 10 of 75 (13.3%) neonates showed at least one neonatal complication, and the only predictor was occurrence of associated abnormalities (OR 7.36, 95% CI: 1.78-30.51). A total of 16 of 75 (21.3%) neonates required postnatal surgery, and the predictors were second-trimester diagnosis (OR 3.92, 95% CI: 1.23-12.51), associated abnormalities (OR 3.81, 95% CI: 1.15-12.64), and bowel location (OR 10.0, 95% CI: 1.48-67.55). CONCLUSIONS Factors associated with adverse outcomes in fetuses diagnosed with abdominal cysts are first-trimester diagnosis and associated abnormalities. Cysts detected in the second trimester and those of intestinal origin are more likely to require surgery.
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Affiliation(s)
- Paula Garcia-Aguilar
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Maternal-Fetal-Medicine Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Nerea Maiz
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Maternal-Fetal-Medicine Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Carlota Rodó
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Maternal-Fetal-Medicine Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Pablo Garcia-Manau
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Maternal-Fetal-Medicine Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Silvia Arévalo
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Maternal-Fetal-Medicine Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Jose Andres Molino
- Department of Pediatric Surgery and Urology, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Gabriela Guillen
- Department of Pediatric Surgery and Urology, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Elena Carreras
- Maternal-Fetal Medicine Unit, Department of Obstetrics, Maternal-Fetal-Medicine Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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Gupta RD, Tamanna N, Siddika N, Haider SS, Apu EH, Haider MR. Obesity and Abdominal Obesity in Indian Population: Findings from a Nationally Representative Study of 698,286 Participants. Epidemiologia (Basel) 2023; 4:163-172. [PMID: 37218876 DOI: 10.3390/epidemiologia4020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/30/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
This study aims to determine and compare the prevalence and correlates of obesity and abdominal obesity in India among participants aged 18-54 years. Data were acquired from the nationally representative National Family Health Survey 2019-21. Age and sex standardized descriptive analyses were conducted to determine the prevalence of obesity and abdominal obesity, and multivariable multilevel logistic regression was performed to identify the factors associated with these conditions. Gender-specific analyses were also conducted. The sample weight was adjusted throughout. The final sample size for this study was 698,286. The prevalence of obesity and abdominal obesity was 13.85% and 57.71%, respectively. Older age, being female, increased educational status and increased wealth index, being married at any point, and residing in an urban area all increased the odds of both obesity and abdominal obesity. Being a resident of the North zone and having a current alcohol intake increased the odds of abdominal obesity. On the other hand, being a resident of the South zone of India increased the odds of obesity. Targeting these high-risk groups can be a strategy for public health promotion programs.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29028, USA
| | - Nowrin Tamanna
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29028, USA
| | - Nazeeba Siddika
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA
| | - Ehsanul Hoque Apu
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
- Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI 48824, USA
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA
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Pitoulias GA, Pitoulias AG, Chatzelas DA, Zampaka T, Loutradis C, Potouridis A, Tachtsi MD. Early Results of Elective Endovascular Repair of Infrarenal Abdominal Aortic Aneurysms With the Minos TM Stent-Graft System. J Endovasc Ther 2023:15266028231172379. [PMID: 37166154 DOI: 10.1177/15266028231172379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE A variety of last-generation endografts are currently available for standard endovascular repair (EVAR) of infrarenal abdominal aortic aneurysms (AAAs). The purpose of this study is to report the preliminary clinical outcomes of the Minos trimodular stent-graft system, which was recently introduced to the European market. MATERIALS AND METHODS Between February 2020 and 2022, we treated 41 consecutive AAA patients (mean age 72.2±8.5, 37 males) with elective standard EVAR using the Minos. The mean maximum diameter of AAAs was 54.7±6.6 mm, the mean proximal neck's (PN) diameter was 24.8±2.7 mm, while the relevant length and angulation were 16.0 mm and 21.7°, respectively. Overall, 22 (53.6%) patients presented with shorter and angulated PN, according to the stent-graft's instructions of use, and in 6 (14.6%) patients the PN angulation >60° was combined with concomitant iliac angulation >60°. Eleven (26.8%) EVARs were performed with concomitant enormous iliac artery narrowing and tortuosity. Finally, in 19 (46.3%) AAAs, the distal iliac landing zone was aneurysmatic and they were treated with the bell-bottom technique in 17 patients and with limb extension to the external iliac artery in two cases. We evaluated technical and clinical success of the index procedures, which was based on the combination of five factors: freedom from EVAR-related mortality, from graft-related endoleak of any type, from migration at any part of graft as well the absence of notable increase AAA's sac maximum diameter and the patency of bifurcated stent-graft and of access vessels. RESULTS Primary technical and clinical success of index procedures was 100%. During a median 12-month radiological follow-up the clinical success remained 100%. No type I or III endoleak, stent-graft migration, EVAR-related death, AAA rupture, or graft-related adverse events or reinterventions were documented. Four (9.8%) type II endoleaks were detected with stable AAA sac diameter. The overall incidence of sac regression was 34.1% (n=14). CONCLUSION The preliminary results of our series showed that Minos provided excellent feasibility and safety features even through angulated and tortuous iliac vessels and in short and angulated PNs. The overall clinical success at 1 year suggests that performance of Minos follows very high standards. Further validation of these promising results with long-term data is acquired to complete the evaluation of this recently introduced stent-graft system. CLINICAL IMPACT The current study explored the clinical performance of a new in market ultra-low profile bifurcated abdominal aortic stent-graft, the MINOS. The early and 12-month results of study suggest that implantation of this stent-graft in standard EVAR, even in hostile proximal aortic neck and iliac vessels conditions, follows very high clinical standards and encourage the further clinical use of MINOS.
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Affiliation(s)
- Georgios A Pitoulias
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece
| | - Apostolos G Pitoulias
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece
| | - Dimitrios A Chatzelas
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece
| | - Theodosia Zampaka
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece
| | - Charalampos Loutradis
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece
| | - Anastasios Potouridis
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece
| | - Maria D Tachtsi
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, "G. Gennimatas" Hospital, Thessaloniki, Greece
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Osztrogonacz P, Lumsden AB. The SAFE-AAA Study: Is One Limb at a Time Better Than Two? Circulation 2023; 147:1277-1280. [PMID: 37093968 DOI: 10.1161/circulationaha.123.064497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Affiliation(s)
- Peter Osztrogonacz
- Department of Cardiovascular Surgery, Houston Methodist Hospital, TX (P.O., A.B.L.)
- Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary (P.O.)
| | - Alan B Lumsden
- Department of Cardiovascular Surgery, Houston Methodist Hospital, TX (P.O., A.B.L.)
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Secemsky EA, Song Y, Sun T, Johnson CG, Gatski M, Wang L, Farb A, Lee RE, Shaw A, Xu J, Yeh RW. Comparison of Unibody and Non-Unibody Endografts for Abdominal Aortic Aneurysm Repair in Medicare Beneficiaries: The SAFE-AAA Study. Circulation 2023; 147:1264-1276. [PMID: 36866664 PMCID: PMC10133018 DOI: 10.1161/circulationaha.122.062123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Concerns have been raised about the long-term performance of aortic stent grafts for the treatment of abdominal aortic aneurysms, in particular, unibody stent grafts (eg, Endologix AFX AAA stent grafts). Only limited data sets are available to evaluate the long-term risks related to these devices. The SAFE-AAA Study was designed with the Food and Drug Administration to provide a longitudinal assessment of the safety of unibody aortic stent grafts among Medicare beneficiaries. METHODS The SAFE-AAA Study was a prespecified, retrospective cohort study evaluating whether unibody aortic stent grafts are noninferior to non-unibody stent grafts with respect to the composite primary outcome of aortic reintervention, rupture, and mortality. Procedures were evaluated from August 1, 2011, through December 31, 2017. The primary end point was evaluated through December 31, 2019. Inverse probability weighting was used to account for imbalances in observed characteristics. Sensitivity analyses were used to evaluate the effect of unmeasured confounding, including the falsification end points of heart failure, stroke, and pneumonia. A prespecified subgroup includes patients treated from February 22, 2016, through December 31, 2017, corresponding to the market release of the most contemporary unibody endograft (Endologix AFX2 AAA stent graft). RESULTS Of 87 163 patients who underwent aortic stent grafting at 2146 US hospitals, 11 903 (13.7%) received a unibody device. The average age was 77.0±6.7 years, 21.1% were female, 93.5% were White, 90.8% had hypertension, and 35.8% used tobacco. The primary end point occurred in 73.4% of unibody device-treated patients versus 65.0% of non-unibody device-treated patients (hazard ratio, 1.19 [95% CI, 1.15-1.22]; noninferior P value of 1.00; median follow-up, 3.4 years). Falsification end points were negligibly different between groups. In a contemporary subgroup of procedures, the cumulative incidence of the primary end point was 37.5% of unibody device-treated patients and 32.7% of non-unibody device-treated patients (hazard ratio, 1.06 [95% CI, 0.98-1.14]). CONCLUSIONS In the SAFE-AAA Study, unibody endografts failed to meet noninferiority compared with non-unibody endografts with respect to aortic reintervention, rupture, and mortality. These data support the urgency of instituting a prospective longitudinal surveillance program for monitoring safety events related to aortic stent grafts.
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Affiliation(s)
- Eric A Secemsky
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., Y.S., T.S., J.X., R.W.Y.).,Harvard Medical School, Boston, MA (E.A.S., R.W.Y.).,Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., R.W.Y.)
| | - Yang Song
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., Y.S., T.S., J.X., R.W.Y.)
| | - Tianyu Sun
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., Y.S., T.S., J.X., R.W.Y.)
| | - Carmen Gacchina Johnson
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD (C.G.J., M.G., L.W., A.F., R.E.L., A.S.)
| | - Megan Gatski
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD (C.G.J., M.G., L.W., A.F., R.E.L., A.S.)
| | - Li Wang
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD (C.G.J., M.G., L.W., A.F., R.E.L., A.S.)
| | - Andrew Farb
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD (C.G.J., M.G., L.W., A.F., R.E.L., A.S.)
| | - Robert E Lee
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD (C.G.J., M.G., L.W., A.F., R.E.L., A.S.)
| | - Aurko Shaw
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD (C.G.J., M.G., L.W., A.F., R.E.L., A.S.)
| | - Jiaman Xu
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., Y.S., T.S., J.X., R.W.Y.)
| | - Robert W Yeh
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., Y.S., T.S., J.X., R.W.Y.).,Harvard Medical School, Boston, MA (E.A.S., R.W.Y.).,Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.A.S., R.W.Y.)
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Schreuder WMA, Dijkstra ML, von Meijenfeldt GCI, Tielliu IFJ, Zeebregts CJ, Saleem BR, van der Laan MJ. Long-Term Survival and Quality of Life After Fenestrated Endovascular Repair for Complex Abdominal Aortic Aneurysms. Vasc Endovascular Surg 2023:15385744231154123. [PMID: 36802836 DOI: 10.1177/15385744231154123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVES Fenestrated endovascular repair (FEVAR) has become a widely used treatment option for complex abdominal aortic aneurysms (AAA) but long-term survival and quality of life (QoL) outcomes are scarce. This single center cohort study aims to evaluate both long-term survival and QoL after FEVAR. METHODS All juxtarenal and suprarenal AAA patients treated with FEVAR in a single-center between 2002 and 2016 were included. QoL scores, measured by the RAND 36-Item Short Form Survey (SF-36), were compared with baseline data of the SF-36 provided by RAND. RESULTS A total of 172 patients were included at a median follow-up of 5.9 years (IQR 3.0-8.8). Follow-up at 5 and 10 years post-FEVAR yielded survival rates of 59.9% and 18%, respectively. Younger patient age at surgery had a positive influence on 10-year survival and most patients died due to cardiovascular pathology. Emotional well-being was better in the research group as compared to baseline RAND SF-36 1.0 data (79.2 ± 12.4 vs 70.4 ± 22.0; P < 0.001). Physical functioning (50 (IQR 30-85) vs 70.6 ± 27.4; P = 0.007) and health change (51.6 ± 17.0 vs 59.1 ± 23.1; P = 0.020) were worse in the research group as compared to reference values. CONCLUSIONS Long-term survival was 60% at 5-years follow-up, which is lower than reported in recent literature. An adjusted positive influence of younger age at surgery was found on long-term survival. This could have consequences for future treatment indication in complex AAA surgery but further large-scale validation is necessary.
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Affiliation(s)
- Wietske M A Schreuder
- Department of Surgery (Division of Vascular Surgery), 10173University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martijn L Dijkstra
- Department of Surgery (Division of Vascular Surgery), 10173University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerdine C I von Meijenfeldt
- Department of Surgery (Division of Vascular Surgery), 10173University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ignace F J Tielliu
- Department of Surgery (Division of Vascular Surgery), 10173University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Clark J Zeebregts
- Department of Surgery (Division of Vascular Surgery), 10173University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ben R Saleem
- Department of Surgery (Division of Vascular Surgery), 10173University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maarten J van der Laan
- Department of Surgery (Division of Vascular Surgery), 10173University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Potharazu AV, Gangemi A. Indocyanine green (ICG) fluorescence in robotic hepatobiliary surgery: A systematic review. Int J Med Robot 2023; 19:e2485. [PMID: 36417426 PMCID: PMC10078519 DOI: 10.1002/rcs.2485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Indocyanine green fluorescence (ICG-F) stains hepatic tumours and delineates vascular and biliary structures in real-time. We detail the efficacy of ICG-F in robotic hepatobiliary surgery. METHODS PubMed, EMBASE, Web of Science, and Cochrane Central were searched for original articles and meta-analyses detailing the outcomes of ICG-F in robotic hepatobiliary surgery. RESULTS 214 abstracts were reviewed; 16 studies are presented. One single-institution study reported ICG-F in robotic right hepatectomy reduced postoperative bile leakage (0% vs. 12%, p = 0.023), R1 resection (0% vs. 16%, p = 0.019), and readmission (p = 0.023) without prolonging operative time (288 vs. 272 min, p = 0.778). Improved visualisation aided in attainment of R0 resection in partial hepatectomies and radical gallbladder adenocarcinoma resections. Fewer ICG-F-aided robotic cholecystectomies were converted to open procedure compared to laparoscopic cholecystectomies (2.1% vs. 8.9%, p = 0.03; 0.15% vs. 2.6%, p < 0.001). CONCLUSIONS ICG-F improves clinical outcomes in robotic hepatobiliary surgery without prolonging operative time. There is an opportunity to standardise ICG administration protocols, especially for hepatectomies.
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Affiliation(s)
- Archit V Potharazu
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Antonio Gangemi
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Policlinico Sant'Orsola IRCCS, Bologna, Italy
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Mozafari K, Pyfrom DP, Archeval-Lao JM, Santos S, Tiesenga F. A Rare Case of Hepatocellular Carcinoma Presenting as a Massive Abdominal Hematoma and Shock: A Case Report. Cureus 2023; 15:e34588. [PMID: 36883074 PMCID: PMC9985870 DOI: 10.7759/cureus.34588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
Hepatocellular carcinoma (HCC) has an affluent blood supply stemming from the hepatic artery. Subsequent spontaneous tumor rupture can lead to massive abdominal hematoma and shock, a rare fatal gastrointestinal incident. The diagnosis of rupture is complicated, with most patients presenting with abdominal pain and shock. Prompt correction of hypovolemic shock is the primary goal of treatment. This rare case presents a 75-year-old male who presented to the emergency department because of abrupt and increasing abdominal pain after a meal. Laboratory data revealed elevated alanine aminotransferase, aspartate aminotransferase, and alpha-fetoprotein levels. Immediate computed tomography demonstrated a defect in the right ventral abdominal wall. The patient underwent an emergency exploratory laparotomy. Despite massive intra-abdominal adhesions, the identified source of bleeding was from the left lobe of the liver at the base of the lesser sac above the pancreas. There was a maximum effort to cease bleeding and minimize blood loss. An ensuing biopsy of the liver revealed HCC. After improving, the patient received instructions to follow up on an outpatient basis. Two months after surgery, the patient endorses no complications. The success outlined in this case highlights the essence of prompt action in an emergency, which delineates the significance of surgical experience in handling unorthodox patient presentations.
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Affiliation(s)
- Kaveh Mozafari
- Surgery, West Suburban Medical Center, Oak Park, USA.,Medicine, St. George's University School of Medicine, St. George, GRD
| | - Dejeau P Pyfrom
- Medicine, Saint James School of Medicine, Park Ridge, USA.,Surgery, West Suburban Medical Center, Chicago, USA
| | - Joancy M Archeval-Lao
- Surgery, West Suburban Medical Center, Chicago, USA.,Medical Education, St. George's University School of Medicine, True Blue, GRD
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Carhuallanqui-Ciocca EI, Echevarría-Quispe JY, Hernández-Vásquez A, Díaz-Ruiz R, Azañedo D. Bibliometric analysis of the scientific production on inguinal hernia surgery in the web of science. Front Surg 2023; 10:1138805. [PMID: 37035575 PMCID: PMC10073695 DOI: 10.3389/fsurg.2023.1138805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Objectives To describe the bibliometric characteristics of the world scientific production in inguinal hernia surgery using the Web of Science Core Collection (WoS) database. Materials and methods A search for original articles published in the WoS up to December 2021 was carried out. Bibliometric analysis was performed using the Bibliometrix data package in R and VOSviewer, version 1.6.17. Results A total of 3,795 articles were identified in the database, with an annual average of 81 published articles and sustained growth with the highest number of publications in 2021. The article "Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures" published in 2017 was the most cited (517 citations). The United States was the country of the corresponding author with the highest number of published articles (725 articles). The author with the highest number of published articles was Rosenberg J., affiliated with the University of Copenhagen, with 52 articles and 765 citations. The journal "Hernia" had the highest number of articles published on inguinal hernias in the WoS, representing 18% of the total number of articles. Finally, the keywords most used were "herniorrhaphy" and "hernioplasty" in 2008, and more recently: "single incision" "society guidelines" and "single port". Conclusions The scientific production of original articles on inguinal hernia surgery has increased. There is currently great interest in research on minimally invasive surgical methods and standardization of procedures based on clinical practice guidelines.
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Affiliation(s)
| | | | - Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Correspondence: Akram Hernández-Vásquez
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40
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Loban M, Gratama JWC, Klemm PL, Van Leeuwen RB, Vriesema H, Bienfait HP. High prevalence of abdominal aortic aneurysm in older men with cerebrovascular disease: Evaluation of a local screening program. Front Neurol 2023; 14:1131322. [PMID: 37114227 PMCID: PMC10126298 DOI: 10.3389/fneur.2023.1131322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Patients with cerebrovascular disease may suffer from other vascular morbidities, such as abdominal aortic aneurysm (AAA). Previously, a high prevalence of AAA has been demonstrated in men 60 years of age and older who have experienced TIA or stroke. This report evaluates the results of a decade's operation of a local screening program for AAA in this selected neurologic population. Methods Men aged ≥60 years and admitted to the neurology ward of a community-based hospital in the Netherlands from 2006 to 2017 with a diagnosis of TIA or stroke were selected for screening. The diameter of the abdominal aorta was assessed by abdominal ultrasonography. Patients with detected AAA were referred for evaluation by a vascular surgeon. Results AAA was detected in 72 of 1,035 screened patients (6.9%). AAAs with a diameter of 3.0-3.9 cm accounted for 61.1% of the total aneurysms found; AAAs with a diameter of 4.0-5.4 cm accounted for 20.8% of the total; and large aneurysms with a diameter of ≥5.5 cm accounted for 18.1% of all aneurysms discovered. A total of 18 patients (1.7%) underwent elective aneurysm repair. Discussion The detection rate of AAA in older men with cerebrovascular disease was roughly 5-fold the detection rate in known European screening programs in older men from the general population. The proportion of large AAAs (≥5.5 cm) was also substantially higher. These findings reveal a previously unknown co-morbidity in patients with cerebrovascular disease and may be helpful for cardiovascular management of this large group of neurologic patients. Current and future AAA screening programs may also benefit from this knowledge.
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Affiliation(s)
- M. Loban
- Department of Neurology, Gelre Hospital, Apeldoorn, Netherlands
| | | | - P. L. Klemm
- Department of Vascular Surgery, Gelre Hospital, Apeldoorn, Netherlands
| | | | - H. Vriesema
- Department of Biometrics, Gelre Hospital, Apeldoorn, Netherlands
| | - Henri Paul Bienfait
- Department of Neurology, Gelre Hospital, Apeldoorn, Netherlands
- *Correspondence: Henri Paul Bienfait
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Rawdha T, Aicha BT, Leila R, Olfa S, Selma B, Ines M, Leila A. Correlation between Abdominal Obesity and Pain in Knee Osteoarthritis. Curr Rheumatol Rev 2023; 19:174-179. [PMID: 35927913 DOI: 10.2174/1573397118666220802123912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/20/2022] [Accepted: 04/20/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Obesity is an independent risk factor for the occurrence of knee osteoarthritis. The influence of abdominal obesity is not well studied. We proposed to determine the relationship between total abdominal obesity, pain, and functional impairment with the severity of radiographic changes in knee osteoarthritis. METHODS A cross-sectional study including 92 patients with knee pain was performed. The evaluation of degree of pain in the knee was assessed by the visual analogue scale and the functional impairment by WOMAC and Lequesne indices. Radiographic severity was assessed by Kellgren and Lawrence score (KL score). RESULTS Mean age of patients was 55.2 years (19-86), with a predominance of women (80.4% of patients). Mean body mass index (BMI) was 30.66 kg/m2 (18.5-49.97). Obesity was found in 53 patients (57.6%). The average waist circumference (WC) was 102.82 (± 15.51) centimeters. Abdominal obesity was found in 80 patients (87%). Patients had a mean visual analogue scale (VAS) of 18 ± 23.24 mm. The average algofunctionnal Lequesne score was 8.95 (0-23), and the WOMAC score was 26.82 (0-69). Fifty percent of patients had stage 3 of OA according to KL score. We found no association between BMI and intensity of knee pain (p = 0.278), but WC was significantly associated with the elevation of VAS (p = 0.008). Physical function was positively correlated with BMI and WC (p = 0.001). Finally, BMI and WC were significantly associated with radiographic severity (grade 1-2 of KL vs. grade 3-4 of KL) (respectively, p = 0.001; p = 0.017). CONCLUSION Both obesity and abdominal obesity are independently associated with pain, disability, and radiographic severity of knee osteoarthritis.
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Affiliation(s)
- Tekaya Rawdha
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
| | - Ben Tekaya Aicha
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
| | - Rouached Leila
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
| | - Saidane Olfa
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
| | - Bouden Selma
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
| | - Mahmoud Ines
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
| | - Abdelmoula Leila
- Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia
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Liu X, Xie X, Jin ZW, Wang H, Song Y, Zhao P, Li L. The Allantois and Urachus: Histological Study Using Human Embryo and Fetuses. Fetal Pediatr Pathol 2022; 41:919-928. [PMID: 34854363 DOI: 10.1080/15513815.2021.2009943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Relatively little is known about allantois and urachal development in early humans. Serial sagittal histological sections from eight human embryos and fetuses were examined to determine allantois development. At gestational age 6-7 weeks, the primitive allantois consists of an enlarged tube located between the umbilical cord and abdominal cavity, whereas the urachus is not yet developed. At 8 weeks, the allantois gradually withdraws from the distal to the proximal end of the umbilical cord, and both the proximal allantois and the rectum (hindgut) start to develop into the cloaca. At 10 weeks, the allantois was located mostly in the abdominal cavity. The urachus forms from the distal end of the allantois and develops into a closed fibrous cord between the base of the urinary bladder and the umbilicus. The urogenital sinus forms from the proximal end of the allantois.
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Affiliation(s)
- Xuelai Liu
- Department of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, Beijing, China
| | - Xianghui Xie
- Department of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, Beijing, China
| | - Zhe-Wu Jin
- Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Huan Wang
- Department of Pathology, Harbin Children Hospital, Harbin, China
| | - Yanbiao Song
- Central Laboratory, Hebei Medical University affiliated 2nd Hospital, Shijiazhuang, China
| | - Peng Zhao
- Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Long Li
- Department of Surgery, Capital Institute of Pediatrics affiliated Children Hospital, Beijing, China
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Guo H, Zhang Y, Ma H, Gong P, Shi Y, Zhao W, Wang A, Liu M, Sun Z, Wang F, Wang Q, Ba X. T-stage-specific abdominal visceral fat, haematological nutrition indicators and inflammation as prognostic factors in patients with clear renal cell carcinoma. Adipocyte 2022; 11:133-142. [PMID: 35285399 PMCID: PMC8920171 DOI: 10.1080/21623945.2022.2048546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Clear cell renal carcinoma (ccRCC) is the most common histological type of renal cancer and has the highest mortality. Several studies have been conducted on the relationship between adipose tissue and ccRCC prognosis, however, the results have been inconsistent to date. The current study aimed at establishing a link between abdominal fat composition and short-term prognosis in patients with ccRCC after T-stage stratification. We retrospectively analysed 250 patients with pathologically confirmed ccRCC (173 low T-stage and 77 high T-stage) in our hospital. The computed tomography (CT) images were evaluated using ImageJ. Then, subcutaneous and visceral fat areas (SFA and VFA), total fat areas (TFA) and the relative VFA (rVFA) were measured and computed. Meanwhile, biochemical indices of blood serum were analysed. The results showed that rVFA in low T-stage cohort who had a history of short-term postoperative complications were significantly lower than those who did not. No such association was observed in the high T-stage cohort. Further investigation revealed that the correlations between biochemical indexes and fat area-related variables varied across T-stage groups. As a result, rVFA is a reliable independent predictor of short-term prognosis in patients with low T-stage ccRCC but not in patients with high T-stage ccRCC.
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Affiliation(s)
- Hao Guo
- Department of Radiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong province, Jinan, China
- Department of Radiology, Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Yumei Zhang
- Department of Radiology, Lanshan Branch of Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Heng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Peiyou Gong
- Department of Radiology, Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Yinghong Shi
- Department of Radiology, Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Wenlei Zhao
- Department of Radiology, Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Aijie Wang
- Department of Radiology, Yaitai Shan Hospital, Shandong province, Yantai, China
| | - Ming Liu
- Department of Radiology, Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Zehua Sun
- Department of Radiology, Yantai Yuhuangding Hospital, Shandong province, Yantai, China
| | - Fang Wang
- Department of Radiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong province, Jinan, China
| | - Qing Wang
- Department of Radiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong province, Jinan, China
| | - Xinru Ba
- Department of Radiology, Yaitai Shan Hospital, Shandong province, Yantai, China
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Muacevic A, Adler JR. Caecal Volvulus, Untwisting the Twisted: A Case Report and Literature Review. Cureus 2022; 14:e30961. [PMID: 36465206 PMCID: PMC9711929 DOI: 10.7759/cureus.30961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 01/25/2023] Open
Abstract
Caecal volvulus is an uncommon surgical condition affecting mostly females in their second and third decade of life. It is of vital importance that the general surgeon recognises, resuscitates, diagnoses, and effectively treats these cases in a timely manner to maximise the chance of a positive outcome for the patient. Whilst there are several types of caecal volvulus, the treatment involves, in most cases, surgical intervention. There is a wide variety of surgical interventions that can be performed, ranging from caecopexy or fixation to lateral wall to performing a right hemicolectomy with primary ileocolic anastomosis. There are several factors that influence this decision and can also be based on an individual surgeon's expertise and experience. We present a case of a 21-year-old female who presented to our Emergency Department with lower abdominal pain, nausea, and vomiting. She was diagnosed with caecal volvulus with the aid of CT imaging, following which she underwent laparotomy in which caecal volvulus was noted. She underwent appendicectomy and caecopexy and was discharged after an uneventful recovery on post-operative day five and remains well on follow-up.
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Abstract
BACKGROUND Laparoscopic radical hysterectomy (LRH) and open abdominal radical hysterectomy (ARH) have been used for cervical cancer treatment. We aimed to perform a meta-analysis to compare the efficacy and safety of LRH and ARH in the treatment of cervical cancer to provide reliable evidence to the clinical cervical cancer treatment. METHODS Two investigators independently searched PubMed and other databases for randomized controlled trials (RCTs) comparing LRH and ARH for cervical cancer treatment up to May 31, 2022. The risk of bias assessment tool recommended by Cochrane library was used for quality assessment. RevMan 5.3 software was used for meta-analysis. RESULTS Fourteen RCTs with a total of 1700 patients with cervical cancer were finally included. Meta-analyses indicated that compared with ARH, LRH reduced the intraoperative blood loss (mean difference [MD]=-58.08; 95% CI, -70.91, -45.24), the time to first passage of flatus (MD=-14.50; 95% CI, -16.55, -12.44) (all P <0.05), and increase the number of lymph nodes removed (MD=3.47; 95% CI, 0.51, 6.43; P =0.02). There were no significant differences in the duration of surgery (MD=27.62; 95% CI, -6.26, 61.49), intraoperative complications (odd ratio [OR]=1.10; 95% CI, 0.17, 7.32), postoperative complications (OR=0.78; 95% CI, 0.33, 1.86), relapse rate (OR=1.45; 95% CI, 0.56, 3.74), and survival rate (OR=0.75; 95% CI, 0.52, 1.08) between LRH group and ARH group (all P >0.05). CONCLUSIONS LRH has more advantages over ARH in the treatment of cervical cancer. Still, the long-term effects and safety of LRH and ARH need more high-quality, large-sample RCTs to be further verified.
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Reyes Valdivia A, Oikonomou K, Milner R, Kasprzak P, Reijnen MMPJ, Pitoulias G, Torsello GB, Pfister K, de Vries JPPM, Chaudhuri A. The Effect of EndoAnchors on Aneurysm Sac Regression for Patients Treated With Infrarenal Endovascular Repair With Hostile Neck Anatomies: A Propensity Scored Analysis. J Endovasc Ther 2022:15266028221127839. [PMID: 36214450 DOI: 10.1177/15266028221127839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To analyze sac evolution patterns in matched patients with hostile neck anatomy (HNA) treated with standard endovascular aneurysm repair (sEVAR) and endosutured aneurysm repair (ESAR). METHODS Observational retrospective study using prospectively collected data between June 2010 and December 2019. ESAR group data were extracted from the primary arm of the PERU registry with an assigned identifier (NCT04100499) at 8 centers and those from the sEVAR came from 4 centers. Suitability for inclusion required: no proximal endograft adjuncts (besides EndoAnchor use), ≤15 mm neck length and minimum of 12-months follow-up imaging. Bubble-shaped neck (noncylindrical short neck with discontinuous seal) aspect was analyzed. Both groups were analyzed using propensity score matching (PSM) for aortic neck length, width, angulation, and device fixation type. Main outcome assessed was sac evolution patterns (sac expansion and regression were defined as >5mm increase or decrease, of the maximum sac diameter respectively; all AAAs within this ±5 mm range in diameter change were considered stable) and secondary outcomes were type-Ia endoleaks; other endoleaks and mortality. A power analysis calculation >80% was confirmed for sac regression evaluation. RESULTS After exclusions, PSM resulted in 96 ESAR and 96 sEVAR patients. Mean imaging follow-up (months) was 44.4±21.3 versus 43.0±19.6 (p=0.643), respectively. The overall number of patients achieving sac regression was higher in the ESAR group (n=57, 59.4% vs n=31, 32.3%; p<0.001) and the cumulative sac regression achieved at 5 years was 65% versus 38% (p=0.003) in favor of the ESAR group. There were no statistically significant differences in type-Ia endoleak and/or other endoleaks. Univariate analysis for sac regression patients in the sEVAR and ESAR group individually showed the bubble-shape neck as a predictor of sac regression failure. There were no statistical differences in overall and aneurysm-related mortality. CONCLUSION Endosutured aneurysm repair provided improved rates of sac regression for patients with AAA and HNA when compared with sEVAR at midterm and up to 5 years, despite similar rates of type-Ia endoleaks, and the need to consider some important limitations. The presence of bubble-shaped neck was a predictor of sac regression failure for both groups equally. CLINICAL IMPACT The use of EndoAnchors aids and improves EVAR treatment in hostile neck anatomies by an increased rate of sac regression when compared to EVAR treatment alone in up to 5 year analysis. Moreover, a trend to reduced number of type Ia endoleaks is also achieved, although not significant in the present study. This data, adds to current and growing evidence on the usefulness of EndoAnchors for AAA endovascular treatment.
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Affiliation(s)
- Andrés Reyes Valdivia
- Department of Vascular and Endovascular Surgery, Ramón y Cajal's University Hospital, Madrid, Spain
| | - Kyriakos Oikonomou
- Department of Vascular Surgery, University Medical Centre Regensburg, Regensburg, Germany
- Department of Vascular and Endovascular Surgery, Cardiovascular Surgery Clinic, University Hospital Frankfurt and Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | - Ross Milner
- Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Piotr Kasprzak
- Department of Vascular Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Michel M P J Reijnen
- Department of Surgery, Rijnstate, Arnhem, The Netherlands
- Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Georgios Pitoulias
- Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, "G. Gennimatas" Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Karin Pfister
- Department of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Jean-Paul P M de Vries
- Division of Vascular Surgery, Department of Surgery, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Arindam Chaudhuri
- Bedfordshire-Milton Keynes Vascular Center, Bedfordshire Hospitals NHS Foundation Trust, Bedford, UK
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Seiler GS, Cohen EB, d'Anjou MA, French J, Gaschen L, Knapp S, Salwei RM, Saunders HM. ACVR and ECVDI Consensus Statement for the Standardization of the Abdominal Ultrasound Examination. Vet Radiol Ultrasound 2022; 63:661-674. [PMID: 36189784 DOI: 10.1111/vru.13151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/27/2022] Open
Abstract
This consensus statement is designed to provide a standard of care document and describes the ACVR and ECVDI definition for performing a standard abdominal ultrasound examination in dogs and cats. The ACVR and ECVDI define a standard abdominal ultrasonographic examination as a complete exam of the abdominal organs which is appropriately documented. The consensus statement intends to provide guidance to veterinary sonographers and veterinarians for the performance and documentation of high-quality diagnostic ultrasound examination. The document may also serve as a teaching aid for veterinary students, veterinarians, and residents in diagnostic imaging who seek proficiency in diagnostic ultrasound. Finally, it may serve an additional role in educating the public as to what a high-quality abdominal ultrasound examination should entail.
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Affiliation(s)
- Gabriela S Seiler
- Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Eli B Cohen
- Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | | | - John French
- Antech Imaging Services, Fountain Valley, California, USA
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Stephanie Knapp
- BluePearl Veterinary Partners of North Carolina, Cary, North Carolina, USA
| | | | - H Mark Saunders
- Lynks Group, PLC Veterinary Imaging, Shelburne, Vermont, USA
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Wessling D, Herrmann J, Afat S, Nickel D, Almansour H, Keller G, Othman AE, Brendlin AS, Gassenmaier S. Application of a Deep Learning Algorithm for Combined Super-Resolution and Partial Fourier Reconstruction Including Time Reduction in T1-Weighted Precontrast and Postcontrast Gradient Echo Imaging of Abdominopelvic MR Imaging. Diagnostics (Basel) 2022; 12. [PMID: 36292057 DOI: 10.3390/diagnostics12102370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose: The purpose of this study was to test the technical feasibility and the impact on the image quality of a deep learning-based super-resolution reconstruction algorithm in 1.5 T abdominopelvic MR imaging. Methods: 44 patients who underwent abdominopelvic MRI were retrospectively included, of which 4 had to be subsequently excluded. After the acquisition of the conventional volume interpolated breath-hold examination (VIBEStd), images underwent postprocessing, using a deep learning-based iterative denoising super-resolution reconstruction algorithm for partial Fourier acquisitions (VIBESR). Image analysis of 40 patients with a mean age of 56 years (range 18−84 years) was performed qualitatively by two radiologists independently using a Likert scale ranging from 1 to 5, where 5 was considered the best rating. Results: Image analysis showed an improvement of image quality, noise, sharpness of the organs and lymph nodes, and sharpness of the intestine for pre- and postcontrast images in VIBESR compared to VIBEStd (each p < 0.001). Lesion detectability was better for VIBESR (p < 0.001), while there were no differences concerning the number of lesions. Average acquisition time was 16 s (±1) for the upper abdomen and 15 s (±1) for the pelvis for VIBEStd, and 15 s (±1) for the upper abdomen and 14 s (±1) for the pelvis for VIBESR. Conclusion: This study demonstrated the technical feasibility of a deep learning-based super-resolution algorithm including partial Fourier technique in abdominopelvic MR images and illustrated a significant improvement of image quality, noise, and sharpness while reducing TA.
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Requejo-Garcia L, Martinez-Lopez R, Plana-Andani E, Medina P, Hernandiz-Martinez A, Miralles-Hernández M. Extra-Thoracic Aneurysms in Marfan Syndrome: A Systematic Review of the Literature. Ann Vasc Surg 2022; 87:548-559. [PMID: 36029951 DOI: 10.1016/j.avsg.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/31/2022] [Accepted: 08/07/2022] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- L Requejo-Garcia
- Angiology and Vascular Surgery Department. Hospital Universitario de La Ribera, Alzira, Valencia
| | - R Martinez-Lopez
- Angiology and Vascular Surgery Department. Hospital Universitario y Politécnico La Fe, Valencia
| | - E Plana-Andani
- Angiology and Vascular Surgery Department. Hospital Universitario y Politécnico La Fe, Valencia; Research Group on hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology. Instituto de Investigación Sanitara-Hospital La Fe, Valencia
| | - P Medina
- Research Group on hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology. Instituto de Investigación Sanitara-Hospital La Fe, Valencia
| | - A Hernandiz-Martinez
- Research Group on Regeneration and Heart Transplantation. Instituto de Investigación Sanitara-Hospital La Fe, Valencia
| | - M Miralles-Hernández
- Angiology and Vascular Surgery Department. Hospital Universitario y Politécnico La Fe, Valencia; Research Group on hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology. Instituto de Investigación Sanitara-Hospital La Fe, Valencia.
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Salö M, Bonnor L, Graneli C, Stenström P, Anderberg M. Ten years of paediatric robotic surgery: Lessons learned. Int J Med Robot 2022; 18:e2386. [PMID: 35240727 PMCID: PMC9541232 DOI: 10.1002/rcs.2386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 01/04/2023]
Abstract
Background Costs and a low total number of cases may be obstacles to the successful implementation of a paediatric robotic surgery programme. The aim of this study was to evaluate a decade of paediatric robotic surgery and to reflect upon factors for success and to consider obstacles. Materials and Methods All children operated on with robotic‐assisted laparoscopic surgery between 2006 and 2016 were included in a retrospective, single‐institutional study in Lund, Sweden. Results A total of 152 children underwent robotic surgery during the study time with the most frequent procedures being fundoplication (n = 55) and pyeloplasty (n = 53). Procedure times decreased significantly during the study period. Overall, 18 (12%) of the operations were converted to open surgery, and seven (5%) patients required a reoperation. Conclusions Despite a low volume of surgery, we have successfully introduced robotic paediatric surgery in our department. Our operative times and conversion rates are continuously decreasing.
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Affiliation(s)
- Martin Salö
- Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Paediatrics, Lund University, Lund, Sweden
| | - Linda Bonnor
- Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden
| | - Christina Graneli
- Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Paediatrics, Lund University, Lund, Sweden
| | - Pernilla Stenström
- Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Paediatrics, Lund University, Lund, Sweden
| | - Magnus Anderberg
- Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Paediatrics, Lund University, Lund, Sweden
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