The Long-Term Durability of Intraoperatively Placed of Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of AAA

Glycogen storage disease type Ia (GSDIa) is caused by defective glucose-6-phosphatase, a key enzyme in carbohydrate metabolism. Affected individuals cannot release glucose during fasting and accumulate excess glycogen and fat in the liver and kidney, putting them at risk of severe hypoglycaemia and secondary metabolic perturbations. Good glycaemic/metabolic control through strict dietary treatment and regular doses of uncooked cornstarch (UCCS) is essential for preventing hypoglycaemia and long-term complications. Dietary treatment has improved the prognosis for patients with GSDIa; however, the disease itself, its management and monitoring have significant physical, psychological and psychosocial burden on individuals and parents/caregivers. Hypoglycaemia risk persists if a single dose of UCCS is delayed/missed or in cases of gastrointestinal intolerance. UCCS therapy is imprecise, does not treat the cause of disease, may trigger secondary metabolic manifestations and may not prevent long-term complications. We review the importance of and challenges associated with achieving good glycaemic/metabolic control in individuals with GSDIa and how this should be balanced with age-specific psychosocial development towards independence, management of anxiety and preservation of quality of life (QoL). The unmet need for treatment strategies that address the cause of disease, restore glucose homeostasis, reduce the risk of hypoglycaemia/secondary metabolic perturbations and improve QoL is also discussed.

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HD 74438: A tight spectroscopic quadruple as possible progenitor of sub-Chandrasekhar Type Ia supernovae

10.21203/rs.3.rs-1050702/v1 ◽

2021 ◽

Author(s):

Thibault Merle ◽

Adrian Hamers ◽

Sophie Van Eck ◽

Alain Jorissen ◽

Mathieu Van der Swaelmen ◽

...

Keyword(s):

Open Cluster ◽

High Resolution Spectroscopy ◽

Type Ia Supernovae ◽

Multiple Systems ◽

Future Evolution ◽

Excellent Candidate ◽

The Galaxy ◽

Type Ia ◽

Ia Supernovae

Abstract Stars often form in multiple systems and may follow a complex evolution involving mass transfer and collisions, leading to mergers that are possible progenitors of Type Ia supernovae (SNe) [1, 2]. The progenitors of such explosions are still highly debated [3]. While binaries have received much attention so far, higher-order stellar systems show a wide variety of interactions especially in tight systems, like long-term gravitational effects playing a key role in triple (where they are called von Zeipel-Lidov-Kozai , [4, 5], hereafter ZLK, oscillations) and quadruple systems. Here we report on the properties of the first spectroscopic quadruple (SB4) found within a star cluster: the 2+2 hierarchical system HD 74438 [6]. Its membership in the open cluster IC 2391 makes it the youngest (43 My) SB4 discovered so far. The eccentricity of the 6 y outer period is 0.46 and the two inner orbits, with periods of 20.5 d and 4.4 d, and eccentricities of 0.36 and 0.15, are not coplanar. Using an innovative combination of ground-based high resolution spectroscopy [7, 8, 9, 10] and Gaia/Hipparcos astrometry [11, 12, 13, 14], we show that this system is undergoing secular interaction that likely pumped the eccentricity of one of the inner orbit higher than expected for the spectral types of its components. We compute the future evolution of HD 74438 by considering gravitational dynamics, stellar evolution, and binary interactions [15], and show that this system is an excellent candidate progenitor of sub-Chandrasekhar Type Ia supernova through white dwarf (WD) mergers. This specific type of SNIa better accounts for the chemical evolution of iron-peak elements in the Galaxy [16].

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Pressure injury to the chest wall caused by vascular graft and endograft after thoracic and thoraco-abdominal aortic repair

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz127 ◽

2019 ◽

Vol 29 (4) ◽

pp. 649-651

Author(s):

Wassim Mansour ◽

Pasqualino Sirignano ◽

Laura Capoccia ◽

Francesco Speziale

Keyword(s):

Chest Wall ◽

Endovascular Graft ◽

Computed Tomographic ◽

Aortic Repair ◽

First Case ◽

Abdominal Aortic ◽

Computed Tomographic Scan ◽

Type Ia ◽

Pressure Injury

Abstract Thoracic and thoraco-abdominal aortic repair remains a challenging issue in vascular surgery, and long-term complications are well described. We report 2 cases of octogenarians with unusual long-term complications after open and endovascular thoracic aortic repair of chest wall pressure injury from the vascular prosthesis. In the first case, a computed tomographic scan of an 80-year-old man showed a pressure injury of the chest wall and rib erosion caused by a Dacron graft. The second case was an 81-year-old woman who presented with external bleeding from the left posterior chest wall. A computed tomographic scan showed a type IA endoleak and chest wall damage with rib erosion and thoracic cutaneous fistulae from the endovascular graft. Both patients were treated by relining the endovascular graft; debriding the surgical fistula was done only in the second case. In our experience, endovascular repair is a good option to avoid a complete open surgical repair.

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