Do Hernias Contribute to Increased Severity of Aneurysmal Disease among Abdominal Aortic Aneurysm Patients?

Abstract Background Connective tissue disorders could contribute to the pathogenesis of both abdominal aortic aneurysms (AAA) and hernias. We tested the hypothesis that hernias in AAA patients contribute to increased severity of the aneurysmal disease. Methods A questionnaire was used to collect information from 195 AAA patients divided into four groups: (1) survivors (n = 22) of ruptured AAA, (2) patients (n = 90) after elective open repair, (3) patients (n = 43) after elective endovascular repair (EVAR), and (4) patients (n = 40) under surveillance of AAA. The control group consisted of 100 patients without AAA whose abdominal computed tomography (CT) scans were examined for the presence of hernias. Mann–Whitney U-test, Chi-squared (χ 2) test, or Fisher's exact test (as appropriate) were used for statistical analyses. Multivariate logistic regression was used to control for potential confounding variables such as sex and age. Results The prevalence of inguinal hernias was significantly higher in the AAA than the control group (25 vs. 9%, p = 0.001) and did not differ between the AAA subgroups (9, 24, 35, and 23% in subgroups 1 through 4, respectively, p = 0.15) based on univariate analysis. The prevalence of inguinal hernias did not differ (p = 0.15) between the two open surgery groups (groups 1 and 2), or when comparing all three operative procedures as a combined group to group 4 (p = 0.73). The prevalences of incisional hernias were 18 and 24% for groups 1 and 2, respectively, with no significant difference (p = 0.39). Inguinal hernia demonstrated a significant association with AAA on multivariate analysis (p = 0.006; odds ratio [OR] = 4.00; 95% confidence interval [CI] = 1.49–10.66). Conclusions Our study confirms previous observations that patients with AAA have a high prevalence of hernias. Our results suggest that hernias do not contribute to increased severity of the aneurysmal disease.

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The Role of a Selective P2Y6 Receptor Antagonist, MRS2578, on the Formation of Angiotensin II-Induced Abdominal Aortic Aneurysms

BioMed Research International ◽

10.1155/2020/1983940 ◽

2020 ◽

Vol 2020 ◽

pp. 1-15 ◽

Cited By ~ 1

Author(s):

Xiao Du ◽

Shilan Zhang ◽

Qunyan Xiang ◽

Jingyuan Chen ◽

Feng Tian ◽

...

Keyword(s):

Receptor Antagonist ◽

Aortic Aneurysms ◽

Control Group ◽

Placebo Control ◽

High Dose ◽

Ang Ii ◽

Abdominal Aortic ◽

Significant Difference ◽

Expression And Activity

Objective. The P2Y6 receptor has been shown to be involved in many cardiovascular diseases, including hypertension and atherosclerosis. The study is aimed at exploring the role of the P2Y6 receptor in Ang II-induced abdominal aortic aneurysm (AAA) formation in apolipoprotein E-deficient (apoE-/-) mice by using its selective antagonist. Methods. Male apoE-/- mice were fed with high-fat diet and infused with angiotensin (Ang) II (1000 ng/kg/min) for 4 weeks to induce AAA or saline as controls. Mice were divided into four groups: normal saline (NS, placebo control) group (n=8), Ang II+vehicle (Ang II) group (n=14), Ang II-low dose MRS2578 (Ang II+MRS-16 mg) group (n=14), and Ang II-high dose MRS2578 (Ang II+MRS-32 mg) group (n=14). Daily intraperitoneal injection with vehicle or MRS2578 was pretreated one week before Ang II infusion. On postoperative day 10, aorta imaging of each group was taken by ultrasonography. After 4 weeks of Ang II infusion, the excised aortas were processed for diameter measurement and quantification of aneurysm severity and tissue characteristics; the blood samples were collected for measurement of the lipid profile and levels of cytokines. Verhoeff’s Van Gieson (EVG) staining and immunochemistry staining were performed to evaluate disruption of the extracellular matrix (ECM) and infiltration of macrophages. Expression and activity of matrix metalloproteinases (MMPs) was measured by gelatin zymography. Results. Treatment with MRS2578 made no significant difference in AAA formation, and maximal aortic diameter yet caused higher AAA rupture-induced mortality from 7% (Ang II) to 21.4% (Ang II+MRS-16 mg) or 42.9% (Ang II+MRS-32 mg), respectively (p<0.05). Consistently, the severity of aneurysm tended to be more deteriorated in MRS2578-treated groups, especially the high-dosage group. The ratios of type III and IV aneurysm were much higher in the MRS2578-coadministered groups (p<0.05). Furthermore, histological analyses showed that administration of MRS2578 significantly increased infiltration of macrophages, expression of monocyte chemotactic protein 1 (MCP-1) and vascular cell adhesion molecule-1 (VCAM-1), and activities of MMP-2 and MMP-9 followed by aggravating degradation elastin in vivo (p<0.05). However, the multiple effects of MRS2578 on the development of AAA are independent of changes in systolic blood pressure and lipid profiles. Conclusions. The present study demonstrated that administration of MRS2578 exacerbated the progression and rupture of experimental AAA through promoting proinflammatory response and MMP expression and activity, which indicated a crucial role of the P2Y6 receptor in AAA development. Clinical Relevance. Purinergic P2Y receptors have attracted much attention since the P2Y12 receptor antagonist had been successfully applied in clinical practice. Elucidating the underlying mechanisms of AAA and exploring potential therapeutic strategies are essential to prevent its progression and reduce the mortality rate.

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Roles and functions of exosomal miRNA in abdominal aortic aneurysm

10.21203/rs.3.rs-18993/v1 ◽

2020 ◽

Author(s):

YuBo Zhao ◽

Shuwei Wan ◽

Chuang Li ◽

Yaming Guo ◽

Gaopo Cai ◽

...

Keyword(s):

Mapk Pathway ◽

Aortic Aneurysms ◽

Functional Enrichment ◽

Mirna Sequence ◽

Control Group ◽

Abdominal Aortic ◽

Exosomal Mirnas ◽

Significant Difference ◽

Healthy Control ◽

Experimental Group

Abstract Background and objective: abdominal aortic aneurysms（AAAs）are the permanent dilatation of the abdominal aorta, ruptured AAA is a serious threat to the patient's life. It’s hardly known about exosomal miRNAs in AAA. The main purpose of this article is to screen miRNAs which differentially expressed in exosomes from normal people and patients with AAA, and to understand the mechanism of work.Material and methods: The plasma of healthy control group and patients with AAA were collected, and the RNAs from exosomes was isolated and sequenced. The mature miRNA sequence of miRBase 21 database was used to identify the known type and expression of miRNAs. DEGseq software was used to analyze the types of miRNAs with significant difference between the experimental group and the control group ( P ＜ 0.05, | log 2 (FoldChange) | ≥ 1 ). The targets of miRNAs were detected by miRTarBase, miRDB, TargetScan and miRWalk software. Targets were analyzed based on Kyoto encyclopedia of genes and genomes（ KEGG ）biological pathway and gene ontology（ GO ）functional enrichment analysis. Conclusion: miRNAs in exosomes regulate in the progress of AAA by activating PI3K-Akt/mTOR and MAPK pathway, and its mechanism needs more research. Background and objective: abdominal aortic aneurysms（AAAs）are the permanent dilatation of the abdominal aorta, ruptured AAA is a serious threat to the patient's life. It’s hardly known about exosomal miRNAs in AAA. The main purpose of this article is to screen miRNAs which differentially expressed in exosomes from normal people and patients with AAA, and to understand the mechanism of work. Material and methods: The plasma of healthy control group and patients with AAA were collected, and the RNAs from exosomes was isolated and sequenced. The mature miRNA sequence of miRBase 21 database was used to identify the known type and expression of miRNAs. DEGseq software was used to analyze the types of miRNAs with significant difference between the experimental group and the control group ( P ＜ 0.05, | log 2 (FoldChange) | ≥ 1 ). The targets of miRNAs were detected by miRTarBase, miRDB, TargetScan and miRWalk software. Targets were analyzed based on Kyoto encyclopedia of genes and genomes（ KEGG ）biological pathway and gene ontology（ GO ）functional enrichment analysis.Conclusion: miRNAs in exosomes regulate in the progress of AAA by activating PI3K-Akt/mTOR and MAPK pathway, and its mechanism needs more research.

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Success Rate of Obturation of Root Canals by Different Techniques in Primary Molars: A Comparative Clinical Study

Current Dentistry ◽

10.2174/2542579x02999200503032916 ◽

2020 ◽

Vol 2 (1) ◽

pp. 36-44

Author(s):

Satyawan G. Damle ◽

Ritika Bansal ◽

Dhanashree D. Sakhare

Keyword(s):

Success Rate ◽

Study Groups ◽

Primary Molars ◽

Control Group ◽

Second Primary ◽

Chi Square ◽

Exact Test ◽

Root Canals ◽

Significant Difference ◽

Comparative Clinical Study

Objective: To compare the success rate of different obturation procedures in primary mandibular second molars clinically and also by digital radiovisiography. Methods: A total of 40 children aged between 4-8 years with deeply carious mandibular second primary molars indicated for single session pulpectomy were selected. Canals were obturated with Metapex. The 3 study groups (Endodontic plugger, Handheld lentulospiral, Navi Tip syringe) were compared with the control group (reamer) both clinically and radiovisiographically. The data collected were statistically analyzed using Pearson’s Chi-square and Fisher’s exact test. Results: The use of Navi tip syringe led to the least number of voids followed by Endodontic plugger and Reamer and the highest number of voids was reported with Lentulospiral. Navitip presented maximum number of optimally filled cases followed by Endodontic plugger and Lentulospiral and least number of optimally filled cases with reamer. However, there was no statistically significant difference (p>0.05) in any of the groups with clinical (pain and tenderness to percussion) and radiographic parameters (presence or absence of voids and length of obturation). Conclusion: Within the limitations of the present study, though the clinical outcome was statistically insignificant, Navitip syringe exhibited encouraging results and is a promising option for obturation in primary teeth.

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Efficacy and safety of doxycycline for the management of small abdominal aortic aneurysms- a meta analysis

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.126 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

A Abdul Razzack ◽

D Rocha Castellanos ◽

A Lopez Mendez ◽

M Fernando Perez Paz ◽

S Pothuru ◽

...

Keyword(s):

Meta Analysis ◽

Abdominal Aortic Aneurysms ◽

Abdominal Aortic Aneurysm Repair ◽

Mean Difference ◽

Aortic Aneurysms ◽

Efficacy And Safety ◽

Funding Sources ◽

Abdominal Aortic ◽

Significant Difference ◽

Aneurysm Repair

Abstract Funding Acknowledgements Type of funding sources: None. Background- Patients with small Abdominal Aortic Aneurysms are managed with surveillance as there is currently insufficient evidence to recommend surgical aneurysm repair. Hence, there is a dire need and interest in pharmacotherapy like tetracycline antibiotics to reduce the need for aneurysm repair. Purpose- To determine the efficacy and safety of doxycycline in the management of small abdominal aortic aneurysms. Methods- Electronic databases (PubMed, Scopus, Embase, Cochrane) were searched until 25th November 2020.The primary outcomes were the mean difference (MD) in aneurysm diameter and the odds ratio (OR) calculated to compare the number of individuals referred to Abdominal aortic aneurysm repair in each group. Results- A total of three studies with 572 participants (Doxycycline = 290; Placebo = 282 ) were included in our analysis. Average follow up was a period of 18 months. For AAA expansion, the combined results demonstrated a statistically significant mean difference in expansion rates favoring the placebo groups over the intervention (WMD-0.75, 95%CI 0.12-1.38; p = 0.02;I2 = 0%) There was no statistically significant difference in the efficacy and safety of doxycycline as opposed to placebo groups for referral to AAA surgery (OR 1.01, 95%CI 0.61-1.69; p = 0.96, I2 = 0%) and all-cause mortality(OR 0.51; 95%CI 0.18-1.43; p = 0.20, I2 =0%) Conclusion- Amongst patients with small abdominal aortic aneurysms, doxycycline did not significantly reduce aneurysm growth. Abstract Figure. A) AAA expansion B)Surgery C)Mortality

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Frequency-Following Response (FFR) in Military Pilots

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1718525 ◽

2020 ◽

Author(s):

Graziela Maria Martins-Moreira ◽

Alessandra Spada Durante

Keyword(s):

Pure Tone Audiometry ◽

Control Group ◽

Study Group ◽

Aircraft Accidents ◽

Frequency Following Response ◽

Significant Difference ◽

Qualitative Variables ◽

Chi Squared ◽

The Right ◽

Military Pilots

Abstract Introduction Good hearing in pilots, including central auditory skills, is critical for flight safety and the prevention of aircraft accidents. Pure tone audiometry alone may not be enough to assess hearing in the members of this population who, in addition to high noise levels, routinely face speech recognition tasks in non-ideal conditions. Objective To characterize the frequency-following response (FFR) of a group of military pilots compared with a control group. Methods Twenty military pilots in the Study Group and 20 non-pilot military personnel, not exposed to noise in their work, in the Control Group, all with normal hearing, aged between 30 and 40 years old, completed a questionnaire to assess their hearing habits, and their FFRs were measured with a /da/ syllable (duration 40 milliseconds, speed 10.9/s), at 80 dB NA in the right ear. All procedures were approved by the ethical committee of the institution. Statistical analysis was performed using the t-Student or Mann-Whitney tests for quantitative variables, and the Fisher or chi-squared tests for qualitative variables, and a value of p < 0.05 was considered to be statistically significant. Results There was no significant difference between the groups regarding auditory habits. In the FFR, wave amplitudes A (p = 0.01) and C (p = 0.04) were significantly lower in the Study Group. Conclusion Working as a military pilot can be a crucial factor in determining an individual's typical FFR pattern, demonstrated in the present study by statistically significant reductions in the amplitudes of the A and C waves.

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Detection of AZF microdeletions and reproductive hormonal profile analysis of infertile sudanese men pursuing assisted reproductive approaches

BMC Urology ◽

10.1186/s12894-021-00834-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hassan Osman Alhassan Elsaid ◽

Tarteel Gadkareim ◽

Tagwa Abobakr ◽

Eiman Mubarak ◽

Mehad A. Abdelrhem ◽

...

Keyword(s):

Y Chromosome ◽

Klinefelter Syndrome ◽

Semen Analysis ◽

Control Group ◽

Male Factor ◽

Exact Test ◽

Fisher's Exact Test ◽

Infertile Men ◽

Significant Difference ◽

Fisher’S Exact Test

Abstract Background Male factor is the major contributor in roughly half of infertility cases. Genetic factors account for 10–15% of male infertility. Microdeletions of azoospermia factors (AZF) on the Yq region are the second most frequent spermatogenesis disorder among infertile men after Klinefelter syndrome. We detected in our previous study a frequency of 37.5% AZF microdeletions which investigated mainly the AZFb and AZFc. We attempted in this study for the first time to evaluate the frequencies of all AZF sub-regions microdeletions and to analyze reproductive hormonal profiles in idiopathic cases of azoospermic and oligozoospermic men from Sudan. Methods A group of 51 medically fit infertile men were subjected to semen analysis. Four couples have participated in this study as a control group. Semen analysis was performed according to WHO criteria by professionals at Elsir Abu-Elhassan Fertility Centre where samples have been collected. We detected 12 STSs markers of Y chromosome AZF microdeletions using a multiplex polymerase chain reaction. Analysis of reproductive hormone levels including Follicle Stimulating, Luteinizing, and Prolactin hormones was performed using ELISA. Comparisons between outcome groups were performed using Student’s t-test Chi-square test or Fisher’s exact test. Results AZF microdeletion was identified in 16 out of 25 Azoospermic and 14 out of 26 of the Oligozoospermic. Microdeletion in the AZFa region was the most frequent among the 30 patients (N = 11) followed by AZFc, AZFd (N = 4 for each) and AZFb (N = 3). Among the Oligozoospermic participants, the most frequent deletions detected were in the AZFa region (N = 10 out of 14) and was significantly associated with Oligozoospermic phenotype, Fisher's Exact Test (2-sided) p = 0.009. Among the Azoospermic patients, the deletion of the AZFc region was the most frequent (N = 9 out of 16) and was significantly associated with Azoospermia phenotype Fisher's Exact Test p = 0.026. There was a significant difference in Y chromosome microdeletion frequency between the two groups. The hormonal analysis showed that the mean levels of PRL, LH, and FSH in Azoospermic patients were slightly higher than those in oligozoospermic. A weak negative correlation between prolactin higher level and Azoospermic patients was detected. (AZFa r = 0.665 and 0.602, p = 0.000 and 0.0004, AZFb r = 0.636 and 0.409, p = 0.000 and 0.025, and AZFd r = 0.398 and 0.442, p = 0.029 and 0.015). The correlation was positive for AZFa and negative for AZFb and AZFd. Conclusions We concluded in this study that the incidences of microdeletions of the Y chromosome confined to AZF a, b, c and d regions is 58.8% in infertile subjects with 31.4% were Azoospermic and 27.5% were Oligozoospermic. This might provide a piece of evidence that these specified regions of the Y chromosome are essential for controlling spermatogenesis. These findings will be useful for genetic counseling within infertility clinics in Sudan and to adopt appropriate methods for assisted reproduction.

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Perforator-Based Flap Reconstruction after Melanoma Resection: Evaluation of Oncological, Aesthetic, and Functional Outcomes

Journal of Reconstructive Microsurgery ◽

10.1055/s-0041-1740925 ◽

2021 ◽

Author(s):

Beniamino Brunetti ◽

Rosa Salzillo ◽

Stefania Tenna ◽

Bruno Brunetti ◽

Mario Alessandri Bonetti ◽

...

Keyword(s):

Functional Outcomes ◽

Locoregional Recurrence ◽

Demographic Data ◽

Exact Test ◽

Significant Difference ◽

Chi Squared ◽

Group A ◽

The Aesthetic ◽

One Year ◽

Group B

Abstract Background Evidence in literature about the best reconstructive approach after melanoma resection is controversial, with some authors advocating that tissue rearrangement flap techniques might hinder the early detection of local relapses. The aim of the present study is to evaluate oncological, aesthetic, and functional outcomes following melanoma reconstruction using pedicled perforator-based flaps. Methods The authors reviewed all patients affected by melanoma treated during a 6-year period. Demographic data, tumor characteristics, and operative variables were evaluated. Locoregional recurrence was assessed with clinical and radiological follow-up. One-year postoperatively patients rated on a 5-point Likert scale the aesthetic and functional outcomes of the procedure. Three blind observers examined preoperative and 1-year postoperative photographs and rated the aesthetic outcome of the reconstructive procedure. Results One-hundred sixty-five patients were treated with wide excision and delayed reconstruction, including pedicled perforator-based flaps in 70 patients (group A) and primary closure in 95 patients (group B). Mean Breslow thickness was 2.972 and 2.189 mm in group A and B, respectively. There was no statistically significant difference in locoregional recurrence (chi-squared test, p = 0.8333; Fisher's exact test, p > 0.9999) between the two groups. Group A reported a higher satisfaction with both the aesthetic (mean rating 4.390 in group A and 4.094 in group B) and functional (mean rating 4.732 in group A and 4.170 in group B) outcomes of the procedure, the latter being statistically significant (p = 0.0006). Conclusion This series suggests that pedicled perforator-based flaps provide optimal aesthetic and functional outcomes in melanoma reconstruction without impairing the locoregional control of the disease.

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Seroprevalence of Toxoplasma gondii in dogs of riverside communities of Mato Grosso Pantanal, Brazil

Revista Brasileira de Parasitologia Veterinária ◽

10.1590/s1984-29612016067 ◽

2016 ◽

Vol 25 (4) ◽

pp. 531-535 ◽

Cited By ~ 7

Author(s):

Juliana Yuki Rodrigues ◽

Arleana do Bom Parto Ferreira de Almeida ◽

Eveline da Cruz Boa Sorte ◽

Naiani Domingos Gasparetto ◽

Felipe Augusto Constantino Seabra da Cruz ◽

...

Keyword(s):

Toxoplasma Gondii ◽

Antibody Test ◽

Human Infection ◽

Mato Grosso ◽

Exact Test ◽

Worldwide Distribution ◽

Significant Difference ◽

Chi Squared ◽

Immunofluorescence Antibody Test ◽

Immunofluorescence Antibody

Abstract Toxoplasma gondii is an intracellular protozoan with worldwide distribution and dogs act as sentinels of human infection. This search aimed to determine the occurrence of antibodies against T. gondii in dogs of the communities on the Cuiabá River, Mato Grosso and variables associated with infection. The dogs of the riverside communities in Cuiabá River, which includes Barranco Alto, Praia do Poço, Engenho Velho, Varginha, Bom Sucesso, Passagem da Conceição and São Gonçalo Beira Rio, were evaluated for the presence of T. gondii antibodies by indirect immunofluorescence antibody test (IFAT). The prevalence and factors associated with infection were calculated by chi-squared test (χ2) or Fisher’s exact test, and univariate and multiple analysis. Of the 248 dogs surveyed, 107 (43.1%) were seropositive for T. gondii. The seroprevalence ranged from 25.6% to 64.3%. There was no statistically significant difference between the communities studied (p > 0.05). As for the associated factors, the only statistically significant factor was that of dogs living with cats (p = 0.02), with approximately twice the risk of acquiring infection. In conclusion, the seroprevalence in dogs of riverside communities in the Baixada Cuiabana demonstrated that high rates of infection, being the factor associated with infection, contact with domestic cats.

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The incidence of iliac aneurysms in patients with abdominal aortic aneurysms: Comparison of four centers in Europe and the USA

VASA ◽

10.1024/0301-1526.33.2.68 ◽

2004 ◽

Vol 33 (2) ◽

pp. 68-71 ◽

Cited By ~ 2

Author(s):

Eugster ◽

Bolli ◽

Pfeiffer ◽

Sandmann ◽

Chuter ◽

...

Keyword(s):

External Iliac Artery ◽

Aortic Aneurysms ◽

Iliac Arteries ◽

Maximal Diameter ◽

Abdominal Aortic ◽

Suprarenal Aorta ◽

Significant Difference ◽

The Usa ◽

Preoperative Ct ◽

Common Iliac Arteries

Background: The purpose of this study was to compare the anatomy of the aortoiliac vessels in patients scheduled for infrarenal abdominal aortic aneurysm (AAA) repair in four different countries. Material and methods: Consecutives series of 100 preoperative CT-scans were evaluated at each center. Diameters of the suprarenal aorta, maximal diameter of the aneurysm, right and left common and external iliac artery as well as the hypogastric arteries were recorded and compared between each center. Results: Configuration of the AAA above bifurcation was similar at each center. The dimensions of the aortic bifurcation and the common iliac arteries were different among the centers. Common iliac arteries with diameters over 25mm were significantly more common at center 1 (p < 0.001, p = 0.002 and p < 0.001). Among centers 2,3 and 4 there was no significant difference in common iliac diameters. Conclusions: Configuration of the iliac arteries in AAA was significantly different for Swiss patients compared to American, Austrian and German patients. Reasons for these differences are unclear, epidemiological or genetic factors may be responsible.

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Prevalence of Abdominal Aortic Aneurysms in Over 65-Year-Old Men with Inguinal Hernias

Annals of The Royal College of Surgeons of England ◽

10.1308/003588408x285937 ◽

2008 ◽

Vol 90 (5) ◽

pp. 386-388 ◽

Cited By ~ 7

Author(s):

Oliver Anderson ◽

Sandy Shiralkar

Keyword(s):

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Selective Screening ◽

Ultrasound Scan ◽

Inguinal Hernias ◽

Abdominal Aortic ◽

Male Patients ◽

A Prospective Study ◽

Old Men ◽

Age Range

INTRODUCTION The aim of this study was to determine the prevalence of abdominal aortic aneurysms (AAAs) in over 65-year-old men who have inguinal hernias and discuss if pre-operative selective screening of this population is appropriate. PATIENTS AND METHODS A prospective study on 70 consecutive male patients with an age range of 65–88 years (mean, 74 years) who were referred to a single vascular consultant's out-patient clinic with an inguinal hernia were screened for the presence of an AAA with an ultrasound scan before hernia repair over a period of 3 years. RESULTS Two patients were found to have an AAA measuring 3.8 cm and 6.0 cm giving an AAA prevalence of 3% (exact 95% confidence interval = 0–10%). CONCLUSIONS This study does not demonstrate an increased AAA prevalence in over 65-year-old male patients with inguinal hernias, scanned pre-operatively when compared to screening programmes. Selective screening of this cohort cannot be justified on this evidence.

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