PSX-A-2 Late-Breaking: Acute Endotoxinemia May Increase Intercostal Temporary Mechanical Nociception in Wethers

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 370-371
Author(s):  
Brian K Whitlock ◽  
Allison Renwick ◽  
Amelia Pi ◽  
Jay A Daniel
Keyword(s):  
Animal Models ◽  
Systemic Inflammation ◽  
Pain Threshold ◽  
Intercostal Space ◽  
Treatment Administration ◽  
Effect Of Treatment ◽  
The Right ◽  
Generalized Hyperalgesia

Abstract Systemic inflammation induced by lipopolysaccharide (LPS; endotoxin) is associated with generalized hyperalgesia in humans and some animal models. However, the effects of endotoxin-induced inflammation on pain threshold in livestock, such as sheep, is unknown. Eight wethers [~1 year of age; 61.3 ± 0.5 kg BW] were administered saline (2 mL; n = 4) or endotoxin (2 mL; 400 ng of LPS / kg BW; n = 4) intravenously. A handheld algometric unit was used to administer temporary mechanical nociception (TMN) before (Day -2) and after (Day 1) treatment administration by the same person three times at two locations on the right thorax (intercostal spaces 6 and 9). Two-way ANOVA was completed in SAS v9.4 (Cary, NC). There were effects of day (P < 0.001) and location (P < 0.0001) on TMN, such that the force needed to induce TMN on Day -2 (2.04 +/- 0.15 kgF) was less than on Day 1 (2.93 +/- 0.15 kgF) and the force needed to induce TMN at intercostal space 6 (1.81 +/- 0.15 kgF) was less than at intercostal space 9 (3.15 +/- 0.15 kgF). While there was no effect of treatment (P = 0.96), or interaction of treatment and location (P = 0.19), day and location (P = 0.25), or treatment and day and location (P = 0.49), there was a tendency for an interaction of treatment and day (P = 0.06), such that TMN was not different on Day 1 (2.73 +/- 0.30 kgF) and Day -2 (2.24 +/- 0.30 kgF) for animals receiving saline but was greater on Day 1 (3.12 +/- 0.30 kgF) than Day -2 (1.83 +/- 0.30 kgF) for animals receiving LPS. While systemic inflammation is associated with reduced pain threshold in some models, acute LPS-induced inflammation may increase intercostal TMN in castrated sheep.

The Art of the Clinician

2021 ◽  
Vol 6 (09) ◽  
pp. 612-615
Author(s):  
Rodríguez-Guerra, Miguel, MD ◽  
Pandey, Neelanjana MD ◽  
Shrestha, Elina, MD ◽  
Vittorio, Timothy J. MD
Keyword(s):  
Correct Diagnosis ◽  
Critical Time ◽  
Mitral Valve Regurgitation ◽  
Intercostal Space ◽  
Av Fistula ◽  
Severe Aortic Regurgitation ◽  
Fibrin Sheath ◽  
Diastolic Murmur ◽  
Small Perforation ◽  
The Right

Background: The promotion of clinical abilities could represent a significant factor leading the clinicians to in making the correct diagnosis in a timely matter. Case: Our patient is a 42-year-old African male with a history of Hypertension, ESRD on hemodialysis via right-sided Permcath (PC), Mastoidectomy & Right ear surgery due to trauma in childhood, AV Fistula (Needed intervention 4 times) in left upper extremity, admitted due to witnessed seizures in the setting of hypertensive emergency. The patient denied family history and toxic habits. While the patient was at the emergency room, CT head revealed stable curvilinear hyper-attenuation thought to be a thrombosed developmental vein more likely than small subarachnoid hemorrhage. He was loaded with levetiracetam, received Ativan 1mg IV and HD done as per Nephrology. The patient was transferred to the floor he was not in acute distress and was asymptomatic, the cardiovascular (CV) examination showed regular pulse, normal S1, S2, S4+ appreciated with 2/4 diastolic murmur at second right intercostal space (ICS); 2/6 pansystolic murmur at third right intercostal space left parasternal border (LPSB) radiated to the right parasternal border (RPSB) and right mid-clavicular line (MCL); 3/6 systolic murmur at 5LICS MCL radiated to the posterior axillar line (PAL). Point of maximal impulse (PMI) displaced to mid axillar line (MAL). Parasternal heave present; the neurological exam was preserved. Endocarditis was suspected and echocardiogram was expedited, it showed severe aortic regurgitation, 1.60cm x 1.68cm mass in the tip of the catheter in the right atrium, possible vegetation in the tricuspid valve with mild regurgitation, moderate mitral valve regurgitation. Later, staphylococcus epidermidis was identified in blood cultures twice, as well as the culture from the PC. The transesophageal echocardiogram found 2.41 X 0.62 cm mass appears to be a fibrin sheath, possibly remnant of a prior catheter, small perforation in the non-coronary cusp likely in the setting of healed endocarditis. Infectious disease onboard for antibiotic management. Conclusion: The art of the clinician goes beyond the available technology; it could prevent the loss of critical time as well as unnecessary studies, guiding a better assessment and treatment of our patients and potentially improving their outcomes.

scholarly journals Novel Diagnostic Approaches to Adamantiades-Behcet's Disease

2005 ◽  
Vol 3 (2) ◽  
pp. 103-108
Author(s):  
M. Hatzistilianou ◽  
S. Hitoglou ◽  
D. Gougoustamou ◽  
M. Antoniades ◽  
S. Pappa ◽  
...  
Keyword(s):  
Serum Levels ◽  
Posterior Uveitis ◽  
Vegf Inhibitors ◽  
Tnf Α ◽  
Inactive Period ◽  
Diagnostic Approaches ◽  
Effect Of Treatment ◽  
Genital Ulcers ◽  
The Right

A 10 year old boy had visual deterioration in both eyes. Visual acuity was 0.2 in the right and 0.3 in the left eye. Further ophthalmologic findings were typical of posterior uveitis. The pediatric physical examination also disclosed aphthous stomatitis and recurrent aphthous genital ulcers. At diagnosis serum levels of IL-1β, IL-6, IL-8, TNF-α, sIL-2R, MCP-1, VEGF, tADA activity in the patient with active and ABD relapse were significantly higher than those in the inactive period of the disease, suggesting that these parameters may be related to disease activity. In addition to the proinflammatory chemokines and cytokines, plasma levels of VEGF and serum tADA activity may be used for the diagnosis of ABD and for monitoring the effect of treatment, as well as the follow-up period. Also, further studies of VEGF may lead to novel therapies with antibodies or other VEGF inhibitors.

scholarly journals A Case of Multiple Posterior Intercostal Artery Common Trunks in Conjunction with Additional Arterial Variations

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Nicholas R. Fanselow ◽  
Nolan Wallace ◽  
Daniel Sehi ◽  
Lokesh Coomar ◽  
John Martin ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Intercostal Space ◽  
Thoracic Wall ◽  
Thoracic Cavity ◽  
Arterial Variation ◽  
Arterial Variations ◽  
First Case ◽  
Male Cadaver ◽  
The Right ◽  
High Level

Several thoracic vasculature variations were observed in an 81-year-old male cadaver during routine dissection. These included 5 common trunks of posterior intercostal arteries, a descending branch of the right vertebral artery, and atypical neurovascular relationships within intercostal spaces. On the right side, two common trunks of posterior intercostal arteries were observed supplying the 4th-7th intercostal spaces and 9th-11th intercostal spaces, respectively. There was also a small accessary branch supplying the 9th intercostal space. The first three posterior intercostal spaces on the right were supplied by a descending branch of the vertebral artery. On the left side, three common trunks of posterior intercostal arteries were encountered, supplying intercostal spaces 3-5, 6-7, and 11 plus the subcostal space. An atypical neurovascular relationship was observed in the right 6th intercostal space, as well as the left 2nd, 3rd, and 6th intercostal spaces. This is the first case report that presents 5 common trunks of posterior intercostal arteries, as well as common trunks in conjunction with other arterial variation in the posterior thoracic wall. These variations carry a high level of clinical significance and may be helpful in guiding decision-making related to surgical procedures related to the posterior thoracic cavity and spine.

Sternotomy Sparing Thoratec Heartmate 3 Implantation via Bilateral Minithoracotomy

2018 ◽  
Vol 13 (1) ◽  
pp. 74-76 ◽  
Author(s):  
Julia Riebandt ◽  
Dominik Wiedemann ◽  
Guenther Laufer ◽  
Daniel Zimpfer
Keyword(s):  
Left Ventricular ◽  
Ascending Aorta ◽  
Intercostal Space ◽  
Implantation Technique ◽  
Thromboembolic Complications ◽  
Short Term ◽  
Short Term Mortality ◽  
Transplant Candidates ◽  
The Right ◽  
Outflow Graft

A novel sternotomy sparing implantation technique for the Thoratec HeartMate 3 is described. Cannulation of the left ventricular apex is performed via a minithoracotomy in the left fourth or fifth intercostal space. The outflow graft is advanced through the pericardium to a second minithoracotomy in the right second intercostal space and then anastomosed to the ascending aorta. This approach was performed in three patients so far with no need for conversion. We did not observe any perioperative adverse events, such as bleeding or thromboembolic complications, as well as no short-term mortality. This technique is especially appealing in multimorbid and frail patients, future transplant candidates, and patients with impaired right ventricular function.

Unusual giant pleural lipomas: imaging features

2021 ◽  
Vol 14 (6) ◽  
pp. e238870
Author(s):  
Dipin Sudhakaran ◽  
Sheragaru Hanumanthappa Chandrashekhara ◽  
Sunil Kumar ◽  
Mohamed Sulaiman
Keyword(s):  
Intercostal Space ◽  
Parietal Pleura ◽  
Imaging Features ◽  
Thoracic Cavity ◽  
Evolutionary Potential ◽  
The Right

Pleural lipomas are rarely encountered in the thoracic cavity. Sometimes, they infiltrate the intercostal space to have a component on either side of the intercostal space forming a hourglass configuration. They are generally solitary, small and asymptomatic. We present the case of a 49-year-old man with two giant pleural lipomas, both originating from the right parietal pleura, and one of which was passing through the intercostal space giving rise to a hourglass-shaped configuration. When they occur, although benign, considering the evolutionary potential, excision is recommended.

scholarly journals Early Response after Catheter Ablation of the Epicardial Substrate in a Patient with Brugada Syndrome Can Be Predicted by High Precordial Leads

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Yae Min Park ◽  
Mi Sook Cha ◽  
Hanul Choi ◽  
Woong Chol Kang ◽  
Seung Hwan Han ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Brugada Syndrome ◽  
Low Voltage ◽  
Early Stage ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Early Response ◽  
Intercostal Space ◽  
The Right ◽  
Fourth Intercostal Space

A 52-year-old male with Brugada syndrome presented with repeated and appropriate shock from an implantable cardioverter defibrillator (ICD). Catheter ablation for substrate elimination targeting low-voltage, complex, and fractionated electrocardiograms and late potentials in the epicardial right ventricular outflow tract was successfully performed. Brugada phenotype in the right precordial leads from the third intercostal space disappeared in the early stage after catheter ablation and that from the standard fourth intercostal space disappeared later. He remained free from ventricular fibrillation over the next fourteen months. We suggest that this novel ablation strategy is effective in Brugada syndrome patients with ICD, and early response after catheter ablation can be predicted by high precordial leads.

scholarly journals Totally endoscopic aortic valve replacement via an anterolateral approach using a standard prosthesis

2019 ◽  
Vol 30 (3) ◽  
pp. 424-430 ◽  
Author(s):  
Masayoshi Tokoro ◽  
Sadanari Sawaki ◽  
Takahiro Ozeki ◽  
Mamoru Orii ◽  
Akihiko Usui ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Operating Time ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Intercostal Space ◽  
Anterolateral Approach ◽  
The Right

Abstract OBJECTIVES Totally endoscopic aortic valve replacement (AVR) is still a challenging operation, and only a few series reports exist in the literature. The purposes of this study were to establish a method for endoscopic AVR and evaluate its initial results. METHODS A total of 47 patients (median age 76 years, 17 men) underwent endoscopic AVR. The main wound was created in the right anterolateral 4th intercostal space through a 4-cm skin incision. No rib spreader was used. A 3-dimensional endoscope was inserted at the midaxillary line. A 5.5-mm trocar was inserted in the 3rd intercostal space, thus creating a 3-port setting similar to that used for endoscopic mitral valve surgery. A standard prosthesis was used, and the sutures were tied using a knot pusher. Results were compared with those of 157 patients who underwent right transaxillary AVR with direct vision plus endoscopic assist. RESULTS Patient backgrounds did not differ significantly between the 2 groups. No deaths occurred in the entire series. There was no conversion to thoracotomy or sternotomy in the endoscopic AVR group. The complication rate did not differ significantly between the 2 groups. The total operating time was significantly shorter in endoscopic AVR (188–206 min); the cardiopulmonary bypass time (130–128 min) and the cross-clamp time (90–95 min) did not differ significantly (median, endoscopic AVR, right transaxillary AVR). Two patients underwent endoscopic double-valve (aortic and mitral) surgery under the same conditions. CONCLUSIONS Endoscopic AVR was possible through 3 ports created in the right anterolateral chest, similar to the procedure for endoscopic mitral valve surgery. By adopting a common approach for both the aortic and the mitral valve operations, endoscopic double-valve surgery can be performed seamlessly.

scholarly journals Chronic Thromboembolic Pulmonary Hypertension – What Have We Learned From Large Animal Models

2021 ◽  
Vol 8 ◽  
Author(s):  
Kelly Stam ◽  
Sebastian Clauss ◽  
Yannick J. H. J. Taverne ◽  
Daphne Merkus
Keyword(s):  
Pulmonary Hypertension ◽  
Animal Models ◽  
Current Knowledge ◽  
Pulmonary Arteries ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Large Animal ◽  
Large Animal Models ◽  
Microvascular Remodeling ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Right

Chronic thrombo-embolic pulmonary hypertension (CTEPH) develops in a subset of patients after acute pulmonary embolism. In CTEPH, pulmonary vascular resistance, which is initially elevated due to the obstructions in the larger pulmonary arteries, is further increased by pulmonary microvascular remodeling. The increased afterload of the right ventricle (RV) leads to RV dilation and hypertrophy. This RV remodeling predisposes to arrhythmogenesis and RV failure. Yet, mechanisms involved in pulmonary microvascular remodeling, processes underlying the RV structural and functional adaptability in CTEPH as well as determinants of the susceptibility to arrhythmias such as atrial fibrillation in the context of CTEPH remain incompletely understood. Several large animal models with critical clinical features of human CTEPH and subsequent RV remodeling have relatively recently been developed in swine, sheep, and dogs. In this review we will discuss the current knowledge on the processes underlying development and progression of CTEPH, and on how animal models can help enlarge understanding of these processes.

scholarly journals The influence of the sensitivity of the trapezius muscle on the changes within the bioelectric tensions of the masticatory muscles

2019 ◽  
Vol 129 (2) ◽  
pp. 52-54
Author(s):  
Grzegorz Zieliński ◽  
Michał Baszczowski ◽  
Michał Ginszt ◽  
Aleksandra Byś ◽  
Piotr Gawda
Keyword(s):  
Pain Threshold ◽  
Muscle Tone ◽  
Statistical Significance ◽  
Pressure Pain Threshold ◽  
Trapezius Muscle ◽  
Masticatory Muscles ◽  
Facial Skeleton ◽  
Pressure Pain ◽  
Level Of Significance ◽  
The Right

Abstract Introduction. Pathological muscle tone can cause changes in the facial skeleton, including tension headaches, tinnitus, temporomandibular joint dysfunctions. The complexity of pathologies and their spectrum may also indicate changes beyond the facial skeleton. The aim of the study was to determine the possible correlation between the pressure pain threshold of the trapezius muscle and the bioelectrical tension on the masticatory muscles. Aim. The aim of the study was to determine the possible correlation between the pressure pain threshold of the trapezius muscle and the bioelectric tension on the masticatory muscles. Material and methods. The number of 36 women applied for the study. They were all examined using an algometer within a trapezius muscle to determine the pressure pain threshold. The electromyographic study was carried out in accordance with the SENIAM guidelines. The resting activity of selected masticatory muscles (temporal and masseter) was recorded for 10 sec. The study involved an 8-channel BioEMG IIITM surface electromyography apparatus with BioPak Measurement System (BioResearch Associates, Inc. Milwaukee, WI, USA). Statistical analysis was carried out using the r-Pearson test. The level of significance was set at 5%. Results. After comparing the bioelectric tension of the masticatory muscles and the pressure pain threshold, left-sided correlation was observed (p<0.05). Both in the right-hand and general comparison, the results did not reach the required level of statistical significance (p>0.05). Conclusions. The pressure pain threshold seems to be linked to the bioelectrical muscle tone of the masticatory muscles. To confirm this observation, further research into a larger and more diverse group of participants is recommended.

scholarly journals Preventative Taping in Futsal: An Exploratory Analysis of Low-Dye Taping on Planter Force Distribution and Pain Sensitivity

2020 ◽  
Vol 10 (2) ◽  
pp. 540
Author(s):  
Sebastian Klich ◽  
Biye Wang ◽  
Aiguo Chen ◽  
Jun Yan ◽  
Adam Kawczyński
Keyword(s):  
Plantar Pressure ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Force Distribution ◽  
Pressure Pain ◽  
Lower Extremity Injuries ◽  
Foot Force ◽  
Extremity Injuries ◽  
The Right

The purpose of the present study was to investigate the changes in plantar foot force distribution (i.e., the percentage of force and force distribution under the rearfoot and forefoot) and plantar pressure pain sensitivity maps in professional futsal players after long-term low-dye taping (LDT). The subjects (n = 25) were male futsal players (age 23.03 ± 1.15 years). During the experiment, a nonelastic tape was applied on the plantar foot surface according to the standards of LDP. The experimental protocol consisted of a 3-day cycle during which the plantar foot force distribution (FFD) and plantar pressure pain threshold (PPT) were measured: (1) before the tape was applied, (2) 24 h after application, and (3) 72 h after application. The results revealed a significant decrease in the force distribution under the rearfoot (p ≤ 0.001) and forefoot (p ≤ 0.001) on the right and left sides. Moreover, the results showed an increase in the plantar pressure pain threshold in all regions of the foot (p ≤ 0.001). The results of this study suggest that plantar fascial taping can be an effective method for normalizing the force distribution on the foot and reducing the plantar pain threshold. The findings provide useful information regarding the prevention of and physical therapy of lower extremity injuries in soccer and futsal.

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