Prevention of Aortic Dissection Suggests a Diameter Shift to a Lower Aortic Size Threshold for Intervention

Cardiology ◽  
2018 ◽  
Vol 139 (3) ◽  
pp. 139-146 ◽  
Author(s):  
Ahmed M. Mansour ◽  
Sven Peterss ◽  
Mohammad A. Zafar ◽  
John A. Rizzo ◽  
Hai Fang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Multivariable Analysis ◽  
Ascending Aorta ◽  
Control Group ◽  
Descending Aorta ◽  
Before And After ◽  
Group A ◽  
And Gender ◽  
Size Threshold ◽  
Aortic Size

Background: Multiple studies have quantified the relationship between aortic size and risk of dissection. However, these studies estimated the risk of dissection without accounting for any increase in aortic size from the dissection process itself. Objectives: This study aims to compare aortic size before and after dissection and to evaluate the change in size consequent to the dissection itself. Methods: Fifty-five consecutive patients (29 type A; 26 type B) with aortic dissection and incidental imaging studies prior to dissection were identified and compared to a control group of aneurysm patients (n = 205). The average time between measurement at and prior to dissection was 1.7 ± 1.9 years (1.9 ± 2.0 years mean inter-image time in the control group). A multivariate regression model controlling for growth rate, age, and gender was created to estimate the effect of dissection itself on aortic size. Results: The mean aortic sizes at and prior to dissection were 54.2 ± 7.0 and 45.1 ± 5.7 mm for the ascending aorta, and 47.1 ± 13.8 and 39.5 ± 13.1 mm for the descending aorta, respectively. The multivariable analysis revealed a significant impact of the dissection itself (p < 0.001) and estimated an increase in size of 7.65 mm (ascending aorta) and 6.38 mm (descending aorta). Thus, a proportional estimate of 82.8% (ascending aorta) and 80.8% (descending aorta) of dissections are made at a size lower than the guideline-recommended threshold (55 mm). Conclusions: The aortic diameter increases substantially due to aortic dissection itself and, thus, aortas are being dissected at clinically meaningfully smaller sizes than natural history analyses have previously suggested. These findings have important implications regarding the size at which the risk of dissection is increased.

scholarly journals PREPARATION AND EVALUATION OF CHEMICALLY INACTIVATED SALMONELLA ENTERITIDIS VACCINE IN CHICKENS

2017 ◽  
Vol 10 (11) ◽  
pp. 341
Author(s):  
Mounir M El-safty ◽  
Hala Mahmoud ◽  
Eman Sa Zaki ◽  
Howaida I Abd-alla
Keyword(s):  
Immune Responses ◽  
Salmonella Enteritidis ◽  
Serum Antibody ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Chemically Induced ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Cell Envelopes

  Objective: Salmonella enteritidis ghosts (SEGs) is a non-living empty bacterial cell envelopes which were generated using a different concentration of sodium hydroxide (NaOH) 6.4 mg/mL and evaluated as a vaccine candidate in specific pathogen-free (SPF) chicken. SEGs have been produced by chemical-mediated lysis and evaluated the potential efficacy of chemically induced SEG vaccine and its ability to induce protective immune responses against virulent S. enteritidis challenge in SPF chickens.Methods: SPF chickens were divided into three groups: Group A (non-vaccinated control), Group B (vaccinated with prepared vaccine), and Group C (vaccinated with commercial vaccine).Results: Vaccination of SPF chicken with SEGs induced higher immune responses before and after virulent challenge. SPF chicken vaccinated with SEGs showed increasing in serum enzyme-linked immunosorbent assay (ELISA) antibodies. During the vaccination period, Groups B and C showed higher serum antibody titer compared to Group A. The minimal inhibitory concentration (MIC) of NaOH was capable of inducing non-living SEGs, and it has successfully generated non-living SEGs by MIC of NaOH.Conclusion: It is a one-step process which means easy manufacturing and low production cost compared to protein E-mediated lysis method. Chemically induced SEG vaccine is a highly effective method for inducing protective immunity. This study strongly suggests that SEGs will be a permissive vaccine, as the method of inhibition of S. enteritidis was safe and cheaper than other methods, and it gave a good protection.

scholarly journals The Effect of Brain-Based Teaching on Young EFL Learners’ Self-Efficacy

2017 ◽  
Vol 10 (5) ◽  
pp. 158 ◽  
Author(s):  
Parastoo Alizadeh Oghyanous
Keyword(s):  
Language Learning ◽  
Self Efficacy ◽  
Foreign Language Learning ◽  
Teaching Approach ◽  
Control Group ◽  
Efl Learners ◽  
Learning And Teaching ◽  
Before And After ◽  
Group A ◽  
Age Range

The present study aimed to investigate the effect of brain-based teaching on the self-efficacy of young EFL learners. The initial participants of the study were 90 learners within the age range of 13-16 who were selected based on convenience sampling. Theses 90 young EFL learners were given a Flyers test the scores of which were used to choose 60 homogeneous learners whose scores fell within the range of +/- one standard deviation from the mean. The 60 selected learners were then divided into an experimental and a control group. A Self-Efficacy Questionnaire for Children (SEQ-C), developed by Muris (2001) was administered to the participants in both groups before and after the treatment after being translated into Persian and piloted for reliability check. To implement brain-based teaching in the experimental group, the researcher taught the lessons based on the three techniques of Brain Based Teaching Approach (BBTA). The three techniques used were Relaxed Alertness (RA), Orchestrated Immersion (OI) and Active Processing (AP) in line with Thomas and Swamy (2014). The results of statistical analyses indicated that brain-based teaching approach had a significant effect on students’ self-efficacy. The findings of the study can have implications for both students and EFL teachers in the realm of foreign language learning and teaching.

scholarly journals Employment and earnings trajectories before and after sickness absence due to major depressive disorder: a nationwide case–control study

2020 ◽  
pp. oemed-2020-106660
Author(s):  
Christian Hakulinen ◽  
Petri Böckerman ◽  
Laura Pulkki-Råback ◽  
Marianna Virtanen ◽  
Marko Elovainio
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Sickness Absence ◽  
Lower Probability ◽  
Control Group ◽  
Major Depressive ◽  
Earnings Losses ◽  
Before And After ◽  
History Of ◽  
And Gender

ObjectivesTo examine employment and earnings trajectories before and after the first sickness absence period due to major depressive disorder (MDD).MethodsAll individuals (n=158 813) in Finland who had a first sickness absence period (lasting longer than 9 days) due to MDD between 2005 and 2015 were matched with one randomly selected individual of the same age and gender with no history of MDD. Employment status and earnings were measured using register-based data annually from 2005 to 2015. Generalised estimating equations were used to examine the trajectories of employment and earnings before and after MDD diagnosis in men and women separately.ResultsSickness absence due to MDD was associated with increased probability of non-employment during and after the year of the first sickness absence period. In men, but not in women, the probability of being employed was lower 5 years before the sickness absence period due to MDD. When compared with the individuals in the control group, men had around 34% and women 15% lower earnings 1 year, and 40% and 23%, respectively, 5 years, after the first sickness absence period due to MDD. More severe MDD and longer duration of sickness absence period were associated with lower probability of being employed.ConclusionsSickness absence due to MDD was associated with considerable reduction in employment and earnings losses. For men and individuals with more severe MDD, this reduction was before the first sickness period. This supports a reciprocal association between employment and earnings with MDD.

The Role of Dialysis Membranes on Intradialytic Selenium Removal and on Selenium Status in Patients Receiving Renal Replacement Therapy

2015 ◽  
Vol 41 (1-3) ◽  
pp. 94-99 ◽  
Author(s):  
Macroui Sonikian ◽  
Artemisia Dona ◽  
Jacob Skarakis ◽  
Sophia Trompouki ◽  
Theodora Miha ◽  
...  
Keyword(s):  
Control Group ◽  
Separate Analysis ◽  
Dialysis Session ◽  
Polysulfone Membrane ◽  
Ethylene Vinyl Alcohol ◽  
Before And After ◽  
Selenium Removal ◽  
Group A ◽  
Patient Groups ◽  
Group B

Background/Aims: Dialysis membrane has been implicated in selenium (Se) deficiency in hemodialysis (HD). Intradialytic Se removal into dialysate through different membranes was investigated. Methods: We studied 19 patients on standard HD with low-flux polysulfone membrane (group A), 10 patients on standard HD with ethylene vinyl alcohol membrane (group B), 12 patients on hemodiafiltration (HDF; group C) and 16 healthy subjects (control group D). Se was measured in blood before and after dialysis session and in effluent dialysate every hour during session. Results: In all patients together, pre-dialysis serum Se levels were lower than those in control group, but, in a separate analysis, only in standard HD. In all patient groups, there was a net Se removal into dialysate but it was greater in HDF patients who, however, had similar pre-dialysis serum Se levels to those in healthy controls. Conclusion: An intradialytic Se loss was found with all 3 membrane types, but it is not the principal factor for Se depletion in HD.

scholarly journals A Randomized Controlled Trial for the Effectiveness of Aromatherapy in Decreasing Salivary Gland Damage following Radioactive Iodine Therapy for Differentiated Thyroid Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Michihiro Nakayama ◽  
Atsutaka Okizaki ◽  
Koji Takahashi
Keyword(s):  
Thyroid Cancer ◽  
Salivary Gland ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Control Group ◽  
Parotid Glands ◽  
Before And After ◽  
Group A ◽  
Gland Function ◽  
Group B

Objective. The aim of this study was to investigate effects of aromatherapy in decreasing salivary gland damage for patients undergoing radioactive iodine (RAI) therapy with differentiated thyroid cancer (DTC). Materials and Methods. The subjects were 71 patients with DTC. They were divided into aromatherapy group (group A, n=35) and a control group (group B, n=36). We blended 1.0 mL of lemon and 0.5 mL of ginger essential oils. The patients in the inhalation aromatherapy group inhaled this blend oil and those in the control group inhaled distilled water as placebo for 10 min during admission. We statistically compared salivary gland function before and after treatment between groups A and B. Results. In comparison with group B, the rate of change of the accumulation rate was significantly higher in the parotid glands and submandibular glands of group A (P<0.05). In comparison with group B, a significant increase in rate of secretion change before and after treatment was noted in the bilateral parotid glands in group A (P<0.05). Conclusion. Because an amelioration of salivary gland function was observed in the present study, our results suggest the efficacy of aromatherapy in the prevention of treatment-related salivary gland disorder. This trial is registered with UMIN Clinical Trial Registry: UMIN000013968.

Disability Onset among Aging Canadians: Evidence from Panel Data

2002 ◽  
Vol 21 (1) ◽  
pp. 117-136 ◽  
Author(s):  
Derek Hum ◽  
Wayne Simpson
Keyword(s):  
Panel Data ◽  
Control Group ◽  
Unique Contribution ◽  
Age Group ◽  
Income Dynamics ◽  
Cross Sectional ◽  
Data Set ◽  
Disability Status ◽  
Before And After ◽  
And Gender

ABSTRACTPast studies of aging and disability have been restricted to and by cross-sectional data. When cross-sectional surveys measure income, disability status and age at a common point in time, it is impossible to discern the process, and consequences, of a disability onset. In other words, it is not possible to examine the circumstances of the same individuals before, and after, the disability onset; nor whether effects differ according to the age at which the disability occurs. The present study uses a new panel data set, the Survey of Labour and Income Dynamics (SLID), to examine the prevalence of disability with respect to age, gender, and other socio-economic characteristics; however, its unique contribution is its investigation of disability onset, and the rates of entry into, and exit from, disability status by age group and gender. Further, we assess the financial circumstances of those who become disabled vis-à-vis a “control group”.

Marginal Adaptation of Direct Class II Composite Restorations with Different Cavity Liners

2013 ◽  
Vol 38 (6) ◽  
pp. E210-E220 ◽  
Author(s):  
R Pecie ◽  
I Onisor ◽  
I Krejci ◽  
T Bortolotto
Keyword(s):  
Elastic Modulus ◽  
Class Ii ◽  
Control Group ◽  
Shrinkage Stress ◽  
Marginal Adaptation ◽  
Composite Restorations ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group D

SUMMARY The aim of this study was to evaluate how cavity linings with different elastic modulus can influence the marginal adaptation (MA) of Class II composite restorations before and after thermo-mechanical loading. Materials and Methods: Forty Class II cavities with margins extending 1 mm below the cement-enamel junction were prepared in extracted human third molars. In each group except the control group, a lining material of 1-mm thickness was applied to the bottom of the cavity and polymerized before placing the resin composite Herculite XRV Ultra (group A: control; group B: Premise Flowable lining; group C: Herculite XRV Ultra lining; and group D: Optibond FL lining). MA was evaluated (with a scanning electron microscope) before and after loading (200,000 loading cycles). Statistical analysis was done using the Shapiro-Wilks test, the analysis of variance test, and Duncan post hoc test at p&lt;0.05. Results: Before loading, the percentages of continuous margins in dentin were superior (p&lt;0.05) for groups C and D (71.1% and 87.2%, respectively) compared to groups A and B (55.7% and 48.3%, respectively). After loading, group D (79.8%) was statistically superior in dentin compared to all of the other groups (43.6%, 35.9%, and 54.4%, respectively). In occlusal enamel, no significant difference was found between groups. The percentage of enamel fractures and the percentage of noncontinuous margins in proximal enamel were high, with no significant difference between liners. It can be concluded that for the materials used in this study, a 1-mm-thick lining with an extremely low elastic modulus (2-3 GPa) could redistribute shrinkage stress. The use of a flowable composite did not significantly improve MA.

scholarly journals Study of the Efficacy of Ksharaplota in Dushtavrana w.s.r to Infected Wound

2020 ◽  
Vol 11 (2) ◽  
pp. 314-321
Author(s):  
Anantkumar V Shekokar ◽  
Vijay P Ukhalkar
Keyword(s):  
Clinical Presentation ◽  
Healing Time ◽  
Control Group ◽  
Infected Wound ◽  
Group Assessment ◽  
Before And After ◽  
Group A ◽  
Level Of Significance ◽  
Group B ◽  
Vast Range

Vrana ( wound and ulcer) & process of healing is the soul of Shalyatantra Chikitsa (Surgical treatment ). Dushta Vrana means getting vitiated by Dosha & hence Dushta Vrana or infected wound is characterized by bad smell, abnormal color with profuse discharge, severe pain and longer healing time. The severity of infected wounds and their vast range of etiologies, The treatment is cleaning & dressing the wound or it can be more extensive. It may require surgical intervention to close the wound and stabilize the patient. Acharya Sushruta defines Kshara as the substance possessing Ksharana and Kshanan properties. Ksharaplota formulation was selected and applied over the affected infected wound with the help of gauze piece. During the preparation of Ksharaplota, it is coated with Snuhi kshira, Apamarga kshara & Haridra. All these drugs are Shodhana & Ropana. It was observed that Ksharaplota has the properties as sustained release of drug, absorbs discharges, less painful & easily acceptable by the patient with excellent Sodhana & Ropana Karma. The clinical study has been done on 438 patients, selected randomly and divided in two groups. Group A 220 patients i.e. trial group, were treated with local application of Ksharaplota. The Group B 218 patients i.e. control group, were treated with Gold standard. The clinical assessment was done on the basis of clinical presentation of Dushta Vrana, (Infected wound) before and after the treatment. As grading used for assessment of parameters which were ordinal in nature, “Wilcoxon Signed Ranks test” was used for within the group assessment (i.e. before and after treatment of a group). For between the group assessment of parameters, Mann Whitney – U test was applied. We had tested hypothesis for each parameter and result was interpreted accordingly. The level of significance was kept at 5% (P=0.05). And the result of the present study found significant.

scholarly journals Protocol on Comparative Clinical Efficacy of Tryushanadi Guggul and Navaka Guggul in Sthoulya (Overweight)

2021 ◽  
pp. 169-175
Author(s):  
Ashvini Dineshrao Pardhekar ◽  
Sadhana Misar(Wajpeyi) ◽  
Vinod Ade
Keyword(s):  
Clinical Efficacy ◽  
The Body ◽  
Control Group ◽  
Arm Circumference ◽  
Before And After ◽  
Group A ◽  
Excessive Intake ◽  
Group B ◽  
Excessive Accumulation

Background: Sthoulya is Medovaha Strotodushtijanya vyadhi, which includes abnormal and excessive accumulation of Medodhatu in the body. This is caused by lack of physical and mental activity, daytime sleep, excessive intake of madhur (sweet), snigdha ahar (oily diet) results in  increase Kaphadosha and meda which results in Sthoulya (overweight) having symptoms of mild dysponea, thirst, drowsiness, excess sleep, appetite, offensive smell from the body, incapability to work and incapability to participate in sexual intercourse. Aim: Comparative clinical efficacy of Tryushanadi Guggul and Navaka Guggul in Sthoulya (overweight). Materials and methods: Total 60 patients of Sthoulya will enrolled and will divided into two groups (each group contains 30). Patients in group A (experimental group) will be given 1 gram Tryushanadi Guggul two times a day after meal with honey and in group B (control group)1 gram Navaka Guggul will administered two times a day after meal with honey for 30 days. Dietary changes and walking (30 minutes) will be advised to patients of both groups. Follow up will be taken on 15th day and 30th day. Assessment of subjective parameters like kshudrashwasa (exertional dyspnoea), swedadhikya (perspiration), atikshudha (increased appetite), nidradhikya (increased sleep) and objective parameters like body weight, B.M.I., mid arm circumference, waist-hip ratio and lipid profile will be done before and after treatment. Results: Subjective and objectives outcomes will be assessed by statistical analysis. Conclusion: It will be drawn from the result obtained.

scholarly journals Bioelastic properties of the aorta in children, adolescents and young adults after cardiac transplantation: a cardiovascular magnetic resonance study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Mueller ◽  
K Gummel ◽  
B Reich ◽  
H Latus ◽  
C Jux ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Cardiac Transplantation ◽  
Ascending Aorta ◽  
Control Group ◽  
Cross Sectional ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Myocardial T1 ◽  
Study Population

Abstract Background Long-term complications after cardiac transplantation are common and typically include arterial hypertension and coronary allograft vasculopathy. Few studies also suggested that heart transplant recipients have an increased arterial stiffness. Purpose This prospective study aimed to assess the bioelastic properties of the aorta as well as LV function, morphology and structure in children and young adults after cardiac transplantation. Methods CMR studies from 34 patients (median age: 17.1 years, range: 8–24 years) who underwent cardiac transplantation in childhood were analysed. Aortic anatomy and distensibility were assessed at five locations of the thoracic aorta using steady-state free precession cine sequences. Pulse wave velocity (PWV) of the aortic arch and the descending thoracic aorta was measured from 2-dimensional phase contrast images. Size and function of the left atrium and the ventricles were assessed from a stack of short axis slices. Myocardial T1 times were determined using a standard MOLLI sequence. Results Cross-sectional areas of the ascending aorta and the aortic arch tended to be lower in patients compared to controls (ascending aorta 464.5±172.5 mm2 vs. 515.3±186.3 mm2, aortic arch 342.4±113.3 mm2 vs. 376.9±148.5 mm2) whereas cross-sectional areas of the descending aorta tended to be higher (aortic isthmus 283.7±102.1 mm2 vs. 257.9±89.5 mm2, aorta descendens diaphragmal 218.4±75.8 mm2 vs. 214.2±75.0 mm2) and showed a correlation with systolic blood pressure (r=0.33). PWV was higher in the aortic arch (4.8±2.4 m/s vs. 3.6±0.7 m/s). Aortic distensibility was slightly higher at all measuring points in the study population compared to the control group and showed an increase with rising distance from the heart (ascending aorta 10.5±5.8 10–3 mm Hg-1, aortic isthmus 13.1±7.5 10–3 mm Hg-1, descending aorta 16.6±6.8 10–3 mm Hg-1). Biventricular volumes were slightly reduced in the patient group compared to the control group but this was not statistically significant. Only left ventricular mass messured during the systolic phase was higher in the study population compared to the control group (males 55.1 g/m2 vs. 53.0 g/m2, females 46.2 g/m2 vs. 45.2 g/m2). T1 mapping demonstrated increased T1 times in the heart-transplanted group compared to published data in healthy adults. In particular, T1 times of the lateral and inferior myocardial segments were higher. Conclusion Patients who underwent cardiac transplantation in childhood seem to have a reduced bioelasticity of the thoracic aorta. Increased myocardial T1 times suggesting alterations in myocardial structure. FUNDunding Acknowledgement Type of funding sources: None.

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