Carotid plaque morphology-An indicator for brain infarcts

Cerebrovascular adverse events are one of the most common causes for morbidity and mortality worldwide. Thromboembolism being the culprit behind a significant number of such events. An attempt has been made to ascertain the association of carotid plaque morphology in the occurrence of ischemic stroke. Heterogeneous plaques (Type 2 & 3) weremostly observed to be ipsilateral to the side of brain infarct, as compared to the contralateral side. Detection of heterogeneous plaques and plaque ulceration in patients may indicate future development of stroke. This study included 75 consecutive patients having anterior circulation infarct in MRI of the brain and atherosclerotic changes in extra cranial carotid system on Carotid Duplex scan. Plaque morphology ipsilateral to the brain infarct was compared to that on the contralateral side. Significantly higher number of heterogeneous plaques (Type 2 & 3) were present ipsilateral to the side of brain infarct, as compared to the contralateral side (p-value 0.004). Plaque ulceration was also observed to be present more frequently on the side of infarct (22.6% on the ipsilateral side and 5.4% on the contralateral side). Moreover, Diabetes mellitus and dyslipidemia were the most prevalent risk factors (78.2% and 65.2%, respectively) in patients with these types of plaques. Detection of heterogeneous plaques and plaque ulceration in patients may indicate future development of stroke, necessitating prompt and appropriate management protocols.Periodic screening of such patients with Carotid Duplex Ultrasonography is expected to be very helpful.

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Carotid plaque and type 2 diabetes mellitus

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.06.3595 ◽

2019 ◽

Vol 26 (06) ◽

Author(s):

Farhat Bashir ◽

Ayesha Nageen ◽

Saera Sohail Kidwai ◽

Jamal Ara

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Carotid Plaque ◽

Doppler Ultrasonography ◽

Laboratory Data ◽

P Value ◽

Cross Sectional ◽

Carotid Doppler

Atherosclerosis is the basic cause of macrovasular complications of diabetes mellitus. It affects all parts of the circulatory tree. An easy and reliable method of diagnosing atherosclerosis is Carotid Doppler ultrasonography. Increased Carotid Intima-Medial thickness (CIMT) and presence of carotid plaque is an important predictor of ischemic heart disease and cerebrovascular accidents. The purpose of this study was to find the association of carotid plaque with cardio-metabolic risk factors in type 2 diabetes mellitus. Study Design: Cross-sectional study. Setting: Medical Out-patient Department of Creek General Hospital, Karachi. Period: One year from June 2015 to May 2016. Subjects and Methods: The study population included 119 cases of type 2 diabetes mellitus. All subjects underwent Carotid Doppler ultrasonography. The demographic, anthropometric, clinical and laboratory data was collected and analyzed through SPSS ver.20.0. The relationship of carotid plaque with different atherosclerotic variables was assessed by Student’s t-test and Chi-square test. P-value of <0.5 was considered significant. Results: Out of 119 patients with type 2 diabetes mellitus, 18.5% had a carotid plaque. The presence of plaque was associated with duration of diabetes, presence of hypertension, BMI, diastolic blood pressure, total cholesterol, triglyceride levels and CIMT. Conclusion: We need to focus on management of the multiple metabolic abnormalities associated with diabetes mellitus in order to prevent atherosclerosis and its associated cardiovascular disease.

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Advances in 3-D Vascular Ultrasound Imaging

10.1115/imece1999-0388 ◽

1999 ◽

Author(s):

Aaron Fenster

Keyword(s):

Carotid Plaque ◽

Imaging Techniques ◽

Plaque Morphology ◽

Non Invasive ◽

Vascular Ultrasound ◽

The Past ◽

Plaque Disruption ◽

Plaque Ulceration ◽

Triggering Mechanisms ◽

Made In

Abstract In spite of the progress in the understanding of atherosclerotic disease made in the past two decades, neither the triggering mechanisms for carotid plaque haemorrhage and disruption, or the importance of plaque ulceration are well understood. Controversies exist because the mechanisms are complex and agreement on definitions (e.g., ulceration) is lacking. Advances in imaging techniques are helping to diagnose and quantify plaque morphology, composition, extent and ulceration (Steifler et al. 1994). In this paper we report on our work focusing on the development of improved non-invasive imaging tools, which will improve the accuracy and reduce the variability of the carotid exam and allow better serial monitoring. These will help elucidate the mechanisms contributing to the last phase of atherosclerosis — plaque disruption and haemorrhage.

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PENGARUH PIJAT BAYI TERHADAP KUALITAS TIDUR BAYI UMUR 0 – 3 BULAN DI WILAYAH KERJA PUSKESMAS SOSIAL PALEMBANG TAHUN 2016

Jurnal Kebidanan : Jurnal Medical Science Ilmu Kesehatan Akademi Kebidanan Budi Mulia Palembang ◽

10.35325/kebidanan.v6i2.91 ◽

2019 ◽

Vol 6 (2) ◽

Author(s):

Juliana Widyastuti Wahyuningsih Juliana Widyastuti Wahyuningsih

Keyword(s):

Experimental Design ◽

Growth And Development ◽

Sampling Technique ◽

P Value ◽

Development Phase ◽

Quality Of Sleep ◽

Infant Massage ◽

Before And After ◽

The Brain

ABSTRAK Tidur merupakan kebutuhan yang harus terpenuhi terutama pada fase perkembangan karena selama tidur akan terjadi perkembangan otak maupun tubuh, sehingga gangguan tidur merupakan masalah yang akan menimbulkan dampak buruk terhadap pertumbuhan dan perkembangan bayi. Kualitas tidur bayi yang baik dapat diciptakan dengan memberikan pemijatan bayi secara rutin. Penelitian ini bertujuan untuk membuktikan bahwa pemijatan dapat mempengaruhi kualitas tidur bayi umur 0-3 bulan. Penelitian ini menggunakan desain penelitian Quasy Eksperimental dengan metode One Group Pretest-Postest. Sampel 22 bayi yang dipilih dengan tehnik Total Sampling yang di observasi sebelum dan sesudah diberikan pemijatan. Variabel yang diukur dalam penelitian ini adalah kualitas tidur bayi 0-3 bulan. Hasil penelitian menunjukkan bahwa ada pengaruh pijat bayi terhadap kualitas tidur bayi umur 0-3 bulan (p value 0,008 < α = 0,05).Berdasarkan hasil penelitian ini disarankan agar keluarga dan masyarakat memberikan pemijatan secara rutin dan mandiri untuk meningkatkan kebutuhan tidur bayi yang berkualitas. ABSTRACT Sleep is a human necessity that must be met, especially in the development phase because during sleep will occur the brain and body developments, so that sleep disturbance is a problem that would cause adverse effects on infants’ growth and development. The good quality of sleep can be created by providing the infants massage routinely. This study aimed to prove that the massage could affect the quality of sleep on the 0-3 months old baby. This study used Quasy-experimental design with One Group Pretest-Posttest. The sample 22 infants selected by total sampling technique observed on before and after the massage. The variables measured in this study are the quality of sleep. The results of study indicate that there is an effect of infant massage to the sleep quality on 0-3 months old babies (p value 0,008 < α = 0,05).Based on the results of this study it recommended for the families and communities to provide infant massage regularly and independently to increase the quality of sleep on the baby.

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The analysis of the connection between plaque morphology of the asymptomatic carotid stenosis and ischemic brain lesions

Vojnosanitetski pregled ◽

10.2298/vsp110519020m ◽

2013 ◽

Vol 70 (11) ◽

pp. 993-998 ◽

Cited By ~ 3

Author(s):

Djordje Milosevic ◽

Janko Pasternak ◽

Vladan Popovic ◽

Dragan Nikolic ◽

Pavle Milosevic ◽

...

Keyword(s):

Risk Factors ◽

Carotid Stenosis ◽

Carotid Plaque ◽

Brain Infarction ◽

Statistical Significance ◽

Brain Parenchyma ◽

Plaque Morphology ◽

Asymptomatic Carotid Stenosis ◽

Asymptomatic Carotid ◽

Silent Brain Infarction

Background/Aim. A certain percentage of patients with asymptomatic carotid stenosis have an unstable carotid plaque. For these patients it is possible to register by modern imaging methods the existence of lesions of the brain parenchyma - the silent brain infarction. These patients have a greater risk of ischemic stroke. The aim of this study was to analyze the connection between the morphology of atherosclerotic carotid plaque in patients with asymptomatic carotid stenosis and the manifestation of silent brain infarction, and to analyze the influence of risk factors for cardiovascular diseases on the occurrence of silent brain infarction and the morphology of carotid plaque. Methods. This retrospective study included patients who had been operated for high grade (> 70%) extracranial atherosclerotic carotid stenosis at the Clinic for Vascular and Transplantation Surgery of the Clinical Center of Vojvodina over a period of 5 years. The patients analyzed had no clinical manifestation of cerebrovascular insufficiency of the carotid artery territory up to the time of operation. The classification of carotid plaque morphology was carried out according to the Gray-Weale classification, after which all the types were subcategorized into two groups: stable and unstable. Brain lesions were verified using preoperative imaging of the brain parenchyma by magnetic resonance. We analyzed ipsilateral lesions of the size > or = 3 mm. Results. Out of a 201 patients 78% had stable plaque and 22% unstable one. Unstable plaque was prevalent in the male patients (male/female ratio = 24.8% : 17.8%), but without a statistically significant difference (p > 0.05). The risk factors (hypertension, nicotinism, hyperlipoproteinemia, and diabetes mellitus) showed no statistically significant impact on carotid plaque morphology and the occurrence of silent brain infarction. Silent brain infarction was detected in 30.8% of the patients. Unstable carotid plaque was found in a larger percentage of patients with silent brain infarction (36.4% : 29.3%) but without a significant statistical difference (p > 0.05). Conclusions. Even though silent brain infarction is more frequent in patients with unstable plaque of carotid bifurication, the difference is of no statistical significance. The effects of the number and type of risk factors bear no statistical significance on the incidence of morphological asymptomatic carotid plaque.

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Synergistic Effects of Milk-Derived Exosomes and Galactose on α-Synuclein Pathology in Parkinson’s Disease and Type 2 Diabetes Mellitus

International Journal of Molecular Sciences ◽

10.3390/ijms22031059 ◽

2021 ◽

Vol 22 (3) ◽

pp. 1059

Author(s):

Bodo C. Melnik

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Dopaminergic Neurons ◽

Vagal Nerve ◽

Β Cells ◽

Pancreatic Β Cells ◽

The Brain

Epidemiological studies associate milk consumption with an increased risk of Parkinson’s disease (PD) and type 2 diabetes mellitus (T2D). PD is an α-synucleinopathy associated with mitochondrial dysfunction, oxidative stress, deficient lysosomal clearance of α-synuclein (α-syn) and aggregation of misfolded α-syn. In T2D, α-syn promotes co-aggregation with islet amyloid polypeptide in pancreatic β-cells. Prion-like vagal nerve-mediated propagation of exosomal α-syn from the gut to the brain and pancreatic islets apparently link both pathologies. Exosomes are critical transmitters of α-syn from cell to cell especially under conditions of compromised autophagy. This review provides translational evidence that milk exosomes (MEX) disturb α-syn homeostasis. MEX are taken up by intestinal epithelial cells and accumulate in the brain after oral administration to mice. The potential uptake of MEX miRNA-148a and miRNA-21 by enteroendocrine cells in the gut, dopaminergic neurons in substantia nigra and pancreatic β-cells may enhance miRNA-148a/DNMT1-dependent overexpression of α-syn and impair miRNA-148a/PPARGC1A- and miRNA-21/LAMP2A-dependent autophagy driving both diseases. MiRNA-148a- and galactose-induced mitochondrial oxidative stress activate c-Abl-mediated aggregation of α-syn which is exported by exosome release. Via the vagal nerve and/or systemic exosomes, toxic α-syn may spread to dopaminergic neurons and pancreatic β-cells linking the pathogenesis of PD and T2D.

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Development of [18F]LU14 for PET Imaging of Cannabinoid Receptor Type 2 in the Brain

International Journal of Molecular Sciences ◽

10.3390/ijms22158051 ◽

2021 ◽

Vol 22 (15) ◽

pp. 8051

Author(s):

Rodrigo Teodoro ◽

Daniel Gündel ◽

Winnie Deuther-Conrad ◽

Lea Ueberham ◽

Magali Toussaint ◽

...

Keyword(s):

Cannabinoid Receptors ◽

Cannabinoid Receptor ◽

Biological Evaluation ◽

Emission Tomography ◽

Tailored Therapy ◽

Positron Emission ◽

Cannabinoid Receptor Type 2 ◽

Attractive Therapeutic Target ◽

The Brain

Cannabinoid receptors type 2 (CB2R) represent an attractive therapeutic target for neurodegenerative diseases and cancer. Aiming at the development of a positron emission tomography (PET) radiotracer to monitor receptor density and/or occupancy during a CB2R-tailored therapy, we herein describe the radiosynthesis of cis-[18F]1-(4-fluorobutyl-N-((1s,4s)-4-methylcyclohexyl)-2-oxo-1,2-dihydro-1,8-naphthyridine-3-carboxamide ([18F]LU14) starting from the corresponding mesylate precursor. The first biological evaluation revealed that [18F]LU14 is a highly affine CB2R radioligand with >80% intact tracer in the brain at 30 min p.i. Its further evaluation by PET in a well-established rat model of CB2R overexpression demonstrated its ability to selectively image the CB2R in the brain and its potential as a tracer to further investigate disease-related changes in CB2R expression.

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Vitamin D status and risk of type 2 diabetes in the Norwegian HUNT cohort study: does family history or genetic predisposition modify the association?

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001948 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001948

Author(s):

Marion Denos ◽

Xiao-Mei Mai ◽

Bjørn Olav Åsvold ◽

Elin Pettersen Sørgjerd ◽

Yue Chen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Family History ◽

Genetic Predisposition ◽

Effect Modification ◽

P Value ◽

Family History Of Diabetes ◽

Increased Risk ◽

History Of

IntroductionWe sought to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and the risk of type 2 diabetes mellitus (T2DM) in adults who participated in the Trøndelag Health Study (HUNT), and the possible effect modification by family history and genetic predisposition.Research design and methodsThis prospective study included 3574 diabetes-free adults at baseline who participated in the HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys. Serum 25(OH)D levels were determined at baseline and classified as <50 and ≥50 nmol/L. Family history of diabetes was defined as self-reported diabetes among parents and siblings. A Polygenic Risk Score (PRS) for T2DM based on 166 single-nucleotide polymorphisms was generated. Incident T2DM was defined by self-report and/or non-fasting glucose levels greater than 11 mmol/L and serum glutamic acid decarboxylase antibody level of <0.08 antibody index at the follow-up. Multivariable logistic regression models were applied to calculate adjusted ORs with 95% CIs. Effect modification by family history or PRS was assessed by likelihood ratio test (LRT).ResultsOver 11 years of follow-up, 92 (2.6%) participants developed T2DM. A higher risk of incident T2DM was observed in participants with serum 25(OH)D level of<50 nmol/L compared with those of ≥50 nmol/L (OR 1.72, 95% CI 1.03 to 2.86). Level of 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in adults without family history of diabetes (OR 3.87, 95% CI 1.62 to 9.24) but not in those with a family history (OR 0.72, 95% CI 0.32 to 1.62, p value for LRT=0.003). There was no effect modification by PRS (p value for LRT>0.23).ConclusionSerum 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in Norwegian adults. The inverse association was modified by family history of diabetes but not by genetic predisposition to T2DM.

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The path from trigeminal asymmetry to cognitive impairment: a behavioral and molecular study

Scientific Reports ◽

10.1038/s41598-021-82265-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Maria Paola Tramonti Fantozzi ◽

Giulia Lazzarini ◽

Vincenzo De Cicco ◽

Angela Briganti ◽

Serena Argento ◽

...

Keyword(s):

Pupil Size ◽

Muscle Spindles ◽

Molecular Study ◽

Contralateral Side ◽

Acute Effects ◽

Adult Rats ◽

Afferent Inputs ◽

Acute And Chronic Effects ◽

The Brain ◽

Mandibular Branch

AbstractTrigeminal input exerts acute and chronic effects on the brain, modulating cognitive functions. Here, new data from humans and animals suggest that these effects are caused by trigeminal influences on the Locus Coeruleus (LC). In humans subjects clenching with masseter asymmetric activity, occlusal correction improved cognition, alongside with reductions in pupil size and anisocoria, proxies of LC activity and asymmetry, respectively. Notably, reductions in pupil size at rest on the hypertonic side predicted cognitive improvements. In adult rats, a distal unilateral section of the trigeminal mandibular branch reduced, on the contralateral side, the expression of c-Fos (brainstem) and BDNF (brainstem, hippocampus, frontal cortex). This counterintuitive finding can be explained by the following model: teeth contact perception loss on the lesioned side results in an increased occlusal effort, which enhances afferent inputs from muscle spindles and posterior periodontal receptors, spared by the distal lesion. Such effort leads to a reduced engagement of the intact side, with a corresponding reduction in the afferent inputs to the LC and in c-Fos and BDNF gene expression. In conclusion, acute effects of malocclusion on performance seem mediated by the LC, which could also contribute to the chronic trophic dysfunction induced by loss of trigeminal input.

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Association between White Matter Ischaemia and Carotid Plaque Morphology as Defined by High-resolution In Vivo MRI

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2009.04.005 ◽

2009 ◽

Vol 38 (2) ◽

pp. 149-154 ◽

Cited By ~ 9

Author(s):

A.J. Patterson ◽

J.M. U-King-Im ◽

T.Y. Tang ◽

D.J. Scoffings ◽

S.P.S. Howarth ◽

...

Keyword(s):

White Matter ◽

High Resolution ◽

Carotid Plaque ◽

Plaque Morphology

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Helicobacter pylori eradication in patients with type 2 diabetes mellitus: Multicenter prospective observational study

SAGE Open Medicine ◽

10.1177/2050312119832093 ◽

2019 ◽

Vol 7 ◽

pp. 205031211983209 ◽

Cited By ~ 2

Author(s):

Seung-Joo Nam ◽

Sung Chul Park ◽

Sang Hoon Lee ◽

Dong Wook Choi ◽

Sung Joon Lee ◽

...

Keyword(s):

Helicobacter Pylori ◽

Observational Study ◽

Prospective Observational Study ◽

Eradication Rate ◽

Laboratory Data ◽

P Value ◽

Diabetic Patients ◽

Multicenter Prospective Observational Study ◽

H Pylori

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.

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