scholarly journals Validity of Signal Peptide-CUB-EGF Domain-containing Protein-1 (SCUBE-1) in the Diagnosis of Aortic Dissection

2020 ◽  
Keyword(s):  
Aortic Dissection ◽  
Signal Peptide ◽  
Emergency Services ◽  
Case Series ◽  
Surface Protein ◽  
Sudden Onset ◽  
Control Group ◽  
Epidermal Growth Factor Domain ◽  
Specificity And Sensitivity ◽  
Contrast Enhanced

Introduction: Diagnosing aortic dissection (AD) in emergency services still represents a challenging issue as it may manifest not only well-known clinical findings such as sudden onset and severe chest pain but also atypical findings similar to ST elevation myocardial infarction or renal colic. Contrast-enhanced imaging investigations, which are expensive and risky due to possible complications, are necessary for diagnosis. Ultrasonography is not always reliable, which necessitates noninvasive diagnostic tests to support a clinical suspicion. Signal peptide-CUB (complement C1r/C1s, Uegf, and Bmp1)-EGF (epidermal growth factor) domain-containing protein 1 (SCUBE-1) is a cell surface protein produced during embryogenesis. This study was conducted to compare the levels of this novel biomarker between patients with AD and healthy volunteers. Methods: This prospective study was conducted on 20 patients diagnosed with AD using contrast-enhanced thoracoabdominal computed tomography angiography. Average age-matched 20 healthy subjects as a control group were included as a reference for biochemical parameters. Results: The mean SCUBE-1 levels were significantly higher in patients with AD [24.51 ( ± 3.01) ng/dL] than in the control group [12.11 ( ± 5.31) ng/dL] (p < 0.001). Receiver-operating characteristic (ROC) curve was plotted to analyze the specificity and sensitivity of AD diagnosis (with 95% confidence intervals), which revealed 95% sensitivity and 76% specificity when the SCUBE-1 level was >19.75 ng/dL.A significant correlation was also observed between dissection types and mortality, as well as extravasation state. Conclusions: This preliminary study demonstrated that plasma SCUBE-1 level is a better and specific biomarker for AD and may be used for diagnosing AD in emergency services. Wider case series and further clinical studies are required to confirm these findings.

Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Type A ◽  
Sudden Onset ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Syndrome ◽  
Bentall Procedure ◽  
The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

scholarly journals Oxidative Stress Biomarkers in Urine of Metal Carpentry Workers Can Be Diagnostic for Occupational Exposure to Low Level of Welding Fumes from Associated Metals

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3167
Author(s):  
Flavia Buonaurio ◽  
Maria Luisa Astolfi ◽  
Daniela Pigini ◽  
Giovanna Tranfo ◽  
Silvia Canepari ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Occupational Exposure ◽  
Oxidation Products ◽  
Control Group ◽  
Welding Fumes ◽  
Oxidative Stress Biomarkers ◽  
Limit Values ◽  
Stress Biomarkers ◽  
Specificity And Sensitivity ◽  
The Impact

Urinary concentrations of 16 different exposure biomarkers to metals were determined at the beginning and at the end of a working shift on a group of workers in the metal carpentry industry. Five different oxidative stress biomarkers were also measured, such as the oxidation products of RNA and DNA metabolized and excreted in the urine. The results of workers exposed to metals were compared to those of a control group. The metal concentrations found in these workers were well below the occupational exposure limit values and exceeded the mean concentrations of the same metals in the urine of the control group by a factor of four at maximum. Barium (Ba), mercury (Hg), lead (Pb) and strontium (Sr) were correlated with the RNA oxidative stress biomarker, 8-oxo-7, 8-dihydroguanosine (8-oxoGuo), which was found able to discriminate exposed workers from controls with a high level of specificity and sensitivity. The power of this early diagnostic technique was assessed by means of the ROC curve. Ba, rubidium (Rb), Sr, tellurium (Te), and vanadium (V) were correlated with the level of the protein oxidation biomarker 3-Nitrotyrosine (3-NO2Tyr), and Ba, beryllium (Be), copper (Cu), and Rb with 5-methylcytidine (5-MeCyt), an epigenetic marker of RNA damage. These effect biomarkers can help in identifying those workers that can be defined as “occupationally exposed” even at low exposure levels, and they can provide information about the impact that such doses have on their health.

Aortic tortuosity index as a predictor of type A aortic dissection

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Scalbert ◽  
O Milleron ◽  
M Para ◽  
R Raffoul ◽  
Q Pellenc ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Ct Scans ◽  
Control Group ◽  
Type A Aortic Dissection ◽  
Total Length ◽  
A Value ◽  
Straight Line ◽  
Patients At Risk ◽  
Geometric Length

Abstract Introduction The risk ok type A aortic dissection (AAD) depends on the degree of aortic wall's alteration, which can result in dilatation or tortuosity. The estimate of this risk relies solely on the evaluation of the diameter of the ascending aorta. Purpose The purpose of this study is to evaluate the presence and importance of aortic tortuosity in patients with type A aortic dissection. Method Postoperative CT scans of patients with type A aortic dissection were compared with CT scans from controls matched for gender and age. After 3D reconstruction, total length (actual distance along aortic center line = Ltot) and geometric length (length of a straight line between start and end of the aortic segment = Lgeo) were measured to calculate the tortuosity index (TI = Ltot / Lgeo). Results Ltot, Lgeo and TI from different aortic segments of the AAD group were higher than in the control group. Ltot and TI of the whole aorta (from aortic valve to bifurcation) were greater in patients with type A aortic dissection (527.7±46.1 mm vs. 475.8±39.7, p&lt;0.0001; and 2.05±0.24 vs. 1.98±0.21, p=0.002 respectively). Total length and TI were greater after exclusion of the ascending part, and a value of this TI &gt;1.3 identifies AAD patients with an accuracy of 74.8% (AUC = 0.792, p&lt;0.0001). TI is altered by risk factors for aortic dissection: it increases with hypertension and age but not by tobacco use, and TI decreases in diabetes. Conclusions Type A aortic dissection is associated with longer aorta and increased aortic tortuosity. This index may help recognize patients at risk for type A aortic dissection. Calculation of tortuosity indexes Funding Acknowledgement Type of funding source: None

scholarly journals Evaluation of Dry Eye after Implantable Collamer Lens Surgery

2020 ◽  
Author(s):  
Haiting Chen ◽  
Xueyan Feng ◽  
Guangzeng Niu ◽  
Yuxiang Fan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Series ◽  
Meibomian Gland ◽  
Quality Score ◽  
Control Group ◽  
Ocular Surface Disease Index ◽  
Implantable Collamer Lens ◽  
Lens Surgery ◽  
Breakup Time

<b><i>Objectives:</i></b> To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. <b><i>Methods:</i></b> This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. <b><i>Results:</i></b> A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. <b><i>Conclusions:</i></b> ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.

scholarly journals Autologous Platelet-Rich Fibrin (PRF) as an Adjunct in the Management of Osteoradionecrosis and Medication-Related Osteonecrosis of Jaws. Case Series in A Single Centre

2021 ◽  
Vol 11 (8) ◽  
pp. 3365
Author(s):  
Benjie Law ◽  
Hui Yuh Soh ◽  
Syed Nabil ◽  
Rama Krsna Rajandram ◽  
Abd Jabar Nazimi ◽  
...  
Keyword(s):  
Case Series ◽  
Cost Effective ◽  
Control Group ◽  
Platelet Rich Fibrin ◽  
Tissue Healing ◽  
Number Of Patients ◽  
Short Period ◽  
Oral And Maxillofacial Region ◽  
Surgical Adjunct ◽  
Autologous Platelet

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.

Evaluation of the Clinical Role of Strain Elastography in Patients Diagnosed With Congenital Torticollis

2021 ◽  
pp. 875647932098324
Author(s):  
Elif Özyazici Özkan ◽  
Mehmet Burak Ozkan ◽  
İshak Abdurrahman İsik
Keyword(s):  
Area Under The Curve ◽  
Muscle Group ◽  
Receiver Operating Curve ◽  
Control Group ◽  
Clinical Role ◽  
Congenital Muscular Torticollis ◽  
Cutoff Value ◽  
Strain Elastography ◽  
Specificity And Sensitivity ◽  
Muscular Torticollis

Objective: The objective of this study was to determine the elasticity of sternocleidomastoid muscle (SCM) in patients with congenital muscular torticollis (CMT). Methods: In all, 41 patients and 22 controls were included in the study, and the elasticity of the patients’ SCM was measured. Echogenicity, thickness, and strain values of the SCM were also obtained. Results: The thickness and strain values of the SCM were higher in the patient group than in the control group ( P = .02 and P = .15). For median values, there was no difference in echogenicity and strain. In the strain elastography evaluation of the receiver operating curve (ROC) for muscle echogenicity in the isoechoic muscle group, the specificity and sensitivity were determined to be 100% and 22%, respectively, for the area under the curve (AOC) value of 0.558 (95% confidence interval [CI], 0.424–0.6686), and the cutoff value was <1.4. In the hyperechoic muscle group, the ROC for AUC values was found to be 0.542 (95% CI, 0.411–0.6686), and the cutoff value was >1.4 with 100% sensitivity and 20.75 specificity. Conclusions: The strain elastography technique can be used in the diagnosis of CMT.

scholarly journals Acute Aortic Dissection in Pregnancy in a Woman with Undiagnosed Marfan Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mandana Master ◽  
Gavin Day
Keyword(s):  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Acute Aortic Dissection ◽  
Congenital Abnormalities ◽  
Surgical Repair ◽  
Phenotypic Expression ◽  
Sudden Onset ◽  
Lower Segment Caesarean Section ◽  
Type B Dissection ◽  
Type A Dissection

We report a case of acute aortic dissection in a lady of 28 weeks of gestation with undiagnosed Marfan syndrome. The patient had been seen in our antenatal clinics. Her history documented in her pregnancy record was negative for genetic/congenital abnormalities. There was no family history documented. Subsequently, at 28 weeks of gestation, the patient presented with sudden onset chest, jaw, and back pain. Further history revealed that her father had died at the age of 27 of an aortic dissection. Echocardiography showed aortic root dissection with occlusion of aortic branches. She subsequently underwent an emergency lower segment caesarean section followed by surgical repair of type A dissection. A simultaneous type B dissection was managed conservatively. On later examination, our patient fulfilled the diagnostic criteria for phenotypic expression of Marfan syndrome. Genetic testing also confirmed that she has a mutation of the fibrillin (FBN 1) gene associated with the disease.

Safety of a Protective Funnel in Primary Breast Augmentation: A Retrospective Analysis of 380 Multicenter Cases in the United States

2021 ◽  
Author(s):  
Aldo Lombardo ◽  
Alfred R Antonetti ◽  
Joel Studin ◽  
Frank Stile ◽  
Dudley Giles ◽  
...  
Keyword(s):  
Breast Augmentation ◽  
Case Series ◽  
The United States ◽  
Future Research ◽  
Control Group ◽  
Superficial Infection ◽  
Class 1 ◽  
Median Volume ◽  
Implant Size ◽  
Potential Risk Factors

Abstract Background Protective funnels devices are commonly used to deliver implants in primary breast augmentation (BA) yet there is a paucity of evidence-based data describing their safety in the literature. Objectives The purpose of the study was to assess the safety of protective funnels in primary BA within the first 30-days postoperatively. Methods This multi-center, Level 3 study retrospectively reviewed the surgical records of 380 consecutive patients (760 breasts) who underwent primary BA by nine board-certified plastic surgeons using the iNPLANT Funnel (Proximate Concepts LLC, Allendale, NJ, USA) for implant delivery between November 2019 and December 2020. Data was collected pertaining to demographics, implant information, surgery details, and postoperative complications. Results The mean patient age was 33 years and 76% patients had a BMI &lt; 25. Of this cohort, 11.4% were smokers, 0.8% had diabetes, and 83% were ASA class 1. All patients received smooth implants with a median volume of 375cc. A total of 8 (2.1%) complications were reported including: 3 hematomas (0.79%), 1 seroma (0.26%) and 1 superficial infection (0.26%). No patient required explantation. We identified ASA class, BMI, surgery duration, and implant size as potential risk factors. Conclusions The data suggest that use of protective funnels, such as the iNPLANT Funnel, in primary BA are a safe option when used according to the manufacturer’s IFU. Its use led to a low infection rate (0.26%) and a complication rate (2.1%) consistent with the average reported in the literature (2%-2.5%). 1 Implications for clinical practice are encouraging and future research will include a prospective analysis with a larger case series and potentially a control group.

Changes in headache frequency in premenopausal obese women with migraine after bariatric surgery: A case series

Cephalalgia ◽  
2011 ◽  
Vol 31 (13) ◽  
pp. 1336-1342 ◽  
Author(s):  
V Novack ◽  
L Fuchs ◽  
L Lantsberg ◽  
S Kama ◽  
U Lahoud ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Reduction ◽  
Case Series ◽  
Control Group ◽  
Obese Women ◽  
Specific Effects ◽  
Migraine Frequency ◽  
Reduced Frequency ◽  
Causal Nature ◽  
Post Bariatric Surgery

Background: The association between migraine and obesity gives the clinician with an exciting possibility to alleviate migraine suffering through weight-reduction gastric-restrictive operations. We hypothesized that bariatric weight-reduction intervention (gastric banding) will be associated with reduction of migraine burden in this population. Methods: A total of 105 women between 18 and 50 years of age, admitted for bariatric surgery between April 2006 and February 2007, were screened for migraine. Twenty-nine with diagnosis of migraine were enrolled into the prospective phase. We followed the migraine pattern of these patients for 6 months post bariatric surgery. Results: Baseline median migraine frequency was six headache days a month. Post bariatric surgery, the migraine-suffering women reported of a lower frequency of migraine attacks ( p < 0.001), shorter duration of the attacks ( p = 0.02), lower medication use during the attack ( p = 0.005), less non-migraine pain (44.8 vs. 33%, p = 0.05), and post-bariatric surgery reduction in headache-related disability assessed by the MIDAS and HIT-6 scores. There was a reduction in migraine frequency among both episodic (from four to one episodes a month) and chronic (from 16.8 to 8.5 episodes per month) migraine patient cohorts separately and combined. Conclusions: Among migraine-suffering premenopausal obese women, we found a reduced frequency of migraine attacks and improvement of headache-related disability post bariatric surgery. Our findings should be interpreted cautiously. The absence of a control group and the non-blinded nature of our small study make it difficult to draw firm conclusions about the causal nature of the headache changes observed in this population. Further study is needed to evaluate the possible specific effects of surgical weight loss on migraine in obese women.

scholarly journals Neurotoxicity of subarachnoid Gd-based contrast agent accumulation: a potential complication of intraoperative MRI?

2021 ◽  
Vol 50 (1) ◽  
pp. E12
Author(s):  
Monika Lauer ◽  
Arne Lauer ◽  
Se-Jong You ◽  
Sara Kluge ◽  
Elke Hattingen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Contrast Agent ◽  
Malignant Glioma ◽  
Adjuvant Treatment ◽  
Subarachnoid Space ◽  
Case Series ◽  
Extent Of Resection ◽  
Intraoperative Mri ◽  
Control Group ◽  
Icu Stay

OBJECTIVEIntraoperative MRI with Gd-based contrast agent (GBCA) improves the extent of resection of contrast-enhancing brain tumors. Signal changes of CSF due to perioperative GBCA leakage in the subarachnoid space have been reported. However, although GBCA potentially exhibits neurotoxic effects, so far no associated complications have been described. In this case series, the authors report a single-center cohort of patients with subarachnoid GBCA extravasation after intraoperative MRI and discuss potential neurotoxic complications and potential ways of avoiding them.METHODSAll patients with CSF signal increase on unenhanced T1-weighted and FLAIR images on postoperative MRI, who had previously undergone tumor resection with use of intraoperative MRI, were retrospectively included and compared with a control cohort. The control group was matched in age, tumor characteristics, and extent of resection; comparisons were made regarding postoperative seizures and ICU stay. A subgroup with initially diagnosed malignant glioma was additionally analyzed for potential delay of initiation of adjuvant treatment and overall survival.RESULTSSeven patients with postoperative GBCA accumulation in the subarachnoid space were identified; 5 presented with focal seizures and altered mental status postoperatively. Poor patient condition led to extended ICU stay and prolonged delay of the initiation of adjuvant treatment in patients with newly diagnosed malignant glioma. Overall survival was reduced compared to the matched control group.CONCLUSIONSThe results suggest that there might be a risk of neurotoxic complications if GBCA that is intravenously applied during neurosurgery leaks into the subarachnoid space. Patients with highly vascularized tumors with intraoperative bleeding seem to be especially at risk for GBCA accumulation and neurotoxic complications. Therefore, awareness of the potential risk of complicating GBCA leakage is mandatory in the application of intraoperative GBCA.

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