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Cureus ◽  
2022 ◽  
Rute Sousa Martins ◽  
Sara Rocha ◽  
Arlindo Guimas ◽  
Rosa Ribeiro

2022 ◽  
Vol 5 (1) ◽  
pp. 41-48
Hidayatullah Hidayatullah ◽  
Shobihatus Syifak ◽  
Choirotussanijjah Choirotussanijjah

Background: Intracerebral hemorrhage or ICH or hemorrhagic stroke is caused by bleeding within brain parenchyma. Riskesdas reported that stroke patients in Indonesia experienced an increase from 7 permil in 2013 to 10.9 permil in 2018. Mortality rate for ICH is estimated 40% in 1 month and 54% in 1 year. Rumah sakit Islam Jemursari (RSI) is the only type B hospital in Wonocolo sub-district, Surabaya city. This study aimed to analyze the pattern of incidents and variations of ICH at RSI Jemursari Surabaya.Method: This was a descriptive observational study. Medical record data is collected  from 2017-2019. The data were obtained from medical records section of total number of ICH, gender, age and outcome of patients. Furthermore, data is analyzed and illustrated through a bar chart and the frequency of mortality is calculated.Results: Total ICH patients at Jemursari Hospital were 310 with 192 male patients and 118 female patients over 3 years. Meanwhile, the most groups experienced ICH were 45-64 years, followed by +65 age group. This is consistent with several epidemiological studies related to ICH, where the incidence of ICH increases with increasing age. The mortality rate for ICH patients, in the 2017-2019 periode, was around 23-30%.Conclusion: It can be concluded that male more susceptible to ICH than female subjects. Meanwhile, the mortality rate for ICH patients ranged from 23-30% in the 2017-2019 period. It is necessary to carry out further evaluation related to other data from the patient. So it could describe incidence rate as well as an overview of the ICH profile at RSI Jemursari.

2022 ◽  
Vincenzo de Matteo ◽  
Felipe Forero ◽  
Sophia Marlene Busch ◽  
Philip Linke ◽  
Peter Wilhelm ◽  

Abstract Introduction The inner diaphyseal diameter of the distal femur, at 20 cm from the lateral joint line, is the strongest risk factor for predicting aseptic loosening in total knee arthroplasty using rotating hinge prosthesis. In this context, the Citak classification has been introduced presenting three different types of the distal femur anatomy. The aim of the study is to develop a novel classification system for the proximal tibia. Materials and Methods Two-hundred patients with standard knee antero-posterior radiographs were included in this study. We measured the inner diameter of the tibia 16 cm distally from the tibial plateau and 3 cm distally from the tibial spine. The ratio between these two measurements was applied as the novel index ratio. Results According to the 25th and 75th percentiles, three groups can be clustered for each gender. A higher distribution of the type B pattern was found in female and male patients. However, type A with a narrow inner diaphyseal diameter was less common in female patients The median intra-observer reliability for rater 1 was 0.997. The inter-observer reliability was high (ICC 0.998). There was a moderate correlation between the AP diameter and height (r = 0,568); a low correlation between the AP diameter and weight (r = 0.376). The novel index shows no significant correlation between the index ratio and height (r = 0.082), weight (r = 0.014) or BMI (r= - 0.038). The novel index shows no statistically significant correlation between the index ratio and height (r = 0.082) or weight (r = 0.014) or BMI (r= - 0.038). Conclusion The novel classification presents three different types of tibia for each gender: type C has a wider inner diaphyseal diameter compared to type A with a narrow inner diaphyseal diameter. Type B has the widest distribution among the subjects.

2022 ◽  
qinghua Yuan ◽  
Yafei Chang ◽  
Peipei Jiang ◽  
Ling Sun ◽  
Yitong Ma ◽  

Abstract Objective: To investigate the impact of MLL3 polymorphisms and Transforming growth factor-β (TGF-β) pathway additional their interactions with type B aortic dissection (AD) risk based on the Chinese population. Methods: We investigated the MLL3 (rs10244604, rs6963460, rs1137721), TGFβ1 (rs1800469), TGFβ2 (rs900), TGFR1 (rs1626340) and TGFR2 (rs4522809) gene polymorphisms analysis. Logistic regression was performed to investigate the association between 7 SNPs and Type B AD. GMDR software was used to analyze gene-gene and gene-environment interactions. Odds ratio (OR) with a 95% confidence interval (CI) was employed to evaluate the association of genes and Type B AD risk. Results: Genotypes and alleles distribution in case and control groups showed significant differences (P<0.05). Logistic regression has shown that the Type B AD risk was the highest in those with rs1137721 CT genotype, (OR=4.33, 95%CI=1.51-12.40). Meanwhile, WBC, Drinking, Hypertension, TG, and LDL-C were independent risk factors for Type B AD. Respectively, Logistic regression showed that the Type B AD risk was the highest in those with rs1137721-TT+CT and rs4522809-AA genotype (OR=6.72, 95% CI=1.56-29.84), and was lowest in those with rs1137721-CC and rs4522809-AA+GG genotype (OR=4.38, 95%CI=0.92-20.83). However, 55-month median long-term follow-up were not show significant.Conclusion: MLL3 (rs1137721) with TGFβ1 (rs4522809) polymorphisms may be closely related to the development of Type B AD. Inflammation reaction and lipid metabolism were associated with the morbility of Type B AD. Moreover, there exist gene-gene interactions among these susceptibility genes. These may become new diagnostic and research goal for Type B AD.

Marcia Helena Mota de Arruda ◽  
Emanuele Dal Pisol Schwab ◽  
Felipe Liss Zchonski ◽  
Josiane de Fátima da Cruz ◽  
Dauri José Tessmann ◽  
Type B ◽  

2022 ◽  
Vol 8 ◽  
Zhengbiao Zha ◽  
Youmin Pan ◽  
Zhi Zheng ◽  
Xiang Wei

Background: Stroke is a severe complication of patients with type B aortic dissection (TBAD) after thoracic endovascular aortic repair (TEVAR). Our aim is to identify predictors of stroke after TEVAR.Methods: From February 2016 to February 2019, 445 patients with TBAD who underwent TEVAR were retrospectively analyzed. Univariate and multivariate analyses were performed to identify predictors of stroke after TEVAR.Results: The total incidence of stroke was 11.5%, with transient neurological dysfunction (TND) of 10.6% and permanent neurological dysfunction (PND) of 0.9%. The average age of the patients was 53.0 ± 3.2 years, and the male/female ratio was 1.17. Univariate analysis suggested that age, body mass index (BMI), diabetes mellitus, chronic obstructive pulmonary disease (COPD), the urgency of repair, type of anesthesia, and left subclavian artery (LSCA) processing were potential risks factors of stroke after TEVAR. Multiple logistic regression identified that LSCA coverage (OR = 5.920, 95% CI: 2.077–16.878), diabetes mellitus (OR = 3.036, 95% CI: 1.025–8.995), and general anesthesia (OR = 2.498, 95% CI: 1.002–6.229) were independent predictors of stroke after TEVAR.Conclusions: Left subclavian artery (LSCA) coverage, diabetes mellitus, and general anesthesia were independent risk factors of stroke after TEVAR for TBAD.

Sven Zhen Cian Tan ◽  
Sidhant Singh ◽  
Joaquin Alfonso Palanca ◽  
Natasha Austin J ◽  
Matti Jubouri ◽  

Background The use of thoracic endovascular aortic repair (TEVAR) for the management of uncomplicated type B aortic dissection (un-TBAD) remains controversial. There is a lack of consensus over whether pre-emptive TEVAR should be carried out in patients with un-TBAD at risk of progression to complicated TBAD. We present a review of current evidence and seek to suggest criteria where endovascular intervention in un-TBAD may prove beneficial relative to pharmacotherapy alone. Methods and Materials PubMed and Cochrane databases were searched using terms including: type B aortic dissection, risk factors, medical therapy, TEVAR, false lumen expansion, and mortality. Papers were selected based on title and abstract. Results Optimal medical therapy remains the mainstay treatment for patients with un-TBAD, however patients with un-TBAD present with varying degrees of disease progression risk. Factors such as age, aortic morphology, history of connective tissue disorders, false lumen thrombosis, and aortic branch involvement may potentiate progression from un-TBAD to complicated TBAD. Short- and long-term outcomes associated with TEVAR for TBAD remain promising. Conclusion Pre-emptive TEVAR may be beneficial in patients with un-TBAD presenting with the above factors, however further prospective research into the optimal timing for TEVAR in un-TBAD is required.

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