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Author(s):  
Jie Zhang ◽  
Linlin Li ◽  
Fangwei Xiu

Diabetic retinopathy (DR) is the most common micro-vascular complication of diabetes, and the leading cause of vision loss and blindness globally. Due to the unsatisfied outcome of current therapies, a novel strategy needs to be developed. BV2 microglial cells were treated with 25 natural compounds respectively in the stimulation of high glucose (HG), to screen for the potential candidate drug. Streptozotocin (STZ)- induced diabetic mice were injected with different doses of the candidate Sesamin every two days for one month. Then, its protective role and possible mechanism were evaluated. Sesamin was selected as candidate drug due to its inhibition on the secretion of tumor necrosis factor-α (TNFα) in the screen assay. Sesamin also dose-dependently inhibited mRNA levels of HG-induced inflammatory cytokines, including TNFα, interleukin (IL)-1β and IL-6, activated NF-κB signaling pathway, and reduced oxidative stress by decreasing reactive oxygen species levels and increasing antioxidant enzymes in the BV2 and primary retinal microglia. Additionally, Sesamin alleviated brain-retinal barrier breakdown by Evan's blue leakage assay and reduced inflammation in Streptozotocin-induced diabetic mice. In conclusion, Sesamin effectively inhibits HG-induced microglial inflammation in the retina both in vivo and in vitro, suggesting that Sesamin might serve as a candidate drug for DR treatment.


Theranostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 277-289
Author(s):  
Long Suo ◽  
Chang Liu ◽  
Qiu-Yang Zhang ◽  
Mu-Di Yao ◽  
Yan Ma ◽  
...  

2021 ◽  
Vol 15 (12) ◽  
pp. 3542-3544
Author(s):  
Maria Mahmood ◽  
Sameer Qureshi ◽  
Rehana, . ◽  
Najaf Abbas ◽  
Uneeba Rehman ◽  
...  

Objective: To determine frequency of complication of modified radical neck dissection in patients at a tertiary care hospital Karachi, Pakistan Material and Methods: Study design: This is a cross sectional section study, conducted at Department of ENT, for Six months from January 1, 2019 to July 1, 2019. All the patients who fulfilled the inclusion criteria and visited to department of ENT, were included in the study after taking informed consent. Patients were discharged by 48-72 hours postoperatively. Patients were assessed daily till the time of discharge for occurrence of nerve complication, wound complications and vascular complications. Data was entered and analyzed by SPSS 21 software. Mean, Frequency and percentage were given for continuous and discreet data respectively. Chi squire test was applied to detect significance. P value of < o.o5 was taken as significant. Results: Mean ± SD of age was 40.31±9.54 with C.I (38.62.......41.99) years. Out of 126 patients 84 (67%) were male and 42 (33%) were female. Out of 126 cases complication 46(37%) developed nerve complication, 47 (37%) had wound complication and vascular complication was documented in 27(21%) cases. Conclusion: surgical complications after modified radical neck surgery are not uncommon. Wound complication was found to be most common followed by nerve and vascular complication. Therefore proper antiseptic measures before, during and after surgery, patient care and careful surgical steps have a role in preventing these dreadful complications. Keywords: Modified Radical Neck Dissection, Complications, Nerve Complication, Wound Complication, Vascular Complication


Author(s):  
Krishan Kumar Meena ◽  
Praveen Sharma ◽  
Swati Srivastava ◽  
Uma Kumari Meena

Introduction: Diabetes mellitus (DM) is common metabolic disorder leading to various complications including micro-vascular complication. Diabetes and thyroid dysfunction can result in abnormalities of one another, as both are strongly implicated in cellular metabolism.  Aim of study was to establish any association between hypothyroidism and micro-vascular complications in patients of type 2 DM. Material and Methods: This Hospital based Cross sectional analytical Study was included 80 Euthyroid and 80 hypothyroid patients of type 2 DM. These patients were subjected to fundus examination (for retinopathy), urine for spot albumin and creatinine ratio and routine microscopy (for nephropathy), clinical examination and NCV (for neuropathy). Results: Age of patients ranged from 30 – 80 years. Most patients had duration of Diabetes > 5 years. Diabetic retinopathy was found in 15% Euthyroid and 37.5% Hypothyroid diabetics (p=0.002). Neuropathy was more in Hypothyroid (35%) as compared to Euthyroid (12.5%) patients (p=0.003). Prevalence of Nephropathy was also significantly more (p=0.011) in Hypothyroids (60%) as compared to Euthyroid (38.75%). Conclusion: Significant association was found between hypothyroidism and micro vascular complications in type 2 Diabetes mellitus. Screening of diabetics for thyroid functions is essential to reduce morbidity. Keywords: Diabetes, thyroid, retinopathy, neuropathy, nephropathy


2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Matteo Maurina ◽  
Damiano Regazzoli ◽  
Francesco Condello ◽  
Antonio Mangieri ◽  
Giulio Giuseppe Stefanini ◽  
...  

Abstract Aims Despite increasing experience and device innovation with transcatheter aortic valve implantation (TAVI), vascular complications are still a major problem and endovascular management is generally the first option. When stent implantation is required, self expandable (SE) stents are generally preferred over balloon expandable (BE) stents as they are more elastic and less compressible. However, BE stents support higher radial outward force, adhere to the vase lumen with greater precision and are less expensive. As no large registry reported data about stents BE alone in this setting, we report our experience with BE stents implantation to manage a vascular complication after TAVI. We believe that our work could be useful and possibly serves as a starting point for future research. Methods and results We retrospectively collected baseline, procedural and follow-up data about 78 patients who were implanted with a BE stent to manage a vascular complication after TAVI. At a median clinical follow-up of 410 days (IQR: 66–1016 days), no percutaneous or surgical interventions were reported after discharge. No cases of symptomatic leg-ischaemia were reported and only one patient was symptomatic for claudication. Doppler follow-up (available for 25 patients; 32%) showed no cases of stent fracture or displacement. Conclusions Our experience showed good acute and long-term results of BE covered stent implantation to manage a vascular complication after TAVI. It is possible that a greater radial outward force is a good choice in terms of hemostasis without necessarily being associated with stent deformation/fracture resulting in restenosis or further interventions. While present data may not be generalized, they may be useful to critically re-evaluate (and eventually reduce) the need of SE stents when treating femoral arteries bleedings.


2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giuseppe Panuccio ◽  
Iolanda Aquila ◽  
Sabato Sorrentino ◽  
Giuseppina Mascaro ◽  
Annalisa Mongiardo ◽  
...  

Abstract Aims The TAVI registry represents a single-centre observational retrospective study that consecutively collected symptomatic patients with severe aortic stenosis between September 2009 and February 2021 at the Magna Graecia University (Catanzaro, Italy). Our aim was to evaluate the rate of complications which can occur after Transcatheter aortic valve replacement (TAVR) and its possible predictors. Methods We included a total of 346 consecutive patients, admitted to our institution between September 2009 and February 2021. Inclusion criteria were: severe aortic stenosis in high-risk patients unsuitable for surgery after cardiac team consent, valve anatomy adjusted according to device instructions for use, life expectancy&gt; 1 year. Clinical, echocardiographic and procedural data were collected and reported in an electronic database. Surgical risk was prospectively assessed using the European Cardiac Operational Risk Assessment System (EuroSCORE II, https://www.euros core.org/calc.html). The mean age of the population was 80.3 ± 5.4 years; 144 patients (41.6%) were male. The average EuroSCORE II was 6.3 ± 5.7. All reported P-values are two-sided and P-values &lt;0.05 were considered significant. STATA (StataCorp, USA) was used for data analysis. Results Out of the total population analysed, the number of patients who underwent a vascular complication was 23 or 6.6%. Female sex was an independent predictor of vascular complication (P 0.015) regardless of the presence of peripheral vascular disease (OR 3.73; 95% CI 1.20–11.5), while no correlation was found with BSA. The number of patients experiencing severe bleeding and/or need for transfusion was 85 or 24.6% of the total. Mean baseline haemoglobin values were 12.1 g/dL ± 1.7 with lower mean values reported during hospitalization of 9.2 g/dL ± 1.4 (P &lt;0.001), while predicted values at discharge were 9.8 g/dL ± 1.2. The pre and post procedural PR interval value was 171.1 ± 33.6 ms vs. 193.3 ± 35.7 ms (P &lt;0.001) (Figure 2). The pre-procedural QRS interval value was 95.0 ± 21.7, the post-procedural mean value was 115.4 ± 26.5 (P &lt;0.001). The number of patients with QRS&gt; 120 ms after the procedure was 92 (26.5%). Out of the total number of patients analysed, the number of subjects who required PM implantation was 77 patients, i.e. 22.3% of the total. Of these, 25 patients (32.4%), Evolut R 45 patients (58.6%) and Sapien 7 patients (9.0%) had received implants. The need for pacemaker implantation did not affect the average length of stay (P 0.5). Conclusions Since its advent, the transfemoral aortic valve prosthesis implant has experienced impressive and continuous growth, radically revolutionizing the treatment of symptomatic severe aortic stenosis. Furthermore, the clear improvement of the procedural safety and efficacy profiles, due on the one hand to the technological evolution of the devices, of the introduction and release systems and of the experience of the operators, has reduced the number of complications related to the implant and improved the management of the same.


2021 ◽  
pp. 152660282110594
Author(s):  
Hirokazu Miyashita ◽  
Noriaki Moriyama ◽  
Mika Laine

Purpose: There is no report on the reproducibility of the ultrasound-navigated MANTA deployment (US-MANTA) technique and little is known about predictors for US-MANTA-related vascular complication (VC). This study aimed to assess the incidence and predictors of access-site VC using the US-MANTA technique and report insights of MANTA-related VC from consecutive cases following large-bore arteriotomy. Materials and Methods: Consecutive patients who underwent transfemoral transcatheter aortic valve replacement with the US-MANTA technique from November 2018 to February 2020 were evaluated. MANTA-related VC was defined as access-site complications leading to major or minor VCs based on Valve Academic Research Consortium-2 criteria. Results: Among 378 patients, 23 cases (6.1%) of MANTA-related VC (major VC: n=7 [1.9%], minor VC: n=16 [4.2%]) were identified. No significant difference was observed in the incidence of MANTA-related VC over the observational period (first quartile: 5.3%, second: 5.4%, third: 7.4%, and fourth: 6.3%, p>.50). In 7 patients with MANTA-related major VC, 4 (57.1%) of complications resulted from incomplete apposition of the toggle due to anterior wall calcification of the common femoral artery (CFA). Anterior calcification of the CFA determined by computed tomography was identified as an independent predictor of MANTA-related VCs. Conclusions: The US-MANTA technique sustainably provides a low rate of access-site VCs following large-bore arteriotomy. Incomplete apposition of the toggle due to anterior calcification of the CFA may lead to ongoing vascular and bleeding complications.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yu Sun ◽  
Huiling Zou ◽  
Xingjia Li ◽  
Shuhang Xu ◽  
Chao Liu

BackgroundsDiabetic retinopathy (DR), the main retinal vascular complication of DM, is the leading cause of visual impairment and blindness among working-age people worldwide. The aim of this study was to investigate the difference of plasma metabolic profiles in patients with DR to better understand the mechanism of this disease and disease progression.MethodsWe used ultrahigh-performance liquid Q-Exactive mass spectrometry and multivariate statistical analyses to conduct a comprehensive analysis of plasma metabolites in a population with DR and proliferative DR (PDR). A risk score based on the level of the selected metabolite was established and evaluated using the least absolute shrinkage and selection operator regularization logistic regression (LASSO-LR) based machine learning model.Results22 differentially expressed metabolites which belonged to different metabolic pathway were identified and confirmed to be associated with the occurrence of DR. A risk score based on the level of the selected metabolite pseudouridine was established and evaluated to strongly associated with the occurrence of DR. Four circulating plasma metabolites (pseudouridine, glutamate, leucylleucine and N-acetyltryptophan) were identified to be differentially expressed between patients with PDR and other patients, and a risk score formula based on these plasma metabolites was developed and assessed to be significantly related to PDR.ConclusionsOur work highlights the possible use of the risk score assessment based on the plasma metabolites not only reveal in the early diagnosis of DR and PDR but also assist in enhancing current therapeutic strategies in the clinic.


Author(s):  
Catharina Strauss ◽  
Alexandra Anker ◽  
Silvan Klein ◽  
Robert Kemper ◽  
Vanessa Brebant ◽  
...  

BACKGROUND: Early detection and treatment of vascular complications in replanted digits is essential for the survival. The perfusion index (PI) represents a marker of peripheral perfusion as it shows the ratio of pulsatile to non-pulsatile blood flow. OBJECTIVE: To evaluate the feasibility and applicability of the PI as a monitoring tool for free flaps and replanted digits by measuring the inter- and intraindividual changes in PI. METHODS: Five patients were postoperatively monitored according to intern standards by hourly clinical evaluation. Additionally, a pulse oximeter with SET-technology® (Masimo Radial 7, Masimo Corporation, Irvine, USA) was added with a LNCS® Red TFA-1 SpO2 sensor (Masimo Corporation, Irvine, USA) and respectively a LNCS® Neo-3 neonatal finger clip to evaluate the perfusion via PI and SpO2. RESULTS: All patients showed sufficient perfusion in clinical controls. There was no detectable vascular complication during follow-up. Mean perfusion index was 0.93 with a median of 0.44. The patients showed a mean SpO2 of 90.59%with a median of 89.21%. CONCLUSION: Our results show a great intra- and interindividual range of PI and SpO2. SpO2 provided an even greater range than PI. Trends in intraindividual PI changes may be a promising monitoring tool for free flaps and replanted digits.


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