An alternative digital workflow for fabricating a mandibular implant-supported complete fixed dental prosthesis with limited restorative space: A clinical report

Publication date: Available online 23 March 2018
Source:The Journal of Prosthetic Dentistry
Author(s): Druthil Belur, William W. Nagy
This clinical report describes the prosthetic rehabilitation of a patient with a mandibular implant-supported complete fixed dental prosthesis with limited interocclusal restorative space. The problem was manifested by repeated fractures of the acrylic resin teeth and distortion of the supporting framework. The definitive restoration included a custom computer-aided design and computer-aided manufacturing (CAD-CAM) titanium framework with the lingual cusps and most of the occlusal table of the mandibular posterior teeth milled in titanium as part of the framework. An esthetic CAD-CAM milled denture base along with teeth was bonded over this framework.



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Comparison of the Dietary Antioxidant Profiles of 21 a priori Defined Mediterranean Diet Indexes

Publication date: Available online 24 March 2018
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Angela Hernández-Ruiz, Belén García-Villanova, Eduardo Guerra-Hernández, Pilar Amiano, María-José Sánchez, Miren Dorronsoro, Esther Molina-Montes
BackgroundThe Mediterranean Diet (MD) is a dietary pattern that features a high quotient of antioxidant-rich foods. Differences in the level of dietary antioxidants intake reflected by different MD indexes has received little research attention.ObjectiveThe purpose of this study was to compare the dietary antioxidant profile of 21 a priori defined indexes of adherence to the MD.DesignA cross-sectional study.Participants/settingA total of 14,756 participants belonging to two Spanish European Prospective Investigation into Cancer and Nutrition cohorts, aged 32 to 69 years, recruited between 1992 and 1996, were included.Main outcome measureParticipants provided information on diet through a validated diet history questionnaire. Antioxidants (vitamin C, beta carotene and α-tocopherol), total antioxidant capacity, total polyphenols, flavonoids, and polyphenol antioxidant content score were estimated using different food composition databases. Twenty-one MD indexes were operationalized.Statistical analysisSpearman correlation coefficients between the indexes were calculated and hierarchical clustering was applied to identify cluster groups. Weighted kappa statistic was estimated to value the scoring agreements between indexes. Antioxidant profiles between the MD indexes were compared based on geometric mean intakes. The relationship between each MD index with the components of the antioxidant profile was evaluated using linear multivariable regression analysis.ResultsCorrelation patterns between the MD indexes showed that about half of the indexes were moderately-to-weakly correlated with each other (rho<0.5). The main cluster groups derived denoted the high-, moderate-, and low-correlated MD indexes. Three MD indexes (MD pattern-2002, Prevention with MD, and Alternate MD index) presented the highest mean intakes of antioxidant vitamins, total antioxidant capacity, total polyphenols, flavonoids, and polyphenol antioxidant content score. These and other indexes (mainly those belonging to the MD Scale group) captured higher intake levels of dietary antioxidants overall.ConclusionsThe level of dietary antioxidant intake that is captured through the different MD indexes differed due to the variation in their construction. Study results also suggest that some MD indexes reflect a higher antioxidant profile.



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A Leadership Taxonomy for Clinical Dietetics Practice

Publication date: Available online 24 March 2018
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Emily Vaterlaus Patten, Kevin Sauer




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The genus Datura L. (Solanaceae) in Mexico and Spain – Ethnobotanical perspective at the interface of medical and illicit uses

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Guillermo Benítez, Martí March-Salas, Alberto Villa-Kamel, Ulises Cháves-Jiménez, Javier Hernández, Nuria Montes-Osuna, Joaquín Moreno-Chocano, Paloma Cariñanos
Ethnopharmacological relevanceThe different species of the genus Datura have been used traditionally by some pre-Columbian civilizations, as well as in medieval rituals linked to magic and witchcraft in both Mexico and Europe. It is also noteworthy the use of different alkaloids obtained from the plants for medicinal purposes in the treatment of various groups of diseases, especially of the respiratory and muscularskeletal systems.Aim of the studyA review of the ethnobotanical uses of the genus Datura in Mexico and Spain has been conducted. We focus on the medicinal and ritualistic uses included in modern ethnobotanical studies, emphasizing the historical knowledge from post-colonial American Codices and medieval European texts. Datura's current social emergency as a drug of recreation and leisure, as well as its link to crimes of sexual abuse is also considered. The work is completed with some notes about the distribution and ecology of the different species and a phytochemical and pharmacological review of Datura alkaloids, necessary to understand their arrival in Europe and the ethnobotanical uses made since thenMaterials and methodsA literature review and compilation of information on traditional medicinal uses of the genus has been carried out from the main electronic databases. Traditional volumes (codices) have also been consulted in libraries of different institutions. Consultations have been made with the National Toxicological Services of Spain and Mexico for toxicological data.ResultsA total of 118 traditional uses were collected in both territories, 111 medicinal ones to be applied in 76 conditions or symptoms included in 13 pathological groups. Although there are particular medicinal uses in the two countries, we found up to 15 similar uses, of which 80% were previously mentioned in post-Colonial American codices. Applications in the treatment of asthma and rheumatism are also highlighted. Apart from medicinal uses, it is worth noting their cultural and social uses, in the case of Mexico relating to diseases such as being scared, astonishment or falling in love, and in the case of Spain, as a recreational drug and lately, for criminal purposes.ConclusionsThis review highlights the variety of uses traditionally given to the different species in both territories. The fact that most of the coincident or similar uses in both countries also appear in the classical codices can be found an example of the flow, not only of the plants from America to Europe, but also of their associated information. It is also relevant that particular uses have derived in both countries, reflecting the difference in the cultural factors and traditions linked to rituals and cultural practices. Finally, the significant growth of Datura consumption in recent years as a drug of leisure and recreation, as well as in crimes of sexual submission, should be considered as research of maximum relevance in the field of forensic botany and toxicology.

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The effects of Nigella sativa L. on obesity: A systematic review and meta-analysis

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Nazli Namazi, Bagher Larijani, Mohammad Hossein Ayati, Mohammad Abdollahi
Ethnopharmacological relevanceNigella sativa L. (N.sativa) is a traditional herbal medicine that has been used for centuries to treat rheumatoid arthritis, diabetes, asthma, and other metabolic disorders. Recently, anti-obesity characteristics of N.sativa have been indicated.Aim of the studyThe effects of N. sativa as a complementary therapy in obesity management remains controversial. We aimed to perform a meta-analysis on the effects of supplementation with N. sativa on some anthropometric indices in adult subjects.Materials and methodsWe searched PubMed/Medline, Cochrane Library, ISI Web of Science, and Scopus databases until June 2017 to identify relevant placebo-controlled clinical trials. Data was reported as weighted mean differences and standard deviations to show the magnitude of effects for N. sativa on body weight, body mass index (BMI) and waist circumference (WC).ResultsFindings of 11 studies revealed that N. sativa supplement reduced body weight (−2.11 kg, 95% CI: −3.61, −0.61, I²:72.4%), BMI (−1.16 kg/m²; 95%CI: −1.81, −0.51; I²: 40.1%) and WC (−3.52 cm, 95%CI: −4.10, −2.92, I² =0%) significantly compared to placebo groups.ConclusionSupplementation with N. sativa exerts a moderate effect on reduction in body weight, BMI and WC. However, due to the high heterogeneity for body weight and limited high quality studies, the findings should be declared by caution. No serious side effects were also reported following N. sativa supplementation. Further studies are needed to clarify the effects of N. sativa on other anthropometric indices.

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Pien-Tze-Huang protects cerebral ischemic injury by inhibiting neuronal apoptosis in acute ischemic stroke rats

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Xiaoqin Zhang, Yiping Zhang, Songqi Tang, Lishuang Yu, Youqin Zhao, Qiangqiang Ren, Xiaoqiang Huang, Wen Xu, Mingqing Huang, Jun Peng
Ethnopharmacological relevancePien-Tze-Huang (PZH) is a famous formula of traditional Chinese medicine used to treating stroke. However, the protective effect of PZH and its mechanisms in acute ischemic stroke remain to be explored.Aim of the studyTo investigate the protective effect of PZH on neuronal apoptosis in acute cerebral ischemic injury rats and explore its underlying mechanisms.Materials and methodsThe effects of PZH were studied in acute ischemic stroke rats induced by transient middle cerebral artery occlusion, and the mitochondria-mediated apoptotic proteins including cytochrome C (Cyt C), Bax, Bcl-xl, P53, caspase-3, and caspase-9 as well as AKT and glycogen synthase kinase-3 beta (GSK-3β) were assessed.ResultsFour days of PZH treatment (180 mg/kg) could significantly reduce cerebral infarct volume, improve neurological deficit, attenuate inflammatory response, and inhibit neuronal apoptosis in acute ischemic stroke rats. Moreover, PZH treatment significantly decreased cytosolic Cyt C, Bax, P53, cleaved caspase-3, and cleaved caspase-9 levels, but elevated mitochondrial Cyt C and Bcl-xl levels. PZH treatment also increased phosphorylation of AKT and GSK-3β.ConclusionPZH potently protects the brain from cerebral ischemia/reperfusion injury in vivo, and inhibiting mitochondria-mediated neuronal apoptosis as well as attenuating inflammatory responses may be involved in this effect. This study provides experimental basis of PZH in treating acute cerebral ischemic stroke, which would provide some novel insights for its prevention and treatment of ischemic stroke.

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Chemical characterization, pharmacological effects, and toxicity of an ethanol extract of Celtis pallida Torr. (Cannabaceae) aerial parts

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Edgar Isaac Rojas-Bedolla, Jorge Luis Gutiérrez-Pérez, Mario Iván Arenas-López, Marco Martin González-Chávez, Juan Ramón Zapata-Morales, Claudia Leticia Mendoza-Macías, Candy Carranza-Álvarez, Juan José Maldonado-Miranda, Martha Alicia Deveze-Álvarez, Angel Josabad Alonso-Castro
Ethnopharmacological relevanceCeltis pallida Torr (Cannabaceae) is employed as a folk medicine for the treatment of inflammation, pain, skin infections, and diarrhea, among other diseases.Aim of the studyThe purpose of this work was to assess the chemical composition, the in vitro and in vivo toxicity, the antimicrobial, anti-inflammatory, antidiarrheal, antinociceptive, locomotor, and sedative effects of an ethanolic extract obtained from Celtis pallida aerial parts (CPE).Materials and methodsThe composition of CPE was carried out by GC-MS. The in vitro and in vivo toxic activity of CPE was estimated with the comet assay (10–1000 µg/ml) for 5 h in peripheral blood mononuclear cells, and the acute toxicity test (500–5000 mg/kg p.o.), for 14 days, respectively. The antimicrobial effect of CPE was evaluated using the minimum inhibitory concentration (MIC) assay, whereas the antidiarrheal activity (10–200 mg/kg p.o.) was calculated using the castor oil test. The antinociceptive effects of CPE (50–200 mg/kg p.o.) were estimated with the acetic acid and formalin tests, as well as the hot plate test. The sedative and locomotor activities of CPE (50–200 mg/kg p.o.) were assessed with the pentobarbital-induced sleeping time test and the rotarod test, respectively.ResultsThe main compound found in CPE was the triterpene ursolic acid (22% of the extract). CPE at concentrations of 100 µg/ml or higher induced genotoxicity in vitro and showed low in vivo toxicity (LD50 > 5000 mg/kg p.o.). Additionally, CPE lacked (MIC > 400 µg/ml) antimicrobial activity but exerts antinociceptive (ED50 = 12.5 ± 1.5 mg/kg) and antidiarrheal effects (ED50 = 2.8 mg/kg), without inducing sedative effects or altering the locomotor activity. The antinociceptive activity of CPE suggests the participation of adrenoceptors, as well as the nitric oxide/cyclic guanosine monophosphate (cGMP) pathway.ConclusionC. pallida exerts its antinociceptive effects probably mediated by the nitric oxide/cyclic guanosine monophosphate (cGMP) pathway.

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Anti-thrombotic and pro-angiogenic effects of Rubia cordifolia extract in zebrafish

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Yi Chen, Pei-Dong Chen, Bei-Hua Bao, Ming-Qiu Shan, Kai-Cheng Zhang, Fang-Fang Cheng, Yu-Dan Cao, Li Zhang, An-Wei Ding
Ethnopharmacological relevanceRubia cordifolia is a common traditional Chinese medicine that promotes blood circulation and eliminates blood stasis, and has been used to cure diseases related to blood stasis syndrome (BSS) clinically for many years. It has been previously demonstrated that anti-thrombosis and pro-angiogenesis can improve BSS. However, the anti-thrombotic and pro-angiogenic activities of Rubia cordifolia have not been well investigated.Aim of studyTo determine the potential anti-thrombotic and pro-angiogenic activities of Rubia cordifolia and to elucidate the underlying mechanisms. In addition, the major chemical constituents of Rubia cordifolia extract (QC) were qualitatively analysed by UPLC-Q-TOF/MS to explore the association between pharmacological activity and chemical constituents.Material and methodsThe QC samples were composed of a 95% ethanol extract and an aqueous extract following extraction using 95% ethanol. UPLC-Q-TOF/MS was used to analyse the major chemical constituents of QC. For the anti-thrombotic experiment of QC, a phenylhydrazine (PHZ)-induced AB strain zebrafish thrombosis model was used. The zebrafish larvae were stained using O-dianisidine, and the heart and caudal vein of the zebrafish were observed and imaged with a fluorescence microscope. The staining intensity of erythrocytes in the heart (SI) of each group and the morphology of thrombus in the caudal vein were used to assess the anti-thrombotic effect of QC. For the pro-angiogenic assay of QC, the intersegmental blood vessel (ISV) insufficiency model of Tg(fli-1: EGFP)y1 transgenic zebrafish (Flik zebrafish), which was induced by the VEGF receptor tyrosine kinase inhibitor II (VRI), was used. The morphology of the intact ISVs and defective ISVs was observed to evaluate the pro-angiogenic activity of QC. The mechanism involved in promoting angiogenesis was studied with real-time PCR.ResultsA total of 12 components in QC were identified based on standard compounds and references, including nine anthraquinones and three naphthoquinones. After treatment with QC, the PHZ-induced thrombosis in AB strain zebrafish larvae decreased to a certain degree, which we believe was related to its dosages, and the therapeutic effect within the 50–200 µg/mL QC treatment groups was especially prominent (P < 0.01, P < 0.001) compared to that in the PHZ model group. Similarly, QC also recovered the loss of the ISVs, which was induced by VRI in Flik zebrafish larvae, which have a certain dose-effect relationship. The pro-angiogenic activity of QC was also conspicuous (P < 0.01, P < 0.001) compared to that of the VRI model group. The following real-time PCR assay proved that QC significantly restored the VRI-induced downregulation of vWF, VEGF-A, kdrl, and flt-1 in Flik zebrafish (P < 0.05, P < 0.01, P < 0.001).ConclusionsA total of 12 compounds from QC were analysed by UPLC-Q-TOF/MS. The data of the pharmacological experiments demonstrated that QC presented anti-thrombotic and pro-angiogenic activities in zebrafish, and the principal active components were likely anthraquinones and naphthoquinones. Thus, the current study provided a theoretical basis for the clinical use of Rubia cordifolia as a traditional Chinese medicine in promoting blood circulation and eliminating stasis.

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The inhibitory effect of gypenoside stereoisomers, gypenoside L and gypenoside LI, isolated from Gynostemma pentaphyllum on the growth of human lung cancer A549 cells

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Shao-Fang Xing, Lin-Hua Liu, Ma-Li Zu, Xiao-Fan Ding, Wei-Ye Cui, Tuo Chang, Xiang-Lan Piao
Ethnopharmacological relevanceGypenosides are major constituents in Gynostemma pentaphyllum (Thunb.) Makino. Previous studies have shown that gypenosides isolated from G. pentaphyllum possess inhibitory effect on the growth of cancer cells, especially A549 cells, with structure-activity relationship (SAR). However, the underlying mechanism of gypenoside-induced A549 cell death remains to be clarified.Aim of the studyTo further investigate SAR and the underlying mechanism of gypenosides in A549 cells.Materials and methodsGypenosides were isolated from G. pentaphyllum using chromatography methods and identified using MS and NMR data. The cytotoxicity was determined with CCK-8 assay. The effects of gypenosides on apoptosis, cell cycle and migration were investigated through cell morphology observation, flow cytometry analysis and key proteins detection.ResultsThree gypenosides, 2α,3β,12β,20(S)-tetrahydroxydammar-24-ene-3-O-β-D-glucopyranoside-20-O-β-D-glucopyranoside, gypenoside L and gypenoside LI were isolated from G. pentaphyllum. Gypenoside stereoisomers, gypenoside L (S configuration at C20) and gypenoside LI (R configuration at C20) showed stronger activity against A549 cells. Furthermore, both induced A549 cell apoptosis through intrinsic and extrinsic pathways evidenced by reducing mitochondrial membrane potential (MMP), generating reactive oxygen species (ROS), releasing more cytochrome c and down-regulating procaspase 8. However, gypenoside L blocked A549 cells in G0/G1, while gypenoside LI induced G2/M arrest, which was further verified by different expression of CDK1, CDK2 and CDK4. In addition, both inhibited A549 cell migration, which was evidenced by down-regulation of MMP-2/9 as well as scratch wound assay and transwell assay.ConclusionC20 of gypenoside played an important role in A549 cell cytotoxicity and gypenoside stereoisomers could be used as potential multi-target chemopreventive agents for cancer.

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Validation of ethnopharmacology of ayurvedic sarasvata ghrita and comparative evaluation of its neuroprotective effect with modern alcoholic and lipid based extracts in β-amyloid induced memory impairment

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Madhuri Shelar, Sadhana Nanaware, S. Arulmozhi, Sathiyanarayanan Lohidasan, Kakasaheb Mahadik
Ethnopharmacological relevanceSarasvata ghrita (SG), a polyherbal formulation from ayurveda, an ancient medicinal system of India, has been used to improve intelligence and memory, treat speech delay, speaking difficulties and low digestion power in children.Aim of the studyStudy aimed to validate the ethno use of SG in memory enhancement through systematic scientific protocol. The effect of SG and modern extracts of ingredients of SG was compared on cognitive function and neuroprotection in amyloid-β peptide 25–35(Aβ25–35) induced memory impairment in wistar rats. Further the underlying mechanism for neuroprotective activity was investigated.Materials and methodsSG was prepared as per traditional method, ethanolic extract (EE) was prepared by conventional method and lipid based extract was prepared by modern extraction method. All extracts were standardised by newly developed HPLC method with respect to marker compounds. SG, EE and LE were administered orally to male Wistar rats at doses of 100,200 and 400 mg/kg Body Weight by feeding needle for a period of 21 days after the intracerebroventricular administration of Aβ25–35 bilaterally. Spatial memory of rats was tested using Morris water maze (MWM) and Radial arm maze (RAM) test. The possible underlying mechanisms for the cognitive improvement exhibited by SG, EE and LE was investigated through ex-vivo brain antioxidant effect, monoamine level estimation, acetylcholine esterase (AchE) inhibitory effect and Brain-derived neurotropic factor (BDNF) levels estimation.ResultsSG, EE and LE were analyzed by HPLC method, results showed that EE extract has high percent of selected phytoconstituents as compared with SG and LE. SG and LE decrease escape latency and searching distance in a dose dependant manner during MWM test. In case of RAM significant decrease in number of errors and increase in number of correct choices indicate an elevation in retention and recall aspects of learning and memory after administration of SG an LE. SG and LE extract can efficiently prevent accumulation of β-amyloid plaque in hippocampus region. There was increase in SOD, GSH, CAT and NO level and decrease in MDA levels in SG and LE administered animals. SG and LE have found to exhibit AchE inhibitiory activity and significant dose-dependant increase in BDNF level in the plasma. SG and LE significantly increased the levels of noradrenaline, dopamine and 5-hydroxytryptamine in the brain.ConclusionThe study validated the neuroprotective activity of SG. The study concludes the extraction efficiency of SG for selected phytoconstituents is less than modern methods. However the neuroprotective activity of SG and LE was found to be greater than EE.

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The pharmacological properties of Ophiocordyceps xuefengensis revealed by transcriptome analysis

Publication date: 12 June 2018
Source:Journal of Ethnopharmacology, Volume 219
Author(s): Jian Jin, Wenli Kang, Can Zhong, You Qin, Rongrong Zhou, Hao Liu, Jing Xie, Lin Chen, Yuhui Qin, Shuihan Zhang
Ethnopharmacological relevanceThe Yao ethnic group in Xuefeng Mountains area have used Xuefeng cordyceps, the caterpillar–fungus complex of Ophiocordyceps xuefengensis, for treating a variety of diseases for long. Just like some other cordyceps, O. xuefengensis, which is identified as the sister taxon of O. sinensis in 2013, also seems to have broad pharmacological properties, not only enhancing human immunity, anti–bacteria, anti–virus, but also anti–tumor. However, investigation of the medicinal fugal species O. xuefengensis can be found only in few literature records since its pharmacological and therapeutic use is mainly in traditional Yao communities by local healers.Aim of the studyThe aim of this study is to collect samples of Xuefeng cordyceps and isolate the strain of O. xuefengensis, to determine bioactive components and evaluate the anti-tumor activity, to obtain the gene expression profile of O. xuefengensis and reveal its pharmacological properties by de novo transcriptome analysis. Accordingly, we attempt to provide information and give a comprehensive understanding of this mysterious medicinal fugal species from traditional Yao communities of China.Material and methodsBioactive components were determined with HPLC–DAD–Q–TOF–MS technology; in vitro anti–tumor activity against 6 cell lines was evaluated using standard MTT assay; transcriptome analysis was done by de novo sequencing; unique genes were functionally profiled basing on Gene Ontology Database and the targeted genes were examined by blast.ResultsTrace cordycepin, an anti–tumor agent, was detected in O. xuefengensis water extract. To some extent, the raw water extract of O. xuefengensis showed in vitro anti–tumor activity, against A549, HepG2, MCF–7, PC–3 and Raji cell lines. A total of 94,858 transcripts and 49,001 unique genes were obtained, amongst, 43.4% unique genes were matched with those of O. sinensis. Not all supposed genes related to cordycepin biosynthetic pathways were found by transcriptome analysis.ConclusionAccording to the gene expression profile, O. xuefengensis is very close to medicinal fungus O. sinensis. Raw water extract of O. xuefengensis, to a certain degree, could inhibit the growth of tumor cells, indicating that this fungus could be a new resource for the exploration of anti–tumor drug.

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The Impact of Suprarenal Fixation on Renal Function Following Endovascular Abdominal Aortic Aneurysm Repair: Meta-analysis Based on Estimated Glomerular Filtration Rate

Publication date: Available online 23 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): T. Calderbank, M. Bown, A. Saratzis
BackgroundEndovascular abdominal aortic aneurysm (AAA) repair (EVAR) is currently used routinely to treat AAA. Suprarenal fixation (SRF) of EVAR grafts can lead to renal dysfunction. A meta-analysis of studies using estimated glomerular filtration rate (eGFR) as a measure of renal injury to assess the effect of SRF on renal function was performed.MethodsAn electronic search was carried out to identify all articles that reported on renal injury following SRF versus infrarenal fixation (IRF) EVAR, and 24 studies were identified. Formal meta-analysis was used to assess eGFR drop at 1 and 5 years. The primary outcome measure was a drop in eGFR >20% at 1 year; secondary measures included eGFR drop >20% at 5 years and "renal dysfunction" based on the definition used in each publication.ResultsFive series reported eGFR reduction >20% at 1 year. The weighted odds ratio (OR) was 1.53 (95% CI 0.67–3.51, p = .31, I² = 53.2%); 9.3% for SRF versus 7.4% for IRF. One study reported eGFR based renal dysfunction at 5 years: OR 1.77 (95% CI 1.04–3.02, p = .03); 16.9% for SRF versus 10.3% for IRF. Nineteen series reported some form of renal dysfunction (5287 SRF vs. 4386 IRF patients, mean follow up: 20.5 months, range 72 h to 5 years). The weighted OR was 1.32 (95% CI 1.01–1.71, p = .03, I² = 28.4%); 5.1% for SRF versus 4.6% for IRF. "Renal dysfunction" definitions varied greatly and were based on creatinine or other inaccurate methods.ConclusionEVAR using SRF does not lead to a significant drop in renal function at 1 year, based on eGFR. Long-term results are limited. Authors should report long-term renal injury using eGFR and not inaccurate arbitrary measures, which are currently common in the literature.



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Commentary on “A Feasibility Study of a New Unibody Branched Stent Graft Applied to Reconstruct the Canine Aortic Arch”

Publication date: Available online 23 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Adeline Schwein, Yannick Georg, Nabil Chakfé




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Response to Commentary on “Five-year Results of Great Saphenous Vein Treatment: A Meta-analysis”

Publication date: Available online 23 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Sterre A.S. Hamann




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Limited Adherence to Peripheral Arterial Disease Guidelines and Suboptimal Ankle Brachial Index Reliability in Dutch Primary Care

Publication date: Available online 23 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): David Hageman, Niels Pesser, Lindy N.M. Gommans, Edith M. Willigendael, Marc R.H.M. van Sambeek, Ellen Huijbers, Aafke Snoeijen, Marc R.M. Scheltinga, Joep A.W. Teijink
Objective/BackgroundThe Dutch College of General Practitioners' guideline on peripheral arterial disease (PAD) provides clear recommendations on the management of PAD. An ankle brachial index (ABI) measurement, prescription of antiplatelet drugs and statins, and supervised exercise therapy (SET) for intermittent claudication (IC) are advised. The aims of this study were to determine the adherence of general practitioners (GPs) to their own guideline on PAD and to evaluate the reliability of primary care ABI measurements.MethodsThis was a cross-sectional study. All patients suspected of having symptomatic PAD who were referred by GPs to a large hospital in 2015 were evaluated regarding three of the guideline criteria: (i) ABI measurement; (ii) prescription of secondary prevention; (iii) initiation of SET. ABI values obtained in primary care and the hospital's vascular laboratory were compared using correlation coefficients and regression analysis. An abnormal ABI was defined as a value <.9 (normal ABI ≥.9).ResultsOf 308 potential patients with new onset PAD, 58% (n = 178) had undergone ABI measurement prior to referral. A modest correlation between ABI values obtained in primary care and the vascular laboratory was found (r = .63, p < .001). Furthermore, a moderate reliability was calculated (intraclass correlation coefficient 0.60, 95% confidence interval 0.49–0.69, p < .001). Of the new patients with an abnormal ABI, 59% used antiplatelet drugs and 55% used statins. A referral for SET was initiated by a GP in 10% of new PAD patients with IC symptoms.ConclusionsAdherence by Dutch GPs to their own society's PAD guideline has room for improvement. The reliability of ABI measurements is suboptimal, whereas rates of prescription of secondary prevention and initiation of SET as primary treatment for IC need upgrading.



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Myocardial Injury is More Common than Deep Venous Thrombosis after Vascular Surgery and is Associated with a High One Year Mortality Risk

Publication date: Available online 23 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Jacek Górka, Kamil Polok, Jakub Fronczek, Karolina Górka, Mateusz Kózka, Paweł Iwaszczuk, Marzena Frołow, P.J. Devereaux, Bruce Biccard, Jacek Musiał, Wojciech Szczeklik
Objective/backgroundVenous thromboembolism (VTE) has been considered the dominant major life threatening vascular complication after non-cardiac surgery, but recent studies have shifted the emphasis toward myocardial injury after non-cardiac surgery (MINS) as a common adverse event in the peri-operative setting. The aim of the present study was to compare the incidence and influence on mortality of two dominant venous and arterial events in the peri-operative period by prospectively screening a consecutive cohort of patients undergoing vascular surgery.MethodsThis was a sub-study of Vascular Events In Non-cardiac Surgery Patients Cohort Evaluation (VISION), the main objective of which was to evaluate major peri-operative complications after non-cardiac surgery. Patients undergoing vascular surgery had their blood collected to measure the Roche fifth generation high sensitivity troponin T (hsTnT) assay before and four times after surgery (6–12 h post-operatively, on the first, second, and third day following the procedure). MINS was defined as an elevated post-operative hsTnT ≥65 ng/L or an hsTnT ≥20 to <65 ng/L with an absolute change of ≥5 ng/L that was judged to be due to ischaemia. All patients underwent ultrasound venous compression testing for deep vein thrombosis (DVT) before, 4, and 7 days after surgery and follow-up was performed by telephone 30 days and 1 year after surgery.ResultsIn total, 164 consecutive patients were included in this sub-study. MINS was diagnosed in 39 patients (23.8%) and DVT in four patients (2.4%). The 1 year mortality was higher in MINS (9/39 [23.1%]) than non-MINS patients (9/125 [7.2%]; p = .006). None of the patients who developed DVT died in the first year after surgery.ConclusionMINS is a common complication after vascular surgery. It occurs more frequently than DVT and is associated with high 1 year mortality.



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Association between physical activity and walking capacity with cognitive function in peripheral artery disease patients

Publication date: Available online 23 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Bruno Remigio Cavalcante, Antonio H. Germano-Soares, Aline M. Gerage, Anthony Leicht, Rafael M. Tassitano, Henrique Bortolotti, Fábio Gazelato de Mello Franco, Nelson Wolosker, Gabriel G. Cucato, Raphael M. Ritti-Dias
ObjectiveTo identify the association between objectively measured physical activity and walking capacity with cognitive function in patients with symptomatic peripheral artery disease.MethodsThis was an observational, cross sectional study. One hundred and thirty patients (age 67 ± 8 years) were recruited at a tertiary centre specializing in vascular disease. Cognitive function (global, memory, executive function and attention) was evaluated using the Montreal Cognitive Assessment tool. Physical activity levels (total, light, and moderate-vigorous) were obtained using an accelerometer. A 6 min and 4 m walk test were undertaken to assess walking capacity. Crude and covariate adjusted, linear regression analyses confirmed significant associations between physical activity levels and walking capacity with cognitive function.ResultsPositive and significant associations were observed between moderate to vigorous physical activity (p = .039) and walking capacity (p = .030) with memory after adjusting for covariates. No significant association was identified between light physical activity and usual gait speed with any cognitive function outcome.ConclusionGreater memory performance was associated with greater moderate to vigorous physical activity levels and walking capacity in patients with symptomatic peripheral artery disease. Clinical interventions focused on improving moderate to vigorous physical activity levels and walking capacity may provide important therapies to potentially enhance cognitive health in patients with peripheral artery disease.



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A Feasibility Study of a New Unibody Branched Stent Graft Applied to Reconstruct the Canine Aortic Arch

Publication date: Available online 23 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): W. Li, S. Zhai, K. Xu, Q. Li, H. Zhong, T. Li, Z. Zhang
ObjectivesThe aim was to evaluate the feasibility and safety of a new unibody branched stent graft for the reconstruction of the canine aortic arch.MethodsThe unibody branched stent grafts included single branched stent grafts and double branched stent grafts. The main stent graft and branched limbs were sutured together. The branched stent grafts were folded into the introducer system, which consisted of a double channel catheter, a detachable sleeve, and an introducer sheath. The branched stent grafts were introduced and deployed into the aortic arch by the delivery system. Twenty adult mongrel dogs were used for the experiments. Ten dogs were implanted with single branched stent grafts; the other 10 were implanted with double branched stent grafts. The surviving animals were followed up for 3 months. Computed tomography angiography (CTA) was performed to observe the status of the branched stent grafts.ResultsAll the unibody branched stent grafts were successfully implanted into the canine aortic arches. The technical success rate was 100%. There was no cerebral infarction, paraplegia or incision infection. CTA showed that all the branched stent grafts were patent; there was no endoleak or stent migration.ConclusionsThe unibody branched stent graft system could be used to reconstruct the aortic arch. The animal experimental procedures demonstrated the safety and feasibility of the unibody branched stent graft system.



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Scholar : intitle:laryngeal - new results

[HTML] Pretherapeutic assessment by multidetector computed tomography for thyroid cartilage invasion in laryngeal cancer: A double-edged sword

M Arora, VD Thakker, G Sindhwani, J Bhatt, M Gupta… - Indian Journal of Medical …, 2018

Abstract Introduction: Almost one-fourth of head and neck cancers in India are
laryngeal cancers. Both conservative and surgical therapeutic approaches are
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LARYNGEAL LEISHMANIASIS IN A 46-YEAR-OLD ETHIOPIAN PATIENT

RI Abdella - Ethiopian Medical Journal, 2018

Abstract Leishmaniasis is a vector-borne zoonotic disease caused by intracellular
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Comparing the Ease of Insertion and Haemodynamic Changes of Laryngeal Mask Airway and Combitube in Patients Undergoing General Anaesthesia.

P KUMAR, B KAUR, AK BASRA, P SARANGAL… - Journal of Clinical & …, 2018

Abstract Introduction: Laryngeal Mask Airway (LMA) and Combitube are used as an
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whenever required. Aim: To compare the ease of insertion and haemodynamic …

 

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Scholar : Decannulation - νέα αποτελέσματα

[HTML] Outcomes of CO 2 laser-assisted posterior cordectomy in bilateral vocal cord paralysis in 132 cases

J Jackowska, EV Sjogren, A Bartochowska… - Lasers in Medical Science, 2018

… We looked at the number of laser glottic procedures necessary to achieve decannulation
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The multidisciplinary approach to pediatric aerodigestive disorders

J Piccione, RP Boesch - Current Problems in Pediatric and Adolescent Health …, 2018

… and some via gastrostomy, has premature spillage and laryngeal penetration
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[HTML] Tracheotomy in the intensive care unit: Guidelines from a French expert panel: The French Intensive Care Society and the French Society of Anaesthesia and …

JL Trouillet, O Collange, F Belafia, F Blot, G Capellier… - Anaesthesia Critical Care & …, 2018

… topics were defined: indications and contraindications for tracheotomy in
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Overview of hemodialysis arteriovenous graft maintenance and thrombosis prevention

M Allon, DL Cull, AM Sheridan

… Nephrol Nurs J 2013; 40:37. https://ift.tt/2G0r28i
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Planning for minimally invasive aortic valve replacement: key steps for patient assessment

P Klein, IDG Klop, GLT Kloppenburg, BP van Putte - European Journal of Cardio-Thoracic …

… placement. Also, safe closure of the aortotomy and control of bleeding from the arterial
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[PDF] Multi-Modality Surgical Approach In Management Of Laryngo-Tracheal Stenosis

A Ansari, A Thomas

… rd postoperative day. Patient followed up on 15 th post operative day and
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A Maqbool, MJ Ryan - Current Problems in Pediatric and Adolescent Health …, 2018

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[PDF] Establishing a Robust Transcatheter PDA Closure Program for Extremely Low Birth Weight Infants

S Sathanandam, L Apalodimas, MD Waller, R Philip…

Page 1. Introduction Extremely Low Birth Weight (ELBW) infants (weight <1kg at
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