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Pediatric Radiology Apr 2022In 2014, a multidisciplinary consensus on the classification of pre- and postnatal urinary tract dilation (UTD classification) was developed. Its goal was to provide a... (Review)
Review
In 2014, a multidisciplinary consensus on the classification of pre- and postnatal urinary tract dilation (UTD classification) was developed. Its goal was to provide a standardized system for evaluating and reporting urinary tract dilation both in the prenatal and postnatal periods. In this review, we summarize insights learned from the implementation of the UTD classification system since its inception, providing clarifications on common points of confusion. In addition, we review current literature in the clinical validation of the UTD classification system to provide credence for its use in managing fetuses and children with urinary tract dilation.
Topics: Child; Consensus; Dilatation; Dilatation, Pathologic; Female; Fetus; Humans; Hydronephrosis; Male; Pregnancy; Ultrasonography, Prenatal; Urinary Tract
PubMed: 34981177
DOI: 10.1007/s00247-021-05263-w -
European Heart Journal Aug 2019Endothelial dysfunction is involved in the development of atherosclerosis, which precedes asymptomatic structural vascular alterations as well as clinical manifestations...
Endothelial dysfunction is involved in the development of atherosclerosis, which precedes asymptomatic structural vascular alterations as well as clinical manifestations of cardiovascular disease (CVD). Endothelial function can be assessed non-invasively using the flow-mediated dilation (FMD) technique. Flow-mediated dilation represents an endothelium-dependent, largely nitric oxide (NO)-mediated dilatation of conduit arteries in response to an imposed increase in blood flow and shear stress. Flow-mediated dilation is affected by cardiovascular (CV) risk factors, relates to coronary artery endothelial function, and independently predicts CVD outcome. Accordingly, FMD is a tool for examining the pathophysiology of CVD and possibly identifying subjects at increased risk for future CV events. Moreover, it has merit in examining the acute and long-term impact of physiological and pharmacological interventions in humans. Despite concerns about its reproducibility, the available evidence shows that highly reliable FMD measurements can be achieved when specialized laboratories follow standardized protocols. For this purpose, updated expert consensus guidelines for the performance of FMD are presented, which are based on critical appraisal of novel technical approaches, development of analysis software, and studies exploring the physiological principles underlying the technique. Uniformity in FMD performance will (i) improve comparability between studies, (ii) contribute to construction of reference values, and (iii) offer an easy accessible and early marker of atherosclerosis that could complement clinical symptoms of structural arterial disease and facilitate early diagnosis and prediction of CVD outcomes.
Topics: Aged; Blood Flow Velocity; Cardiovascular Diseases; Consensus; Diagnostic Techniques, Cardiovascular; Dilatation, Pathologic; Endothelium, Vascular; Humans; Middle Aged; Nitric Oxide
PubMed: 31211361
DOI: 10.1093/eurheartj/ehz350 -
Current Opinion in Allergy and Clinical... Oct 2023Inflammatory mediators are a focus of recent corneal ectasia (CE) research and are a profound, modifiable contributor to CE in general and keratoconus (KC) in... (Review)
Review
PURPOSE OF REVIEW
Inflammatory mediators are a focus of recent corneal ectasia (CE) research and are a profound, modifiable contributor to CE in general and keratoconus (KC) in particular, opening a path to explore new methods of control. As advanced imaging technology and expanded population screening allow for earlier detection, the possibility of early intervention can profoundly change the prognosis of CE.
RECENT FINDINGS
Significant increases in the inflammatory mediators and immune components have been observed in the cornea, tear fluid, and blood of ectasia patients, while inflammation dampeners such as vitamin D and their receptors are reduced. Atopy and allergy have a strong association with KC, known to increase itch factors and stimulate eye rubbing, a risk factor in ectasia pathogenesis. Management of atopy or allergic conditions and topical anti-inflammatories has helped stabilize CE disease.
SUMMARY
Strategies such as monitoring inflammatory factors and using immune or inflammatory modulators, including managing subclinical inflammation, may be clinically beneficial in stabilizing the disease and improving outcomes. The detected factors are biomarkers, but as yet unproven to be sensitive or specific enough to be considered biomarkers for early detection of CE. The establishment of such biomarkers could improve the therapeutic outcome.
Topics: Humans; Dilatation, Pathologic; Cornea; Keratoconus; Inflammation; Inflammation Mediators; Hypersensitivity, Immediate; Biomarkers
PubMed: 37490610
DOI: 10.1097/ACI.0000000000000935 -
Cardiology Clinics Aug 2020Aortic dilatation is common in patients with congenital heart disease and is seen in patients with bicuspid aortic valve and those with conotruncal congenital heart... (Review)
Review
Aortic dilatation is common in patients with congenital heart disease and is seen in patients with bicuspid aortic valve and those with conotruncal congenital heart defects. It is important to identify patients with bicuspid aortic valve at high risk for aortic dissection. High-risk patients include those with the aortic root phenotype and those with syndromic or familial aortopathies including Marfan syndrome, Loeys-Dietz syndrome, and Turner syndrome. Aortic dilatation is common in patients with conotruncal congenital heart defects and rarely results in aortic dissection.
Topics: Aortic Dissection; Aorta; Aortic Diseases; Bicuspid Aortic Valve Disease; Dilatation, Pathologic; Heart Defects, Congenital; Humans; Risk Assessment
PubMed: 32622488
DOI: 10.1016/j.ccl.2020.04.002 -
Gastroenterology Clinics of North... Dec 2019Insufficient absorptive mucosal surface is the fundamental problem in the short bowel state. Intestinal adaptation has been well studied, and it is well recognized that... (Review)
Review
Insufficient absorptive mucosal surface is the fundamental problem in the short bowel state. Intestinal adaptation has been well studied, and it is well recognized that it may lead to dilatation of the bowel with increased thickness of the bowel wall, resulting from both mucosal hypertrophy and hyperplasia. Autologous reconstructive surgery exploits bowel dilatation in short bowel syndrome and maximizes the absorptive potential of the available mucosal surface. Indeed, autologous gastrointestinal reconstructive procedures may be better viewed as optimizing bowel diameter rather than focusing on length, thus allowing better prograde peristalsis and improved contact between luminal nutrients and mucosa, ultimately enhancing absorption.
Topics: Digestive System Surgical Procedures; Dilatation, Pathologic; Gastrointestinal Transit; Humans; Intestines; Short Bowel Syndrome; Tissue Expansion
PubMed: 31668183
DOI: 10.1016/j.gtc.2019.08.009 -
Journal of Medical Ultrasonics (2001) Apr 2024The initial means of detecting right ventricular (RV) dilatation is often transthoracic echocardiography (TTE), and once the presence of RV dilatation is suspected,... (Review)
Review
The initial means of detecting right ventricular (RV) dilatation is often transthoracic echocardiography (TTE), and once the presence of RV dilatation is suspected, there is the possibility of RV volume overload, RV pressure overload, RV myocardial disease, and even nonpathological RV dilatation. With respect to congenital heart disease with RV volume overload, defects or valvular abnormalities can be easily detected with TTE, with the exception of some diseases. Volumetric assessment using three-dimensional echocardiography may be useful in determining the intervention timing in these diseases. When the disease progresses in patients with pulmonary hypertension as a result of RV pressure overload, RV dilatation becomes more prominent than hypertrophy, and RV functional parameters predict the prognosis at this stage of maladaptive remodeling. The differential diagnosis of cardiomyopathy or comparison with nonpathological RV dilatation may be difficult in the setting of RV myocardial disease. The characteristics of RV functional parameters such as two-dimensional speckle tracking may help differentiate RV cardiomyopathy from other conditions. We review the diseases presenting with RV dilatation, their characteristics, and echocardiographic findings and parameters that are significant in assessing their status or intervention timing.
Topics: Humans; Diagnosis, Differential; Echocardiography; Heart Ventricles; Ventricular Dysfunction, Right; Hypertrophy, Right Ventricular; Echocardiography, Three-Dimensional; Dilatation, Pathologic; Hypertension, Pulmonary
PubMed: 38228943
DOI: 10.1007/s10396-023-01399-4 -
La Revue Du Praticien Sep 2019
Topics: Dilatation, Pathologic; Dura Mater; Humans; Magnetic Resonance Imaging; Marfan Syndrome
PubMed: 32233318
DOI: No ID Found -
Journal of Refractive Surgery... Dec 2021
Topics: Corneal Surgery, Laser; Corneal Topography; Dilatation, Pathologic; Humans
PubMed: 34914561
DOI: 10.3928/1081597X-20211025-01 -
Clinical & Experimental Optometry Aug 2023Corneal cross-linking is a photopolymerization technique traditionally used to strengthen corneal tissue. Corneal cross-linking utilizes riboflavin (vitamin B2) as a... (Review)
Review
Corneal cross-linking is a photopolymerization technique traditionally used to strengthen corneal tissue. Corneal cross-linking utilizes riboflavin (vitamin B2) as a photosensitizer and ultraviolet-A light (UVA) to create strong covalent bonds within the corneal stroma, increasing tissue stiffness. Multiple studies have demonstrated corneal cross-linking's effectiveness in treating corneal ectasia, a progressive, degenerative, and non-inflammatory thinning disorder, as quantified by key tomographic, refractive, and visual parameters. Since its introduction two decades ago, corneal cross-linking has surpassed its original application in halting corneal ectatic disease and its application has expanded into several other areas. Corneal cross-linking also possesses antibacterial, antienzymolytic and antioedematous properties, and has since become a tool in treating microbial keratitis, correcting refractive error, preventing iatrogenic ectasia, stabilising bullous keratopathy and controlling post keratoplasty ametropia. This review provides an overview of the current evidence base for the therapeutic non-ectasia applications of cornea cross-linking and looks at future developments in the field.
Topics: Humans; Dilatation, Pathologic; Cross-Linking Reagents; Collagen; Cornea; Photosensitizing Agents; Riboflavin; Photochemotherapy; Corneal Diseases; Ultraviolet Rays; Refractive Errors; Keratoconus
PubMed: 36690333
DOI: 10.1080/08164622.2022.2159790 -
Forensic Science, Medicine, and... Jun 2023Following a witnessed lethal lightning strike of an adult male who was standing outside in a storm, numerous Lichtenberg figures were identified upon external...
Following a witnessed lethal lightning strike of an adult male who was standing outside in a storm, numerous Lichtenberg figures were identified upon external examination of the body. Sectioning across multiple areas of linear erythema in the figures showed no subcutaneous hemorrhage. This was later confirmed on histology which showed only subtle dermal capillary dilatation with no interstitial hemorrhage or inflammation in these areas. The only areas of interstitial hemorrhage were present in adjacent scattered punctate burns from arcing. The documented resolution of Lichtenberg figures within hours would be more in keeping with temporary functional capillary dilatation, shown in this case, rather than with tissue alteration by interstitial hemorrhage or inflammation.
Topics: Adult; Humans; Male; Skin; Lightning Injuries; Dilatation, Pathologic; Inflammation; Hemorrhage
PubMed: 37046062
DOI: 10.1007/s12024-023-00612-7