-
International Journal of Cardiology Nov 2023The athlete's heart is a well-known phenomenon characterized by a harmonic remodelling that affects the cardiac chambers. However, whether mild-to-moderate aortic...
BACKGROUND
The athlete's heart is a well-known phenomenon characterized by a harmonic remodelling that affects the cardiac chambers. However, whether mild-to-moderate aortic dilatation can be considered normal in athletes is debated. This study aimed to evaluate the ratio between left ventricular (LV) size and aortic dimensions, reporting the normal values of the ratio between the aortic root diameters at the level of the sinuses of Valsalva and LV diameters (AoD/LVEDD ratio) in a wide cohort of competitive athletes.
MATERIALS AND METHODS
Competitive athletes were compared with sedentary subjects and patients with aortic dilatation. 1901 subjects who underwent echocardiography from 2019 to 2022 were retrospectively enrolled: 993 athletes (74% males, mean age 26 ± 7 years), 410 sedentary (74.1% males, mean age 29 ± 11 years) and 498 patients with aortic dilatation (74.3% males, mean age 56 ± 7 years).
RESULTS
Patients with aortic dilatation had both an absolute (39.2 ± 2.4 mm) and indexed (19.4 ± 2.2 mm/m2) aortic diameter larger than athletes (30.6 ± 3.2 mm; 16.1 ± 1.5 mm/m, p < 0.05) and sedentary subjects (30.5 ± 3.1 mm; 16.5 ± 1.6 mm/m, p < 0.05), with no differences between athletes and sedentary subjects. The AoD/LVEDD ratio was lower in athletes (0.59 ± 0.06) compared to controls (0.65 ± 0.05, p < 0.05) and patients with aortic dilatation (0.81 ± 0.06, p < 0.05). The patients with aortopathy had the lowest LVEDD/AoD ratio, while competitive athletes had the highest, with values of 1.71 ± 0.16 in the latter (overall p value<0.001).
CONCLUSIONS
In this study, we reported the AoD/LVEDD and LVEDD/AoD ratio values in a cohort of healthy athletes, additional parameters that could help confirm the harmonic remodelling in the athlete's heart.
Topics: Male; Humans; Young Adult; Adult; Adolescent; Middle Aged; Female; Aorta, Thoracic; Retrospective Studies; Heart Ventricles; Heart; Athletes; Aortic Diseases
PubMed: 37480998
DOI: 10.1016/j.ijcard.2023.131202 -
Journal of Clinical Medicine May 2022We aimed to determine whether retinal vessel diameters and retinal oxygen saturation in newly diagnosed patients with multiple sclerosis (pwMS) are different from those...
We aimed to determine whether retinal vessel diameters and retinal oxygen saturation in newly diagnosed patients with multiple sclerosis (pwMS) are different from those of a healthy population. Retinal blood vessel diameters were measured using imaging with a spectrophotometric non-invasive retinal oximeter. Twenty-three newly diagnosed untreated relapsing-remitting MS (RRMS) patients (mean age: 32.2 ± 7.5 years, age range = 18-50 years, 56.5% female) were measured and compared to 23 age- and sex-matched healthy controls (HCs) (mean age: 34.8 ± 8.1 years). Patients with Optic Neuritis were excluded. Retinal venular diameter (143.8 µm versus 157.8 µm: mean; = 0.0013) and retinal arteriolar diameter (112.6 µm versus 120.6 µm: mean; = 0.0089) were smaller in pwMS when compared with HCs, respectively. There was no significant difference in the oxygen saturation in retinal venules and arterioles in pwMS (mean: 60.0% and 93.7%; = 0.5980) compared to HCs (mean: 59.3% and 91.5%; = 0.8934), respectively. There was a significant difference in the median low contrast visual acuity (2.5% contrast) between the pwMS and the HC groups ( = 0.0143) Retinal arteriolar and venular diameter may have potential as objective biomarkers for MS.
PubMed: 35683496
DOI: 10.3390/jcm11113109 -
SAGE Open Medicine 2022Activities that require increased load bearing are known to cause bony hypertrophy. This phenomenon has been documented in the dominant arm of athletes in sports...
OBJECTIVE
Activities that require increased load bearing are known to cause bony hypertrophy. This phenomenon has been documented in the dominant arm of athletes in sports requiring significant utilization of a single limb. The literature addressing this effect in rodeo athletes, however, is minimal. Studies evaluating rodeo athletes are primarily focused on acute injury management rather than chronic symptoms resulting from changes in bone and soft tissue. We designed a study to evaluate bony hypertrophy in athletes without acute injury.
METHOD
Rodeo bareback riders presented with frequent pain in their grip arm, no radiographic evidence of injury, and clinical signs of peripheral nerve compression. Anteroposterior and lateral X-rays taken for initial evaluation in 17 bareback rodeo athletes were retrospectively reviewed. The diameter of bilateral ulnas was measured at its longitudinal midpoint. Ratio of Ulnar Diameters (grip arm/free arm) and Percentage Diameter Difference were calculated. An independent samples -test was used to assess differences in diameters of grip and non-grip arms.
RESULT
The mean ulnar diameter was 18.4 ± 3.5 in the grip arm and 16.6 ± 3.5 in the non-grip arm ( < 0.001). The mean ratio of grip to free arm ulnar diameter was 1.42 ± 0.21 (range = 1.05-1.92). The mean diameter percent difference measured 42.3% (range = 4.7%-92.0%), and the grip arm was observed to have a greater ulnar diameter compared to the non-grip arm.
CONCLUSION
There are significant anatomic differences in the grip arm of bareback rodeo athletes compared to the contralateral arm. In cases of persistent pain in the grip arm and no evidence of acute injury, these differences may be relevant to pain symptoms and should be considered as part of the assessment and treatment algorithm.
PubMed: 35223028
DOI: 10.1177/20503121221077831 -
Investigative Ophthalmology & Visual... May 2022Infantile nystagmus syndrome (INS) causes altered visual development and can be associated with abnormal retinal structure, to which vascular development of the retina...
PURPOSE
Infantile nystagmus syndrome (INS) causes altered visual development and can be associated with abnormal retinal structure, to which vascular development of the retina is closely related. Abnormal retinal vasculature has previously been noted in albinism but not idiopathic infantile nystagmus. We compared the number and diameter of retinal vessels in participants with albinism (PWA) and idiopathic infantile nystagmus (PWIIN) with controls.
METHODS
Fundus photography data from 24 PWA, 10 PWIIN, and 34 controls was analyzed using Automated Retinal Image Analyzer (ARIA) software on a field of analysis centered on the optic disc, the annulus of which extended between 4.2 mm and 8.4 mm in diameter.
RESULTS
Compared with controls, the mean number of arterial branches was reduced by 24% in PWA (15.5 vs. 20.3, P < 0.001), and venous branches were reduced in both PWA (29%; 12.9 vs. 18.2, P < 0.001) and PWIIN (17%; 15.1 vs. 18.2, P = 0.024). PWA demonstrated 7% thinner "primary" (before branching) arteries (mean diameter: 75.39 µm vs. 80.88 µm, P = 0.043), and 13% thicker (after branching) "secondary" veins (66.72 µm vs. 59.01 µm in controls, P = 0.009).
CONCLUSIONS
PWA and PWIIN demonstrated reduced retinal vessel counts and arterial diameters compared with controls. These changes in the superficial retinal vascular network may be secondary to underdevelopment of the neuronal network, which guides vascular development and is also known to be disrupted in INS.
Topics: Albinism; Genetic Diseases, X-Linked; Humans; Nystagmus, Congenital; Nystagmus, Pathologic; Optic Disk; Retinal Vessels
PubMed: 35616929
DOI: 10.1167/iovs.63.5.33 -
Pharmaceutics Mar 2024In this work, polyvinylpyrrolidone (PVP)- and β-cyclodextrin (β-CD)-based composite powders containing curcumin (CURC) were obtained through the supercritical...
In this work, polyvinylpyrrolidone (PVP)- and β-cyclodextrin (β-CD)-based composite powders containing curcumin (CURC) were obtained through the supercritical antisolvent (SAS) technique. Pressure, total concentration of CURC/carrier in dimethylsulfoxide, and CURC/carrier ratio effects on the morphology and size of the precipitated powders were investigated. Using PVP as the carrier, spherical particles with a mean diameter of 1.72 μm were obtained at 12.0 MPa, 20 mg/mL, and a CURC/PVP molar ratio equal to 1/2 mol/mol; using β-CD as the carrier, the optimal operating conditions were 9.0 MPa and 200 mg/mL; well-defined micrometric particles with mean diameters equal to 2.98 and 3.69 μm were obtained at molar ratios of 1/2 and 1/1 mol/mol, respectively. FT-IR spectra of CURC/ β-CD inclusion complexes and coprecipitated CURC/PVP powders revealed the presence of some peaks of the active compounds. The stoichiometry of the complexes evaluated through the Job method revealed that β-CD formed inclusion complexes with CURC at a molar ratio equal to 1/1. Dissolution profiles revealed that in comparison with the curve of the pure ingredient, the SAS-processed powders obtained using both PVP and β-CD have an improved release rate.
PubMed: 38543246
DOI: 10.3390/pharmaceutics16030352 -
Turkish Journal of Anaesthesiology and... Feb 2022Debates continue about the cricoid pressure, which has been used for many years to prevent gastric aspiration during intubation. Using ultrasound, the effects of this...
OBJECTIVE
Debates continue about the cricoid pressure, which has been used for many years to prevent gastric aspiration during intubation. Using ultrasound, the effects of this maneuver and alternatives like paralaryngeal pressure are revealed. The aim of this observational study was to determine the effect of paralaryngeal pressure with an ultrasound probe on the esophageal diameter in patients with different body mass indexes and neck circumferences.
METHODS
After measuring the neck circumference at the level of the cricoid cartilage, the esophagus was visualized by ultrasonography. Compression was applied medially at a 45° angle toward the vertebral column by the ultrasound probe and esophageal anteroposterior outer diameters were measured. Correlations between body mass index, neck circumference, esophageal diameter, and esophageal diameter change ratio were evaluated with Pearson's r value.
RESULTS
One hundred ten volunteers (52 women and 58 men) with mean age 33.7 ± 8.02 years and mean body mass index 25.6 ± 4.65 kg m-2 were recruited. The esophagus was located 78.18% partially to the left, 4.54% completely to the left, 1.81% to the right of the cricoid ring. In 15.45%, esophagus could not be displayed. The mean diameter of the esophagus was 7.6 ± 1.1 mm before pressure and 5.6 ± 0.09 mm after pressure (P < .001). There was no significant correlation between diameter change percentage and body mass index (r=-0.22; P > .05). However, weak correlation was found between diameter change percentage and neck circumference (r=-0.33; P=.016).
CONCLUSIONS
Paralaryngeal pressure with an ultrasound probe has the potential to occlude the esophagus and may be effective in all patient groups.
PubMed: 35256340
DOI: 10.5152/TJAR.2021.1427 -
BMC Oral Health Jul 2022Despite many advances in dentistry, no objective and quantitative method is available to evaluate gingival shape. The surface curvature of the optical scans represents...
BACKGROUND
Despite many advances in dentistry, no objective and quantitative method is available to evaluate gingival shape. The surface curvature of the optical scans represents an unexploited possibility. The present study aimed to test surface curvature estimation of intraoral scans for objective evaluation of gingival shape.
METHODS
The method consists of four main steps, i.e., optical scanning, surface curvature estimation, region of interest (ROI) definition, and gingival shape analysis. Six different curvature measures and three different diameters were tested for surface curvature estimation on central (n = 78) and interdental ROI (n = 88) of patients with advanced periodontitis to quantify gingiva with a novel gingival shape parameter (GS). The reproducibility was evaluated by repeating the method on two consecutive intraoral scans obtained with a scan-rescan process of the same patient at the same time point (n = 8).
RESULTS
Minimum and mean curvature measures computed at 2 mm diameter seem optimal GS to quantify shape at central and interdental ROI, respectively. The mean (and standard deviation) of the GS was 0.33 ± 0.07 and 0.19 ± 0.09 for central ROI using minimum, and interdental ROI using mean curvature measure, respectively, computed at a diameter of 2 mm. The method's reproducibility evaluated on scan-rescan models for the above-mentioned ROI and curvature measures was 0.02 and 0.01, respectively.
CONCLUSIONS
Surface curvature estimation of the intraoral optical scans presents a precise and highly reproducible method for the objective gingival shape quantification enabling the detection of subtle changes. A careful selection of parameters for surface curvature estimation and curvature measures is required.
Topics: Gingiva; Humans; Radionuclide Imaging; Reproducibility of Results
PubMed: 35820843
DOI: 10.1186/s12903-022-02322-y -
Platelets Dec 2023Arterial tonometry and vascular calcification measures are useful in cardiovascular disease (CVD) risk assessment. Prior studies found associations between tonometry...
Arterial tonometry and vascular calcification measures are useful in cardiovascular disease (CVD) risk assessment. Prior studies found associations between tonometry measures, arterial calcium, and CVD risk. Activated platelets release angiopoietin-1 and other factors, which may connect vascular structure and platelet function. We analyzed arterial tonometry, platelet function, aortic, thoracic and coronary calcium, and thoracic and abdominal aorta diameters measured in the Framingham Heart Study Gen3/NOS/OMNI-2 cohorts ( = 3,429, 53.7% women, mean age 54.4 years ±9.3). Platelet reactivity in whole blood or platelet-rich plasma was assessed using 5 assays and 7 agonists. We analyzed linear mixed effects models with platelet reactivity phenotypes as outcomes, adjusting for CVD risk factors and family structure. Higher arterial calcium trended with higher platelet reactivity, whereas larger aortic diameters trended with lower platelet reactivity. Characteristic impedance (Zc) and central pulse pressure positively trended with various platelet traits, while pulse wave velocity and Zc negatively trended with collagen, ADP, and epinephrine traits. All results did not pass a stringent multiple test correction threshold ( < 2.22e-04). The diameter trends were consistent with lower shear environments invoking less platelet reactivity. The vessel calcium trends were consistent with subclinical atherosclerosis and platelet activation being inter-related.
Topics: Female; Male; Humans; Calcium; Pulse Wave Analysis; Blood Pressure; Platelet Activation; Atherosclerosis
PubMed: 37609998
DOI: 10.1080/09537104.2023.2238835 -
Resuscitation Apr 2021Intraosseous (IO)-access plays an alternative route during resuscitation. Our study in preterm and term stillborns was performed to find alternative IO puncture sites...
AIM
Intraosseous (IO)-access plays an alternative route during resuscitation. Our study in preterm and term stillborns was performed to find alternative IO puncture sites beside the recommended proximal tibia.
METHODS
The cadavers used were legal donations. 20 stillborns (mean: 29.2weeks, IQR 27.1-39.6) were investigated. Spectral-CT were analysed to calculate the diameter and circumferences of: i) proximal humerus ii) distal femur iii) proximal tibia iv) diaphyseal tibial. Contrast medium was applied under video documentation to investigate the drainage into the vascular system.
RESULTS
In term newborns, diameter of the cortex of the proximal humeral head is 12.1 ± 1.8 mm, distal end of the femur 11.9 ± 3.4 mm and the proximal tibial bone 12.0 ± 2.4 mm with cross-sectional diameter of 113.5 ± 19.7 mm, 120.6 ± 28.2 mm and 111.6 ± 29.5 mm, respectively. Regarding the preterm groups, there is a strong age-related growth in diameter and cross -sectional size. The diaphyseal area is the smallest in all measured bones with an age-dependent increase and is about half of that of metaphyseal diameters (proximal and distal) and about one third of that of metaphyseal cross sectional areas. The proximal femoral head region has the largest diameter of all measured bones with an egg-shaped formation with an extensive joint capsula. All investigated metaphyseal areas lack a clearly enclosed bone marrow cavity. Infusion of contrast medium into the distal femoral end and the proximal humerus head demonstrate the drainage of contrast medium into the central venous system within seconds.
CONCLUSION
Proximal humeral head and distal femoral end might be alternative IO areas which may lead to further IO puncture sites in neonates.
PubMed: 33862177
DOI: 10.1016/j.resuscitation.2021.04.004 -
Clinical Oral Investigations Sep 2023To investigate the intraosseous arterial pathways and anastomoses in the alveolar aspects of the maxilla in order to better understand the arterial scattering pattern.
OBJECTIVES
To investigate the intraosseous arterial pathways and anastomoses in the alveolar aspects of the maxilla in order to better understand the arterial scattering pattern.
MATERIALS AND METHODS
Eleven cadavers were selected for macroscopic intraosseous arterial analyses by corrosion casting. The red-colored acrylic resin was injected into the external carotid arteries. The specimens were kept in an enzymatic solution at 36 °C for about 60 days, depending on the process progression. After removal of the soft tissues and drying, the bone was macerated by potassium hydroxide to analyze the course and the mean diameters of the intraosseous anastomoses.
RESULTS
Vertico-oblique and horizontal intraosseous arteries and anastomoses between the greater palatine-, posterior superior alveolar-, and infraorbital arteries were detected. The vertico-oblique anastomoses were found on the anterolateral wall of the maxilla and the alveolar crest with a mean diameter of 0.46 mm; nevertheless, the horizontal (transalveolar) anastomoses were identified in the interdental septum/alveolar crest with the mean diameter of 0.41 mm. From the horizontal anastomoses, small intraseptal branches supplied the territory of the alveolar socket in various directions.
CONCLUSIONS
The localization of intraosseous arterial anastomoses is critical in implant-related surgeries, predominantly to maintain proper circulation.
CLINICAL RELEVANCE
Based on vertico-oblique and transalveolar anastomoses, simultaneous buccal- and palatal flap elevation (particularly on the palatal side) should be avoided to minimize patient morbidity and intra- or postoperative complications. Moreover, preserving transverse loops in the interdental septum is essential during implant surgeries, which can significantly influence collateral periosteal and osteal circulation to prevent ischemia.
Topics: Humans; Maxilla; Dental Implants; Arteries; Cadaver
PubMed: 37460902
DOI: 10.1007/s00784-023-05141-9