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Journal of Family Medicine and Primary... May 2024Flow-mediated dilation (FMD) of the brachial artery is an ultrasonography test that assesses the endothelial response to reactive hyperemia. The aim of this study was to...
INTRODUCTION
Flow-mediated dilation (FMD) of the brachial artery is an ultrasonography test that assesses the endothelial response to reactive hyperemia. The aim of this study was to assess the changes in FMD in preeclamptic pregnant patients and compare them with normotensive pregnant females.
METHODS
An analytical cross-sectional comparative study was conducted in the Department of Obstetrics and Gynaecology at King George's Medical University (KGMU) after obtaining ethical approval. A total of 110 normotensive and 100 preeclamptic patients were recruited for the study. Using a Toshiba Ultrasound Machine with a 7-12 MHz probe, the baseline diameter of the brachial artery D1 was measured. Afterward, the cuff of the sphygmomanometer was placed distally on the forearm and it was inflated up to ≥250 mm of Hg pressure and later slowly deflated. At 90 seconds after cuff deflation, the mean of three measurements of vessel caliber (D2) was obtained. The FMD% was obtained by the following equation: FMD (%) = [(D2 - D1)/D1] ×100, where D1 = basal diameter and D2 = post-occlusion diameter. All patients were followed till delivery for maternofetal outcome.
RESULTS
FMD% was significantly lower in the preeclampsia group, and it went on decreasing with increasing severity of preeclampsia. At the cutoff of 9.4 for FMD%, its sensitivity for the prediction of preeclampsia was 65.3%, specificity was 89.3%, positive predictive value (PPV) was 94%, and negative predictive value (NPV) was 50%.
DISCUSSION
FMD is a noninvasive test, and it gets decreased before clinical signs of preeclampsia, so it can be used as a predictor of preeclampsia.
PubMed: 38948563
DOI: 10.4103/jfmpc.jfmpc_773_23 -
Indian Journal of Orthopaedics Jul 2024Recently the peroneus longus tendon (PLT) gained popularity in anterior cruciate ligament (ACL) reconstruction and has been utilized with satisfactory outcomes. However,...
BACKGROUND
Recently the peroneus longus tendon (PLT) gained popularity in anterior cruciate ligament (ACL) reconstruction and has been utilized with satisfactory outcomes. However, there are concerns regarding donor site morbidity. This study aims to compare the functional outcome of ACL reconstruction using hamstring (HT) and PLT autografts and evaluate the donor site morbidity.
METHODS
Patients who underwent ACL reconstruction were allocated to two groups (HT and PLT). Graft diameter was measured intraoperatively. Knee functional outcome was evaluated with IKDC and Tegner-Lysholm scores preoperatively, and postoperatively after 3 months, 6 months, and 1 year. Donor site morbidities were assessed with thigh circumference measurements, subjective evaluation of sensory disturbances, and ankle scoring with AOFAS and FADI scores.
RESULTS
At 1-year follow-up, the PLT group showed comparable IKDC ( = 0.925) and Tegner-Lysholm ( = 0.600) scores with those of the HT group. The mean graft diameter in the PLT group (7.93 ± 0.52 mm) was larger compared with the HT group (7.43 ± 0.50 mm) ( < 0.001). The incidence of thigh atrophy (HT-16.7%, PLT-10%) and sensory disturbances (HT-73.3%, PLT-10%) was greater in the HT group. There was no significant ankle donor site morbidity in the PLT group (AOFAS-98.67 ± 3.45, FADI-99.23 ± 1.69).
CONCLUSION
ACL reconstruction with PLT had comparable functional outcome with that of HT at 1 year. However, PLT demonstrated larger graft diameter, less donor site morbidity, and enhanced muscle recovery without significantly affecting the ankle function. PLT can be safely used as an acceptable alternative graft choice harvested from outside the knee for ACL reconstruction.
PubMed: 38948366
DOI: 10.1007/s43465-024-01185-5 -
Endoscopic Ultrasound 2023Management of hepatic abscesses has traditionally been performed by image-guided percutaneous techniques. More recently, EUS drainage has been shown to be efficacious...
BACKGROUND AND OBJECTIVES
Management of hepatic abscesses has traditionally been performed by image-guided percutaneous techniques. More recently, EUS drainage has been shown to be efficacious and safe. The aim of this study is to compare EUS-guided percutaneous catheter drainage (PCD) of hepatic abscesses.
METHODS
Patients who underwent EUS-guided drainage or PCD of hepatic abscesses from January 2018 through November 2021 from 4 international academic centers were included in a dedicated registry. Demographics, clinical data preprocedure and postprocedure, abscess characteristics, procedural data, adverse events, and postprocedure care were collected.
RESULTS
Seventy-four patients were included (mean age, 63.9 years; 45% male): EUS-guided ( = 30), PCD ( = 44). Preprocedure Charlson Comorbidity Index scores were 4.3 for the EUS group and 4.3 for the PCD group. The median abscess size was 8.45 × 6 cm (length × width) in the EUS group 7.3 × 5.5 cm in the PCD group. All of the abscesses in the EUS group were left-sided, whereas the PCD group contained both left- and right-sided abscesses (29 and 15, respectively). Technical success was 100% in both groups. Ten-millimeter-diameter stents were used in most cases in the EUS group, and 10F catheters were used in the PCD group. The duration to resolution of symptoms from the initial procedure was 10.9 days less in the EUS group compared with the PCD group ( < 0.00001). Hospital length of stay was shorter in the EUS group by 5.2 days ( = 0.000126). The EUS group had significantly fewer number of repeat sessions: mean of 2 7.7 ( < 0.00001) and trended toward fewer number of procedure-related readmissions: 10% 34%. The PCD group had a significantly higher number of adverse events ( = 27 [61%]) when compared with the EUS group ( = 5 [17%]; = 0.0001).
CONCLUSIONS
EUS-guided drainage is an efficacious and safe intervention for the management of hepatic abscesses. EUS-guided drainage allows for quicker resolution of symptoms, shorter length of hospital stay, fewer adverse events, and fewer procedural sessions needed when compared with the PCD technique. However, EUS-guided drainage may not be feasible in right-sided lesions.
PubMed: 38948125
DOI: 10.1097/eus.0000000000000033 -
ACS Omega Jun 2024This study aimed to increase the stability and solubility of the Algerian L. (ASHO) essential oil through nanoencapsulation. Nanoemulsions of ASHO (MF-ASHEO) were...
This study aimed to increase the stability and solubility of the Algerian L. (ASHO) essential oil through nanoencapsulation. Nanoemulsions of ASHO (MF-ASHEO) were developed to evaluate their antioxidant and antimicrobial potential, stability, and cytotoxicity using microfluidization at 150 MPa for five cycles. MF-ASHO showed 8 compounds (99.56%) vs ASHEO's 26 compounds (95.46%). Carvacrol increased to 94.51%, replacing γ-terpinene, which decreased to 0.43%. The MF-ASHEO nanoemulsion had a mean particle size of 41.72 nm, a monomodal size distribution pattern, a mean ζ-potential of -39.4 mV, and a polydispersity index (PDI) mean value of 0.291. Micrographs showed spherical nanoparticles with varying diameters in nm. ASHEO was more toxic than MF-ASHEO against HepG2, Vero, and WI-38, according to the MTT and WST-1 assays. ASHEO demonstrated antiradical and antibacterial activity and inhibited biofilm formation. It also had an enhanced antifungal effect and reduced mycotoxin production. The MF-ASHEO sample showed no activity except in reducing mycotoxin production, where it performed better than ASHEO. and ADME results confirmed the inhibitory action of carvacrol on the key enzymes of the aflatoxin biosynthetic mechanism and the target proteins associated with bactericidal/bacteriostatic effects. The microfluidization process dramatically affects not only the oil's volatile content but also its biological activity.
PubMed: 38947844
DOI: 10.1021/acsomega.4c00315 -
ACS Omega Jun 2024The fuel in a scramjet combustor must be injected into a high-speed crossflow and mixed with supersonic air in a very short period of time in order for the scramjet jet...
The fuel in a scramjet combustor must be injected into a high-speed crossflow and mixed with supersonic air in a very short period of time in order for the scramjet jet to operate reliably. More generally, the supersonic air is produced by the lower cover, similar to a Laval type nozzle, of the scramjet combustor. However, significant variation in lower cover geometry is prone to produce unstable vortexes. The unstable vortexes are accompanied by nonuniform stress and strain and are detrimental to the lower cover, even to the combustor. Inspired by mechanical design, this study proposes to change lower cover geometry by decreasing its sizes and then evaluates effects of these changes on kerosene fuel-air interaction in the combustor. The evaluation is based on three-dimensional computational fluid dynamics with couple level set and volume of fluids, which characterizes the penetration height, span expansion area, shock wave angle, and Sauter mean diameter of kerosene jets for three different injection diameters (0.5, 1.0, and 1.5 mm). The simulated air-kerosene interactions reasonably agree with the past numerical findings at identical working conditions. This result demonstrates the effectiveness of the changed lower cover geometry for the scramjet combustor.
PubMed: 38947818
DOI: 10.1021/acsomega.4c03500 -
International Journal of Cardiology Jun 2024Anatomic variations of the patent foramen ovale (PFO) are commonly observed, yet limited research has investigated their impact on clinical outcomes following...
BACKGROUND
Anatomic variations of the patent foramen ovale (PFO) are commonly observed, yet limited research has investigated their impact on clinical outcomes following transcatheter closure. We aimed to explore the association between PFO morphology and clinical outcomes.
METHODS
Consecutive patients with cryptogenic stroke who underwent PFO closure were prospectively enrolled at a single center from September 2019 to April 2023. Patients were categorized into simple and complex groups based on PFO morphology. Composite events were compared between the two groups during a median follow-up of 24 months, including all-cause mortality, recurrent stroke, residual moderate or severe shunt, and symptomatic atrial fibrillation.
RESULTS
A total of 247 patients were enrolled, with a mean age of 41.9 ± 13.0 years and 45.3% males. Ninety-one (36.8%) patients had complex PFO. These individuals were older (45.4 ± 12.5 years vs. 39.9 ± 12.9 years; P = 0.001), more males (56.0% vs. 39.1%; P = 0.010), had longer procedure times (54 ± 32 min vs 46 ± 29 min; P = 0.044), and had a higher rate of using delivery sheath-assisted crossing of the PFO (22.0% vs 12.8%; P = 0.040) than those with simple PFO. The estimated event rates were 27.9% and 11.3% (P = 0.006) in the complex and simple PFO groups, respectively (12.9 events and 5.2 events per 100 person-years; P = 0.001). After adjusting for age, sex, hypertension, diabetes, smoking, device type, and left atrial diameters, complex PFO remained independently associated with composite events (HR 2.10, 95%CI 1.06-4.17, P = 0.034).
CONCLUSIONS
Patients with complex PFO may suffer from a higher risk of adverse events following transcatheter PFO closure.
PubMed: 38945369
DOI: 10.1016/j.ijcard.2024.132307 -
Journal of Microencapsulation Jun 2024Green-synthesis of biodegradable polymeric curcumin-nanoparticles using affordable biodegradable polymers to enhance curcumin's solubility and anti-oxidative potential....
Green-synthesis of biodegradable polymeric curcumin-nanoparticles using affordable biodegradable polymers to enhance curcumin's solubility and anti-oxidative potential. The curcumin-nanoparticle was prepared based on the ionic-interaction method without using any chemical surfactants, and the particle-size, zeta-potential, surface-morphology, entrapmentefficiency, and in-vitro drug release study were used to optimise the formulation. The antioxidant activity was investigated using H2DCFDA staining in the zebrafish (Danio rerio) model. The mean-diameter of blank nanoparticles was 178.2 nm (±4.69), and that of curcuminnanoparticles was about 227.7 nm (±10.4), with a PDI value of 0.312 (±0.023) and 0.360 (±0.02). The encapsulation-efficacy was found to be 34% (±1.8), with significantly reduced oxidative-stress and toxicity (∼5 times) in the zebrafish model compared to standard curcumin. The results suggested that the current way of encapsulating curcumin using affordable, biodegradable, natural polymers could be a better approach to enhancing curcumin's water solubility and bioactivity, which could further be translated into potential therapeutics.
PubMed: 38945157
DOI: 10.1080/02652048.2024.2362188 -
Updates in Surgery Jun 2024Malignancy risk calculation models were developed using the clinical and radiological features. It was aimed to compare pulmonary nodule risk calculation models and...
Malignancy risk calculation models were developed using the clinical and radiological features. It was aimed to compare pulmonary nodule risk calculation models and evaluate their effectiveness and applicability for the Turkish population. Between 2014 and 2019, 351 patients who were operated on for pulmonary nodules were evaluated with the following data: age, gender, smoking history, family history of lung cancer, extrapulmonary malignancy and granulomatous disease, nodule diameter, attenuation character, side, localization, spiculation, nodule count, presence of pulmonary emphysema, FDG uptake in PET/CT of the nodule, and definitive pathology data. Malignancy risk scores were calculated using the equations of the Brock, Mayo, and Herder models. The results were evaluated statistically. The mean age of the 351 patients (236 men, 115 women) was 57.84 ± 10.87 (range 14-79) years, and 226 malignant and 125 benign nodules were observed. Significant correlations were found between malignancy and age (p < 0.001), nodule diameter (p < 0.001), gender (p < 0.009), speculation (p < 0.001), emphysema (p < 0.05), FDG uptake (p < 0.001). All three models were found effective in the differentiation (p < 0.001). The ideal threshold value was determined for the Brock (19.5%), Mayo (23.1%), and Herder (56%) models. All models were effective for nodules of > 10 mm, but none of them were for 0-10 mm. Brock was effective in ground-glass nodules (p = 0.02) and all models were effective for semi-solid and solid nodules. None of the groups could provide AUC values as high as those achieved in the original studies. This suggests the need to optimize models and malignancy risk thresholds for Turkish population.
PubMed: 38944649
DOI: 10.1007/s13304-024-01901-8 -
Oral Surgery, Oral Medicine, Oral... May 2024We aimed to investigate the relationship between the presence of the accessory maxillary ostium (AMO) with mucosal thickening (MT) and maxillary sinus cysts (MSCs).
OBJECTIVES
We aimed to investigate the relationship between the presence of the accessory maxillary ostium (AMO) with mucosal thickening (MT) and maxillary sinus cysts (MSCs).
STUDY DESIGN
This single-center retrospective study included patients who underwent paranasal sinus computed tomography (CT) between November 2022 and February 2023. We excluded patients with natural maxillary ostium (NMO) occlusion. Two radiologists evaluated the presence of AMOs, MT, and MSCs in CT images and measured their dimensions using a three-dimensional volumetric analysis program.
RESULTS
We included 125 patients (mean age: 36.47 ± 16.0 years; male/female: 67/58). In total, 65 patients (52%) had single or multiple AMOs. No significant relationship was found between the presence of an AMO and the presence of MT on either side (P ≥ .306). There was a statistically significant difference between the presence of an AMO and MSC on the right side (P = .002), but not on the left side (P = .477). The diameter of the AMO and the distance from the AMO to the maxillary sinus floor were not correlated with mucosal thickness or MSC volume, but the distance from the AMO to the sinus floor had a small positive correlation with total maxillary sinus volume.
CONCLUSIONS
The presence of an AMO and its increased diameter may not contribute to ipsilateral maxillary sinusitis in patients whose unilateral or bilateral NMOs are not occluded.
PubMed: 38944642
DOI: 10.1016/j.oooo.2024.05.008 -
International Journal of Biological... Jun 2024Electrospun nanofibers exhibit a significant potential in the synthesis of nanostructured materials, thereby offering a promising avenue for enhancing the efficacy of...
Electrospun nanofibers exhibit a significant potential in the synthesis of nanostructured materials, thereby offering a promising avenue for enhancing the efficacy of wound care. The present study aimed to investigate the wound-healing potential of two biomacromolecules, PCL-Gelatin nanofiber adhered with bone marrow-derived mesenchymal stem cells (BMSCs). Characterisation of the nanofiber revealed a mean fiber diameter ranging from 200 to 300 nm, with distinctive elemental peaks corresponding to polycaprolactone (PCL) and gelatin. Additionally, BMSCs derived from bone marrow were integrated into nanofibers, and their wound-regenerative potential was systematically evaluated through both in-vitro and in-vivo methodologies. In-vitro assessments substantiated that BMSC-incorporated nanofibers enhanced cell viability and crucial cellular processes such as adhesion, and proliferation. Subsequently, in-vivo studies were performed to demonstrate the wound-healing efficacy of nanofibers. It was observed that the rate of wound healing of BMSCs incorporated nanofibers surpassed both, nanofiber and BMSCs alone. Furthermore, histomorphological analysis revealed accelerated re-epithelization and improved wound contraction in BMSCs incorporated nanofiber group. The fabricated nanofiber incorporated with BMSCs exhibited superior wound regeneration in animal model and may be utilised as a wound healing patch.
PubMed: 38944073
DOI: 10.1016/j.ijbiomac.2024.133447