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Operative Neurosurgery (Hagerstown, Md.) Apr 2024Posterior inferior cerebellar artery (PICA) aneurysms account for 0.3% of all intracranial aneurysms, and they commonly present with a complex fusiform morphology that...
Dolichoectatic Posterior Inferior Cerebellar Artery Aneurysm Treated With Excision and Posterior Inferior Cerebellar Artery Double Reimplantation Bypass: 2-Dimensional Operative Video.
Posterior inferior cerebellar artery (PICA) aneurysms account for 0.3% of all intracranial aneurysms, and they commonly present with a complex fusiform morphology that necessitates unique bypass strategies.1-5 An adolescent boy with a familial predisposition to aneurysmal subarachnoid hemorrhage was identified as harboring a fusiform aneurysm of the right distal PICA, characterized by 2 outflow branches. Our recommended treatment strategy involved a right far lateral craniotomy, followed by P1 PICA reanastomosis and P2 PICA reimplantation. Informed written consent was obtained. On exposure, the aneurysm was trapped, and the inflow and 2 outflow PICA branches were excised. Revascularization was established through a P1 PICA end-to-end reanastomosis using running continuous suturing techniques, followed by P2 PICA end-to-side reimplantation into a more distal portion of PICA. Subsequent indocyanine green videoangiography confirmed patency of the P2 PICA reimplantation; however, the initial P1 PICA reanastomosis was noted to be thrombosed. After several unsuccessful attempts to dissolve the thrombus, the decision was made to proceed with a P2 PICA side-to-side in situ reimplantation into the V4 segment of the vertebral artery. Indocyanine green videoangiography and postoperative digital subtraction angiography confirmed patency of the PICA double reimplantation bypass. The patient tolerated the procedure well and was discharged home at his neurological baseline. This video showcases the microsurgical treatment of a complex dolichoectatic, distal PICA aneurysm using a double reimplantation technique, in addition to highlighting bypass decision-making processes for managing complex PICA aneurysms.
PubMed: 38687093
DOI: 10.1227/ons.0000000000001188 -
Emerging Microbes & Infections Dec 2024A free-range organic broiler () premises in Staffordshire was infected by high pathogenicity avian influenza virus (HPAIV) H5N8 during the 2020-2021 epizootic in the...
A free-range organic broiler () premises in Staffordshire was infected by high pathogenicity avian influenza virus (HPAIV) H5N8 during the 2020-2021 epizootic in the United Kingdom (UK). Following initial confirmation of the infection in poultry, multiple wild bird species were seen scavenging on chicken carcasses. Detected dead wild birds were subsequently demonstrated to have been infected and succumbed to HPAIV H5N8. Initially, scavenging species, magpie () and raven () were found dead on the premises but over the following days, buzzards () were also found dead within the local area with positive detection of HPAIV in submitted carcasses. The subacute nature of microscopic lesions within a buzzard was consistent with the timeframe of infection. Finally, a considerable number of free-living pheasants () were also found dead in the surrounding area, with carcasses having higher viral antigen loads compared to infected chickens. Limited virus dissemination was observed in the carcasses of the magpie, raven, and buzzard. Further, an avirulent avian paramyxovirus type 1 (APMV-1) was detected within poultry samples as well as in the viscera of a magpie infected with HPAIV. Immunohistochemistry did not reveal colocalization of avian paramyxovirus antigens with lesions, supporting an avirulent APMV-1 infection. Overall, this case highlights scenarios in which bi-directional transmission of avian viral diseases between commercial and wild bird species may occur. It also underlines the importance of bio separation and reduced access when infection pressure from HPAIV is high.
Topics: Animals; Influenza in Birds; Chickens; Animals, Wild; Disease Outbreaks; Influenza A Virus, H5N8 Subtype; United Kingdom; Poultry Diseases; Poultry; Crows; Birds
PubMed: 38686548
DOI: 10.1080/22221751.2024.2348521 -
Journal of Clinical Medicine Apr 2024Descending necrotizing mediastinitis (DNM) is a life-threatening condition, generally caused by downward dissemination of oropharyngeal infections through cervical...
Descending necrotizing mediastinitis (DNM) is a life-threatening condition, generally caused by downward dissemination of oropharyngeal infections through cervical fascial planes. Mediastinal drainage is conventionally achieved by thoracotomy, but a Video-Assisted Thoracoscopic Surgery (VATS) approach is gaining interest due to the reduced invasiveness of procedure. We aimed to evaluate the effectiveness of VATS treatment in patients with DNM. We conducted a retrospective multicenter study including patients with descending mediastinitis that underwent mediastinal drainage through VATS (VATS group) or thoracotomy (thoracotomy group), both in association with cervical drainage. Patients with mediastinitis secondary to cardiac, pulmonary, or esophageal surgery were excluded. The intergroup differences regarding surgical outcome and postoperative morbidity and mortality were compared. A total of 21 patients were treated for descending mediastinitis during the study period. Cervicotomy and thoracotomy were performed in 15 patients (71%), while cervicotomy and VATS were performed in 6 patients (29%). There were no significant differences in surgical outcome, postoperative morbidity, and mortality between groups. VATS treatment was not associated with a higher complication rate. Patients in the VATS group had a shorter operative time ( = 0.016) and shorter ICU stay ( = 0.026). VATS treatment of DNM is safe and effective. The comparison with thoracotomy showed no significant differences in postoperative morbidity and mortality. The VATS approach is associated with a shorter operative time and ICU stay than thoracotomy.
PubMed: 38673713
DOI: 10.3390/jcm13082440 -
Journal of Fungi (Basel, Switzerland) Apr 2024In recent years, the incidence of fungal infections in humans has increased dramatically, accompanied by an expansion in the number of species implicated as etiological... (Review)
Review
In recent years, the incidence of fungal infections in humans has increased dramatically, accompanied by an expansion in the number of species implicated as etiological agents, especially environmental fungi never involved before in human infection. Among fungal pathogens, species are the most common opportunistic fungi that can cause local and systemic infections, especially in immunocompromised individuals. () is the most common causative agent of mucosal and healthcare-associated systemic infections. However, during recent decades, there has been a worrying increase in the number of emerging multi-drug-resistant non- (NAC) species, i.e., , , , , , and . In particular, , also known as or , is a heterothallic ascomycete yeast-like fungus that has received attention in recent decades as a cause of local and systemic fungal diseases. Today, the new definition of the complex, which consists of , , and , was proposed after sequencing the 18S rRNA gene. Currently, the complex is mostly associated with non-severe ear and eye infections, although a few cases of severe candidemia have been reported in immunocompromised individuals. Low susceptibility to currently available antifungal drugs is a rising concern, especially in NAC species. In this regard, a high rate of resistance to azoles and more recently also to echinocandins has emerged in the complex. This review focuses on epidemiological, biological, and clinical aspects of the complex, including its pathogenicity and drug resistance.
PubMed: 38667965
DOI: 10.3390/jof10040294 -
Surgical and Radiologic Anatomy : SRA Jun 2024This article presents a comprehensive exploration of neurovascular anatomy of the encephalon, focusing specifically on the intricate network within the posterior... (Review)
Review
PURPOSE
This article presents a comprehensive exploration of neurovascular anatomy of the encephalon, focusing specifically on the intricate network within the posterior circulation and the posterior fossa anatomy; enhancing understanding of its dynamics, essential for practitioners in neurosurgery and neurology areas.
METHOD
A profound literature review was conducted by searching the PubMed and Google Scholar databases using main keywords related to neurovascular anatomy. The selected literature was meticulously scrutinized. Throughout the screening of pertinent papers, further articles or book chapters were obtained through additional assessment of the reference lists. Furthermore, four formalin-fixed, color latex-injected cadaveric specimens preserved in 70% ethanol solution were dissected under surgical microscope (Leica Microsystems Inc, 1700 Leider Ln, Buffalo Grove, IL 60089, USA), using microneurosurgical as well as standard instruments, and a high-speed surgical drill (Stryker Instruments 1941 Stryker Way Portage, MI 49002, USA). Ulterior anatomical dissection was performed.
RESULTS
Detailed examination of the basilar artery (BA), a common trunk formed by the union of the left and right vertebral arteries, denoted a tortuous course across the basilar sulcus. Emphasis is then placed on the Posterior Inferior Cerebellar Artery (PICA), Anterior Inferior Cerebellar Artery (AICA) and Superior Cerebellar Artery (SCA). Each artery's complex course through the posterior fossa, its divisions, and potential stroke-related syndromes are explored in detail. The Posterior Cerebral Artery (PCA) is subsequently unveiled. The posterior fossa venous system is explained, categorizing its channels. A retrograde exploration traces the venous drainage back to the internal jugular vein, unraveling its pathways.
CONCLUSION
This work serves as a succinct yet comprehensive guide, offering fundamental insights into neurovascular anatomy within the encephalon's posterior circulation. Intended for both novice physicians and seasoned neuroanatomists, the article aims to facilitate a more efficient clinical decision-making in neurosurgical and neurological practices.
Topics: Humans; Cadaver; Dissection; Cranial Fossa, Posterior; Vertebral Artery; Basilar Artery
PubMed: 38652250
DOI: 10.1007/s00276-024-03358-1 -
International Journal of Psychology :... Apr 2024Theory and research suggest that threats aroused by a given crisis lead to conspiracy beliefs. Although crises involve the arise of multiple threats (e.g., economic,...
Theory and research suggest that threats aroused by a given crisis lead to conspiracy beliefs. Although crises involve the arise of multiple threats (e.g., economic, safety, etc.) diversely affecting various needs and outcomes (i.e., cognition, emotion and behaviour), no research has yet focused on specific relations that different threats may have with the endorsement of conspiracy beliefs. In this study, we distinguished between health and economic threats aroused by the COVID-19 pandemic, and we tested their associations with conspiracy beliefs. Findings from two correlational studies conducted in Italy and Argentina showed that while COVID-19's economic threat was positively and consistently related to conspiracy beliefs, the relationship between COVID-19's health threat and conspiracy beliefs was negative and significant in the Italian sample and non-significant in the Argentinian sample. Results are discussed within the context of the effects of multiple threats elicited by crises on conspiracy beliefs.
PubMed: 38649334
DOI: 10.1002/ijop.13128 -
Polski Merkuriusz Lekarski : Organ... 2024Aim: To find the causes and factors behind the Pica disorder, which helps in early diagnosis and appropriate treatments..
OBJECTIVE
Aim: To find the causes and factors behind the Pica disorder, which helps in early diagnosis and appropriate treatments..
PATIENTS AND METHODS
Materials and Methods: A retrospective cross-section study was carried out between July 1, 2022, and April 20, 2023, enrolling 300 patients from different provinces of central and south Iraq with Pica disease whose diagnosis depended on specialized physicians according to WHO guidelines. The participants were following up for three to six months in private clinics.
RESULTS
Results: 92.4% of the patients were female, and 41% of patients were under 20 years old, with low ferritin, HB, and vitamin D levels (80% of cases), and these markers showed a negative correlation with the number of Pica. Chowing of ice and clay were the common types of Pica, which represent about 30% each, while 34% of cases had multiple types, which had signs and symptoms of fever, palpitation, vomiting, abdominal pain, paleness, headaches, and hair loss. Six-month flows were better than three months.
CONCLUSION
Conclusions: Pica was a disorder that could lead to behavior and emotional abnormalities that caused the patients to eat some things that were eaten by healthy people. This may be, as concluded from our results, due to reduced levels of ferritin, hemoglobin (Hb), and vitamin D that caused these psychological problems.
Topics: Adult; Female; Humans; Male; Young Adult; Ferritins; Middle Eastern People; Pica; Retrospective Studies; Vitamin D; Vitamins
PubMed: 38642359
DOI: 10.36740/Merkur202402112 -
Physical Review Letters Mar 2024An amplitude analysis of the B^{0}→K^{*0}μ^{+}μ^{-} decay is presented using a dataset corresponding to an integrated luminosity of 4.7 fb^{-1} of pp collision...
An amplitude analysis of the B^{0}→K^{*0}μ^{+}μ^{-} decay is presented using a dataset corresponding to an integrated luminosity of 4.7 fb^{-1} of pp collision data collected with the LHCb experiment. For the first time, the coefficients associated to short-distance physics effects, sensitive to processes beyond the standard model, are extracted directly from the data through a q^{2}-unbinned amplitude analysis, where q^{2} is the μ^{+}μ^{-} invariant mass squared. Long-distance contributions, which originate from nonfactorizable QCD processes, are systematically investigated, and the most accurate assessment to date of their impact on the physical observables is obtained. The pattern of measured corrections to the short-distance couplings is found to be consistent with previous analyses of b- to s-quark transitions, with the largest discrepancy from the standard model predictions found to be at the level of 1.8 standard deviations. The global significance of the observed differences in the decay is 1.4 standard deviations.
PubMed: 38613276
DOI: 10.1103/PhysRevLett.132.131801 -
Animals : An Open Access Journal From... Apr 2024Due to the fencing of the Przewalski's gazelle (), the microcytic anemia incidence rate continues to increase. The primary pathological symptoms include emaciation,...
Due to the fencing of the Przewalski's gazelle (), the microcytic anemia incidence rate continues to increase. The primary pathological symptoms include emaciation, anemia, pica, inappetence, and dyskinesia. To investigate the cause of microcytic anemia ailment in the Przewalski's gazelle, the Upper Buha River Area with an excessive incidence was chosen as the experimental pasture, and the Bird Island Area without microcytic anemia disease was chosen as the control field. Then, the mineral contents in the soil, forage, blood, and liver, as well as the blood routine parameters and biochemical indexes were measured. The findings showed that the experimental pasture had much lower Se content in the soil and forage than the control field ( < 0.01), while the impacted pasture had significantly higher S content in the forage. The damaged gazelles had considerably lower Se and Cu contents and higher S content in the blood and liver than the healthy gazelles ( < 0.01). The presences of Hb, HCT, MCV, and MCH were significantly decreased compared to those in healthy gazelles ( < 0.01). The experimental group had a significantly lower level of GSH-Px activity in their serums compared to the control group ( < 0.01). In the treatment experiment, ten gazelles from the affected pasture were orally administered CuSO, 6 g/animal once every 10 days for two consecutive times, and all gazelles were successfully cured. Therefore, it is possible that low Se content in the soil induced an increase in the absorption of S content by forage, leading to the deficiency of secondary Cu in the Przewalski's gazelles, resulting in microcytic anemia.
PubMed: 38612353
DOI: 10.3390/ani14071114 -
Translational Stroke Research Apr 2024The objective of this study is to conduct a systematic review and meta-analysis aimed at evaluating the efficacy and safety of flow-diverting devices (FDs) treatment for...
The objective of this study is to conduct a systematic review and meta-analysis aimed at evaluating the efficacy and safety of flow-diverting devices (FDs) treatment for intracranial vertebral artery (VA) aneurysms. We searched PubMed, Web of Science, OVID, and Embase for English-language studies up to February 2024 and included clinical studies on FD treatment of intracranial VA aneurysms. Sensitivity analysis evaluated outcome stability. Of 2273 articles, 29 studies involving 541 aneurysms treated with FDs were included. Based on the Methodological Index for Non-Randomized Studies (MINORS), six were high-quality and 23 moderate quality. FD treatment showed a 95% rate of favorable clinical outcomes (95% CI, 89-99%), 81% (95% CI, 74-88%) complete aneurysmal occlusion, 4% (95% CI, 2-7%) ischemic complication incidence, 1% (95% CI, 0-3%) hemorrhagic complication incidence, 95% (95% CI, 87-100%) posterior inferior cerebellar artery (PICA) preservation, and 6% (95% CI, 3-10%) in-stent stenosis or occlusion across clinical and angiographic follow-up periods of 13.62 months (95% CI, 10.72-16.52) and 11.85 months (95% CI, 9.36-14.33), respectively. Subgroup analyses, based on a 12-month angiographic follow-up threshold, indicated no statistically significant differences in rates of complete aneurysm occlusion, PICA preservation, or in-stent stenosis or occlusion incidence (p > 0.05) between subgroups. Moreover, significant differences were observed in clinical and angiographic outcomes between ruptured and unruptured aneurysms, particularly in hemorrhagic complications (p < 0.05), without significant disparity in ischemic complications (p > 0.05). The results' stability was confirmed via sensitivity analysis. FDs treatment for VA aneurysms is efficacious and safe, offering high rates of positive clinical and angiographic outcomes with minimal complications, underscoring FDs' viability as a treatment option for VA aneurysms. The study was registered with PROSPERO (registration number: CRD42024499894).
PubMed: 38602659
DOI: 10.1007/s12975-024-01251-y