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Atherosclerosis Jun 2024The role of aortic mineralization in the pathogenesis of acute type B aortic dissection (TBAD) is unclear. Whether thoracic aortic calcification (TAC) and circulating...
BACKGROUND AND AIMS
The role of aortic mineralization in the pathogenesis of acute type B aortic dissection (TBAD) is unclear. Whether thoracic aortic calcification (TAC) and circulating alkaline phosphatase (ALP) activity are associated with acute TBAD risk remains elusive.
METHODS
Observational and Mendelian randomization (MR) studies were conducted sequentially. Using propensity score matching (1:1) by age and sex, patients with acute TBAD (n = 125) were compared with control patients (n = 125). Qualitative (score) and quantitative (volume) analyses of the TAC burden on different thoracic aortic segments were conducted using non-enhanced computed tomography. Univariate and multivariate analyses were used to identify significant independent risk factors for TBAD and TAC burden, respectively. MR was finally used to determine the causal relationship between elevated ALP activity and TBAD risk.
RESULTS
The qualitative and quantitative analyses revealed that TAC burden was significantly higher in the TBAD group, except for in the ascending aortic segment (both p < 0.05). Preoperative circulating ALP was significantly elevated in the TBAD group (p < 0.001). The elevated TAC burden score on the descending thoracic aortic segment (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31-8.37) and increased ALP activity (OR 1.03, 95% CI 1.01-1.06) was independently associated with TBAD risk. Interestingly, ALP was significantly positively associated with TAC burden, and MR analyses confirmed that ALP genetically predicted TBAD risk.
CONCLUSIONS
Elevated ALP may trigger TBAD risk via the increased volume of TAC. Aortic mineralization may not protect the aorta itself.
PubMed: 38944894
DOI: 10.1016/j.atherosclerosis.2024.118519 -
Journal of the American Geriatrics... Jun 2024Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and...
BACKGROUND
Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults.
METHODS
We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self-rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function.
RESULTS
We analyzed data from 3940 respondents over 10 years of follow-up. A greater number of sensory disabilities was associated with greater hazard of low self-rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self-rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self-rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01).
CONCLUSIONS
Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults.
PubMed: 38944677
DOI: 10.1111/jgs.19056 -
Cardiovascular and Interventional... Jun 2024Retrograde type A aortic dissection (RTAD) represents a serious complication of endovascular treatment for type B aortic dissection (TBAD). To avoid RTAD, it is...
PURPOSE
Retrograde type A aortic dissection (RTAD) represents a serious complication of endovascular treatment for type B aortic dissection (TBAD). To avoid RTAD, it is recommended to land the proximal end of the stent graft in a non-dissected aortic segment. In this study, we investigated whether landing in the dissection area increased the number of events at the proximal site.
METHODS
We conducted a retrospective review of endovascular treatments for TBAD at a single institution between 2009 and 2022. Patients were divided into two groups: group A, with a proximal landing zone entirely within the dissected area, and group B, with the proximal extent of the seal zone in the non-dissected area. We evaluated the occurrence of proximal events, including RTAD, and examined long-term outcomes to assess the validity of landing in the dissection area.
RESULTS
The study included eighty-nine patients who underwent endovascular treatment for TBAD. New intimal tears in the proximal landing site occurred in 3 cases (3.4%), with 1 case (2%) in group A and 2 cases (5.1%) in group B, showing no significant difference. Among the three cases, one (1.1%) in group B with zone 2 landing resulted in RTAD. At 60 months, the overall survival was 85%, and freedom from aorta-related mortality was 88%, with no significant difference between the groups.
CONCLUSION
Even if the proximal landing is in a dissected area, a treatment strategy performed in zone 3 without proximal landing in zone 2, seeking a non-dissected area, can still provide sufficient therapeutic effects. Level of Evidence 3 Retrospective single-center cohort analysis.
PubMed: 38944660
DOI: 10.1007/s00270-024-03791-0 -
Arthroscopy : the Journal of... Jun 2024Cadaveric investigation of the pathomechanics of hip ischiofemoral impingement syndrome is revealing, and shows that hip external rotation reduces the ischiofemoral...
Cadaveric investigation of the pathomechanics of hip ischiofemoral impingement syndrome is revealing, and shows that hip external rotation reduces the ischiofemoral space, as does hip extension, combined femoral and acetabular anteversion, and coxa valga. "Impingement syndromes" are a combined failure of compatibility of the anatomy to the desired movement pattern. 3D models based on CT imaging can create a patient specific model that predicts area of collision area and points of impact during multiplanar movement. 3D models based on MRI of the hip shows higher frequency of extra-articular impingement at early stages of external rotation and extension in hips that displayed ischiofemoral impingement compared to non-impinging hips. However, a limit of fluoroscopy as well as 3D modeling is that soft tissue is not revealed. Cadaveric dissection reveals muscle, nerve, and blood vessels that best explain the pathoanatomy. We owe a great debt not only to researchers, but also to human cadaveric gift donors.
PubMed: 38944321
DOI: 10.1016/j.arthro.2024.06.030 -
Annals of Vascular Surgery Jun 2024Thoracic aortic aneurysms evolving within a type IIIb chronic aortic dissection are mostly treated with the deployment of an endograft. However, several cases of...
Thoracic aortic aneurysms evolving within a type IIIb chronic aortic dissection are mostly treated with the deployment of an endograft. However, several cases of dissecting aneurysms are associated with a significant dilatation of the aortic arch. These cases are usually managed in two steps : arch reconstruction or supra-aortic trunk debranching at first and a secondary graft deployment for the descending thoracic aorta. We present through this case series an alternative approach for this severe condition which consists in the replacement of the thoracic aorta from its hemi-arch to the distal thoracic or visceral aorta using a left thoracotomy. We deliberately neglected the remaining dissecting aorta if its diameter was below 45 mm, hypothesizing its non evolution after repair. From 2012 to 2021, 9 patients have been treated for a thoracic aneurysm evolving after a IIIb chronic aortic dissection using a left thoracotomy and a 19°C circulatory arrest. Immediate postoperative results show no mortality nor neurological disorders and the 7 years follow up for all of these 9 cases enlightened the absence of aneurysmal evolution especially for the distal anastomosis and the remaining dissected aorta. This work suggests that this direct approach strategy can definitively treat a thoracic dissecting aneurysm unsuitable for a simple endovascular treatment.
PubMed: 38944192
DOI: 10.1016/j.avsg.2024.04.012 -
Microbes and Infection Jun 2024The endogenous retrovirus type W (HERV-W) is a human-specific entity, which was initially discovered in multiple sclerosis (MS) patient derived cells. We initially found...
The endogenous retrovirus type W (HERV-W) is a human-specific entity, which was initially discovered in multiple sclerosis (MS) patient derived cells. We initially found that the HERV-W envelope (ENV) protein negatively affects oligodendrogenesis and controls microglial cell polarization towards a myelinated axon associated and damaging phenotype. Such first functional assessments were conducted ex vivo, given the human-specific origin of HERV-W. Recent experimental evidence gathered on a novel transgenic mouse model, mimicking activation and expression of the HERV-W ENV protein, revealed that all glial cell types are impacted and that cellular fates, differentiation, and functions were changed. In order to identify HERV-W-specific signatures in glial cells, the current study analyzed the transcriptome of ENV protein stimulated microglial- and astroglial cells and compared the transcriptomic signatures to lipopolysaccharide (LPS) stimulated cells, owing to the fact that both ligands can activate toll-like receptor-4 (TLR-4). Additionally, a comparison between published disease associated glial signatures and the transcriptome of HERV-W ENV stimulated glial cells was conducted. We, therefore, provide here for the first time a detailed molecular description of specific HERV-W ENV evoked effects on those glial cell populations that are involved in smoldering neuroinflammatory processes relevant for progression of neurodegenerative diseases.
PubMed: 38944109
DOI: 10.1016/j.micinf.2024.105382 -
International Journal of Surgery Case... Jun 2024Transverse testicular ectopia (TTE) is a rare congenital condition characterized by migration of both testes through the same inguinal canal and often presents with an...
INTRODUCTION
Transverse testicular ectopia (TTE) is a rare congenital condition characterized by migration of both testes through the same inguinal canal and often presents with an inguinal hernia. TTE is associated with various genitourinary anomalies.
CASE PRESENTATION
A three-year-old boy presented with a non-palpable right testis and a palpable undescended left testis in the left inguinal area. Ultrasound (US) indicated the presence of both testes in the left inguinal canal. In surgery, the two testes were found with separated cord and one hernia sac which was dissected and ligated thus the two cords freed. Next, subdartos pouches were created on both scrotum sides, so that testes placed into the left side first, and then a window created in the scrotal septum which allowed the right testis to be translocated and secured in the right subdartos pouch without tension.
DISCUSSION
TTE is a rare condition and the etiology is not definitively known. TTE usually presents with an inguinal hernia and contralateral cryptorchidism. The diagnosis is made during surgery, but some radiological methods can help in diagnosis. Management is usually surgical and involves interventions such as hernia repair, reduction of the testis and orchiopexy. Continuous monitoring is essential for ensuring postoperative testes health and evaluating the risk of malignancy.
CONCLUSION
TTE should be suspected in cases with unilateral empty scrotum and family history of genital disorders. US is critical for accurately localizing the testes, along with surgical exploration, to proceed with the appropriate surgical intervention.
PubMed: 38943934
DOI: 10.1016/j.ijscr.2024.109949 -
Current Opinion in Plant Biology Jun 2024Studying morphological novelties offers special insights into developmental biology and evolution. The inflated calyx syndrome (ICS) is a largely unrecognized but... (Review)
Review
Studying morphological novelties offers special insights into developmental biology and evolution. The inflated calyx syndrome (ICS) is a largely unrecognized but fascinating feature of flower development, where sepals form balloon-like husks that encapsulate fruits. Despite its independent emergence in many lineages of flowering plants, the genetic and molecular mechanisms of ICS remain unknown. Early studies in the Solanaceae genus Physalis put forth key roles of MADS-box genes in ICS. However, recent work suggests these classical floral identity transcription factors were false leads. With newfound capabilities that allow rapid development of genetic systems through genomics and genome editing, Physalis has re-emerged as the most tractable model species for dissecting ICS. This review revisits current understanding of ICS and highlights how recent advancements enable a reset in the search for genetic and molecular mechanisms using unbiased, systematic approaches.
PubMed: 38943829
DOI: 10.1016/j.pbi.2024.102595 -
Plant & Cell Physiology Jun 2024Root parasitic plants in the Orobancheceae, such as Striga and Orobanche, cause significant damage to crop production. The germination step of these root parasitic...
Root parasitic plants in the Orobancheceae, such as Striga and Orobanche, cause significant damage to crop production. The germination step of these root parasitic plants is induced by host-root-derived strigolactones (SLs). After germination, the radicles elongate toward the host and invade the host root. We have previously discovered that a simple amino acid, tryptophan (Trp), as well as its metabolite, the plant hormone indole-3-acetic acid (IAA), can inhibit radicle elongation of Orobanche minor. These results suggest that auxin plays a crucial role in the radicle elongation step in root parasitic plants. In this report, we used various auxin chemical probes to dissect the auxin function in the radicle growth of O. minor and Striga hermonthica. We found that synthetic auxins inhibited radicle elongation. In addition, auxin receptor antagonist, auxinole, rescued the inhibition of radicle growth by exogenous IAA. Moreover, a polar transport inhibitor of auxin, N-1-naphthylphthalamic acid (NPA), affected radicle bending. We also proved that exogenously applied Trp is converted into IAA in O. minor seeds, and auxinole partly rescued this radicle elongation. Our data demonstrate a pivotal role of auxin in radicle growth. Thus, manipulation of auxin function in root parasitic plants should offer a useful approach to combat these parasites.
PubMed: 38943636
DOI: 10.1093/pcp/pcae071 -
Bratislavske Lekarske Listy 2024This study aimed to assess the perceived need among surgical residents to revisit their anatomical knowledge and evaluate their attitude towards integrating clinical...
OBJECTIVE
This study aimed to assess the perceived need among surgical residents to revisit their anatomical knowledge and evaluate their attitude towards integrating clinical anatomists into surgical residency program curriculum.
BACKGROUND
While medical students learn human anatomy during undergraduate years, the practical application of clinically oriented anatomy becomes vital in surgical specialties. However, this aspect has not been adequately addressed in Indian surgical residency programs.
METHODS
An 11-item questionnaire, including closed-ended and Likert-scale questions, was administered to 153 surgical residents. Consent was obtained, and responses were collected via Google Forms.
RESULTS
Half of the respondents (50%) felt confident in their self-directed anatomy learning, but 87% believed integrating clinical anatomists would enhance their surgical expertise. Additionally, 88% saw value in revisiting cadaveric dissection. Third-year residents showed a significantly higher inclination towards cadaveric dissection. Deficiencies in the curriculum and time constraints were identified as major barriers.
CONCLUSION
The study highlights a perceived need among surgical residents to augment their anatomical knowledge, advocating for the integration of clinical anatomists and cadaveric dissection into training. A collaborative approach, emphasizing both horizontal and vertical integration of anatomy, is recommended to enhance surgical education and practice. (Tab. 4, Fig. 1, Ref. 25).
Topics: Humans; Internship and Residency; Anatomy; Surveys and Questionnaires; Curriculum; Anatomists; India; Female; Male; Surgeons; Dissection; Attitude of Health Personnel; General Surgery
PubMed: 38943507
DOI: 10.4149/BLL_2024_69