Carotid endarterectomy (CEA) is an effective surgical option for stroke prophylaxis in most patients. Restenosis after CEA can lead to re-intervention and adverse events, but the factors predicting restenosis are poorly understood. Apolipoprotein J (ApoJ) is considered to be a novel predictive factor of vascular restenosis and is associated with a large number of processes related to atherosclerosis and cell-cycle phases. The aim of this study was to elucidate the predictive value of Apo J in internal carotid artery (ICA) restenosis following CEA. This retrospective study examined all prospectively collected data for patients who underwent CEA at our surgical department over a 2-year period. The serum ApoJ levels of 100 patients were examined; 56 patients who underwent CEA comprised the vascular group (VG), and 44 patients who underwent minor surgery comprised the control group (CG). ApoJ samples were obtained preoperatively, 24 h after the surgical procedure and at 1, 6 and 12 months thereafter during the follow-up. The preoperative difference in ApoJ levels between the CG and VG was statistically signifcant; the mean values were 39.11±14.16 and 83.03±35.35 μg/mL, respectively. In the VG, the serum ApoJ levels were 112.09±54.40, 71.20±23.70, 69.92±25.76 and 62.25±19.17 μg/mL at postoperative day 1 and at 1, 6 and 12 months post-operatively, respectively, while the ApoJ concentrations of patients in the CG remained unchanged. Further subdivision of the VG into patients with or without restenosis revealed that restenosis patients presented signifcantly higher mean ApoJ values than non-restenosis VG patients. In summary, ApoJ seems to be an important predictor for carotid restenosis at 6 and 12 months postoperatively.
Warfarin-induced skin necrosis is an infrequent and well-recognized complication of warfarin treatment. The incidence was estimated between 0.01% and 0.1% whereas a paradoxal prothrombotic state that arises from warfarin therapy seems to be responsible for this life-threatening disease. To the best of our knowledge we present the first case of an old woman diagnosed with warfarin-induced skin necrosis, in whom novel oral anticoagulants and extensive surgical debridement were combined safely with excellent results.
Background:
Carbon dioxide (CO2) exists in nature around us. In the middle of the 20th century, the
intraluminal injection of CO2 demonstrated similar results to those of Digital Subtraction Angiography (DSA)
with an iodinated contrast agent (ICA). Since then, the technology behind CO2 DSA has developed significantly.
Objective:
The aim of this study is to inform physicians about the unique properties of CO2 and its physiology
after intraluminal injection.
Methods:
An extensive search for English literature on the properties of CO2 and the physiology of intraluminal
administration was conducted using Pubmed.
Results:
There is sufficient literature on the properties of CO2 and the physiology of CO2 DSA. A review of this
literature explains what happens to the human organism after the injection of CO2.
Conclusions:
There is enough evidence that CO2 DSA is both effective, diagnostic and safe, but the properties of
CO2 should be taken under consideration as complications occur, although rarely.
expressed in patients with abdominal aortic aneurysm (AAA) and healthy donors that could be used as potential biomarkers. Methods -Thirty patients with AAA (AAA group), 16 healthy volunteers (CTR group) and 11 patients with carotid stenosis (EAC group) were recruited. In CTR group and EAC group the presence of AAA was discarded by abdominal Eco-Doppler.The study consists in two phases. First, 179 miRs that are abundant in plasma were screened, with Serum/plasma Focus microRNA PCR Panel V4 (Exiqon), in a sample of 14 subjects (7 from AAA group, 7 from CTR group). Results, expressed as CTs, were normalized to an endogenous reference miR (miR-191-5p). miRs candidates were identified with a classification algorithm of Random Forest. Second, selected miRs were quantified with RT-qPCR in the whole sample (N¼57). Results were adjusted with a multivariable regression model according to cardiovascular risk factors (age, hypertension, diabetes and smoking habits). The analysis was done with the statistical software R (3.3.2 version) with a significant p-value under 0.05. Results -After the preliminary phase, we selected 9 miRs candidates that could be differentially expressed in patients with AAA and CTR group. The 9 miRs were quantified in the whole sample (N¼57) and 7 of these miRs were slightly overexpressed in AAA.After the adjustment with a multivariable model we observed that miR-27b-3p and miR-221-3p were overexpressed in AAA 1.6 times (p¼0.047, IC95%, 0.014-0.841) and 1.9 times (p¼0.001, IC95%, 0.145-0.521) respectively, with respect to the CTR group. No differences were found when compared these miRs expression in AAA group and EAC group. Conclusion -We have found two circulating miRs that are differentially expressed in patients with AAA regarding to healthy donors. However these miRs resulted unspecific and they were elevated in patients with carotid stenosis too. These miRs could be involved in common mechanisms to both pathologies, indeed, it has been previously described that miR-221-3p could be related to vascular smooth muscle cells proliferation(3) and vulnerability of the atherosclerotic plaque and miR-27b-3p could be involved in metabolism of lipids(4) and cholesterol efflux.
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