1,616 research outputs found

    Systemic function impairment and neurodegeneration in the general population

    Get PDF

    Intracranial aneurysms in patients with Kawasaki disease or thoracic aortic aneurysms

    Get PDF
    Saccular intracranial aneurysm (sIA) is the most common type of IAs and characterized by outpoching sac with a neck arising from the cerebral artery wall. Pathophysiology of IAs are still poorly understood. Fusiform IA is a focal circumferential dilatation of the cerebral artery and unlike sIAs, do not have aneurysm neck, which make their treatment more complex compared to sIAs. The primary goal in the study I and II were to evaluate if Kawasaki disease (KD) is associated with increased risk for IAs (I) and white matter hyperintensities (WMH) (II); in the study III if sIAs are related with increased risk for thoracic aortic aneurysms (TAA) or dilatations (TAD); and in the study IV was to evaluate outcomes of flow diverter stent (FD) treatment of the ruptured posterior circulation fusiform IAs. In the study (I and II) 40 adults with a history of KD in a childhood were screened with brain Magnetic Resonance Imaging and Angiography for IAs and brain WMHs. No IAs were found in KD patients, which is significantly under the prevalence of 10% (95% CI 0%-8.8%, p = 0.03) that is the recommended limit for IA screening. In the study (II), we found that Kawasaki disease is related with increased WMH burden compared to age- and sex-matched migraine controls. Our study suggests that KD is not associated with IAs, but instead is associated with increased WMH burden, indicating long-term cerebrovascular involvement of KD. In the study (III) we retrospectively reviewed 411 patients with sIAs and available imaging studies (computed tomography or magnetic resonance imaging) of all thoracic aortic segments for TADs and TAAs. The prevalence of TADs and TAAs were 18% and 8%. Rheumatic disease and alcohol abuse were significant risk factors for TADs/TAAs. Our results suggests that sIAs might be associated with increased risk for TAAs and TADs. In the study (IV) five patients with ruptured posterior circulation fusiform aneurysms and treated with a FD were reviewed rertrospectively. We found that FD is a feasible treatment option for ruptured fusiform posterior circulation IAs, with a high aneurysm occlusion rate (100% at 6-months) and 80% of patients had a good outcome. However, FD treatment carries a significant risk for complications and should be considered only when other treatment options are not available.Aivovaltimoaneurysmien yhteys Kawasakin tautiin ja rinta-aortan laajentumiin. Sakkulaarinen aivovaltimoaneurysma (sIA) on yleisin aivoaneurysmatyyppi. SIA on aivovaltimoiden seinämästä työntyvä paikallinen pullistuma, joka yhdistyy aivovaltimon seinämään kaulalla. Fusiforminen IA on aivovaltimon paikallinen laajentuma ja toisin kuin sIA:ssa, fusiformisessa IA:ssa ei ole erillistä kaulaa, joka tekee hoidosta haastavaa. IA:ien syntymisen patofysiologia tunnetaan huonosti. Tutkimuksien (I) ja (II) tavoitteena oli selvittää, onko lapsuuden Kawasakin taudilla yhteyttä suurentuneeseen riskiin vuotamattomille IA:lle ja aivojen valkean aineen muutoksille. Tutkimuksen (III) tavoitteena oli selvittää ovatko sIA:t yhteydessä suurentuneeseen riskiin torakaaliaortan aneurysmille (TAA) tai dilataatioille (TAD). Tutkimuksen (IV) tarkoituksena oli selvittää flow diverter stenttihoidon (FD) tuloksia vuotaneiden takaverenkierron fusiformisten IA:ien hoidossa. Tutkimuksissa (I ja II) 40:lle lapsuudessa Kawasakin taudin sairastaneelle potilaalle suoritettiin aivojen ja aivoverisuonten magneettikuvaus IA:ien ja WMH muutosten seulomiseksi. Valkean aineen muutosten määrää verrattiin ikä- ja sukupuolivakioituihin verrokkeihin (migreenipotilaat). Kawasakin taudin sairastaneilla potilailla ei todettu IA:a ja prevalenssi oli merkittävästi alle suositellun IA:en seulontarajan 10 % (95 % CI 0 %-8.8 %, p= 0.03). Sen sijaan Kawasakin taudin sairastaneilla henkilöillä oli merkittävästi enemmän valkean aineen muutoksia verrokkeihin nähden, viitaten siihen, että Kawasakin taudilla voi olla myös aivoverisuoniin kohdistuvia vaikutuksia. Tutkimuksessa (III) analysoimme retrospektiivisetsti 411 sIA potilasta, joilla oli kuvannettu rinta-aortta tietokonetomografialla tai magneettikuvauksella. TAD:n ja TAA:n prevalenssi oli 18 % ja 8 %. Reumasairaus ja alkoholin väärinkäyttö lisäsivät merkittävästi riskiä TAD:lle/TAA:lle. SIA:iin saattaa liittyä suurentunut riski TAD:lle/TAA:lle. Tutkimuksessa (IV) analysoimme retrospektiivisesti viisi potilasta, joiden vuotanut aivojen takaverenkierron fusiforminen IA oli hoidettu FD:llä. Aneurysmien hoitotulokset olivat hyviä FD:llä ja 80 % potilaista toipuivat hyvin. FD hoitoon liittyy kuitenkin merkittäviä komplikaatioriskejä ja FD hoitoa tulisi miettiä vuotaneissa aneurysmissa vain, jos muut hoitovaihtoehdot katsotaan mahdottomiksi

    Effects of municipal smoke-free ordinances on secondhand smoke exposure in the Republic of Korea

    Get PDF
    ObjectiveTo reduce premature deaths due to secondhand smoke (SHS) exposure among non-smokers, the Republic of Korea (ROK) adopted changes to the National Health Promotion Act, which allowed local governments to enact municipal ordinances to strengthen their authority to designate smoke-free areas and levy penalty fines. In this study, we examined national trends in SHS exposure after the introduction of these municipal ordinances at the city level in 2010.MethodsWe used interrupted time series analysis to assess whether the trends of SHS exposure in the workplace and at home, and the primary cigarette smoking rate changed following the policy adjustment in the national legislation in ROK. Population-standardized data for selected variables were retrieved from a nationally representative survey dataset and used to study the policy action’s effectiveness.ResultsFollowing the change in the legislation, SHS exposure in the workplace reversed course from an increasing (18% per year) trend prior to the introduction of these smoke-free ordinances to a decreasing (−10% per year) trend after adoption and enforcement of these laws (β2 = 0.18, p-value = 0.07; β3 = −0.10, p-value = 0.02). SHS exposure at home (β2 = 0.10, p-value = 0.09; β3 = −0.03, p-value = 0.14) and the primary cigarette smoking rate (β2 = 0.03, p-value = 0.10; β3 = 0.008, p-value = 0.15) showed no significant changes in the sampled period. Although analyses stratified by sex showed that the allowance of municipal ordinances resulted in reduced SHS exposure in the workplace for both males and females, they did not affect the primary cigarette smoking rate as much, especially among females.ConclusionStrengthening the role of local governments by giving them the authority to enact and enforce penalties on SHS exposure violation helped ROK to reduce SHS exposure in the workplace. However, smoking behaviors and related activities seemed to shift to less restrictive areas such as on the streets and in apartment hallways, negating some of the effects due to these ordinances. Future studies should investigate how smoke-free policies beyond public places can further reduce the SHS exposure in ROK

    30th European Congress on Obesity (ECO 2023)

    Get PDF
    This is the abstract book of 30th European Congress on Obesity (ECO 2023

    Analysis of the retina and visual pathway by OCT, OCTA and psychophysical tests in asymptomatic subjects at high genetic risk for the development of Alzheimer's disease

    Get PDF
    Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 15-07-2022La Enfermedad de Alzheimer (EA) es una enfermedad neurodegenerativa progresiva que se caracteriza: por una atrofia cortical difusa, declive de las funciones cognitivas, así como la agregación anormal de proteínas como la beta amiloide fibrilar (Aß) y tau hiperfosforilada (p-Tau).El factor de riesgo prevalente es la edad avanzada, tras el cual destaca la herencia genética. Elmayor factor de riesgo genético conocido es ser portador de al menos un alelo 4 del gen de la apoliproteina E (ApoE). Otro de los factores que incrementa el riesgo para desarrollar la EA, es la historia familiar de primer grado. Los signos cerebrales de la EA aparecen décadas antes del inicio clínico de la enfermedad. Dado que la relación entre cerebro y retina se establece ya desde la etapa embrionaria, los cambios retinianos detectados con técnicas de diagnóstico oftalmológico en sujetos con alto riesgo genético para el desarrollo de EA posibilitan la identificación de potenciales pacientes de EA en etapas muy tempranas...Alzheimer's disease (AD) is a progressive neurodegenerative disease characterised by: diffuse cortical atrophy, decline in cognitive functions, as well as abnormal aggregation of proteins such as fibrillar amyloid Beta (Aβ) and hyperphosphorylated tau(p-Tau).The prevalent risk factor is older age, after which genetic inheritance is the most important. The major known genetic risk factor is carrying at least one 4 allele of the apoliprotein E (ApoE 4)gene. Another factor that increases the risk of developing AD is a first-degree family history. Brain signs of AD appear decades before clinical onset of the disease. Since the relationship between brain and retina is established as early as the embryonic stage, retinal changes detected with ophthalmological diagnostic techniques in subjects at high genetic risk for developing AD make it possible to identify potential AD patients at very early stages..Fac. de MedicinaTRUEunpu

    Hemodynamic Quantifications By Contrast-Enhanced Ultrasound:From In-Vitro Modelling To Clinical Validation

    Get PDF
    • …
    corecore