Postoperative fluid collection after hybrid debranching and endovascular repair of thoracoabdominal aortic aneurysms

ObjectiveHybrid thoracic endovascular aneurysm repair (H-TEVAR) to include visceral and renal debranching has emerged as a potential therapeutic option for thoracoabdominal aneurysms (TAAA). This study was performed to characterize the frequently noted development of postoperative fluid collections surrounding the bypass grafts.MethodsAll patients undergoing H-TEVAR from 2000-2010 (n = 39, 43.6% male) were identified. One hundred thirty-two bypasses were constructed (median 4 per patient) using either polyester (30), thin-walled polytetrafluoroethylene (ePTFE, 100) or saphenous vein (2). Follow-up computed tomography (CT) imaging was routinely performed at 1 and 6 months, and annually thereafter.ResultsOf the 37 patients with one follow-up CT, 20 (54.1%) were found to have fluid collections. The natural history of the 17 patients with collections and further follow-up imaging was variable, with 2 resolving, 6 stable, and 9 enlarging. Two patients with collections developed evidence of graft infection requiring reoperation. Two patients with enlarging sterile collections required evacuation for symptoms. By multivariate analysis, both preoperative creatinine (P = .005) and number of bypasses constructed (P = .04) independently correlated with the development of a fluid collection.ConclusionsPostoperative fluid collections following hybrid debranching procedures identified in this series represent a unique complication not previously described. The subsequent clinical course of these fluid collections is variable and ranges from benign to frank graft infection and relate both to patient factors, as well as specific operative strategies. Longer-term studies with more robust numbers of patient numbers are warranted to determine whether this complication may limit the long-term durability of this procedure

Postoperative fluid collection after hybrid debranching and endovascular repair of thoracoabdominal aortic aneurysms

ObjectiveHybrid thoracic endovascular aneurysm repair (H-TEVAR) to include visceral and renal debranching has emerged as a potential therapeutic option for thoracoabdominal aneurysms (TAAA). This study was performed to characterize the frequently noted development of postoperative fluid collections surrounding the bypass grafts.MethodsAll patients undergoing H-TEVAR from 2000-2010 (n = 39, 43.6% male) were identified. One hundred thirty-two bypasses were constructed (median 4 per patient) using either polyester (30), thin-walled polytetrafluoroethylene (ePTFE, 100) or saphenous vein (2). Follow-up computed tomography (CT) imaging was routinely performed at 1 and 6 months, and annually thereafter.ResultsOf the 37 patients with one follow-up CT, 20 (54.1%) were found to have fluid collections. The natural history of the 17 patients with collections and further follow-up imaging was variable, with 2 resolving, 6 stable, and 9 enlarging. Two patients with collections developed evidence of graft infection requiring reoperation. Two patients with enlarging sterile collections required evacuation for symptoms. By multivariate analysis, both preoperative creatinine (P = .005) and number of bypasses constructed (P = .04) independently correlated with the development of a fluid collection.ConclusionsPostoperative fluid collections following hybrid debranching procedures identified in this series represent a unique complication not previously described. The subsequent clinical course of these fluid collections is variable and ranges from benign to frank graft infection and relate both to patient factors, as well as specific operative strategies. Longer-term studies with more robust numbers of patient numbers are warranted to determine whether this complication may limit the long-term durability of this procedure

Elevating the impact of conservation physiology by building a community devoted to excellence, transparency, ethics, integrity and mutual respect

[Extract] Ten years ago, the journal Conservation Physiology was launched jointly by the Society for Experimental Biology and Oxford University Press. Much has been accomplished since 2012 including publishing over 600 papers in the journal and helping to build a sense of place for aspiring and practicing conservation physiologists (Cooke et al., 2020). Yet, more work is needed to further elevate the impact of conservation physiology as a discipline and community. Here, we summarize what is needed to build and strengthen a community devoted to not only excellence, transparency, ethics, integrity and mutual respect, but also courage to tackle some of the overarching challenges humanity faces. As active voices in the conservation physiology community we hope that this paper will help shape the future of our discipline while also guiding the activities and priorities of the journal and editorial team. Since the term ‘conservation physiology’ was coined by Wikelski and Cooke (2006) it has emerged as an essential component of conservation science and practice. Conservation physiology is about the use of physiological tools, knowledge and concepts to understand and solve conservation problems across diverse taxa (Cooke et al., 2013). It is regarded as being particularly effective at understanding mechanisms, generating cause–effect relationships (e.g. threat X does Y to organism Z), creating predictive tools and testing conservation interventions (Cooke and O’Connor, 2010). Issues relevant to conservation physiology range from very local, focused on recovery of an imperilled population (Birnie-Gauvin et al., 2017), to global-scale issues such as tackling the UN Sustainable Development Goals (Cooke et al., 2020) and the climate crisis (Madliger et al., 2021c). The discipline is now supported by a conceptual framework (Coristine et al., 2014), a journal (https://academic.oup.com/conphys) and a reference book (Madliger et al. 2021a). There is also a growing community of researchers who engage in conservation physiology and even define themselves as conservation physiologists (Madliger et al., 2021b). Moreover, in conservation physiology there are success stories that demonstrate the potential of conservation physiology (Madliger et al., 2016)

Multiple primary melanomas in a CDKN2A mutation carrier exposed to ionizing radiation

Background: Recent research has shown a possible causal relationship between ionizing radiation exposure and melanoma. Individuals with mutations in CDKN2A (cyclin-dependent kinase inhibitor 2A), the major melanoma predisposition gene, have an increased susceptibility to melanoma-promoting exposures, such as UV light. We describe a patient from a familial melanoma pedigree with 7 primary melanomas on the right side of her body, the first occurring 5 years after exposure to atmospheric nuclear bomb testing in the 1950s. Observations: Physical examination revealed phototype I skin, red hair, and 26 nevi (14 on the right and 12 on the left side of her body). One nevus was larger than 5 mm, and 2 were clinically atypical. Sequence analysis demonstrated a known deleterious mutation in CDKN2A (G-34T) and homozygosity for a red hair color variant in MC1R (melanocortin 1 receptor) (R151C). Fluorescence in situ hybridization analysis of blood, fibroblasts, and melanocytes from both upper extremities ruled out mosaicism. Conclusions: Individuals such as this patient, who has CDKN2A and MC1R mutations, are likely to be more susceptible to environmental insults. A careful review of environmental exposures in these vulnerable cases may reveal cancer-promoting agents, such as ionizing radiation, that go unnoticed in less susceptible populations

A brain-infecting parasite impacts host metabolism both during exposure and after infection is established

Metabolic costs associated with parasites should not be limited to established infections. Even during initial exposure to questing and attacking parasites, hosts can enact behavioural and physiological responses that could also incur metabolic costs. However, few studies have measured these costs directly. Hence, little is known about metabolic costs arising from parasite exposure. Furthermore, no one has yet measured whether and how previous infection history modulates metabolic responses to parasite exposure. Here, using the California killifish Fundulus parvipinnis and its brain‐infecting parasite Euhaplorchis californiensis, we quantified how killifish metabolism, behaviour and osmoregulatory phenotype changed upon acute exposure to parasite infectious stages (i.e. cercariae), and with long‐term infection. Exposure to cercariae caused both naïve and long‐term infected killifish to acutely increase their metabolic rate and activity, indicating detection and response to parasite infectious stages. Additionally, these metabolic and behavioural effects were moderately stronger in long‐term infected hosts than naïve killifish, suggesting that hosts may develop learned behavioural responses, nociceptor sensitization and/or acute immune mechanisms to limit new infections. Although established infection altered the metabolic response to parasite exposure, established infection did not alter standard metabolic rate, routine metabolic rate, maximum metabolic rate, aerobic scope or citrate synthase enzyme activity. Unexpectedly, established infection reduced lactate dehydrogenase enzyme activity in killifish brains and relative Na+/K+‐ATPase abundance in gills, suggesting novel mechanisms by which E. californiensis may alter its hosts\u27 behaviour and osmoregulation. Thus, we provide empirical evidence that parasites can disrupt the metabolism of their host both during parasite exposure and after infection is established. This response may be modulated by previous infection history, with probable knock‐on effects for host performance, brain energy metabolism, osmoregulation and ecology. A free Plain Language Summary can be found within the Supporting Information of this article

Geology of the Victoria quadrangle (H02), Mercury

Mercury’s quadrangle H02 ‘Victoria’ is located in the planet’s northern hemisphere and lies between latitudes 22.5° N and 65° N, and between longitudes 270° E and 360° E. This quadrangle covers 6.5% of the planet’s surface with a total area of almost 5 million km2. Our 1:3,000,000-scale geologic map of the quadrangle was produced by photo-interpretation of remotely sensed orbital images captured by the MESSENGER spacecraft. Geologic contacts were drawn between 1:300,000 and 1:600,000 mapping scale and constitute the boundaries of intercrater, intermediate and smooth plains units; in addition, three morpho-stratigraphic classes of craters larger than 20 km were mapped. The geologic map reveals that this area is dominated by Intercrater Plains encompassing some almost-coeval, probably younger, Intermediate Plains patches and interrupted to the north-west, north-east and east by the Calorian Northern Smooth Plains. This map represents the first complete geologic survey of the Victoria quadrangle at this scale, and an improvement of the existing 1:5,000,000 Mariner 10-based map, which covers only 36% of the quadrangle