Maternal Arterial Stiffness in Women Who Subsequently Develop Pre-Eclampsia

BACKGROUND/OBJECTIVES: Pre-eclampsia (PE) is associated with profound changes in the maternal cardiovascular system. The aim of the present study was to assess whether alterations in the maternal arterial stiffness precede the onset of PE in at risk women. METHODOLOGY/PRINCIPAL FINDINGS: This was a cross sectional study involving 70 pregnant women with normal and 70 women with abnormal uterine artery Doppler examination at 22-24 weeks of gestation. All women had their arterial stiffness (augmentation index and pulse wave velocity of the carotid-femoral and carotid-radial parts of the arterial tree) assessed by applanation tonometry in the second trimester of pregnancy, at the time of the uterine artery Doppler imaging. Among the 140 women participating in the study 29 developed PE (PE group) and 111 did not (non-PE group). Compared to the non-PE group, women that developed PE had higher central systolic (94.9 ± 8.6 mmHg vs 104.3 ± 11.1 mmHg; p  =  < 0.01) and diastolic (64.0 ± 6.0 vs 72.4 ± 9.1; p < 0.01) blood pressures. All the arterial stiffness indices were adjusted for possible confounders and expressed as multiples of the median (MoM) of the non-PE group. The adjusted median augmentation index was similar between the two groups (p  =  0.84). The adjusted median pulse wave velocities were higher in the PE group compared to the non-PE group (carotid-femoral: 1.10 ± 0.14 MoMs vs 0.99 ± 0.11 MoMs; p < 0.01 and carotid-radial: 1.08 ± 0.12 MoMs vs 1.0 ± 0.11 MoMs; p < 0.01). CONCLUSIONS/SIGNIFICANCE: Increased maternal arterial stiffness, as assessed by pulse wave velocity, predates the development of PE in at risk women

Statistical Modeling of Single Target Cell Encapsulation

High throughput drop-on-demand systems for separation and encapsulation of individual target cells from heterogeneous mixtures of multiple cell types is an emerging method in biotechnology that has broad applications in tissue engineering and regenerative medicine, genomics, and cryobiology. However, cell encapsulation in droplets is a random process that is hard to control. Statistical models can provide an understanding of the underlying processes and estimation of the relevant parameters, and enable reliable and repeatable control over the encapsulation of cells in droplets during the isolation process with high confidence level. We have modeled and experimentally verified a microdroplet-based cell encapsulation process for various combinations of cell loading and target cell concentrations. Here, we explain theoretically and validate experimentally a model to isolate and pattern single target cells from heterogeneous mixtures without using complex peripheral systems.Wallace H. Coulter Foundation (Young Investigator in Bioengineering Award)National Institutes of Health (U.S.) (Grant R01AI081534)National Institutes of Health (U.S.) (Grant R21AI087107

A cohort evaluation on arterial stiffness and hypertensive disorders in pregnancy

10.1186/1471-2393-12-160BMC Pregnancy and Childbirth12-BPCM

European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis

Aims:Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. Methods and results: A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. Conclusion: This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities

ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2-care pathways, treatment, and follow-up

Aims: Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results: A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion: This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities

Evaluation of effects of certain parameters related with hip joint on the functional capacity in children with cerebral palsy

Cerebral palsy (CP) is a neuro-developmental disorder resulting from nonprogressive injury of immature brain tissue. Deformity of lower extremity is a frequently seen condition in children with CP. The changes in the hip joint and related anatomical structures affect the functional capacity and restrict ambulation of the children with CP.In this study, parameters like the collodiaphyseal angle (femoral inclination), acetabular index angle (AI), center edge angle (CE), migration percentage (MP) and pelvic obliquity (PO), which are used to evaluate the hip joint and its pathological changes, were measured. The effects of the obtained results on the functional capacity of the lower extremity that was assessed by the gross motor function measure were investigated in children with CP. The relationships of these parameters within the CP group and with the control group were examined. The CP group was composed of 34 children (24 hemiparetic and 10 diparetic, Gross Motor Functional Classification System level I) while the control group was composed of 26 children who visited the emergency department because of trauma without dislocation and broken of the hips, legs and spine.It was found that hemiparetic and diparetic children with CP, who were at the same GMFCS level and age group, had similar hip morphology. However, the results have revealed that hemiparetic children had better walking, running and jumping abilities than those of diparetics according to the gross motor function measure. No difference was determined between the children with CP and the control group regarding the measured parameters of hip morphology, except PO. Both in the children with CP and the control group, the femoral inclination angle was found to be higher bilaterally comparing with previous data. It was thought that the increase in AI angle of the diparetic children with CP may cause susceptibility to hip displacement

Biomechanical and morphometric features of long flexor tendons of toes: a cadaveric study

Tendons of flexor hallucis longus (FHL) and flexor digitorum longus (FDL) can be used as grafts. Slips from FHL to FDL have been reported to contribute to flexion function of toes.Aim of the study was to determine the contribution of FHL slips to function of small toes by biomechanical aspects. It was also aimed to determine the lengths of FHL and FHL tendon grafts harvested by different surgical techniques.Thirteen fresh frozen amputee legs were dissected. Some classification regarding connection types between FDL and FHL tendons, and contribution of FHL slips to long flexor tendons of toes were classified. Lengths of FHL and FDL tendon grafts, harvested by different surgical procedures, were measured by digital caliper. Biomechanical features of tendons and slips were evaluated with the help of tensile test device. All measurements were statistically analyzed. Connections between FHL and FDL tendons were classified as two types. Type I: slips from FHL to FDL in 11 cases. Type II: cross connections in 2 cases. FHL slips contributed into the long flexor tendons of second and third toes. Biomechanical features of tendons of second to four toes were similar to each other regarding stiffness, tensile strength, Young modulus, maximum stress. The same properties of these toes were significantly different from fifth toe. No statistical difference was found between FHL and FDL tendons. Lengths of FDL grafts, harvested by medial and plantar approaches were 6:16 cm and 9:05 cm, respectively. Lengths of FHL grafts, harvested by single, double and minimal invasive techniques were 5:08 cm, 7.02 cm and 20:16 cm, respectively. By this study, biomechanical features of the slips between FHL and FDL tendons, and long flexor tendons of toes were revealed. In addition, functional effects of these structures on toes were evaluated

Induction of Liver Hypertrophy for Extended Liver Surgery and Partial Liver Transplantation: State of the Art of Parenchyma Augmentation–Assisted Liver Surgery

Background Liver surgery and transplantation currently represent the only curative treatment options for primary and secondary hepatic malignancies. Despite the ability of the liver to regenerate after tissue loss, 25–30% future liver remnant is considered the minimum requirement to prevent serious risk for post-hepatectomy liver failure. Purpose The aim of this review is to depict the various interventions for liver parenchyma augmentation–assisting surgery enabling extended liver resections. The article summarizes one- and two-stage procedures with a focus on hypertrophy- and corresponding resection rates. Conclusions To induce liver parenchymal augmentation prior to hepatectomy, most techniques rely on portal vein occlusion, but more recently inclusion of parenchymal splitting, hepatic vein occlusion, and partial liver transplantation has extended the technical armamentarium. Safely accomplishing major and ultimately total hepatectomy by these techniques requires integration into a meaningful oncological concept. The advent of highly effective chemotherapeutic regimen in the neo-adjuvant, interstage, and adjuvant setting has underlined an aggressive surgical approach in the given setting to convert formerly “palliative” disease into a curative and sometimes in a “chronic” disease