Single-center experience in the treatment of visceral artery aneurysms

Background: Visceral artery aneurysms (VAAs), although rare, represent a life-threatening disease with high mortality rates. With the more frequent use of diagnostic tests, there has been an incidental detection of these lesions which are mostly asymptomatic. It follows that surgeons are increasingly called to decide on the most appropriate management of VAAs between an open surgical or endovascular approach and among the different endovascular options currently available. The aim of this retrospective study was to evaluate the results of open surgery and interventional endovascular strategies of visceral artery aneurysms with respect to technical success, therapy-associated complications, and postinterventional follow-up in the elective and emergency situation. Methods: From January 1992 to January 2017, 125 open surgical or endovascular interventions for VAA were performed at our institution. Once the VAA was diagnosed and the indication for treatment was assessed, the preoperative diagnostic work-up consisted of contrast computed tomography (CT) or magnetic resonance imaging (MRI) and, in some patients, digital subtraction angiography. Follow-up included clinical and duplex ultrasound scan (DUS) and contrast-enhanced ultrasound to assess the treated vessel patency and organ perfusion after 1, 6, and 12 months, and yearly thereafter. CT or MRI controls were also performed at 1 year of follow-up and only when DUS was not diagnostic or showed a complication thereafter. After the first 5 years of follow-up, the status of the patient was obtained by a structured telephone survey. Results: The treatment option was endovascular in 56 of 125 cases (44.8%). Technical success was 98.3%. In one case, the procedure was interrupted for the extensive dissection of the afferent vessel. Twenty-six patients were treated by coil embolization while 29 with covered stenting. The endovascular approach was in emergency in two cases (3.6%). In the endovascular group, mortality was nil. Complications occurred in 5 cases (8.9%): 1 subacute intestinal ischemia caused by superior mesenteric artery dissection, 2 aneurysm reperfusion, 1 stent thrombosis, and 1 massive splenic hematoma. In 69 (55.2%) cases, surgical treatment was preferred, with 24 VAA resections and 45 arterial reconstructions. In 20 cases (29%), open surgery was performed in emergency conditions. In the surgical group, 8 emergency patients (40%) died intraoperatively. The mortality after elective surgical interventions was nil. Complications after surgery were 4 graft late thrombosis (5.8%): asymptomatic in three cases and requiring splenectomy in one. Conclusions: There is no overall consensus regarding the indications for treatment of VAA. Currently in emergent setting, the endovascular approach should be considered as the first choice because of its reduced invasiveness, faster way to access and bleeding control; this accounts for the lower morality of the interventional therapy than open surgery. Endovascular approach is effective for elective repair of VAAs, but procedure-related complications may occur in a not negligible number of patients. Given comparable mortality rates and low procedure-related complication rate, surgical approach still has space in the elective management of VAAs, especially for aneurysms unsuitable or challenging for the endovascular option in patients with low surgical risk. The size, location, and morphology of VAAs, systemic or local comorbidities, and specific anatomical situations such as previous abdominal surgery should dictate treatment choice

Promoting international collaboration on ocean acidification data management. Ocean Acidification International Coordination Centre Workshop; Monaco, 23-24 April 2014

Ocean acidification, often referred to as “the other carbon dioxide problem,” is the progressive increase in ocean acidity that has taken place since the onset of the industrial revolution. Biological and ecological studies of ocean acidification impacts only began in the late 1990s, but the field has evolved rapidly, with exponential growth in the past decade. For example, 374 papers on this subject were published in 2013, compared with only 18 in 2004 (see http://tinyurl.com/oaicc-biblio)

Pelagic metabolism of the Scheldt estuary measured by the oxygen method on an annual scale

Pelagic gross primary production (GPP), community respiration (CR) and nitrification were measured in the turbid Scheldt Estuary by the oxygen Winkler method from January to December 2003 at monthly intervals (EUROTROPH EU project). Five stations along the estuary were investigated, corresponding to a salinity (S) range of 0-25. Water was sampled and incubated until sunset in 60 ml glass bottles stored in a 5 compartment incubator kept at in situ temperature by flowing water. Irradiance was controlled in each compartment by filters having a shading capacity ranging from 0 to 100%. In order to estimate the oxygen consumption due to the respiration and nitrification processes, samples were incubated, in the dark compartment, with and without addition of nitrification inhibitors. Net community production (NCP) was most of the time negative in the estuary with values ranging from -275 to +31mmol O2.m-2.d-1 and the lowest values were found near Antwerp (S = 2). Strong pelagic GPP and positive NCP rates were observed in the freshwater part during summer with a maximal value in June (+373mmol O2.m-2.d-1), corresponding to an increase of the O2 concentration and a decrease of the partial pressure of CO2 (pCO2) in the water column during this period. Nitrification contributes 5 to 60% of the oxygen consumption in the water column with highest values measured in the inner part of the estuary due to high ammonium and suspended matter concentrations. Assuming a C/O2 molar ratio of 0.07, we estimated that nitrification represents on an annual scale 35% of organic matter production at salinity 2 which is consistent with previous estimates. NCP rates measured in 2003 are among the lowest reported in the literature and confirm the strong heterotrophic status of the Scheldt Estuary

Impact of ocean acidification on a key Arctic pelagic mollusc (Limacina helicina)

Thecosome pteropods (shelled pelagic molluscs) can play an important role in the food web of various ecosystems and play a key role in the cycling of carbon and carbonate. Since they harbor an aragonitic shell, they could be very sensitive to ocean acidification driven by the increase of anthropogenic CO2 emissions. The impact of changes in the carbonate chemistry was investigated on Limacina helicina, a key species of Arctic ecosystems. Pteropods were kept in culture under controlled pH conditions corresponding to pCO2 levels of 350 and 760 μatm. Calcification was estimated using a fluorochrome and the radioisotope 45Ca. It exhibits a 28% decrease at the pH value expected for 2100 compared to the present pH value. This result supports the concern for the future of pteropods in a high-CO2 world, as well as of those species dependent upon them as a food resource. A decline of their populations would likely cause dramatic changes to the structure, function and services of polar ecosystems

Evaluation of data-based estimates of anthropogenic carbon in the Arctic Ocean

The Arctic Ocean is particularly vulnerable to ocean acidification, a process that is mainly driven by the uptake of anthropogenic carbon (Cant) from the atmosphere. Although Cant concentrations cannot be measured directly in the ocean, they have been estimated using data-based methods such as the transient time distribution (TTD) approach, which characterizes the ventilation of water masses with inert transient tracers, such as CFC-12. Here, we evaluate the TTD approach in the Arctic Ocean using an eddying ocean model as a test bed. When the TTD approach is applied to simulated CFC-12 in that model, it underestimates the same model's directly simulated Cant concentrations by up to 12%, a bias that stems from its idealized assumption of gas equilibrium between atmosphere and surface water, both for CFC-12 and anthropogenic CO2. Unlike the idealized assumption, the simulated partial pressure of CFC-12 (pCFC-12) in Arctic surface waters is undersaturated relative to that in the atmosphere in regions and times of deep-water formation, while the simulated equivalent for Cant is supersaturated. After accounting for the TTD approach's negative bias, the total amount of Cant in the Arctic Ocean in 2005 increases by 8% to 3.3 ± 0.3 Pg C. By combining the adjusted TTD approach with scenarios of future atmospheric CO2, it is estimated that all Arctic waters, from surface to depth, would become corrosive to aragonite by the middle of the next century even if atmospheric CO2 could be stabilized at 540 ppm

Botanical sources, chemistry, analysis, and biological activity of furanocoumarins of pharmaceutical interest

The aim of this work is to provide a critical review of plant furanocoumarins from different points of view, including their chemistry and biosynthetic pathways to their extraction, analysis, and synthesis, to the main biological activities found for these active compounds, in order to highlight their potential within pharmaceutical science. The limits and the possible improvements needed for research involving these molecules are also highlighted and discussed

Optimization and validation of the quantitative assay of flavonoids in Achyrocline satureioides and A. flaccida

Several populations of Achyrocline satureioides and Achyrocline flaccida from Argentina, two aromatic herbal species widely used in traditional medicine in South America and both known as marcela, were analyzed. The aims of this work were to evaluate the amounts of flavonoids that characterize these species in this country and provide a quantitative assay to be included in the monograph of marcela for future Argentine Pharmacopoeia editions. The extraction method and analysis by HPLC of the main flavonoids, quercetin and 3-O-methylquercetin, were optimized. The validation parameters of the method were determined. The analysis of the different parts of these plants was carried out thereafter. Inflorescences were the parts displaying the highest content of such flavonoids. It was found that A. flaccida had a slightly higher content of flavonoids than A. satureioides (1.2 ± 0.4 % of quercetin, 0.8 ± 0.3 % of 3-Omethylquercetin; 0.8 ± 0.2 % of quercetin and 0.7 ± 0.5 % of 3-O-methylquercetin, respectively).Colegio de Farmacéuticos de la Provincia de Buenos Aire

GNSS-based Location Determination System Architecture for railway performance assessment in presence of local effects

GNSS plays a strategic role on the introduction of the Virtual Balise functionality and the train integrity. Thanks to GNSS, it could be possible to realize cost effective solutions to increase the safety in the regional lines, where the traffic density is lower. The train position estimation is implemented taking into account that the train is constrained to lie on the track (i.e. track constraint). In this way, we can express the position in terms of the curvilinear abscissa (progressive mileage) of the track corresponding to the train position. However, the impact of local effects such as multipath, foliage attenuation and shadowing in the railway environment plays a crucial role due to the presence of infrastructures like platform roofs, side walls, tunnel entrances, buildings and so on close to the trackside. In the paper, we analyse the impact of those threats on the train GNSS-based position estimation performance. At this aim, several scenarios have been generated by using both real data acquired on a railway test-bed in Sardinia, and synthetic data generated in the lab through ad hoc multipath and foliage models. A sensitivity analysis has been conducted, varying main scenarios parameters (e.g. height of obstacles, presence of trees and shadowing). The result of the performed analysis, in terms of availability, accuracy and integrity, are here presented. mitigations implemented by the ERTMS at system level are not considered since the attention is focused on GNSS only

Current molecular and clinical insights into uveal melanoma (Review)

Uveal melanoma (UM) represents the most prominent primary eye cancer in adults. With an incidence of approximately 5 cases per million individuals annually in the United States, UM could be considered a relatively rare cancer. The 90.95% of UM cases arise from the choroid. Diagnosis is based mainly on a clinical examination and ancillary tests, with ocular ultrasonography being of greatest value. Differential diagnosis can prove challenging in the case of indeterminate choroidal lesions and, sometimes, monitoring for documented growth may be the proper approach. Fine needle aspiration biopsy tends to be performed with a prognostic purpose, often in combination with radiotherapy. Gene expression profiling has allowed for the grading of UMs into two classes, which feature different metastatic risks. Patients with UM require a specialized multidisciplinary management. Primary tumor treatment can be either enucleation or globe preserving. Usually, enucleation is reserved for larger tumors, while radiotherapy is preferred for small/medium melanomas. The prognosis is unfavorable due to the high mortality rate and high tendency to metastasize. Following the development of metastatic disease, the mortality rate increases to 80% within one year, due to both the absence of an effective treatment and the aggressiveness of the condition. Novel molecular studies have allowed for a better understanding of the genetic and epigenetic mechanisms involved in UM biological activity, which differs compared to skin melanomas. The most commonly mutated genes are GNAQ, GNA11 and BAP1. Research in this field could help to identify effective diagnostic and prognostic biomarkers, as well as novel therapeutic targets