A new technique for hypogastric artery embolization

We report a new procedure for embolization of hypogastric arteries simultaneously with aortoiliac stenting. Eight patients with aortoiliac (n = 6) and iliac (n = 2) aneurysms have been treated with this procedure. The technique involves the placement of a hook catheter near the hypogastric artery or in the sac, and the endoprosthesis insertion is done by using the same arteriotomy. The endoprosthesis is deployed and the coil is released. Saline is injected into the sac. The catheter is removed and the balloon at the distal end of the endoprosthesis is inflated. Computed tomography images showed periprosthesis or aneurysm thrombosis. No endoleaks or coils displacement in the sac were found

Differences in the relation between bone mineral content and lean body mass according to gender and reproductive status by age ranges

The present study aims: (1) to explore the influence of lean mass (LM) on bone mineral content (BMC), (2) to investigate the pubertal influences on the BMC–LM relation, and (3) to perform Z-score charts of BMC–LM relation, stratified by gender and reproductive status categorized by age ranges. A cross-sectional analysis was conducted using 4001 healthy subjects between 7 and 90 years participating in the Health Workers Cohort Study. Of these, 720 participants were ≤ 19 years, 2417 were women ≥ 20 years, and 864 were men ≥ 20 years. Using Dual X-ray absorptiometry (DXA), we measured BMC and LM. Participants’ pubertal development was assessed according to Tanner’s stage scale. To describe BMC–LM relation, simple correlation coefficients were computed. To produce best-fit equations, an ANOVA test was conducted. Z-score graphs for the BMC–LM relation were obtained. In general, the BMC–LM correlations were linear and highly significant. For boys, curves were virtually parallel, with similar intercepts and a progressive displacement of values toward the upper-right region of the graph, for each Tanner subgroup. For girls, curves for Tanner 1-2 and 4-5 stages were parallel; but, in girls Tanner 4-5, the intercepts were significantly higher by about +300–400 g of BMC (P < 0.001). For postmenopausal women, the curve was parallel to that for the premenopausal but showed a lower intercept (P < 0.001). We provide DXA reference data on a well-characterized cohort of 4001 healthy subjects. These reference curves provide a reference value for the assessment and monitoring of bone health in all age groups included in the present study.Fil: Denova Gutiérrez, Edgar. Instituto Nacional de Salud Pública; MéxicoFil: Clark, Patricia. Hospital Infantil de México Federico Gómez. Unidad de Investigación en Epidemiología Clínica; México. Universidad Nacional Autónoma de México; MéxicoFil: Capozza, Ricardo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Centro de Estudios de Metabolismo Fosfocálcico; ArgentinaFil: Nocciolino, Laura Marcela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Centro de Estudios de Metabolismo Fosfocálcico; ArgentinaFil: Ferretti, Jose Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Centro de Estudios de Metabolismo Fosfocálcico; ArgentinaFil: Velázquez Cruz, Rafael. Instituto Nacional de Medicina Genómica México. Laboratorio de Genómica del Metabolismo Óseo; MéxicoFil: Rivera, Berenice. Universidad Nacional Autónoma de México; MéxicoFil: Cointry, Gustavo Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Centro de Estudios de Metabolismo Fosfocálcico; ArgentinaFil: Salmerón, Jorge. Universidad Nacional Autónoma de México; México. Instituto Nacional de Salud Pública; Méxic

Histological analysis of the wall of a healthy and varicose vein and their correlation with their biomechanical properties

Objetivos: Las varices son una enfermedad muy frecuente en la población, cuya patogenia aun no está clara. Los cambios en la pared de la vena varicosa respecto a la sana determinan su comportamiento biomecánico y la aparición de varices. El presente estudio tiene por objetivo establecer dichas características estructurales en la pared de la vena sana y varicosa, su correlación con los cambios biomecánicos y su contribución a la patogenia de las varices. Métodos: Se llevó a cabo un estudio descriptivo tomando 10 muestras de vena varicosa de pacientes intervenidos de varices mediante crosectomía de la unión safenofemoral, y 4 muestras de vena sana en pacientes sometidos a amputación en los que se descartó enfermedad venosa previa. Las muestras fueron procesadas para su análisis histológico con microscopía óptica con las tinciones de hematoxilina-eosina, orceína y picrosirius. Se determinaron las propiedades biomecánicas en ambos grupos, calculándose el esfuerzo y deformación de ruptura, así como el módulo elástico medio. Resultados: Se han observado cambios histológicos en la pared de la vena varicosa respecto de la sana, con engrosamiento a nivel intimal y en la capa media, aumento de fibras colágenas, disminución de elásticas y alteración de la morfología de las células musculares lisas que pierden su orientación característica. Asimismo se ha encontrado un menor esfuerzo y deformación de ruptura y una mayor rigidez en el grupo de venas varicosas. Dichas alteraciones contribuyen a la deformidad de la pared venosa y la incompetencia valvular, implicados en la aparición de varices. Conclusiones: Las alteraciones histológicas observadas en la pared de la vena varicosa pueden correlacionarse con los cambios en las características biomecánicas y con el proceso patogénico que favorece la aparición de varices.Purpose: Varicose veins are a very common disease, whose pathogeny still remains unclear. Changes in the varicose vein wall in relation to the normal vein, determine its biomechanical behaviour and the appearance of varicose veins. The purpose of this study is to correlate structural and biomechanical properties of healthy and varicose veins, and its contribution to the appearance of varicose veins. Methods: A descriptive study was performed. 10 samples were taken from patients who underwent varicose vein surgery, which consisted in crosectomy of the safeno-femoral junction, and 4 samples of healthy vein from patients who underwent major amputation after dismissing those with signs or symptoms of venous disease. Results: Histological changes have been observed in the varicose vein wall in relation to the healthy vein, consisting in intimal and media thickening, increased amount of collagen fibres, decrease of elastic fibres, and lack of characteristic morphology and orientation in muscular cells. In addition, a lower strain and deformation rupture, and high stiffness has been observed in varicose veins. These changes contribute to varicose vein deformation, valvular incompetence and the appearance of varicose veins. Conclusion: Histological changes in varicose veins correlate with biomechanical properties and pathogenic process leading to varicose veins appearance

Characteristics, structure, and effects of an on-line tool for improvement in adolescents competency for interaction with alcohol: the e-ALADOTM utility

This research report aims to present the characteristics, structure and effects of a psychoeducational technological innovation (called the e-ALADO Program) for the prevention of alcohol intake in adolescents. Based on the Competency model for interaction with alcohol, this program consists of a total of 24 lessons that promote conceptual, procedural, and attitudinal learning, in ICT format (www.alado.es). The hypothesis of this validation study established that adolescents treated with the program would improve their levels of competence and their interaction behavior with alcohol, depending of their personal level of self-regulation. A total of 148 adolescents from 12 to 16 years of age from three Spanish educational centers with different sociocultural contexts participated. A quasi-experimental methodology with repeated measures and use of inferential analysis was used (ANOVAs and MANOVAs). The results show a main principal effect of the Treatment variable, of the Self-Regulation Level variable, and an interaction effect of Treatment × Self-regulation in the conceptual and attitudinal subcompetence for interaction with alcohol. The results are discussed in the face of new technological developments that allow the evaluation and intervention in the prevention of alcohol intake with adolescents. An important implication of this work is related to the importance of self-regulation as a psychological variable. Also, the suitability of psychoeducational interventions with new technological formats in the prevention of adolescents¿ alcohol intake as entrepreneurial activity. Keywords: prevention of alcohol intake, competence model, adolescence, e-Program, technological utilit

Local deformation in a hydrogel induced by an external magnetic field

The aim of this study is to prove the feasibility of a system able to apply local mechanical loading on cells seeded in a hydrogel for tissue engineering applications. This experimental study is based on a previously developed artificial cartilage model with different concentrations of poly(vinyl alcohol) (PVA) that simulates the cartilage extracellular matrix (ECM). Poly(l-lactic acid) (PLLA) microspheres with dispersed magnetic nanoparticles (MNPs) were produced with an emulsion method. These microspheres were embedded in aqueous PVA solutions with varying concentration to resemble increased viscosity of growing tissue during regeneration. The ability to induce a local deformation in the ECM was assessed by applying a steady or an oscillatory magnetic field gradient to different PVA solutions containing the magnetic microparticles, similarly as in ferrogels. PLLA microparticle motion was recorded, and the images were analyzed. Besides, PVA gels and PLLA microparticles were introduced into the pores of a polycaprolactone scaffold, and the microparticle distribution and the mechanical properties of the construct were evaluated. The results of this experimental model show that the dispersion of PLLA microparticles containing MNPs, together with cells in a supporting gel, will allow applying local mechanical stimuli to cells during tissue regeneration. This local stimulation can have a positive effect on the differentiation of seeded cells and improve tissue regeneration.The authors gratefully acknowledge the financial support from the Spanish Ministry of Economy and Competitiveness through the MAT2013-46467-C4-1-R project, including the Feder funds. CIBER-BBN is an initiative funded by the VI National R&D&I Plan 2008-2011, Iniciativa Ingenio 2010, Consolider Program. CIBER Actions are financed by the Instituto de Salud Carlos III with assistance from the European Regional Development Fund. The authors thank "Servicio de Microscopia Electronica" of Universitat Politecnica de Valencia for their invaluable help. The translation of this paper was funded by the Universitat Politecnica de Valencia, Spain.Vikingsson, L.; Vinals Guitart, Á.; Valera Martínez, A.; Riera Guasp, J.; Vidaurre Garayo, AJ.; Gallego Ferrer, G.; Gómez Ribelles, JL. (2016). Local deformation in a hydrogel induced by an external magnetic field. Journal of Materials Science. 51(22):9979-9990. https://doi.org/10.1007/s10853-016-0226-8S997999905122Eyre D (2002) Collagen of articular cartilage. Arthritis Res 4:30–35Roughley PJ, Lee ER (1994) Cartilage proteoglycans: structure and potential functions. Microsc Res Tech 28:385–397Gillard GC, Reilly HC, Bell-Booth PG, Flint MH (1979) The influence of mechanical forces on the glycosaminoglycan content of the rabbit flexor digitorum profundus tendon. 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Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies

Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions