Compression ultrasonography for false femoral artery aneurysms: Hypocoagulability is a cause of failure

Objectives:false femoral artery aneurysm is an occasional complication of percutaneous cardiovascular radiological procedures. Compression ultrasonography causes thrombosis non-invasively, reducing need for operative intervention. The technique fails in a proportion of cases. Analysis was undertaken to identify causes of failure.Design:prospective open study.Materials and Methods:patients presenting with false femoral artery aneurysm since 1984 were identified from a computerised database (BIPAS). Since 1993 compression ultrasonography has been performed as first line treatment according to a standard protocol. Prospectively collected ultrasonographic data and case notes were reviewed to identify causes of failed compression.Results:false femoral artery aneurysm occurred as a complication in 32/26 687 (0.12%) cardiovascular radiological procedures. Eighteen aneurysms were treated by compression. The technique was successful in 11/18 (61%) cases but primary failure occurred in seven cases. Six out of seven had bleeding abnormalities (Chi-squared analysis with Yates correction 10.55, p=0.0012), four were anticoagulated and compression was subsequently successful following reversal of warfarin therapy in three of these patients. In 4/18 cases surgical repair was necessary.Conclusions:compression ultrasonography is an effective treatment of false femoral aneurysms, however, hypocoagulability is a significant cause of failure. For patients in whom anticoagulation cannot be reversed, primary surgical repair should be considered

Low-energy dynamics of the γγ→ππ\gamma\gamma\to\pi\pi reaction

We calculate the one-quark-loop amplitude for the low energy $\gamma\gamma\to\pi\pi$ collision in the context of the Nambu and Jona-Lasinio model with scalar and pseudoscalar four quark couplings to all orders in the external momenta. We show that the NJL predictions for the $\gamma\gamma\to\pi^+\pi^-$ reaction are not far from the Born amplitude, which is close to the data, and is compatible with the chiral perturbation theory estimations. We determine the corrections given by the NJL model in leading order of $1/N_c$ to the chiral loop amplitude for $\gamma\gamma\to\pi^0\pi^0$. Numerical results for the $\gamma\gamma\rightarrow\pi\pi$ cross sections and for pion polarizabilities are given.Comment: 20 pages in LaTex, 3 figures in 1 Postscript fil

Exact General Relativistic Perfect Fluid Disks with Halos

Using the well-known ``displace, cut and reflect'' method used to generate disks from given solutions of Einstein field equations, we construct static disks made of perfect fluid based on vacuum Schwarzschild's solution in isotropic coordinates. The same method is applied to different exactsolutions to the Einstein'sequations that represent static spheres of perfect fluids. We construct several models of disks with axially symmetric perfect fluid halos. All disks have some common features: surface energy density and pressures decrease monotonically and rapidly with radius. As the ``cut'' parameter $a$ decreases, the disks become more relativistic, with surface energy density and pressure more concentrated near the center. Also regions of unstable circular orbits are more likely to appear for high relativistic disks. Parameters can be chosen so that the sound velocity in the fluid and the tangential velocity of test particles in circular motion are less then the velocity of light. This tangential velocity first increases with radius and reaches a maximum.Comment: 22 pages, 25 eps.figs, RevTex. Phys. Rev. D to appea

Decorin reduces intraocular pressure and retinal ganglion cell loss in rodents through fibrolysis of the scarred trabecular meshwork

Purpose. To investigate whether Decorin, a matrikine that regulates extracellular matrix (ECM) deposition, can reverse established trabecular meshwork (TM) fibrosis, lower IOP, and reduce progressive retinal ganglion cell (RGC) death in a novel rodent model of TM fibrosis. Methods. Adult rats had intracameral (IC) injections of human recombinant (hr) TGF-β over 30 days (30d; to induce TM fibrosis, raise IOP, and initiate RGC death by 17d) or PBS (controls) and visually evoked potentials (VEP) were measured at 30d to evaluate resultant visual pathway dysfunction. In some animals TGF-β injections were stopped at 17d when TM fibrosis and IOP were consistently raised and either hrDecorin or PBS IC injections were administered between 21d and 30d. Intraocular pressure was measured biweekly and eyes were processed for immunohistochemical analysis of ECM deposition to assess TM fibrosis and levels of matrix metalloproteinases (MMP) and tissue inhibitors of matrix metalloproteinases (TIMP) to assess fibrolysis. The effect of hrDecorin treatment on RGC survival was also assessed. Results. Transforming growth factor–β injections caused sustained increases in ECM deposition in the TM and raised IOP by 17d, responses that were associated with 42% RGC loss and a significant decrease in VEP amplitude measured at 30d. Decorin treatment from 17d reduced TGF-β–induced TM fibrosis, increased levels of MMP2 and MMP9 and lowered TIMP2 levels, and lowered IOP, preventing progressive RGC loss. Conclusions. Human recombinant Decorin reversed established TM fibrosis and lowered IOP, thereby rescuing RGC from progressive death. These data provide evidence for the candidacy of hrDecorin as a treatment for open-angle glaucoma

The risk of cardiac failure following metal-on-metal hip arthroplasty

Aims The aim of this study was to determine whether patients with metal-on-metal (MoM) arthroplasties of the hip have an increased risk of cardiac failure compared with those with alternative types of arthroplasties (non-MoM). Patients and Methods A linkage study between the National Joint Registry, Hospital Episodes Statistics and records of the Office for National Statistics on deaths was undertaken. Patients who underwent elective total hip arthroplasty between January 2003 and December 2014 with no past history of cardiac failure were included and stratified as having either a MoM (n = 53 529) or a nonMoM (n = 482 247) arthroplasty. The primary outcome measure was the time to an admission to hospital for cardiac failure or death. Analysis was carried out using data from all patients and from those matched by propensity score. Results The risk of cardiac failure was lower in the MoM cohort compared with the non-MoM cohort (adjusted hazard ratio (aHR) 0.901; 95% confidence interval (CI) 0.853 to 0.953). The risk of cardiac failure was similar following matching (aHR 0.909; 95% CI 0.838 to 0.987) and the findings were consistent in subgroup analysis. Conclusion The risk of cardiac failure following total hip arthroplasty was not increased in those in whom MoM implants were used, compared with those in whom other types of prostheses were used, in the first seven years after surgery. Cite this article: Bone Joint J 2018;100-B:20–

A real-world evaluation of radium-223 in combination with abiraterone or enzalutamide for the treatment of metastatic castration-resistant prostate cancer

Introduction Radium-223, abiraterone, and enzalutamide have each been shown to significantly improve survival as monotherapy in patients with metastatic castration-resistant prostate cancer. However, effects of combination radium-223 plus abiraterone or enzalutamide on survival and safety remain unclear. Patients and methods This single-center retrospective cohort study used electronic health record data of patients with metastatic castration-resistant prostate cancer and bone metastases who were treated with radium-223 between April 1, 2014 and February 19, 2019. Patients who received radium-223 monotherapy were compared to patients who received a combination of radium-223 plus either abiraterone or enzalutamide. The primary endpoint was overall survival. Secondary endpoints included progression-free survival, time to symptomatic skeletal event, symptomatic skeletal event-free survival, and incidence of drug-related adverse events. Time-to-event analyses were estimated by log rank tests using Kaplan-Meier curves. Hazard ratios and 95% confidence intervals were derived from Cox proportional hazards models. Chi-square tests evaluated difference in serious adverse events between the two arms. Results A total of 60 patients met inclusion criteria (n = 41 in the monotherapy arm, n = 19 in the combination arm). Differences in median overall survival were not observed (12.7 vs. 12.8 months; HR 1.15, 95% CI 0.59-2.23; P = 0.68), but median progression-free survival was significantly longer in the combination arm (7.6 vs. 4.9 months; HR 1.94, 95% CI 1.11-3.40; P = 0.02). Significant differences were not observed in time to first SSE (P = 0.97), SSE-free survival (P = 0.16), or in the overall incidence of serious adverse events (P = 0.45). Conclusion Combination radium-223 plus abiraterone or enzalutamide did not improve overall survival, but prolonged progression-free survival without increasing the incidence of serious adverse events in metastatic castration-resistant prostate cancer patients with bone metastases. However, these results are limited by small numbers and patient selection inherent in retrospective analysis

An infinite family of magnetized Morgan-Morgan relativistic thin disks

Applying the Horsk\'y-Mitskievitch conjecture to the empty space solutions of Morgan and Morgan due to the gravitational field of a finite disk, we have obtained the corresponding solutions of the Einstein-Maxwell equations. The resulting expressions are simply written in terms of oblate spheroidal coordinates and the solutions represent fields due to magnetized static thin disk of finite extension. Now, although the solutions are not asymptotically flat, the masses of the disks are finite and the energy-momentum tensor agrees with the energy conditions. Furthermore, the magnetic field and the circular velocity show an acceptable physical behavior.Comment: Submitted to IJTP. This paper is a revised and extended version of a paper that was presented at arXiv:1006.203

Large Nc and Chiral Dynamics

We study the dependence on the number of colors of the leading pi pi scattering amplitude in chiral dynamics. We demonstrate the existence of a critical number of colors for and above which the low energy pi pi scattering amplitude computed from the simple sum of the current algebra and vector meson terms is crossing symmetric and unitary at leading order in a truncated and regularized 1/Nc expansion. The critical number of colors turns out to be Nc=6 and is insensitive to the explicit breaking of chiral symmetry. Below this critical value, an additional state is needed to enforce the unitarity bound; it is a broad one, most likely of "four quark" nature.Comment: RevTeX4, 6 fig., 5 page

f0(980) meson as a K bar K molecule in a phenomenological Lagrangian approach

We discuss a possible interpretation of the f0(980) meson as a hadronic molecule - a bound state of K and bar K mesons. Using a phenomenological Lagrangian approach we calculate the strong f0(980) to pi pi and electromagnetic f0(980) to gamma gamma decays. The compositeness condition provides a self-consistent method to determine the coupling constant between f0 and its constituents, K and bar K. Form factors governing the decays of the f0(980) are calculated by evaluating the kaon loop integrals. The predicted f0(980) to pi pi and f0(980) to gamma gamma decay widths are in good agreement with available data and results of other theoretical approaches.Comment: 21 pages, 11 figures, revised version accepted for publication in Eur. Phys. J.

Two-dimensional Quantum-Corrected Eternal Black Hole

The one-loop quantum corrections to geometry and thermodynamics of black hole are studied for the two-dimensional RST model. We chose boundary conditions corresponding to the eternal black hole being in the thermal equilibrium with the Hawking radiation. The equations of motion are exactly integrated. The one of the solutions obtained is the constant curvature space-time with dilaton being a constant function. Such a solution is absent in the classical theory. On the other hand, we derive the quantum-corrected metric (\ref{solution}) written in the Schwarzschild like form which is a deformation of the classical black hole solution \cite{5d}. The space-time singularity occurs to be milder than in classics and the solution admits two asymptotically flat black hole space-times lying at "different sides" of the singularity. The thermodynamics of the classical black hole and its quantum counterpart is formulated. The thermodynamical quantities (energy, temperature, entropy) are calculated and occur to be the same for both the classical and quantum-corrected black holes. So, no quantum corrections to thermodynamics are observed. The possible relevance of the results obtained to the four-dimensional case is discussed.Comment: Latex, 28 pges; minor corrections in text and abstract made and new references adde