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Maurizio Domanin Daniele Bissacco Davide Le Van Christian Vergara 《Journal of vascular surgery》2018,67(3):887-897
Objective
The aim of the study was to provide, by means of computational fluid dynamics, a comparative analysis after carotid endarterectomy (CEA) between patch graft (PG) and primary closure (PC) techniques performed in real carotid geometries to identify disturbed flow conditions potentially involved in the development of restenosis.Methods
Eight carotid geometries in seven asymptomatic patients who underwent CEA were analyzed. In six cases (A-F), CEA was performed using PG closure; in two cases (G and H), PC was performed. Three-dimensional carotid geometries, derived from postoperative magnetic resonance angiography, were reconstructed, and a computational fluid dynamics analysis was performed. A virtual scenario with PC closure was designed in patients in whom PG was originally inserted and vice versa. This allowed us to compare for each patient hemodynamic effects in the PG and PC scenarios in terms of oscillatory shear index (OSI) and relative residence time (RRT), considered indicators of disturbed flow.Results
For the six original PG cases, the mean averaged-in-space OSI was 0.07 ± 0.01 for PG and 0.03 ± 0.02 for virtual-PC (difference, 0.04 ± 0.01; P = .0016). The mean of the percentage of area (%A) with OSI >0.2 resulted in 10.08% ± 3.38% for PG and 3.80% ± 3.22% for virtual-PC (difference, 6.28 ± 1.91; P = .008). For the same cases, the mean of the averaged-in-space RRT resulted in 5.48 ± 3.40 1/Pa for PG and 2.62 ± 1.12 1/Pa for virtual-PC (difference, 2.87 ± 1.46; P = .097). The mean of %A RRT >4.0 1/Pa resulted in 26.53% ± 12.98% for PG and 9.95% ± 6.53% for virtual-PC (difference, 16.58 ± 5.93; P = .025). For the two original PC cases, the averaged-in-space OSIs were 0.02 and 0.04 for PC and 0.03 and 0.02 for virtual-PG; the %A OSIs >0.2 were 0.9% and 7.6% for PC and 3.0% and 2.2% for virtual-PG; the averaged-in-space RRTs were 1.8 and 2.0 1/Pa for PC and 2.9 and 1.9 1/Pa for virtual-PG; the %A RRTs >4.0 1/Pa were 6.8% and 9.8% for PC and 9.4% and 6.2% for virtual-PG. These results revealed generally higher disturbed flows in the PG configurations with respect to the PC ones.Conclusions
OSI and RRT values were generally higher in PG cases with respect to PC, especially for high carotids or when the arteriotomy is mainly at the bulb region. Thus, an elective use of patch should be considered to prevent disturbed flows. 相似文献5.
Megan Sutter Laiene Olabarrieta Landa Amilkar Calderón Chagualá Helmer Chacón Peralta Gina Vergara Torres Paul B. Perrin Juan Carlos Arango-Lasprilla 《PM & R》2017,9(1):8-14
Background
Stroke is a primary cause of death and disability in upper-middle–income countries such as Colombia. Given the lack of comprehensive rehabilitation for stroke patients in Colombia, there is a need to assess longitudinal mental health problems poststroke in this region.Objective
To compare the course of mental health in stroke patients to healthy controls over the first year poststroke in Ibague, Colombia.Design
Cross-sectional study.Setting
The Psychological Attention Center of Antonio Nariño University in Ibague, Colombia.Participants
Stroke patients (n = 50) and age- and gender-matched healthy controls (n = 50).Methods
Patients and controls completed self-report Spanish versions of demographic information, injury-related characteristics, and mental health questionnairesMain Outcome Measurements
Outcomes assessed included mental health (depression, anxiety, and stress) at 3, 6, and 12 months poststroke.Results
Hierarchical linear models suggested that stroke patients had worse depression and anxiety over time than controls (P < .001). Among patients, depression and anxiety decreased over time (P < .001), whereas stress increased over time (P < .01). The findings suggest that although anxiety and depression improved over time in stroke patients, their mental health remained significantly lower than that of controls.Conclusions
This is the first study to examine the course of mental health over the first year poststroke in Latin America, specifically in Ibague, Colombia. Despite the improvements in anxiety and depression over the first year poststroke, patient anxiety and depression were still worse in comparison to those in healthy controls. The current findings indicate a need for rehabilitation services in Colombia, especially targeting mental health issues.Level of Evidence
I 相似文献6.
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B. Housez M. Cazaubiel C. Vergara J.‐M. Bard A. Adam A. Einerhand P. Samuel 《Journal of human nutrition and dietetics》2012,25(5):488-496
Background: To assess consumers’ acceptance of a new fibre, it is essential to evaluate its digestive tolerance after ingestion. We aimed to determine the tolerance of increasing dosages of Promitor? Soluble Gluco Fibre (SGF; Tate&Lyle, Hoffman Estates, IL, USA) up to 70 g fibre per day using a validated gastrointestinal composite score. Methods: A composite score of gastrointestinal tolerance integrating gastrointestinal symptoms, stool frequency and consistency was applied. To statistically validate this composite score, the gastrointestinal tolerance of inulin (10 g versus 20 g containing, respectively, 9 g versus 18 g of fibre) was assessed in 18 healthy volunteers in a randomised double‐blind placebo‐controlled cross‐over study. Second, in a double‐blind placebo‐controlled cross‐over study with 20 healthy volunteers, the gastrointestinal tolerance of SGF in both acute and ‘spread over the day’ conditions of consumption was assessed. Results: By contrast to 10 g, 20 g of inulin demonstrated a significant difference in composite score compared to placebo [P < 0.001, difference = 7.6; 95% confidence interval (CI) = 3.8–11.3]. These values were considered as reference during the second study. In acute conditions, 40 g of SGF fibre was the highest (threshold) dose tested that indicates the digestive tolerance criteria (difference from placebo on the composite score <7.6 and upper limit of the 95% CI <11.3); this is twice the amount tolerated for inulin. In ‘spread over the day’ conditions, 65 g of SGF fibre was the threshold dose (P < 0.001, difference = 6.5; 95% CI = 3.4–9.5). Conclusions: The results of the present study demonstrate that 40 g of SGF fibre, when consumed as a single dose, and 65 g of SGF fibre, when consumed in multiple‐doses, across the day are well‐tolerated by healthy volunteers. 相似文献
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Elsa De La Chesnaye Juan Pablo Méndez Ricardo López-Romero María de los Angeles Romero-Tlalolini María Dolores Vergara Mauricio Salcedo Sergio R Ojeda 《International journal of clinical and experimental pathology》2015,8(9):10192-10203
Epithelial ovarian cancer is one of the most lethal of gynecological malignancies. Due to its lack of early symptoms, detection usually occurs when the tumor is no longer confined to the ovary. We previously identified Fbxw15, a gene encoding an F-box protein in the mouse ovary, and showed that its expression is developmentally regulated. Here we report the molecular analysis of its human homologue, FBXW12 in epithelial ovarian tumors. To search for FBXW12 gene mutations, we PCR-amplified and sequenced the coding region of FBXW12, the gene’s 5-untranslated region and the proximal promoter in each of 30 EOC tumors. Promoter methylation was determined by DNA bisulfite conversion, followed by methylation specific PCR. FBXW12 intracellular localization was identified by means of immunohistochemistry. A complete deletion of the gene’s coding region, the 5’-UTR and the proximal promoter, was observed in 3 EOC samples. Eight of the remaining 27, had a deletion of the 5’-UTR, and the proximal promoter. FBXW12 mRNA was detected in 2 of the 19 samples without deletions. The methylation specific PCR results demonstrated CpGs methylation in the FBXW12 proximal promoter. Immunohistochemistry assay revealed that within the normal ovary, FBXW12 has an oocyte specific expression, whereas in EOC samples it is present in the ovarian surface epithelium. Our results indicate that the FBXW12 gene is deleted in approximately ten percent of the EOC cases studied; such deletions comprised either the FBXW12 promoter or the mRNA-encoding region. Moreover, FBXW12 could be epigenetically silenced by CpGs methylation in some of these EOC cases. 相似文献