Recognizing subtle near-occlusion in carotid stenosis patients: a computed tomography angiographic study

Introduction

Near-occlusion of the internal carotid artery (ICA) is a significant luminal diameter (LD) reduction beyond a tight atherosclerotic carotid stenosis (CS). Recognition of even subtle near-occlusions is essential to prevent underestimation of the stenosis degree. Our goal was to investigate the prevalence of near-occlusion among CS patients using a single standard criterion to facilitate its recognition, even when distal ICA LD reduction is not visually evident in computed tomography angiography (CTA).

Methods

We analysed carotid artery CTAs of 467 patients with moderate-to-severe CS scheduled for endarterectomy. We performed measurements of the bilateral distal ICA LDs from thin axial source images and utilized a 1.0 mm intra-individual side-to-side distal ICA LD difference to distinguish near-occlusions, based on a previous study, aware of the vagaries of measurement. For analysis stratification, we excluded cases with significant carotid pathology affecting LD measurements.

Results

We discovered 126 near-occlusions fulfilling our criterion of ipsilateral near-occlusion: the mean LD side-to-side difference (mm) with 95% confidence interval being 1.8 (1.6, 1.9) and a standard deviation of 0.8 mm. Among the 233 cases not meeting our near-occlusion criterion, we found 140 moderate (50–69%) and 93 severe (70–99%) ipsilateral stenoses.

Conclusion

The utilization of 1.0 mm cut-off value for the intra-individual distal ICA LD side-to-side difference to distinguish atherosclerotic ICA near-occlusion leads to a relatively high incidence of near-occlusion. In CTA, recently suggested to be used for near-occlusion diagnosis, a discriminatory 1.0 mm cut-off value could function as a pragmatic tool to enhance the detection of even subtle near-occlusions.

     

双相障碍患儿父母基于知识转化模式的健康管理实践

目的 探究基于知识转化模式(Knowledge to Action Framework,KTA)的健康管理在双相障碍Ⅱ型抑郁相患儿父母中的应用效果.方法 将80例双相障碍Ⅱ型抑郁相患儿父母应用随机数字袁法分为对照组和干预组各40例,对照组接受常规健康管理;干预组接受基于知识转化模式的健康管理.于基线时和干预12周后调查两组患儿及父母负性情绪,于干预12周后调查两组患儿父母双相障碍疾病知识及技术掌握情况.结果 干预12周后,两组患儿及父母焦虑自评、抑郁自评得分显著低于基线时,干预组下降更加明显(均P＜0.01).干预12周后,干预组患儿父母在疾病知识、健康管理技术和复诊要求方面得分显著高于对照组(均P＜0.01).结论 基于知识转化模式的健康管理改善了双相障碍患儿及父母负性情绪,促使患儿父母更好地掌握疾病知识,提升管理技能.     

Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies

Background

The purpose of this study is to assess the effects of lifestyle risk factors on the risk of hospitalization for sciatica and to determine whether overweight or obesity modifies the effect of leisure-time physical activity on hospitalization for sciatica.

Molecular epidemiology of dengue virus strains from Finnish travelers

We characterized 11 dengue virus (DENV) isolates obtained from Finnish travelers during 2000-2005 using monoclonal antibodies and phylogenetic analysis. The analysis of DENV isolated from travelers contributes to the global picture of strain distribution and circulation. The isolates included all serotypes, including a DENV-2 isolate from Ghana.     

Dietary intake and major food sources of polyphenols in Finnish adults

Phenolic acids, flavonoids, proanthocyanidins, and ellagitannins are polyphenols that may have beneficial effects on human health and provide protection against chronic diseases. To date, limited data exist on quantitative intake of polyphenols. The aims of this study were to estimate the quantitative intakes of polyphenols by using analyzed concentrations together with individual food consumption records and to determine major dietary sources. Analyzed concentrations of phenolic acids, anthocyanidins, and other flavonoids, proanthocyanidins, and ellagitannins (44 total polyphenol compounds) were entered into the national food composition database, Fineli. The absolute intakes of the polyphenols and the corresponding food sources were calculated on the basis of 48-h dietary recalls of 2007 Finnish adults. The mean total intake of polyphenols was 863 +/- 415 mg/d. Phenolic acids comprised the dominant group of polyphenols (75% of total intake) followed by proanthocyanidins (14%) and anthocyanidins and other flavonoids (10%). Due to their high consumption and high concentrations of phenolic acids, coffee and cereals were the main contributors to total polyphenol intake. Berries and berry products were the main source for anthocyanidins, ellagitannins, and proanthocyanidins, and fruits were the main source for flavonols, flavones, and flavanones. The results give additional support to the recommendations for a varied diet with fruits, berries, cereals, and vegetables.     

25-Hydroxyvitamin D and functional outcomes in adolescents

Vitamin D is essential for bone growth and development in children and adolescents. Adolescence is a crucial phase in bone development. Cross-sectional studies have shown a relation between vitamin D status and bone mineral density in adolescents. Long-term supplementation studies have supported the importance of vitamin D for bone health in adolescence. However, we need more studies on the optimal serum 25-hydroxyvitamin D concentration and the optimal vitamin D dosage for bone health in this age group. In addition, we need to evaluate the best way to increase vitamin D status in the general public from a public health point of view.