SARS-CoV-2 Vaccination Coverage and Key Public Health Indicators May Explain Disparities in COVID-19 Country-Specific Case Fatality Rate Within European Economic Area.

Aim To investigate the reasons for disparity regarding the country-specific COVID-19-related case fatality rate (CFR) within the 30 countries of the European Economic Area (EEA). Materials and methods Data regarding population, area, COVID-19-associated infections/deaths, vaccination, life expectancy, elderly population, infant mortality, gender disparity, urbanization, gross domestic product (GDP), income per capita, health spending per capita, physicians, nursing personnel, hospital beds, ICU beds, hypertension, diabetes, obesity, and smoking from all EEA countries were collected from official sources on January 16, 2022. Correlation coefficients were computed, and optimal scaling using ridge regression was used to reach the most parsimonious multivariate model assessing any potential independent correlation of public health parameters with COVID-19 CFR.

Acute esophageal necrosis complicating diabetic ketoacidosis in a patient with type II diabetes mellitus and excessive cola consumption: a case report.

Unlabelled: Acute esophageal necrosis (AEN) implicates poor tissue perfusion, functionally defective mucosal barrier, and corrosive injury of the esophageal mucosa, typically characterized by diffuse, circumferential greyish or black discoloration of the esophagus in esophagogastroduodenoscopy. Low-volume states, as diabetic ketoacidosis (DKA), predispose to AEN. Cola drinks diminish the esophageal pH by decreasing the lower esophageal sphincter pressure.

Spatial Distribution of Abdominal Aortic Aneurysm Surface Expansion and Correlation With Maximum Diameter and Volume Growth.

Background: Abdominal aortic aneurysm (AAA) growth rate, measured as maximum diameter (Dmax) change over time, is used as a surrogate marker of rupture risk. However, AAA expansion presents significant spatial variability. We aim to record the spatial distribution of regional wall surface expansion.

Correlation of Intraluminal Thrombus Deposition, Biomechanics, and Hemodynamics with Surface Growth and Rupture in Abdominal Aortic Aneurysm-Application in a Clinical Paradigm.

Background: The natural history of abdominal aortic aneurysm (AAA) can be investigated through longitudinal evaluation of localized aneurysm characteristics exploiting clinical images. The major challenge is to identify corresponding regions between follow-ups. We have recently developed an algorithm (VascForm) based on nonrigid registration that can obtain surface correspondence and quantify surface growth distribution.

A robust approach for exploring hemodynamics and thrombus growth associations in abdominal aortic aneurysms.

Longitudinal studies of vascular diseases often need to establish correspondence between follow-up images, as the diseased regions may change shape over time. In addition, spatial data structures should be taken into account in the statistical analyses to avoid inferential errors. This study investigates the association between hemodynamics and thrombus growth in abdominal aortic aneurysms (AAAs) while emphasizing on the abovementioned methodological issues.

A novel approach for local abdominal aortic aneurysm growth quantification.

Although aneurysm size still remains the most accepted predictor of rupture risk, abdominal aortic aneurysms (AAAs) with maximum diameter smaller than 5 cm may also rupture. Growth rate is an additional marker for rupture risk as it potentially reflects an undesirable wall remodeling that leads to fast regional growth. Currently, an indication for surgery is an expansion rate >10 mm/year, measured as change in maximum diameter over time.

Routine use of an aortic balloon to resolve possible inflow stenosis induced by the inflatable ring fixation mechanism of the Ovation endograft.

Purpose: To investigate if the routine use of an aortic balloon within 15-30 min after Ovation stent graft ring inflation would resolve any inflow stenosis, which may reach 60 %, at the level of the sealing rings. Moreover, we estimated the potential hemodynamic compromise in these patients during rest and exercise.

Methods: Following 3-dimensional reconstruction of AAA models, cross-sectional area of the infrarenal aorta just proximal the sealing mechanism (A , R , respectively) and internal area at the site of stenosis (A , R , respectively) were measured for 83.

Effect of intraluminal thrombus asymmetrical deposition on abdominal aortic aneurysm growth rate.

Purpose: To determine the relationship between asymmetrical intraluminal thrombus (ILT) deposition in abdominal aortic aneurysm (AAA) and growth rate and to explore its biomechanical perspective.

Methods: Thirty-four patients with AAA underwent at least 2 computed tomography scans during surveillance. The volumes of the AAA (VAAA) and thrombus (VILT) and the maximum thrombus thickness (ILTthick) were computed.

A comparative review of the hemodynamics and pathogenesis of cerebral and abdominal aortic aneurysms: lessons to learn from each other.

Objective: Cerebral aneurysms (CAs) and abdominal aortic aneurysms (AAAs) are degenerative vascular pathologies that manifest as abnormal dilations of the arterial wall. They arise with different morphologies in different types of blood vessels under different hemodynamic conditions. Although treated as different pathologies, we examine common pathways in their hemodynamic pathogenesis in order to elucidate mechanisms of formation.

The influence of intraluminal thrombus on noninvasive abdominal aortic aneurysm wall distensibility measurement.

Abdominal aortic aneurysm wall distensibility can be estimated by measuring pulse pressure and the corresponding sac volume change, which can be obtained by measuring wall displacement. This approach, however, may introduce error if the role of thrombus in assisting the wall in bearing the pulse pressure loading is neglected. Our aim was to introduce a methodology for evaluating and potentially correcting this error in estimating distensibility.

Graft inflow stenosis induced by the inflatable ring fixation mechanism of the Ovation stent-graft system: hemodynamic and clinical implications.

Purpose: To investigate the observed inflow stenosis at the O-rings of the Ovation stent-graft and evaluate its hemodynamic and clinical impact.

Methods: The study involved 49 consecutive patients (48 men; mean age 71.2 ± 7.

Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment.

Purpose: To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement.

Materials And Methods: Thirty-four small AAAs (initially presenting a maximum diameter <5.5cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined.

Advancements in identifying biomechanical determinants for abdominal aortic aneurysm rupture.

Abdominal aortic aneurysms are a common health problem and currently the need for surgical intervention is determined based on maximum diameter and growth rate criteria. Since these universal variables often fail to predict accurately every abdominal aortic aneurysms evolution, there is a considerable effort in the literature for other markers to be identified towards individualized rupture risk estimations and growth rate predictions. To this effort, biomechanical tools have been extensively used since abdominal aortic aneurysm rupture is in fact a material failure of the diseased arterial wall to compensate the stress acting on it.

Deformation and distensibility distribution along the abdominal aorta in the presence of aneurysmal dilatation.

Background: In order to evaluate the elastic behavior of the abdominal aortic aneurysm (AAA), the distribution of aortic deformation during the cardiac cycle is measured. Moreover, the distensibility of the AAA composite structure consisting of the AAA wall and the intraluminal thrombus (ILT), as well as that of the adjacent non-aneurysmal aortic segment (NAA), are calculated.

Methods: Ten patients underwent electrocardiographically-gated computed tomography.

Changes in geometric configuration and biomechanical parameters of a rapidly growing abdominal aortic aneurysm may provide insight in aneurysms natural history and rupture risk.

Background: Abdominal aortic aneurysms (AAA) are currently being treated based on the maximum diameter criterion which has often been proven insufficient to determine rupture risk in case of every AAA. We analyzed a rare case of an AAA which presented an extremely fast growth focusing on biomechanical determinants that may indicate a high risk profile. The examination of such a case is expected to motivate future research towards patient-specific rupture risk estimations.

Discrepancies in determination of abdominal aortic aneurysms maximum diameter and growth rate, using axial and orhtogonal computed tomography measurements.

Purpose: Maximum diameter and growth rate of abdominal aortic aneurysms (AAAs) which are currently used as the only variables to set the indication for elective repair are recorded through computed tomography (CT) measurements on an axial plane or on an orthogonal plane that is perpendicular to vessel centerline, interchangeably. We will attempt to record possible discrepancies between the two methods, identify whether such differences could influence therapeutic decisions and determine in which cases this should be expected.

Materials And Methods: We retrospectively reviewed sixty CT-scans performed in thirty-nine patients.

Estimation of wall properties and wall strength of aortic aneurysms using modern imaging techniques. One more step towards a patient-specific assessment of aneurysm rupture risk.

Abdominal aortic aneurysmal disease is a major health problem with rupture representing its main complication accompanied by great mortality. Elective repair is currently performed with mortality rates <3%, based upon size or expansion rate, with a recommended threshold of 5.5 cm maximum diameter or >1cm/year enlargement.

Progressive aneurysm development following hemodynamic insult.

Object: Hemodynamic insult has been speculated to be a key factor in intracranial aneurysm formation; however, it is unclear whether a sustained insult is necessary. The authors examined whether aneurysmal degradation would continue despite the normalization of wall shear stress (WSS) by adaptive outward vascular remodeling.

Methods: Twenty-five rabbits underwent either sham operation (5 animals) or bilateral common carotid artery ligation (20 animals) to augment basilar artery (BA) flow.

Characterization of critical hemodynamics contributing to aneurysmal remodeling at the basilar terminus in a rabbit model.

Background And Purpose: Hemodynamic insult by bilateral common carotid artery ligation has been shown to induce aneurysmal remodeling at the basilar terminus in a rabbit model. To characterize critical hemodynamics that initiate this remodeling, we applied a novel hemodynamics-histology comapping technique.

Methods: Eight rabbits received bilateral common carotid artery ligation to increase basilar artery flow.

Endothelial cell layer subjected to impinging flow mimicking the apex of an arterial bifurcation.

Little is known about endothelial responses to the impinging flow hemodynamics that occur at arterial bifurcation apices, where intracranial aneurysms usually form. Such hemodynamic environments are characterized by high wall shear stress (WSS >40 dynes/cm(2)) and high wall shear stress gradients (WSSG >300 dynes/cm(3)). In this study, confluent bovine aortic endothelial cells were exposed to impinging flow in a T-shaped chamber designed to mimic a bifurcation.

Nitric oxide-dependent stimulation of endothelial cell proliferation by sustained high flow.

Little is understood about endothelial cell (EC) responses to high flow, which mediate adaptive outward remodeling as well as cerebral aneurysm development. Opposite EC behaviors have been reported in vivo including cell loss during aneurysm initiation and cell proliferation during adaptive outward remodeling. This study aims at elucidating the EC growth response to elevated wall shear stress (WSS) and determining if nitric oxide (NO) is involved.

Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation.

Background And Purpose: Arterial bifurcation apices are common sites for cerebral aneurysms, raising the possibility that the unique hemodynamic conditions associated with flow dividers predispose the apical vessel wall to aneurysm formation. This study sought to identify the specific hemodynamic insults that lead to maladaptive vascular remodeling associated with aneurysm development and to identify early remodeling events at the tissue and cellular levels.

Methods: We surgically created new branch points in the carotid vasculature of 6 female adult dogs.

A model system for mapping vascular responses to complex hemodynamics at arterial bifurcations in vivo.

Objective: Cerebral aneurysms are preferentially located at arterial bifurcation apices with complex hemodynamics. To understand disease mechanisms associated with aneurysm initiation, we attempted to establish a causal relationship between local hemodynamics and vascular responses.

Methods: Arterial bifurcations were surgically created from native common carotid arteries in two dogs, angiographically imaged 2 weeks and 2 months later, and then excised.