Interleukin-6 Receptor Signaling and Abdominal Aortic Aneurysm Growth Rates.

Background: The Asp358Ala variant (rs2228145; A>C) in the IL (interleukin)-6 receptor ( IL6R) gene has been implicated in the development of abdominal aortic aneurysms (AAAs), but its effect on AAA growth over time is not known. We aimed to investigate the clinical association between the IL6R-Asp358Ala variant and AAA growth and to assess the effect of blocking the IL-6 signaling pathway in mouse models of aortic aneurysm rupture or dissection.

Methods: Using data from 2863 participants with AAA from 9 prospective cohorts, age- and sex-adjusted mixed-effects linear regression models were used to estimate the association between the IL6R-Asp358Ala variant and annual change in AAA diameter (mm/y).

Endovascular treatment for ruptured abdominal aortic aneurysm.

Background: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved.

Meta-Analysis of Genome-Wide Association Studies for Abdominal Aortic Aneurysm Identifies Four New Disease-Specific Risk Loci.

Rationale: Abdominal aortic aneurysm (AAA) is a complex disease with both genetic and environmental risk factors. Together, 6 previously identified risk loci only explain a small proportion of the heritability of AAA.

Objective: To identify additional AAA risk loci using data from all available genome-wide association studies.

Endovascular Aneurysm Repair Increases Aortic Arterial Stiffness When Compared to Open Repair of Abdominal Aortic Aneurysms.

Objectives: The initial survival advantage seen with endovascular aneurysm repair (EVAR) over open repair does not persist in the long term. Pulse wave velocity (PWV) is a measure of arterial stiffness, and increased PWV is an independent risk factor for increased cardiovascular morbidity and mortality. This prospective comparative pilot study examined the effect of implantation of an aortic graft on PWV in patients undergoing open or endovascular aortic aneurysm repair.

The implications of different criteria for grading carotid artery stenosis by duplex ultrasound.

Purpose: Duplex ultrasound is the first-line mode of investigation for carotid stenosis, whose severity could be graded according to NASCET or St. Mary's ratio criteria. The aim of this study was to compare these two methods and review the literature.

Screening for Peripheral Arterial Disease and Carotid Artery Disease in Patients With Abdominal Aortic Aneurysm.

Screening for concomitant atherosclerotic disease is important in cardiovascular risk reduction. This study assessed the prevalence of carotid artery disease (CAD) and peripheral arterial disease (PAD) in patients with known abdominal aortic aneurysms (AAAs). All patients with AAA attending the vascular laboratory between the January 1, 2007, and December 31, 2009, were eligible for a carotid ultrasound and measurement of ankle brachial indices.

Endovascular treatment for ruptured abdominal aortic aneurysm.

Background: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) can develop in both men and women as they grow older. It is most commonly seen in men over the age of 65 years. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, a fatal event unless timely repair can be achieved.

PET-CT as a predictor of outcome in resectable colorectal liver metastases.

Introduction: PET-computed tomography (PET-CT) is a useful staging imaging modality in colorectal liver metastases (CRLM). This study aimed to determine whether PET-CT parameters, standardized uptake value (SUV) and reconstructed tumour volume (RTV), are predictors of prognosis and survival.

Methods: A study of all resectable CRLM patients in the regional HPB unit from 2007-2009 was performed.

A variant in LDLR is associated with abdominal aortic aneurysm.

Background: Abdominal aortic aneurysm (AAA) is a common cardiovascular disease among older people and demonstrates significant heritability. In contrast to similar complex diseases, relatively few genetic associations with AAA have been confirmed. We reanalyzed our genome-wide study and carried through to replication suggestive discovery associations at a lower level of significance.

Modulation of gut barrier function in patients with obstructive jaundice using probiotic LP299v.

Objectives: This study aimed to determine the effect of LP229v on intestinal permeability and tumour necrosis factor (TNF) p55 receptor concentrations in patients with obstructive jaundice undergoing biliary drainage.

Patients And Methods: Patients undergoing biliary drainage were recruited and randomized into three groups to receive Lactobacillus plantarum 299v (LP299v), inactivated LP299v (placebo) or water. These were administered daily at noon until 7 days after biliary drainage.

Referral patterns, clinical examination and the two-week-rule for breast cancer: a cohort study.

Introduction: Current NHS guidelines require patients with suspected breast cancer to be seen urgently at a specialist breast clinic. The aim of this study was to assess referral patterns and clinical findings of patients referred to a specialist breast clinic.

Materials And Methods: A prospective database was maintained for consecutive patients referred.

The use of antiendotoxin peptides in obstructive jaundice endotoxemia.

Background: Two novel antiendotoxin peptides, P6 and C1, may reduce the inflammatory response. This study aimed to determine the effect of endotoxin on hepatic cytokine response and to assess P6 and C1-related attenuation of the proinflammatory response to endotoxemia, in experimental biliary obstruction.

Materials And Methods: 15 Male Wistar rats were randomized to one of three groups: bile duct ligation (BDL)+P6 (n=5), BDL+C1 (n=5), and BDL+no peptide (n=5).

Surveillance strategies according to the rate of growth of small abdominal aortic aneurysms.

The management of small abdominal aortic aneurysms (AAA) is by ultrasound surveillance. The study aimed to calculate their growth rate, identify risk factors and determine appropriate screening intervals. The local screening programme and hospital records were used to identify patients with a small (< 5.

Abdominal aortic aneurysm is associated with a variant in low-density lipoprotein receptor-related protein 1.

Abdominal aortic aneurysm (AAA) is a common cause of morbidity and mortality and has a significant heritability. We carried out a genome-wide association discovery study of 1866 patients with AAA and 5435 controls and replication of promising signals (lead SNP with a p value < 1 × 10(-5)) in 2871 additional cases and 32,687 controls and performed further follow-up in 1491 AAA and 11,060 controls. In the discovery study, nine loci demonstrated association with AAA (p < 1 × 10(-5)).

Cytokine response to portal endotoxaemia and neutrophil stimulation in obstructive jaundice.

Introduction: An exaggerated proinflammatory response to endotoxaemia can occur in obstructive jaundice. The aims of this study were to determine the hepatic proinflammatory and anti-inflammatory cytokine response to endotoxaemia in experimental biliary obstruction and to determine the source of interleukin-6 (IL-6) using immunohistochemistry.

Methodology: Male Wistar rats were randomized into three groups: bile duct ligation (BDL), sham operation, and control groups.

The impact of radiation dose exposure during endovascular aneurysm repair on patient safety.

Objective: Endovascular aneurysm repair (EVAR) exposes patients to radiation during the procedure and in subsequent follow-up. The study goal was to calculate the radiation dose in our unit and compare it against other published data and national guidelines.

Methods: All EVAR procedures were identified from a prospectively maintained database.

Can the National Health Service Cancer Plan timeline be applied to colorectal hepatic metastases?

Introduction: The National Health Service (NHS) Cancer Plan guidelines recommend a maximum 2-week wait from referral to first appointment, and 2 months from referral to treatment for primary cancers. However, there are currently no guidelines available for metastatic disease. In the UK, nearly half of all colorectal cancer patients develop hepatic metastases.

Common polymorphisms of Fibulin-5 and the risk of abdominal aortic aneurysm development.

Fibulin-5 is a crucial protein in the connective tissue structure of the aortic wall. The purpose of this study was to determine if genetic variation within the Fibulin-5 gene was associated with abdominal aortic aneurysms (AAA). AAA patients, with disease-free controls, were recruited and a past medical history questionnaire completed.

Evaluation of angiography as the sole imaging study for the proximal aortic neck prior to EVAR.

Background: Angiographic assessment is an alternative to computerised tomography (CT) prior to endovascular aneurysm repair (EVAR). We evaluated angiography in aortic neck morphology assessment as an alternative investigation.

Methods: Patients admitted for elective or emergency EVAR were assessed by pre-operative CT and intra-operative angiography.

The influence of COX-2 single nucleotide polymorphisms on abdominal aortic aneurysm development and the associated inflammation.

Introduction: Cyclooxygenase (COX)-2 influences cardiovascular disease and serum concentration of high-sensitivity C-reactive protein (hsCRP). The study purpose was to determine the influence of single nucleotide polymorphisms (SNPs) of the COX-2 gene on abdominal aortic aneurysm (AAA) development and serum hsCRP concentrations.

Patients And Methods: Patients with AAA and disease-free controls were recruited.

The effects of abdominal compartment hypertension after open and endovascular repair of a ruptured abdominal aortic aneurysm.

Objective: This study assessed if emergency endovascular repair (eEVR) reduces the increase in intra-abdominal compartment pressure and host inflammatory response in patients with ruptured abdominal aortic aneurysm (AAA).

Methods: Thirty patients with ruptured AAA were prospectively recruited. Patients were offered eEVR or emergency conventional open repair (eOR) depending on anatomic suitability.

The vascular and biochemical effects of cilostazol in patients with peripheral arterial disease.

Objectives: Cilostazol improves walking distance and quality of life in patients with peripheral arterial disease (PAD). This study assessed the vascular and biochemical effects of cilostazol therapy in PAD patients.

Methods: PAD patients were prospectively recruited to a randomized, double-blinded, placebo-controlled trial.

The vascular and biochemical effects of cilostazol in diabetic patients with peripheral arterial disease.

Objectives: Cilostazol improves walking in patients with peripheral arterial disease (PAD). We hypothesized that cilostazol reduces diabetic complications in PAD patients.

Methods: Diabetic PAD patients were prospectively recruited to a randomized double-blinded, placebo-controlled trial, using cilostazol 100mg twice a day.