Microvascular complications of pediatric-onset type 1 diabetes are common in low-income countries. In this study, we aimed at reviewing microvascular outcomes in 6 cases with type 1 diabetes over 14 to 31 years of follow-up. Severe proliferative diabetic retinopathy (PDR) and/or diabetic macular edema (maculopathy) (DME) and overt diabetic nephropathy (macroalbuminuria) were seen among 4 of 6 patients, whereas severe diabetic peripheral neuropathy with Charcot neuroarthropathy was seen in 1 patient only, who had the longest duration of follow-up. The weighted mean (SD) (95% confidence interval) hemoglobin A was 8.9 (1.6) (8.4-9.4)% [74 (17) (68-80) mmol/mol] for PDR/DME and 8.6 (1.7) (8.0-9.0)% [71 (19) (65-77) mmol/mol] for macroalbuminuria. Thyroid autoimmunity was positive in 3 patients with overt hypothyroidism in 2 of them. Worse microvascular outcomes among these cases might be attributed to poor glycemic control, lack of knowledge, and limited financial resources.
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http://dx.doi.org/10.1177/1179551417749217 | DOI Listing |
J Am Acad Orthop Surg
November 2024
From the Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore (Lee), the Department of Orthopedic Surgery (Sammarco), the Department of Neurosurgery (Spinner), Mayo Clinic, Rochester, MN, and the Division of Hand and Microvascular Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (Shin).
Painful neuromas are a complex clinical condition that results in notable disability and functional impairment after injury to a peripheral nerve. When regenerating axons lack a distal target, they form a stump neuroma. Up to 60% of neuromas are painful because of mechanical sensitivity and crosstalk between nerve fibers.
View Article and Find Full Text PDFActa Neurochir (Wien)
January 2025
Department of Neurosurgery, The Fourth Affiliated Hospital of Soochow University, Suzhou, China.
Background: Superficial temporal artery (STA)-middle cerebral artery (MCA) side-to-side microvascular anastomosis can achieve the same clinical effects as traditional STA-MCA end-to-side anastomosis in extracranial-intracranial revascularization surgery, furthermore, STA-MCA side-to-side anastomosis has the lower risk of postoperative cerebral hyperperfusion syndrome (CHS) and the potential to recruit all scalp arteries as the donor sources via self-regulation. Therefore, STA-MCA side-to-side microvascular anastomosis seems to be a revascularization strategy superior to traditional STA-MCA end-to-side anastomosis. In this study, we presented seven cases in which a STA-MCA side-to-side microvascular anastomosis was performed with a 4-5 mm long arteriotomy using the in-situ intraluminal suturing technique.
View Article and Find Full Text PDFOphthalmol Sci
November 2024
Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan Province, China.
Objective: To investigate the short-term blood flow changes and image features of the retina and choroid in patients who underwent carotid artery revascularization (CAR) for severe carotid artery stenosis using widefield swept-source OCT angiography (OCTA).
Design: Prospective study.
Participants: This prospective study included 112 eyes (56 eyes on the ipsilateral side and 56 eyes on the contralateral side) of 56 participants with severe carotid artery stenosis.
Semin Liver Dis
January 2025
Hepatology, University of Pennsylvania, Philadelphia, United States.
Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation.
View Article and Find Full Text PDFAlzheimers Dement
January 2025
Institute for Biomedical Engineering and Institute of Pharmacology and Toxicology, Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Introduction: Transcranial pulse stimulation (TPS) is increasingly being investigated as a promising potential treatment for Alzheimer's disease (AD). Although the safety and preliminary clinical efficacy of TPS short pulses have been supported by neuropsychological scores in treated AD patients, its fundamental mechanisms are uncharted.
Methods: Herein, we used a multi-modal preclinical imaging platform combining real-time volumetric optoacoustic tomography, contrast-enhanced magnetic resonance imaging, and ex vivo immunofluorescence to comprehensively analyze structural and hemodynamic effects induced by TPS.
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