Introduction: Abdominal aortic aneurysm (AAA, triple A) is one of the less common but important causes of abdominal pain. This study aimed to evaluate the characteristics and outcome of patients presenting to emergency department with triple A.
Methods: In this retrospective cross-sectional study, all cases with confirmed triple A, who were presented to the emergency department of Shohadaye Tajrish Hospital, Tehran, Iran from 2006 to 2017 (10 years) were enrolled using census sampling method.
Results: 500 cases with the mean age of 68.11 ± 11.98 (25 - 94) years were studied (84% male). The mean duration of symptoms was 2.32 ± 9.58 months and mean aneurysmal size was 63.91 ± 20.08 mm. In 4 (0.8 %) cases, atrial fibrillation (AF) was found during cardiac monitoring. Patients stayed in the hospital for an average of 7.06 ± 6.32 days. Aneurysmal leak was seen in 130 (26%) cases based on abdominal computed tomography (CT) scan findings. 369 (73.8%) cases underwent aneurysmorrhaphy, 126 (25.2%) were treated with non-surgical approaches, and 5 (1%) underwent grafting. 104 (20.8%) died and 396 (79.2%) were treated successfully. Older age (p = 0.017), shock state at the time of presentation (p < 0.0001), leakage of aneurysm (p < 0.001), larger size of aneurysm (p = 0.024), and aneurysmorrhaphy (p < 0.001) were among the factors significantly associated with mortality.
Conclusion: Based on the findings, the most frequent presenting symptom of patients was abdominal pain. The mortality rate of this series was 21% and older age, shock state, leakage of aneurysm, larger size of aneurysm, and performing aneurysmorrhaphy were among the factors significantly associated with mortality.
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JAMA
January 2025
Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania.
Importance: T helper 2 (T2) cells and T helper 17 (T17) cells are CD4+ T cell subtypes involved in asthma. Characterizing asthma endotypes based on these cell types in diverse groups is important for developing effective therapies for youths with asthma.
Objective: To identify asthma endotypes in school-aged youths aged 6 to 20 years by examining the distribution and characteristics of transcriptomic profiles in nasal epithelium.
JAMA Surg
January 2025
Breast Unit, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye.
Importance: Increasing evidence supports the oncologic safety of de-escalating axillary surgery for patients with breast cancer after neoadjuvant chemotherapy (NAC).
Objective: To evaluate the oncologic outcomes of de-escalating axillary surgery among patients with clinically node (cN)-positive breast cancer and patients whose disease became cN negative after NAC (ycN negative).
Design, Setting, And Participants: In the NEOSENTITURK MF-1803 prospective cohort registry trial, patients from 37 centers with cT1-4N1-3M0 disease treated with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) alone or with ypN-negative or ypN-positive disease after NAC were recruited between February 15, 2019, and January 1, 2023, and evaluated.
J Invasive Cardiol
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia.
Objectives: A recent coronavirus-related factory shutdown led to a global shortage of iodinated contrast. The authors evaluated how the contrast shortage impacted percutaneous coronary interventions (PCI).
Methods: Using a statewide database incorporating CathPCI registry data from 19 hospitals, the authors evaluated 2 time periods: pre-shortage (May 1, 2021 - April 30, 2022) and during the shortage (May 1, 2022 - October 31, 2022).
J Invasive Cardiol
December 2024
Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland.
Objectives: Antegrade wiring (AW) is the most common coronary chronic total occlusion (CTO) crossing strategy and usually relies upon stepwise guidewire escalation starting from the low tip-load polymer-jacketed wire (standard guidewire escalation). The authors aimed to investigate whether the upfront use of intermediate tip-load polymer-jacketed guidewire translates into improved procedural outcomes of CTO percutaneous coronary intervention (PCI).
Methods: The Gladius First trial was a single-center, investigator-initiated, randomized, prospective trial.
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