Artificial human sera: a breakthrough?

Abstract

It is not common that a Brief Communication is chosen for an Editorial; however, the work presented by Offermann et al. (1) deserves to be commented. Obviously the in vitro diagnosis of allergic sensitisation is based on the determination of soluble allergen-specific IgE in serum (2). Although the correlation between sIgE and allergic sensitization might be disturbed by the presence of clinically irrelevant cross-reactive carbohydrate determinants (3), in most cases allergen-specific IgE in serum can be correlated with the symptomatic (4).

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Cannabis sativa allergy: looking through the fog

Abstract

IgE-mediated Cannabis (C. sativa, marihuana) allergy seems to be on the rise. Both active and passive exposure to cannabis allergens may trigger a C. sativa sensitization and/or allergy. The clinical presentation of a C. sativa allergy varies from mild to life-threatening reactions and often seems to depend on the route of exposure. In addition, sensitization to cannabis allergens can result in various cross-allergies, mostly for plant foods. This clinical entity, designated as the "cannabis-fruit/vegetable syndrome" might also imply cross-reactivity with tobacco, natural latex and plant-food derived alcoholic beverages. Hitherto, these cross-allergies are predominantly reported in Europe and appear mainly to rely upon cross-reactivity between non-specific lipid transfer proteins (ns-LTPs) or thaumatin-like proteins (TLPs) present in C. sativa and their homologues, ubiquitously distributed throughout plant kingdom. At present, diagnosis of cannabis-related allergies predominantly rests upon a thorough history completed with skin testing using native extracts from crushed buds and leaves. However, quantification of specific IgE (sIgE) antibodies and basophil activation tests (BAT) can also be helpful to establish correct diagnosis. In the absence of a cure, treatment comprises absolute avoidance measures. Whether avoidance of further use will halt the extension of related cross-allergies remains uncertain.

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3D physiological model of the aortic valve incorporating small coronary arteries

Summary

The diseases of the coronary arteries and the aortic root are still the leading causes of mortality and morbidity worldwide. In this study, a 3D global fluid-structure interaction of the aortic root with inclusion of anatomically inspired small coronary arteries using the finite element method is presented. This innovative model allows to study the impact and interaction of root biomechanics on coronary hemodynamics and brings a new understandings to small coronary vessels hemodynamics. For the first time, the velocity profiles and shear stresses are reported in distal coronary arteries as a result of the aortic flow conditions in a global fluid-structure interaction model.

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Comparative study of chlorhexidine dressings versus simple gauze dressings in midline laparotomy wound

2016-09-03T07-00-50Z
Source: International Journal of Research in Medical Sciences
Jignesh A. Gandhi, Pravin H. Shinde, Alpana A. Awasthi, Rohan Digarse, Amit P. Kawle.
Background: Wound infections are the most common complication of surgery that adds significantly to the morbidity of the patient and the cost of the treatment. Most of the surgical site infections are preventable. Dressing is an active element of wound management, designed to control infection and promote healing. This study was done to compare clinical efficacy of normal gauze dressings versus chlorhexidine dressings in midline laparotomy wounds. Methods: Patients with midline laparotomy incision were randomized to receive either gauze or chlorhexidine dressings. Bacterial colonization, post- operative fever, frequency of infection, change of dressings, hospital stay and postoperative pain were assessed at the start of treatment and at weekly intervals until full healing occurred. Results: A total of 128 patients were enrolled in the study and divided into 2 groups viz chlorhexidine group (Group A) and Simple gauze group (Group B) with 64 patients each. Wound cultures, change of antibiotics, post-operative soakage, median hospital stay duration, postoperative pain, post- operative wound infection, and follow up visits for wound healing were compared between two groups A and B and statistical significance established. Conclusions: The analysis of wound culture, fever incidence and frequency of infection on Chlorhexidine dressings showed decreasing trends compared to traditional dressings.


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Advancing Implementation Research and Practice in Behavioral Health Systems

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Outcome after Interruption or Preservation of Internal Iliac Artery Flow During Endovascular Repair of Abdominal Aorto-iliac Aneurysms

Publication date: Available online 2 September 2016
Source:European Journal of Vascular and Endovascular Surgery
Author(s): G.N. Kouvelos, A. Katsargyris, G.A. Antoniou, K. Oikonomou, E.L.G. Verhoeven
AimThe aim was to conduct a systematic review of the literature investigating outcomes after interruption or preservation of the internal iliac artery (IIA) during endovascular aneurysm repair (EVAR).MethodsA systematic review was undertaken using the MEDLINE and EMBASE databases to identify studies reporting IIA management during EVAR. The search identified 57 articles: 30 reported on IIA interruption (1468 patients) and 27 on IIA preservation (816 patients).ResultsThe pooled 30 day buttock claudication (BC) rate was 29.2% (95% CI 24.2–34.7). Patients undergoing bilateral IIA interruption had a higher incidence of BC than patients with unilateral IIA interruption (36.5% vs. 27.2%, OR 1.7, 95% CI 1.11–2.6, p = .01). During a median follow up of 17 months, the pooled rate of persistent BC was 20.5% (95% CI 15.7–26.2). Of the patients, 93.9% underwent an endovascular revascularization procedure for IIA preservation. Most patients (87.6%) had an iliac branched device, and technical success was 96.2%. Within 30 days of EVAR, 4.3% of internal iliac branches occluded. During a median follow up of 15 months, the pooled occlusion rate at the site of IIA revascularization was 8.8% (95% CI 6.8–11.3). In patients treated with an iliac-branched device, 5.2% of internal iliac branches and 1.7% of external iliac arteries occluded. The pooled BC rate on the side of the IIA revascularization during follow up was 4.1% (95% CI 2.9–5.9). Pooled rates of late device related endoleak type I or III and secondary procedures on the side of the previous IIA revascularization were 4.6% (95% CI 3.2–6.5) and 7.8% (95% CI 5.7–10.7) respectively.ConclusionUnilateral or bilateral IIA occlusion during EVAR seems to carry a substantial risk of significant ischemic complications in nearly one quarter of patients. Bilateral IIA occlusion was related to a significantly higher rate of BC. IIA preservation techniques represent a significant improvement in the treatment of aorto-iliac aneurysms and have been associated with high technical success and low morbidity.



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Commentary on ‘Fluid-Structure Interaction Simulations of Aortic Dissection With Bench Validation’

Publication date: Available online 3 September 2016
Source:European Journal of Vascular and Endovascular Surgery
Author(s): J.P. Archie




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