Safety Evaluation of Unibody Endografts for Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis.

BACKGROUND: The unibody bifurcated aortic endograft (AFX/AFX2) has emerged as a treatment option for abdominal aortic aneurysms (AAAs). This systematic review and meta-analysis aimed to evaluate the safety of the unibody endograft. METHODS: A literature search was conducted in Cochrane Library, Scopus, Web of Science, and PubMed. Studies assessing the unibody endograft for abdominal aortic aneurysm repair between 2014 and 2023 were included. The defined primary outcomes were the incidences of type I, II, and III endoleaks. The secondary outcomes were access site problems, aneurysm-related mortality, aneurysm rupture, all-cause mortality, aneurysm sac growth, limb occlusion, stent graft migration, and technical success rate. RESULTS: 14 studies including 12 observational studies and two randomized controlled trials (RCTs) were included in the systematic review. The meta-analysis included 10 studies with 12,690 patients that reported the measured outcomes, and excluded four studies that did not. Type II endoleaks had the highest incidence of 12% (95% CI: 4-20%), followed by type III endoleaks with an incidence of 3% (95% CI: 1-5). The incidence of type I endoleaks was 1% (95% CI: 0-2%). A subgroup analysis by follow-up duration showed that type II endoleak incidence was higher after one to two years of follow-up than three to four years of follow-up. The incidence of aneurysmal mortality was 2% (95% CI: 0-7%); limb occlusion was 1% (95% CI: 0-1%); stent graft migration was 1% (95% CI: 0-2%); aneurysmal rupture was 6% (95% CI: 2-11%); access site problems were 7% (95% CI: 2-13%); aneurysm sac growth was 2% (95% CI: 0-4%);, all-cause mortality was 21% (95% CI: 4-38%), and technical success rate was 100% (95% CI: 98-100%). CONCLUSION: The unibody endograft is a safe and minimally invasive approach for AAA repair. However, potential complications necessitate close patient follow-up after the intervention.

Kaposi varicelliform eruption: an unusual presentation caused by varicella zoster virus in a healthy adult patient - a case report.

BACKGROUND: Kaposi Varicelliform Eruptions (KVE), also known as eczema herpeticum, is a rare and potentially life-threatening dermatological condition primarily attributed to herpes simplex virus (HSV) infection, with less frequent involvement of Coxsackie A16, vaccinia, Varicella Zoster, and smallpox viruses. Typically associated with pre-existing skin diseases, especially atopic dermatitis, KVE predominantly affects children but can manifest in healthy adults. Characterized by painful clusters of vesicles and sores on the skin and mucous membranes, it often masquerades as other dermatological disorders. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain relief and inflammation, though their potential role as KVE triggers remains uncertain. CASE REPORT: Here, we present a case of an 18-year-old female with KVE attributed to Varicella Zoster virus (VZV) and successfully treated with oral acyclovir within a week, underscoring the significance of early recognition and intervention. KVE can manifest with systemic symptoms like fever, fatigue, and lymphadenopathy and may involve multiple organ systems, necessitating possible antibiotic use for complications. CONCLUSION: This case underscores the importance of prompt KVE identification and consideration of antiviral therapy to enhance patient outcomes. Further research is warranted to elucidate predisposing factors for this rare condition.

Saussurea lappa root extract ameliorates the hazards effect of thorium induced oxidative stress and neuroendocrine alterations in adult male rats.

The present study was aimed to estimating the effect of Saussurea lappa (costus) root extract on thorium accumulation in different brain regions (cerebral cortex, cerebellum, and hypothalamus) of adult male albino rats and also to evaluate the antioxidant effect and thyroid gland modulation activity of costus following thorium toxicity. Adult male rats were randomly allocated into four groups; control group receiving saline (0.9% NaCl), thorium group receiving an intraperitoneal (i.p.) injection of thorium nitrate (Th; 6.3 mg/kg bwt), costus group receiving an oral administration of costus extract at 200 mg/kg bwt and costus + thorium group receiving costus 1 h before thorium injection. Thorium injection in rats for 28 days resulted in the accumulation of Th maximally in the cerebellum followed by the cerebral cortex and then in the hypothalamus. The accumulation of Th was associated with significant disturbance in sodium and potassium ions. A significant decrease in monoamines was also observed in different brain regions. Furthermore, the results indicated that Th-induced oxidative stress evidenced by increased lipid peroxidation and nitric oxide and decrease the glutathione content. Additionally, Th caused a significant increase in thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) levels in the serum of rats. However, the pre-administration of costus alleviated all of those disturbances. Our results revealed that costus extract exerted its protective effect mainly through potentiating the antioxidant defense system.

Thorium exerts hazardous effects on some neurotransmitters and thyroid hormones in adult male rats.

Assessment of the hazardous effects of thorium, a naturally radioactive element, on the nervous and endocrine systems, which are intimately involved in maintaining homeostasis, is important. In the present study, rats were divided into control and thorium groups and were decapitated after 2, 4, and 6 weeks. We observed that intraperitoneally injected thorium (6.3 mg/kg body weight) crossed the blood-brain barrier and was localized in the cerebellum, cerebral cortex, and hypothalamus of the rats in the given order. Thorium administration significantly decreased the GSH level and increased MDA, NO, and Fe3+ levels. Furthermore, thorium administration decreased NE and DA levels and induced fluctuations in 5-HT level. Thorium administration also increased serum TSH level, which in turn increased T4 and T3 levels. Together, these results indicate that thorium administration stimulates TSH secretion, which significantly increases T4 and T3 secretion from the thyroid gland. Moreover, these results indicate that thorium administration exerts hazardous effects on the neuroendocrine axis.