Aneurysmal degeneration of a saphenous vein graft following the repair of a popliteal aneurysm: case report and literature review.

True aneurysm formation in arterialized autologous veins is an unusual complication. A saccular aneurysmal degeneration of 53 mm (maximal diameter) of a saphenous vein graft inserted for repair of a popliteal aneurysm, four years after implantation, is reported. The patient (with prior history of abdominal aortic aneurysm) had been initially treated through a posterior approach. A new saphenous vein bypass grafting (medial approach) was performed. Histological examination revealed myointimal fibrosis, medial degeneration and inflammation. In spite of the widespread use of the autologous saphenous vein as an arterial substitute, this complication is extremely rare and its etiology remains unclear. Atherosclerosis is considered to be the main cause of aneurysm formation in vein grafts, but current data suggest that additional etiopathogenic factors should be further investigated. We note the rarity of this finding and review the literature for true aneurysm formation within vein grafts used for bypass procedures.

Alterations of specific biomarkers of metabolic pathways in vascular tree from patients with Type 2 diabetes.

The aims of this study were to check whether different biomarkers of inflammatory, apoptotic, immunological or lipid pathways had altered their expression in the occluded popliteal artery (OPA) compared with the internal mammary artery (IMA) and femoral vein (FV) and to examine whether glycemic control influenced the expression of these genes. The study included 20 patients with advanced atherosclerosis and type 2 diabetes mellitus, 15 of whom had peripheral arterial occlusive disease (PAOD), from whom samples of OPA and FV were collected. PAOD patients were classified based on their HbA1c as well (HbA1c ≤ 6.5) or poorly (HbA1c > 6.5) controlled patients. Controls for arteries without atherosclerosis comprised 5 IMA from patients with ischemic cardiomyopathy (ICM). mRNA, protein expression and histological studies were analyzed in IMA, OPA and FV. After analyzing 46 genes, OPA showed higher expression levels than IMA or FV for genes involved in thrombosis (F3), apoptosis (MMP2, MMP9, TIMP1 and TIM3), lipid metabolism (LRP1 and NDUFA), immune response (TLR2) and monocytes adhesion (CD83). Remarkably, MMP-9 expression was lower in OPA from well-controlled patients. In FV from diabetic patients with HbA1c ≤6.5, gene expression levels of BCL2, CDKN1A, COX2, NDUFA and SREBP2 were higher than in FV from those with HbA1c >6.5. The atherosclerotic process in OPA from diabetic patients was associated with high expression levels of inflammatory, lipid metabolism and apoptotic biomarkers. The degree of glycemic control was associated with gene expression markers of apoptosis, lipid metabolism and antioxidants in FV. However, the effect of glycemic control on pro-atherosclerotic gene expression was very low in arteries with established atherosclerosis.

Evaluación clínica de hidróxido de calcio en la prevención del dolor en dientes permanentes con pulpa necrótica / No disponible

El dolor postoperatorio como resultado de la terapia de conductos es un efecto colateral bastante frecuente en el tratamiento de dientes con pulpa necrótica sin fístula, que puede durar de horas a días, debido en parte a una reacción inflamatoria de la zona peri-radicular. Objetivo. Fue evaluar la eficacia clínica del hidróxido del calcio en la prevención del dolor en dientes permanentes con pulpa necrótica. Material y métodos. Se realizó un estudio en 80 pacientes de 18 a 45 años que requerían tratamiento endodóncico en piezas no vitales sin fístula. Resultados. Se observó que el uso del hidróxido reduce el dolor y la frecuencia de agudizaciones postoperatorias fue relativamente baja. El análisis estadístico realizado consistió en la aplicación de la prueba ji cuadrada (ᵡ2) para independencia en tablas de contingencia ayudados por el software SPSS versión 12. Conclusiones. Se concluye que el hidróxido de calcio como tratamiento en la prevención del dolor postoperatorio en pulpas necróticas sin fístula, no evita la sintomatología postoperatoria ya que existen otros factores que deben ser considerados y aunque son controlados dentro del tratamiento, pueden ser causa de la aparición del dolor entre citas (AU)

Postoperative pain as a result of the root canal therapy is a very frequent side effect in teeth with necrotic pulps without sinus tract that may last a few hours to several days during the endodontic treatment due to the inflammatory reaction in the periradicular area. Objective. The focus of this study was to evaluate the clinical efficacy of calcium hydroxide in preventing postoperative pain in teeth with necrotic pulps. Materials and Methods. Eighty different patients between 18 and 45 years old who required endodontic treatment in non-vital teeth without sinus tract. Results. It was observed that the frequency of postoperative pain exacerbation was relatively low. the statistical analysis was based on the Chi square test (ᵡ2), for the independence in contingency charts. Software SPSS versión 12 was used. Conclusión. This allows us to reach the conclusion that calcium hydroxide used as a treatment to prevent postoperative pain in necrotic pulps without sinus tract does not avoid postoperative symptomatology because there are other factors that should be taken into account and although they are under control within the treatment, it is possible that they influence over the occurrence of interappointment pain (AU)