METHODS: We performed a systematic review in multiple databases (including PubMed, MEDLINE, EMBASE, and Scopus) from 1966 to May 18, 2019, to identify all case reports and case series describing patients with ankle pseudo aneurysm. This systematic review was performed in accordance with the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA). Our inclusion criteria included patients with ankle pseudo aneurysm of any age. We excluded reports in which the individual level data is not available. Patients demographic (gender, age), clinical characteristics (precipitating event, duration), diagnostic modality and treatment were recorded.
RESULT: There were in total 23 case reports identified on ankle pseudo aneurysm from 1966 until 2018. Among these twenty-three reports, 16 (70%) were male and seven (30%) patients were female. Age distribution showed higher number of reports among young adults, 15 patients (65%). Based on our systematic review trauma (48%), arthroscope (48%) and arthrodesis (4%) were the etiologies described in all these case reports. Ultrasound duplex and CT Angiogram has been used as a single modality in three reports each. In fifteen patients (65%) combination of imaging has been used for diagnosis. Anterior tibial artery is the most commonly injured vessel among the reported cases, comprised of 14 (61%) patients. Among these arthroscopes were the highest reported precipitating events, 9 (64%), followed by trauma in four patients (29%) and arthrodesis in one patient (7%). Treatment modalities described in all previous reports were excision and ligation, 10 (42%); excision of sac and primary repair, 4 (17%); excision of sac followed by reversed saphenous venous graft repair, 2 (8%); US guided compression, 2 (8%); US guided thrombin injection, 4 (17%); stenting, 1 (4%) and coiling, 1 (4%).
CONCLUSION: Ankle pseudoaneurysm is mostly preventable by detailed initial assessment following trauma or careful approach during arthroscope. Evolving diagnostic modality and treatment has shed some light into noninvasive management of pseudo aneurysm of ankle.
METHODS: MiRNA profiling was conducted on plasma samples from 18 patients with primary aldosteronism taken during adrenal venous sampling on an Illumina MiSeq platform. Bioinformatics and machine learning identified 9 miRNAs for validation by reverse transcription real-time quantitative polymerase chain reaction. Validation was performed on a cohort consisting of 108 patients with known subdifferentiation. A 30-patient subset of the validation cohort involved both adrenal venous sampling and peripheral, the rest only peripheral samples. A neural network model was used for feature selection and comparison between adrenal venous sampling and peripheral samples, while a deep-learning model was used for classification.
RESULTS: Our model identified 10 miRNA combinations achieving >85% accuracy in distinguishing unilateral primary aldosteronism and bilateral adrenal hyperplasia on a 30-sample subset, while also confirming the suitability of peripheral samples for analysis. The best model, involving 6 miRNAs, achieved an area under curve of 87.1%. Deep learning resulted in 100% accuracy on the subset and 90.9% sensitivity and 81.8% specificity on all 108 samples, with an area under curve of 86.7%.
CONCLUSIONS: Machine learning analysis of circulating miRNAs offers a minimally invasive alternative for primary aldosteronism lateralization. Early identification of bilateral adrenal hyperplasia could expedite treatment initiation without the need for further localization, benefiting both patients and health care providers.
METHODOLOGY: Studies were identified by searching the SCOPUS, SPORTDiscus, PubMed, Web of Science, and CNKI databases up to May 13, 2024, using the following inclusion criteria: (a) healthy population; (b) comparison of LL-BFR vs HLR training; (c) pre- and post-training assessment of muscle strength (dynamic, isometric, and isokinetic), muscle power, jump, or speed performance; (d) PEDro scale score ≥4. The methodological quality of the included studies was assessed using the PEDro tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, with meta-analyses conducted using the R program.
RESULTS: A total of 41 studies, involving 853 subjects, were included in the meta-analysis. Based on the PEDro scores and GRADE assessment, the overall quality of the included studies was assessed as moderate. LL-BFR training showed a slightly smaller effect on maximal strength compared to HLR training (ES = -0.19, 95% CI [-0.31 to -0.06], p < 0.01). There were no significant differences between LL-BFR and HLR training for muscle power (ES = -0.04, 95% CI [-0.33 to 0.24], p > 0.05), jump performance (ES = -0.08, 95% CI [-0.30 to 0.15], p > 0.05), and speed (ES = -0.28, 95% CI [-0.71 to 0.15], p > 0.05). Additionally, individual characteristics (i.e., age, gender, and training status) and training parameters (i.e., training duration, frequency, cuff pressure, and cuff width) did not significantly moderate the training effect.
CONCLUSIONS: LL-BFR training showed slightly less improvement in maximal strength compared to HLR training but demonstrated comparable effects on muscle power, jump performance, and speed in healthy individuals in healthy individuals. These findings suggest that LL-BFR may be a practical and effective alternative for individuals seeking performance improvements with lower training loads.
METHODS: A literature search was performed on PUBMED, SCOPUS AND EMBASE. The following keywords were used: ethmoidal artery; anterior ethmoidal artery; anterior ethmoidal canal; ethmoid sinus; ethmoid roof; skull base. The search was conducted over a period of 6 months between October 2016 and April 2017.
RESULTS: 105 articles were retrieved. 76 articles which were either case reports or unrelated topics were excluded. Out of the 29 full text articles retrieved, 16 articles were selected; 3 were cadaveric dissection, 5 combined cadaveric dissection and computed tomography (CT) and the rest were of CT studies. All studies were of level III evidence and a total of 1985 arteries were studied. Its position at the skull base was influenced by the presence of supraorbital ethmoid cell (SOEC) and length of the lateral lamella of cribriform plate (LLCP). Inter population morphological variations contribute to the anatomical variations.
CONCLUSIONS: The average diameter of AEA was 0.80 mm and the intranasal length was 5.82 mm. 79.2% was found between the second and third lamellae, 12.0% in the third lamella, 6% posterior to third lamella and 1.2% in the second lamella. Extra precaution should be taken in the presence of a well-pneumatized SOEC and a long LLCP as AEA tends to run freely below skull base.