Abnormal Course Research Articles

The Persistence of Stigma Reduction After Teaching Abnormal Psychology Using Celebrity Narratives

Research shows that stigma toward mental illness prevents a large percentage of college students from seeking help. Finding pedagogies that can be utilized in the classroom to reduce stigma is important. The present study replicated previous research that utilized celebrity case material in the teaching of abnormal psychology for the purpose of reducing public stigma toward mental illness and help seeking. The present study also examined whether stigma reductions would persist beyond the initial post-testing. Data were collected using a pre-post design from 48 (experimental group) and 23 (control group) college undergraduates enrolled in an abnormal psychology course. Compared to the control group, the use of celebrities as narratives to teach about mental illness resulted in reduced public stigma toward mental illness and reduced stigma toward seeking help which persisted over a 6-month time period.

An abnormal course of the interazygos vein: a case report

BackgroundThe azygos venous system in the posterior mediastinum has a complex developmental pattern.Case presentationDuring the dissection of this region, we encountered a variation in this system. In this case, we observed that the accessory hemiazygos and hemiazygos veins in the left side passed anterior to the aorta and drained to the azygos vein located on the left side of the vertebral column. Other structures were normal in this area.ConclusionsThis variation is important in mediastinal surgery and radiographic interpretation.

Estimation of the stability of skeletal muscle myoglobin of chilled pork treated with brine activated by low-frequency high-intensity ultrasound

We studied the effect of ultrasonic activation of brine (3%) during salting on the degree of stability of colour parameters of pork with normal (NOR) and abnormal course of autolysis in the CIE Lab colour space. The mechanism of stabilisation of the colour of meat is attributed to donor–acceptor bonds of metmyoglobin (MetMb). The accumulation of excessive number of free electrons in the medium are capable of activating MetMb. This reduces the activity of meat, when the native participants of the metmyoglobin reductase system and their own antioxidant systems of meat are depleted.Based on the additive calculation of deviations (increase / decrease) by the coordinates L*, a*, b* in the CIE Lab system, and the total colour difference (ΔE) in control and experimental samples, recommendations were developed. To optimize the colour characteristics of all types of meat, both on the surface and in the thickness of the meat, the preliminary activation of a 3% brine in a low-frequency submersible ultrasonic unit is recommended. Moreover, preliminary cavitation activation of a 3% is more preferable to stabilise the colour of PSE – meat (pale, soft, exudative (watery),) brine in a flow-through installation.

Assessment of physiological disturbances during pre‐ and early postnatal development based on microscopic analysis of human deciduous teeth from the Late Epipaleolithic site of Shubayqa 1 (Jordan)

To study pre- and early postnatal tooth formation and to analyze the effects of physiological disturbances on enamel and dentin formation in deciduous teeth of infants from the Late Epipaleolithic (Natufian) site Shubayqa 1. Ten deciduous teeth from six infants (ages at death between 21 and 239 days) were analyzed by light and scanning electron microscopy. Marked prism cross-striations and an abnormal wavy course of the prisms were recorded in pre- and postnatal enamel of all analyzed teeth. Single or multiple accentuated incremental lines were observed in prenatal enamel of nine teeth and in postnatal enamel of eight teeth. Accentuated Andresen lines and broader zones exhibiting an enhanced calcospheritic pattern were recorded in the pre- and postnatally formed dentin of nine teeth. The structural abnormalities in the pre- and postnatally formed enamel of the infants are considered indicative of chronic stress that negatively affected the activity of secretory ameloblasts. The structural aberrations in pre- and postnatal dentin denote that odontoblasts were also affected by this stress. The presence of single or multiple accentuated incremental lines in pre- and postnatal enamel is interpreted as reflecting (short-term) impacts of higher intensity superimposed on the chronic stress. Our findings suggest compromised maternal health affecting the late fetus and compromised health in newborns. Although limited by the small number of analyzed individuals, the present study contributes to the knowledge of maternal and early infant health conditions in Late Epipaleolithic populations.

The Role of Ultrasound in Dunbar Syndrome: Lessons Based on a Case Report

Patient: Male, 55-year-oldFinal Diagnosis: Dunbar syndromeSymptoms: Epigastric pain • weight lossMedication: —Clinical Procedure: NoneSpecialty: Gastroenterology and Hepatology • RadiologyObjective:Rare diseaseBackground:Dunbar syndrome is a rare vascular alteration caused by the abnormal course of the median arcuate ligament of the diaphragm, which in some patients causes chronic compression of the celiac artery and can cause non-specific symptoms such as diarrhea, retro-sternal pain, vomiting, swelling, and nausea, or a typical symptomatic triad with weight loss, post-prandial abdominal pain, and epigastric murmur. Color Doppler ultrasound and duplex Doppler ultrasound provide a complete diagnostic framework of this disease.Case Report:We describe a case of 55-year-old man with post-prandial epigastric pain, significant weight loss, and several episodes of retro-sternal pain. He underwent multidetector computed tomography of the abdomen and color duplex Doppler ultrasound examination of the celiac artery that highlighted stenosis of the celiac artery, more severe in expiratory apnea. The computed tomography showed the typical aspect of the celiac artery, with the “hook sign”. A duplex Doppler ultrasound examination showed a significant increase in peak speed (226 cm/s) due to severe stenosis of the celiac artery by the median arched ligament of the diaphragm.Conclusions:This case is unique due to the severity of the celiac artery stenosis and the unusual clinical presentation of the patient who had frequent episodes of retro-sternal pain. The significant increase in peak velocity in the celiac artery in expiratory apnea, if associated with the typical symptomatology in the absence of other alterations of the splanchnic vessels, can be considered, in our opinion, sufficient for the diagnosis of Dunbar syndrome.

Vertebral Artery Loops and Cervicobrachial Pain

AbstractVertebral artery loop formation is an uncommon anatomical variation which may be asymptomatic or can cause cervicobrachial pain, radiculopathy, or even bone erosions and enlargement of neural foramina. As this entity is one of the uncommon causes of cervical radiculopathy, this report aims to create awareness among radiologists and clinicians, as vertebral artery loops may be seen incidentally in routine neuroimaging. magnetic resonance imaging (MRI) with magnetic resonance (MR) angiography or multislice computerized tomography (CT) angiography plays an important role in diagnosing as well as creating a roadmap for the surgery.Vertebral artery loop formation as a cause of radiculopathy is an uncommon condition. An abnormal course of vessel can lead to vascular injury during surgery, hence preoperative evaluation with CT or MRI is essential.1 2 Anomalous looping of vertebral artery can cause neurovascular compression apart from bony erosion, widening of vertebral foramen, and even vertebrobasilar insufficiency. Clinical features of vertebral artery loop formation can be radiculopathy, compression over cervical cord leading to sensory and motor deficit, and vertigo when associated with vertebra–basilar insufficiency, which is known as vascular vertigo. It has also been postulated that loop formation of vertebral artery can also lead to posterior circulation infarcts. Left vertebral artery is more prone for loop formation than the right vertebral artery, probably due to increased caliber in greater proportion of individuals. Multilevel and bilateral tortuosity can occur in younger patients rarely where imaging plays an important role.

Detection of Coronary Artery Anomaly in Tetralogy of Fallot: Comparison of Two Angiographic Views

Background: The definite treatment of tetralogy of Fallot (TOF) as the most common cyanotic congenital heart disease is open heart surgery and the operation technique depends on the coronary artery anatomy. Objectives: We aimed to evaluate the sensitivity and specificity of various root Aortogram views to detect abnormal coronary artery configuration and course in these patients. Methods: In this retrospective study, the reports of coronary anatomy in angiography and operation notes of TOF patients since 2005 to 2018 were evaluated. The sensitivity and specificity of the two common root Aortogram views including the left anterior oblique/cranial (LAO/CRA) and left anterior oblique/caudal (LAO/CAU) were determined. Results: Four hundred and fifty one patients with the median age of 28 months (3 - 432 months) were included. All patients had LAO/CRA views and 199 patients had both LAO/CRA and LAO/CAU views. The rate of coronary abnormalities reported by surgery was 8%, and abnormal origin of the left anterior descending artery from the right coronary artery was the most common reported anomaly (4.4%). The sensitivity of the LAO/CAU view was 100%, but LAO/CRA view was about 75% in detecting abnormal coronary configuration. Both of them had excellent specificity (~100%). No significant sex difference was seen between different coronary anatomy abnormalities. Conclusions: The Caudal root angiogram is an essential view to evaluate coronary artery anatomy in TOF patients and it seems that there is no need for other views like lateral view, but relying on LAO/CRA view alone may lead to significant misdiagnosis of the coronary arteries, crossing the right ventricular outflow tract (RVOT).

Intraoperatively self-made bovine pericardial graft for portomesenteric reconstruction in pancreatic surgery.

Vascular encasement or infiltration of the portomesenteric veins can compromise resectability and local tumour control in pancreatic resections. So far, there is no consensus on how vascular reconstruction should be performed. Bovine pericardium has shown promising results, particularly in infected arterial vascular reconstructions. The aim of this study is to evaluate the feasibility and technical success of portomesenteric venous vascular reconstruction using bovine pericardium in pancreatic resections. Retrospective analysis of portomesenteric reconstruction using bovine pericardium (patches, self-made tube grafts) in pancreatic resections between 2014 and 2019. The primary endpoint examined was the technical success rate and short-term patency of vascular reconstruction. In addition to clinical surveillance and laboratory routine testing, patency was tested with duplex scans (4h postoperatively) and computed tomography imaging in case of an abnormal clinical course and as part of the oncological follow-up. In 15 surgical procedures (pancreaticoduodenectomy (12, 80%), pancreatic left resection (3, 20%)), vascular reconstruction was performed with superior mesenteric vein (6/15), portal vein (7/15) and the junction between superior mesenteric and splenic vein (2/15). Eighty percent of the reconstructions were tube grafts (12/15), and the remaining were patch plasties. In 13/15 (87%) of the cases, the vascular reconstruction was patent; in 2/15 (13%), there was one stenosis without reintervention need and one graft failure with complete thrombosis. Out of 15 patients, 4 major complications according to Clavien-Dindo classification (IIIa n= 2, 13%; IIIb n= 1, 7%; V n= 1, 7%) were documented. Latest re-imaging after surgery among the 10 patients with imaging follow-up more than 1month postoperatively was after 6.5months ((median, interquartile range 4-12months), and clinical follow-up was at 6.7months (median, 3.3-13months)). Due to its off-the-shelf availability, portomesenteric reconstruction using bovine pericardium seems to be a feasible and safe method in pancreatic resection with vascular encasement. Xenopericardial grafts can be crafted to any size and are applicable in potentially infected environment.

Model Pembelajaran Menarik Dengan Menggunakan Aplikasi Kahoot Sebagai Bahan Evaluasi Keberhasilan Belajar Untuk Mahasiswa

Interesting learning model is a method for transferring knowledge in order to maintained the quality of education and teaching skill, especially during pandemic coronavirus disease 2019 (COVID19) by not reducing the quality of teaching during Work From Home, an interesting form of learning by utilizing learning media in the network is proven to be able to optimize student learning success. This research was carried out on Psychology Study Program Students, Faculty of Education, Manado State University, during the even semester learning period of Abnormal Psychology courses attended by 48 students. The subject begins by attending synchronous offline learning at the beginning of the meeting and proceeding synchronously and asynchronously online using the google classroom (asynchronous) and Zoom Cloud Meeting (synchronous) media. Evaluation of student learning success through the Kahoot game application (gamebased learning) results in a percentage of 80.62% of students' success in answering all the questions given. It can be concluded that the learning model is interesting and fun by using the Kahoot application as an evaluation of learning success for students and also able to maintain the quality of education and teaching significantly.Keywords: knowledge transfer, work from home, learning models, online, kahoot.

A mitochondrial-targeted red fluorescent probe for detecting endogenous H2S in cells with high selectivity and development of a visual paper-based sensing platform

Hydrogen sulfide (H2S) is a lipid-soluble gas signal molecule that plays a vital role in numerous abnormal pathological courses. Therefore, monitoring the changes of intracellular H2S level is undoubtedly of great scientific significance. Here, a red fluorescent probe SXR was reported, which is in view of the ICT mechanism. SXR showed rapid response (∼6 min), excellent selectivity and large Stokes shift (∼90 nm) to H2S. In addition, fluorescent imaging experiments further proved that SXR could detect endogenous and exogenous H2S in mitochondria, which provided a powerful tool for in-depth study of H2S function in various physiological courses. More importantly, a convenient visual paper-based sensor platform was designed, proving the favorable practicability for quantitative scanning and detecting of H2S with smart phone.

Identification of large-for-gestational age fetuses using antenatal customized fetal growth charts: Can we improve the prediction of abnormal labor course?

IntroductionFetal overgrowth is an acknowledged risk factor for abnormal labor course and maternal and perinatal complications. The objective of this study was to evaluate whether the use of antenatal ultrasound-based customized fetal growth charts in fetuses at risk for large-for-gestational age (LGA) allows a better identification of cases undergoing caesarean section due to intrapartum dystocia. Material and methodsAn observational study involving four Italian tertiary centers was carried out. Women referred to a dedicated antenatal clinic between 35 and 38 weeks due to an increased risk of having an LGA fetus at birth were prospectively selected for the study purpose. The fetal measurements obtained and used for the estimation of the fetal size were biparietal diameter, head circumference, abdominal circumference and femur length, were prospectively collected. LGA fetuses were defined by estimated fetal weight (EFW) >95th centile either using the standard charts implemented by the World Health Organization (WHO) or the customized fetal growth charts previously published by our group. Patients scheduled for elective caesarean section (CS) or for elective induction for suspected fetal macrosomia or submitted to CS or vacuum extraction (VE) purely due to suspected intrapartum distress were excluded. The incidence of CS due to labor dystocia was compared between fetuses with EFW >95th centile according WHO or customized antenatal growth charts. ResultsOverall, 814 women were eligible, however 562 were considered for the data analysis following the evaluation of the exclusion criteria. Vaginal delivery occurred in 466 (82.9 %) women (435 (77.4 %) spontaneous vaginal delivery and 31 (5.5 %) VE) while 96 had CS. The EFW was >95th centile in 194 (34.5 %) fetuses according to WHO growth charts and in 190 (33.8 %) by customized growth charts, respectively. CS due to dystocia occurred in 43 (22.2 %) women with LGA fetuses defined by WHO curves and in 39 (20.5 %) women with LGA defined by customized growth charts (p 0.70). WHO curves showed 57 % sensitivity, 72 % specificity, 24 % PPV and 91 % NPV, while customized curves showed 52 % sensitivity, 73 % specificity, 23 % PPV and 91 % NPV for CS due to labor dystocia. ConclusionsThe use of antenatal ultrasound-based customized growth charts does not allow a better identification of fetuses at risk of CS due to intrapartum dystocia.

Frequency of coronary artery anomalies and relationship between coronary artery with anomalous origin and myocardial bridge

The association between coronary artery with anomalous origin and myocardial bridge is not investigated well yet. We aimed to investigate the incidence of coronary artery anomalies and the relationship between coronary artery with anomalous origin and the presence of myocardial bridge. The coronary angiography records of 6100 patients who undergone coronary angiography in Eskisehir Osmangazi University – school of medicine hospital between 2008 and 2010 were retrospectively assessed. The Angelini classification system was used to classify the coronary artery anomalies. Coronary arteries were classified in three classes: (i) Coronary artery with anomalous origin, (ii) abnormal course (myocardial bridge) and; (iii) termination (fistula). Myocardial bridge is a type of coronary anomaly and is defined as the case where a segment of the epicardial coronary artery is covered by myocardium. The incidence of coronary artery anomalies was 3.1%. Coronary artery with anomalous origin was 1.5%, myocardial bridge was 1.4% and fistula was 0.3%. The frequency of coronary artery anomalies was significantly higher in males (66.7%) than in females (33.3%). Among the coronary arteries with anomalous origin, the circumflex and left descending artery originating from separate ostia in the left aortic sinus was the most common anomaly. Myocardial bridge was significantly higher in males (81.9%) than in females (18.07%). Among the coronary artery with anomalous origin, originating of right coronary artery from left sinus of valsalva was significantly higher with the presence of myocardial bridge (p

Persistent Left Superior Vena Cava (LSVC) And Permanent Pacemaker Implantation: Series Of 4 Cases

Persistent Left Superior Vena Cava (LSVC) not very uncommon in cardiovascular intervention. It often poses problem during Permanenet Pacemaker Implantation (PPM) due to anatomic abnormal course of the venous system. Here we have reported series of 4 such cases.

Aberrant course of facial nerve in the middle ear cavity

Facial nerve (FN) course anomaly is often found in patients with congenital aural atresia or other ear anomaly, but in this case report, we report an abnormal FN course with dehiscent facial canal found in a patient with congenital conductive hearing loss without any accompanying auricular deformity or cholesteatoma.

262P - Gestational trophoblastic tumours: Experience of the medical oncology department Hassan II University Hospital-Morocco about 29 cases

BackgroundGestational trophoblastic tumors (GTTs) are the malignant forms of gestational trophoblastic diseases. They always follow a pregnancy, most often molar. The diagnosis of TTG is based on an abnormal course of HCG (chorionic gonadotropin hormone) and / or signs of ultrasound invasion and/or histological confirmation. Methodsit is a retrospective study of 29 cases of GTT collected at the medical oncology department of Hassan II University Hospital-Fez, over a period of 7 years from January 2010 to December 2016. ResultsThe average age was 35 years old. Sixty-five percent (65%) of our patients were pauciparous. The causal pregnancy was in 83% of cases a molar pregnancy. The staging of patients revealed pulmonary metastases in 67% of cases, liver in 19% of cases, renal in 7% of cases and cerebral in 7% of cases. Nine patients (31 %) underwent hysterectomy, with postoperative chemotherapy for 8 patients. Fifty-two percent (52%) were at high risk while 48% were low risk. Low risk patients received methotrexate-based monochemotherapy, and HCG hormone became negative after an average of 6.5 cycles. High risk patients received a polychemotherapy with differents protocols used; EMA-CO, BEP, or Cisplatin-Etoposid-MTX protocol, after an average of 3.28 cycles, the HCG hormone became negative. Eighty-six percent of our patients benefited from clinical and biological monitoring. The evolution of our patients was marked by a complete clinical and biological remission in 89.65% of patients, after an average of 12 weeks. The median survival was 76.4±2.7 months, after a median follow-up of 29.78 months. ConclusionsMalignant gestational trophoblastic tumors are a rare and challenging disease with heavy psychosocial impact hat affect the young woman who has not only had a pregnancy loss but also may be faced with a life-threatening illness. More understanding of risk factors, carcinogenesis and management is required to improve the outcome of thes patients. larger studies are still needed. Legal entity responsible for the studyThe authors. FundingHas not received any funding.All authors have declared no conflicts of interest.

P3652Hemodynamic and clinical impact of ANOmalous connections of CORonary arteries using computed tomography-derived Fractional Flow Reserve (FFRCT) from the ANOCOR registry

Abstract Background With the emergence of coronary computed tomography angiography (CCTA), ANOmalous connections of CORonary arteries (ANOCOR) are more frequently diagnosed than previously reported. CT-derived Fractional Flow Reserve (FFRCT) is a non-invasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features could help for the management of patients with ANOCOR. Objective We aimed to retrospectively evaluate the clinical impact of FFRCT analysis in the ANOCOR registry population with 3 year-follow-up. Method The ANOCOR registry included adult patients with ANOCOR detected during invasive coronary angiogram or CCTA performed between January 2010 and January 2013. Among 472 patients included, 105 patients had a cardiac CT during the inclusion period. Results We retrospectively performed FFR-CT and obtained successful analyses in 54 patients of 60±13 years with a complete 3-year clinical follow-up. Thirty-six (67%) patients had conservative treatment and 18 (33%) patients had coronary revascularization after the CCTA. FFRCT analysis showed that ANOCOR course slightly reduces the mean FFRCT value of 1 at the ostium to 0.90±0.10 downstream the abnormal course and had a distal vessel mean FFRCT value 0.82±0.11. No statistical difference of FFRCT values were observed between ANOCOR at risk and non at risk and between conservative and revascularization groups. At 3 years of follow-up, only one patient had unplanned revascularizations of ANOCOR vessel in the conservative strategy group. Conclusion We observed favorable FFRCT values of ANOCOR and non ANOCR vessels. Patients treated conservatively and revascularized had excellent clinical outcome at 3 years of follow up.

CURRENT UNDERSTANDING AND MANAGEMENT OF ANOMALOUS AORTIC ORIGIN OF CORONARY ARTERIES: A PANCANADIAN SURVEY

Anomalous aortic origin of coronary arteries (AAOCA) is a significant cause of sudden cardiac death (SCD) in children and adolescents. This is a rare congenital anomaly in which a coronary artery does not originate from its respective sinus of Valsalva, and follows an abnormal course. Because most AAOCA patients are likely asymptomatic, the prevalence of AAOCA remains unknown. When symptomatic, patients mostly present with angina, syncope or dyspnea on exertion. The natural history of AAOCA and the pathophysiology of AAOCA-related SCD are poorly understood, thus AAOCA evaluation and management remain controversial.

Diagnosis and Management of Anomalous Left Anterior Descending Coronary Artery from the Pulmonary Artery in an Asymptomatic Infant.

Anomalous origin of the left anterior descending coronary artery from the pulmonary artery is a rare variant of anomalous origin of the left main coronary artery from the pulmonary artery. We report on a seemingly asymptomatic patient with ALADCAPA and a small restrictive muscular ventricular septal defect diagnosed by echocardiogram in the neonatal period. Our patient underwent elective repair at 3.5months of age after which feeding and growth improved dramatically. Multimodality imaging is helpful to confirm this rare anomaly; however, echocardiographic clues including lack of left coronary branching or an abnormal coronary course should raise suspicion for ALADCAPA. This case provides support for early repair in children with an incidental finding of this anomaly as subclinical ischemia may be under-recognized by available testing but may lead to symptoms later in life.

Percutaneous Coronary Intervention for Coronary Arteries with Origin and Course Anomalies: Case Reports and Literature Review

Coronary artery anomalies (CAAs) are defined as variants of normal epicardial coronary arteries. They are mostly detected incidentally during coronary angiography. Clinical studies have shown that abnormal origins and courses of coronary arteries make them more prone to atherosclerosis. Percutaneous treatment for atherosclerotic occlusions in anomalous coronary arteries has some difficulties, including inadequate guiding-catheter support and the need for an experienced operator. Here, we describe successful percutaneous coronary interventions for critical stenoses in 2 different CAAs and present a brief literature review.

Prediction of congenital diaphragmatic hernia with abnormal course of fetal superior mesenteric artery detected by ultrasound in first-trimester

Objective To investigate the clinical value of abnormal course of fetal superior mesenteric arteries (SMA) detected by ultrasound during the first trimester (11-13+6 weeks) in predicting congenital diaphragmatic hernia (CDH). Methods This study enrolled women who underwent fetal nuchal translucency (NT) screening during the first trimester in Central Hospital of Panyu District from March to December 2017. Low-speed high-definition flow imaging was used to observe the course of fetal SMA, and it was regarded as abnormal when the angle between SMA and abdominal aorta >90°. Once abnormal course of the SMA was suspected, the position of fetal thoracic cavity and abdominal organs would be scanned carefully. Furthermore, ultrasound examinations would be repeated at 16-18, 20-24, 28-32 and 37-40 weeks of gestation. Fetus diagnosed as CDH by ultrasound would be scheduled for MRI or autopsy to confirm the diagnosis. Pregnancy outcomes of all cases were followed up by telephone. Descriptive statistical analysis was used in this study. Results A total of 6 899 gravidas (6 964 fetuses) underwent NT scan during the first trimester were enrolled and the SMA of all fetuses were successfully displayed. Three cases with abnormal course of the SMA were identified. Two of them were diagnosed with left CDH at 17+ and 23+ weeks of gestation, which was confirmed by autopsy after termination of pregnancy, and the other one terminated pregnancy in first trimester due to a large omphalocele. Among the 6 961 fetuses with normal SMA, the pregnancy outcomes of 6 120 were successfully followed up, only one of which was found to have left CDH at 32 gestational weeks by ultrasound examination, and was later confirmed by neonatal MRI after delivery. No other fetal CDH was detected. Conclusions Abnormal course of the SMA identified in early pregnancy may be a simple and effective indicator for CDH that allow early intervention and treatment. Key words: Pregnancy trimester, first; Mesenteric artery, superior; Congenital abnormalities; Hernias, diaphragmatic, congenital; Forecasting