Incidence Of Rupture Research Articles

Poster 375: Incidence of Tendon Ruptures in the US: Comparison of Differences Across Racial Groups

Poster 375: Incidence of Tendon Ruptures in the US: Comparison of Differences Across Racial Groups

Eleven-Year Outcomes of a Screening Project for Abdominal Aortic Aneurysm (AAA) in 65-Year-Old Men.

Since 2011, the Department of Vascular Surgery at Oslo University Hospital has offered screening for abdominal aortic aneurysm (AAA) to 65-year-old men living in Oslo, Norway. The aim of this study was to evaluate the effect of the screening project on AAA-related mortality and rupture and repair rates in the screened population. This cohort study included men that participated in AAA screening at the Department of Vascular Surgery at Oslo University Hospital in the period May 2011 to September 2019. All men with screen-detected AAA (aortic diameter ≥30 mm) and subaneurysmal aortic dilatation (aortic diameter 25-29 mm) were included. A stratified (1:1 with the subaneurysm group), randomized selection of men with normal aortic diameter (<25 mm) upon screening was also included. The follow-up data on events (ruptures, repairs, and deaths) after screening were collected retrospectively from patient electronic medical records at Oslo University Hospital, the National Population Register and the Norwegian Cause of Death Registry (CoDR). In total, 2048 men were included, with a median follow-up time of 7.1 years (IQR 3.8). Among men with screen-detected AAA, 0.6% died of AAA-related causes (0.9 AAA-related deaths per 1000 person-years). The rupture rate was 0.3% among men with screen-detected AAA or subaneurysmal aortic dilatation, giving an incidence of 0.5 ruptures per 1000 person-years. The overall repair rate in the AAA group was 20.6% (36.1 repairs per 1000 person-years) and 0.6% (0.9 repairs per 1000 person-years) in the subaneurysm group. In a population screened for AAA, the incidence of rupture and the AAA-related mortality was very low. Almost one-fifth of the participants with screen-detected AAA underwent elective repair, representing a group that might have presented with rupture if untreated. These results indicate that screening is valuable in preventing AAA rupture and AAA-related mortality.

The Relationship of Episiotomy to Perineal Tears in Labor Women

Episiotomy is a rupture made in the perinea between the vaginal open and the anus to release the baby. Episiotomy is not recommended because it may lead to an increase in the amount of blood lost. The number of events in the field of obstetrics around the world in 2009 accrued 2.7 million cases of perineal rupture wounds in mothers. The purpose of this research was to determine the relationship of episiotomy in labor to the incidence of perineal rupture in the maternal mother at the Ernita maternity clinic. This research is quantitative research with analytical design. The population in this research is all maternal mothers at Ernita maternity hospital as many as 95 people. The sampling technique used in this research is the total population that is sampling from all mother maternity data. The results showed that of 54 people (57%) who performed the episiotomy action in the majority of labor perineal rupture that is as many as 35 people (37%). Chi-square test results there is a relationship between episiotomy in labor to the incidence of perineal rupture in the maternal maternal mother where the p value is 0.040 &lt;0.05. It is desirable for midwives to reduce the action of episiotomy by doing proper labor delivery.

A Factors Influencing the Incidence of Premature Rupture of Membrane (Prom) in Maternity Mothers

Abstract&#x0D; &#x0D; Premature rupture of membranes (KPD) or Premature Rupture Of The Membrane (PROM) is a rupture of the membranes before delivery if the opening in primi is less than 3 cm and in multi it is less than 5 cm. Based on the latest data obtained at Idaman Banjarbaru Hospital, mothers who experienced KPD in 2016 were 145 mothers with KPD out of 1594 mothers giving birth (9%) and in 2017 there was an increase of 242 mothers experiencing KPD out of 1974 mothers giving birth (12.25%). This study aimed to discover the factors that influence the incidence of premature rupture of membranes (PROM) in women giving birth. Research method: The research design used in this research is descriptive. The population in this study were all mothers with premature rupture of membranes at Idaman Banjarbaru Hospital in 2017 as many as 242 people. The sampling technique used systemic random sampling with a total sample of 152 people—a collection tool for medical record data documentation. The analysis used is univariate analysis with a percentage formula. The results showed that the number of mothers giving birth with KPD based on the causal factors at Idaman Banjarbaru Hospital in 2017 was caused by abnormalities in the location of the fetus as many as 8 people (5.3%), age factor &lt;20 &amp;&gt; 35 years as many as 34 people (22.4%) ), parity factors 1&amp;&gt;4 were 80 people (52.6%), and multiple pregnancy factors were 6 people (3.9%). Suggestions for routine ANC in pregnant women and the need for further research on other factors that can cause premature rupture of membranes.&#x0D; &#x0D; Keywords: Factors, KPD, mothers giving birth

Associations of Culprit Vessel Size and Plaque Characteristics in Patients with ST-Segment Elevation Myocardial Infarction.

Small vessel disease (SVD) widely exists in patients with acute coronary syndrome. However, the plaque characteristic of SVD has not been investigated. Optical coherence tomography (OCT) of culprit lesion was examined in 576 patients with ST-segment elevation myocardial infarction (STEMI) and finally 404 patients with qualified images were analysed of plaque phenotypes and microstructure. The cohort was divided into three groups according to vessel diameters of culprit lesion which were measured by OCT. Major adverse cardiac events (MACEs) were recorded of each patient and compared among patients with different vessel diameters and plaque phenotypes. Gender, age and body mass index (BMI) were significantly different among patients with different diameters of culprit vessels (98.4% vs. 85.7% vs.71.4%, p 0.001; 40.0 7.0 vs. 54.9 6.6 vs. 68.9 5.8, p 0.001; 28.4 4.0 vs. 25.8 2.9 vs. 25.2 3.0, p 0.001, respectively). Moreover, patients with diameters of culprit lesion 3 mm presented with more incidence of plaque rupture and macrophage (57.7% vs. 42.1% vs. 46.2%, p = 0.015, 55.1% vs. 41.0% vs. 36.9%, p = 0.010). Total MACE did not differ among groups of different vessel diameters and plaque phenotypes. Vessel size of culprit lesion is significantly associated with plaque phenotype in patients with STEMI. However, patients with different diameters and plaque phenotypes showed no significant difference of clinical outcomes. NCT03593928.

Short-term prognosis of very-preterm infants of ethnic minorities and Han nationality at high altitude: a single-center, retrospective study

Objective We aimed to analyze the perinatal care of very-preterm infants (VPIs) in plateau areas of China and to explore any differences in short-term outcomes between ethnic minorities and Han nationality. Methods VPIs with gestational age (GA) <32 weeks admitted to Qinghai Red Cross Hospital from 1 January 2018 to 31 December 2020 were enrolled. Maternal information, neonatal information, perinatal care and discharge outcomes were retrospectively collected and analyzed. Results A total of 302 VPIs were examined, including 143 (47.4%) ethnic minority infants and 159 (52.6%) Han infants. Mothers of ethnic minority infants were significantly younger than those of Han infants (27 y vs. 30 y, p < .001). There were no differences in the incidence of assisted reproduction, multiple pregnancies, maternal hypertension, clinical chorioamnionitis or premature rupture of membranes >18 h between ethnic minority mothers and Han mothers. Lower proportions of cesarean section and incidence of maternal diabetes were observed in ethnic minority mothers than in Han mothers [(9.1 vs.17.6%, p < .05) and (42.7 vs. 57.9%, p < .05, respectively)]. Meanwhile, fewer antenatal steroids were used in minority group than Han group (65.7 vs. 81.1%, p < .05). No significant differences in rates of death, active treatment, necrotizing enterocolitis stage ≥2, moderate-to-severe BPD, and incidence of severe retinopathy of prematurity in VPIs were found between the two groups and in all GA subgroups. Severe neurological injury was significantly less common in the minority newborns than in the Han infants (1.2 vs. 6.1%, p < .05). Compared with Han group, no excess risk of death, death or major morbidity, death despite active treatment, death or major morbidity despite active treatment was observed in ethnic minorities, with or without adjusting for gestational age and prenatal steroids. Conclusions Short-term prognosis of VPIs of ethnic minorities were similar to those of Han nationality.

Tape-Reinforced Graft Suturing and Retensioning of Adjustable-Loop Cortical Buttons Improve Quadriceps Tendon Autograft Biomechanics in Anterior Cruciate Ligament Reconstruction: A Cadaveric Study

To investigate the biomechanical effects of tape-reinforced graft suturing and graft retensioning for all-soft tissue quadriceps tendon (ASTQT) anterior cruciate ligament reconstruction (ACLR) in a full-construct human cadaveric model. Harvested cadaveric ASTQT grafts were assigned to either (1) double-suspensory adjustable-loop cortical button device (ALD) fixation in which both graft ends were fixed with a suspensory fixation device with (n= 5) or without (n= 5) tape-reinforced suturing or (2) single-suspensory distal tendon fixation in which only the patellar end was fixed with an ALD (n= 5) or fixed-loop cortical button device (FLD) (n= 5). All specimens were prepared using a No. 2 whipstitch technique, and tape-reinforced specimens had an integrated braided tape implant. Graft preparation time was recorded for double-suspensory constructs. Samples were tested on an electromechanical testing machine using a previously published protocol simulating rehabilitative kinematics and loading. Tape-reinforced graft suturing resulted in greater graft load retention after cycling (11.9% difference, P= .021), less total elongation (mean [95% confidence interval (CI)], 5.57 mm [3.50-7.65 mm] vs 32.14 mm [25.38-38.90 mm]; P < .001), greater ultimate failure stiffness (mean [95% CI], 171.9 N/mm [158.8-185.0 N/mm] vs 119.4 N/mm [108.7-130.0 N/mm]; P < .001), and less graft preparation time (36.4% difference, P < .001) when compared with unreinforced specimens. Retensioned ALD constructs had less cyclic elongation compared with FLD constructs (mean total elongation [95% CI], 7.04 mm [5.47-8.61 mm] vs 12.96 mm [8.67-17.26 mm]; P= .004). Tape-reinforced graft suturing improves time-zero ASTQT ACLR construct biomechanics in a cadaveric model with 83% less total elongation, 44% greater stiffness, and reduced preparation time compared with a whipstitched graft without tape reinforcement. ALD fixation improves construct mechanics when compared with FLD fixation as evidenced by 46% less total elongation. Tape-reinforced implants and graft retensioning using ALDs improve time-zero ACLR graft construct biomechanics in a time-zero biomechanical model. Clinical studies will be necessary to determine whether these implants improve clinical outcomes including knee laxity and the incidence of graft rupture.

Impact of axial length on visual outcomes and complications in phacoemulsification surgery: a multicenter database study.

To analyze the impact of axial length (AL) on the visual outcome and rate of perioperative complications in phacoemulsification surgery. Retrospective clinical database study. Cataract surgery data of 217,556 eyes was extracted from the electronic medical records of 8 ophthalmic centers in the United Kingdom from July 2003 to March 2015. A total of 88,774 eyes without ocular co-pathologies were grouped eyes according to AL (mm): short AL (< 22), average AL (22-26; reference group), and long AL (> 26). We analyzed visual acuity (VA) outcomes at 4weeks, 4-12weeks, and 12-24weeks postoperatively, as well as the incidence of posterior capsular rupture (PCR), torn iris (TI), cystoid macular edema (CME), and retinal detachment (RD). Mean pre-operative VA (logMAR) was the worst in eyes with long AL compared to average and short AL eyes (VA 0.59 vs. 0.58 and 0.56; p < 0.001). However, post-operative VA at 4-12weeks was slightly better in the long AL group (0.14 in short and average AL; 0.12 in long AL, p < 0.001). We observed an increased odds of TI in the short AL group (OR 2.09, 95% CI 1.60-2.75). There was increased risk of RD in long AL eyes (p < 0.001). However, PCR and CME rates were not different. In the absence of any coexisting ocular pathology, AL alone did not have an impact on VA improvement or the risk of encountering PCR or CME. The risk of TI was greater in the short AL group, and the risk of RD was higher in the long AL group.

Feasibility of energy‐guided short duration protocol of laser balloon based pulmonary vein isolation for atrial fibrillation (EG‐Laser Study)

AbstractBackgroundLaser balloon‐based pulmonary vein isolation (LB‐PVI) is available for atrial fibrillation (AF) ablation. The lesion size depends on laser energy; however, the default protocol is not an energy‐based setting. We hypothesized that an energy‐guided (EG) short‐duration protocol may be an alternative to shorten the procedure time without affecting efficacy and safety.MethodsWe evaluated the efficacy and safety of the EG short‐duration protocol (EG group) (target energy 120 J/site [12W/10s; 10W/12s; 8.5W/14s; 5.5W/22s]) compared with the default protocol (control group) (12W/20s; 10W/20s; 8.5W/20s; 5.5W/30s).ResultsA total of 52 consecutive patients (EG: n = 27 [103veins] and control: n = 25 [91veins]) undergoing LB‐PVI (64 ± 10 years, 81% male, 77% paroxysmal) were enrolled. The EG group had a shorter total time in the pulmonary vein (PV) (43.0 ± 13.9 min vs. 61.1 ± 16.0 min, p &lt; .0001), a shorter total laser application time (1348 ± 254 sec vs. 2032 ± 424 sec, p &lt; .0001), and lower total laser energy (12455 ± 2284J vs. 18084 ± 3746J, p &lt; .0001). There was no difference in the total number of laser applications (p = 0269) or first‐pass isolation (p = .725). Acute reconduction was identified only in one vein in the EG. No significant differences were observed in the incidence of pinhole rupture (7.4% vs. 4%, p = 1.000) or phrenic nerve palsy (3.7% vs. 12%, p = .341). During a mean follow‐up of 13.5 ± 6.1 months, Kaplan‐Meier analysis revealed no significant difference in atrial tachyarrhythmia recurrence (p = .227).ConclusionLB‐PVI with the EG short‐duration protocol may be achieved in a shorter procedure time to avoid deterioration of efficacy and safety. The EG protocol is feasible as a novel point‐by‐point manual laser‐application approach.

Hubungan Penolong Persalinan Terhadap Kejadian Ruptur Perenium Spontan pada Persalinan Kala II

Perineal rupture is one of the causes of bleeding, which occurs because the perineum is not strong enough to withstand the stretch when the fetus passes. The purpose of this study was to determine the effect of birth attendants on the incidence of spontaneous perineal rupture in the second stage of labour. The research method used in this study is observation where research is conducted without intervening in research subjects. The population in this study were all midwives who assisted spot deliveries at the Asy Safira and Mother clinics, with the sample used as a total sampling which was taken using a consecutive sampling technique based on a predetermined time. The results of the study showed that most of the position of the second stage birth attendant's hands was not in accordance with the APN of 21 people (55.3%). 50% of cases of deliveries performed with normal birth assistance resulted in grade II perineal tears. There is an effect of the position of the second stage birth attendant's hand on perineal laceration with p = 0.020. Birth attendants are expected to continue to improve their knowledge and skills in performing childbirth assistance

Downregulation of YAP Activity Restricts P53 Hyperactivation to Promote Cell Survival in Confinement.

Cell migration through confining three dimensional (3D) topographies can lead to loss of nuclear envelope integrity, DNA damage, and genomic instability. Despite these detrimental phenomena, cells transiently exposed to confinement do not usually die. Whether this is also true for cells subjected to long-term confinement remains unclear at present. To investigate this, photopatterning and microfluidics are employed to fabricate a high-throughput device that circumvents limitations of previous cell confinement models and enables prolonged culture of single cells in microchannels with physiologically relevant length scales. The results of this study show that continuous exposure to tight confinement can trigger frequent nuclear envelope rupture events, which in turn promote P53 activation and cell apoptosis. Migrating cells eventually adapt to confinement and evade cell death by downregulating YAP activity. Reduced YAP activity, which is the consequence of confinement-induced YAP1/2 translocation to the cytoplasm, suppresses the incidence of nuclear envelope rupture and abolishes P53-mediated cell death. Cumulatively, this work establishes advanced, high-throughput biomimetic models for better understanding cell behavior in health and disease, and underscores the critical role of topographical cues and mechanotransduction pathways in the regulation of cell life and death.

Don't go breakin' my heart: cardioprotective alterations to the mechanical and structural properties of reperfused myocardium during post-infarction inflammation.

Myocardial infarctions (MIs) kickstart an intense inflammatory response resulting in extracellular matrix (ECM) degradation, wall thinning, and chamber dilation that leaves the heart susceptible to rupture. Reperfusion therapy is one of the most effective strategies for limiting adverse effects of MIs, but is a challenge to administer in a timely manner. Late reperfusion therapy (LRT; 3 + hours post-MI) does not limit infarct size, but does reduce incidences of post-MI rupture and improves long-term patient outcomes. Foundational studies employing LRT in the mid-twentieth century revealed beneficial reductions in infarct expansion, aneurysm formation, and left ventricle dysfunction. The mechanism by which LRT acts, however, is undefined. Structural analyses, relying largely on one-dimensional estimates of ECM composition, have found few differences in collagen content between LRT and permanently occluded animal models when using homogeneous samples from infarct cores. Uniaxial testing, on the other hand, revealed slight reductions in stiffness early in inflammation, followed soon after by an enhanced resistance to failure for cases of LRT. The use of one-dimensional estimates of ECM organization and gross mechanical function have resulted in a poor understanding of the infarct's spatially variable mechanical and structural anisotropy. To resolve these gaps in literature, future work employing full-field mechanical, structural, and cellular analyses is needed to better define the spatiotemporal post-MI alterations occurring during the inflammatory phase of healing and how they are impacted following reperfusion therapy. In turn, these studies may reveal how LRT affects the likelihood of rupture and inspire novel approaches to guide scar formation.

The Relationship Between Anemia in Pregnancy and Premature Rupture of the Membranes (PROM)

Anemia in pregnancy is a condition with a hemoglobin (Hb) level of &lt; 11 g% which is characterized by complaints of weakness, dizzy eyes , paleness, and even palpitations. Anemia is one of the factors that causes Premature Rupture of The Membrans (PROM). Mothers who experience anemia, the iron or hemoglobin which is a carrier in the blood will decrease, which results in fragility in several parts of the amniotic membrane, which at the same time causes leakage in the area. This study aims to determine the relationship between anemia in pregnancy and the occurrence of PROM. This study uses the design method study Observational Descriptive , Correlation Analytical Research Method with Retrospective Approach . The data source was obtained from all pregnant women at the gestational age of TM II and III who carried out pregnancy checks at the Maduran Health Center, Maduran Village, Maduran District, Lamongan Regency, at 12 Februari 2023 – 12 Mei 2023 with a total population of 31 people. The sampling technique used purposive sampling . Statistical tests used Chi-Square and data were analyzed using the Fisher Exact Test . Based on the results of the study, the majority of respondents who experienced anemia as many as 16 respondents (51.6 % ). The majority of respondents who experienced PROM were 19 respondents ( 61.2 %), while the majority of respondents who experienced anemia and PROM were 14 respondents ( 45.1% ) . The conclusion of this study is that there is a relationship between anemia in pregnancy and the incidence of premature rupture of membranes (PROM) at the Maduran Health Center, Maduran Village, Maduran District, Lamongan Regency with a p-value (0.001).

The Enigma of Treating Colorectal Cancer and an Abdominal Aortic Aneurysm

As the average lifespan of individuals increases, malignancies and cardiovascular diseases are becoming a common cause of morbidity and mortality. The treatment of abdominal aortic aneurysms (AAAs) with concomitant diagnosis of colorectal cancer (CRC) is challenging. We aim to review the experience of a single tertiary institution in the management of patients with concurrent diagnosis of AAA and CRC hoping to glean information on how better to treat these patients. This is a retrospective review of all individuals treated between 2009 and 2022 at a large tertiary care center who had a documented diagnosis of CRC and AAA. A careful review of 102 patients resulted in a sample of 89 patients. Of the 89 patients in our cohort, 39 (43.8%) were diagnosed with CRC over 1 year before their AAA diagnosis. Fifteen (16.9%) patients were diagnosed with an AAA over 1 year before their CRC diagnosis and 35 (39.3%) were diagnosed concurrently with both CRC and AAA (Fig). In the concurrent subgroup, AAA was found on cancer staging workup CT scans, and we found the following in regard to their treatment: 12 (34.3%) individuals underwent CRC resection and surveillance of an AAA between 3 and 4 cm, 14 (40.0%) underwent CRC resection and surveillance of an AAA between 4 and 5 cm, and 3 (8.6%) had an AAA of over 5 cm and met criteria for repair; however, they had metastatic CRC and passed on hospice. There were no incidents of aneurysm rupture during surveillance. Ultimately, of the 35 individuals with concomitant AAA and CRC, 6 (17.1%) required treatment for both conditions—3 individuals had an endovascular aneurysm repair (EVAR) 4 to 6 months before CRC surgical resection, 2 had an EVAR after completing chemoradiation, and 1 individual had an EVAR 1.5 weeks after fecal diversion for obstructing CRC. In this group, there were no incidents of operative mortality. The treatment of both CRC and AAA has limited guidelines on how to proceed with the Society of Vascular Surgery level 2C recommendation for concomitant treatment. Our retrospective review of a single tertiary center identified 35 patients who were found to have an AAA during CRC workup. Although the majority had a small AAA that could be surveilled, of those who required repair, we found that EVAR was the sole approach. Further studies are needed to assess long-term outcomes with larger patient volumes from multiple institutions to recommend a definitive treatment algorithm.

Psychosocial consequences after screening of abdominal aortic aneurysm among 65 year old men

BackgroundIn order to reduce the incidence of abdominal aortic aneurysm rupture and mortality, the Swedish Medical Council has introduced a national abdominal aortic aneurysm (AAA) screening program that offers ultrasound examination of 65-year-old men. Screening programmes of AAA may confer both benefits and harms. The study aim was to investigate the psychosocial consequences of AAA screening among men with screening-detected AAA as compared to men identified as AAA-negative at screening, using an AAA-specific questionnaire. MethodsThis cross-sectional study investigated the psychosocial consequences of AAA screening measured with a condition-specific questionnaire. This study focused on the Experience of the Diagnosis and the Screening Procedure in terms of Anxiety, Sense of Dejection and Existential Values. One hundred and fifty-eight men with AAA (63%) and 275 with normal aorta size (55%) completed the diagnosis-specific questionnaire. ResultsNinety-six percent of men with screening detected AAA did not regret the screening examination, the corresponding figure for controls being 99.6%. Seventy percent of AAA patients were surprised that something was wrong in their body. Some (85%) of men with AAA were current or previous smokers, about half of them (45%) felt guilty about it and 78% of the current smokers in the AAA group had considered stopping smoking. Both groups considered changing lifestyle, although at a higher rate (32%) among AAA cases than controls (20%), with differences both in intention to change their ways to exercise (p = 0.019) and food intake (p = 0.001).Intergroup differences were identified for the majority of items as captured by the questionnaire where men identified with AAA reported more negative psycho-social consequences for all evaluated items except for the items: Regret of the screening examination (p = 0.069) and feeling terrified (p = 0.10). Fifty-one percent of AAA cases stated that they feared rupture, and 12% were anxious about rupture during sexual activity whereas 57% were worried about rupture during intense physical activity. ConclusionMen who were diagnosed with AAA reported more psychosocial consequences compared to controls; still only a minority of AAA cases reported psychosocial consequences in greater occurrence. To some degree, men with AAA also feared rupture during various types of activities. There appears to be a need for improved patient information and easy access to caregivers for men with screening-detected AAA, which might help to reduce psychosocial consequences associated with the diagnosis.

The impact of antiplatelet therapy on the descending thoracic aorta fate and long-term prognosis of extensive repaired type A aortic dissection.

To evaluate the impact of antiplatelet therapy on the long-term descending thoracic aorta (DTA) fate and prognosis of extensive repaired type A aortic dissection (TAAD). 1147 eligible TAAD patients from January 2010 to December 2019 were stratified into non-antiplatelet (n = 754) and antiplatelet groups (n = 393). The primary end points were overall survival, and DTA remodelling, including false lumen (FL) thrombosis and aortic redilation. The secondary end points were DTA reintervention or rupture and major bleeding events (MBEs). The 5-year overall survival rates were 95.6% and 94.3% in the non-antiplatelet and antiplatelet groups (P = 0.53), respectively. In the stent covering segment, the 1-year FL complete thrombosis rates were 92.1% and 92.4% in the non-antiplatelet and antiplatelet groups (P = 0.27), respectively, while in the stent uncovering segment, the 5-year FL complete thrombosis rates were 47.1% and 56.5% in the non-antiplatelet and antiplatelet groups (P = 0.12), respectively. Antiplatelet therapy was not an independent predictor of aortic redilation at the pulmonary artery bifurcation (β±SE = -0.128 ± 0.203, P = 0.53), diaphragm (β±SE = 0.143 ± 0.152, P = 0.35) or coeliac artery (β±SE = 0.049 ± 0.136, P = 0.72) levels. With death as a competing risk, the cumulative incidences of DTA reintervention or rupture at 5 years were 4.6% and 4.0% in the non-antiplatelet and antiplatelet groups (sHR = 0.85, 95% CI, 0.49∼1.19; P = 0.58), respectively, and the 5-year cumulative incidences of MBEs were 2.1% and 2.3% in the non-antiplatelet and antiplatelet groups (sHR = 0.82, 95% CI, 0.56∼2.67; P = 0.62), respectively. Antiplatelet therapy did not impact long-term DTA FL thrombosis, redilation, reintervention or rupture, MBEs or overall survival on extensive repaired TAAD. Thus, antiplatelet therapy can be administered as indicated on extensive repaired TAAD.

O066 Outcomes following fenestrated and branched endovascular repair (F/BEVAR) of complex aneurysms in octogenarians: a time to event meta-analysis

Abstract Introduction Objective: To evaluate the clinical outcomes of F/BEVAR among octogenarians. Methods Databases were systematically searched for studies that compared outcomes following F/BEVAR between octogenarians and non-octogenarians. The primary outcome measures were peri-operative mortality, survival, re-intervention, aortic rupture, and aneurysm-related deaths. Secondary outcomes were peri-operative outcomes. Results Seven studies published between 2017 and 2022 were included reporting on a total of 7,552 patients (&amp;gt;80yrs, 1536; &amp;lt;80yrs, 6016). More males (OR [95% CI] 0.83 [0.73-0.94], p.003), smokers (OR 0.50 [0.43-0.58], p&amp;lt;.001) patients with ASA &amp;gt;3 (OR 0.72 [0.52-0.98], p=.04), hypercholesterolaemia (OR 0.56, [0.42-0.73], p&amp;lt;.001), and pulmonary disease (OR 0.75, [0.66-0.86], p&amp;lt;.001) were observed in non-octogenarians. There was no significant difference in the peri-operative mortality between the two groups, but the hazard of overall mortality during follow-up was significantly higher in the octogenarian group (HR 1.67 [1.27–2.20], p&amp;lt;.001). There was no statistically significant difference in re-intervention (HR 0.96, [0.85-1.09], p=.057) or aneurysm-related deaths (OR 0.02, [-0.02-0.07], p=.31) between the two groups, but older patients were at greater risk of aortic rupture during follow-up (OR 4.71, [1.73–12.85], p=.002). Octogenarians were at a greater risk of intra-operative blood loss (WMD 54.73 [17.89-91.58], p=.004), endoleaks on completion angiogram (ORs 1.42, [1.20-1.67], p&amp;lt;.001), cardiac events (1.34 [1.12-1.62], p=.002) and endoleaks during follow-up (OR 1.40[1.03-1.91], p=.03). The body of evidence for most primary outcomes was judged to be low. Conclusion Survival is lower in octogenarians but there was no significant difference in aneurysm-related deaths or re-interventions, despite the increased incidence of aortic rupture and endoleaks during follow-up.

The Anxiety Level and Premature Rupture of Membrane Incidence during COVID-19 Pandemic

Abstract&#x0D; Objective: To determine the association between anxiety level and premature rupture of membrane incidence during COVID-19 pandemic.&#x0D; Methods: This study was a case-control study. The subjects of this study were patients giving birth at RSUD Dr. Moewardi Surakarta Hospital and UNS Sukoharjo Hospital in June - October 2021. Sampling was done by the purposive sampling technique on 70 samples. Data were analyzed using the chi-square test and logistic regression test.&#x0D; Results: Characteristic data of the study samples found that most of the study samples was severe anxiety (40%). There was a significant association between the level of anxiety with PROM incident (p = 0.00), and pregnant women with severe anxiety had a risk of PROM of 3.761 times compared to pregnant women who were not anxious (OR=3.761). In multivariate analysis, it was found that the most influential variable on the incidence of premature rupture of membranes was the level of anxiety (p=0.001) compared to parity (p=0.155), employment status (0.193), and education level (0.576).&#x0D; Conclusion: There was a significant association between anxiety level and premature rupture of membranes incidence during the COVID-19 pandemic, and there was an increased risk of premature rupture of membranes in pregnant women with severe anxiety levels during the COVID-19 pandemic.&#x0D; Keywords: anxiety level; premature rupture of membrane; COVID-19 pandemic.

The Influence Of The Trend Of Childbirth Using The Blowing Method With Perineal Rupture Incidents At TPMB Ika Fatmawati In 2022

Background: The trend of giving birth using the blowing method is used in a repetitive pattern for breathing exercises. There are many advantages of this steady, rhythmic breathing pattern during labor one of which is that the abdominal cavity can grow in size as a result of the increased relaxation of the abdominal muscles caused by breathing exercises. Purpose of Writing: To Influence the Trend of Childbirth Using the Blowing Method with Perineal Rupture Events at TPMB Ika Fatmawati in 2022. Research Methods: In this study, it was an experimental (quasi-experimental) design with The Nonrandomized Control Group Pretest Posttest Design with a quantitative approach. Sampling in this study is the total sampling of 30 people. divided into 2 groups, namely 15 people in the intervention group and 15 people in the control group. The sampling technique used was a strategy to identify the sample by taking respondents who happened to be available or the time available at the location according to the needs of the study. The inclusion criteria were women who gave birth normally, while the exclusion criteria were TBBJ counts of more than 3800 grams. Results: Results of statistical test analysis independent sample t test obtained Asymp. Sig (2 – Talled), namely 0.004 &lt; α (0.05) it can be concluded that there is an influence of the trend of blowing births with perineal rupture events at TPMB Ika Fatmawati in 2022. Conclusions and suggestions: The results of this study are expected that midwives can carry out the trend of giving birth by blowing and making the mother's mood calm so that it can reduce the incidence of perineal rupture.

Abstract 278: Ccr2 Inhibition Impacts Abdominal Aortic Aneurysm Rupture In Rodents

Background: There is growing evidence that monocyte chemoattractant protein (MCP-1) / C-C chemokine receptor type 2 (CCR2) axis crucially affects the initiation and progression of abdominal aortic aneurysm (AAA). We hypothesize that inhibition of CCR2 may prevent AAA inflammation and rupture. Methods: 40 Male and 49 female Sprague-Dawley rats underwent intraluminal infrarenal abdominal aortic exposure to elastase to induce AAA. Rats received daily β-aminopropionitrile to promote AAA rupture. On post-operative day 3 (POD3), a treatment group (15 males, 17 females) received daily oral gavage of a CCR2 inhibitor (CCR2i; RS-504393), and a control group (25 males, 32 females) received no CCR2i. On POD6, both groups underwent PET/CT with a CCR2 targeting radiotracer 64 Cu-DOTA-ECL1i. In addition, AAA tissue cytokine/chemokine arrays were evaluated. Incidence of AAA rupture was evaluated in the remaining surviving rats until POD14 (Figure 1A). Results: Compared with controls, the incidence of AAA rupture was reduced in treated male AAA rats (0% vs 56%, p &lt;0.001; and tended to decreased in treated female AAA rats (18% vs 42%, p =0.09;). PET/CT demonstrated that male and female treatment groups had significantly decreased 64 Cu-DOTA-ECL1i uptake in AAAs ( p= 0.02 for male AAAs , p &lt;0.001 for females, Figure 1B). All cytokines, including MCP-1, RANTES, IL-17A, IL-18, IL-1B, IL-6, IL-10, except TNF-a were significantly reduced in the male treatment group compared to control group ( p &lt;0.05; Figure 1C). Interestingly, in the female treatment group, IL-1B was significantly decreased ( p &lt;0.05), and RANTES was significantly increased ( p &lt;0.05). Conclusion: In rats, CCR2 appears to be a promising theranostic biomarker for AAAs. CCR2i can greatly impact AAA tissue inflammation and reduces the incidence of AAA rupture. Differences between male and female rats suggest that CCR2 signaling may be different in AAA between sexes and highlights future avenues of further investigation.