Minimum Diameter Research Articles

Transfemoral-only transcatheter aortic valve replacement: A single center experience of 400 consecutive patients.

In transcatheter aortic valve replacement (TAVR),transfemoral (TF) access offers several advantages over alternative access routes. Advances in sheaths and valve delivery technology have catalyzed the feasibility of TF-TAVR, even in challenging anatomies. Report procedural characteristics and outcomes of a TAVR program aiming for a 100% TF access rate. Consecutive patients undergoing TAVR were enrolled in a prospective registry. Equipment used to facilitate TF-access in challenging anatomies included low-profile sheaths, dilatators, peripheral balloons, covered and uncovered self-expandingand balloon-expandable stents, and intravascular lithotripsy (IVL). A total of 400 patients with a mean age of 81 ± 6 years (42% female) were analyzed. Minimal iliofemoral artery diameter (MLD) of the main access side was <5 mm in 42 (10.5%), extreme tortuosity was present in 65 (16.3%), and severe calcification in 59 (14.8%). TF-access was successful in 399 (99.8%) patients. A transaxillary access was used in one patient. In multivariable analysis, an MLD < 5 mm was the strongest predictor for vascular complications (11.9% vs. 3.9%, OR: 3.86, 95% CI: 1.38-10.8, p = 0.01). Such patients also had more major/life-threatening bleeding (14.2% vs. 3.1%, p < 0.001) and required more planned and unplanned peripheral interventions to enable TFaccess (35.8% vs. 3.4%, p < 0.001). Our study shows that utilization of dedicated sheaths, peripheral balloons, stents, and IVL enables TAVR via TF access in >99% of patients. However, rates of vascular and bleeding complications in patients with narrow iliofemoral arteries (MLD < 5 mm) were high.

Determining risk factors for vascular and bleeding complications after TAVR using CT angiography

Abstract Funding Acknowledgements None. Introduction The use of pre-procedural computed tomography angiography (CTA) of the iliofemoral sector in the planning of transaortic valve replacement (TAVR) has demonstrated a reduction in the risk of vascular complications in patients undergoing TAVR. In this study, we aimed to characterise the clinical and radiological factors associated with bleeding and vascular complications after TAVR. Methods Patients undergoing transfemoral TAVR in a tertiary centre between 2017 and 2019 were included in this analysis. All patients underwent iliofemoral CTA before the procedure and classical CTA-derived data as well as iliofemoral calcium volume were collected. Clinical data and outcomes regarding bleeding events, as well as vascular complications according to Valve Academic Research Consortium 2 (VARC-2) criteria, were also collected. 207 patients were included in this analysis, of whom 53% were women. The median age was 82 years (IQR 76-86) and the median STS mortality risk score was 3.9% (IQR 2.59-5.99). In this population, vascular complications according to the VARC-2 criteria occurred in 33% of patients (19% with major complications). Patients with lower body mass index (BMI) were more likely to suffer vascular complications. Vascular access with fluoroscopy was associated with a higher prevalence of complications compared to ultrasound-guided vascular access (62% vs. 38%, p=0.037). When considering radiological criteria, smaller minimum luminal diameter and area of the common femoral and external iliac arteries were associated with a greater risk of vascular complications, as were increased sheath to external iliac artery ratios and luminal attenuation values (p&amp;lt;0.05 for all). Bleeding complications occurred in 20 patients, with a greater prevalence of bleeding events in female patients (77% vs. 23%, p=0.001). Patients with a lower BMI, a history of obstructive pulmonary disease or coronary artery disease, aortic insufficiency and fluoroscopic valvular access were more likely to have bleeding complications. Regarding radiological criteria, decreased maximal luminal diameter of the common femoral artery and smaller minimal luminal diameters and areas of the external iliac artery were associated with bleeding complications. Increased sheath-to-femoral artery ratios and luminal attenuation values were associated with an increased risk of vascular complications (p&amp;lt;0.05 for all). Conclusion Our study underscores the importance of pre-procedural CTA in TAVR planning and identifies separate risk factors for vascular and bleeding complications.

Advantages of robot-assisted resection of large mediastinal tumors: a single-center preliminary study.

Current study aims to assess the safety and efficacy of robot-assisted thoracoscopic surgery (RATS) for sizable mediastinal masses with a minimum diameter ≥6cm, compared with video-assisted thoracoscopic surgery (VATS) and open surgery. This study enrolled 130 patients with mediastinal tumors with no less than 6 cm diameter in Zhongnan Hospital, Wuhan University, including 33 patients who underwent RATS, 52 patients who underwent VATS and 45 patients who underwent open surgery. After classifying based on mass size and whether it has invaded or not, we compared their clinical characteristics and perioperative outcomes. There was no significant difference in age, gender, mass size, myasthenia gravis, mass location, pathological types (p>0.05) in three groups. Patients undergoing open surgery typically presenting at a more advanced stage (p<0.05). No obvious difference was discovered in the average postoperative length of stay, operation duration, chest tube duration and average postoperative day 1 drainage output between RATS group and VATS group (p>0.05), while intraoperative blood loss in RATS group was significantly lower than VATS group (p=0.046). Moreover, the postoperative length of stay, operation duration, chest tube duration and intraoperative blood loss in RATS group were significantly lower than open surgery group (p<0.001). RATS is a secure and efficient approach for removing large mediastinal masses at early postoperative period. In comparison with VATS, RATS is associated with lower intraoperative blood loss. Compared with open surgery, RATS is also associated with shorter postoperative length of stay, operation duration, chest tube duration and intraoperative blood loss.

Successful endovascular treatment of an occluded external iliac artery with a minimum outer vessel diameter of 2.5mm.

Successful endovascular treatment of an occluded external iliac artery with a minimum outer vessel diameter of 2.5mm.

Combined Amniotic Membrane Graft and Autologous Retinal Transplant for Repair of Refractory Chronic Myopic Macular Holes

Purpose: To report a technique for reconstruction of large, persistent, chronic, myopic macular holes using a combined human amniotic membrane graft and autologous retinal transplant (AMN-ART). Methods: Three patients with large, myopic macular holes that failed prior surgical attempts and underwent subretinal amniotic membrane graft with overlying autologous retinal transplant and short-term perfluorocarbon tamponade. Pre- and postoperative visual acuity (VA) and images were analyzed at 3, 6, and 9 months. Results: All 3 myopic macular holes remained closed at 9 months with resolution of central scotoma. The first case, a 69-year-old female, presented with a persistent macular hole whose minimum linear diameter was 1085 μm. Her pre-op VA of 20/200 improved by 9 months to 20/100. Secondly, a 72-year-old male with history of recurrent retinal detachment repair with silicone oil and persistent macular hole of 1134 μm presented with pre-op VA of 20/200, which was unchanged at 9 months. Lastly, a 76-year-old female with a persistent macular hole of 935 μm with preop VA of 20/80 improved by 9 months post-op to 20/50. No complications were encountered related to the grafts. Conclusion: Combined AMN-ART may provide a surgical option for repair of refractory, large, chronic myopic macular holes with underlying atrophy.

A novel antifungal nanoemulsion based on reuterin-assisted synergistic essential oils: Preparation and in vitro/in vivo characterization

A novel antifungal nanoemulsion based on reuterin-assisted synergistic essential oils: Preparation and in vitro/in vivo characterization

Uplifting the study of the inline inspection technique on the buckling pipelines in pipeline integrity management strategy

This work reports the development of inline inspection (ILI) methodology to enhance the pigging activity for the dented pipeline, facilitate the pigging process to prevent Pipeline Inspection Gauge (PIG) from getting stuck and improve the safety passage for buckled pipelines. The recent report unveils the condition of the UNPIGGABLE pipelines, which reduce the inner diameter of pipelines to 257.51 mm, equivalent to 27.58 % of the initial diameter and restricts the pigging activity. In this report, the pull-through test coupled with the collapsibility test was conducted. The success of the test above allows the ILI equipment based on the magnetic flux leakage (MFL) technique to record the internal and external wall loss inwardly and geometric defect on diameter of the pipelines. The prepared artificial dented pipeline was made before it underwent several tests. Based on the pull-through test, the maximum force of 27000 N is more significant than the pipeline operating pressure to enable the MFL tool to pass through the pipelines despite exhibiting the geometry anomaly. Compressing the opposite magnetic yoke of the collapsibility test is critical, showing that the ILI MFL tool reaches its maximum compression of 242 mm. The value is lower than the minimum internal diameter of 257 mm. The ILI results show that the highest metal loss was achieved at 73 % at 15504 m at the bottom of the inspected pipelines. At the same time, the dented area reduces to more than 6 % of the pipelines’ nominal outer diameter and imposes the pipe’s integrity status to red. The distinctive result of the research can be used to model the future unprecedented pigging process when buckles appear in pipelines

Iron-Based Nanoparticles Synthesis, Characterization, and Antimicrobial Effectiveness

Background: Antimicrobial resistance (AMR) has emerged as a significant and pressing public health concern, posing serious challenges to effectively preventing and treating persistent diseases. Developing new antibiotics with different mechanisms of action is crucial to effectively address challenges in treating infections. A lot of work has already been done on mono-metallic nanoparticles to address the issue.Methods: This study aimed to synthesize multi-metallic iron, silver, and chitosan-embedded nanoparticles using a green approach. Iron, silver, chitosan nanoparticles, and a composite of iron–silver–chitosan was also synthesized. The synthesized nanoparticles and composites were characterized through X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and Fourier Transform Infrared Spectroscopy (FTIR) to evaluate their structural parameters. Their antimicrobial efficacy was investigated through MIC (minimum inhibitory concentration), MBC (minimum bactericidal concentration), and well-disk diffusion assays against Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Staphylococcus epidermidis and Candida albicans.Results: The size of the Cu-NPs, Cu-Ag NPs, and Cu-Ag-CS NPs were found to be in the range of 32-40 nm size with a spherical shape. The nanocomposites' MIC and MBC were calculated to be 125 μg/mL and 500 μg/mL, respectively. The nanocomposites exhibited a range of clear inhibition zones, with a minimum diameter of 12 ± 0.5 mm and a maximum diameter of 22 ± 0.5 mm. Conclusion: The iron–silver–chitosan nanocomposite has been shown to have significant antimicrobial effects in the laboratory environment compared to other nanoparticles hence can be applied as potential biomedical/biological candidates in future.Keywords: Antibacterial; Antifungal Agents; Iron; Silver; Chitosan; Nanoparticles

Subsurface stratigraphy suggested by the layered ejecta craters in the Martian northern planitiae

The formation of layered ejecta craters (LECs) is generally thought to be related to the subsurface water-ice. The distribution of LECs in the northern regions of Mars (0 to 70° N) features both local and latitudinal variations, e.g., there are generally few LECs within volcanic areas, and the observed minimum and median diameters of the LECs decreases with increasing latitude. The observed minimum diameters of the LECs in the six planitiae within the northern lowlands suggest the roof depth of the LECs-forming layer has clear lateral variability, ranging between ∼90 m in the Arcadia Planitia and ∼280 m in the Isidis Planitia. The observed LECs are suggested to mainly form during the Amazonian, implying that the LEC-forming water-ice-bearing strata might be still present. The variation might reflect the comprehensive influence on the subsurface water-ice by the climate conditions and geologic events during the Amazonian period. The proposed subsurface stratigraphies in the six planitiae suggest that the total thickness of the LECs-related strata in the Chryse Planitia is the largest (∼4.6 km) and in the Arcadia Planitia is the smallest (∼1.6 km). There could be as much as ∼3.5–16 million km3 subsurface water stored in these strata, resulting in a ∼24–110 m global equivalent layer (GEL) of water. Given that water is a fundamental ingredient to life, its migration from surface to subsurface shifts the focus of its exploration. Both Arcadia and Utopia Planitiae represent ideal candidates as locations where both shallow and deep subsurface water-ice might be abundant, they represent high-priority targets for future missions at mid-latitudes for biosignature searching and in-situ resource utilization.

Preoperative Ultrasound for the Prediction of Postinduction Hypotension: A Systematic Review and Meta-Analysis

Postinduction hypotension (PIH) is closely associated with postoperative adverse outcomes. Preoperative hypovolemia is a key risk factor, and many parameters are available from ultrasound to detect hypovolemia, but the accuracy of PIH from ultrasound remains unclear. This systematic review and meta-analysis aimed to evaluate the commonly used measurements from ultrasound to predict PIH. We searched the PubMed, Cochrane Library, Embase, CNKI, and Web of Science databases from their inception to December 2023. Thirty-six studies were included for quantitative analysis. The pooled sensitivities for the inferior vena cava collapsibility index (IVC-CI), maximum inferior vena cava diameter (DIVCmax), minimum inferior vena cava diameter (DIVCmin), and carotid artery corrected flow time (FTc) were 0.73 (95% CI = 0.65, 0.79), 0.66 (95% CI = 0.54, 0.77), 0.74 (95% CI = 0.60, 0.85), and 0.81 (95% CI = 0.72, 0.88). The pooled specificities for the IVC-CI, DIVCmax, DIVCmin, and carotid artery FTc were 0.82 (95% CI = 0.75, 0.87), 0.75 (95% CI = 0.66, 0.82), 0.76 (95% CI = 0.65, 0.84), and 0.87 (95% CI = 0.77, 0.93). The AUC for the IVC-CI, DIVCmax, DIVCmin, and carotid artery FTc were 0.84 (95% CI = 0.81, 0.87), 0.77 (95% CI = 0.73, 0.81), 0.82 (95% CI = 0.78, 0.85), and 0.91 (95% CI = 0.88, 0.93). Our study demonstrated that ultrasound indices are reliable predictors for PIH. The carotid artery FTc is probably the optimal ultrasound measurement for identifying patients who will develop PIH in our study.

Imaging and clinical predictors of surgery in stricturing ileal Crohn's disease: a retrospective study from a large pediatric hospital.

(1) To determine the frequency of surgical management in children with Crohn's Disease (CD) and a new radiologic ileal stricture, and (2) to identify imaging and clinical features that predict the need for surgery. This retrospective study included pediatric patients (< 21 years old) with CD and a new ileal stricture diagnosed by MRE, CTE, or CT between July 2018 and June 2023. Three board-certified radiologists recorded stricture length, maximum mural thickness, minimum lumen diameter, maximum upstream diameter, and simplified magnetic resonance index of activity (sMaRIA) score. Anthropometrics, laboratory data, and surgical interventions performed after stricture diagnosis were also recorded. Multivariable logistic regression was used to identify imaging and clinical variables associated with the need for surgery. 44 pediatric CD patients (median age 16.5years) presented with a new ileal stricture during the study period. 30 (68.2%) patients required surgery, with a median time of 87.5days between stricture diagnosis and surgery. Median stricture measurements were length: 7.0cm, maximum mural thickness: 7.3mm, minimum lumen diameter: 0.2cm, and maximum upstream diameter: 3.3cm. Median sMaRIA score was 3.0, and 14 (31.8%) strictures had associated internal penetrating disease. Stricture ratio (ratio of maximum upstream lumen diameter to minimum lumen diameter) (OR = 1.15 [95% CI 1.02-1.30]; p = 0.02) and sMaRIA (OR = 2.12 [95% CI 0.87-5.17; p = 0.10) were associated with need for surgery. Surgery remains common in stricturing pediatric CD, with increasing stricture ratio and sMaRIA score associated with need for surgical management.

A NOVEL SURGICAL TECHNIQUE FOR GIANT AND REFRACTORY MACULAR HOLES: AUTOLOGOUS TENON CAPSULE PLUG

Purpose: To evaluate the safety and efficiency of the autologous Tenon capsule plug (ATCP) technique for the treatment of large (1000 um&lt;) and refractory macular holes (MHs). Methods: This retrospective, interventional, case series included 3 patients who underwent 23-gauge vitrectomy and ATCP technique for giant or refractory MH. All patients underwent a complete ophthalmic examination including optical coherence tomography (OCT), OCT angiography (OCTA), and microperimetry (MP). The changes in retinal structure and function were evaluated. Results: The minimum follow-up was 6 months. The preoperative minimum hole diameters were 728 um, 422 um, and 1154 um for case 1, case 2, and case 3 respectively. Case 1 and case 2 had an idiopathic MH that failed to close after vitrectomy with (internal limiting membrane) ILM peeling, whereas case 3, who had a giant, irregular MH underwent the ATCP technique as the primary intervention. Complete hole closure was achieved in all patients at the last follow-up. However, case 1 required a second ATCP surgery due to dislodgement of the plug in the early postoperative period. The BCVA increased in all patients. The final MP analysis revealed that the percentage of fixation points at circles 4o for case 1, case 2 and case 3 were 93.5%, 99.9% and 95.6% respectively. Conclusions: We suggest that the ATCP technique can provide a simple, cheap, repeatable, and readily available surgical solution for the treatment of giant and refractory macular holes. Further prospective studies with a larger sample size are needed to confirm our preliminary results.

Relationship between lymphocytes and idiopathic macular hole

BackgroundAn idiopathic macular hole (IMH) is a full-thickness anatomic defect extending from the internal limiting membrane to the photoreceptor layer of the macula without any known cause. Recently, clinical laboratory markers of systemic inflammatory status derived from complete blood counts have been evaluated in ocular diseases. This study aimed to explore whether they could predict the development and progression of IMHs.MethodsA retrospective review of 36 patients with IMH and 36 sex-and-age-matched patients with cataracts was conducted. We collected complete blood counts of all participating individuals and calculated systemic immunoinflammatory indicators. The maximum base diameter of the IMH (BD), minimum diameter of the IMH (MIN), height of the IMH (H), area of the intraretinal cyst (IRC), and curve lengths of the detached photoreceptor arms were measured on optical coherence tomography (OCT) images. We used these values to calculate the macular hole index (MHI), tractional hole index (THI), diameter hole index (DHI), hole form factor (HFF), and macular hole closure index (MHCI). We performed a receiver operating characteristic (ROC) curve analysis of 30 patients with IMH who were followed up 1 month after surgery.ResultsLymphocyte counts were significantly higher in the IMH group. No other significant differences were observed between the IMH and control groups. Lymphocyte counts in the IMH group were significantly negatively correlated with MIN and BD and were significantly positively correlated with MHI, THI, and MHCI. However, lymphocyte counts were not significantly correlated with H, IRC, DHI, and HFF. In the ROC analysis, BD, MIN, MHI, THI, and MHCI were significant predictors of anatomical outcomes. According to the cut-off points of the ROC analysis, lymphocyte counts were compared between the above-cut-off and below-cut-off groups. Lymphocyte counts were significantly higher in the MIN ≤ 499.61 μm, MHI ≥ 0.47, THI ≥ 1.2, and MHCI ≥ 0.81 groups. There were no significant differences between the above-cut-off and below-cut-off BD groups.ConclusionsAlthough inflammation may not be an initiating factor, it may be involved in IMH formation. Lymphocytes may play a relatively important role in tissue repair during the developmental and postoperative recovery phases of IMH.

The pulmonary protective potential of vanillic acid-loaded TPGS-liposomes: modulation of miR-217/MAPK/NF-κb signalling pathway

The aim is to investigate the possible pulmonary protective effect of vanillic acid (VA) in liposome-TPGS nanoparticles, to overcome VA’s poor bioavailability. VA was successfully extracted. Liposomes were prepared using thin film hydration. Central composite design was adopted for optimisation of liposomes to get the maximum entrapment efficiency (EE%) and the minimum mean diameter, where the liposomes were further modified with TPGS, and tested for PDI, zeta-potential, and in-vitro drug release. In-vivo study on mice with LPS-acute pulmonary toxicity was tested. TPGS-modified VA-liposomes showed EE% of 69.35 ± 1.23%, PS of 201.7 ± 3.23 nm, PDI of 0.19 ± 0.02, and zeta-potential of −32.2 ± 0.32 mv. A sustained drug release of the TPGS-modified VA-liposomes was observed compared to standard VA, and a pulmonary-protective effect through decreasing miR-217 expression with subsequent anti-inflammatory effect through suppression of MAPK and PI3K/NF-κB pathways was also demonstrated in the current study. TPGS-modified VA-liposomes showed an enhanced bioavailability and a sustained drug release with promising pulmonary protective effects against acute pulmonary injury diseases.

Internal surface inspection method under linear structured light illumination based on dual non-coaxial optical paths

The inner space of tubular and hole-like workpieces, such as oil pipes and cylinders, is limited in volume and has no effective means of measuring the inner surface under geometric constraints.This paper proposes a non-coaxial optical path line structured light method for inner surface inspection, which can significantly reduce the device size and working distance. The method constructs two non-coaxial optical paths for light source and imaging, and uses two fixed reflectors to achieve the deflection of the optical axes of the light source and imaging paths.After theoretical derivation and verification, a sample device was designed and fabricated for experiments. The device measures approximately 22 mm by 24 mm in cross-section, the maximum insertion distance is about 200 mm, and the minimum inner diameter of the accessible space is 50 mm.The results show that the optical path design does not destroy the original homography relationship, and can still ensure the measurement capability comparable to the existing methods when reducing the device size to 10% of the original. The method has obvious advantages when applied to the inspection of tubular and hole-like workpieces in fields such as petrochemical industry, military equipment, etc.

Measurement of dynamic pupillometry parameters in adult Indian population.

To determine normative dynamic pupillometry data in healthy Indian adults and to investigate the effect of age on various pupillary parameters. Pupillometry measurements were obtained on healthy participants using an automatic dynamic pupillometry device, the NPi-200 (NeurOptics Inc., Irvine, CA, USA). Various measurements, including neurologic pupil index (NPi), resting pupil size (Size), minimum pupil diameter (MIN), percentage change in pupil size (CH), constriction velocity (CV), maximum constriction velocity (MCV), latency (LAT), and dilatation velocity (DV), were obtained in routine clinical settings and analyzed statistically for change with age. A total of 470 participants (470 eyes) were analyzed. Mean NPi was 4.31 ± 0.31, Size was 4.38 ± 0.80 mm, MIN was 2.87 ± 0.49 mm, CH was 34.67 ± 4.15%, CV was 2.74 ± 0.68 mm/s, MCV was 4.16 ± 0.98 mm/s, LAT was 0.23 ± 0.02 s, and DV was 1.13 ± 0.25 mm/s. NPi and LAT were positively correlated (P < 0.01), whereas Size, MIN, CH, CV, MCV, and DV were negatively correlated with age (P < 0.01). No statistically significant difference was observed between males and females. The study offers normative data on dynamic pupillometry parameters across various age groups within a healthy Indian population, which would serve as a reference for future studies in diverse clinical scenarios. It also elucidates that age significantly influences values in the NPi algorithm.

Paper-based humidity sensor for wearable based on near-field electrohydrodynamic direct writing

Flexible humidity sensors have been widely used in wearable electronics, owing to their flexibility and compatibility with electronic device substrates. This study fabricated a flexible paper-based humidity sensor with a grid-like sensing film using the near-field electrohydrodynamic direct writing (NFEDW) method. A grid-like sensing layer with a dense network of carbon nanotubes/cellulose nanofiber (CNTs/CNF) was prepared, and induced by a voltage field applied during printing. The effects of the substrates and pattern width on the performance of the sensor were systematically investigated. The prepared sensor exhibited high sensitivity of 101 % at 95 % relative humidity (RH). An interlocking structure formed between the CNTs/CNF composite and the paper substrate, endowing the sensor with outstanding bending (minimum diameter of 5 mm) and folding (up to 100 times) durability. Furthermore, the prepared sensor exhibited rapid response performance (17 % within 10 s). This addresses the issue of long response time, which is typically associated with CNTs-based sensors, making these sensors more suitable to practical applications. The above-mentioned advantages enable the sensor to be used for respiration monitoring and even for vocal recognition. Finally, a real-time respiration monitoring platform was developed to demonstrate the sensor’s potential in wearable devices.

Effect of subclavian vein diameter combined with perioperative fluid therapy on preventing post-induction hypotension in patients with ASA status I or II

BackgroundPerioperative hypotension is frequently observed following the initiation of general anesthesia administration, often associated with adverse outcomes. This study assessed the effect of subclavian vein (SCV) diameter combined with perioperative fluid therapy on preventing post-induction hypotension (PIH) in patients with lower ASA status.MethodsThis two-part study included patients aged 18 to 65 years, classified as ASA physical status I or II, and scheduled for elective surgery. The first part (Part I) included 146 adult patients, where maximum SCV diameter (dSCVmax), minimum SCV diameter (dSCVmin), SCV collapsibility index (SCVCI) and SCV variability (SCVvariability) assessed using ultrasound. PIH was determined by reduction in mean arterial pressure (MAP) exceeding 30% from baseline measurement or any instance of MAP < falling below 65 mmHg for ≥ a duration of at least 1 min during the period from induction to 10 min after intubation. Receiver Operating Characteristic (ROC) curve analysis was employed to determine the predictive values of subclavian vein diameter and other relevant parameters. The second part comprised 124 adult patients, where patients with SCV diameter above the optimal cutoff value, as determined in Part I study, received 6 ml/kg of colloid solution within 20 min before induction. The study evaluated the impact of subclavian vein diameter combined with perioperative fluid therapy by comparing the observed incidence of PIH after induction of anesthesia.ResultsThe areas under the curves (with 95% confidence intervals) for SCVCI and SCVvariability were both 0.819 (0.744–0.893). The optimal cutoff values were determined to be 45.4% and 14.7% (with sensitivity of 76.1% and specificity of 86.7%), respectively. Logistic regression analysis, after adjusting for confounding factors, demonstrated that both SCVCI and SCVvariability were significant predictors of PIH. A threshold of 45.4% for SCVCI was chosen as the grouping criterion. The incidence of PIH in patients receiving fluid therapy was significantly lower in the SCVCI ≥ 45.4% group compared to the SCVCI < 45.4% group.ConclusionsBoth SCVCI and SCVvariability are noninvasive parameters capable of predicting PIH, and their combination with perioperative fluid therapy can reduce the incidence of PIH.

Outcomes of 25-Gauge Pars Plana Vitrectomy in the Treatment of Idiopathic Macular Hole

Aim: The main aim of this study is to evaluate the anatomical and functional results of pars plana vitrectomy (PPV) with peeling of the internal limiting membrane (ILM), membrane blue staining and subsequent expansile gas tamponade (perfluoropropane) in the treatment of idiopathic macular hole (IMH). Material and methods: The retrospective analysis consisted of 100 eyes of a total of 100 patients (61 women and 39 men) with IMH, operated on at the Department of Ophthalmology of the Slovak Medical University and University Hospital Bratislava from 1 January 2021 to 1 January 2024, using 25-gauge PPV with ILM peeling and perfluoropropane tamponade (C3F8) of 15% concentration. After surgery, the patients were required to remain in a face-down position for at least one week. Best corrected visual acuity (BCVA), minimal linear diameter (MLD) on optic coherence tomography, macular hole closure type and occurrence of complications were evaluated. The obtained results were expressed with the use of arithmetic averages and displayed in graphs. Results: Primary closure of macular hole was achieved in 93 patients (93%). The most frequently occurring type of closure was 1A. After surgery, the BCVA of all patients improved, from an average value of 0.101 preoperatively to 0.300 one year after surgery. In all groups of patients (regardless of the size of the macular hole before surgery), during the one-year follow-up period there was a gradual increase in BCVA with its stabilization by 6 months. The main factors that influenced postoperative BCVA were the preoperative values of MLD and BCVA. Conclusion: PPV with ILM peeling and perfluoropropane tamponade is an effective treatment for idiopathic macular holes with a success rate of more than 90%. This surgical procedure, associated with a relatively low number of complications, brings patients a definite improvement of BCVA.

A comparison of function lumen imaging probe measurements of anal sphincter function in fecal incontinence.

The functional lumen imaging probe (FLIP) is a test of anal sphincter distensibility under evaluation by specialist centers. Two measurement protocols termed "stepwise" and "ramp" are used, risking a lack of standardization. This study aims to compare the performance of these protocols to establish if there are differences between them. Patients with fecal incontinence were recruited and underwent measurement with both protocols at a tertiary pelvic floor referral unit. Differences in minimum diameter, FLIP bag pressure, and distensibility index (DI) at rest and during squeeze were calculated at various FLIP bag volumes. Twenty patients (19 female, mean age 61 [range: 38-78]) were included. The resting minimum diameter at 30 and 40 mL bag volumes were less in the stepwise protocol (mean bias: -0.55 mm and -1.18 mm, p < 0.05) along with the DI at the same bag volumes (mean bias: -0.37 mm2/mmHg and -0.55 mm2/mmHg, p < 0.05). There was also a trend towards greater bag pressures at 30 mL (mean bias: +2.08 mmHg, p = 0.114) and 40 mL (mean bias: +2.81 mmHg, p = 0.129) volumes in the stepwise protocol. There were no differences between protocols in measurements of minimum diameter, maximum bag pressure, or DI during voluntary squeeze (p > 0.05). There are differences between the two commonly described FLIP measurement protocols at rest, although there are no differences in the assessment of squeeze function. Consensus agreement is required to agree the most appropriate FLIP measurement protocol in assessing anal sphincter function.