Management of spontaneous intracranial hypotension - Transorbital ultrasound as discriminator.

OBJECTIVE Spontaneous intracranial hypotension (SIH) is most commonly caused by cerebrospinal fluid (CSF) leakage. Therefore, we hypothesised that patients with orthostatic headache (OH) would show decreased optic nerve sheath diameter (ONSD) during changes from supine to upright position. METHODS Transorbital B-mode ultrasound was performed employing a high-frequency transducer for ONSD measurements in the supine and upright positions. Absolute values and changes of ONSD from supine to upright were assessed. Ultrasound was performed in 39 SIH patients, 18 with OH and 21 without OH, and in 39 age-matched control subjects. The control group comprised 20 patients admitted for back surgery without headache or any orthostatic symptoms, and 19 healthy controls. RESULTS In supine position, mean ONSD (±SD) was similar in patients with (5.38±0.91 mm) or without OH (5.48±0.89 mm; p=0.921). However, in upright position, mean ONSD was different between patients with (4.84±0.99 mm) and without OH (5.53±0.99 mm; p=0.044). Furthermore, the change in ONSD from supine to upright position was significantly greater in SIH patients with OH (-0.53±0.34 mm) than in SIH patients without OH (0.05±0.41 mm; p≤0.001) or in control subjects (0.01±0.38 mm; p≤0.001; area under the curve: 0.874 in receiver operating characteristics analysis). CONCLUSIONS Symptomatic patients with SIH showed a significant decrease of ONSD, as assessed by ultrasound, when changing from the supine to the upright position. Ultrasound assessment of the ONSD in two positions may be a novel, non-invasive tool for the diagnosis and follow-up of SIH and for elucidating the pathophysiology of SIH.

Circulating oxidized LDL is associated with the occurrence of echolucent plaques in the carotid artery in 61-year-old men.

OBJECTIVE The aim of this study was to elucidate the relationship between the echogenicity of carotid artery plaques and the following risk factors: circulating oxLDL, hsCRP, the metabolic syndrome (MetS), and several of the traditional cardiovascular (CV) risk factors. MATERIAL AND METHODS A cross-sectional population-based study of 513 sixty-one-year-old men. The levels of circulating oxLDL were determined in plasma samples by sandwich ELISA utilizing a specific murine monoclonal antibody (mAb-4E6). High-sensitivity CRP was measured in plasma by ELISA. Plaque occurrence, size and echogenicity were evaluated from B-mode ultrasound registrations in the carotid arteries. Plaque echogenicity was assessed based on a four-graded classification scale. RESULTS A higher frequency of echolucent carotid plaques was observed with increasing levels of oxLDL and systolic blood pressure (p = 0.008 and p = 0.041, respectively). Subjects with the MetS had a significantly higher frequency of echogenic plaques than subjects without the MetS (p = 0.009). In a multiple logistic regression analysis, oxLDL turned out to be independently associated with echolucent carotid plaques. CONCLUSIONS The occurrence of echolucent carotid plaques was associated with oxLDL and systolic blood pressure, and oxLDL was associated with echolucent carotid plaques independently of systolic blood pressure.

Circulating oxidized low-density lipoprotein is associated with echolucent plaques in the femoral artery independently of hsCRP in 61-year-old men.

OBJECTIVES The aim of the study was to test the hypothesis that circulating markers of inflammation (high-sensitive C-reactive protein, hsCRP) and oxidative modification of lipids (oxidized low-density lipoprotein, oxLDL) were associated with the occurrence of echolucent rather than echogenic femoral artery plaques in a cross-sectional population based cohort of 513, 61-year-old men. BACKGROUND The relationships between circulating oxLDL, hsCRP and the occurrence of echolucent plaques in the femoral artery have not previously been investigated. METHODS The levels of circulating oxLDL and hsCRP were determined in plasma by ELISA. Plaque occurrence, size and echogenicity were measured by B-mode ultrasound in the right femoral artery. Assessment of plaque echogenicity was based on the classification (grades 1-4) proposed by Gray-Weale et al. RESULTS A higher frequency of echolucent femoral plaques was observed in subjects with the metabolic syndrome and current smokers (p=0.01 and p<0.001, respectively) as well as with increasing levels of oxLDL and hsCRP (p=0.002 and p=0.005, respectively). In a multiple logistic regression analysis oxLDL and current smokers turned out to be independent associated with the presence of echolucent femoral artery plaques. CONCLUSIONS The results of the present study support our hypothesis that circulating oxLDL is a marker of an unstable echolucent plaque phenotype in the femoral artery in man.

Report of the commissioners appointed ... to inquire concerning charities in England [and Wales] for the education of the poor ...

Set consists of 32 reports, together with indexes and digests, pub. in Reports and papers of the House of Commons, 1819-1843. cf. General index to the bills, reports, accounts and other papers printed by order of the House of Commons: 1801-1832, p. 144; and 1832-1844, p. 218.

Rimas de los Andes.

At head of title: Francisco Chiriboga B.

The problem of the world and the church reconsidered in three letters to a friend /

With an introduction by James Booth, C. B.

Aunque la mona se vista de seda ̲̲: juguete cómico en un acto /

No. 5, in vol. 14 with binder's title: Teatro Español : serie B.

Arkhiv biologicheskikh nauk.

"Organ Vsesoi͡uznogo instituta ėksperimentalʹnoĭ medit͡siny.

Quartett in F moll. Op. 7,II. Für 2 Violinen, Violoncell und Klavier /

Breitkopf & Härtels Kammermusik-Bibliothek, Nr. 1900a/b

Emergency oil lift program and related oil problems.

Hearings held Feb. 5 - Mar. 22, 1957.

Inventaire-sommaire des archives départementales antérieures à 1790 : Isère /

t. 1. Archives civiles. Séries A et B.

!Un pollo que sufre mucho! : juguete cómico en un acto /

On cover: Administración General de Obras Dramáticas y Líricas.

Thirty years in the Arctic regions : a narrative of the explorations and adventures of Sir John Franklin

"Copyright by the Keystone Publishing Co." -- T.p. verso

Nouveau dictionnaire historique ou Histoire abregée de tous les hommes qui se sont fait un nom par le génie, les talens, les vertus, les erreurs [et]c., depuis le commencement du monde jusqu'à nos jours ... /

Contiene: A-B.

Joannis Jacobi Mangeti ... Bibliotheca scriptorum medicorum, veterum et recentiorum : in qua sub eorum omnium qui a mundi primordiis ad hunc usque annum vixerunt, nominibus, ordine alphabetico, adscriptis, vitae compendiô enarratur, opiniones [et] scripta, modesta subinde adjectâ epikrísei recensentur, ac sectae praecipuae, sub quârumque propriâ apellatione explicantur : sicque historia medica vere universalis exhibetur ... : tomus primus : pars prima.

Contiene : Litt. A-B.