Quantification of progression and regression of carotid vessel atherosclerosis using 3D ultrasound images
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Abstract:
Atherosclerosis is an inflammatory process similar to scar formation in the inner wall of the artery. It is the underlying cause of heart attacks and some strokes. Atherosclerotic lesions in the artery wall are called plaques. 3D ultrasound (US) has been used to monitor the progression of carotid vessel plaques in symptomatic and asymptomatic patients. Different ways of measuring various ultrasound phenotypes of atherosclerosis have been developed. Here, we report on the development and application of a method used to analyze changes in carotid plaque morphology from 3D US. In an effort to extend our previous work in plaque thickness analysis, we developed a procedure that facilitates the visualization and comparison of the distribution of plaque thickness by mapping the 3D arterial structure into a 2D plane.Keywords:
Arterial wall
KEY FINDINGSAsymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur.• Manifestations of COVID-19 are highly varied and may include asymptomatic cases, who do not manifest with anysigns and symptoms despite testing positive for COVID-19 by viral nucleic acid tests. Pre-symptomatic cases areinfected individuals who are still in their incubation period, hence do not exhibit any symptoms yet but eventuallydevelop symptoms.• As of June 2020, only 586 (2.8%) of the 20,990 active cases in the Philippines were classified as asymptomatic,but it is unclear whether cases are pre-symptomatic or carriers (true asymptomatic).• Based on 36 observational studies (case reports, case series, cross-sectional and cohort studies) and 9 statisticalmodeling analysis, asymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur. However, 3studies reported no transmission from pre-symptomatic and asymptomatic cases.• Studies on viral load comparing symptomatic cases with pre-symptomatic and asymptomatic cases reportedcontradicting results. The duration of viral shedding was significantly longer for symptomatic patients comparedto asymptomatic patients but similar for asymptomatic and pre-symptomatic patients.• Therewas no difference in the transmission rates of symptomatic and asymptomatic cases. However,the estimatedinfectivity and probability of transmission was higherfor symptomatic cases compared to asymptomatic cases, butresults were imprecise due to a wide confidence interval.• The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recognize thepossibility of pre-symptomatic and asymptomatic transmission. According to WHO, current evidence suggestsasymptomatic cases are less likely to transmit the virus than symptomatic cases.
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Viral Shedding
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Abstract We aim to systematically review the characteristics of asymptomatic infection in the coronavirus disease 2019 (COVID‐19). PubMed and EMBASE were electronically searched to identify original studies containing the rate of asymptomatic infection in COVID‐19 patients before 20 May 2020. Then mate‐analysis was conducted using R version 3.6.2. A total of 50 155 patients from 41 studies with confirmed COVID‐19 were included. The pooled percentage of asymptomatic infection is 15.6% (95% CI, 10.1%‐23.0%). Ten included studies contain the number of presymptomatic patients, who were asymptomatic at screening point and developed symptoms during follow‐up. The pooled percentage of presymptomatic infection among 180 initially asymptomatic patients is 48.9% (95% CI, 31.6%‐66.2%). The pooled proportion of asymptomatic infection among 1152 COVID‐19 children from 11 studies is 27.7% (95% CI, 16.4%‐42.7%), which is much higher than patients from all aged groups. Abnormal CT features are common in asymptomatic COVID‐19 infection. For 36 patients from 4 studies that CT results were available, 15 (41.7%) patients had bilateral involvement and 14 (38.9%) had unilateral involvement in CT results. Reduced white blood cell count, increased lactate dehydrogenase, and increased C‐reactive protein were also recorded. About 15.6% of confirmed COVID‐19 patients are asymptomatic. Nearly half of the patients with no symptoms at detection time will develop symptoms later. Children are likely to have a higher proportion of asymptomatic infection than adults. Asymptomatic COVID‐19 patients could have abnormal laboratory and radiational manifestations, which can be used as screening strategies to identify asymptomatic infection.
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Essential hypertension
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Objective: To assess the influence of aging on serum lipids and lipoproteins in menopausal women and to determine whether arterial hypertension can determine carotid artery wall intima-media thickening in these subjects. Design: We assessed cholesterol, low density lipoprotein cholesterol, triglycerides, and carotid artery wall intima-media thickness in 729 menopausal women aged 40-65 years, divided into four age groups (40-45 years. 46-50 years. 51-55 years, and 56-60 years). Results: Serum lipids and lipoproteins rose progressively in the different age groups. Carotid wall thickness also increased and was more evident when accompanied by arterial hypertension. Conclusions: Our results suggest that elevated serum lipids and lipoproteins are interrelated with increased carotid artery wall intima-media thickness. Moreover, they showed the benefits of hormone replacement therapy. {Memopause 1999:6:230-232. © 1999. The North American Menopause Society.)
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Intima-media thickness
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Introduction: The prevalence of peripheral arterial disease (PAD) ranges between 4.5% and 57% and is independently associated with cardiovascular disease burden irrespective of symptoms. Two thirds of cases are thought to be asymptomatic and may go unrecognised. Local prevalence and natural progression of asymptomatic PAD is unknown.Methods: This one year, non-interventional longitudinal study, aimed to determine prevalence and progression of asymptomatic PAD in patients with cardiovascular risk factors. Results: Of 217 patients screened, 36% had asymptomatic disease in 113 legs. Of sixty two who returned for follow-up, eight normal legs developed asymptomatic PAD, and 46%, asymptomatic at baseline showed disease progression. Initial baseline ABI showed significant change over 1 year of follow-up (p=0.001) and 21% (13) of patients eventually developed intermittent claudication. Also, 52% of baseline asymptomatic participants having at least one associated cardiovascular risk factor showed disease progression over 1 year. Those developing claudication demonstrated significant ABI deterioration. Having two or more cardiovascular risk factors significantly affected progression of asymptomatic disease, (p = 0.031). Conclusion: Study confirms high prevalence of asymptomatic PAD in our population and significant disease progression in one year.Key words: Peripheral Artery Disease, Risk Factors, Asymptomatic, Disease Progression
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Intermittent claudication
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Retrospective review of the Southeastern Vascular Study Group between January 2011 and December 2018 Of 8303 carotid endarterectomies (CEAs) and 1876 carotid artery stenting (CAS) procedures, slightly more than half of patients were asymptomatic in each group. Symptomatic patients had significantly higher rates of in-hospital neurologic events, myocardial infarction, and death after CEA and of neurologic events after CAS than asymptomatic patients. There was no difference in mortality among symptomatic and asymptomatic male and female patients at 3 years after CEA, but asymptomatic men had significantly higher 3-year mortality than women after CAS. Long-term mortality risk in asymptomatic men should be considered before offering CAS.
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To define characteristics of pediatric asymptomatic idiopathic intracranial hypertension (IIH).We retrospectively reviewed our Neuro-Ophthalmology database (2000-2006) for all cases of symptomatic and asymptomatic pediatric IIH.Out of 45 IIH cases, 14 (31.1%) were asymptomatic (incidental examination). When compared with children with symptomatic IIH, asymptomatic cases were younger [5.6 (1.8-15) vs 11.0 (5-17) years, P = 0.007], had lower percentage of obesity (14.3% vs 48.4%, P = 0.046), and had male predominance (71.4% vs 38.7%, P = 0.06). Asymptomatic cases required shorter duration of acetazolamide treatment [3 (0-8), vs 6 (0-20) months, P = 0.021], and resulted in complete resolution of swollen discs.We speculate that asymptomatic IIH may be more common in young children and could represent a milder form or a presymptomatic phase before evolving into classic symptomatic IIH. Further studies to assess the clinical significance of asymptomatic IIH are warranted.
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