Non-cirrhotic Extra-Hepatic Porto-Systemic Shunt Causing Adult-Onset Encephalopathy Treated with Endovascular Closure

We describe the case of a 54-year-old woman admitted to the Emergency Department complaining of recurrent episodes of confusion and worsening cognitive impairment. At admission, the patient displayed slowing cognitive-motor skills with marked static ataxia and impaired gait. Hyperammonemia was detected in the serum. An abdominal computed tomography (CT) excluded portal hypertension and liver cirrhosis, detecting a congenital extra-hepatic porto-systemic shunt which is a highly unusual vascular malformation. The patient was treated by interventional radiologists with a successful endovascular closure.Areas CoveredWe have performed a review of the last three decades of the literature, starting from the introduction of CT scanning in common clinical practice. Eighteen studies (case reports) described 29 patients with encephalopathy secondary to hyperammonemia due to CEPS in the absence of liver cirrhosis: They underwent treatment similar to our case report of CEPS.Expert CommentaryEncephalopathy secondary to hyperammonemia in the absence of hepatic dysfunction is an important diagnostic dilemma to many clinicians. An interventional radiologic approach is currently preferred.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research

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In this study, a wireless slot-antenna integrated temperature-pressure-humidity (TPH) sensor loaded with complementary split ring resonator (CSRR) for harsh-environment applications was presented. The sensor is a multi-resonance structure with three separate resonant frequencies, which renders simultaneous measurements of temperature, pressure and humidity by placing sensitive elements in the corresponding CSRR structures. The sensitivity mechanisms for the temperature, pressure and humidity sensing are described in detail. The sensor was customized and fabricated on the high temperature co-fired ceramics (HTCC) using the ...
Source: Sensors and Actuators B: Chemical - Category: Chemistry Source Type: research
ConclusionsCT ‐guided biopsy is a safe and highly accurate diagnostic method for SCLNs.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
Authors: Wang H, Liu Z, Shen Z, Fang L, Zhang S Abstract OBJECTIVES: To identify the predictors of coronary involvement, and to determine the impact of coronary involvement on long-term outcomes in patients with Takayasu's arteritis (TAK). METHODS: This retrospective cohort study of TAK patients with coronary evaluation by angiography or computed tomography angiography was conducted in a tertiary center between 1990 and 2018. Risk factors for coronary involvement and predictors of overall survival, cardiovascular event-free survival, and relapse-free survival were investigated. RESULTS: The median follow-up...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Authors: Liegeon G, Antoni G, Pialoux G, Capitant C, Cotte L, Charreau I, Tremblay C, Cua E, Senneville E, Raffi F, Meyer L, Molina JM, ANRS-IPERGAY study group Abstract INTRODUCTION: Daily pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is associated with a small but statistically significant decrease in estimated glomerular filtration rate (eGFR). We assessed the renal safety of on-demand PrEP with TDF/FTC in HIV-1 uninfected men. METHODS: We used data from the randomized double-blind placebo-controlled ANRS-IPERGAY trial and its open-label extension conducted betwee...
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
Diagnosis, treatment &management of prosthetic valve thrombosis: the key considerations. Expert Rev Med Devices. 2020 Feb 21;: Authors: Gündüz S, Kalçık M, Gürsoy MO, Güner A, Özkan M Abstract Introduction: Prosthetic heart valve thrombosis is a life-threatening complication after valve replacement surgery. Although subtherapeutic anticoagulation is the main cause, there are many other conventional and esoteric predisposing factors.Areas covered: The etiopathogenesis, diagnosis and management of prosthetic heart valve thrombosis with particular focus on conventional...
Source: Expert Review of Medical Devices - Category: Medical Devices Tags: Expert Rev Med Devices Source Type: research
Conclusions. Among persons surviving to age 70, the cumulative incidence of AF was over 50% during follow-up. Mortality rate was twice as high in participants with AF compared to participants without AF. Among participants with AF first recorded at a screening examination, the increased risk was only 29%. PMID: 32079431 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
Authors: Zeng Q, Zhao L, Wang C, Gao M, Han X, Chen C, Tu C, Han P, Li J Abstract Background: A high prevalence of autoimmune thyroid disease (AITD) has been observed in patients with autoimmune liver disease (AILD); however, data on the clinical relationship between AILD and AITD remain scant. We aimed to evaluate the relationship between AILD and AITD.Methods: We performed a retrospective study using medical records from 324 patients with AILD, 113 of whom had concurrent AITD.Results: Patients with autoimmune hepatitis (AIH) were more likely to develop AITD (45.8%), followed by autoimmune hepatitis-primary biliar...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Publication date: September 2020Source: Materials Today Communications, Volume 24Author(s): Łukasz Byczyński, Michał Dutkiewicz, Rafał Januszewski, Paulina Wrona, Barbara Pilch - PiteraAbstractIsocyanurate containing siloxane was employed for modification of high - solid epoxy coatings based on diglycidyl ether of bisphenol A, which were cured with isophorone diamine. The structure of the samples was investigated by FTIR spectroscopy. The thermal behavior was studied by differential scanning calorimetry and thermogravimetric analysis. Hydrophobicity of coatings was determined by contact angle measurements and by calcul...
Source: Materials Today Communications - Category: Materials Science Source Type: research
Publication date: Available online 22 February 2020Source: Journal of Materials Processing TechnologyAuthor(s): Suman Chatterjee, Ankit Kumar Pandey, Siba Sankar Mahapatra, Kanwer Singh Arora, Ajit BeheraAbstractWelding of nitinol (NiTi) shape memory alloy (SMA) and titanium-based alloy (Ti6Al4V) finds potential application in aerospace and medical industries. However, joining of these materials poses challenging issues because material properties of each material interacts to give rise to hybrid system performance. In the present study, copper was used as an intermediate layer to restrict the formation of brittle intermet...
Source: Journal of Materials Processing Technology - Category: Materials Science Source Type: research
Publication date: Available online 22 February 2020Source: Journal of Materials Research and TechnologyAuthor(s): Yaokun Pan, Jingtao Wang, Hongwei Cui, Rui Feng, Benkui Gong, Xingchuan Zhao, Ning Hou, Bangran Cui, Yurong Song, Tao YangAbstractBiodegradable microarc oxidation (MAO) coatings were prepared on the Mg-2.0Zn-0.5Ca alloys treated with and without deep cryogenic treatment (DCT). Scanning electron microscope (SEM) and X-ray diffractometer (XRD) were used to characterize the coating morphology and phase composition. The electrochemical corrosion behavior was investigated using the electrochemical workstation. The e...
Source: Journal of Materials Research and Technology - Category: Materials Science Source Type: research
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