| Authors: |
Gabriela M. Galan OMS-III, Andrew D. Vogel OMS-III, T. Konrad Rajab MD |
| Abstract: |
Marfan syndrome is named after Antoine Marfan, who described a 5-year-old child with congenital elongation of the digits and other skeletal abnormalities in 1896. While Marfan syndrome is a systemic connective tissue disorder predominantly involving the skeletal, cardiovascular, and ocular systems, the cardiovascular system presents the most life-threatening complications. Most cardiovascular pathologies surround the left ventricular outflow tract and aorta with aortic dissection requiring emergent surgical management to the progression of mitral regurgitation requiring elective surgery. Intensive care management along with a tailored approach to the surgical management of a patient with Marfan syndrome is critical to their survival. Current surgical operations for patients include aortic root surgery, valve sparing root replacements, aortic root replacements with conduits, and mitral valve repairs. Further research is necessary to determine the molecular, endovascular, pharmaceutical, and surgical management of Marfan syndrome. This review attempts to concisely discuss the diagnosis, complications, medical and intensive care management of Marfan Syndrome while further divulging on the surgical management of those with this disease process. |
| Authors: |
Rebecca Suk, M.S., OMS-II, Andrew D. Vogel, M.S., OMS-III, Christa Haran, M.S., OMS-II, Patrick G. Dickinson, OMS-III, Kelvin G.M. Brockbank, Ph.D., T. Konrad Rajab, M.D. |
| Abstract: |
Cryopreservation traditionally relies on conventional freezing, employing cryoprotective agents and slow cooling to sub-zero temperatures, but it's plagued by ice crystal formation damaging tissues and organs upon thawing. Ice-free vitrification utilizes specialized cryoprotectants, preserving tissues and organs in an ice crystal-free, glassy state, halting biological activity, and maintaining structural fidelity. Precise cooling and warming rates are critical for successful vitrification. Nanowarming is an emerging method, utilizing nanoscale energy applications for controlled rapid rewarming. This technique is applicable to tissues like osteochondral tissues, blood vessels, small organs, and heart valves for transplantation. By employing magnetic nanoparticles and inductive heating within a magnetic field, nanowarming minimizes thermal stress, prevents ice formation, and enhances the chances of restoring functionality. These innovations have the potential to revolutionize organ transplantation, addressing organ scarcity and extending preservation duration. They also hold promise in regenerative medicine for storing and transplanting stem cells and engineered tissues, aiding tissue repair and replacement. While ice-free vitrification and nanowarming show remarkable potential, they are still in early development. Challenges include scalability, optimizing cryoprotectant solutions, and ensuring long-term viability upon rewarming. Further interdisciplinary research must be dedicated to exploring this innovative method that could revolutionize organ transplantation. |
| Authors: | Rija Zehra MPH, MBBS, Emmanuel Tangco MD, Syed Fatmi MD |
| Abstract: | GLP-1 receptor agonists (GLP1 RA) have been employed in clinical practice for the management of DM since its initial approval in 2005. This class of medication now has become a multimodal modality for DM and weight loss but also plays an integral role as part of GDMT with overall mortality benefits. Despite significant benefits, several common adverse effects vary from nausea, vomiting, headaches, and dizziness, with some severe but rare side effects including pancreatitis, AKI, and its reported association with thyroid cancer; the association has been reported exclusively with the use of liraglutide and exenatide. We reviewed several clinical trials (CT) and studies relating to GLP1 RA and their risk association with thyroid cancer. In an animal experimental study, the use of liraglutide activated the GLP1 receptors on C-cells causing an increase in the incidence of C-cell neoplasia. Another study exhibited no C-cell proliferation or calcitonin release after the use of liraglutide. Similarly, in a longitudinal 2-year human CT, data did not demonstrate any significant risk for either activation or growth of C-cell cancer in response to liraglutide. On the contrary, an observational case-control study performed utilizing a French database, established an increased risk of all thyroid cancers with 1-3 years of GLP-1 RA use. While there are varied conclusions from different studies, there is clear evidence of GLP-1 receptor expression in papillary thyroid cancer cells, therefore it is imperative to further investigate its actions on different types of thyroid cancers, as research continues to evolve with this treatment modality. |