Proud to share our educational support of the next generation of medical students

Rajasinghe Foundation for Vascular Research and Education Foundarion proud to support the next generation of physicians through scholarships at Duke University School of Medicine.

Here is a testimonial we would like to share

“My name is Christopher Calixte and I want personally thank you for the Rajasinghe Vascular Research scholarship I received recently. This means a lot to me especially considering my humble upbringing. I was born in Flatbush, Brooklyn that was riddled with crime and socioeconomic distress. Thankfully I have two loving parents whom are immigrants from Haiti that always reminded that my education should be my top priority. Though education always came first I balanced it with sports all the way through high school.”

 

Letter-Christopher

 

We are very happy to provide this kind of impact by bringing educational support to the next generation of medical students.

Help to change lives for the better, forever! Support Rally For Littles

Big Brothers Big Sisters of the Sun Coast – Rally for Littles is an event that will take place this December 15th, 2018.

Big Brothers Big Sisters of the Sun Coast holds itself accountable for children in its program to achieve measurable outcomes, such as educational success; avoidance of risky behaviors; and higher aspirations, greater confidence and better relationships. The organization provides children facing adversity, often those of single or low-income households or families with strong and enduring, professionally supported one-to-one mentoring relationships that change their lives for the better, forever.

 

You can help by voting (with a donation) for your favorite car.

The order of cars in the rally will be determined by your donations.

Dr. Hiranya Rajasinghe will be driving car number 113. A magnificent Grey Ferrari 488 GTB.

You can support his car by making your donation on this link:

https://one.bidpal.net/rally4littles/browse/donation(details:item/15)

Come out for a great day of food, exotic cars, silent auction and prizes at our Rally For Littles.

Announcing The Manora Elizabeth Panthiage Jayatilleke Fund at Yale University

In memory of Manora Elizabeth Jayatilleke, 1942 – 2018

1942 – 2018, Mrs. Manora Elizabeth Jayatilleke

 

The Rajasinghe Vascular Research and Education Foundation announces the establishment of the Manora Elizabeth Panthiage Jayatilleke Fund at Yale University to help support undergraduate science research particularly for disadvantaged minorities and women as part of the STARS Fellowship Program.

You can check more abouth the program here: https://science.yalecollege.yale.edu/stars

Manora Elizabeth Jayatilleke was a career woman scientist, mentor, and loving mother.

She earned her Bachelor of Science degree at University of Ceylon, Colombo (Sri Lanka) and Masters in Science at Columbia University, New York City (USA).

Her research focused on the biochemistry of liver and alcohol disease at the Bronx VA Hospital, Mount Sinai School of Medicine for over 25 years. She is survived by her three children Arundathi Jayatilleke MD, Ruwan Jayatilleke, and Hiranya A. Rajasinghe MD who are the donors of the endowed fellowship.

Abdominal Aortic Aneurysm Treatment & Medical Management

What is Abdominal Aortic Aneurysm?

“When we talk about Abdominal Aortic Aneurysm Treatment, try to picture the lower part of your aorta getting bigger and bigger. It if grows too much, then the risk of a rupture increases, and the level of danger is higher.

Your life could be in danger and measures need to be taken.

Professional measures in this case, as in any medical case.

An aneurysm takes place when plaques build up inside artery walls. With age these plaques appear more often, affecting the levels of oxygenated blood that are transported to every single part of your body.

Signs and Symptoms

An aneurysm can grow at a very slow rate, without showing any signs over time. Most are spotted on a checkout with your trusted health professional.

If there is a problem, then you will experience any or several these symptoms:

  • A sharp pain in your chest, abdomen or lower back. This uncomfortable sensation can lasts several hours or days. The pain could span through buttocks or legs.
  • A toe turns black or, maybe, blue.
  • You notice your skin is kind of sweaty
  • You start to feel dizzy or weak
  • Your heart rate increases dramatically
  • Vomit

 

Diagnosis

As in everything related with health, the sooner a diagnosis is done, the better.

The Vascular Group of Naples is an institution that advocates for the use of the best technology available.

These are some of the terms you will find more often:

  • Angiogram: this is the most used term in the field when it comes to diagnose an aneurysm. During an X-Ray procedure, blood clots are exposed thanks to a catheter.
  • Abdominal Ultrasound: This procedure allows the physician to have a clear “picture”, thanks to sound waves that go through body tissue located in the abdomen.
  • CT Scan: Here, a bigger picture is taken, in the sense that images are created not only of the abdomen, as with the Abdominal Ultrasound, but the aorta, heart and blood vessels.
  • MRI (Magnetic Resonance Imaging): This is a big piece of equipment, a magnet to be more precise. Computerized images of heart and vessels are created in a very detailed way.

 

Causes

Most of the causes are related with one thing: your lifestyle.

To be more specific, you avoid it by having a healthy lifestyle.

Chances of suffering an Aneurysm are higher if you are overweight, if your diet includes foods with high presence of fat or if you smoke on a regular basis.

There are also other causes that are not under your control like infections on the aorta or high blood pressure.

Risk Factors

Other risk factors that are out of your control are:

  • If you are over 65 years old.
  • Men have a higher propensity to suffer an abdominal aneurysm.
  • Genes play a role here as well, if there is history in your family, there are a chances of having an aneurysm at a younger age.

Prevention

Even there are some factors that you cannot control directly, there are activities that can help you prevent an aneurysm, and most diseases, just by using a daily discipline:

  • Heart health: stay away from cigarettes. In general, avoid smoking.
  • Medication: if you have being diagnosed and are require taking your medication, try to follow your physician instructions as much as you can.
  • Screening test: to be more certain, scheduled an ultrasound with your physician. It helps to spot any kind of problem right away.

 

Initial Management

Going into more detail, if you are diagnose, this is an overview of how the procedure will be:

– Prehospital care

As with any health procedure, paying attention to details is critical.

You can visualize prehospital care as follows:

  • Breathing is highly important, that is why our professionals makes sure that you don´t have any problem by maintaining a proper oxygenation all the time.
  • The physician in charge may ask some question to know more about the history of the patient.
  • As in any hospital procedure, the patient vital signs will be monitored upon arrival or while on route to the hospital in an ambulance.
  • The physician must pay attention to any symptom that might indicate that the patient could suffer a shock during the intervention.

 

– Emergency department care

When conditions mandate that the patient needs surgical intervention, all the equipment and procedures are set up to deal with things like: hemorrhagic shock, which are dealt with blood transfusions and surgery.

The clinicians must be aware of sudden changes in blood pressure.

Options for Surgical Intervention

Over the last 50 years there have been 2 established procedures:

–          Open Repair

Open repair of AAA has a survival rate of 96%. Cardiac risk is reduced thanks to constant cardiac investigations and beta blockade.

Laboratory assessment is one of the first steps that need to be performed as well as a careful examination of the patient history and amplification on some details the clinician might consider of high importance.

Patient current lifestyle needs to be carefully examined to spot possible mental and physical deterioration.

All risk factors are listed and taken in consideration.

–          Endovascular Repair

Also known as EVAR, has become, over the last 30 years, into a wide alternative to Open Repair.

Its minimal invasive techniques and lower preoperative risks made this one of the most used procedures. It has extended, even to elder population.

EVAR consist in accessing the abdominal aorta via small incisions over the femoral vessels.

An endograft is placed within the lumen of the AAA.

Think of these grafts as protection that decreases the pressure of the walls. This way, the risk of aortic rupture is lowered.

Consultations

The support of a radiologist is mandatory to determine if ultrasonography or Magnetic Resonance Imaging.

If the abdominal aorta exceeds a diameter of 3 cm there must be a follow-up with a vascular surgeon.

Over 4 cm a surgical repair is the best approach.

As in any surgery, anesthesia is required along with the necessary personnel to perform a successful surgery.

All professional health assessment needs to be done with precision and quality standards must be followed.

Complications

If it is too late and the AAA is not diagnosed, these problems may arise:

  • Rupture: there is only a 20% survival rate in an emergency situation. Remember that the aorta supplies most of the blood to the body. That´s why is so critical.
  • Blood clots: that bloods flows through the body without any restriction is vital. That´s why a block on any blood vessel can cause troubles.

 

Aneurysm Terminology

Aneurysm Definition: for adult patients, a diameter bigger than 3 cm, is considered aneurysmal.

Less than 4.0 cm, we talk about small aneurysms.

Between 4.0 cm and 5.5 cm we talk about medium aneurysms.

Larger than 5.5 cm, are called larger aneurysms.

An expansion larger than 5.0 cm in a period of 6 months increases the risks.

Aneurysm Repair

Elective AAA repair is not recommended until the risk of rupture exceeds the risks associated with repair. This is a critical point where professional decisions are needed.

Other factors are very important to be considered: the presence of a coexistent peripheral artery disease. Diseases such as: iliac aneurysm and femoral aneurysm.

Observations are key when talking about conservative management. These procedures include clinical evaluation and AAA surveillance

Medical Risk Assessment

As physicians, we look for perioperative complications such as: coronary ischemia, arrhythmias or pneumonia.

Patients with smoking history need a closer observation, since the risk factors are more much higher and there are correlated with other diseases.

Conservative Management

As an accepted rule, AAA smaller than 5.5 cm need to be managed in a more conservative way.

Potentially Beneficial Therapies:

  • Stop smoking: aneurysm is a word with high chances of being mentioned on a regular smoker record.

It is on the patient´s will and discipline to control this behavior. More than control it, it is best to eliminate it definitely.

  • Physical activity: a daily physical activity is a must for patients diagnose with AAA, this a fact accepted not only in the medical community but in society in general.

Moderated physical activity is the first step. It is best if these activities are monitored by a health professional. Otherwise, the risks will be others. Moderation is best.

Professional recommendation also applies for a proper diet.

Statistics

In the paper “Epidemiology of Aortic Aneurysm Repair in the United States from 1993 to 2003”, it is stated that AAA has been described in the medical community over the last 50 years.

To spot trends in mortality, samples were taken between 1993 and 2003 in the United States.

These are their results:

“Overall rates of treated unruptured and ruptured AAAs remained stable (unruptured 12 to 15/100,000; ruptured 1 to 3/100,000). In 2003, 42.7% of unruptured and 8.8% of ruptured AAAs were repaired through an endovascular approach. Inhospital mortality following unruptured AAA repair continues to decline for open repair (5.3% to 4.7%, P = 0.007).

Mortality after elective endovascular AAA repair also has statistically decreased (2.1% to 1.0%, P =0.024) and remains lower than open repair.

Mortality rates for ruptured AAAs following repair remain high (open: 46.5% to 40.7%, P = 0.01; endovascular: 40.0% to 35.3%, P =0.823).”

This shows certain level of stability for patients treated with elective is Abdominal Aortic Aneurysm, although there is a change in the treatment paradigm where there is a preference for elective endovascular AAA repair.

My Social Media Profiles

To avoid any kind of misrepresentation regarding my name I want my patients to know which my official social media profiles are:

Doximity: one of the biggest healthcare professionals network in the country.

Youtube: I use this network to upload videos with patient testimonials about new procedures.

Dailymotion: This is another video social network I use to share some videos about my practice.

Linkedin: The greatest professional network in the world. I use it to keep in touch with colleagues.

Researchgate: I use this platform to upload many of my academic papers.

DevianArt: I like this network to keep track of beautiful images.

Academia: This is another network I use to upload some research papers.

Tumblr: this is an old blogging account I opened long ago, but I like to keep track of it.

Crunchbase: this is another business network I like to keep track of.

Facebook: this is my official account for the biggest social network in the world.

Onlineprnews: Press release service I use in different occasions.

Soundcloud: This is a profile I opened to enjoy some relaxing tracks.

Naymz: social media reputation management tool.

I will keep updating new profiles on different social networks as they are created.

 

 

Types of Vascular Tests

If you are researching about vascular diseases, chances are that you are interested in the different tests associated with them.

These are the most common test:

Angiogram:

I already made a post about what is an Angiogram. In summary, it can serve well as a diagnostic procedure and as a therapeutic procedure.

By making use of X-Rays it helps your surgeon to decide the best treatment options.

Sedation is usually necessary so be sure to let know your surgeon about your allergies and if you have history with anesthesia.

Ankle-Brachial Index or ABI Test:

Also known as Segmental Pressure Test, Toe Pressure Test, Toe-Brachial Index (TBI)

But, besides the names, what you need to know is that this is a non-invasive test that make use of inflatable cuffs to gauge circulation and to check how is the blood pressure in arteries located in different parts of the body.

This test rarely present complications. The presence of side effects are very rare.

To give as much as information as possible to the technician is strongly advice.

Ask your surgeon about what is the proper clothing you need to bring for more comfort.

Carotid Duplex:

This test focused on the carotid arteries to spot possible blood blockages.

This is a painless and non-invasive procedure that can be performed in any well equipped facility.

Risks in this test are very low.

In 2-3 days the report with the results are ready to be delivered.

Computed Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA) Tests:

These tests make use of advance technology by making use of images to provide visual information about the current state of the blood vessels and to spot potential issues.

As a result the vascular surgeon has more information about the disease and how to proceed.

Duplex Ultrasound:

Ultrasounds help the vascular surgeon to make an evaluation of the actual state of the blood flow both in arteries and veins.

Unlike other tests, since precision is mandatory, this must be carry on a well-equipped vascular laboratory and a well prepared professional in the field.

In all these tests, ask your vascular surgeon for guidance and advice on how to prepare yourself before the procedure is performed.

How to Spot Peripheral Aneurysms Symptoms

Peripheral Aneurysms Symptoms

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

You might be worry of having an aneurysms and that is why you reach my website. Maybe by searching for Peripheral Aneurysms Symptoms on Google.

Well, let me enlighten you as best as I can.

First, you need to know that there an aneurysms occur in the aorta. It can be the thoracic aorta or the abdominal aorta.

When we talk about a peripheral aneurysm, we are talking about affections in arteries other than the aorta.

The area with the higher chances of suffering this kind of aneurism is in the popliteal artery. This is located in the area in the back of the lower thigh and knee.

Also, it happens that if you are diagnosed with peripheral aneurysm in one leg, it is very likely that you also have the same condition in your other leg.

This are the peripheral aneurysms symptoms you need to watch out:

You need to know that 65% of patients might not notice any physical symptom.

If that is not your case or you are suspicious, and depending of their location, you might have experimented something similar to:

  • A lump you feel pulsating
  • After performing a physical activity, you feel leg or arm pain
  • While resting, you experience leg or arm pain
  • Sudden pain in toes or fingers
  • Numbness in your arms or legs
  • In an extreme case, gangrene or death tissue.

There is the risk of a stroke if the carotid artery is involve.

Now, hopefully, you are not suffering any of this symptoms. But you might be interested in know what causes a peripheral aneurism.

There isn´t certainty about a definitive cause.

Several researches link this condition to atherosclerosis. As our bodies age, your arteries narrow and get weaker. It is a natural process.

What you can do is to watch out not to speed up the process. How you might be wondering?

Just stay away from the following:

  • High levels of cholesterol
  • Smoking
  • High levels of blood pressure
  • Obesity
  • Your family history

I hope you have now a clear picture of how to spot peripheral aneurysms symptoms.

If after reading this info you think you might be suffering peripheral aneurysm, don´t hesitate and go to visit your most trusted physician.

For deeper information, I recommend to visit VascularWeb.org 

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