The year 2017 in cardiology : aorta and peripheral circulation

Peer reviewe

Risks for Peripheral Arterial Disease in the Elderly with Type 2 Diabetes Mellitus : Their Correlation with High Sensitivity C-reactive Protein and Ankle-brachial Index

The Indonesian elderly population has been projected to increase up to about four-fold inthree decades (1990-2020). As a consequence of this population trend, the increased prevalence ofdegenerative diseases would be inevitable; this would include the prevalence of peripheral arterialdisease.This study aims to identify the correlation of diverse risk factors, either traditional or nontraditional,with the ankle-brachial index scores, and the correlation of novel non-traditional riskfactor, e.i. high sensitive C-reactive protein with the prevalence of perioheral arterial disease in theelderly, age 60-80 years old, with type 2 diabetes mellitus.Among the 146 elderly patients with type 2 diabetes mellitus, and based on measurement ofthe ABI score, approximately 30.9% of them had PAD. Some traditional and non-traditional riskfactors having a significant correlation with the ankle-brachial index score, were age (r = -0.396, p <0.001 for right ABI; r = -0.509, p < 0.001 for left ABI), supine systolic blood pressure (r= -0.268, p =0.012 for right ABI; r = -0.267, p = 0.013 for left ABI), 2-hour post-prandial blood glucose (r= -0.252, p = 0.018 for right ABI), and hsCRP (r = -0.280, p = 0.011 for right ABI; r = -0.402, p <0.001 for left ABI); whereas other risk factors like obesity based on waist circumference and BMI,non-supine systolic blood pressure, fasting blood glucose, HbA1C, duration of diabetes, plasma lipidsdid not show statistically significant different odd ratios. After linear regression test for risk factorshaving significant correlations with ABI, age and hsCRP were found to influence the ABI scores.Based on a case-control study, risk factors which, to some extent, had statistically significant valuesas risk factors, include older age (? 70 years old; OR = 7.737 [CI = 2.515-23.805]; p < 0.001),relatively high supine diastolic blood pressure (? 90 mmHg; OR = 6.882 [CI = 0.789-60.060]; p =0.048), and high concentration of hsCRP (> 3 mg/L; OR = 4.420 [CI = 1.287-15.181]; p = 0.013).Among these statistically significant risk factors, after logistic regression test analysis, only the age ofthe patient appeared to have significant influence on the prevalence of PAD.In conclusion, this study demonstrates a negative correlation between hsCRP and ABI score;and high levels of hsCRP appeared to be a risk factor for PAD. The age of the patient, however,appeared to be the strongest risk factor for PAD

A review on the investigation of peripheral neuropathy at Mater Dei Hospital

The term peripheral neuropathy encompasses a wide range of disorders. The underlying causes of peripheral neuropathy are diverse. It is very difficult to ascertain the incidence of peripheral neuropathy with any degree of certainty, but it is a manifestation of several common multisystem disorders, whose incidence is on the rise, such as diabetes and Human Immunodeficiency (HIV) virus infection. Worldwide, the population prevalence is about 2,400 per 100,000 (2.4%), rising with age to 8,000 per 100,000 (8%).1 Peripheral neuropathy can significantly impact an individual's quality of life especially if undiagnosed and untreated. Investigation of peripheral neuropathy is expensive and time consuming, and is best performed in a stepwise approach. Even in the best of circumstances, an aetiological diagnosis is not always achieved. At present, the existing guidelines deal with the treatment of peripheral neuropathy but there are none on how patients with peripheral neuropathy should be investigated.peer-reviewe

Digital interface for bi-directional communication between a computer and a peripheral device

For transmission of data from the computer to the peripheral, the computer initially clears a flipflop which provides a select signal to a multiplexer. A data available signal or data strobe signal is produced while tht data is being provided to the interface. Setting of the flipflop causes a gate to provide to the peripherial a signal indicating that the interface has data available for transmission. The peripheral provides an acknowledge or strobe signal to transfer the data to the peripheral. For transmission of data from the peripheral to the computer, the computer presents the initially cleared flipflop. A data request signal from the peripheral indicates that the peripheral has data available for transmission to the computer. An acknowledge signal indicates that the interface is ready to receive data from the peripheral and to strobe that data into the interface

Peripheral Interaction for Sports - Exploring Two Modalities for Real-Time Feedback

We believe that sports is a domain that would both provide valuable input to the area of peripheral interaction, as well as benefit from peripheral interaction itself. We present two pilot studies on peripheral interaction for cross-country skiing and golf using vibration feedback and audio feedback respectively. We believe the results of these initial studies are encouraging and aim to pursue the concept of peripheral interaction for the sports domain

Peripheral Ossifying Fibroma

Peripheral ossifying fibroma is a relatively uncommon gingival growth that is considered to be reactive in nature and postulated to appear secondary to irritation or trauma. They usually occur in young adults with a female predominance and are solitary in nature. We report a case of peripheral ossifying fibroma in a 55-year old femal

Ultrasound Guided Placement of Single-Lumen Peripheral Intravenous Catheters in the Internal Jugular Vein

Introduction: The peripheral internal jugular (IJ), also called the “easy IJ,” is an alternative to peripheral venous access reserved for patients with difficult intravenous (IV) access. The procedure involves placing a single-lumen catheter in the IJ vein under ultrasound (US) guidance. As this technique is relatively new, the details regarding the ease of the procedure, how exactly it should be performed, and the safety of the procedure are uncertain. Our primary objective was to determine the success rate for peripheral IJ placement. Secondarily, we evaluated the time needed to complete the procedure and assessed for complications. Methods: This was a prospective, single-center study of US-guided peripheral IJ placement using a 2.5-inch, 18-gauge catheter on a convenience sample of patients with at least two unsuccessful attempts at peripheral IV placement by nursing staff. Peripheral IJ lines were placed by emergency medicine (EM) attending physicians and EM residents who had completed at least five IJ central lines. All physicians who placed lines for the study watched a 15-minute lecture about peripheral IJ technique. A research assistant monitored each line to assess for complications until the patient was discharged. Results: We successfully placed a peripheral IJ in 34 of 35 enrolled patients (97.1%). The median number of attempts required for successful cannulation was one (interquartile range (IQR): 1 to 2). The median time to successful line placement was 3 minutes and 6 seconds (IQR: 59 seconds to 4 minutes and 14 seconds). Two lines failed after placement, and one of the 34 successfully placed peripheral IJ lines (2.9%) had a complication – a local hematoma. There were, however, no arterial punctures or pneumothoraces. Although only eight of 34 lines were placed using sterile attire, there were no line infections. Conclusion: Our research adds to the growing body of evidence supporting US-guided peripheral internal jugular access as a safe and convenient procedure alternative for patients who have difficult IV access

Dysregulation of NAD+ metabolism induces a Schwann cell dedifferentiation program

The Schwann cell (SC) is the major component of the peripheral nervous system (PNS) that provides metabolic and functional support for peripheral axons. The emerging roles of SC mitochondrial function for PNS development and axonal stability indicate the importance of SC metabolism in nerve function and in peripheral neuropathies associated with metabolic disorders. Nicotinamide adenine dinucleotide (NA