The diagnostic approach and management of hypertension in the emergency department

Hypertension urgency and emergency represents a challenging condition in which clinicians should determine the assessment and/or treatment of these patients. Whether the elevation of blood pressure (BP) levels is temporary, in need of treatment, or reflects a chronic hypertensive state is not always easy to unravel. Unfortunately, current guidelines provide few recommendations concerning the diagnostic approach and treatment of emergency department patients presenting with severe hypertension. Target organ damage determines: the timeframe in which BP should be lowered, target BP levels as well as the drug of choice to use. It's important to distinguish hypertensive emergency from hypertensive urgency, usually a benign condition that requires more likely an outpatient visit and treatment

Percutaneous Catheter Dilatation of Benign Ureteroenteric Anastomotic Strictures Followed or not by Retrograde Transconduit Placement of a Catheter: Long Term Results

BACKGROUND: We report our experience on multiple balloon dilatations for benign ureteroenteric anastomotic strictures after total cystectomy and urinal deviation by ileal conduit, followed or not by retrograde placement of a permanent catheter through the stoma of the ileal conduit. PATIENTS AND METHODS: Patients were classified in two groups: Group A included patients treated only by multiple balloon dilatations and Group B patients in whom multiple dilatations were followed by retrograde insertion of a permanent catheter through the stoma of the ileal conduit, which then had to be replaced regularly. Records of survival and patency rates were recorded. RESULTS: Twenty patients with 24 benign ureteroenteric anastomotic strictures referred to radiology department. Long-term results were available in only 15 patients, who finally included in the study. In Group A long term follow-up was achieved in five patients. Mean primary patency time of stenoses (interval between initial dilatation and recurrence) was 33.2 months. This time-period proved to be the same as the survival time of Group A patients, since all five patients eventually succumbed to the underlying disease or other reasons. In Group B, 6 patients are still alive and 4 patients eventually succumbed to the underlying disease or other reasons. Mean primary patency time of stenoses was 38.1 months. CONCLUSIONS: Balloon dilatations of benign ureteroenteric anastomotic strictures, due to radical cystectomy and urinal deviation by ileal conduit, were technically successful in all cases. Patency rate was comparable in the two study groups. However, regular catheter replacement through the ileal conduit is well tolerated and gives a sense of security to both patient and physician

Exercise Capacity and All-Cause Mortality in African American and Caucasian Men With Type 2 Diabetes

OBJECTIVE - The purpose of this study was to assess the association between exercise capacity and mortality in African Americans and Caucasians with type 2 diabetes and to explore racial differences regarding this relationship. RESEARCH DESIGN AND METHODS - African American (n = 1,703; aged 60 ± 10 years) and Caucasian (n = 1,445; aged 62 ± 10 years) men with type 2 diabetes completed a maximal exercise test between 1986 and 2007 at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, California. Three fitness categories were established (low-, moderate-, and high-fit) based on peak METs achieved. Subjects were followed for all-cause mortality for 7.3 ± 4.7 years. RESULTS - The adjusted mortality risk was 23% higher in African Americans than in Caucasians (hazard ratio 1.23 [95% CI 1.1-1.4]). A graded reduction in mortality risk was noted with increased exercise capacity for both races. There was a significant interaction between race and METs (P \u3c 0.001) and among race and fitness categories (P \u3c 0.001). The association was stronger for Caucasians. Each 1-MET increase in exercise capacity yielded a 19% lower risk for Caucasians and 14% for African Americans (P \u3c 0.001). Similarly, the risk was 43% lower (0.57 [0.44- 0.73]) for moderate-fit and 67% lower (0.33 [0.22-0.48]) for high-fit Caucasians. The comparable reductions in African Americans were 34% (0.66 [0.55-0.80]) and 46% (0.54 [0.39-0.73]), respectively. CONCLUSIONS - Exercise capacity is a strong predictor of all-cause mortality in African American and Caucasian men with type 2 diabetes. The exercise capacity-related reduction in mortality appears to be stronger and more graded for Caucasians than for African Americans. © 2009 by the American Diabetes Association

Finding Semantically Related Videos in Closed Collections

Modern newsroom tools offer advanced functionality for automatic and semi-automatic content collection from the web and social media sources to accompany news stories. However, the content collected in this way often tends to be unstructured and may include irrelevant items. An important step in the verification process is to organize this content, both with respect to what it shows, and with respect to its origin. This chapter presents our efforts in this direction, which resulted in two components. One aims to detect semantic concepts in video shots, to help annotation and organization of content collections. We implement a system based on deep learning, featuring a number of advances and adaptations of existing algorithms to increase performance for the task. The other component aims to detect logos in videos in order to identify their provenance. We present our progress from a keypoint-based detection system to a system based on deep learning

Detecting Manipulations in Video

This chapter presents the techniques researched and developed within InVID for the forensic analysis of videos, and the detection and localization of forgeries within User-Generated Videos (UGVs). Following an overview of state-of-the-art video tampering detection techniques, we observed that the bulk of current research is mainly dedicated to frame-based tampering analysis or encoding-based inconsistency characterization. We built upon this existing research, by designing forensics filters aimed to highlight any traces left behind by video tampering, with a focus on identifying disruptions in the temporal aspects of a video. As for many other data analysis domains, deep neural networks show very promising results in tampering detection as well. Thus, following the development of a number of analysis filters aimed to help human users in highlighting inconsistencies in video content, we proceeded to develop a deep learning approach aimed to analyze the outputs of these forensics filters and automatically detect tampered videos. In this chapter, we present our survey of the state of the art with respect to its relevance to the goals of InVID, the forensics filters we developed and their potential role in localizing video forgeries, as well as our deep learning approach for automatic tampering detection. We present experimental results on benchmark and real-world data, and analyze the results. We observe that the proposed method yields promising results compared to the state of the art, especially with respect to the algorithm’s ability to generalize to unknown data taken from the real world. We conclude with the research directions that our work in InVID has opened for the future

Molecular Mechanisms Associated with Nicotine Pharmacology and Dependence.

Tobacco dependence is a leading cause of preventable disease and death worldwide. Nicotine, the main psychoactive component in tobacco cigarettes, has also been garnering increased popularity in its vaporized form, as derived from e-cigarette devices. Thus, an understanding of the molecular mechanisms underlying nicotine pharmacology and dependence is required to ascertain novel approaches to treat drug dependence. In this chapter, we review the field's current understanding of nicotine's actions in the brain, the neurocircuitry underlying drug dependence, factors that modulate the function of nicotinic acetylcholine receptors, and the role of specific genes in mitigating the vulnerability to develop nicotine dependence. In addition to nicotine's direct actions in the brain, other constituents in nicotine and tobacco products have also been found to alter drug use, and thus, evidence is provided to highlight this issue. Finally, currently available pharmacotherapeutic strategies are discussed, along with an outlook for future therapeutic directions to achieve to the goal of long-term nicotine cessation