Coronary revascularization in patients with left ventricle systolic dysfunction, current challenges and clinical outcomes

Copyright: \ua9 2022 The Author(s). Published by IMR Press. This is an open access article under the CC BY 4.0 license. The effects of coronary revascularization in patients with left ventricle systolic dysfunction (LVSD) are not well studied. The decision about revascularization and its timing remain challenging, not only related to procedural risk, but also linked to other several limitations including assessment of ischemia, viability, and ability to predict LV recovery. The role of viability as a prognostic marker for patients with LVSD and its use as a therapeutic target remains debatable. In this article, we will review the role of LVSD in patients undergoing coronary revascularization alongside the role of ischemia and viability assessment. We will provide a review of the literature on the outcomes of coronary revascularization, both surgically and percutaneously, in patients with LVSD

Enhanced Recovery After Surgery (ERAS) Protocols In General Surgery: A Review Of Implementation And Outcomes

ERAS is a group of protocols that aim at affecting positively patients & surrounding lives. surgeons, nurses, physiotherapists, anesthetists, and even healthcare centers hospitals, labs, and pharmacies. Reducing the cost for both hospitals &patients, decreasing the duration of residency in hospitals, and improving patient compliance, developing performance & increasing teamwork between medical staff and patients all fall under the advantages of ERAS. Since it affects the 3 stages of any operation (preoperative-intraoperative-perioperative) it was necessary to implement a suitable protocol for each patient to achieve the best results mostly quitting smoking, fasting for a period before surgery, maintaining body temperature, pressure, and glucose level and the postoperative instructions , care & nutrition to guarantee success and avoidance to recurrence or complications

The balance between daylighting and thermal performance based on exploiting the kaleidocycle typology in hot arid climate of Aswan, Egypt

A building's facade has significant impact on energy consumption. This paper investigates a specific facade configuration based on origami: kaleidocycle rings that can be morphed to enhance daylight uniformity and reduce total energy consumed for heating and cooling. This paper utilizes simulation techniques for identifying the most efficient daylight and thermal performance by incorporating parametric optimization using Grasshopper and Diva-for-Rhino. Analysis was conducted using the Daylight Dynamic Performance Metrics (DDPMs) specifically Spatial Daylight Autonomy (sDA) and Annual Sunlight Exposure (ASE) based on the new IES approved daylight metrics. The simulation was carried out for a south-oriented facąde of an office room in Aswan, Egypt, through two phases both used genetic algorithm to drive kaleidocycle parameters. The first phase simulated daylighting for facąde optimization which influenced the second phase that run to reach the balance point between daylight and thermal performance. Results demonstrate that kaleidocycle rings of 26 cm size and 64 rotation angle exceed the LEED V4 daylighting requirements and achieve a remarkable energy saving of 23% in comparison to non-optimized configuration.</p

Management of Coronary Artery Perforation

Coronary artery perforation (CAP) is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI), however if recognized and managed promptly, its adverse consequences can be minimized. Risk factors for CAP include the use of advanced PCI technique (such as atherectomy and chronic total occlusion interventions) and treatment of severely calcified lesions. There are 3 major types of CAP depending on location: (a) large vessel perforation, (b) distal vessel perforation, and (c) collateral perforation. Large vessel perforation is usually treated with implantation of a covered stent, whereas distal and collateral vessel perforations are usually treated with coil or fat embolization. In this article we provide a state-of-the-art overview of the contemporary management of CAP

Aggressive adenoid cystic carcinoma involving palate extending to maxillary sinus in a young female

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that affects the head and neck region. It is a malignant tumor arising from minor salivary glands, palate being the most common intraoral location, usually affecting individuals of the fifth decade. This tumor generally has a slow growth rate, and it is often present for several years before the patient seeks treatment. We report a case of extensive ACC involving palate, extending to a maxillary sinus in a young lady

Modeling Novel Non-JTAG IEEE 1687-Like Architectures

International audienceMany modern devices have a very limited number of digital pins, yet they are often quite complicated internally. Such These ICs can’t afford the luxury of a traditional JTAG TAP controller and the associated 4 or 5 extra pins. Nonetheless, these devices often contain significant digital and analog content. This complexity makes testing very challenging. Moreover, IP-based design might often results in having an instrument buried deep inside a device, whose the access of which requires transitioning through multiple interfaces and controllers. This is exactly the situation DfT and test engineers face when designing and implementing tests for embedded IP. Techniques proposed for IEEE P1687.1 enable an automated mechanism for retargeting tests through a variety of non-TAP interfaces. This makes these products ideal candidates for IJTAG and IJTAG.1 test strategies.In this paper, we focus on demonstrating how on-chip test functions and IP can be successfully controlled and observed through non-TAP interfaces by controlling data flow using RVF (Relocatable Vector Format) and callbacks. This unique and novel approach ensures tool interoperability and allows tools to view model interfaces in the same way, without requiring special descriptions for each one. The paper proposes an automated tool flow for retargeting the tests and provides example implementations on several specialized designs including I2C, IEEE 1149.7, TPSP (2 pin Serial Port)an In-System TAP, IEEE 1149.7-like interface, and a security bloc

Preparation of Activated and Non-Activated Carbon from Conocarpus Pruning Waste as Low-Cost Adsorbent for Removal of Heavy Metal Ions from Aqueous Solution

Conocarpus pruning waste, an agricultural byproduct, was converted into low-cost activated and non-activated carbons and used for the remediation of Cd2+, Cu2+, and Pb2+ from aqueous solutions. The carbonization was carried out at 400 °C, while the activation was carried out in the presence of KOH and ZnCl2. Batch single-solute and multi-solute equilibrium and kinetic experiments were carried out to determine the adsorption capacities of the prepared activated and non-activated carbons, and these were further compared with commercially available activated carbon. The results showed that KOH-activated carbon (CK) outperformed the other activated and non-activated carbons in terms of adsorption efficiency. CK removed >50% of the applied Cd2+ and Cu2+ and 100% of Pb2+ at the initial concentration of 40 mg L-1. Interestingly, the performance of Conocarpus-derived non-activated carbon was better than that of the commercial activated carbon, as observed from the Langmuir maximum adsorption capacities of 65.61, 66.12, and 223.05 µmol g-1 for Cd2+, Cu2+, and Pb2+, respectively. The Pb2+ was the metal most easily removed from aqueous solution because of its large ionic radius. The kinetic dynamics were well described by the pseudo-second order and Elovich models

Complex percutaneous coronary intervention in patients unable to undergo coronary artery bypass grafting during the COVID-19 pandemic: insights from the UK-ReVasc registry

OBJECTIVES: Cardiac surgery for coronary artery disease was dramatically reduced during the first wave of the COVID-19 pandemic. Many patients with disease ordinarily treated with coronary artery bypass grafting (CABG) instead underwent percutaneous coronary intervention (PCI). We sought to describe 12-month outcomes following PCI in patients who would typically have undergone CABG. METHODS: Between March 1 and July 31, 2020, patients who received revascularization with PCI when CABG would have been the primary choice of revascularization were enrolled in the prospective, multicenter UK-ReVasc Registry. We evaluated the following major adverse cardiovascular events at 12 months: all-cause mortality, myocardial infarction, repeat revascularization, stroke, major bleeding, and stent thrombosis. RESULTS: A total of 215 patients were enrolled across 45 PCI centers in the United Kingdom. Twelve-month follow up data were obtained for 97% of the cases. There were 9 deaths (4.3%), 5 myocardial infarctions (2.4%), 12 repeat revascularizations (5.7%), 1 stroke (0.5%), 3 major bleeds (1.4%), and no cases of stent thrombosis. No difference in the primary endpoint was observed between patients who received complete vs incomplete revascularization (residual SYNTAX score £ 8 vs > 8) (P = .22). CONCLUSIONS: In patients with patterns of coronary disease in whom CABG would have been the primary therapeutic choice outside of the pandemic, PCI was associated with acceptable outcomes at 12 months of follow-up. Contemporary randomized trials that compare PCI to CABG in such patient cohorts may be warranted