45 research outputs found

    A SIMULATION MODEL FOR MANAGING PARAMETERS OF INTELLIGENT SECURITY SYSTEM

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    Security systems are the guarantee of stable functioning of the organization, company, office, industry, housing and other types of buildings. For entire security, complex control devices are set on the building which has to be protected, like fire and burglar alarms, video-audio controls and access systems. Intelligent Security Management System is built on Atmel’s microcontrollers. This allows the system to be flexible and to modify it easily if needed. The reliability of the security system depends on its uniqueness. This given security system is easily modified and hence its reliability is high. The system can be easily integrated into a variety of external modules, which can further increase the factor of reliability. It’s also easy to adopt it to various security management systems. Many of the security and video surveillance systems allow to control the situation of the object from a large distance. From any point of the planet, we can track and manage the security system modes and make easy changes in them, which enable adequate reaction.Digital complexes of video surveillance are one of the variants of defense organization. The main areas of their use are the most important objects and large areas where buildings are located far from each other.Security systems are the guarantee of stable functioning of the organization, company, office, industry, housing and other types of buildings. For entire security, complex control devices are set on the building which has to be protected, like fire and burglar alarms, video-audio controls and access systems. Intelligent Security Management System is built on Atmel’s microcontrollers. This allows the system to be flexible and to modify it easily if needed. The reliability of the security system depends on its uniqueness. This given security system is easily modified and hence its reliability is high. The system can be easily integrated into a variety of external modules, which can further increase the factor of reliability. It’s also easy to adopt it to various security management systems. Many of the security and video surveillance systems allow to control the situation of the object from a large distance. From any point of the planet, we can track and manage the security system modes and make easy changes in them, which enable adequate reaction.Digital complexes of video surveillance are one of the variants of defense organization. The main areas of their use are the most important objects and large areas where buildings are located far from each other

    Outcomes of Laparotomic Myomectomy during Pregnancy for Symptomatic Uterine Fibroids: A Prospective Cohort Study

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    Background: The incidence of pregnant women with uterine fibroids is increasing. As they are reactive to hormonal stimuli, in some cases, uterine fibroids tend to grow during pregnancy and potentially generate symptoms with different levels of severity, causing maternal-fetal complications. In very select cases, when other treatment strategies fail to manage symptoms and there is a substantial risk of adverse pregnancy outcomes, a surgical approach during pregnancy may be considered. Methods: From 2016 to 2021, the data from 28 pregnant women with symptomatic uterine fibroids who underwent laparotomic myomectomy during pregnancy were prospectively collected, and operative and maternal-fetal outcomes were analyzed (ClinicalTrial ID: NCT06009562). Results: The procedure was carried out between 14 and 16 weeks of pregnancy. Four (14.3%) patients had intraoperative complications (miscarriages) and nine (32.1%) had postoperative complications (threatened preterm birth). Overall, 24 (85.7%) women delivered at full term (mean: 38.2 gestational weeks), more than half (n = 13; 54.2%) by vaginal delivery, with normal fetal weights and 1 and 5 min Apgar scores. Conclusions: Laparotomic myomectomy during pregnancy can be considered in selected cases for uterine fibroids with severe symptoms when other treatment options have failed and there is high risk of adverse maternal-fetal outcomes

    Дистальный лучевой доступ: есть ли клиническая выгода?

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    For decades, the femoral artery has been the most common access for diagnostic and therapeutic endovascular operations. However, over the past 20 years, radial access has been gaining popularity as being safer and more practical with more significant benefits. Recently, the new distal radial access has proven to be equal or perhaps even safer than the vascular access for diagnostic and therapeutic coronary and non-coronary interventions. Today, this access should be in the arsenal of every interventional surgeon.На протяжении десятилетий бедренная артерия была наиболее частым доступом при проведении диагностических и лечебных эндоваскулярных операций. Однако последние 20 лет радиальный доступ набирает популярность как более безопасный и практичный со значительным количеством преимуществ. В последнее время новый дистальный радиальный доступ оказался равным или возможно даже более безопасным сосудистым доступом для диагностических и лечебных коронарных и некоронарных вмешательств. На сегодняшний день этот доступ должен быть в арсенале каждого интервенционного хирурга

    Global Chronic Total Occlusion Crossing Algorithm

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    The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.info:eu-repo/semantics/publishedVersio

    Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review

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    The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration

    Lessons Learned After 760 Neurointerventions via the Upper Extremity Vasculature: Pearls and Pitfalls.

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    BACKGROUND: The radial approach has been gaining more widespread use by neurointerventionalists fueled by data from the cardiology literature showing better safety and overall reduced morbidity. OBJECTIVE: To present our institution\u27s experience with the radial approach for neuroendovascular interventions in 614 consecutive patients who underwent a cumulative of 760 procedures. METHODS: A retrospective analysis was performed and identified neuroendovascular procedures performed via the upper extremity vasculature access site. RESULTS: Amongst 760 procedures, 34.2% (260) were therapeutic, and 65.7% (500) were nontherapeutic angiograms. Access sites were 71.5% (544) via a conventional radial artery, 27.8% (211) via a distal radial artery, 0.5% (4) via an ulnar artery, and 0.1% (1) via the brachial artery. Most of the procedures (96.9%) were performed via the right-sided (737), 2.9% (22) via the left-sided, and 0.1% (1) via a bilateral approach. Major access site complications occurred at a rate of 0.9% (7). The rate of transfemoral conversion was 4.7% (36). There was a statistically higher incidence of transfemoral conversion when repeat procedures were performed using the same access site. Also, there was no significant difference between nontherapeutic procedures performed using the right and left radial access, and conventional versus distal radial access. Procedural metrics improved after completion of 14 procedures, indicating a learning curve that should be surpassed by operators to reach optimal outcomes. CONCLUSION: Radial artery catheterization is a safe and effective means of carrying out a wide range of neuroendovascular procedures associated with excellent clinical outcomes and an overall low rate of periprocedural complications

    Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention.

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    Outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have improved because of advancements in equipment and techniques. With global collaboration and knowledge sharing, we have identified 7 common principles that are widely accepted as best practices for CTO-PCI.  1. Ischemic symptom improvement is the primary indication for CTO-PCI.  2. Dual coronary angiography and in-depth and structured review of the angiogram (and, if available, coronary computed tomography angiography) are key for planning and safely performing CTO-PCI.  3. Use of a microcatheter is essential for optimal guidewire manipulation and exchanges.  4. Antegrade wiring, antegrade dissection and reentry, and the retrograde approach are all complementary and necessary crossing strategies. Antegrade wiring is the most common initial technique, whereas retrograde and antegrade dissection and reentry are often required for more complex CTOs.  5. If the initially selected crossing strategy fails, efficient change to an alternative crossing technique increases the likelihood of eventual PCI success, shortens procedure time, and lowers radiation and contrast use.  6. Specific CTO-PCI expertise and volume and the availability of specialized equipment will increase the likelihood of crossing success and facilitate prevention and management of complications, such as perforation.  7. Meticulous attention to lesion preparation and stenting technique, often requiring intracoronary imaging, is required to ensure optimum stent expansion and minimize the risk of short- and long-term adverse events. These principles have been widely adopted by experienced CTO-PCI operators and centers currently achieving high success and acceptable complication rates. Outcomes are less optimal at less experienced centers, highlighting the need for broader adoption of the aforementioned 7 guiding principles along with the development of additional simple and safe CTO crossing and revascularization strategies through ongoing research, education, and training

    Anatomic basis and physiological rationale of distal radial artery access for percutaneous coronary and endovascular procedures

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    Transradial access offers important advantages over transfemoral access, including overall increased procedure comfort and better outcomes. Still, complications of transradial access exist, with radial artery occlusion being the most clinically relevant one. Puncture sites in the hand allowing distal radial artery access have initially been described for anterograde angioplasty of occluded radial arteries and could represent a valuable alternative to traditional wrist puncture for radial artery catheterization. What may at first appear as a "radialist eccentricity" definitely has a sound rationale, which the authors review. Knowledge of the anatomic and physiological principles at the basis of distal radial artery access is essential to promote rigorous understanding and practice of this new opportunity for both patients and interventional specialists. (c) 2018 by the American College of Cardiology Foundation
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