The reversal of anticoagulation in clinical practice

Widespread use of anticoagulant drugs for treatment and ­prevention of thromboembolic events means it is common to encounter patients requiring reversal of anticoagulation for management of bleeding or invasive procedures. While supportive and general measures apply for patients on all agents, recent diversification in the number of licensed agents makes an understanding of drug-specific reversal strategies essential. Recognising effects upon, and limitations of, laboratory measures of coagulation also plays an important role. An understanding of reversal strategies alone is insufficient to competently care for patients who may require anticoagulation reversal. It is also necessary to reduce the need for reversal through correct prescribing and by employing appropriate periprocedural bridging strategies for elective and semi-elective procedures. Finally, consideration of whether and when to reintroduce an anticoagulant drug following reversal is important not only to balance bleeding and thrombotic risks for individual patients but also for timely management of discharge

Anàlisi i optimització de panells perforats utilitzant conceptes metamaterials

[ES] Los materiales fonoabsorbentes mejoran el confort acústico controlando la reverberación y reduciendo los niveles de ruido. Los materiales porosos, como las espumas de celda abierta, destacan en la absorción de frecuencias medias y altas, pero son menos eficaces en frecuencias bajas, mientras que las estructuras resonantes, como los paneles perforados, ofrecen durabilidad y personalización. Estos paneles suelen utilizar formas de perforación sencillas. Este estudio se centra en la mejora de la absorción acústica mediante la exploración de paneles con geometrías internas variadas, como cónica, reloj de arena, reloj de arena inverso, perforaciones con extensiones redondeadas en forma de burbuja y perforaciones con estructuras resonantes incrustadas. También se investiga la influencia de redondear los bordes y rellenar la cámara de aire con materiales porosos. Para analizar los sistemas se aplica un modelo analítico basado en el método de la matriz de transferencia y un modelo de elementos finitos. Los resultados analíticos muestran una buena concordancia con los resultados FEM; sin embargo, se identifica una limitación angular en un caso de perforación cónica, que puede deberse a la simplificación 1D asumida en el TMM. Se utilizan modelos de EF para examinar las estructuras con resonadores embebidos. Se realizan estudios paramétricos para identificar la influencia de la variación de los parámetros geométricos en la absorción. Se propone un método de diseño basado en la optimización de las características geométricas de un panel cónico. Se imprimieron en 3D tres muestras óptimas con perforaciones cónicas y una con un resonador en forma de toroide incrustado de dimensiones elegidas arbitrariamente. Las muestras se ensayaron experimentalmente siguiendo el procedimiento presentado en la norma ISO 10534-2. Se observó una buena concordancia entre las predicciones y los resultados de las mediciones.[EN] Sound-absorbing materials enhance acoustic comfort by controlling reverberation and reducing noise levels. Porous materials like open-cell foams excel at absorbing medium to high frequencies but are less effective at lower frequencies, while resonant structures such as perforated panels offer durability and customization. Such panels normally use simple perforation shapes. This study focuses on improving sound absorption by exploring panels with varied internal geometries such as tapered, hourglass, inverse-hourglass, perforations with rounded bubble-shaped extensions, and perforations with embedded resonant structures. The influence of rounding the edges and filling the air gap with porous materials is also investigated. An analytical model based on the transfer matrix method and a finite element model are implemented to analyse the systems. The analytical results show good agreement with the FEM results; however, an angle limitation in a tapered perforation case is identified, which can be due to the 1D simplification assumed in the TMM. FE models are used for examining the structures with embedded resonators. Parametric studies are performed to identify the influence of varying geometrical parameters on absorption. A design method based on optimisation of the geometrical characteristics of a tapered panel is proposed. Three optimal samples with tapered perforations and one with an embedded torus-shaped resonator with arbitrarily chosen dimensions were 3D printed. The samples were experimentally tested using the procedure presented in ISO 10534-2. A good agreement between the predictions and measurement results was found.Czuprynska, G. (2023). Analysis and optimization of perforated panels making use of metamaterial concepts. Universitat Politècnica de València. http://hdl.handle.net/10251/20146

Thromboprophylaxis in temporary lower limb immobilization: Extrapolate with care

Thrombosis and Hemostasi

Virulence of Trichomonas vaginalis strains according to clinical form of trichomonosis

Estimation of virulence of T. vaginalis strains injected subcutaneously to mice was done. T. vaginalis strains were obtained from the urinogenital tracts of patients with different clinical forms of trichomonosis. The virulence of T. vaginalis strains measured by infiltration size was found to depend upon a clinical form of trichomonosis. It was moreover shown that the cutaneous infiltration size is proportional to a dose of Trichomonas administered subcutaneously. Histopathological analysis of cutaneous infiltration itself is not decisive as to the strains virulence, yet in addition to macroscopic examination it may be a criterium in the studies on strain pathogenicity

Direct oral anticoagulants for the management of venous thromboembolism in patients with HIV - a single centre experience

info:eu-repo/semantics/publishedVersio