638 research outputs found
Multiple Organ Transplantation after Suicide by Acetaminophen and Gunshot Wound
Emergency physicians (EP) and medical toxicologists are integral in identifying and treating patients with overdoses. Transplant centers are expanding acceptance criteria to consider those with poison-related deaths. We present a case of a simultaneous gunshot wound to the head and an acetaminophen overdose. This case highlights the importance of EPs and medical toxicologists in recognizing the medical complexity of suicides, optimizing treatment, and timing of organ procurement. Early antidote administration and aggressive supportive care allowed the patient to be evaluated as a potential donor. EPs and medical toxicologists have integral roles in overdose patients as organ donors
Pacing in hypertrophic obstructive cardiomyopathy: A randomized crossover study
Background Uncontrolled studies have shown that short atrioventricular delay dual chamber pacing reduces outflow tract obstruction in hypertrophic obstructive cardiomyopathy. Although the exact mechanism of this beneficial effect is unclear, this seems a promising potential new treatment for hypertrophic obstructive cardiomyopathy. Method In order to evaluate the impact of pacing therapy, we performed a randomized multicentre double-blind crossover (pacemaker activated vs non activated) study to investigate modification of echocardiography, exercise tolerance, angina, dyspnoea and quality of life in 83 patients with a mean age of 53 (range 22-87) years with symptoms refractory or intolerant to classical drug treatment. Results After 12 weeks of activated or inactivated pacing, independent of which phase was first, the pressure gradient fell from 59±36 mmHg to 30±25 mmHg (P<0·001) with active pacing. Exercise tolerance improved by 21% in those patients who at baseline tolerated less than 10 min of Bruce protocol; symptoms of dyspnoea and angina also improved significantly from NYHA class 2·4 to 1·4 and 1·0 to 0·4, respectively (P<0·007). Quality of life assessment with a validated questionnaire objectivated the subjective improvement. Conclusion Pacemaker therapy is of clinical and haemodynamic benefit for patients with hypertrophic obstructive cardiomyopathy, left ventricular outflow gradient at rest over 30 mmHg who are symptomatic despite drug treatmen
Inappropriate ICD Discharge Related to Electrical Muscle Stimulation in Chiropractic Therapy: A Case Report
Nonlinear ac response of anisotropic composites
When a suspension consisting of dielectric particles having nonlinear
characteristics is subjected to a sinusoidal (ac) field, the electrical
response will in general consist of ac fields at frequencies of the
higher-order harmonics. These ac responses will also be anisotropic. In this
work, a self-consistent formalism has been employed to compute the induced
dipole moment for suspensions in which the suspended particles have nonlinear
characteristics, in an attempt to investigate the anisotropy in the ac
response. The results showed that the harmonics of the induced dipole moment
and the local electric field are both increased as the anisotropy increases for
the longitudinal field case, while the harmonics are decreased as the
anisotropy increases for the transverse field case. These results are
qualitatively understood with the spectral representation. Thus, by measuring
the ac responses both parallel and perpendicular to the uniaxial anisotropic
axis of the field-induced structures, it is possible to perform a real-time
monitoring of the field-induced aggregation process.Comment: 14 pages and 4 eps figure
Simultaneous removal of CO2, SO2, and NOx from flue gas by liquid phase dehumidification at cryogenic temperatures and low pressure
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