8 research outputs found

    Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: current status in 37 ESC countries

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    Aims Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy in ST-elevation myocardial infarction (STEMI). We conducted this study to evaluate the contemporary status on the use and type of reperfusion therapy in patients admitted with STEMI in the European Society of Cardiology (ESC) member countries. Methods and results A cross-sectional descriptive study based on aggregated country-level data on the use of reperfusion therapy in patients admitted with STEMI during 2010 or 2011. Thirty-seven ESC countries were able to provide data from existing national or regional registries. In countries where no such registries exist, data were based on best expert estimates. Data were collected on the use of STEMI reperfusion treatment and mortality, the numbers of cardiologists, and the availability of PPCI facilities in each country. Our survey provides a brief data summary of the degree of variation in reperfusion therapy across Europe. The number of PPCI procedures varied between countries, ranging from 23 to 884 per million inhabitants. Primary percutaneous coronary intervention and thrombolysis were the dominant reperfusion strategy in 33 and 4 countries, respectively. The mean population served by a single PPCI centre with a 24-h service 7 days a week ranged from 31 300 inhabitants per centre to 6 533 000 inhabitants per centre. Twenty-seven of the total 37 countries participated in a former survey from 2007, and major increases in PPCI utilization were observed in 13 of these countries. Conclusion Large variations in reperfusion treatment are still present across Europe. Countries in Eastern and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encourage

    Propofol dexmedetomidine versus propofol ketamine for anesthesia of endoscopic retrograde cholangiopancreatography (ERCP) (A randomized comparative study)

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    Objectives: The aim of this study was to compare the effects of propofol/dexmedetomidine and propofol/ketamine combinations for anesthesia in patients undergoing ERCP regarding hemodynamic changes, propofol requirements and the recovery criteria. Patient and methods: Sixty patients aged 20–50 years ASA II or III scheduled for ERCP were enrolled in this study. Patients were randomly allocated into two equal groups: dexmedetomidine/propofol (DP) group and ketamine/propofol (KP) group. DP patients received a loading dose of iv dexmedetomidine 1 μg/kg over 15 min then maintained by a 0.5 μg/kg/h. Group KP patients received a loading dose of iv ketamine 1 mg/kg over15 min then maintained by 0.5 mg/kg/h. Induction of anesthesia was achieved with propofol 2 mg/kg, atracurium 0.5 mg/kg to facilitate endotracheal intubation. Anesthesia was maintained by propofol infusion 5 mg/kg/h, intermittent iv propofol boluses (0.5 mg/kg) were administered if needed. MAP and HR were recorded before loading of study drugs (baseline) and recorded every 5 min after beginning of loading throughout the procedure and just after intubation, then every 15 min for one hour post-operative. Total propofol consumption, recovery time, VAS and postoperative complications (PONV, cognitive dysfunction, and respiratory complications) were recorded. Results: The intra-procedural HR and MAP showed high statistical significant differences between both groups throughout the procedure with lower values in DP group (p < 0.01 or <0.001). During the post-procedural period, the HR and MAP were significantly lower in DP group. Propofol consumption was comparable in both groups (268.0 ± 122.3 mg) in DP group versus (304.7 ± 142.0 mg) in KP group. Postprocedural recovery time was significantly shorter in DP group (5.7 ± 1.7 min) compared with (22.2 ± 8.2 min) KP group (p < 0.01). VAS was comparable in the two groups. PONV was 46.67% of KP group, while it was absent in DP group. Post-operative cognitive disorders showed a high statistical significant difference between both groups (p < 0.001) with no cases was reported in DP group. No respiratory complications in both groups. Conclusion: Dexmedetomidine–propofol combination as TIVA during ERCP showed better intra-and post-procedural hemodynamic stability, less PONV, less postoperative cognitive dysfunctions and shorter recovery time when compared with ketamine–propofol combination

    Machine Learning-based Module for Monitoring LTE/WiFi Coexistence Networks Dynamics

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    Long-Term Evolution (LTE) technology is expected to shift some of its transmissions into the unlicensed band to overcome the spectrum scarcity problem. Nevertheless, in order to effectively use the unlicensed spectrum, several challenges have to be addressed. The most important of which is how to coexist with the incumbent unlicensed WiFi networks. Incorporating the intelligence component into the network radios is foreseen to resolve the intrinsic network challenges, rather than conventional non-adaptive action plans. Specifically, an intelligent cognitive engine (CE) that continuously monitors the environment, and dynamically decides upon the best mechanisms and their configuration to suit a given scenario, is essential. In this work, we propose a machine learning-based monitoring module that provides real-time situational awareness that is envisaged to provide the necessary adaptivity, intelligence, autonomy, and learning capabilities. The objective of the proposed intelligent monitoring module is to sense, assess and select the most appropriate scheduling and resource allocation (SRA) algorithm at each LTE base station, according to the different coexistence scenarios. We propose a random forest classifier that maximizes the overall LTE throughput without degrading that of the WiFi network. Numerical simulations are presented to demonstrate the effectiveness of the monitoring module in achieving robust adaptive results under new unfamiliar network environments. Furthermore, we shed some lights on the comparison between the performance of multiple SRA algorithms under dynamic network settings

    Effect of Nano-Fertilizers on Alfalfa Plants Grown under Different Salt Stresses in Hydroponic System

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    In light of climate change and the ever-increasing population, salt stress has become a critical issue for agriculture and food security. The use of nano-fertilizers in agriculture is a promising application for salt stress management. Therefore, we investigated a hydroponic experiment to evaluate the effect of different nano-fertilizers: macro-nutrient (K2SO4) and micro-nutrient (ZnO and SiO2) on two alfalfa (Medicago sativa L.) genotypes: (Susceptible: Bulldog 505, and tolerant: Mesa-Sirsa) grown with different salt concentrations (6 and10 dS m&minus;1) in split-split design. The results demonstrated that nano-K2SO4 enhanced shoot dry weight, plant height, number of flowers, number of tillers, root length, root fresh weight, and root dry weight under both salt levels. Addition of nano-K2SO4 enhanced plant relative water contents and electrolyte leakage with both genotypes under different salt levels. Nano-SiO2 promoted proline and SOD production with high salinity with values of (0.78 and 1.06 &micro;mol g&minus;1 FW) and 191.15 and 143.46 U. g&minus;1 FW under Bulldog and Mesa-Sirsa, respectively. The application of nano-ZnO promoted plant micro-elements under 6 dS m&minus;1 with both genotypes. The incorporation of nano-fertilizers into hydroponic systems provides a promising strategy, especially in regions with low water quality

    New Insights into Adipokines as Potential Biomarkers for Type-2 Diabetes Mellitus

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