330 research outputs found
Patent arterial duct, bottle-meal, and fatal myocardial ischaemia
A patent arterial duct in pre-term neonates is frequent. Systemic complications consecutive to left-to-right shunting are well known but fatal myocardial ischaemia has not been described till now. The presented premature baby died from catecholamine refractory cardiogenic shock. Autoptic examination revealed acute ischaemic changes predominantly in the inner third of myocardium, speaking of coronary hypoperfusion due to a steal phenomenon secondary to the patent arterial duc
Life-threatening orolingual angioedema during thrombolysis in acute ischemic stroke
Background: Orolingual angioedema can occur during thrombolysis with alteplase in stroke patients. However, data about its frequency, severity and the significance of concurrent use of angiotensin-converting-enzyme inhibitors (ACEi) are sparse. Objective: (1), to alert to the potentially life-threatening complication of orolingual angioedema. (2), to present CT-scans of the tongue which exclude lingual hematoma. (3), to estimate the frequency of orolingual angioedema. (4), to evaluate the risk associated with the concurrent use of ACEi. Methods: Single center, databank-based observational study on 120 consecutive patients with i. v. alteplase for acute stroke. Meta-analysis of all stroke studies on alteplase-associated angioedema, which provided detailed information about the use of ACEinhibitors. Across studies, the Peto odds ratio of orolingual angioedema for "concurrent use of ACEi" was calculated. Results: Orolingual angioedema occurred in 2 of 120 patients (1.7%, 95% CI 0.2-5.9 %).Angioedema was mild in one, but rapidly progressive in another patient. Impending asphyxia prompted immediate intubation. CT showed orolingual swelling but no bleeding. One of 19 (5%) patients taking ACEi had orolingual angioedema, compared to 1 of 101 (1%) patients without ACEi. Medline search identified one further study about the occurrence of alteplase-associated angioedema in stroke patients stratified to the use of ACEi. Peto odds ratio of 37 (95 % CI 8-171) indicated an increased risk of alteplasetriggered angioedema for patients with ACEi (p <0.001). Conclusion: Orolingual angioedema is a potentially life-threatening complication of alteplase treatment in stroke patients, especially in those with ACEi. Orolingual hematoma as differential diagnosis can be excluded by CT-sca
Residuen in honing bij continu gebruik van THYMOL als varroabestrijdingsmiddel
Het Zwitserse bijeninstituut Liebefelde doet onderzoek naar de thymolresiduen in honing van volken die meerdere jaren achter elkaar een continubehandeling hebben ondergaan met thymol, volgens de Frakno-thymolmethode (genoemd naar de ontwerper Franz Knobelspies). Uit de eerste resultaten blijkt dat de gemeten thymolconcentraties in de buurt liggen van de in Zwitserland geldende maximumwaarde (0,8 mg thymol per kg honing) en dat de continubehandeling met thymol nog niet kan worden aanbevolen i.v.m. twijfels over de honingkwaliteit. Het verwijderen van de thymol gedurende de dracht kan het residu in de honing verminderen, maar dan kan de varroamijtbestrijding (Varroa destructor) onvoldoende zijn. Het systeem mag overigens in Nederland niet worden toegepast. Artikel vertaald uit Das Bienenmütterchen 55(7/8):147-148(2003) en 55(9):166-167(2003
Considering Polymorphism in Change-Based Test Suite Reduction
With the increasing popularity of continuous integration, algorithms for
selecting the minimal test-suite to cover a given set of changes are in order.
This paper reports on how polymorphism can handle false negatives in a previous
algorithm which uses method-level changes in the base-code to deduce which
tests need to be rerun. We compare the approach with and without polymorphism
on two distinct cases ---PMD and CruiseControl--- and discovered an interesting
trade-off: incorporating polymorphism results in more relevant tests to be
included in the test suite (hence improves accuracy), however comes at the cost
of a larger test suite (hence increases the time to run the minimal
test-suite).Comment: The final publication is available at link.springer.co
Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA A meta-analysis
OBJECTIVE: To determine associations between cerebral microbleed (CMB) burden with recurrent
ischemic stroke (IS) and intracerebral hemorrhage (ICH) risk after IS or TIA.
METHODS: We identified prospective studies of patients with IS or TIA that investigated CMBs and
stroke (ICH and IS) risk during 5 CMBs)
and distribution. We calculated absolute event rates and pooled risk ratios (RR) using randomeffects
meta-analysis.
RESULTS: We included 5,068 patients from 15 studies. There were 115/1,284 (9.6%) recurrent IS
events in patients with CMBs vs 212/3,781 (5.6%) in patients without CMBs (pooled RR 1.8 for
CMBs vs no CMBs; 95% confidence interval [CI] 1.4–2.5). There were 49/1,142 (4.3%) ICH
events in those with CMBs vs 17/2,912 (0.58%) in those without CMBs (pooled RR 6.3 for CMBs
vs no CMBs; 95% CI 3.5–11.4). Increasing CMB burden increased the risk of IS (pooled RR [95%
CI] 1.8 [1.0–3.1], 2.4 [1.3–4.4], and 2.7 [1.5–4.9] for 1 CMB, 2–4 CMBs, and 5 CMBs, respectively).
CONCLUSIONS: CMBs are associated with increased stroke risk after IS or TIA. With increasing CMB
burden (compared to no CMBs), the risk of ICH increases more steeply than that of IS. However, IS
absolute event rates remain higher than ICH absolute event rates in all CMB burden categories
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