IVUS-VH relation to the extent and composition of atherosclerotic plaque and clinical outcome prognosis

Background and aim: Most frequent and generally unpredictable coronary plaque rupture impacts the burden of coronary artery disease but features or signs related to plaque remodeling into the high risk structure are not clearly detectable by using ordinary visualization methods. Till yet there are no evident criteria for additional using IVUS. The aim of the study was to determinate intravascular ultrasound virtual histology (IVUS-VH) importance in identifying high risk plaques, which can contribute to increased rupture hazard. Methods: We selected 30 patients with stabile angina pectoris. 50 plaques were analyzed with coronary angiography digital assessment tool and IVUS similarly. Differences of stenoses measured by both methods, then were calculated and compared to composition of plaques evaluated by IVUS-VH. Results: Plaques were mostly formed of fibrous tissue (FI) (2.6 mm2; 57.89 %). Necrosis was found to make in average one-fifth of analyzed plaques (0.75 mm2, 19.60 %). Calcification made up the smallest part of plaques (0.3 mm2, 8.58 %). Plaques with higher necrosis component appeared to be significantly greater in IVUS compared to coronary angiography. In group A necrosis made up 1.40±1.05 mm2; group B – 0.87±0.52 mm2, and group C – 0.62 ±0.45 mm2 (p= 0.020). The same tendency was observed with FI: group A – 3.38±3.20 mm2; group B – 2.90±2.6 mm2 and group C – 2.04±165 mm2 (p= 0.082). Correlation analysis revealed negative moderate relationship between groups and necrosis percentage (r= –0.40, p= 0.004), and FI (r= –0.29, p= 0.039) components of the plaques. Conclusion: IVUS-VH provides new insight into the evaluation of different composition of plaques. However, despite the advantages, IVUS-VH remains costly and not always technically adaptive procedure, so it is necessary to pursue for new methods or technologies to identify atherosclerotic plaques at risk

Investigation of 5-Year Interconnections between Local Earth Magnetic Field Fluctuations and Acute Myocardial Infarction in Lithuania

The impact of the local Earth magnetic field (LEMF) on cardiovascular events has been studied recently. Data gathered during past years encouraged us to conduct this epidemiological analysis evaluating the association between changes in LEMF and hospital admissions due to AMI in Lithuania between August 2014 and September 2019. This study is unique due to its coverage of all Lithuanian patients. The frequency of morbidity of AMI was compared with the intensity of the LEMF and correlation coefficient was evaluated. The LEMF was measured by the Global Coherence Monitoring Network magnetometer located in Lithuania. LEMF was measured by pikotesla square (pT²). The LEMF was analized in five frequency ranges [Hz], generally called between Schumann resonance, which overlap with the human brain activity waves on electroencefalogram (EEG) frequency ranges (here, they are named as SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz), SBeta (15-32Hz) and SGamma (32-65Hz) to distinguish from the EEG bands). Significant correlations between weekly admissions of AMI cases and the weekly LEMF strength in five frequency ranges and in total range was found. A clear negative correlation was observed between cases of AMI in female group and LEMF frequency ranges SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz), SBeta (15-32Hz) and in total range. In the second half of the year the number of AMI is lower, therefore negative correlations between SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz) and SBeta (15-32Hz) ranges are stronger than in the first one. This is particularly noticeable in 2016 and 2018 years

RESEARCH Open Access Preparedness of Lithuanian general practitioners

to provide mental healthcare services: a cross-sectional surve

Round-Trip Delay Estimation in OPC UA Server-Client Communication Channel

In this paper an estimation of round-trip delay (RTD) in OPC UA server-client channel was investigated in various data communication networks including Ethernet, WiFi, and 3G. Testing was carried out using the developed IoT gateway device running OPC UA server and remote computer running OPC UA client. The server and the client machines were configured to operate in Virtual Private Network powered by OpenVPN. Experimental analysis revealed that RTD values are distributed in the wide range exhibiting difficult-to-explain outliers significantly exceeding average RTD value. A preliminary exploration of the correlation between instantaneous load of communication gateway processor and RTD peaks was carried out on ARM Cortex A8 Texas instruments processors running at 600 MHz and 800 MHz clock frequency

Enabling factors for antibiotic prescribing for upper respiratory tract infections:Perspectives of Lithuanian and Russian general practitioners

INTRODUCTION: General practitioners (GPs) write about 80% of all antibiotic prescriptions, the greatest number of them for patients with respiratory tract infections. However, there is a lack of research targeting the influence of external factors on antibiotic prescribing by physicians. This study aimed to explore experiences of GPs in Lithuania and the Russian Federation with regard to antibiotic prescription for upper respiratory tract infections. By such means it might be possible to reveal external enabling factors that influence antibiotic prescribing in these countries. METHOD: Five focus groups were performed with 22 GPs from Lithuania and 29 GPs from the Kaliningrad Region of the Russian Federation; then, thematic analysis of data was performed. RESULTS: Six thematic categories were identified that are related to external forces enabling antibiotic prescription: the necessity for political leadership to encourage clinically grounded antibiotic use; over-the-counter sale of antibiotics; designation of antibiotics as reimbursable medications; supervision by external oversight institutions; lack of guidelines for the treatment of upper respiratory tract infections; and pharmaceutical company activities. CONCLUSIONS: Comprehensive efforts to reduce the burden of non-clinically grounded antibiotic prescription should go beyond addressing factors at the physician–patient level and take into account important factors in the enabling environment as well

A Simple Strategy to Reduce Contrast Media Use and Risk of Contrast-Induced Renal Injury during PCI: Introduction of an “Optimal Contrast Volume Protocol” to Daily Clinical Practice

Contrast-induced acute kidney injury is the leading cause of iatrogenic acute nephropathy. Development of contrast-induced nephropathy (CIN) increases the risk of adverse long- and short-term patients outcomes, the hospital costs, and length of hospitalization. There are a couple of methods described for CIN prevention (statin prescription, prehydration, contrast media (CM) clearance from the blood system, and decrease amounts of contrast volume). The CM volume to patient’s creatinine clearance ratio is the main factor to predict the risk of CIN development. The safe CM to creatinine clearance ratio limits have been established. The usage of CM amount depends on personal operators habits and inside center regulations. There is no standardized contrast usage protocol worldwide. The aim of this study was to establish an easy to use, cheap, and efficient protocol to estimate a personalized safe CM dose limit for every patient based on their kidney function. These limits are announced during the “Time Out” before the procedure. Our study included 519 patients undergoing interventional coronary procedures: 207 patients into the “Optimal Contrast Volume” arm and 312 into the control group. Applying the protocol into a daily clinical practice leads to a significant reduction in CM volume used for all type of procedures and the development of CIN in comparison with a control group