Fala Osborna w trakcie hipotermii terapeutycznej u młodego pacjenta z ostrym zespołem wieńcowym z uniesieniem odcinka ST, powikłanym nagłym zatrzymaniem krążenia

A 37 year-old male patient was admitted to the intensive care unit after an out-of-hospital cardiac arrest due to ventricular fibrillation in a course of ST-segment elevation acute coronary syndrome. On admission, the patient was unconscious witha Glasgow Coma Scale (GCS) score of 5. A percutaneous coronary intervention and mild therapeutic hypothermia (HT), defined as maintaining body temperature between 32°C and 34°C, were performed. During HT on ECG, we observed Osborn waves, which resolved spontaneously after re-warming. After five days of recovery, the patient scored 15 on GCS and did not show any neurological deficits

Czy kardiolog powinien rutynowo uwzględniać zaburzenia oddychania podczas snu jako czynnik ryzyka chorób układu sercowo-naczyniowego?

We report a case of a 61-year-old male patient who presented with reduced exercise capacity, dyspnea, lower limbs oedema,irregular heart rhythm, loud, irregular snoring, history of poorly controlled hypertension, nocturnal hypertension spikes, andmorning headaches. Patient underwent ECG Holter monitoring and polygraphy, which revealed severe obstructive sleepapnea. In ECG Holter monitoring atrial fibrillation with pauses to 6.5 s were observed. Patient was referred for continuouspositive airway pressure (CPAP) treatment. Three-months of CPAP therapy resulted in significant decrease in apnea-hypopneaindex (31.6/h vs. 5.1/h) and better control of hypertension and heart failure. CPAP treatment allowed us to reduce patient’s cardiovascular risk. Cardiologist should routinely screen and evaluate patients for sleep disordered breathing, especially when patients are obese, have hypertension and/or arrhythmias

The application of time-frequency methods of acoustic signal processing in the diagnostics of tram drive components

The paper presents the course of investigations and the analysis of the possibility of applying selected methods of time-frequency processing of non-stationary acoustic signals in the assessment of the technical condition of tram drive  components, as well as a new combined method proposed by the authors. An experiment was performed in the form of a pass-by test of the acoustic pressure generated by a Solaris Tramino S105p tram. A comparative analysis has been carried out for an efficient case and a case with damage to the traction gear of the third bogie in the form of broken gear teeth. The recorded signal was analyzed using short-time Fourier transform (STFT) and continuous wavelet transform (CWT). It was found that the gear failure causes an increase in the sound level generated by a given bogie for frequencies within the range of characteristic frequencies of the tested device. Due to the limitations associated with the fixed window resolution in STFT and the inability to directly translate scales to frequencies in CWT, it was found that these methods can be helpful in determining suspected damage, but are too imprecise and prone to errors when the parameters of both transforms are poorly chosen. A new CWT-Cepstrum method was proposed as a solution, using the wavelet transform as a pre-filter before cepstrum signal processing. With a sampling rate of 8192 Hz, a db6 mother wavelet, and a scale range of 1:200, the new method was found to infer the occurrence of damage in an interpretation-free manner. The results were validated on an independent pair of trams of the same model with identical damage and as a reference on a pair of undamaged trams demonstrating that the method can be successfully replicated for different vehicles

Can thromboembolic risk be associated with erectile dysfunction in atrial fibrillation patients?

Background: Erectile dysfunction (ED) is highly prevalent in patients with diseases of cardiovascular system, including patients with atrial fibrillation (AF). Reasons for this high co-prevalence include endothelial dysfunction, inflammation, oxidative and emotional stress associated with AF. Association of AF-induced prothrombotic state and possible microthrombi in penile arteries with ED remains unclear. The present study aims to assess if probability of AF-associated risk of peripheral thromboembolism may be associated with ED in AF patients. Methods: Probability of thromboembolic complications was assessed with two commonly used risk scores CHADS2 and CHA2DS2-VASc in a group of continuous AF patients. All patients were also asked to fill an IIEF-5 questionnaire designed for screening for ED. Results: Mean CHADS2 score in the whole study group was 1.1 ± 1.0 points and CHA2DS2- -VASc was 1.5 ± 1.4 points. ED was present in 57.4% of the 129-person study population. In patients with ED, both CHADS2 (0.9 ± 1.0 vs. 1.3 ± 1.1; p = 0.03) and CHA2DS2-VASc (1.2 ± 1.1 vs. 1.8 ± 1.5; p = 0.03) scores were significantly higher than in the group without dysfunction. After dividing the patients according to age into groups younger than 65 years vs. ≥ 65 years, observed correlation was no longer significant in the younger group (p > 0.05). In patients ≥ 65 years, in whom the risk scores are routinely used, dysfunction both CHADS2 (1.1 ± 0.9 vs. 2.0 ± 0.9; p = 0.02) and CHA2DS2-VASc (2.3 ± 1.1 vs. 3.4 ± 1.3; p = 0.04) scores were higher in the group with ED. Conclusions: Erectile dysfunctions in AF patients are associated with elevated cardioembolic risk. We postulate that the diagnosis of ED should be considered an additional marker of prothrombotic state, and may be useful in clinical decision-making, especially in patients ≥ 65 years old.

Advanced programming of cardiac resynchronisation therapy under echocardiographic examination: is it feasible and efficient?

In patients with heart failure treated with cardiac resynchronisation therapy (CRT), proper programming of the device can enhance the benefits of stimulation. Nowadays, adjustment of atrio-ventricular delay (AVD) is usually guided by echocardiography and performed only in resting conditions. The issue of optimal CRT programming during exercise, and the decision regarding the use of rate-adaptive pacing and rate-adaptive AVD algorithm during CRT, are largely empirical. We present a case report, and we indicate that programming of rate-adaptive pacing and rate-adaptive AVD algorithm on the basis of extended echocardiographic evaluation can further benefit the individual patient

Reddening and Extinction Toward the Galactic Bulge from OGLE-III: The Inner Milky Way's Rv ~ 2.5 Extinction Curve

We combine VI photometry from OGLE-III with VVV and 2MASS measurements of E(J-K_{s}) to resolve the longstanding problem of the non-standard optical extinction toward the Galactic bulge. We show that the extinction is well-fit by the relation A_{I} = 0.7465*E(V-I) + 1.3700*E(J-K_{s}), or, equivalently, A_{I} = 1.217*E(V-I)(1+1.126*(E(J-K_{s})/E(V-I)-0.3433)). The optical and near-IR reddening law toward the inner Galaxy approximately follows an R_{V} \approx 2.5 extinction curve with a dispersion {\sigma}_{R_{V}} \approx 0.2, consistent with extragalactic investigations of the hosts of type Ia SNe. Differential reddening is shown to be significant on scales as small as as our mean field size of 6', with the 1{\sigma} dispersion in reddening averaging 9% of total reddening for our fields. The intrinsic luminosity parameters of the Galactic bulge red clump (RC) are derived to be (M_{I,RC}, \sigma_{I,RC,0}, (V-I)_{RC,0}, \sigma_{(V-I)_{RC}}, (J-K_{s})_{RC,0}) = (-0.12, 0.09, 1.06, 0.121, 0.66). Our measurements of the RC brightness, brightness dispersion and number counts allow us to estimate several Galactic bulge structural parameters. We estimate a distance to the Galactic center of 8.20 kpc, resolving previous discrepancies in distance determinations to the bulge based on I-band observations. We measure an upper bound on the tilt {\alpha} \approx 40{\deg}. between the bar's major axis and the Sun-Galactic center line of sight, though our brightness peaks are consistent with predictions of an N-body model oriented at {\alpha} \approx 25{\deg}. The number of RC stars suggests a total stellar mass for the Galactic bulge of 2.0*10^{10} M_{\odot}, if one assumes a Salpeter IMF.Comment: 61 Pages, 21 Figures, 4 Tables, Submitted to The Astrophysical Journal and modified as per a referee report. Includes reddening, reddening law, differential reddening, mean distance, dispersion in distance, surface density of stars and errors thereof for ~9,000 bulge sightlines. For a brief video explaining the key result of this paper, see http://www.youtube.com/user/OSUAstronom