Clinical application of results of the ISCHEMIA trial

More than a decade after the Clinical Outcomes Utilising Revascularization and Aggressive Drug Evaluation (COURAGE) trial, International Study of Comparative Health Effectiveness With Medical And Invasive Approaches (ISCHEMIA) is the second large clinical trial to challenge the concept of revascularization in chronic coronary syndromes whilst addressing some of the shortfalls of its predecessor

Patients with complicated Pott's disease: Management in a rehabilitation department and functional prognosis

AbstractObjectiveThe objective is to study the rehabilitation management and to assess autonomy in daily life activities as well as walking recovery in patients with complicated Pott's disease.Patients and methodsRetrospective study in nine patients over a period of 8 years extending from 2000 to 2008, collated in the Department of Physical Medicine and Functional Rehabilitation, CHU Sahloul, Sousse, Tunisia.ResultsThe mean age of our patients was 43.8 years; sex ratio was 5/4. The spine involvement of tuberculosis was dorsal in seven cases, dorso-lumbar in one patient, and multiple (cervical, dorsal and lumbar) in one case. All patients were paraplegic with a neurological involvement of the bladder. They had prior antituberculosis chemotherapy for at least 8 months. Decompression surgery was performed in six cases. Two female patients presented disorders of spinal posture during treatment requiring surgical revision with osteosynthesis. All patients received additional rehabilitation care. Following a mean duration of hospitalisation in the Rehabilitation department of 47 days with twice-daily sessions of tailored physiotherapy, three patients remained in complete paraplegia, autonomous in wheel-chair and with vesical and sphincter incontinence. The measure of functional independence (MFI) was at admission/discharge 71/92.ConclusionRehabilitation takes an important place in the medico-surgical management in Pott's disease, to limite or compensate the disabilities and handicap related to this pathology

Theory of band gap bowing of disordered substitutional II-VI and III-V semiconductor alloys

For a wide class of technologically relevant compound III-V and II-VI semiconductor materials AC and BC mixed crystals (alloys) of the type A(x)B(1-x)C can be realized. As the electronic properties like the bulk band gap vary continuously with x, any band gap in between that of the pure AC and BC systems can be obtained by choosing the appropriate concentration x, granted that the respective ratio is miscible and thermodynamically stable. In most cases the band gap does not vary linearly with x, but a pronounced bowing behavior as a function of the concentration is observed. In this paper we show that the electronic properties of such A(x)B(1-x)C semiconductors and, in particular, the band gap bowing can well be described and understood starting from empirical tight binding models for the pure AC and BC systems. The electronic properties of the A(x)B(1-x)C system can be described by choosing the tight-binding parameters of the AC or BC system with probabilities x and 1-x, respectively. We demonstrate this by exact diagonalization of finite but large supercells and by means of calculations within the established coherent potential approximation (CPA). We apply this treatment to the II-VI system Cd(x)Zn(1-x)Se, to the III-V system In(x)Ga(1-x)As and to the III-nitride system Ga(x)Al(1-x)N.Comment: 14 pages, 10 figure

Methodologies synthesis

This deliverable deals with the modelling and analysis of interdependencies between critical infrastructures, focussing attention on two interdependent infrastructures studied in the context of CRUTIAL: the electric power infrastructure and the information infrastructures supporting management, control and maintenance functionality. The main objectives are: 1) investigate the main challenges to be addressed for the analysis and modelling of interdependencies, 2) review the modelling methodologies and tools that can be used to address these challenges and support the evaluation of the impact of interdependencies on the dependability and resilience of the service delivered to the users, and 3) present the preliminary directions investigated so far by the CRUTIAL consortium for describing and modelling interdependencies

Transesophageal echocardiography-guided versus fluoroscopy-guided patent foramen ovale closure : A single center registry

Percutaneous closure of patent foramen ovale (PFO) is conventionally performed under continuous transesophageal echocardiographic (TEE) guidance. We aimed to evaluate whether a simplified procedural approach, including pure fluoroscopy-guidance and final TEE control, as well as an aimed 'next-day-discharge' is comparable with the conventional TEE-guided procedure in terms of periprocedural and intermediate-term outcomes.All patients who underwent a PFO closure at our center between 2010 and 2022 were retrospectively included. Prior to June 2019 cases were performed with continuous TEE guidance (TEE-guided group). Since June 2019, only pure fluoroscopy-guided PFO closures have been performed with TEE insertion and control just prior to device release (fluoroscopy-guided group). We analyzed procedural aspects, as well as long term clinical and echocardiographic outcomes.In total 291 patients were included in the analysis: 197 in the TEE-guided group and 94 in the fluoroscopy-guided group. Fluoroscopy-guided procedures were markedly shorter (48 ± 20 min vs. 25 ± 9 min; p < .01). There was no difference in procedural complications, including death, major bleeding, device dislodgement, stroke or clinically relevant peripheral embolization between the two groups (.5% vs. 0%; p = .99). Hospital stay was also shorter with the simplified approach (2.5 ± 1.6 vs. 3.5 ± 1.2 days; p < .01), allowing 85% same-day discharges during the last 12 months of observation period. At 6 ± 3 months echocardiographic follow-up a residual leakage was described in 8% of the TEE-guided cases and 2% of the fluoroscopy-guided cases (p = .08).While a complete TEE-free PFO closure might have potential procedural risks, our approach of pure fluoroscopy-guided with a brisk final TEE check seems to be advantageous in terms of procedural aspects with no sign of any acute or intermediate-term hazard and it could offer an equitable compromise between the two worlds: a complete TEE procedure and a procedure without any TEE