Thromboembolic Disease in Patients With Cancer and COVID-19: Risk Factors, Prevention and Practical Thromboprophylaxis Recommendations–State-of-the-Art.

Cancer and COVID-19 are both well-established risk factors predisposing to thrombosis. Both disease entities are correlated with increased incidence of venous thrombotic events through multifaceted pathogenic mechanisms involving the interaction of cancer cells or SARS-CoV2 on the one hand and the coagulation system and endothelial cells on the other hand. Thromboprophylaxis is recommended for hospitalized patients with active cancer and high-risk outpatients with cancer receiving anticancer treatment. Universal thromboprophylaxis with a high prophylactic dose of low molecular weight heparins (LMWH) or therapeutic dose in select patients, is currentlyindicated for hospitalized patients with COVID-19. Also, prophylactic anticoagulation is recommended for outpatients with COVID-19 at high risk for thrombosis or disease worsening. However, whether there is an additive risk of thrombosis when a patient with cancer is infected with SARS-CoV2 remains unclear In the current review, we summarize and critically discuss the literature regarding the epidemiology of thrombotic events in patients with cancer and concomitant COVID-19, the thrombotic risk assessment, and the recommendations on thromboprophylaxis for this subgroup of patients. Current data do not support an additive thrombotic risk for patients with cancer and COVID-19. Of note, patients with cancer have less access to intensive care unit care, a setting associated with high thrombotic risk. Based on current evidence, patients with cancer and COVID-19 should be assessed with well-established risk assessment models for medically ill patients and receive thromboprophylaxis, preferentially with LMWH, according to existing recommendations. Prospective trials on well-characterized populations do not exist

C++ Annotations

This document is intended for knowledgable users of C who would like to make the transition to C++. It is a guide for `our' programming courses, which are given yearly at the State University of Groningen. As such, this document is not a complete C/C++ handbook, but rather serves as an addition to other documentation sources

Parametry vzdušných rázových vln nitroesterů: Propan-1,2,3-triyl trinitrátu, propan-1,2-diyl dinitrátu, ethan-1,2-diyl dinitrátu a methyl nitrátu

A knowledge of blast wave parameters generated by detonating explosives is important for the evaluation of protective measures, modelling validation and post blast analysis. The relevant data are available for solid military explosives, but not for liquid or homemade explosives. In this contribution we present comparison of experimental incident blast wave parameters for bare charges, weighing from 100 g to 1 kg, of liquid esters of nitric acid, including propane-1,2,3-triyl trinitrate (NG), propane-1,2-diyl dinitrate (PGDN), ethane-1,2-diyl dinitrate (EGDN) and methyl nitrate (MeN), amongst themselves and with TNT charges of approximately the same size. The TNT equivalents, determined from both the incident overpressures and the impulse of the positive phase of the blast wave, were above 100% and showed relatively high scatter. The strongest blast wave parameters under otherwise identical conditions were observed for charges of methyl nitrate.Znalost parametrů vzdušných rázových vln (VRV) generovaných detonací výbušin je důležitá z hlediska ochranných opatření, validaci výpočetních modelů a povýbuchové analýzy. Relevantní data jsou k dispozici pro tuhé vojenské výbušiny, nikoliv však pro výbušiny kapalné či podomácku vyráběné. V tomto příspěvku předkládáme porovnání parametrů dopadajících VRV neutěsněných náloží kapalných nitroesterů propan-1,2,3-triyl trinitrátu (NG), propan-1,2-diyl dinitrátu (PGDN), ethan-1,2-diyl dinitrátu (EGDN) a methyl nitrátu (MeN) o hmotnostech 100g až 1kg. Porovnání je provedeno jak mezi estery navzájem, tak i oproti přibližně stejně velkých náloží TNT. TNT ekvivalenty stanoveny jak z dopadajícího přetlaku tak i z impulzu pozitivní fáze VRV jsou přes 100% a vykazují poměrně velký rozptyl. Nejvyšší parametry VRV při jinak identických podmínkách byly stanoveny pro nálože MeN

OPTIMEX: Měření detonační rychlosti pasivním vláknovým systémem

Detonation velocity (VOD) is one of the most important parameters describing the detonation process of a particular explosive. This article summarizes some peculiarities that we have come across when building and testing our new passive optical VOD meter - OPTIMEX. The advantages of using multiple probes with independent signal recording is discussed. The practical issues related to an explosive's translucency are solved. Finally, a new method for detonation velocity data evaluation is proposed and demonstrated.Detonační rychlost je jedním z nejdůležitějších parametrů popisujících proces detonace konkrétní výbušiny. Tento článek shrnuje nekteré poznatky, ke kterým jsme došli v průběhu vývoje našeho nového pasivního přístroje, nazvaného OPTIMEX, pro měření detonační rychlosti. Jsou rozebrány výhody využití více oddělených měřících kanálů. Je popsáno vyřešení problému s transparentností výbušin. V závěru je navržena nová metoda vyhodnocení naměřených dat

Fat Embolism After Autologous Facial Fat Grafting

BACKGROUND: Autologous facial fat grafting has gained popularity in recent years and is considered to be safe. This paper presents the case of a patient who died due to massive cerebral microfat embolism after facial fat grafting. OBJECTIVES: The aim of this study was to raise awareness and provide more evidence on the prevention and treatment of this potentially lethal complication of facial fat grafting. METHODS: A detailed report was made of the case. Two online databases were searched for similar cases of facial fat embolism resulting in neurologic and/or visual symptoms. Thereafter a literature search was conducted to verify the etiology, current treatment options, and preventive measures. RESULTS: Forty-nine cases with similar events were found in the literature. The most common injected area was the glabella (36.1%), and an average of 16.7 mL fat was injected. The main complications were visual impairment, with 88.5% of cases resulting in permanent monocular blindness, and neurologic symptoms, some of which never fully recovered. Including the present patient, 7 cases were fatal. Fat embolism can occur in the veins and arteries of the face. Two possible pathways for fat embolism exist: the macroscopic, mechanical pathway with immediate signs, and the microscopic, biochemical pathway with delayed symptoms. Mechanical embolectomy and corticosteroids are suggested treatment options but evidence for their efficacy is lacking. Several different preventive measures are described. CONCLUSIONS: Although facial fat grafting is considered a safe procedure, one should be aware of the risk of fat embolism. Underreporting of this adverse event is likely. With no effective treatment and often detrimental outcomes, preventive measures are of utmost importance to improve patient safety. LEVEL OF EVIDENCE: 4

Applicability and comparison of surrogate techniques for modeling of selected heating problems

Possibilities of using surrogate techniques for modeling selected strongly nonlinear coupled problems of heating are evaluated. The main purpose is to significantly reduce the computing time in the case of computations of many variants of a given task by the finite element method on the condition of obtaining results of a still acceptable accuracy. Frequently used surrogate techniques (based on Kriging, neural network etc.) are tested on a particular problem of induction-assisted laser welding that represents a very complicated 3D problem. Here, the most important output quantities are the internal structure of weld (decisive for its mechanical parameters) and its depth that depend on a number of input parameters (power of laser beam, velocity of shift of the welded parts, overall geometry and material properties etc.) and must be known before the process of welding itself. The paper presents both full model of this process and considered surrogate algorithms, and compares the results obtained. It is shown that a careful selection of the surrogate technique together with suitable choice of its input data is very beneficial and may result in high savings in design of the process. Implementation performance and suitability of particular techniques of this kind are also evaluated