23 research outputs found

    Filter life span in postoperative cardiovascular surgery patients requiring continuous renal replacement therapy, using a post dilution regional citrate anticoagulation continuous hemofiltration circuit

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    Background: Regional citrate anticoagulation (RCA) is the recommended standard for continuous renal replacement therapy (CRRT). This study assesses its efficacy in patients admitted to critical care following cardiovascular surgery and the influence of standard antithrombotic agents routinely used in this specific group. Methods: Consecutive cardiovascular surgery patients treated with post-dilution hemofiltration with RCA were included in this prospective observational study. The primary outcome of the study was CRRT circuit life-span adjusted for reasons other than clotting. The secondary outcome evaluated the influence of standard antithrombotic agents (acetylsalicylic acid [ASA], low molecular weight heparin [LMWH] or fondaparinux as thromboprophylaxis or treatment dose with or without ASA) on filter life. Results: Fifty-two patients underwent 193 sessions of CVVH, after exclusion of 15 sessions where unfractionated heparin was administered. The median filter life span was 58 hours. Filter life span was significantly longer in patients receiving therapeutic dose of LMWH or fondaparinux (79 h [2–110]), in comparison to patients treated with prophylactic dose of LMWH or fondaparinux (51 h [7–117], p < 0.001), and patients without antithrombotic prophylaxis (42 h [2–91], p < 0.0001). 12 bleeding episodes were observed; 8 occurred in patients receiving treatment dose anticoagulation, 3 in patients receiving prophylactic dose anticoagulation and 1 in a patient with no antithrombotic prophylaxis. Conclusions: A post dilution hemofiltration with RCA provides prolonged filter life span when adjusted for reasons other than clotting. Patients receiving treatment dose anticoagulation had a significantly longer filter life span than those who were on prophylactic doses or ASA alone

    Medical applications of model based dynamic thermography

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    The proposal to use active thermography in medical diagnostics is promising in some applications concerning investigation of directly accessible parts of the human body. The combination of dynamic thermograms with thermal models of investigated structures gives attractive possibility to make internal structure reconstruction basing on different thermal properties of biological tissues. Measurements of temperature distribution synchronized with external light excitation allow registration of dynamic changes of local temperature dependent on heat exchange conditions. Preliminary results of active thermography applications in medicine are discussed. For skin and under- skin tissues an equivalent thermal model may be determined. For the assumed model its effective parameters may be reconstructed basing on the results of transient thermal processes. For known thermal diffusivity and conductivity of specific tissues the local thickness of a two or three layer structure may be calculated. Results of some medical cases as well as reference data of in vivo study on animals are presented. The method was also applied to evaluate the state of the human heart during the open chest cardio-surgical interventions. Reference studies of evoked heart infarct in pigs are referred, too. We see the proposed new in medical applications technique as a promising diagnostic tool. It is a fully non-invasive, clean, handy, fast and affordable method giving not only qualitative view of investigated surfaces but also an objective quantitative measurement result, accurate enough for many applications including fast screening of affected tissues

    The measurement of product placement

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    Product placement can be defined as utilisation of a real product or a service directly in audiovisual works, under clear, contractually-agreed terms. The methodology for measuring the effectiveness of funds invested in product placement in audiovisual works has not been developed yet. The authors of this paper propose a possible solution for measuring the effectiveness of product placement, which they applied in the Vinari (Winemakers) TV series. The authors proceeded from the price. A sponsor of a TV commercial would have to pay to reach the target group to the same extent as when using product placement. The CPP (Cost per Point) approach was used, i.e. the cost of reaching 1% of the target group. Reaching the target group was surveyed by means of a primary investigation of the perception of the sponsor's company as a financial backer of cultural activities by using questionnaires. The authors based their calculations of effectiveness regarding the sponsoring of a television series using elements of brand and product placement on a model calculation of the current advertising prices for a thirty-second advertising spot in relation to the CPP. The average recall of the product placement in the sponsored series represented 16% of the target group. It was calculated that if broadcasting TV spots, the price would be CZK 6.7 million, which is more than six times the amount of the value of the sponsorship. The survey shows that there are positive benefits related to the support of the Vinari (Winemakers) TV series. A significant fact is also that respondents were still able to recall this sponsorship even after several days and not only when this information actually reached them. No pricelist or media can guarantee that a communicated message will be recalled, so sponsorship in TV series is concluded to be highly effective for reasonable price and with prolonged effect which surpass advertising expectations. © Institute of Society Transformation, 2016

    Transcatheter aortic valve replacement with self-expandable ACURATE neo as compared to balloon-expandable SAPIEN 3 in patients with severe aortic stenosis: Meta-analysis of randomized and propensity-matched studies

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    Frequent occurrence of paravalvular leak (PVL) after transcatheter aortic valve replacement (TAVR) was the main concern with earlier-generation devices. Current meta-analysis compared outcomes of TAVR with next-generation devices: ACURATE neo and SAPIEN 3. In random-effects meta-analysis, the pooled incidence rates of procedural, clinical and functional outcomes according to VARC-2 definitions were assessed. One randomized controlled trial and five observational studies including 2818 patients (ACURATE neo n = 1256 vs. SAPIEN 3 n = 1562) met inclusion criteria. ACURATE neo was associated with a 3.7-fold increase of moderate-to-severe PVL (RR (risk ratio): 3.70 (2.04\u20136.70); P < 0.0001), which was indirectly related to higher observed 30-day mortality with ACURATE valve (RR: 1.77 (1.03\u20133.04); P = 0.04). Major vascular complications, acute kidney injury, periprocedural myocardial infarction, stroke and serious bleeding events were similar between devices. ACURATE neo demonstrated lower transvalvular pressure gradients both at discharge (P < 0.00001) and at 30 days (P < 0.00001), along with lower risk of patient\u2013prosthesis mismatch (RR: 0.29 (0.10\u20130.87); P = 0.03) and pacemaker implantation (RR: 0.64 (0.50\u20130.81); P = 0.0002), but no differences were observed regarding composite endpoints early safety and device success. In conclusion, ACURATE neo, as compared with SAPIEN 3, was associated with higher rates of moderate-to-severe PVL, which were indirectly linked with increased observed 30-day all-cause mortality

    Practical experience and improvement in aerosol sampling for trace analysis of airborne radionuclides in ground level air. Pt. 2: 1993 - 1998

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    In November 1989 the Polish government and the German government signed a bilateral agreement on scientific and technological co-operation. In the framework of this co-operation the Central Laboratory for Radiological Protection (Centralne Laboratorium Ochrony Radiologicznej, CLOR), Warsaw, the company physik-technik-innovation (PTI), Erlangen, and the physikalisch-technische bundesanstalt (PTB), Braunschweig, conducted a co-operation project in the field of monitoring of the airborne radioactivity in ground level air. This progress report deals with the history, the scientific activities and the results of the project covering the period from July 1993 to December 1998. The co-operation, which is still continued, is based on an agreement between CLOR, PTB and PTI. (orig.)Available from TIB Hannover: RA 3143(42) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman
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