13 research outputs found

    A Strange Case of Acute Abdomen

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    Design of IIR digital filters with critical monotonic passband amplitude characteristic: A case study

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    A case study is reported related to the design of IIR digital filters exhibiting critical monotonic amplitude characteristic (CMAC) in the pass band. This kind of amplitude characteristic offers several advantages as compared to its non-monotonic counterparts, although it has not been studied thoroughly so far, if at all. After giving a short overview of the way of CMACs generation, arguments will be listed in favor of the IIR version of the digital filter function realization. Next, the IIR implementation of the digital filters will be considered in short. The main part of the paper will be devoted to the design sequence of this kind of filters which will be illustrated on the example of a band-pass filter obtained by a set of transformations from an all-pole low-pass analogue prototype. This will be the first time a CMAC band-pass IIR digital filter is reported.</jats:p

    The Different Clinical Courses of Legionnaires&rsquo; Disease in Newborns from the Same Maternity Hospital

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    In children, the incidence of Legionnaires&rsquo; disease (LD) is unknown, hospital-acquired LD is associated with clinical risk factors and environmental risk, and children with cell-mediated immune deficiency are at high risk of infection. Both newborns were born in the same delivery room; stayed in the same hospital room where they were cared for, bathed, and breastfed; were male; were born on time, with normal birth weight, and with high Apgar score at birth; and survived this severe infection (L. pneumophila, serogroup 2-15) but with different clinical courses. In neonate 1, bleeding in the brain, thrombosis of deep pelvic veins, and necrosis of the lungs, which left behind cystic and cavernous changes in the lungs, were found, while neonate 2 suffered from pneumonia alone. The only difference in risk factors for LD between these two newborns is the number of days of illness until the start of azithromycin treatment (sixth versus the third day of illness). We suggest that a change in the guidelines for diagnosing and treating community-acquired pneumonia and hospital-acquired pneumonia in newborns is needed in terms of mandatory routine testing for Legionella pneumophila. Early initiation of macrolide therapy is crucial for the outcome of LD in the newborn

    SARS-CoV-2 vaccination modelling for safe surgery to save lives: Data from an international prospective cohort study

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    Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population
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