Asymptomatic fatal post-lobectomy hemopericardium

We report a case of an asymptomatic post-lobectomy hemopericardium in a female who died suddenly at day two post surgery. Autopsy revealed no pathologic findings, but 250 ml of blood and clots in the pericardium and a non-significant injury to the epicardial fat overlying the circumflex artery territory

Plasma homocysteine levels in Indian patients with acute ischemic stroke

Background: Homocysteine has primary atherogenic and prothrombotic properties. The present study aimed to assess serum homocysteine levels in patients with ischemic stroke and to find association of serum homocysteine levels with various patient related variables.Methods: This observational study included patients who were admitted with the diagnosis of stroke in Sri Ventateswara Ramnarain Ruia Government General Hospital. Patients were evaluated for risk factors like hypertension, diabetes mellitus and hyperlipidemia. Total homocysteine estimation was done and survival of the patients was assessed at the time of discharge from the hospital.Results: Most common risk factor for stroke in our study population was dyslipidemia (40%), followed by hypertension (36%). Total homocysteine levels were raised in 92% of the patients. Patients with homocysteine levels less than 15mM/L had lacunar infarcts. Homocysteine levels higher than 100mM/L were found in 18% of the patients and they all had large sized lesions. Significantly higher mean homocysteine levels were found among patients with large lesions (70.15±2.65 vs 21.68±8.02, p value <0.05). Among various risk factors, higher mean homocysteine levels were found to be associated with dyslipidemia (p value <0.05). No association between hypertension, diabetes mellitus or smoking history was found with higher homocysteine levels. Patients who survived had significantly lower homocysteine levels as compared to non survivors (39.3±19.84 vs 100±18.82, p value<0.001).Conclusions: Further studies are needed on homocysteine and stroke fur using homocysteine as screening test and for initiation of preventive therapy of stroke based on homocysteine levels

Does drug‐induced sleep endoscopy predict surgical success in transoral robotic multilevel surgery in obstructive sleep apnea?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136419/1/lary26255_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136419/2/lary26255.pd

DC-Transformer Modelling, Analysis and Comparison of the Experimental Investigation of a Non-Inverting and Non-Isolated Nx Multilevel Boost Converter (Nx MBC) for Low to High DC Voltage Applications

This paper mainly focuses on the analysis, DC-transformer modeling, comparison, and experimental investigation of a non-inverting and non-isolated Nx multilevel boost converter (Nx MBC) for low to high DC applications. Recently, numerous isolated and non-isolated DC-DC converter configurations have been addressed for low to high DC voltage conversion purposes, which is vital for several applications (e.g., renewable energy, medical equipment, hybrid vehicles, fuel cells, DC-links, multilevel inverters, and drive applications), by utilizing and modifying the structure of reactive elements (switched capacitors and switched inductor circuitry). Among all the switched reactive structures, voltage multiplier circuitry provides a feasible solution for low to high DC voltage conversion due to its flexible and modular structure, voltage clamping capability, reduced rating of components, and ease of modification. Non-inverting and non-isolated Nx MBC combine the features and structures of conventional boost converters and voltage multiplier circuitry. DC-transformer modeling of Nx MBC is discussed for the continuous current mode (CCM) and discontinuous current mode (DCM), which helps to analyze the characteristics of the converter in a more practical way and helps to study the effect of semiconductor components, internal resistances, and load on the voltage conversion ratio of the converter. The mode of operation of Nx MBC in the CCM and DCM is also discussed with the boundary condition. The derived analysis is verified by simulations and experimental investigations, and the obtained results of 3x MBC always show good agreement with each other and the theoretical analysis.This publication was made possible by NPRP grant # [X-033-2-007] from the Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the authors.Scopu

Impact of COVID-19 pandemic on STEMI care: An expanded analysis from the United States.

OBJECTIVE: To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care. BACKGROUND: We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data. METHODS: Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019-February 2020 and March-April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC. RESULTS: Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18-38, p \u3c .001), number of activations leading to angiography (34%, 95% CI: 12-50, p = .005) and number of activations leading to PPCI (20%, 95% CI: 11-27, p \u3c .001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (-0.2 to 44, p = .05). CONCLUSIONS: The COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI