Coronary artery fistulas morphology in coronary computed tomography angiography

Background: The aim of the study was to evaluate coronary artery fistulas (CAFs) in coronary computed tomography angiography (coronary CTA) and verify whether there is correlation between the fistula’s morphology and other cardiac functional findings and clinical data.Materials and methods: A group of 14,308 patients who were diagnosed in coronary CTA was retrospectively analysed. Achieved data were related to referrals.Results: Coronary artery fistula frequency was 0.43% in the examined population. The assessment of coronary artery disease was the most frequent indication for the examination. In 2 out of 3 cases the diagnosis of CAFs was incidental. Fistulas to cardiac chambers were significantly shorter than those to other vascular structures (19.9 vs. 61.8 mm, respectively, p = 0.001). Pulmonary trunk was most often the drainage site. Fistulas with singular supply and drainage constituted the majority. The new morphologic classification of CAFs was introduced with linear, spiral, aneurysmal, grid-like and mixed types. Most numerous was the spiral type group. Patients with aneurysmal fistulas had a tendency for wider diameter of aorta and pulmonary trunk. Smallest left ventricle fraction was observed in gridlike fistulas (48.0%, comparing to 59.2% for all patients with fistulas, p = 0.001). Concomitant abnormalities were found in 13.1% of CAFs patients.Conclusions: Computed tomography angiography has proven to be a useful tool in CAFs detection and morphological assessment. Proposed classification may simplify the predictions whether fistula has a significant influence on cardiac function; however, further studies are needed

Bilateral double-layered patella in a patient with advanced knee osteoarthritis

Double layered patella (DLP) is a rare anomaly of the patella that may go undiagnosed, especially in patients with progressive knee dysfunction and early degenerative changes. Clinical symptoms such as motion-dependent pain and anterior knee pain most typically occur in adolescents or young adults; however, gradually increasing pain and early generalised degenerative changes have also been seen in patients over 40 years old. Diagnosis of DLP could be difficult, especially in cases with coexisting arthrosis. DLP is considered to be pathognomonic for the diagnosis of multiple epiphyseal dysplasia and usually coexists with other anomalies seen in this syndrome, such as hip dysplasia. In extremely rare cases, DLP can occur as a solitary disorder. The prevalence of such cases, however, is unknown, and they could be easily misdiagnosed. Computed tomography and magnetic resonance imaging are the most sensitive radiological methods used in DLP diagnosis. This case report presents a case of a bilateral DLP incidentally found in a 47-year-old patient with advanced arthritis referred for arthroplasty because of increasing symptoms of knee joint failure with no other abnormalities recorded. An important goal of our case study is to raise the awareness of this abnormality with radiologists and orthopaedic surgeons

Continuous positive airway pressure (CPAP) in nonapneic asthma: A clinical review of current evidence

© 2020 by Turkish Thoracic Society-. The use of continuous positive airway pressure (CPAP) in asthma has been a point of debate over the past several years. Various studies, including those on animals and humans have attempted to understand the role and pathophysiology of CPAP in patients with either well controlled or poorly controlled asthma. The aim of this manuscript is to review the currently available literature on the physiologic and clinical effects of CPAP in animal models of asthma and on humans with stable asthma

Non-invasive ventilation in patients with an altered level of consciousness : a clinical review and practical insights

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respiratory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preservation of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed

Non-invasive ventilation in patients with an altered level of consciousness. A clinical review and practical insights

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation.Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed

Numerical model of fricional damper for glas – making robot lance

The need to design a friction damper for glass-making robots arose because of the excessive vibrations, which occur in the course of their work. The robots are commonly used in the manufacture of glassware. The vibrations adversely affect the work of ball gatherers, which results in a large number of defects in the finished glass products. As a result of the vibrations molten glass may become unevenly distributed on the ball's surface and as the material flows down the ball into the mould the thermal conditions of its solidification may change. It is proposed to damp the vibrations by means of a prototype friction damper mounted directly on the ball gatherer lance. The glass-making robot lance with the friction damper was modelled. The vibrations of the glass-making robot lance tip under static load and impact excitation were measured during simulations. Also the relative displacements of the damper rings in the course of the excitations were measured. Moreover, the dependence between the preload force and the system's damping decrement was determined. The main aim was to select proper operating parameters for the proposed structure in order to obtain maximum system damping

Comparison of Methods for Adjusting and Controlling the Preload of Angular-Contact Bearings

The effect of preload on the operating conditions of angular-contact bearings is described. The interdependences occurring during mutual displacements of bearing rings at different bearing contact angles are discussed. The criteria of the classification into low-speed and high-speed angular-contact bearings are presented. Selected methods of preloading angular-contact bearings are compared and discussed. Their advantages and disadvantages with regard to the active control and adjustment of the bearing system during its operation are presented. The structure of a developed test stand with a spindle assembly is described. Preliminary measurements of the behaviour of the spindle assembly during operation are reported. Conclusions are drawn and the direction for further research is indicated

Finite Element Modelling of burr formation in metal cutting

The paper presents a two-dimensional FEM model of burr formation in metal cutting. Abaqus/Explicit software was used for the build of the model. The workpiece geometry, the tool and the cutting parameters were modelled. Physical properties and the method of deformation and fracture of the workpiece material is described using Johnson Cook's constitutive law and the ductile damage criterion. The simulation of the edge formation process during orthogonal cutting was carried out for different depths of cut and cutting speeds. The results of these simulations allowed the verification of the FEM model. The components of the resultant cutting force measured during the actual cutting process with the values of these forces determined based on FEM simulation of this process were compared. The geometry of burrs formed during the actual and simulated the edge forming process was assessed. The analysis showed that the FEM model built enabled a correct prediction of the shape of the workpiece edge and the estimation of geometric features of the edge

New ideas, old problems? Heated tobacco products – a systematic review

Heated tobacco products (HTPs) are a form of nicotine delivery intended to provide an alternative to traditional cigarettes. The aim of this systematic review was to present the current state of knowledge on HTPs with an emphasis on the potential impact of HTP use on human health. During the preparation of this systematic review, the literature on HTPs available within Medline/PubMed, EMBASE, CINAHL, ScienceDirect, and Google Scholar was retrieved and examined. In the final review, 97 research papers were included. The authors specifically assessed the construction and operation of HTPs, as well as the chemical composition of HTP tobacco sticks and the generated aerosol, based on evidence from experimental animal and cellular studies, and human-based studies.Heated tobacco products were found to generate lower concentrations of chemical compounds compared to traditional cigarettes, except for water, propylene glycol, glycerol, and acetol. The nicotine levels delivered to the aerosol by HTPs were 70–80% as those of conventional combustion. The results of in vitro and in vivo assessments of HTP aerosols revealed reduced toxicity, but these were mainly based on studies sponsored by the tobacco industry. Independent human-based studies indicated that there was a potentially harmful impact of the active and passive HTP smoking on human health. Currently, a large body of knowledge on HTP exposures and health effects is provided by the tobacco industry (52% of identified studies). Based on the available evidence, HTPs produce lower levels of toxic chemicals, compared to conventional cigarettes, but they are still not risk-free. Int J Occup Med Environ Health. 2019;32(5):595–63