23 research outputs found
Primjena infracrvene termografije kod mehaničkog ispitivanja materijala
U radu je prikazana analiza rezultata eksperimentalnih istraživanja procesa deformiranja plosnatih epruveta. Eksperimentom je obuhvaćeno statičko vlačno ispitivanje epruveta izrađenih od nodularnog lijeva pri dvije brzine deformiranja. Raspodjele pomaka i temperatura na vanjskim plohama epruveta za vrijeme eksperimenta određene su pomoću metoda fotogrametrije (optičkim sustavom ARAMIS) te pomoću termoparova i infracrvene termografije. Cilj rada je bio dovesti u korelaciju elastoplastične deformacije i prirast površinskih temperatura u opterećenim epruvetama. Dobiveni eksperimentalni rezultati će omogućiti točnije kalibriranje parametara materijala u termoplastičnim konstitutivnim modelima
Molekularna epidemiologija infekcije vrstom Mycobacterium tuberculosis u goveda i ljudi - prikaz slučaja.
We describe a case of transmission of Mycobacterium (M.) tuberculosis infection from a man to cattle. M. tuberculosis was isolated from the bronchial lymph nodes of a heifer that reacted positively to bovine tuberculin but showed no gross pathological changes at slaughter. The cattle owner died of tuberculosis the same year the heifer was diagnosed with M. tuberculosis infection. M. tuberculosis strains isolated from the heifer and its owner were genotyped by mycobacterial interspersed repetitive units - variable number tandem repeat (MIRUVNTR) typing, which revealed identical MIRU profiles for both isolates. This is the first described case of M. tuberculosis infection in cattle and the first case of human-to-animal transmission of M. tuberculosis in Croatia.Opisan je slučaj prijenosa zaraze vrstom Mycobacterium (M.) tuberculosis s čovjeka na govedo. M. tuberculosis je izdvojen iz bronhalnih limfnih čvorova junice koja je pozitivno reagirala na tuberkulin, a prilikom klanja nisu utvrđene patomorfološke promjene karakteristične za tuberkulozu. Iste godine vlasnik goveda je preminuo od posljedica tuberkuloze. Izolati M. tuberculosis iz goveda i čovjeka bili su genotipizirani pomoću metode određivanja promjenjivog broja opetovanih sljedova nukleotida (engl. mycobacterial interspersed repetitive units - variable-number tandem repeat [MIRU-VNTR]) i u oba je slučaja bio utvrđen identičan rezultat genotipizacije. Ovo je prvi opisani slučaj zaraze vrstom M. tuberculosis u goveda i prvi slučaj prijenosa ove bolesti s čovjeka na govedo u Hrvatskoj
Wrist arthroscopy
Artroskopija ručnog zgloba je minimalno invazivna endoskopska metoda koja omogućuje
dijagnosticiranje i liječenje pojedinih bolesti i ozljeda ručnog zgloba (RZ), mediokarpalnog
zgloba (MKZ) i distalnog radioulnarnog zgloba (DRUZ). Ovu minimalno invazivnu kiruršku metodu
prvi je opisao Yung-Cheng Chen 1979., no njezina šira primjena u kliničkoj praksi počinje
tek nakon 1986., kada je Terry Lane Whipple preporučio distrakciju RZ-a i precizne lokalizacije
ulaznih mjesta (portala), kako bi se učinila pravilna i potpuna evaluacija RZ-a prilikom izvođenja
artroskopije. Iako je prvotno artroskopija RZ-a bila samo dijagnostička metoda, tijekom
vremena, zahvaljujući kontinuiranom napretku tehnologije i uvođenju inovacija u instrumentaciji
i operativnoj tehnici, artroskopija RZ-a postaje i terapeutska metoda. Cilj ovog rada prikazati
je osnove o artroskopiji RZ-a, a one uključuju: povijesni razvoj, indikacije i kontraindikacije,
evaluaciju i probir bolesnika za artroskopiju RZ-a na temelju anamneze, fizikalnog pregleda i
slikovne obrade, pripremu za artroskopiju RZ-a, potrebnu opremu, poznavanje izvanzglobne
anatomije, portale (ulazna mjesta), poznavanje unutarzglobne anatomije, preduvjete, tehniku
artroskopije RZ-a, prednosti i nedostatke ove operativne metode, komplikacije i zaključak.Wrist arthroscopy is minimally invasive endoscopic procedure which enables the diagnosis
and treatment of certain diseases and injuries of the wrist joint (WJ), midcarpal joints
(MCJs) and distal radioulnar joint (DRUJ). This minimally invasive surgical procedure was first
described by Yung-Cheng Chen in 1979. However, its widespread application in clinical practice
began after 1986, when Terry Lane Whipple recommended wrist distraction and precise
localization of portals to do proper and complete evaluation of the wrist when performing arthroscopy.
Although initially wrist arthroscopy was only a diagnostic tool, during time due to
the continuous advancement of technology and the introduction of innovations in instrumentation
and surgical technique, wrist arthroscopy became a therapeutic method. The aim of
this professional paper is to present the basics of wrist arthroscopy, which include: historical
development, indications and contraindications, evaluation and selection of patients for wrist
arthroscopy on the basis of history, physical examination and diagnostic imaging procedures,
wrist arthroscopy setup, the necessary equipment, superficial anatomy, portals, intraarticular
anatomy, preconditions, technique of wrist arthroscopy, the advantages and disadvantages of
this surgical procedure, complications, and conclusion
Wrist arthroscopy
Artroskopija ručnog zgloba je minimalno invazivna endoskopska metoda koja omogućuje
dijagnosticiranje i liječenje pojedinih bolesti i ozljeda ručnog zgloba (RZ), mediokarpalnog
zgloba (MKZ) i distalnog radioulnarnog zgloba (DRUZ). Ovu minimalno invazivnu kiruršku metodu
prvi je opisao Yung-Cheng Chen 1979., no njezina šira primjena u kliničkoj praksi počinje
tek nakon 1986., kada je Terry Lane Whipple preporučio distrakciju RZ-a i precizne lokalizacije
ulaznih mjesta (portala), kako bi se učinila pravilna i potpuna evaluacija RZ-a prilikom izvođenja
artroskopije. Iako je prvotno artroskopija RZ-a bila samo dijagnostička metoda, tijekom
vremena, zahvaljujući kontinuiranom napretku tehnologije i uvođenju inovacija u instrumentaciji
i operativnoj tehnici, artroskopija RZ-a postaje i terapeutska metoda. Cilj ovog rada prikazati
je osnove o artroskopiji RZ-a, a one uključuju: povijesni razvoj, indikacije i kontraindikacije,
evaluaciju i probir bolesnika za artroskopiju RZ-a na temelju anamneze, fizikalnog pregleda i
slikovne obrade, pripremu za artroskopiju RZ-a, potrebnu opremu, poznavanje izvanzglobne
anatomije, portale (ulazna mjesta), poznavanje unutarzglobne anatomije, preduvjete, tehniku
artroskopije RZ-a, prednosti i nedostatke ove operativne metode, komplikacije i zaključak.Wrist arthroscopy is minimally invasive endoscopic procedure which enables the diagnosis
and treatment of certain diseases and injuries of the wrist joint (WJ), midcarpal joints
(MCJs) and distal radioulnar joint (DRUJ). This minimally invasive surgical procedure was first
described by Yung-Cheng Chen in 1979. However, its widespread application in clinical practice
began after 1986, when Terry Lane Whipple recommended wrist distraction and precise
localization of portals to do proper and complete evaluation of the wrist when performing arthroscopy.
Although initially wrist arthroscopy was only a diagnostic tool, during time due to
the continuous advancement of technology and the introduction of innovations in instrumentation
and surgical technique, wrist arthroscopy became a therapeutic method. The aim of
this professional paper is to present the basics of wrist arthroscopy, which include: historical
development, indications and contraindications, evaluation and selection of patients for wrist
arthroscopy on the basis of history, physical examination and diagnostic imaging procedures,
wrist arthroscopy setup, the necessary equipment, superficial anatomy, portals, intraarticular
anatomy, preconditions, technique of wrist arthroscopy, the advantages and disadvantages of
this surgical procedure, complications, and conclusion
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Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.
Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
A Support Vector Machine-Based Dynamic Network for Visual Speech Recognition Applications
Visual speech recognition is an emerging research field. In this paper, we examine the suitability of support vector machines for visual speech recognition. Each word is modeled as a temporal sequence of visemes corresponding to the different phones realized. One support vector machine is trained to recognize each viseme and its output is converted to a posterior probability through a sigmoidal mapping. To model the temporal character of speech, the support vector machines are integrated as nodes into a Viterbi lattice. We test the performance of the proposed approach on a small visual speech recognition task, namely the recognition of the first four digits in English. The word recognition rate obtained is at the level of the previous best reported rates