Integration of Temporal Abstraction and Dynamic Bayesian Networks in Clinical Systems. A preliminary approach

Abstraction of temporal data (TA) aims to abstract time-points into higher-level interval concepts and to detect significant trends in both low-level data and abstract concepts. TA methods are used for summarizing and interpreting clinical data. Dynamic Bayesian Networks (DBNs) are temporal probabilistic graphical models which can be used to represent knowledge about uncertain temporal relationships between events and state changes during time. In clinical systems, they were introduced to encode and use the domain knowledge acquired from human experts to perform decision support. A hypothesis that this study plans to investigate is whether temporal abstraction methods can be effectively integrated with DBNs in the context of medical decision-support systems. A preliminary approach is presented where a DBN model is constructed for prognosis of the risk for coronary artery disease (CAD) based on its risk factors and using as test bed a dataset that was collected after monitoring patients who had positive history of cardiovascular disease. The technical objectives of this study are to examine how DBNs will represent the abstracted data in order to construct the prognostic model and whether the retrieved rules from the model can be used for generating more complex abstractions

Ischaemic preconditioning preserves antioxidant enzyme activity and reduces cell damage of in vivo rat hearts undergoing acute ischaemia

Acute myocardial ischaemia causes increased production of oxygen free radicals 1, which may react with cellular membrane lipids causing lipid peroxidation2. Intrinsic antioxidant enzymes such as, superoxide dismutase (SOD) and glutathione peroxidase (GPx) may protect cellular integrity from oxygen free radicals3. In addition preconditioning (IPC) of the myocardium, has been proved useful in reducing ischaemic and reperfusion injury4

Prevalence of Hypertension in patients with chronic Coronary Artery Disease in Cyprus

Coronary Artery Disease (CAD) is the most common type of heart disease and a major cause of mortality worldwide. This study highlights the significance of hypertension as a risk factor in patients with CAD and compares its prevalence to those of EUROASPIRE IV (EUS-IV), ESC Atlas of Cardiology (Atlas) and Cyprus Survey of Coronary Heart Disease of 2006 (CY-2006). A retrospective, observational study was conducted, by the Registry of Cyprus Heart Survey, where 375 individuals with chronic CAD were examined in Nicosia General Hospital Cardiology Clinics, between the years 2011 and 2014. Their medical history regarding hypertension was noted and the data was analyzed using Microsoft Excel software. The total prevalence of hypertension, based on the past medical history of the patients was 59%.Out of these, 52% were found to have elevated blood pressure on their visit to the Cardiology Clinic. The total mean systolic blood pressure amongst the study group was 136 mmHg, with no significant differences between males and females (136 mmHg and 134 mmHg respectively).The findings of the present study are the same compared to those of the CY-2006 (52% both), but slightly higher than the findings of EUS-IV (52% vs. 42.7%) and significantly higher than those recorded in the Atlas (52% vs. 24.8%). The results show that there is still much potential to improve hypertension management in patients with established CAD

Endovascular Treatment of Aneurysm With Side Branches - A Simple Method. Myth or Reality?

PURPOSE: The aim of this study is to present performance data on the use of the multilayer stent which is a 3-dimensional (3D) braided mesh made of interconnected layers, particularly in patients with side branches within the aneurysm. METHODS:  A study protocol was designed to examine the safety and efficacy of the multilayer stent in patients with aneurysms in different target vessels. Between December 2006 and November 2009, 19 patients were enrolled in the study. Four patients had a renal aneurysm (1 male / 3 females) (mean diameter: 18 mm), while the other 15 patients (all males) had iliac artery (n=12, mean diameter: 25 mm),  popliteal artery (n=1, diameter: 55 mm), thoracic aorta (n=1, diameter: 57mm) and abdominal aorta (n=1, diameter: 97.3 mm) aneurysms. RESULTS: The multilayer stent was successfully deployed in all patients (100% technical success); Mean follow-up for the peripheral aneurysms was 28 months (range 12 to 36) and for the aortic aneurysms was 3 months. The occlusion rate of the aneurysm at the peripheral arteries was 100% and all the side branches remained patent. For the thoracic and the abdominal aneurysms, the 3 months computed tomography angiography (CTA) showed patent artery side branches and reduced blood flow inside the sac. CONCLUSION: The multilayer stent seems to be efficient with regard to the side branches which remain patent and the aneurysm is excluded. The question remains about the time needed to achieve the exclusion of the aneurysm in large arteries such as the thoracic and abdominal aorta; we believe this is related to the number and size of the branches within the aneurysm as well as the size of the target vessel itself. A larger multi center study is needed to confirm the suitability of the multilayer stent for the large thoracic, abdominal and thoracoabdominal aneurysms

Biomarkers predict in-hospital major adverse cardiac events in covid-19 patients : A multicenter international study

Background: The COVID-19 pandemic carries a high burden of morbidity and mortality worldwide. We aimed to identify possible predictors of in-hospital major cardiovascular (CV) events in COVID-19. Methods: We retrospectively included patients hospitalized for COVID-19 from 10 centers. Clinical, biochemical, electrocardiographic, and imaging data at admission and medications were collected. Primary endpoint was a composite of in-hospital CV death, acute heart failure (AHF), acute myocarditis, arrhythmias, acute coronary syndromes (ACS), cardiocirculatory arrest, and pulmonary embolism (PE). Results: Of the 748 patients included, 141(19%) reached the set endpoint: 49 (7%) CV death, 15 (2%) acute myocarditis, 32 (4%) sustained-supraventricular or ventricular arrhythmias, 14 (2%) cardiocirculatory arrest, 8 (1%) ACS, 41 (5%) AHF, and 39 (5%) PE. Patients with CV events had higher age, body temperature, creatinine, high-sensitivity troponin, white blood cells, and platelet counts at admission and were more likely to have systemic hypertension, renal failure (creatinine ≥ 1.25 mg/dL), chronic obstructive pulmonary disease, atrial fibrillation, and cardiomyopathy. On univariate and multivariate analysis, troponin and renal failure were associated with the composite endpoint. Kaplan–Meier analysis showed a clear divergence of in-hospital composite event-free survival stratified according to median troponin value and the presence of renal failure (Log rank p < 0.001). Conclusions: Our findings, derived from a multicenter data collection study, suggest the routine use of biomarkers, such as cardiac troponin and serum creatinine, for in-hospital prediction of CV events in patients with COVID-19