1,720 research outputs found
A rare ventricular septal defect: a case repor
No full textLeft ventricular-right atrial communications, known collectively as the Gerbode defect, are rare types of ventricular septal defects. Acquired forms of this defect have been described as a complication of cardiac surgery, bacterial endocarditis, chest trauma, or myocardial infarction. Diagnosis of this rare defect is challenging, but can be confirmed with echocardiography or cardiac magnetic resonance imaging. Until 6 years ago, these communications were corrected only surgically, often with relatively high mortality. However, few case reports of transcatheter closures of the defects have recently been reported with excellent results. We describe a 69-year-old patient with left ventricular-right atrial communication secondary to mitral valve surgery. The diagnosis was made by transesophageal and real-time three-dimensional echocardiography. The defect was closed percutaneously using an Amplatzer device. At follow-up, there was no residual flow and the patient improved clinically.© 2013 Il Pensiero Scientifico Editore
Optimal dose of bivalirudin in dialysis patients at high risk of heparin-induced thrombocytopenia undergoing percutaneous coronary intervention: case report
No full textBivalirudin is a direct thrombin inhibitor that has been approved for use in patients with or at risk for heparin-induced thrombocytopenia undergoing percutaneous coronary intervention. The efficacy of bivalirudin has been well documented in the setting of percutaneous coronary intervention, but there are only few data on its use in chronic dialysis-dependent patients. Bivalirudin is mainly eliminated enzymatically (80%) and to a lesser extent renally (20%). Nevertheless, in patients with chronic kidney disease a substantial increase in coagulation time and bleeding complications has been reported. Therefore, dosage adjustments may be necessary in patients with renal impairment. Dosing and monitoring recommendations in dialysis patients have not yet been established. We describe the case of a 77-year-old man with non-ST-elevation acute coronary syndrome complicated by heparin-induced thrombocytopenia and acute renal failure requiring dialysis treatment. During percutaneous coronary intervention, anticoagulant therapy with bivalirudin was administered at non-standard doses, though already documented in the literature
RIC-HSCT for MF/SS
No full textAdvanced-stage mycosis fungoides and Sezary syndrome (MF/SS) have a poor prognosis. Allogeneic hematopoietic stem cell transplantation (HSCT), particularly using a reduced-intensity conditioning (RIC) regimen, is a promising treatment for advanced-stage MF/SS. We performed RIC-HSCT in nine patients with advanced MF/SS. With a median follow-up period of 954days after HSCT, the estimated 3-year overall survival was 85.7% (95% confidence interval, 33.4-97.9%) with no non-relapse mortality. Five patients relapsed after RIC-HSCT; however, in four patients whose relapse was detected only from the skin, persistent complete response was achieved in one patient, and the disease was manageable in other three patients by the tapering of immunosuppressants and donor lymphocyte infusion, suggesting that graft-versus-lymphoma effect and "down-staging" effect from advanced stage to early stage by HSCT improve the prognosis of advanced-stage MF/SS. These results suggest that RIC-HSCT is an effective treatment for advanced MF/SS
Preparation of mono-sized epoxy/MF microcapsulesin the appearance of polyvinyl alcohol as co-emulsifier
No full textFor epoxy microcapsules embedded in concrete as mechanic-triggered self-healing adhesive, globular shape with uniform size is the basic requirement to ensure the solid shell broken and the liquid core released at a designed stress. In this paper, monodispersed melamine\u96formaldehyde (MF) resin-walled epoxy E-51 microcapsules were successfully fabricated in an in situ polycondensation process, in which a certain amount of polyvinyl alcohol (PVA) solution was added as coemulsifier to control the microcapsules\u92 shape and size. Detail investigation shows, with the cooperation of PVA, the microcapsule morphologies and size distribution were ease to be adjusted by the parameters such as emulsifying agents, agitation rate, pH value and acidification time
ACT Family Violence Intervention Program review
No full textThis paper reports on a review of the Australian Capital Territory’s Family Violence Intervention Program, which provides an interagency response to family violence matters.
The scope of the review was to analyse the program’s activities and outcomes using 2007–08 data provided by participating agencies, supported by in-depth interviews with key stakeholders including victims whose matters had been finalised in court. After the completion of this report, additional data from 2008–09 and 2009–10 was made available by some Family Violence Intervention Program (FVIP) participating agencies. Although not within the scope of this evaluation, these data pointed to some preliminary improvements in the FVIP
NF membrane fouling by aluminum and iron coagulant residuals after coagulation-MF pretreatment
No full textThe effects of coagulant residuals on fouling of a nanofiltration (NF) membrane were investigated. Experiments were carried out with a laboratory-scale microfiltration (MF)-NF setup and a pilot MF-NF plant. In the laboratory-scale experiments, NF feed water was pretreated with poly-aluminum chloride (PACl) or alum followed by MF. NF membrane permeability declined when the feed water contained residual aluminum at 18 μg/L or more, but not when it was lower than 9 μg/L. When pretreated with ferric chloride, no substantial decline of NF membrane permeability was observed: residual iron did not affect the permeability. When SiO2 was added to the water before the pretreatment with PACl, the NF membrane permeability declined at about double the speed. Thermodynamic calculations and elemental analysis of foulants recovered from the membranes indicated that the majority of inorganic foulants were compounds composed of aluminum, silicate, and possibly potassium. In the pilot plant, NF feed was pretreated by PACl. Transmembrane pressure for NF doubled over 4.5 months of operation. Although the aluminum concentration in the NF feed was not high (30 μg/L), analysis of membrane foulants revealed excessive accumulation of aluminum and silicate, also suggesting that aluminum residuals caused the membrane fouling by alumino-silicates or aluminum hydroxide
Association of bleeding, mortality and sex in acute coronary syndromes: the missing triangle
No full textAimsPercutaneous coronary intervention (PCI) and antithrombotic drugs are the standard therapy for patients with acute coronary syndromes (ACS), but their impact on bleeding and mortality in women has not been adequately investigated.MethodsThis was a prospective observational cohort study of ACS patients, who were referred to 6 of the 13 centres belonging to the REgistro regionale AngiopLastiche dell'Emilia-Romagna programme in Emilia-Romagna for coronary angiography and PCI between June 2010 and November 2011. The aim of the study was to verify whether the incidence of Global Registry of Acute Coronary Events-defined in-hospital bleeding after an ACS is significantly higher in women than in men, and to evaluate its impact on short and long-term mortality.ResultsThe analysis involved a total of 1686 patients (511 women and 1175 men). The women were older and more frequently affected by hypertension, congestive heart failure and single-vessel disease; however, none of the clinical or procedural variables was significantly different between the sexes after statistical adjustment. There was a significantly higher rate of in-hospital bleeding among the women [8.6 vs. 5.8%; adjusted odds ratio 1.73, 95% confidence interval (CI) 1.19-2.52, P=0.004], but the adjusted hazard ratio for short and long-term all-cause mortality was not significantly different. After optimal adjustment, bleeding, but not female sex, was identified as a predictor of short-term all-cause mortality (hazard ratio 2.68, 95% CI 1.21-5.93, P=0.01), but this was not confirmed in the case of long-term mortality (hazard ratio 1.57, 95% CI 0.91-2.71, P=0.10).ConclusionAfter optimal adjustment for baseline differences, the findings of this contemporary Italian PCI registry study showed that women experience bleeding more frequently, but do not have worse mortality outcomes than men. Bleeding was confirmed as an independent predictor of short-term mortality
Damage Detection Through Modal Flexibility-Based Deflections: Application to a Full-Scale RC Shear Wall Building
No full textIn civil engineering structures it is highly desirable to detect the presence of damage and changes in the global structural behavior at the earliest possible stage, and, among the many existing strategies for vibration-based damage detection, modal flexibility (MF)-based approaches are promising tools. However, in most of the existing studies, the experimental validation of such approaches has been performed on small-scale laboratory structures, where damage has been artificially imposed as stiffness reductions, for example by substituting some structural elements. It is thus important to continue to test the effectiveness of such MF-based approaches on full-scale structures characterized by more realistic damaged conditions. This paper focuses on the methods for output-only damage detection and localization that are based on the estimation of structural deflections from modal flexibility, and the objective of this paper is to test the applicability of such methods for locating damage in a full-scale reinforced concrete (RC) structure that has experienced earthquake-induced damage. The considered structure is a shear wall building that can be modeled as a bending moment-deflecting cantilever structure, and was tested on the large-scale University of California, San Diego—Network for Earthquake Engineering Simulation (UCSD-NEES) shaking table. Two approaches, which are based, respectively, on the estimation of the curvature and the damage-induced rotation from the deflections, have been applied and compared on the data of the considered case study. These approaches have been applied in different scenarios characterized by different data sets and by a different number of degrees-of-freedom measured on the considered structure
Correction Factor on Dynamic Force in a Marsh Funnel Test for Tunneling
No full textThis paper presents an improvement on a previous model for predicting the Marsh funnel (MF) test that is used in slurry shield tunneling for evaluating the rheological properties of bentonite slurries. The improvement focuses on the prediction of the dynamic part for fluids with small MF times. The velocity profile of the Herschel-Bulkley fluid in a laminar pipe flow condition is first investigated and a correction factor is introduced in the improved model. Comparisons of results from experiments and calculations with the previous model confirm the improved performance over the existing model. The rheological parameters obtained from the improved model show good resemblance to those obtained from a laboratory viscometer. The work also provides a reference to similar applications such as fluid transportation through pipelines where dynamic pressure dominates and therefore should be correctly predicted considering its velocity profile in a laminar condition.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Offshore and Dredging Engineerin
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