Feasibility of transcatheter closure of multiple defects within the oval fossa

2001 ◽  
Vol 11 (3) ◽  
pp. 314-319 ◽  
Author(s):  
Peter Ewert ◽  
Felix Berger ◽  
Oliver Kretschmar ◽  
Hashim Abdul-Khaliq ◽  
Brigitte Stiller ◽  
...  
Keyword(s):  
Transcatheter Closure ◽  
Control Group ◽  
Atrial Septal Aneurysm ◽  
Residual Shunt ◽  
Multiple Defects ◽  
Single Defect ◽  
The Mean ◽  
The Times ◽  
Time Required ◽  
Mean Time

Background: Multiple perforations in the floor of the oval fossa may be an obstacle for transcatheter closure. Thus, we analyzed the interventions in 33 patients with more than one interatrial communication in comparison with 370 procedures with a single defect. Methods and Results: A diagnostic catheterization, which included a balloon-sizing maneuver, was performed. We implanted a total of 46 occluders, made up of 42 Amplatzers and 4 CardioSEALs. In 20 patients, the defects were closed with a single occluder, namely 18 Amplatzer and 2 CardioSEAL devices. Complete closure was achieved in 15 patients, while a tiny residual shunt remained in 5 patients. In 13 patients, two devices were implanted, without any residual shunt being found immediately after implantation. In 3 patients, the occluders did not touch each other. In 10 patients, their rims overlapped. In comparison with the control group, the group with multiple defects did not differ in the distribution of age, gender, and indications for device closure. The mean time of the procedure, and the time required for fluoroscopy, however, were significant longer (P< 0.001). These times ranged from 45 to 250 minutes with a median of 140 minutes, and from 0.0 to 39.2 minutes, with a median of 12.0 minutes, respectively. Also, the association with an atrial septal aneurysm was significantly more frequent 61 vs. 17%; P< 0.001). The times taken during insertion of double devices were also significantly longer than those needed for insertion of a single device (P< 0.001). Conclusions: Transcatheter closure of multiple defects within the oval fossa is feasible with currently available occluders, albeit than, in selected cases it is necessary to implant two devices.

scholarly journals Early Neuromuscular Blockade in Children with Pediatric Acute Respiratory Distress Syndrome

2020 ◽  
Vol 09 (03) ◽  
pp. 201-206
Author(s):  
Surabhi Chandra ◽  
Sahil Goel ◽  
Ritika Dawra
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Neuromuscular Blockade ◽  
Distress Syndrome ◽  
Control Group ◽  
Case Group ◽  
The Mean ◽  
Mean Time

AbstractPediatric acute respiratory distress syndrome (PARDS) is a challenging problem with high mortality. Role of neuromuscular blockade in the management of ARDS to date has been controversial, and this study was done to study the role of neuromuscular blockade in children having PARDS and development of associated complications, if any. This was a prospective, case–control study conducted in the pediatric intensive care unit (PICU) of a tertiary care teaching hospital, over a period of 24 months. Patients of age 1 to 18 years who presented with or developed PARDS during their course of hospitalization were included after written informed consent was obtained from their parents and/or guardians. Patients with PARDS requiring invasive mechanical ventilation were partitioned into a case group and a control group. Case group patients were sedated and paralyzed using midazolam (1 µg/kg/min) and vecuronium (1 µg/kg/min), respectively, along with institution of definitive management. Control group patients were given definitive and supportive therapy, but no neuromuscular blocking agents (NMBAs). All patients were followed up for signs and symptoms of myopathy or neuropathy during the entire duration of hospital stay and up to 3 months after discharge. During the study period, 613 patients were admitted to the PICU of which 91 patients qualified as having PARDS. Sepsis was the main etiology in 67 of the 91 patients (73.6%) with PARDS. Fifty-nine patients were included in the study, of which 29 patients were included in the case group and 30 patients were included in the control group. Among the 29 case group patients, 25 patients (86.2%) were successfully extubated. Four patients from the case group expired, while 14 out of 30 control group patients (46.7%) expired. Hypotension was present in 26 case group patients (89.6%), of which all showed resolution within 48 hours of definitive treatment. The mean time to resolution of hypotension was 41.6 hours (standard deviation [SD]: 5.759; range: 24–48) for case group patients, significantly lower (p < 0.0001) than the mean time to resolution of 103 hours (SD: 18.995; range: 90–126) for the 10 control group patients with hypotension that survived. Mean oxygenation index (OI) following 48 hours of vecuronium therapy was significantly lower (p < 0.0001; 95% confidence interval: 5.9129–9.9671) than mean OI at admission for case group patients. None of the patients receiving vecuronium exhibited neuromuscular deficit during their hospital stay, at time of discharge, or at follow-up evaluation up to 3 months after discharge. In this study, pediatric cases diagnosed with PARDS and managed with mechanical ventilation and vecuronium therapy had improved mean OI following 48 hours of NMBA therapy and a lower mortality when compared with matched control group patients. Incidence of NMBA-related weakness was not commonly observed in these patients.

scholarly journals Time required to move cash through slot machines

2018 ◽  
Vol 21 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Karen Kelly ◽  
Carl James Schwarz ◽  
Ricardo Gomez ◽  
Kim Marsh
Keyword(s):  
British Columbia ◽  
Slot Machines ◽  
Content Type ◽  
The Public ◽  
Average Value ◽  
The Mean ◽  
Time Required ◽  
Rest Breaks ◽  
Mean Time ◽  
Practical Implications

Purpose The purpose of this paper is to present an empirical study on the time needed to load and disburse cash using bill validators on slot machines and stand-alone cash dispensers in casinos in British Columbia under a Ticket In Ticket Out (TITO) system. Design/methodology/approach Testing took place over two days, using 18 machines. The results were extrapolated to estimate the approximate time required to process $1,000,000 with different average bill amounts in the cash mix and three different bill validator machines in common use. The average value per bill using the cash mix used by the public in the casino was $33.11 [standard error (SE) $2.11]. Findings The mean time/accepted note ranged from 4.12 to 9.65 s, depending on bill validator type. This implies that the time needed to load $1,000,000 onto credit slips using bill validators on slot machines ranges from 35 to 81 h, excluding rest breaks and other breaks. The time needed to redeem $1,000,000 is estimated to be 3 h. Practical/implications The implications of these finding for illicit actors to successfully launder large amounts of cash are discussed. Given the time needed to physically handle the cash, and other control systems currently in use in casinos in British Columbia, processing large amounts of cash using bill validators on slot machines would require a highly organized team that would find it difficult to elude detection. Originality/value The trial results provide a baseline estimate to be used going forward when investigating or proposing money laundering methodologies that include slot machines.

Treatment of hyperthyroidism with a small single daily dose of methimazole

1988 ◽  
Vol 119 (1) ◽  
pp. 139-144 ◽  
Author(s):  
Yasuo Mashio ◽  
Mutsuo Beniko ◽  
Akemi Ikota ◽  
Hiroaki Mizumoto ◽  
Haruhiko Kunita
Keyword(s):  
Divided Dose ◽  
Dose Regimen ◽  
Single Daily Dose ◽  
Once Daily ◽  
Daily Dose ◽  
The Mean ◽  
Time Required ◽  
Daily Dose Regimen ◽  
Mean Time ◽  
Immunoglobulin Levels

Abstract. A prospective randomized trial with the conventional divided doses (10 mg 3 times daily, N = 29) and a small single daily dose (15 mg once daily, N = 25) of methimazole for the treatment of Graves' hyperthyroidism was performed. Within 8 weeks, almost 80% of the patients in both groups became euthyroid. The mean time required to achieve the euthyroid state was 6.0 ± 2.8 and 6.0 ± 3.8 weeks, respectively. TSH binding inhibitor immunoglobulin was found in about 90% of the patients in both groups before methimazole treatment. However, a gradual fall of its levels was observed in nearly all patients after treatment. There was no difference in the mean levels of TSH binding inhibitor immunoglobulin between the two groups during therapy. We conclude that the single daily dose regimen of 15 mg of methimazole will control Graves' hyperthyroidism in most patients, and TSH binding inhibitor immunoglobulin levels decrease in this regimen in the same way as with the conventional divided dose regimen (10 mg 3 times daily).

Increased heart rate accelerates norepinephrine washout from normal myocardium

1987 ◽  
Vol 253 (6) ◽  
pp. H1581-H1585 ◽  
Author(s):  
R. J. Henning ◽  
J. Cheng ◽  
A. M. Bhat ◽  
M. N. Levy
Keyword(s):  
Heart Rate ◽  
Ventricular Myocardium ◽  
Neuronal Uptake ◽  
Control Group ◽  
Inotropic Response ◽  
Sympathetic Stimulation ◽  
Uptake Mechanism ◽  
The Mean ◽  
Time Required ◽  
Experimental Group

We determined whether a change in heart rate affected the decay of the ventricular inotropic response to sympathetic stimulation in an experimental group and in a control group of anesthetized dogs. We induced complete heart block in each animal and paced the ventricles at rates of 90, 120, and 150 min-1 during two observation periods. In the experimental group, desipramine hydrochloride was given during the second period to block the neuronal uptake mechanism. The control animals did not receive desipramine during either period. The time required for the ventricular inotropic response to decay by 50% after cessation of a 2-min train of sympathetic stimulation was used as an index of the rate of norepinephrine washout from the myocardial interstitium. As we increased the pacing rate over the range of 90-150 min-1 in the experimental group, the mean decay half times (+/- SE) decreased by 36 +/- 4% (P less than 0.001) before desipramine and by 26 +/- 6% (P less than 0.001) in the presence of desipramine. These decrements in the decay half times were not significantly different from each other. The mean decay half times decreased by 36 +/- 4% (P less than 0.001) in the control dogs; the effects did not change appreciably from the first to the second observation period. We conclude that an increase in pacing frequency facilitates the washout of norepinephrine from the ventricular myocardium; this facilitation is equally pronounced regardless of whether the neuronal uptake mechanism is intact or suppressed.

Development of a commercial price schedule for producers and processors of lambs

1989 ◽  
Vol 29 (1) ◽  
pp. 23 ◽  
Author(s):  
DL Hopkins
Keyword(s):  
Multiple Regression ◽  
Carcass Weight ◽  
Commercial Application ◽  
Commercial Development ◽  
Time And Motion ◽  
Motion Study ◽  
The Mean ◽  
Fat Score ◽  
The Times ◽  
Mean Time

Equations were developed to predict the weight of trimmed retail (bone-in) cuts, trim, fat and bone from 321 lamb carcasses, ranging in carcass weight from 4.8 to 26.8 kg and in fat depth at the GR site (12th rib) from 1 to 31 mm. For commercial application, the equations were developed using a multiple regression program with the predictors carcass weight and GR. All equations explained a large amount of the variation in component weights (r2 = 0.76-0.99). A time and motion study using 172 carcasses showed that the times required to butcher carcasses of low fat (score 1 and 2) were similar. Likewise the mean time taken to butcher score 3 carcasses was similar to that of score 1 carcasses. However, it took significantly longer (P<0.05) to butcher score 3 carcasses than score 2 carcasses, and score 4 and 5 carcasses than score 3 carcasses. In addition, the mean times taken to butcher score 4 and 5 carcasses were significantly different (P< 0.05). By using multiple regression analysis it was shown that carcass weight, fatscore, their interaction and the butcher all significantly affected the butchering time. The findings of this work are discussed as they apply to the commercial development of price schedules and show that, when based on yield, lean heavy carcasses are more profitable for processing.

403 CONTROL OF OVULATION IN SOWS IN THE TROPICAL ENVIRONMENT USING HUMAN CHORIONIC GONADOTROPHIN IN COMPARISON WITH GONADOTROPIN-RELEASING HORMONE ANALOG

2010 ◽  
Vol 22 (1) ◽  
pp. 358
Author(s):  
K. Buranaamnuay ◽  
K. Wongkaweewit ◽  
R. Raksasub ◽  
P. Prommachart ◽  
P. Tummaruk ◽  
...  
Keyword(s):  
Hormonal Treatment ◽  
Control Group ◽  
Gnrh Analog ◽  
Exact Test ◽  
Group 4 ◽  
Hormone Analog ◽  
The Mean ◽  
Group 5 ◽  
Minimum Daily Temperature ◽  
Mean Time

The reproductive performance of sows is influenced by numerous factors, including environment. The time of ovulation in response to hormonal treatment might vary depending on climate. Because control of ovulation in pigs using hormonal treatments has not been studied in the tropical climate, the effect of hCG or GnRH analog (buserelin) on the time of ovulation in weaned sows was investigated. Thirty-three multiparous Landrace (L; n = 14) and Yorkshire (Y; n = 19) sows housed in the mating and gestation unit on a commercial swine farm in Thailand were used. The average of maximum and minimum daily temperature and daily humidity during experiment was 35°C and 25°C and 31%, respectively. Estrus detection by back pressure test and presence of a mature boar was performed every 6 h. Only sows with weaning to estrus interval (WOI) of ≤7 days were studied. Estrous sows were randomly allocated to 3 groups: a control group (4 Y and 6 L), which was given no treatment; a group (5 Y and 5 L) given 750 IU of hCG i.m. at the beginning of estrus (hCG group); and a group (5 Y and 8 L) given 10 μg of GnRH analog i.m. at the beginning of estrus (GnRH group). The mean time of ovulation was monitored by transrectal ultrasonography every 6 h from the onset of estrus. Interval from onset of estrus to mean time of ovulation (EOI) was analyzed using general linear model procedures of SAS (version 9.0; SAS Institute, Cary, NC, USA). Least squares means and standard deviations of EOI were compared using ANOVA. The proportion of sows ovulating within 45 h after onset of estrus was compared using Fisher’s exact test. Differences with P < 0.05 were considered significant. All of the sows in the control and hCG groups ovulated within 5 days after onset of estrus, but 3 out of 13 (23%) sows in the GnRH group developed cystic follicles; these 3 sows were excluded from the analyses. Overall, WOI was 3.8 ± 0.9 days and did not differ among the groups (P ± 0.05). The breed of sow had no effect on the EOI (P ± 0.05). Although the EOI did not differ among the control (43.0 ± 19.2 h), hCG (40.2 ± 5.5 h), and GnRH (37.5 ± 10.3 h) groups (P ± 0.05), variation was less (P = 0.001) after administration of hCG or GnRH. In addition, the proportions of sows that ovulated within 45 h after onset of estrus in the hCG (9/10 sows) and GnRH (8/10 sows) groups tended to be higher than in the control group (5/10 sows; P = 0.10). In conclusion, results indicate that both hCG and GnRH are efficacious in inducing ovulation at a predictable time in weaned, spontaneously estrous sows. The occurrence of follicular cysts in GnRH-treated sows requires further investigation.

scholarly journals Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

2018 ◽  
Vol 42 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Masashi Tagaya ◽  
Kazunobu Hara ◽  
Shunsuke Takahashi ◽  
Saki Nagoshi ◽  
Hiroki Handa ◽  
...  
Keyword(s):  
Extracorporeal Circulation ◽  
Polymer Coating ◽  
Coating Agent ◽  
Biocompatible Polymer ◽  
Time Points ◽  
Antithrombin Activity ◽  
Antithrombotic Effects ◽  
The Mean ◽  
Time Required ◽  
Mean Time

Objective: Extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPCA) that has a hydrophilic blood-contacting layer, but hemofilters are not. We aimed to investigate the antithrombotic properties of a BPCA-coated hemofilter. Methods: Four experiments using BPCA-coated circuits and non-coated hemofilters and four experiments using BPCA-coated circuits and BPCA-coated hemofilters were performed with whole human blood and compared by measuring the circuit pressure every 5 min, antithrombin activity every 40 min, and thrombin–antithrombin complex every 40 min, for a total of 240 min of recirculation. Results: The mean time required for the pressure at the inlet of the hemofilter to increase sharply was longer in BPCA-coated than in non-coated hemofilters (66 ± 11 min vs 25 ± 9 min, p < 0.01). The mean antithrombin activity value at 200 and 240 min of recirculation was significantly higher in the experiments with BPCA-coated versus non-coated hemofilters (43.3 ± 2.87 vs 33.3 ± 5.74, p = 0.04; 42.8 ± 3.59 vs 31.0 ± 5.35, p = 0.01, respectively); the antithrombin activity values at the other time points were not significantly different. Furthermore, all thrombin–antithrombin complex values in experiments with the BPCA-coated hemofilters achieved overrange at 80 min of recirculation, whereas those with the non-coated hemofilter achieved overrange at 40 min. Conclusion: This study suggests that BPCA-coated hemofilters can inhibit antithrombin consumption, contributing to antithrombotic effects in extracorporeal circulation circuits.

scholarly journals Controlled thawing of foods

2000 ◽  
Vol 18 (No. 5) ◽  
pp. 194-200 ◽  
Author(s):  
K. Hoke ◽  
L. Klíma ◽  
R. Grée ◽  
M. Houška
Keyword(s):  
Power Level ◽  
Point Of View ◽  
Hot Water ◽  
Similar Process ◽  
Hot Air ◽  
Air Temperatures ◽  
The Mean ◽  
Level 1 ◽  
The Times ◽  
Mean Time

The various ways of thawing of model food made for comparison of these processes from point of view of duration. The experiments were conducted under condition that the surface temperature of the thawed food did not overcome 15°C. Shortest mean time of thawing was achieved for vacuum-steam thawing. Regarding to the regime chosen the time of thawing varied between 18.4–29 min. The similar process of vacuum thawing with steam generated from hot water placed below the food was also successful. For this process the mean time of thawing was predicted between 30.5 and 35 min. If the starting temperature of the water was below the boiling point at vacuum level in the chamber the time of thawing was much longer (about 49 min). For hot air thawing we have tested two regimes with temperature of air 50 and 70°C. For both air temperatures the times of thawing were similar being 52.1 and 53.6 min, respectively. Microwave thawing was depending on the power of microwave oven. The time of thawing was achieved 28.9 min at power level 1, at power level “thawing” the process duration was 34.4 min.

Timing should no Longer be an Obstacle to Oocyte Cryopreservation in Patients with Cancer

2016 ◽  
Vol 103 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Giorgia Mangili ◽  
Enrico Papaleo ◽  
Cristina Sigismondi ◽  
Rossella Masciangelo ◽  
Veronica Sarais ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Oocyte Cryopreservation ◽  
Relevant Issue ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
Anticancer Treatment ◽  
The Mean ◽  
Time Required ◽  
Second Period ◽  
Mean Time

Purpose Anticancer treatment-related infertility is preventable with oocyte cryopreservation, but this is often not considered a relevant issue, due to lack of knowledge and time. The aim of this study is to prove that adequate organization of an Oncofertility Unit and the use of new protocols for controlled ovarian stimulation (COS) can reduce the time required by the procedure, encouraging consultants and patients to preserve fertility before gonadotoxic treatments. Methods A total of 125 patients diagnosed with malignant tumors were referred to the Oncofertility Unit of San Raffaele Hospital: 52 patients between April 2011 and October 2013 and 73 patients between October 2013 and November 2015. The 2 periods differ in office organization and type of COS protocol used. Results Between the 2 periods, a reduction in the mean number of days required from first counseling to the initiation (6.45 ± 1.058 vs 1.61 ± 0.228) and the end of the COS (17.83 ± 1.227 vs 13.70 ± 0.393) was observed (p<0.0001). No differences exist in the groups between the mean time required to complete COS (11.38 ± 0.360 vs 12.17 ± 0.309; p = 0.11) and mean number of frozen oocytes (8.458 ± 1.060 vs 10.30 ± 0.919; p = 0.22). Furthermore, in the second period, the number of patients who accepted fertility preservation increased (46.15% vs 64.38%; p<0.05). Conclusions Renewed organization of the Oncofertility Unit and the newest random-start COS protocol allowed us to shorten the time for oocyte cryopreservation and start anticancer treatment on time.

scholarly journals Individualized Experience With Percutaneous Transcatheter Closure of Multiple Atrial Septal Defects: A Single-Center Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhenquan Wang ◽  
Yi Zhan ◽  
Jiahui Jin ◽  
Tingting Wu ◽  
Songyue Zhang ◽  
...  
Keyword(s):  
Transcatheter Closure ◽  
Atrial Septal Aneurysm ◽  
Single Center ◽  
Residual Shunt ◽  
Closure Rate ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Single Center Study ◽  
Center Study

Multiple atrial septal defects (ASDs) are one type of secundum ASD, most of which have an atrial septal aneurysm or long interdefect distance. In our retrospective single-center study, we reviewed different closure strategies for multiple ASDs. We analyzed 50 patients who underwent percutaneous transcatheter closure from May 2011 to July 2019. Information on the patients' characteristics, operation procedure, occluder selection, and complications was collected. According to the feature of the defects and device choice, multiple ASDs were divided into five groups. A successful operation was achieved in every patient. A total of 50 patients were implanted with 58 devices, with 26 patients implanted with a single standard ASD occluder (ASDO); six patients were implanted with double standard ASDOs, and only one patient was implanted with three standard ASDOs. There were 17 patients whose closure was made using the small-waist–big-edge ASDO. Seventy-six percent of the patients (38/50) had an immediate residual shunt. During the mean follow-up of 25.76 ± 22.53 months, the complete closure rate was 92%. Except for two patients with a transient atrioventricular block, individualized experience with percutaneous transcatheter closure for multiple ASDs was effective in a single-center study. After a mid- to long-term follow-up, the multiple ASDOs and small-waist–big-edge ASDO had no serious adverse events or complications.

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