The Evolution of Lead Extraction

2009 ◽  
Vol 5 (1) ◽  
pp. 32
Author(s):  
Melanie Maytin ◽  
Laurence M Epstein ◽  
◽  
Keyword(s):  
Natural Selection ◽  
Lead Extraction ◽  
Significant Morbidity ◽  
Extraction Techniques ◽  
Extraction Technology ◽  
Device Management ◽  
Future Developments ◽  
The Past ◽  
New Methods ◽  
Life Threatening

Prior to the introduction of successful intravascular countertraction techniques, options for lead extraction were limited and dedicated tools were non-existent. The significant morbidity and mortality associated with these early extraction techniques limited their application to life-threatening situations such as infection and sepsis. The past 30 years have witnessed significant advances in lead extraction technology, resulting in safer and more efficacious techniques and tools. This evolution occurred out of necessity, similar to the pressure of natural selection weeding out the ineffective and highly morbid techniques while fostering the development of safe, successful and more simple methods. Future developments in lead extraction are likely to focus on new tools that will allow us to provide comprehensive device management and the design of new leads conceived to facilitate future extraction. With the development of these new methods and novel tools, the technique of lead extraction will continue to require operators that are well versed in several methods of extraction. Garnering new skills while remembering the lessons of the past will enable extraction technologies to advance without repeating previous mistakes.

scholarly journals Key Lessons from the ELECTRa Registry in the Modern Era of Transvenous Lead Extraction

2017 ◽  
Vol 6 (3) ◽  
pp. 111 ◽  
Author(s):  
Angelo Auricchio ◽  
François Regoli ◽  
Giulio Conte ◽  
Maria Luce Caputo ◽  
◽  
...  
Keyword(s):  
Electronic Devices ◽  
Implantation Rate ◽  
Cardiac Resynchronisation Therapy ◽  
Lead Extraction ◽  
The Past ◽  
Comorbidity Burden ◽  
Cardiac Resynchronisation ◽  
Life Threatening ◽  
Resynchronisation Therapy ◽  
Modern Era

The implantation rate of cardiac electronic devices has grown over the past decades. The number of treated patients has increased in parallel with the complexity of the patient population treated, being older, frailer, having more complex devices (in particular, cardiac resynchronisation therapy) and presenting with a greater comorbidity burden. As a consequence, there is a rising number of related implanted system complications, including malfunction and infection. Thus, the demand for transvenous lead extraction (TLE) has also substantially increased. To identify the indication to TLE by various operators and centres, techniques used to perform TLE, and the safety and efficacy of the current clinical practice of TLE, a large prospective registry has been started in Europe – the European Lead Extraction Controlled (ELECTRa) Registry. The key findings of the ELECTRa Registry are discussed in the present review and placed in the context of previous knowledge. The ELECTRa Registry confirms that the TLE procedure is a safe and effective treatment, with an acceptable risk–benefit ratio that is comparable with other well-known cardiological invasive procedures. Of course, TLE is accompanied by potential life-threatening complications; the vast majority of these can be managed by an experienced multidisciplinary team. Multiple factors predict complications, including patient/lead profile, centre experience and procedure volumes, which may suggest caution when accepting a patient for TLE.

Brain-eating Amoebae Infection: Challenges and Opportunities in Chemotherapy

2019 ◽  
Vol 19 (12) ◽  
pp. 980-987 ◽  
Author(s):  
Mohammad Ridwane Mungroo ◽  
Ayaz Anwar ◽  
Naveed Ahmed Khan ◽  
Ruqaiyyah Siddiqui
Keyword(s):  
Mortality Rate ◽  
Free Living ◽  
Outdoor Activities ◽  
The Past ◽  
Free Living Amoeba ◽  
Challenges And Opportunities ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Living Nature ◽  
Treatment And Diagnosis

Pathogenic free-living amoeba are known to cause a devastating infection of the central nervous system and are often referred to as “brain-eating amoebae”. The mortality rate of more than 90% and free-living nature of these amoebae is a cause for concern. It is distressing that the mortality rate has remained the same over the past few decades, highlighting the lack of interest by the pharmaceutical industry. With the threat of global warming and increased outdoor activities of public, there is a need for renewed interest in identifying potential anti-amoebic compounds for successful prognosis. Here, we discuss the available chemotherapeutic options and opportunities for potential strategies in the treatment and diagnosis of these life-threatening infections.

scholarly journals PyroMEMS as Future Technological Building Blocks for Advanced Microenergetic Systems

Micromachines ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 118
Author(s):  
Jean-Laurent Pouchairet ◽  
Carole Rossi
Keyword(s):  
Building Block ◽  
Building Blocks ◽  
Small Scale ◽  
Technological Evolution ◽  
Research Groups ◽  
Function Block ◽  
The Past ◽  
New Methods ◽  
Safety And Reliability ◽  
Electronically Controllable

For the past two decades, many research groups have investigated new methods for reducing the size and cost of safe and arm-fire systems, while also improving their safety and reliability, through batch processing. Simultaneously, micro- and nanotechnology advancements regarding nanothermite materials have enabled the production of a key technological building block: pyrotechnical microsystems (pyroMEMS). This building block simply consists of microscale electric initiators with a thin thermite layer as the ignition charge. This microscale to millimeter-scale addressable pyroMEMS enables the integration of intelligence into centimeter-scale pyrotechnical systems. To illustrate this technological evolution, we hereby present the development of a smart infrared (IR) electronically controllable flare consisting of three distinct components: (1) a controllable pyrotechnical ejection block comprising three independently addressable small-scale propellers, all integrated into a one-piece molded and interconnected device, (2) a terminal function block comprising a structured IR pyrotechnical loaf coupled with a microinitiation stage integrating low-energy addressable pyroMEMS, and (3) a connected, autonomous, STANAG 4187 compliant, electronic sensor arming and firing block.

Machine learning for rediscovering revolutionary ideas of the past

2021 ◽  
pp. 105971232098304
Author(s):  
R Alexander Bentley ◽  
Joshua Borycz ◽  
Simon Carrignon ◽  
Damian J Ruck ◽  
Michael J O’Brien
Keyword(s):  
Language Processing ◽  
Scientific Progress ◽  
Phylogenetic Inference ◽  
The Past ◽  
New Methods ◽  
Inherent Nature ◽  
Social Learning Processes ◽  
High Level ◽  
Scientific Ideas ◽  
Revolutionary Science

The explosion of online knowledge has made knowledge, paradoxically, difficult to find. A web or journal search might retrieve thousands of articles, ranked in a manner that is biased by, for example, popularity or eigenvalue centrality rather than by informed relevance to the complex query. With hundreds of thousands of articles published each year, the dense, tangled thicket of knowledge grows even more entwined. Although natural language processing and new methods of generating knowledge graphs can extract increasingly high-level interpretations from research articles, the results are inevitably biased toward recent, popular, and/or prestigious sources. This is a result of the inherent nature of human social-learning processes. To preserve and even rediscover lost scientific ideas, we employ the theory that scientific progress is punctuated by means of inspired, revolutionary ideas at the origin of new paradigms. Using a brief case example, we suggest how phylogenetic inference might be used to rediscover potentially useful lost discoveries, as a way in which machines could help drive revolutionary science.

scholarly journals Trauma-Induced Coagulopathy: Overview of an Emerging Medical Problem from Pathophysiology to Outcomes

Medicines ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 16
Author(s):  
Gabriele Savioli ◽  
Iride Francesca Ceresa ◽  
Luca Caneva ◽  
Sebastiano Gerosa ◽  
Giovanni Ricevuti
Keyword(s):  
Major Trauma ◽  
Management Strategies ◽  
Medical Problem ◽  
Current Evidence ◽  
Potential Drug ◽  
The Past ◽  
Trauma Induced Coagulopathy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Trauma Mortality

Coagulopathy induced by major trauma is common, affecting approximately one-third of patients after trauma. It develops independently of iatrogenic, hypothermic, and dilutive causes (such as iatrogenic cause in case of fluid administration), which instead have a pejorative aspect on coagulopathy. Notwithstanding the continuous research conducted over the past decade on Trauma-Induced Coagulopathy (TIC), it remains a life-threatening condition with a significant impact on trauma mortality. We reviewed the current evidence regarding TIC diagnosis and pathophysiological mechanisms and summarized the different iterations of optimal TIC management strategies among which product resuscitation, potential drug administrations, and hemostatis-focused approaches. We have identified areas of ongoing investigation and controversy in TIC management.

EU-China Student and Academic Staff Mobility: Present Situation and Future Developments

2012 ◽  
Vol 1 (2) ◽  
pp. 282-300 ◽  
Author(s):  
Cécile Mathou ◽  
Jin Yan
Keyword(s):  
European Union ◽  
Qualitative Data ◽  
Academic Staff ◽  
Present Situation ◽  
Research Process ◽  
The European Union ◽  
Future Developments ◽  
The Past ◽  
Comprehensive Information

Abstract The objective of this study was to provide comprehensive information about student and academic staff mobility between the European Union (EU) and China as well as the main strategies and policies in place to promote mobility. Based on quantitative and qualitative data provided by national authorities and various stakeholders consulted throughout the research process, the study aimed at taking stock of the situation and identifying trends regarding EU-China learning mobility over the past ten years. It also aimed at drawing recommendations to improve current and future mobility actions between the two regions.

Advantages in Environmental Compliance For Maritime Corrosion Control

2015 ◽  
Author(s):  
Eric Lethe
Keyword(s):  
Material Selection ◽  
Shop Floor ◽  
Chief Financial Officer ◽  
Successful Implementation ◽  
The Past ◽  
New Methods ◽  
Traditional Procedure ◽  
Environmentally Sound ◽  
A Company ◽  
Selection Of

The need for environmentally compliant processes and materials in the Painting Industry grows more pressing every day. As the need for these processes grows, so grows the confusion regarding the selection and implementation of these new methods and materials. In the past, price and traditional procedure were the only criteria by which a material was procured. Speed and compliance with Original Equipment Manufacturer specification governed how things were done on the shop floor. With the advent of the environmental regulations, processes are being examined all across the globe. In many of the larger companies, the chief environmental officer has as important a role as the comptroller or Chief Financial Officer. Environmental managers are often not chemists or line painters, and typically, the environmental manager is skilled only in the policies of waste disposal, spill clean up, or remediation. The methods whereby a company can minimize the generation of hazardous waste remain less familiar. Often the examination of possible alternate techniques and materials are left for the last minute, or are conducted by personnel who are unfamiliar with how to make changes work. This is usually a recipe for failure in the implementing of anything new. This paper will suggest methods for selection of alternative products and processes in a clear and organized manner. Salient discussion points will be: 1. Process Examination 2. Material Selection 3. Steps For Successful Implementation 4. Possible Impediments 5. How to Avoid Risky Alternatives It will focus on procedures that will assist in the decision making process, and hopefully be of use in the choosing of environmentally sound equipment, chemicals, and methodologies.

Venomous Bites and Stings

2018 ◽  
Author(s):  
J Patrick Walker
Keyword(s):  
Significant Morbidity ◽  
Tissue Necrosis ◽  
Black Widow ◽  
Significant Treatment ◽  
The Us ◽  
Bites And Stings ◽  
Life Threatening ◽  
Compartment Pressures ◽  
Widow Spider

Approximately 8000 persons are bitten by venomous snakes in the US each year.  Mortality is low (4 to 6/yr), but morbidity can be significant, treatment costly. Overuse of surgery and antivenom is common. Simply cutting the wound with attempted aspiration is not indicated. Fasciotomy should only be used for patients with elevated compartment pressures. CroFab is a highly effective (but expensive) treatment useful for serious envenomation. Antivenom should be used in patients with life-threatening symptoms (hypotension, clinical coagulopathy) or rapid advancement of local signs, and to reduce compartment pressures to avoid fasciotomy. The most significant morbidity from insect envenomation is secondary to anaphylaxis. A bite from the black widow spider can induce abdominal cramping and pain that can mimics an acute abdomen. Brown recluse envenomation can produce tissue necrosis and long-term complications. Most events are seen rarely by the average physician; this review can be a useful guide in management.  Key words: antivenom, copperhead bite, CroFab, insect bite, rattlesnake bite, snakebite, water moccasin bite

Jerzy Topolski’s Marxist Anthropocentrism

2021 ◽  
Vol 15 (3) ◽  
pp. 361-377
Author(s):  
Ewa Domańska ◽  
Paul Vickers
Keyword(s):  
Historical Materialism ◽  
Philosophy Of History ◽  
Marxist Theory ◽  
Collective Agency ◽  
Future Developments ◽  
The Past ◽  
Current State ◽  
The World ◽  
Separate Discipline

Abstract In this article I demonstrate that the ideas outlined in Jerzy Topolski’s Methodology of History (Polish 1968, English translation 1976) could not only offer a reference point for and indeed enrich ongoing debates in the philosophy of history, but also help to set directions for future developments in the field. To support my argument, I focus on two themes addressed in Topolski’s work: 1) the understanding of the methodology of history as a separate discipline and its role both in defending the autonomy of history and in creating an integrated knowledge of the past, which I read here through the lens of the current merging of the humanities and natural sciences; and 2) the role of a Marxist anthropocentrism based on the notion of humans as the creators of history, which I consider here in the context of the ongoing critique of anthropocentrism. I point to the value of continuing to use concepts drawn from Marxist vocabulary, such as alienation, emancipation, exploitation and overdetermination, for interpreting the current state of the world and humanity. I stress that Marxist anthropocentrism, with its support for individual and collective agency, remains crucial to the creation of emancipatory theories and visions of the future, even if it has faced criticism for its Eurocentrism and might seem rather familiar and predictable when viewed in the context of the contemporary humanities. Nevertheless, new manifestations of Marxist theory, in the form of posthumanist Marxism and an interspecies historical materialism that transcends anthropocentrism, might play an important role in redefining the humanities and humanity, including its functions and tasks within human and multispecies communities.

Reporting altered test results in hemolyzed samples: is the cure worse than the disease?

2017 ◽  
Vol 55 (8) ◽  
pp. 1112-1114 ◽  
Author(s):  
Giuseppe Lippi ◽  
Gianfranco Cervellin ◽  
Mario Plebani
Keyword(s):  
Laboratory Data ◽  
Turnaround Time ◽  
Reliable Data ◽  
Test Results ◽  
The Past ◽  
Laboratory Test Results ◽  
Performance Specifications ◽  
Life Threatening ◽  
The Many ◽  
Definition Of

AbstractThe management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement. This approach carries some advantages, namely the timely communication of potentially life-threatening laboratory values, but also some drawbacks. These especially include the challenging definition of validated performance specifications for hemolyzed samples, the need to producing reliable data with the lowest possible uncertainty, the short turnaround time for repeating most laboratory tests, the risk that the comments may be overlooked in short-stay and frequently overcrowded units (e.g. the emergency department), as well as the many clinical advantages of a direct communication with the physician in charge of the patient. Despite the debate remains open, we continue supporting the suggestion that suppressing data in unsuitable (hemolyzed) samples and promptly notifying the clinicians about the need to recollect the samples remains the most (clinically and analytically) safe practice.

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