scholarly journals Techniques, indications and complications of pericardiocentesis

2021 ◽  
Author(s):  
Mohammed Shafik Elkahwagy ◽  
Ahmad Faraj Alenezi ◽  
Hibah Farhan Alenezi ◽  
Bader Naji Al-Hussain ◽  
Mohammad Ahmad Allwaim ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Management Plan ◽  
External Pressure ◽  
Pericardial Fluid ◽  
Peripheral Tissues ◽  
Best Management ◽  
Potential Development ◽  
Ventricular Filling ◽  
Indications And Complications

The main aim of pericardiocentesis is to remove excess fluid in the pericardial space and enhance the functions of the heart to intervene against the development of many complications. Accordingly, the procedure is usually performed to manage cardiac tamponade to correct secondary hypotension that attributes to the low stroke volume as a result of the external pressure of the pericardial fluid on the chambers of the heart. In the present literature review, we have discussed the techniques, indications, and complications of pericardiocentesis. Furthermore, the main techniques and approaches include computed tomography-guided pericardiocentesis, echo-guided, and fluoroscopy-guided techniques. These modalities can be successfully used for hemodynamically unstable patients to adequately remove excess fluid to normalize ventricular filling and maintain adequate cardiac output to the peripheral tissues. Considerations for using the modality have been made for small effusions and many authors suggest that it should not be routinely used in these situations. Many major and minor complications can occur secondary to conducting pericardiocentesis. The major complications might include lacerations of the intercostal vessels of the coronary arteries, injury to the cardiac chambers, death, puncture of the peritoneal cavity or abdominal viscera, pneumopericardium, pneumothorax which might require chest intubation, pericardial decompression syndrome, and ventricular arrhythmias. Therefore, carefully approaching these patients and deciding the best management plan, in addition to providing proper interventional approaches for the potential development of these complications is essential to enhance the intended outcomes and enhance the quality of care.

472 Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Did We Learn from the National Bowel Cancer Audit?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C Li ◽  
S Z Y Ooi ◽  
T Woo ◽  
P H M Chan
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
External Validation ◽  
Distant Metastases ◽  
Management Plan ◽  
Bowel Cancer ◽  
Clinical Factors ◽  
Quality Outcomes ◽  
Colorectal Cancer Patients

Abstract Aim To identify the most relevant clinical factors in the National Bowel Cancer Audit (NBOCA) that contribute to the variation in the quality of care provided in different hospitals for colorectal cancer patients undergoing surgery. Method Data from 36,116 patients with colorectal cancer who had undergone surgery were retrospectively collected from the NBOCA and analysed from 145 and 146 hospitals over two years. A validated multiple linear regression was performed to compare the identified clinical factors with various quality outcomes. The quality outcomes defined in this study were the length of hospitalisation, 2-year mortality, readmission rate, 90-day mortality, and 18-month stoma rate. Results Four clinical factors (laparoscopy rate, abdominal-perineal-resection-of-rectum (APER), pre-operative radiotherapy and patients with distant metastases) were shown to have a significant (p < 0.05) impact on the length of hospitalisation and 18-month stoma rate. 18-month stoma rate was also significantly associated with 2-year mortality. External validation of the regression model demonstrated the Root-Mean-Square-Error of 0.811 and 4.62 for 18-month stoma rate and 2-year mortality respectively. Conclusions Hospitals should monitor the four clinical factors for patients with colorectal cancer during perioperative care. Clinicians should consider these factors along with the individual patients’ history when formulating a management plan for patients with colorectal cancer.

Management of Type 2B von Willebrand Disease during Pregnancy

2017 ◽  
Vol 137 (2) ◽  
pp. 89-92 ◽  
Author(s):  
David McLaughlin ◽  
Ron Kerr
Keyword(s):  
Autosomal Dominant ◽  
Case Reports ◽  
Management Plan ◽  
Von Willebrand Disease ◽  
Best Management ◽  
First Case ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Ristocetin Cofactor ◽  
Platelet Transfusions

Type 2B von Willebrand disease is a rare bleeding condition resulting in thrombocytopenia and a reduction in large VWF multimers. It usually has an autosomal dominant pattern of inheritance. We report the management of a patient with type 2B von Willebrand disease, whose diagnosis was confirmed by demonstration of a R1306W mutation, through her first pregnancy. The patient's von Willebrand factor (VWF) antigen and VWF ristocetin cofactor levels rose throughout pregnancy, with an associated drop in the platelet count. The patient was successfully managed through labour to a surgical delivery with VWF concentrate, platelet transfusions and tranexamic acid. The patient delivered a male baby who was found to have inherited type 2B von Willebrand disease and had a significant cephalhaematoma at delivery. The baby was managed with VWF concentrate and platelet transfusions and made a full recovery. There is a lack of evidence to guide the best management of pregnant patients with type 2B von Willebrand disease. We adopted a pragmatic management plan, in keeping with other published case reports. To the best of our knowledge, this is the first case report in which the child was found to have inherited type 2B von Willebrand disease and encountered bleeding problems, making this case unique amongst the published literature.

scholarly journals Discriminative sparse coding in the analysis of electrocardiogram during ventricular arrhythmias

2021 ◽  
Author(s):  
Iman Kalaji
Keyword(s):  
Ventricular Fibrillation ◽  
Sparse Coding ◽  
Ventricular Arrhythmias ◽  
Treatment Options ◽  
Survival Rates ◽  
Learning Approach ◽  
Time Frequency ◽  
Frequency Domains ◽  
Optimized Treatment

Abnormalities in the rhythmic electromechanical contractions of the heart results in cardiac arrhythmias. When these abnormalities rise from the ventricles of the heart, they are classified as ventricular arrhythmias. The two major types of ventricular arrhythmias are ventricular tachycardia (VT) and ventricular fibrillation (VF). Ventricular fibrillation is the most dangerous among the two arrhythmias, that usually leads to sudden cardiac death if not treated immediately. Annually about 40,000 sudden cardiac deaths are reported in Canada. Due to high mortality rate and serious impact on quality of life, researchers have been focusing on characterizing ventricular arrhythmias that may lead to delivering optimized treatment options in improving the survival rates. In this thesis two major types of ventricular arrhythmias were analyzed and quantified by performing discriminative sparse coding analysis called label consistent K-SVD using time frequency dictionaries that are well localized in time and frequency domains. The analyzed signals were 670 ECG ventricular arrhythmia segments from 33 patients extracted from the Malignant Ventricular Ectopy and Creighton University Tachy-Arrhythmia databases. Using the LCKSVD dictionary learning approach, an overall maximum classification accuracy of 73.3% was achieved with a hybrid optimized wavelet dictionary. Based on the comparative analysis, the trained (learned) dictionaries yielded better performance than the untrained dictionaries. The results indicate that discriminative sparse coding approach has greater potential in extracting signal adaptive and morphologically discriminative time-frequency structures in studying ventricular arrhythmias.

scholarly journals Theoretical bases for academics’ potential development: foreign and domestic experience

2021 ◽  
pp. 5-19
Author(s):  
Yurii Skyba ◽  
Hanna Lebedynets
Keyword(s):  
Higher Education ◽  
Teaching And Learning ◽  
The European Union ◽  
Association Agreement ◽  
Intangible Resources ◽  
Quality Of Higher Education ◽  
Potential Development ◽  
Organizational Information ◽  
The University

Ensuring and improving the quality of teaching and learning, in particular the academics’ potential development, is reflected in strategic European and domestic documents, namely in the Association Agreement between Ukraine and the European Union, the Paris Communiqué, the Strategy for Higher Education in Ukraine for 2021-2031 and others. The expediency for academics’ potential development is confirmed by the results of a national survey on the needs for the development of Ukrainian universities in the process of reforming higher education in the context of European integration. The article highlights the problems of academics’ potential development. Based on foreign and domestic experience, the theoretical bases for academics’ potential development, in particular the conceptual and terminological apparatus and structural components of teaching metacompetence are substantiated. The concept «potential of an academic» is defined as a set of intellectual, intangible resources, conditions and opportunities created for the production and accumulation of new knowledge, ideas, technologies, competencies and other productive properties at the university, which combines two levels of connections functioning in unity. The first level of connections are resources that are the result of past and present, and the second – opportunities, i.e. those abilities and connections that are future-oriented, constantly changing, evolving, forming new abilities, characteristics, including elements of the future development. The following components are distinguished in the structure of teaching metacompetence: prognostic; design; objective; innovative; pedagogical partnership; organizational; information and digital; reflexive; linguistic and communicative; inclusive; motivational; health-preserving; emotional-ethical and evaluative-analytical. The development of the above components of teaching metacompetence will help ensure the quality of higher education and increase the competitiveness of the university in the educational services market.

scholarly journals Discriminative sparse coding in the analysis of electrocardiogram during ventricular arrhythmias

2021 ◽  
Author(s):  
Iman Kalaji
Keyword(s):  
Ventricular Fibrillation ◽  
Sparse Coding ◽  
Ventricular Arrhythmias ◽  
Treatment Options ◽  
Survival Rates ◽  
Learning Approach ◽  
Time Frequency ◽  
Frequency Domains ◽  
Optimized Treatment

Abnormalities in the rhythmic electromechanical contractions of the heart results in cardiac arrhythmias. When these abnormalities rise from the ventricles of the heart, they are classified as ventricular arrhythmias. The two major types of ventricular arrhythmias are ventricular tachycardia (VT) and ventricular fibrillation (VF). Ventricular fibrillation is the most dangerous among the two arrhythmias, that usually leads to sudden cardiac death if not treated immediately. Annually about 40,000 sudden cardiac deaths are reported in Canada. Due to high mortality rate and serious impact on quality of life, researchers have been focusing on characterizing ventricular arrhythmias that may lead to delivering optimized treatment options in improving the survival rates. In this thesis two major types of ventricular arrhythmias were analyzed and quantified by performing discriminative sparse coding analysis called label consistent K-SVD using time frequency dictionaries that are well localized in time and frequency domains. The analyzed signals were 670 ECG ventricular arrhythmia segments from 33 patients extracted from the Malignant Ventricular Ectopy and Creighton University Tachy-Arrhythmia databases. Using the LCKSVD dictionary learning approach, an overall maximum classification accuracy of 73.3% was achieved with a hybrid optimized wavelet dictionary. Based on the comparative analysis, the trained (learned) dictionaries yielded better performance than the untrained dictionaries. The results indicate that discriminative sparse coding approach has greater potential in extracting signal adaptive and morphologically discriminative time-frequency structures in studying ventricular arrhythmias.

scholarly journals A cross sectional survey in paediatricians pertaining to management of functional gastrointestinal disorders in infants: Indian perspectives

2020 ◽  
Vol 7 (10) ◽  
pp. 2015
Author(s):  
Shrish Bhatnagar ◽  
Roshan R. Mane ◽  
Irfan A. Shaikh ◽  
Ganesh Kadhe
Keyword(s):  
Quality Of Life ◽  
Parental Education ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Disorders ◽  
Cross Sectional Survey ◽  
Management Options ◽  
Cross Sectional ◽  
Breastfed Infants ◽  
Best Management

Background: Functional gastrointestinal disorders (FGIDs) in infants and toddlers possess extensive burden to the parents and healthcare professionals. Guidelines addressing the practices in diagnosis and management of FGIDs in infants in Indian subcontinent is unavailable. Hence this study assessed current knowledge, attitude and practice of pediatricians in diagnosis and treatment of FGIDs.Methods: A cross-sectional survey based on a structured questionnaire assessed pediatrician’s knowledge about prevalence and profile of most common GI disorders in pediatric age groups (birth to 12 months), association of FGIDs with different feeding practices, impact of FGID on quality of life, various management options and physician preferred method of treatment.Results: Colic was rated as the most common GI disorder, followed by gassiness/fussiness, regurgitation and constipation. About 59% pediatricians come across FGIDs more in formula-fed infants compared to breastfed infants (4.2%) and 93.9% pediatricians affirm that FGIDs affect quality of life. Approximately 91% pediatricians believed reassurance and education was the best management option, which was also reported as the preferred mode of management by about 89% pediatricians, whereas pharmacological therapies were the least preferred (1.6%). For breastfed infants suffering with regurgitation, colic or constipation, majority pediatricians opted for switching to 100% whey partially hydrolysed protein formula; sequentially followed by use of pre/probiotics and switch to extensively hydrolyzed protein formula.Conclusions: Parental education and reassurance offer an ideal mode of management of FGIDs. Partially hydrolysed protein formula may be considered one of the best management options irrespective of the FGID condition in infants who are breastfeed.

scholarly journals Análise da proposta do Plano de Manejo para estruturação do Parque Estadual do Biribiri

2012 ◽  
Vol 5 (2) ◽  
Author(s):  
Raquel Campos Antunes ◽  
Álvaro José Ferreira Tôrres ◽  
Raquel Faria Scalco
Keyword(s):  
Environmental Impacts ◽  
Management Plan ◽  
Park Management ◽  
Structured Interviews ◽  
Natural Park ◽  
Physical Infrastructure ◽  
Environmental Development ◽  
Research Analysis

A presente pesquisa foi desenvolvida com o objetivo de analisar a proposta do Plano de Manejo do Parque Estadual do Biribiri – PEBI, localizado em Diamantina – MG, no que se refere à implantação de estruturas físicas de apoio à visitação e gestão do Parque. Para tanto, foram utilizados os seguintes procedimentos metodológicos: pesquisa bibliográfica, pesquisa de gabinete, análise do plano de manejo e entrevista semiestruturada com atores que se mostraram relevantes para a realização deste estudo. Por meio do desenvolvimento destas etapas, foi possível entender a necessidade de atualização, revisão e implementação das estruturas propostas no Plano de Manejo do PEBI para oferecer condições mínimas para sua visitação. Percebeu-se que a presença de tais estruturas poderia contribuir de maneira positiva,pois possibilitariam um maior controle e segurança ao Parque, aumento da conservação do meio ambiente, além damelhoria da qualidade da visitação turística da área. Constatou-se, ainda, que a implantação de tais estruturas contribuiria para minimizar impactos ambientais negativos e para o desenvolvimento turístico, socioeconômico e ambiental de Diamantina e região. ABSTRACT This research was developed with the purpose of analyzing the proposal of the Management Plan of the Biribiri State Natural Park (PEBI), located in Diamantina (MG, Brazil), with regard to the deployment of physical infrastructure to support visitors and park management. For this purpose, we used the following methodological proceedings: bibliographic research, cabinet research, analysis of the management plan and semi-structured interviews with actors that were relevant to this study. Through the development of these steps, we can understand the necessity for updating, revision and implementation of the proposed structures in the Management Plan of the PEBI to offer the minimum conditions for their visitation. It was noticed that the presence of such structures could contribute in a positive way, as would enable greater control and security to the park, increased conservation of the environment, in addition to improving the quality of tourist visitation in this area. It was found also that the implementation of such structures would help to minimize negative environmental impacts and for tourism, socioeconomic and environmental development of Diamantina and region.

Dermatology

2018 ◽  
Author(s):  
Gemma Simcox
Keyword(s):  
Quality Of Life ◽  
Skin Disease ◽  
Skin Diseases ◽  
Systemic Disease ◽  
Management Plan ◽  
Dermatological Examination ◽  
Common Skin ◽  
Life Threatening ◽  
The Uk

Skin disease has a serious impact on an individual’s quality of life. It is well recognized that conditions such as psoriasis may have a similar impact on a patient’s quality of life to chronic diseases such as diabetes, hypertension, and depression. Skin problems account for approximately 20% of all patient consultations in primary care in the UK. It is important that clinicians are able to diagnose common skin diseases such as acne, eczema, psoriasis, and cutaneous malignancies and initiate an appropriate management plan. This requires the ability to take a full history and conduct a complete examination. A complete dermatological examination involves examination of the entire skin, mucous membranes, hair, and nails. The description of cutaneous pathologies should include the location and distribution of lesions. The morphology of a lesion or each component of a generalized eruption should be noted. Other organ systems may also need to be examined. The questions in this chapter will test your knowledge of the skin problems that are frequently encountered in non-specialist clinical practice. Other more rare skin disorders are also covered, either because they are potentially life-threatening or because they are a sign of systemic disease. The questions are designed to improve your ability to recognize the morphology and distribution of cutaneous physical signs. Hopefully you will find these questions stimulating and an aid to improving your knowledge of skin disease.

Psychosocial Issues of Patients With Implantable Cardioverter Defibrillators

2005 ◽  
Vol 14 (4) ◽  
pp. 294-303 ◽  
Author(s):  
Sandra B. Dunbar
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Standard Therapy ◽  
Ventricular Arrhythmias ◽  
Evidence Based ◽  
Psychosocial Issues ◽  
Implantable Cardioverter Defibrillators ◽  
Life Threatening ◽  
Cardioverter Defibrillators

Use of implantable cardioverter defibrillators has become standard therapy for patients at high risk for life-threatening ventricular arrhythmias. Although acceptance of the device is generally high among patients and their families, quality of life and psychosocial issues associated with use of the defibrillators deserve greater attention to improve outcomes. Psychosocial issues, their ramifications, and theory-and evidence-based approaches to improving outcomes are described.

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