Search results for: pulmonary heart valve

Authors: Yori Gidron, Laura Caton, Irit Ben-Aharon

Abstract:

Background: Many patients and even certain clinicians attribute cancer development to psychosocial factors. Yet, empirical data supports more the prognostic role, rather than the etiological role, of psychosocial factors in cancer. Part of the inconsistency may result from not considering possible moderating factors in the etiological role of psychosocial factors. One important candidate moderating factor is the vagal nerve, whose activity is indexed by heart-rate variability (HRV). The vagal nerve may prevent cancer since it reduces inflammation on the one hand, and since it increases anti-tumor immunity on the other hand. This study examined the moderating role of the vagus in the relation between life threatening events (LTE) and cancer development. Method: We re-analyzed data from the Lifelines Dutch longitudinal cohort study of over 150,000 people. The present study included 82,751 adults, who initially were cancer-free. We extracted information on background factors (e.g., age, gender, fat consumption), whether they ever experienced LTE, HRV and cancer diagnosis as reported by patients in annual clinic visits. HRV was derived from brief ECGs. Results: Of the full sample, 1011 people developed cancer during a follow-up. In the full sample, LTE significantly predicted cancer development (R.R = 1.063 p < .01) and HRV significantly predicted a reduced risk of cancer development (R.R = .506 p <.001). Importantly, LTE significantly predicted cancer only when HRV was low (R.R = 1.056, 95% CI: 1.007 - 1.108, p < .05) but not when HRV was high (R.R = 1.014; 95% CI: 0.916 - 1.122, p > 0.05), independent of confounders. Conclusions: To the best of our knowledge, this is the first study showing in a large sample that LTE predict cancer development, and that this occurs only when vagal nerve activity (HRV) is relatively low. These results could result from lack of vagal modulation of inflammation and also from lack of vagal modulation of stress responses. Results are in line with the cancer-protective role of the vagus. HRV needs to be routinely monitored in the population and future intervention trials need to examine whether vagal nerve activation can prevent cancer in people with LTE and with other cancer risk factors.

Keywords: cancer development, life-events, moderation, vagal nerve

Procedia PDF Downloads 160

Authors: A. Bortkiewcz, A. Dudarewicz, P. Małecki, M. Kłaczyński, T. Wszołek, Małgorzata Pawlaczyk-Łuszczyńska

Abstract:

Low-frequency noise (LFN) has been recognized as a special environmental pollutant. It is usually considered a broadband noise with the dominant content of low frequencies from 10 Hz to 250 Hz. A growing body of data shows that LFN differs in nature from other environmental noises, which are at comparable levels but not dominated by low-frequency components. The primary and most frequent adverse effect of LFN exposure is annoyance. Moreover, some recent investigations showed that LFN at relatively low A-weighted sound pressure levels (40−45 dB) occurring in office-like areas could adversely affect the mental performance, especially of high-sensitive subjects. It is well documented that high-frequency noise disturbs various types of human functions; however, there is very little data on the impact of LFN on well-being and health, including the cardiovascular system. Heart rate variability (HRV) is a sensitive marker of autonomic regulation of the circulatory system. Walker and co-workers found that LFN has a significantly more negative impact on cardiovascular response than exposure to high-frequency noise and that changes in HRV parameters resulting from LFN exposure tend to persist over time. The negative reactions of the cardiovascular system in response to LFN generated by wind turbines (20-200 Hz) were confirmed by Chiu. The scientific aim of the study is to assess the relationship between the spectral-temporal characteristics of LFN and the activity of the autonomic nervous system, considering the subjective assessment of annoyance, sensitivity to this type of noise, and cognitive and general health status. The study will be conducted in 20 male students in a special, acoustically prepared, constantly supervised room. Each person will be tested 4 times (4 sessions), under conditions of non-exposure (sham) and exposure to noise of wind turbines recorded at a distance of 250 meters from the turbine with different frequencies and frequency ranges: acoustic band 20 Hz-20 kHz, infrasound band 5-20 Hz, acoustic band + infrasound band. The order of sessions of the experiment will be randomly selected. Each session will last 1 h. There will be a 2-3 days break between sessions to exclude the possibility of the earlier session influencing the results of the next one. Before the first exposure, a questionnaire will be conducted on noise sensitivity, general health status using the GHQ questionnaire, hearing organ status and sociodemographic data. Before each of the 4 exposures, subjects will complete a brief questionnaire on their mood and sleep quality the night before the test. After the test, the subjects will be asked about any discomfort and subjective symptoms during the exposure. Before the test begins, Holter ECG monitoring equipment will be installed. HRV will be analyzed from the ECG recordings, including time and frequency domain parameters. The tests will always be performed in the morning (9-12) to avoid the influence of diurnal rhythm on HRV results. Students will perform psychological tests 15 minutes before the end of the test (Vienna Test System).

Keywords: neurovegetative control, heart rate variability (HRV), cognitive processes, low frequency noise

Procedia PDF Downloads 68

Authors: Lauren Dhugga, Meena Parameswaran, David Blundell, Abbas Khushnood

Abstract:

Context: A multidisciplinary weekly safety briefing was implemented at the Paediatric Cardiothoracic Unit at the Freeman Hospital in Newcastle-upon-Tyne. It is a tertiary referral centre with a quarternary cardiac paediatric intensive care unit and provides complexed care including heart and lung transplants, mechanical support and advanced heart failure assessment. Aim: The aim of this briefing is to provide a structured platform of communication, in an effort to improve efficiency, safety, and patient care. Problem: The paediatric cardiothoracic unit is made up of a vast multidisciplinary team including doctors, intensivists, anaesthetists, surgeons, specialist nurses, echocardiogram technicians, physiotherapists, psychologists, dentists, and dietitians. It provides care for children with congenital and acquired cardiac disease and is one of only two units in the UK to offer paediatric heart transplant. The complexity of cases means that there can be many teams involved in providing care to each patient, and frequent movement of children between ward, high dependency, and intensive care areas. Currently, there is no structured forum for communicating important information across the department, for example, staffing shortages, prescribing errors and significant events. Strategy: An initial survey questioning the need for better communication found 90% of respondents agreed that they could think of an incident that had occurred due to ineffective communication, and 85% felt that incident could have been avoided had there been a better form of communication. Lastly, 80% of respondents felt that a weekly 60 second safety briefing would be beneficial to improve communication within our multidisciplinary team. Based on those promising results, a weekly 60 second safety briefing was implemented to be conducted on a Monday morning. The safety briefing covered four key areas (SAFE): staffing, awareness, fix and events. This was to highlight any staffing gaps, any incident reports to be learned from, any issues that required fixing and any events including teachings for the week ahead. The teams were encouraged to email suggestions or issues to be raised for the week or to approach in person with information to add. The safety briefing was implemented using change theory. Effect: The safety briefing has been trialled over 6 weeks and has received a good buy in from staff across specialties. The aim is to embed this safety briefing into a weekly meeting using the PDSA cycle. There will be a second survey in one month to assess the efficacy of the safety briefing and to continue to improve the delivery of information. The project will be presented at the next clinical governance briefing to attract wider feedback and input from across the trust. Lessons: The briefing displays promise as a tool to improve vigilance and communication in a busy multi-disciplinary unit. We have learned about how to implement quality improvement and about the culture of our hospital - how hierarchy influences change. We demonstrate how to implement change through a grassroots process, using a junior led briefing to improve the efficiency, safety, and communication in the workplace.

Keywords: briefing, communication, safety, team

Procedia PDF Downloads 131

Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

Abstract:

Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

Procedia PDF Downloads 193

Authors: Omar Awad, R. Mamat, F. Yusop, M. M. Noor, I. M. Yusri

Abstract:

Fusel oil is a by-product obtained through the fermentation of some agricultural products. The fusel oil properties are closer to other alternative combustible types and the limited number of studies on the use of fusel oil as an alcohol derivative in SI engines constitutes to the base of this study. This paper experimentally examined the impacts of a by-product of alcohol, which is fusel oil by blending it with gasoline, on engine performance, combustion characteristics, and emissions in a 4-cylinder SI engine. The test was achieved at different engine speeds and a 60 % throttle valve (load). As results, brake power, BTE, and BSFC of F10 are higher at all engine speeds. Maximum engine BTE was 33.9%, at the lowest BSFC with F10. Moreover, it is worth seeing that the F10 under rich air-fuel ratio has less variation of COVIMEP compared to the F20 and gasoline. F10 represents shorter combustion duration, thereby, the engine power increased. NOx emission for F10 at 4500 rpm was lower than gasoline. The highest value of HC emission is obtained with F10 compared to gasoline and F20 with an average increase of 11% over the engine speed range. CO and CO2 emissions increased when using fusel oil blends.

Keywords: fusel oil, spark ignition engine, by-product alcohol, combustion characteristics, engine emissions, alternative fuel

Procedia PDF Downloads 465

Authors: Hyun Chang Kim, Yong Hun Jung, Kyung Woon Jeung

Abstract:

Background: From the viewpoint of cardiac pump theory, the area of the left ventricle (LV) subjected to compression increases as the LV lies closer to the sternum, possibly resulting in higher blood flow in patients with LV closer to the sternum. However, no study has evaluated LV position during cardiac arrest or its relationship with hemodynamic parameters during cardiopulmonary resuscitation (CPR). The objectives of this study were to determine whether the position of the LV relative to the anterior-posterior axis representing the direction of chest compression shifts during cardiac arrest and to examine the relationship between LV position and hemodynamic parameters during CPR. Methods: Subcostal view echocardiograms were obtained from 15 pigs with the transducer parallel to the long axis of the sternum before inducing ventricular fibrillation (VF) and during cardiac arrest. Computed tomography was performed in three pigs to objectively observe LV position during cardiac arrest. LV position parameters including the shortest distance between the anterior-posterior axis and the mid-point of the LV chamber (DAP-MidLV), the shortest distance between the anterior-posterior axis and the LV apex (DAP-Apex), and the area fraction of the LV located on the right side of the anterior-posterior axis (LVARight/LVATotal) were measured. Results: DAP-MidLV, DAP-Apex, and LVARight/LVATotal decreased progressively during untreated VF and basic life support (BLS), and then increased during advanced cardiovascular life support (ACLS). A repeated measures analysis of variance revealed significant time effects for these parameters. During BLS, the end-tidal carbon dioxide and systolic right atrial pressure were significantly correlated with the LV position parameters. During ACLS, systolic arterial pressure and systolic right atrial pressure were significantly correlated with DAP-MidLV and DAP-Apex. Conclusions: LV position changed significantly during cardiac arrest compared to the pre-arrest baseline. LV position during CPR had significant correlations with hemodynamic parameters.

Keywords: heart arrest, cardiopulmonary resuscitation, heart ventricle, hemodynamics

Procedia PDF Downloads 180

Authors: Tarcisio F. Leao, Bruno Utiyama, Jeison Fonseca, Eduardo Bock, Aron Andrade

Abstract:

This work presents a blood flow estimator based in Look-Up-Table (LUT) for control of Left Ventricular Assist Device (LVAD). This device has been used as bridge to transplantation or as destination therapy to treat patients with heart failure (HF). Destination Therapy application requires a high performance LVAD; thus, a stable control is important to keep adequate interaction between heart and device. LVAD control provides an adequate cardiac output while sustaining an appropriate flow and pressure blood perfusion, also described as physiologic control. Because thrombus formation and system reliability reduction, sensors are not desirable to measure these variables (flow and pressure blood). To achieve this, control systems have been researched to estimate blood flow. LVAD used in the study is composed by blood centrifugal pump, control, and power supply. This technique used pump and actuator (motor) parameters of LVAD, such as speed and electric current. Estimator relates electromechanical torque (motor or actuator) and hydraulic power (blood pump) via LUT. An in vitro Mock Loop was used to evaluate deviations between blood flow estimated and actual. A solution with glycerin (50%) and water was used to simulate the blood viscosity with hematocrit 45%. Tests were carried out with variation hematocrit: 25%, 45% and 58% of hematocrit, or 40%, 50% and 60% of glycerin in water solution, respectively. Test with bovine blood was carried out (42% hematocrit). Mock Loop is composed: reservoir, tubes, pressure and flow sensors, and fluid (or blood), beyond LVAD. Estimator based in LUT is patented, number BR1020160068363, in Brazil. Mean deviation is 0.23 ± 0.07 L/min for mean flow estimated. Larger mean deviation was 0.5 L/min considering hematocrit variation. This estimator achieved deviation adequate for physiologic control implementation. Future works will evaluate flow estimation performance in control system of LVAD.

Keywords: blood pump, flow estimator, left ventricular assist device, look-up-table

Procedia PDF Downloads 171

Authors: Erdinç Vural, Bülent Özdalyan, Serkan Özel

Abstract:

The four-stroke single cylinder diesel engine has been used in this study, the pistons and valves of the engine have been stabilized, the aluminum oxide (Al₂O₃) in different ratios has been added in the power of zirconium (ZrO₂) magnesium oxide (MgO), and has been coated with the plasma spray method. The pistons and valves of the combustion chamber of the engine are coated with 5 different (ZrO₂ + MgO), (ZrO₂ + MgO + 25% Al₂O₃), (ZrO₂ + MgO + 50% Al₂O₃), (ZrO₂ + MgO + 75% Al₂O₃), (Al₂O₃) sample. The material tests have been made for each of the coated engine parts with the scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD) using Cu Kα radiation surface analysis methods. The engine tests have been repeated for each sample in any electric dynamometer in full power 1600 rpm, 2000 rpm, 2400 rpm and 2800 rpm engine speeds. The material analysis and engine tests have shown that the best performance has been performed with (ZrO₂ + MgO + 50% Al₂O₃). Thus, there is no significant change in HC and Smoke emissions, but NOx emission is increased, as the engine improves power, torque, specific fuel consumption and CO emissions in the tests made with sample A3.

Keywords: ceramic coating, material characterization, engine performance, exhaust emissions

Procedia PDF Downloads 361

Authors: Daljinder Singh, J.S.Dhillon, Balraj Singh

Abstract:

According to no free lunch theorem, a single search technique cannot perform best in all conditions. Optimization method can be attractive choice to solve optimization problem that may have exclusive advantages like robust and reliable performance, global search capability, little information requirement, ease of implementation, parallelism, no requirement of differentiable and continuous objective function. In order to synergize between exploration and exploitation and to further enhance the performance of Bat algorithm, the paper proposed a modified bat algorithm that adds additional search procedure based on bat’s previous experience. The proposed algorithm is used for solving the economic load dispatch (ELD) problem. The practical constraint such valve-point loading along with power balance constraints and generator limit are undertaken. To take care of power demand constraint variable elimination method is exploited. The proposed algorithm is tested on various ELD problems. The results obtained show that the proposed algorithm is capable of performing better in majority of ELD problems considered and is at par with existing algorithms for some of problems.

Keywords: bat algorithm, economic load dispatch, penalty method, variable elimination method

Procedia PDF Downloads 451

Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

Abstract:

Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

Procedia PDF Downloads 477

Authors: Faezeh Jahanpour, Shahin Dezhdar, Saeedeh Firouz Bakht, Afshin Ostovar

Abstract:

Objective: The hospitalized premature babies often undergo various painful procedures such as venous sampling. The Kangaroo mother care (KMC) method is one of the pain reduction methods, but as mother’s presence is not always possible, this research was done to compare the effect of swaddling and KMC method on venous sampling pain on premature neonates. Methods: In this randomized clinical trial 90 premature infants selected and randomly alocated into three groups; Group A (swaddling), Group B (the kangaroo care), and group C (the control). From 10 minutes before blood sampling to 2 minutes after that in group A, the infant was wrapped in a thin sheet, and in group B, the infant was under Kangaroo care. In all three groups, the heart rate and arterial oxygen saturation in time intervals of 30 seconds before, during, 30-60-90, and 120 seconds after sampling were measured and recorded. The infant’s face was video recorded since sampling till 2 minutes and the videos were checked by a researcher who was unaware of the kind of intervention and the pain assessment tools for infants (PIPP) for time intervals of 30 seconds were completed. Data analyzed by t-test, Q square, Repeated Measure ANOVA, Kruskal-Wallis, Post-hoc and Bonferroni test. Results: Findings revealed that the pain was reduced to a great extent in swaddling and kangaroo method compared to that in control group. But there was not a significant difference between kangaroo and swaddling care method (P ≥ 0.05). In addition, the findings showed that the heart rate and arterial oxygen saturation was low and stable in swaddling and Kangaroo care method and returned to base status faster, whereas, the changes were severe in control group and did not return to base status even after 120 seconds. Discussion: The results of this study showed that there was not a meaningful difference between swaddling and kangaroo care method on physiological indexes and pain in infants. Therefore, swaddling method can be a good substitute for kangaroo care method in this regard.

Keywords: Kangaroo mother care, neonate, pain, premature, swaddling, venipuncture,

Procedia PDF Downloads 202

Authors: Alireza Alizadeh, Hossein Ghadimi, Oveis Abedinia, Noradin Ghadimi

Abstract:

A Particle Swarm Optimization with Time Varying Acceleration Coefficients (PSO-TVAC) is proposed to determine optimal economic load dispatch (ELD) problem in this paper. The proposed methodology easily takes care of solving non-convex economic load dispatch problems along with different constraints like transmission losses, dynamic operation constraints and prohibited operating zones. The proposed approach has been implemented on the 3-machines 6-bus, IEEE 5-machines 14-bus, IEEE 6-machines 30-bus systems and 13 thermal units power system. The proposed technique is compared to solve the ELD problem with hybrid approach by using the valve-point effect. The comparison results prove the capability of the proposed method giving significant improvements in the generation cost for the economic load dispatch problem.

Keywords: PSO-TVAC, economic load dispatch, non-convex cost function, prohibited operating zone, transmission losses

Procedia PDF Downloads 380

Authors: Pulari C. Milu Maria Anto

Abstract:

Background: Cognitive Rehabilitation/Retraining has been variously used in the research literature to represent non-pharmacological interventions that target the cognitive impairments with the goal of ameliorating cognitive function and functional behaviors to optimize the quality of life. Along with adult’s cognitive impairments, the need to address acquired cognitive impairments (due to any chronic illnesses like CHD - congenital heart diseases or ALL - Acute Lymphoblastic Leukemia) among child populations is inevitable. Also, it has to be emphasized as same we consider the cognitive impairments seen in the children having neurodevelopmental disorders. Methods: All published brain image studies (Hermann, B. et al,2002, Khalil, A. et al., 2004, Follin, C. et al, 2016, etc.) and studies emphasizing cognitive impairments in attention, memory, and/or executive function and behavioral aspects (Henkin, Y. et al,2007, Bellinger, D. C., & Newburger, J. W. (2010), Cheung, Y. T., et al,2016, that could be identified were reviewed. Based on a systematic review of the literature from (2000 -2021) different brain imaging studies, increased risk of neuropsychological and psychosocial impairments are briefly described. Clinical and research gap in the area is discussed. Results:30 papers, both Indian studies and foreign publications (Sage journals, Delhi psychiatry journal, Wiley Online Library, APA PsyNet, Springer, Elsevier, Developmental medicine, and child neurology), were identified. Conclusions: In India, a very limited number of brain imaging studies and neuropsychological studies have done by indicating the cognitive deficits of a child having or undergone chronic illness. None of the studies have emphasized the relevance nor the need of implementingCR among such children, even though its high time to address but still not established yet. The review of the current evidence is to bring out an insight among rehabilitation professionals in establishing a child specific CR and to publish new findings regarding the implementation of CR among such children. Also, this study will be an awareness on considering cognitive aspects of a child having acquired cognitive deficit (due to chronic illness), especially during their critical developmental period.

Keywords: cognitive rehabilitation, neuropsychological impairments, congenital heart diseases, acute lymphoblastic leukemia, epilepsy, and neuroplasticity

Procedia PDF Downloads 168

Authors: Samaneh Nazeri, Bagher Mojazi Amiri, Hamid Farahmand

Abstract:

Production of high quality fish eggs with reasonable hatching rate makes a success in aquaculture industries. It is influenced by the environmental stimulators and inhibitors. Diazinon is a widely-used pesticide in Golestan province (Southern Caspian Sea, North of Iran) which is washed to the aquatic environment (3 mg/L in the river). It is little known about the effect of this pesticide on the embryogenesis of sturgeon fish, the valuable species of the Caspian Sea. Hormonal content of the egg is an important factor to guaranty the successful passes of embryonic stages. In this study, the fate of Persian sturgeon embryo to 24, 48, 72, and 96-hours exposure of diazinon (LC₅₀ dose) was tested. Also, the effect of thyroid hormones (T3 and T4) on these embryos was tested concurrently or separately with diazinon LC ₅₀ dose. Fertilized eggs are exposed to T3 (low dose: 1 ng/ml, high dose: 10 ng/ml), T4 (low dose: 1 ng/ml, high dose: 10 ng/ml). Six eggs were randomly selected from each treatment (with three replicates) in five developmental stages (two cell- division, neural, heart present, heart beaten, and hatched larvae). The possibility of changing T3, T4, and cortisol contents of the embryos were determined in all treated groups and in every mentioned embryonic stage. The hatching rate in treated groups was assayed at the end of the embryogenesis to clarify the effect of thyroid hormones and diazinon. The results indicated significant differences in thyroid hormone contents, but no significant differences were recognized in cortisol levels at various early life stages of embryos. There was also significant difference in thyroid hormones in (T3, T4) + diazinon treated embryos (P˂0.05), while no significant difference between control and treatments in cortisol levels was observed. The highest hatching rate was recorded in HT3 treatment, while the lowest hatching rate was recorded for diazinon LC₅₀ treatment. The result confirmed that Persian sturgeon embryo is less sensitive to diazinon compared to teleost embryos, and thyroid hormones may increase hatching rate even in the presence of diazinon.

Keywords: Persian sturgeon, diazinon, thyroid hormones, cortisol, embryo

Procedia PDF Downloads 293

Authors: Thibaud Berthomier, Ali Mansour, Luc Bressollette, Frédéric Le Roy, Dominique Mottier, Léo Fréchier, Barthélémy Hermenault

Abstract:

Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators.

Keywords: deep venous thrombosis, ultrasonography, elastography, scattering operator, wavelet, spectral clustering

Procedia PDF Downloads 468

Authors: Wissem Abdaoui, Ilhem Mokhtari, Adel Gouri, Benouareth Djamel Eddine

Abstract:

Contracted in a health facility, hospital-acquired infections are a major public health problem in recent years. The increase of nosocomial infections is partly related to diagnostic and therapeutic advances in medicine. The aim of our study was to isolate and diagnose some types of bacteria that are circulating in the hospital by performing different samples at two medical services: Pulmonary and Infectious Diseases. The antibiotic susceptibility tests were performed for bacterial isolates. The results have shown that there is a predominance of enterobacteria followed by the staphylococcus with its two species epidermidis ans saprophyticus. The study of the antibiogramme identified that some of these bacteria have a resistant profile against all the tested antibiotics. The fight against nosocomial infections is difficult because it must act on several factors: quality of care, safety of the hospital environment, hygiene, wearing gloves etc. are all areas that should be of heightened vigilance and preventive measures.

Keywords: nosocomial infection, isolation, identification, sensitivity and resistance to antibiotics

Procedia PDF Downloads 367

Authors: Munkhtuul G., Bolortsetseg Z., Lutzul M., Sugar N., Nyamdorj D., Nomundari B., Zesemdorj O., Erdenebayar N., Lkhagvasuren T. S., Munkhbayarlakh S., Bayasgalan T. Uurtuya S. H.

Abstract:

Background: Elevated serum uric acid (SUA) levels are observed in metabolic and cardiovascular conditions as an early predictor of metabolic syndrome (MS). Hyperuricemia, characterised by high uric acid levels in serum, increases the risk of developing MS by 1.6 times. Being overweight and obese significantly contributes to developing MS and cardiovascular disorders. In Mongolia, the prevalence of overweight and obesity is reaching 48.8% among individuals aged 15 to 49 years, indicating a potential surge in the incidence of MS, cardiovascular disorders, diabetes mellitus, and gout.Objective: This study aimed to determine the SUA levels in men diagnosed with MS and investigate the factors influencing these levels.Methods: A total of 119 men aged 30-60, who underwent preventive examinations and resided in Ulaanbaatar city, were included in the study. The criteria established by the International Diabetes Federation (IDF), American Heart Association (AHA), and the National Heart, Lung, and Blood Institute (NHLBI) were employed to define metabolic syndrome. Hyperuricemia was defined as SUA levels ≥7 mg/dL. Dietary intake was evaluated through the 24-hour recall method.Results: The study revealed that the prevalence of MS among the participants was 42.9% (n=51), with hyperuricemia observed in 16.8% (n=20) of the individuals. Among men diagnosed with MS, 21.3% (n=10) exhibited hyperuricemia. The mean SUA levels were as follows: 4.7±0.8 mg/dL in the healthy group, 5.9±1.1 mg/dL in men without MS but presenting central obesity, and 6.2±1.3 mg/dL in men with MS. After adjusting for age and body mass index (BMI), a positive correlation was observed between SUA levels and triglycerides (β=0.93) as well as lipid accumulation product (LAP) (β=0.92) in men with MS. In the central obesity group, SUA levels exhibited a positive correlation with triglycerides (β=0.91), visceral adiposity index (VAI) (β=0.73), LAP (β=0.92), and cardiometabolic index (CMI) (β=0.69). The risk of hyperuricemia increased by 3.29 times with elevated triglycerides and 3.53 times with an increased LAP.Conclusion: The findings indicate that abdominal fat accumulation, as indicated by elevated triglyceride levels and LAP, is associated with increased SUA levels in men with MS. However, no significant relationship was observed between SUA levels and dietary intake.

Keywords: central obesity, obesity, triglycerides, hyperuricemia

Procedia PDF Downloads 49

Authors: Eric Chappel, Dimitry Dumont-Fillon, Hugo Musard, Harald van Lintel

Abstract:

A microfluidic radial diffuser typically comprises a hole in a membrane, a small gap and pillar centred with the hole. The fluid is forced to flow radially in this gap between the membrane and the pillar. Such diffusers are notably used to form flow control valves, wherein several holes are machined into a flexible membrane progressively deflecting against pillars as the pressure increases. The fluidic modelling of such diffuser is made difficult by the presence of a transition region between the hole and the diffuser itself. An experimental investigation has been conducted using SOI wafers to form membranes with only one centred hole and Pyrex wafers for the substrate and pillars, both wafers being anodically bonded after alignment. A simple fluidic model accounting for the specific geometry of the diffuser is proposed and compared to experimental results. A good match is obtained, for Reynolds number in the range 0.5 to 35 using the analytical formula of a radial diffuser in the laminar regime with an effective inner radius that is 40% smaller than the real radius, in order to simulate correctly the flow constriction at the entrance of the diffuser.

Keywords: radial diffuser, flow control valve, numerical modelling, drug delivery

Procedia PDF Downloads 268

Authors: Amin Sedighfar, M. R. Moniri

Abstract:

Determination of state of charge (SOC) in today’s world becomes an increasingly important issue in all the applications that include a battery. In fact, estimation of the SOC is a fundamental need for the battery, which is the most important energy storage in Hybrid Electric Vehicles (HEVs), smart grid systems, drones, UPS and so on. Regarding those applications, the SOC estimation algorithm is expected to be precise and easy to implement. This paper presents an online method for the estimation of the SOC of Valve-Regulated Lead Acid (VRLA) batteries. The proposed method uses the well-known Kalman Filter (KF), and Neural Networks (NNs) and all of the simulations have been done with MATLAB software. The NN is trained offline using the data collected from the battery discharging process. A generic cell model is used, and the underlying dynamic behavior of the model has used two capacitors (bulk and surface) and three resistors (terminal, surface, and end), where the SOC determined from the voltage represents the bulk capacitor. The aim of this work is to compare the performance of conventional integration-based SOC estimation methods with a mixed algorithm. Moreover, by containing the effect of temperature, the final result becomes more accurate. 

Keywords: Kalman filter, neural networks, state-of-charge, VRLA battery

Procedia PDF Downloads 180

Authors: Bachir Bentouati, Lakhdar Chaib, Saliha Chettih, Gai-Ge Wang

Abstract:

The problem of economic dispatch (ED) is the basic problem of power framework, its main goal is to find the most favorable generation dispatch to generate each unit, reduce the whole power generation cost, and meet all system limitations. A heuristic algorithm, recently developed called Stud Krill Herd (SKH), has been employed in this paper to treat non-convex ED problems. The proposed KH has been modified using Stud selection and crossover (SSC) operator, to enhance the solution quality and avoid local optima. We are demonstrated SKH effects in two case study systems composed of 13-unit and 40-unit test systems to verify its performance and applicability in solving the ED problems. In the above systems, SKH can successfully obtain the best fuel generator and distribute the load requirements for the online generators. The results showed that the use of the proposed SKH method could reduce the total cost of generation and optimize the fulfillment of the load requirements.

Keywords: stud krill herd, economic dispatch, crossover, stud selection, valve-point effect

Procedia PDF Downloads 189

Authors: S. Nishat Fatima Rizvi, Tulika Chandra, Abbas Ali Mahdi, Devisha Agarwal

Abstract:

Introduction: Blood components are an unexplored area prone to numerous discoveries which influence patient’s care. Experiments at different levels will further change the present concept of blood banking. Hyperlipidemia is a condition of elevated plasma level of low-density lipoprotein (LDL) as well as decreased plasma level of high-density lipoprotein (HDL). Studies show that platelets play a vital role in the progression of atherosclerosis and thrombosis, a major cause of death worldwide. They are activated by many triggers like elevated LDL in the blood resulting in aggregation and formation of plaques. Hyperlipidemic platelets are frequently transfused to patients with various disorders. Screening the random donor platelets for hyperlipidemia and correlating the condition with other donor criteria such as lipid rich diet, oral contraceptive pills intake, weight, alcohol intake, smoking, sedentary lifestyle, family history of heart diseases will lead to further deciding the exclusion criteria for donor selection. This will help in making the patients safe as well as the donor deferral criteria more stringent to improve the quality of blood supply. Technical evaluation and assessment will enable blood bankers to supply safe blood and improve the guidelines for blood safety. Thus, we try to study the correlation between hyperlipidemic platelets with platelets parameters, weight, and specific history of the donors. Methodology: This case control study included 100 blood samples of Blood donors, out of 100 only 30 samples were found to be hyperlipidemic and were included as cases, while rest were taken as controls. Lipid Profile were measured by fully automated analyzer (TRIGL:triglycerides),(LDL-C:LDL –Cholesterol plus 2nd generation),CHOL 2: Cholesterol Gen 2), HDL C 3: HDL-Cholesterol plus 3rdgeneration)-(Cobas C311-Roche Diagnostic).And Platelets parameters were analyzed by the Sysmex KX21 automated hematology analyzer. Results: A significant correlation was found amongst hyperlipidemic level in single time donor. In which 80% donors have history of heart disease, 66.66% donors have sedentary life style, 83.3% donors were smokers, 50% donors were alcoholic, and 63.33% donors had taken lipid rich diet. Active physical activity was found amongst 40% donors. We divided donors sample in two groups based on their body weight. In group 1, hyperlipidemic samples: Platelet Parameters were 75% in normal 25% abnormal in >70Kg weight while in 50-70Kg weight 90% were normal 10% were abnormal. In-group 2, Non Hyperlipidemic samples: platelet Parameters were 95% normal and 5% abnormal in >70Kg weight, while in 50-70Kg Weight, 66.66% normal and 33.33% abnormal. Conclusion: The findings indicate that Hyperlipidemic status of donors may affect the platelet parameters and can be distinguished on history by their weight, Smoking, Alcoholic intake, Sedentary lifestyle, Active physical activity, Lipid rich diet, Oral contraceptive pills intake, and Family history of heart disease. However further studies on a large sample size will affirm this finding.

Keywords: blood donors, hyperlipidemia, platelet, weight

Procedia PDF Downloads 300

Authors: Pedro Llanos, Diego García

Abstract:

Spaceflight is considered the last frontier in terms of science, technology, and engineering. But it is also the next frontier in terms of human physiology and performance. After more than 200,000 years humans have evolved under earth’s gravity and atmospheric conditions, spaceflight poses environmental stresses for which human physiology is not adapted. Hypoxia, accelerations, and radiation are among such stressors, our research involves suborbital flights aiming to develop effective countermeasures in order to assure sustainable human space presence. The physiologic baseline of spaceflight participants is subject to great variability driven by age, gender, fitness, and metabolic reserve. The objective of the present study is to characterize different physiologic variables in a population of STEM practitioners during an aerobatic flight. Cardiovascular and pulmonary responses were determined in Science Astronaut Candidates (SACs) during unusual attitude aerobatic flight indoctrination. Physiologic data recordings from 20 subjects participating in high-G flight training were analyzed. These recordings were registered by wearable sensor-vest that monitored electrocardiographic tracings (ECGs), signs of dysrhythmias or other electric disturbances during all the flight. The same cardiovascular parameters were also collected approximately 10 min pre-flight, during each high-G/unusual attitude maneuver and 10 min after the flights. The ratio (pre-flight/in-flight/post-flight) of the cardiovascular responses was calculated for comparison of inter-individual differences. The resulting tracings depicting the cardiovascular responses of the subjects were compared against the G-loads (Gs) during the aerobatic flights to analyze cardiovascular variability aspects and fluid/pressure shifts due to the high Gs. In-flight ECG revealed cardiac variability patterns associated with rapid Gs onset in terms of reduced heart rate (HR) and some scattered dysrhythmic patterns (15% premature ventricular contractions-type) that were considered as triggered physiological responses to high-G/unusual attitude training and some were considered as instrument artifact. Variation events were observed in subjects during the +Gz and –Gz maneuvers and these may be due to preload and afterload, sudden shift. Our data reveal that aerobatic flight influenced the breathing rate of the subject, due in part by the various levels of energy expenditure due to the increased use of muscle work during these aerobatic maneuvers. Noteworthy was the high heterogeneity in the different physiological responses among a relatively small group of SACs exposed to similar aerobatic flights with similar Gs exposures. The cardiovascular responses clearly demonstrated that SACs were subjected to significant flight stress. Routine ECG monitoring during high-G/unusual attitude flight training is recommended to capture pathology underlying dangerous dysrhythmias in suborbital flight safety. More research is currently being conducted to further facilitate the development of robust medical screening, medical risk assessment approaches, and suborbital flight training in the context of the evolving commercial human suborbital spaceflight industry. A more mature and integrative medical assessment method is required to understand the physiology state and response variability among highly diverse populations of prospective suborbital flight participants.

Keywords: g force, aerobatic maneuvers, suborbital flight, hypoxia, commercial astronauts

Procedia PDF Downloads 114

Authors: Vassilena Dakova, Mariana Panayotova-Pencheva

Abstract:

The present work focused on the study of pulmonary helminth-fauna of the stone marten in Bulgaria in terms of which the data are little. For the purpose, four stone martens were helminthologically necropsied according to the common technique. In addition, some of the injured lung parts were investigated after their boiling in lactic acid and subsequent compression. Four nematode species from different families of order Strongylida and Trichocephalida were found in the lungs. These were Crenosoma petrowi Morosov, 1939; Eucoleus aerophilus Creplin, 1839; Filaroides martis Werner, 1782 and Sobolevingylus petrowi Romanov, 1952. Some of the parasite structures with taxonomic importance were measured and described. According to our best knowledge, the species F. martis and S. petrowi are recorded for the first time as a part of the helminth-fauna of Southeast Europe and Bulgaria in particular.

Keywords: Bulgaria, Crenosoma petrowi, Eucoleus aerophilus, Filaroides martis, lung parasites, Sobolevingylus petrowi, stone martens

Procedia PDF Downloads 131

Authors: Fayez Hanna, Viet Tran

Abstract:

A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

Procedia PDF Downloads 84

Authors: Osamede Asowata

Abstract:

The current resurgence of interest in the use of renewable energy is driven by the need to reduce the high environmental impact of fossil-based energy. The aim of this paper is to evaluate the effect of a stationary PV panel on the charging rate of deep-cycle valve regulated lead-acid (DCVRLA) batteries. Stationary PV panels are set to a fixed tilt and orientation angle, which plays a major role in dictating the output power of a PV panel and subsequently on the charging time of a DCVRLA battery. In a basic PV system, an energy storage device that stores the power from the PV panel is necessary due to the fluctuating nature of the PV voltage caused by climatic conditions. The charging and discharging times of a DCVRLA battery were determined for a twelve month period from January through December 2012. Preliminary results, which include regression analysis (R2), conversion-time per week and work-time per day, indicate that a 36 degrees tilt angle produces a good charging rate for a latitude of 26 degrees south throughout the year.

Keywords: tilt and orientation angles, solar chargers, PV panels, storage devices, direct solar radiation.

Procedia PDF Downloads 231

Authors: Mohd Jaish Siddiqui

Abstract:

Laryngeal TB is extremely rare in the pediatric population, accounting for 1% of all cases. Here, we present a case of laryngeal TB with miliary tuberculosis and tuberculous encephalitis, presented with sore throat, hoarseness, severe cough and, acute obstruction the larynx, sputum for AFB was negative, T-SPOT was positive and X-pert was positive, bronchoscopy revealed multiple nodules and edema around the larynx, epiglottis, bilateral arytenopharyngeal folds and vocal cord. Enhanced MRI revealed multiple small nodules in bilateral cerebral hemispheres and right thalamus, however CSF was negative. We reviewed the LTB cases that were published up to 2021. A total of twenty fine cases were identified in English literature. The most common manifestation was hoarseness of voice with 80% followed by stridor 40% of cases. Pulmonary involvement was found in 36% of cases, whereas, 45% of cases had no underlying TB. We did not find any case who developed tuberculous encephalitis in the literature.

Keywords: laryngeal tb, treatment, tuberculous encephalitis, children

Procedia PDF Downloads 34

Authors: Mohamed A. G. H. Abdalsadig, Amir Nourian, G. G. Nasr, Meisam Babaie

Abstract:

Gas lift optimization is becoming more important now a day in petroleum industry. A proper lift optimization can reduce the operating cost, increase the net present value (NPV) and maximize the recovery from the asset. A widely accepted definition of gas lift optimization is to obtain the maximum output under specified operating conditions. In addition, gas lift, a costly and indispensable means to recover oil from high depth reservoir entails solving the gas lift optimization problems. Gas lift optimization is a continuous process; there are two levels of production optimization. The total field optimization involves optimizing the surface facilities and the injection rate that can be achieved by standard tools softwares. Well level optimization can be achieved by optimizing the well parameters such as point of injection, injection rate, and injection pressure. All these aspects have been investigated and presented in this study by using experimental data and PROSPER simulation program. The results show that the well head pressure has a large influence on the gas lift performance and also proved that smart gas lift valve can be used to improve gas lift performance by controlling gas injection from down hole. Obtaining the optimum gas injection rate is important because excessive gas injection reduces production rate and consequently increases the operation cost.

Keywords: optimization, production rate, reservoir pressure effect, gas injection rate effect, gas injection pressure

Procedia PDF Downloads 400

Authors: Vitaliy Petrov, Natalia Shusharina, Vitaliy Kasymov, Maksim Patrushev, Evgeny Bogdanov

Abstract:

The leading worldwide death reasons are ischemic heart disease and other cardiovascular illnesses. Generally, the common symptom is high blood pressure. Long-time blood pressure control is very important for the prophylaxis, correct diagnosis and timely therapy. Non-invasive methods which are based on Korotkoff sounds are impossible to apply often and for a long time. Implantable devices can combine longtime monitoring with high accuracy of measurements. The main purpose of this work is to create a real-time monitoring system for decreasing the death rate from cardiovascular diseases. These days implantable electronic devices began to play an important role in medicine. Usually implantable devices consist of a transmitter, powering which could be wireless with a special made battery and measurement circuit. Common problems in making implantable devices are short lifetime of the battery, big size and biocompatibility. In these work, blood pressure measure will be the focus because it’s one of the main symptoms of cardiovascular diseases. Our device will consist of three parts: the implantable pressure sensor, external transmitter and automated workstation in a hospital. The Implantable part of pressure sensors could be based on piezoresistive or capacitive technologies. Both sensors have some advantages and some limitations. The Developed circuit is based on a small capacitive sensor which is made of the technology of microelectromechanical systems (MEMS). The Capacitive sensor can provide high sensitivity, low power consumption and minimum hysteresis compared to the piezoresistive sensor. For this device, it was selected the oscillator-based circuit where frequency depends from the capacitance of sensor hence from capacitance one can calculate pressure. The external device (transmitter) used for wireless charging and signal transmission. Some implant devices for these applications are passive, the external device sends radio wave signal on internal LC circuit device. The external device gets reflected the signal from the implant and from a change of frequency is possible to calculate changing of capacitance and then blood pressure. However, this method has some disadvantages, such as the patient position dependence and static using. Developed implantable device doesn’t have these disadvantages and sends blood pressure data to the external part in real-time. The external device continuously sends information about blood pressure to hospital cloud service for analysis by a physician. Doctor’s automated workstation at the hospital also acts as a dashboard, which displays actual medical data of patients (which require attention) and stores it in cloud service. Usually, critical heart conditions occur few hours before heart attack but the device is able to send an alarm signal to the hospital for an early action of medical service. The system was tested with wireless charging and data transmission. These results can be used for ASIC design for MEMS pressure sensor.

Keywords: MEMS sensor, RF power, wireless data, oscillator-based circuit

Procedia PDF Downloads 578

Authors: Sanjay Dhiraaj, Puneet Goyal, Aditya Kapoor, Gaurav Misra

Abstract:

In electrocardiography, an ECG artefact is used to indicate something that is not heart-made. Although technological advancements have produced monitors with the potential of providing accurate information and reliable heart rate alarms, despite this, interference of the displayed electrocardiogram still occurs. These interferences can be from the various electrical gadgets present in the operating room or electrical signals from other parts of the body. Artefacts may also occur due to poor electrode contact with the body or due to machine malfunction. Knowing these artefacts is of utmost importance so as to avoid unnecessary and unwarranted diagnostic as well as interventional procedures. We report a case of ECG artefacts occurring due to patient warming blanket and its consequences. A 20-year-old male with a preoperative diagnosis of exstrophy epispadias complex was posted for surgery under epidural and general anaesthesia. Just after endotracheal intubation, we observed nonspecific ECG changes on the monitor. At a first glance, the monitor strip revealed broad QRs complexes suggesting a ventricular bigeminal rhythm. Closer analysis revealed these to be artefacts because although the complexes were looking broad on the first glance there was clear presence of normal sinus complexes which were immediately followed by 'broad complexes' or artefacts produced by some device or connection. These broad complexes were labeled as artefacts as they were originating in the absolute refractory period of the previous normal sinus beat. It would be physiologically impossible for the myocardium to depolarize so rapidly as to produce a second QRS complex. A search for the possible reason for the artefacts was made and after deepening the plane of anaesthesia, ruling out any possible electrolyte abnormalities, checking of ECG leads and its connections, changing monitors, checking all other monitoring connections, checking for proper grounding of anaesthesia machine and OT table, we found that after switching off the patient’s warming apparatus the rhythm returned to a normal sinus one and the 'broad complexes' or artefacts disappeared. As misdiagnosis of ECG artefacts may subject patients to unnecessary diagnostic and therapeutic interventions so a thorough knowledge of the patient and monitors allow for a quick interpretation and resolution of the problem.

Keywords: ECG artefacts, patient warming blanket, peri-operative arrhythmias, mobile messaging services

Procedia PDF Downloads 260

Authors: Abraham J. Rizkalla, Tristan D. Yan

Abstract:

Atrial myxoma is the most common primary cardiac tumor, and can result in cardiac failure secondary to obstruction, or systemic embolism due to fragmentation. Traditionally, excision of atrial an myxoma has been performed through median sternotomy, however the robotic approach offers several advantages including less pain, improved cosmesis, and faster recovery. Here, we highlight the less well recognized advantages and technical aspects to robotic myxoma resection. This video-presentation demonstrates the resection of a papillary subtype left atrial myxoma using the DaVinci© Xi surgical robot. The 10x magnification and 3D vision allows for the interface between the tumor and the interatrial septum to be accurately dissected, without the need to patch the interatrial septum. Several techniques to avoid tumor fragmentation and embolization are demonstrated throughout the procedure. The tumor was completely excised with clear margins. There was no atrial septal defect or mitral valve injury on post operative transesophageal echocardiography. The patient was discharged home on the fourth post-operative day. This video-presentation highlights the advantages of the robotic approach in atrial myxoma resection compared with sternotomy, as well as emphasizing several technical considerations to avoid potential complications.

Keywords: cardiac surgery, left atrial myxoma, cardiac tumour, robotic resection

Procedia PDF Downloads 62