The QRS changes during ischemia have historically been more difficult to parameterize
and have not come into clinical practice. This paper presented a new approach to analyze ischemia
by time parameter extraction of RS-Segment of the QRS complex. The proposed methodology
mainly focused on two prominent areas; first: detection of R and S points via Fast Fourier Transform
(FFT) based windowing & thresholding techniques with a sliding edge method. Second: calculating
the RS-Duration. The performances of the detection methods are validated and RS-Duration is
evaluated with the Fantasia database (Fantasia) for 20 healthy subjects & Long-Term ST Database
(LTSTDB) for 80 ischemic patients. The RS-Segment detection sensitivity (Se) and specificity (Sp)
are calculated 100% for Fantasia Database, whereas sensitivity (Se) is 91.6% and specificity (Sp) is
974% for LTSTDB.
Today, in addition to measurement of left ventricular ejection fraction, the simple 12-lead surface ECG remains the only evidence-based means of identifying patients who may obtain the substantial benefits of CRT
The QRS changes during ischemia have historically been more difficult to parameterize
and have not come into clinical practice. This paper presented a new approach to analyze ischemia
by time parameter extraction of RS-Segment of the QRS complex. The proposed methodology
mainly focused on two prominent areas; first: detection of R and S points via Fast Fourier Transform
(FFT) based windowing & thresholding techniques with a sliding edge method. Second: calculating
the RS-Duration. The performances of the detection methods are validated and RS-Duration is
evaluated with the Fantasia database (Fantasia) for 20 healthy subjects & Long-Term ST Database
(LTSTDB) for 80 ischemic patients. The RS-Segment detection sensitivity (Se) and specificity (Sp)
are calculated 100% for Fantasia Database, whereas sensitivity (Se) is 91.6% and specificity (Sp) is
974% for LTSTDB.
Today, in addition to measurement of left ventricular ejection fraction, the simple 12-lead surface ECG remains the only evidence-based means of identifying patients who may obtain the substantial benefits of CRT
Presented by D.Niall Ferguson at 9th Pulmonary Medicine Update Course held at Cairo, Egypt.
This course is the leading Pulmonary Critical Care event in Egypt. The course is organized by Scribe (www.scribeofegypt.com)
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
505 definitions of arterial remodeling in post mortem and intravascular ultrasound research pasterkamp2
1. Definitions of arterial remodeling in
post mortem and Intravascular
ultrasound research
G. Pasterkamp
Experimental Cardiology, UMC and
Interuniversity cardiology Institute of the
Netherlands, Utrecht, The Netherlands
2. Arterial remodeling
Gradual Luminal narrowing
Expansive
remodeling
Constrictive
remodeling
Glagov et al. New Engl J Med 1987;316:1371-1375
Pasterkamp et al. Circulation 1995;91:1444-1449
3. Background
In international literature, the modes of
arterial geometrical remodeling are
differentially defined resulting in
different prevalence numbers.
The current presentation will show and
discuss the most widely used definitions
4. L = Lesion
R1 = most proximal site
R2 = proximal reference with normal lumen and least
amount of plaque
R3 = distal reference with normal lumen and least
amount of plaque
lumen
plaque
LR2 R3R1
5. Definition 1
Remodeling Index (RI)= VA L / ( (VA R2 + VA R3)/2)
lumen
plaque
LR2 R3R1
Expansive remodeling when RI >1.05
Intermediate remodeling when RI >0.95 or < 1.05
Constrictive remodeling when RI <0.95
Smits et al. Heart 1999;82:461-464
von Birgelen et al. J Am Coll Cardiol 2001;37:1864-1870.
Schoenhagen et al. Circulation 1999;101:598-603
6. Definition 2
RI= VA L / ( (VA R2 + VA R3)/2)
lumen
plaque
LR2 R3R1
Expansive remodeling when RI >1.0
Constrictive remodeling when RI <1.0
Dangas et al. Circulation 1999;99:3149-3154.
Nakamura et al. J Am Coll Cardiol. 2001 Jan;37(1):63-9
Okura et al. J Am Coll Cardiol 2001;37:1031-1035.
7. Definition 3
lumen
plaque
LR2 R3R1
Expansive remodeling when VA L > VA R2 and VA L > VA R3
Constrictive remodeling when VA L < VA R2 and VA L < VA R3
Other values: intermediate remodeling
Nishioka et al. J Am Coll Cardiol 1996;27:1571-1576
Wexberg et al. J Am Coll Cardiol 2000;36:1860-1869.
8. Definition 4
lumen
plaque
Expansive/no remodeling when VA L / VA R2 > 0.78
Constrictive remodeling when VA L / VA R2 < 0. 78
Mintz et al Circulation 1997;95:1791-1798.
Upper limit of normal tapering over 10 mm never exceeds
21% of vessel area reference limit at 0.78
LR2 R3R1
9. Definition 5
RI= VA L / ( VA R1)
lumen
plaque
LR2 R3R1
Expansive remodeling when RI >1.0
Constrictive remodeling when RI <1.0
Taylor et al. J Am Coll Cardiol 1999 Sep;34(3):760-7
10. Definition 6
RI = VA L / VA R2 (site with
least amount of plaque
lumen
plaque
LR2 R3R1
Expansive remodeling when RI > 1.05
Constrictive remodeling when RI < 0.95
Other values: intermediate remodeling
Pasterkamp et al. J Am Coll Cardiol 1995;26:422-428.
(Only applied peripheral arteries)
11. Remodeling definitions lead to large variations
in prevalence numbers.
expansive
remodeling
intermediate
remodeling
constrictive
remodeling
definition
remodeling
Mintz et al 512 (85%) 91 (15%) 4
Nishioka et al 19 (53%) 7 (20%) 9 (27%) 3
Smits et al 24 (35%) 16 (23%) 29 (42%) 1
Wexberg et al 70 (29%) 110 (45%) 64 (26%) 3
Dangas et al. 269 (42%) 377 (58%) 2
Nakamura et al. 68 (54%) 57 (46%) 2
Okura et al. 59 (55%) 49 (45%) 2
Von Birgelen et al. 38 (48%) 22 (28%) 19 (24%) 1
Pasterkampet al. 226 (37%) 383 (63%) 2
Schoenhagenet al. 70 (53%) 26 (20%) 35 (27%) 1
12. Which definition is best?
All studies are cross-sectional
The reference is not free of atherosclerotic disease
The reference may have been remodeled in either
direction
We do not know which definition gives us the best
estimate of the prevalence of the different remodeling
modes.
13. Which definitions make sense?
• Definitions 1-4 share the same receipt, only
the tresholds differ.
• Definition 5 may be used in casuistic studies,
but in larger studies on prevalence this
definition should not be used (it will, by definition,
approximate the 50% for each remodeling mode)
• Definition 6 can only be used in non tapering
vessels.
14. Conclusion
• The prevalence of constrictive and expansive
remodeling differs widely in literature due to
the application of different definitions.
• Without serial studies, there is no gold
standard for the reference site.
• The definition of the remodeling modes merit
careful consideration when prevalences are
mentioned.
