This document summarizes recent advances in electrophysiology technologies:
1. New devices include dual chamber leadless pacemakers and a multi-electrode balloon catheter for radiofrequency ablation.
2. Subcutaneous ICDs eliminate transvenous leads, and a leadless CRT system is in development.
3. Improved ablation technologies include laser and radiofrequency balloon catheters.
4. Wearable and implantable devices are replacing Holter monitors for arrhythmia detection.
5. New electroanatomical mapping systems provide higher resolution maps.
6. MRI and ultrasound guidance are being used to visualize ablation effects.
7. Smartwatches can detect atrial fibrillation with E
Research Inventy : International Journal of Engineering and Science is published by the group of young academic and industrial researchers with 12 Issues per year. It is an online as well as print version open access journal that provides rapid publication (monthly) of articles in all areas of the subject such as: civil, mechanical, chemical, electronic and computer engineering as well as production and information technology. The Journal welcomes the submission of manuscripts that meet the general criteria of significance and scientific excellence. Papers will be published by rapid process within 20 days after acceptance and peer review process takes only 7 days. All articles published in Research Inventy will be peer-reviewed.
The field of transcatheter mitral valve repair (TMVr) for
mitral regurgitation (MR) is rapidly evolving. Besides the
well-established transcatheter mitral edge-to-edge repair
approach, there is also growing evidence for therapeutic
strategies targeting the mitral annulus and mitral valve
chordae. A patient-tailored approach, careful patient
selection and an experienced interventional team is crucial
in order to optimise procedural and clinical outcomes. With
further data from ongoing clinical trials to be expected,
consensus in the Heart Team is needed to address these
complexities and determine the most appropriate TMVr
therapy, either single or combined, for patients with severe
MR
Power Protection for Digital Medical Imaging and Diagnostic EquipmentSchneider Electric
Medical imaging and diagnostic equipment (MIDE) is
increasingly being networked to Picture Archiving and
Communications Systems (PACS), Radiology Information
Systems (RIS), Hospital Information Systems
(HIS), and getting connected to the hospital intranet as
well as the Internet. Failing to implement the necessary
physical infrastructure can result in unexpected
downtime, and safety and compliance issues, which
translates into lost revenue and exposure to expensive
litigations, negatively affecting the bottom line. This
paper explains how to plan for physical infrastructure
when deploying medical imaging and diagnostic
equipment, with emphasis on power and cooling.
A talk about the future of cardiology (also medicine in general) given on the 28th april 2014 in the Medical University of Silesia in Poland to doctors and students. It shows the trends of medicine and medical technology development with the biggest potential.
Research Inventy : International Journal of Engineering and Science is published by the group of young academic and industrial researchers with 12 Issues per year. It is an online as well as print version open access journal that provides rapid publication (monthly) of articles in all areas of the subject such as: civil, mechanical, chemical, electronic and computer engineering as well as production and information technology. The Journal welcomes the submission of manuscripts that meet the general criteria of significance and scientific excellence. Papers will be published by rapid process within 20 days after acceptance and peer review process takes only 7 days. All articles published in Research Inventy will be peer-reviewed.
The field of transcatheter mitral valve repair (TMVr) for
mitral regurgitation (MR) is rapidly evolving. Besides the
well-established transcatheter mitral edge-to-edge repair
approach, there is also growing evidence for therapeutic
strategies targeting the mitral annulus and mitral valve
chordae. A patient-tailored approach, careful patient
selection and an experienced interventional team is crucial
in order to optimise procedural and clinical outcomes. With
further data from ongoing clinical trials to be expected,
consensus in the Heart Team is needed to address these
complexities and determine the most appropriate TMVr
therapy, either single or combined, for patients with severe
MR
Power Protection for Digital Medical Imaging and Diagnostic EquipmentSchneider Electric
Medical imaging and diagnostic equipment (MIDE) is
increasingly being networked to Picture Archiving and
Communications Systems (PACS), Radiology Information
Systems (RIS), Hospital Information Systems
(HIS), and getting connected to the hospital intranet as
well as the Internet. Failing to implement the necessary
physical infrastructure can result in unexpected
downtime, and safety and compliance issues, which
translates into lost revenue and exposure to expensive
litigations, negatively affecting the bottom line. This
paper explains how to plan for physical infrastructure
when deploying medical imaging and diagnostic
equipment, with emphasis on power and cooling.
A talk about the future of cardiology (also medicine in general) given on the 28th april 2014 in the Medical University of Silesia in Poland to doctors and students. It shows the trends of medicine and medical technology development with the biggest potential.
A sample of my pitch-deck writing and related market research for a revolutionary and next-generation micro cardiovascular stent, which incorporates nanotechnology, MEMS, computer controlled surgery algorithms, and MRI. I conducted this work for a client, an inventor and scientist who gave me permission to make this sample public.
The development of a wireless LCP-based intracranial pressure sensor for trau...IJECEIAES
Raised intracranial pressure (ICP) in traumatic brain injury (TBI) patients can lead to death. ICP measurement is required to monitor the condition of a patient and to inform TBI treatment. This work presents a new wireless liquid crystal polymer (LCP) based ICP sensor. The sensor is designed with the purpose of measuring ICP and wirelessly transmitting the signal to an external monitoring unit. The sensor is minimally invasive and biocompatible due to the mechanical design and the use of LCP. A prototype sensor and associated wireless module are fabricated and tested to demonstrate the functionality and performance of the wireless LCP-based ICP sensor. Experimental results show that the wireless LCP-based ICP sensor can operate in the pressure range of 0 - 60.12 mmHg. Based on repeated measurements, the sensitivity of the sensor is found to be 25.62 µVmmHg-1, with a standard deviation of ± 1.16 µVmmHg-1. This work represents a significant step towards achieving a wireless, implantable, minimally invasive ICP monitoring strategy for TBI patients.
A Review of Atherectomy in Peripheral Arterial Diseaseasclepiuspdfs
Atherectomy involves exciting technology and offers expanded treatment options for PAD. Data are scant so far in most lower extremity territories to support its use over other interventions, but newer results are promising. There is still a financial benefit to choosing atherectomy in the outpatient setting that likely drives much of its popularity among interventionalists. Atherectomy is an exciting technology for peripheral vascular intervention. Its use has greatly increased over the last decade. Data on its superiority to angioplasty or angioplasty with stenting are scant. Here, we review atherectomy techniques and principles along with results and controversy surrounding its use.
Abstract: An automated Implantable Cardioverter Defibrillator (AICD) is a small battery powered electrical
impulse generator, implanted in patients who are in the risk of sudden cardiac death or ventricular tachycardia,
and is programmed to detect the cardiac arrhythmia. Components of AICD are Leads, Electrode and
Generator[1]. The electric shock is created by the generator carried by leads and delivered with the electrodes.
The generator is of the size of 2 inches approximately, and 3 ounces weight. Working of AICD includes
rectification of arrhythmia by means of pacing Cardioversion defibrillation. Current devices have appreciable
functions including diagnosis, stored electro-grams and verification of shock appropriations and battery
longevity upto 6 yrs. Here using mutual inductance[2] functions carried out with the help of a transcutaneous
transformer and storing electric charge through magnetic field absolute longevity of the battery could be
reached. Since, battery longevity has been tremendously increased the recurrence of surgery can be prevented.
Thus, our device will bring remarkable revolution in cardiology by saving human lives from arrhythmia and
periodical replacement of the device.
Keywords:-ADC, Faraday’s Law, Micro-controller (MC), Mutual inductance, Transcutaneous transformer
An automated Implantable Cardioverter Defibrillator (AICD) is a small battery powered electrical
impulse generator, implanted in patients who are in the risk of sudden cardiac death or ventricular tachycardia,
and is programmed to detect the cardiac arrhythmia. Components of AICD are Leads, Electrode and
Generator[1]. The electric shock is created by the generator carried by leads and delivered with the electrodes.
The generator is of the size of 2 inches approximately, and 3 ounces weight. Working of AICD includes
rectification of arrhythmia by means of pacing Cardioversion defibrillation. Current devices have appreciable
functions including diagnosis, stored electro-grams and verification of shock appropriations and battery
longevity upto 6 yrs. Here using mutual inductance
[2] functions carried out with the help of a transcutaneous
transformer and storing electric charge through magnetic field absolute longevity of the battery could be
reached. Since, battery longevity has been tremendously increased the recurrence of surgery can be prevented.
Thus, our device will bring remarkable revolution in cardiology by saving human lives from arrhythmia and
periodical replacement of the device
Telemedicine System For Cardiac PatientsSharad Karwa
The aim of this project is to create a personalized heart monitoring system using smart phones and electrodes and mobile application which is capable of monitoring the health of high risk cardiac patients. The smart phone application analyses in real-time sensor and environmental data and can automatically alert the doctors and pre-assigned caregivers when a heart patient is in danger. It also transmits sensor data to a given healthcare centre for remote monitoring by a nurse or cardiologist. The project aims to have a better system that is always with patient to monitor clearly and make the record of abnormalities obtained. If we are in dangerous or unconscious condition, it alerts the user or alerts doctor or relative by making a call to family doctor or some relative. The system can be personalized and rehabilitation programs can monitor the progress of a patient. These rehabilitation programs can be used to give advice or to reassure the patient.
A Real Time Electrocardiogram (ECG) Device for Cardiac PatientsIJERD Editor
Now-a-days due to rising stress levels, change in lifestyles and a variety of different issues, the number of people suffering from heart related diseases is increasing. This number would significantly rise in the next few years. As the technology enhanced, a significant paradigm shift has been observed in the biomedical industry. To tackle the heart related issues, technology can be introduced in one’s life. This paper proposes a wireless, wearable ECG device capable of processing the patient’s ECG in a real time environment. It is capable of comparing the ECG with threshold parameters, and if ECG of the patient is not in the range of the threshold values, the device notifies the cardiac patient’s mobile phone by sending a Multimedia Messaging Service (MMS) of the changed ECG and, in turn the patient’s mobile phone sends this changed ECG image to the mobile phone present at the hospital.
EVOLUTION IN CARDIAC RESYNCHRONIZATION THERAPY
Moving towards Leadless pacing mainly in cases with difficult coronary sinus anatomy, where placing the LV lead is difficult.
A FRAMEWORK FOR THE INTERCONNECTION OF CONTROLLER AREA NETWORK (CAN) BASED CR...ijait
Patient monitoring helps increasing the mortality by timely notification of exceeding vital signs. By using the vital sign data the critical care staff can make necessary life saving interventions. This requires the underlying network to be very robust so that timely and error free information flow can be guaranteed. Moreover there is a need for a cost effective and robust network technology for continuous and real- time vital signs monitoring in resource constraint settings in developing countries. In this paper we proposed a system of hospitals with interconnected intensive care units. Each intensive care unit employs Controller Area Network (CAN) as underlying technology for networking of bedside units. The data of these bedside units can be communicated with other hospital using higher level protocols such as Ethernet. This allow the hospital staff to share the health information of the patients with the specialized staff in another hospital to provide better cure to the patient and consequently can increase the mortality.
To every girl and every woman, this word is provided: You are princess, You’re ambassador to the king , You’re a servant of the King, Jesus Christ is the king, Jesus is in your heart, You can befriend Jesus
A sample of my pitch-deck writing and related market research for a revolutionary and next-generation micro cardiovascular stent, which incorporates nanotechnology, MEMS, computer controlled surgery algorithms, and MRI. I conducted this work for a client, an inventor and scientist who gave me permission to make this sample public.
The development of a wireless LCP-based intracranial pressure sensor for trau...IJECEIAES
Raised intracranial pressure (ICP) in traumatic brain injury (TBI) patients can lead to death. ICP measurement is required to monitor the condition of a patient and to inform TBI treatment. This work presents a new wireless liquid crystal polymer (LCP) based ICP sensor. The sensor is designed with the purpose of measuring ICP and wirelessly transmitting the signal to an external monitoring unit. The sensor is minimally invasive and biocompatible due to the mechanical design and the use of LCP. A prototype sensor and associated wireless module are fabricated and tested to demonstrate the functionality and performance of the wireless LCP-based ICP sensor. Experimental results show that the wireless LCP-based ICP sensor can operate in the pressure range of 0 - 60.12 mmHg. Based on repeated measurements, the sensitivity of the sensor is found to be 25.62 µVmmHg-1, with a standard deviation of ± 1.16 µVmmHg-1. This work represents a significant step towards achieving a wireless, implantable, minimally invasive ICP monitoring strategy for TBI patients.
A Review of Atherectomy in Peripheral Arterial Diseaseasclepiuspdfs
Atherectomy involves exciting technology and offers expanded treatment options for PAD. Data are scant so far in most lower extremity territories to support its use over other interventions, but newer results are promising. There is still a financial benefit to choosing atherectomy in the outpatient setting that likely drives much of its popularity among interventionalists. Atherectomy is an exciting technology for peripheral vascular intervention. Its use has greatly increased over the last decade. Data on its superiority to angioplasty or angioplasty with stenting are scant. Here, we review atherectomy techniques and principles along with results and controversy surrounding its use.
Abstract: An automated Implantable Cardioverter Defibrillator (AICD) is a small battery powered electrical
impulse generator, implanted in patients who are in the risk of sudden cardiac death or ventricular tachycardia,
and is programmed to detect the cardiac arrhythmia. Components of AICD are Leads, Electrode and
Generator[1]. The electric shock is created by the generator carried by leads and delivered with the electrodes.
The generator is of the size of 2 inches approximately, and 3 ounces weight. Working of AICD includes
rectification of arrhythmia by means of pacing Cardioversion defibrillation. Current devices have appreciable
functions including diagnosis, stored electro-grams and verification of shock appropriations and battery
longevity upto 6 yrs. Here using mutual inductance[2] functions carried out with the help of a transcutaneous
transformer and storing electric charge through magnetic field absolute longevity of the battery could be
reached. Since, battery longevity has been tremendously increased the recurrence of surgery can be prevented.
Thus, our device will bring remarkable revolution in cardiology by saving human lives from arrhythmia and
periodical replacement of the device.
Keywords:-ADC, Faraday’s Law, Micro-controller (MC), Mutual inductance, Transcutaneous transformer
An automated Implantable Cardioverter Defibrillator (AICD) is a small battery powered electrical
impulse generator, implanted in patients who are in the risk of sudden cardiac death or ventricular tachycardia,
and is programmed to detect the cardiac arrhythmia. Components of AICD are Leads, Electrode and
Generator[1]. The electric shock is created by the generator carried by leads and delivered with the electrodes.
The generator is of the size of 2 inches approximately, and 3 ounces weight. Working of AICD includes
rectification of arrhythmia by means of pacing Cardioversion defibrillation. Current devices have appreciable
functions including diagnosis, stored electro-grams and verification of shock appropriations and battery
longevity upto 6 yrs. Here using mutual inductance
[2] functions carried out with the help of a transcutaneous
transformer and storing electric charge through magnetic field absolute longevity of the battery could be
reached. Since, battery longevity has been tremendously increased the recurrence of surgery can be prevented.
Thus, our device will bring remarkable revolution in cardiology by saving human lives from arrhythmia and
periodical replacement of the device
Telemedicine System For Cardiac PatientsSharad Karwa
The aim of this project is to create a personalized heart monitoring system using smart phones and electrodes and mobile application which is capable of monitoring the health of high risk cardiac patients. The smart phone application analyses in real-time sensor and environmental data and can automatically alert the doctors and pre-assigned caregivers when a heart patient is in danger. It also transmits sensor data to a given healthcare centre for remote monitoring by a nurse or cardiologist. The project aims to have a better system that is always with patient to monitor clearly and make the record of abnormalities obtained. If we are in dangerous or unconscious condition, it alerts the user or alerts doctor or relative by making a call to family doctor or some relative. The system can be personalized and rehabilitation programs can monitor the progress of a patient. These rehabilitation programs can be used to give advice or to reassure the patient.
A Real Time Electrocardiogram (ECG) Device for Cardiac PatientsIJERD Editor
Now-a-days due to rising stress levels, change in lifestyles and a variety of different issues, the number of people suffering from heart related diseases is increasing. This number would significantly rise in the next few years. As the technology enhanced, a significant paradigm shift has been observed in the biomedical industry. To tackle the heart related issues, technology can be introduced in one’s life. This paper proposes a wireless, wearable ECG device capable of processing the patient’s ECG in a real time environment. It is capable of comparing the ECG with threshold parameters, and if ECG of the patient is not in the range of the threshold values, the device notifies the cardiac patient’s mobile phone by sending a Multimedia Messaging Service (MMS) of the changed ECG and, in turn the patient’s mobile phone sends this changed ECG image to the mobile phone present at the hospital.
EVOLUTION IN CARDIAC RESYNCHRONIZATION THERAPY
Moving towards Leadless pacing mainly in cases with difficult coronary sinus anatomy, where placing the LV lead is difficult.
A FRAMEWORK FOR THE INTERCONNECTION OF CONTROLLER AREA NETWORK (CAN) BASED CR...ijait
Patient monitoring helps increasing the mortality by timely notification of exceeding vital signs. By using the vital sign data the critical care staff can make necessary life saving interventions. This requires the underlying network to be very robust so that timely and error free information flow can be guaranteed. Moreover there is a need for a cost effective and robust network technology for continuous and real- time vital signs monitoring in resource constraint settings in developing countries. In this paper we proposed a system of hospitals with interconnected intensive care units. Each intensive care unit employs Controller Area Network (CAN) as underlying technology for networking of bedside units. The data of these bedside units can be communicated with other hospital using higher level protocols such as Ethernet. This allow the hospital staff to share the health information of the patients with the specialized staff in another hospital to provide better cure to the patient and consequently can increase the mortality.
To every girl and every woman, this word is provided: You are princess, You’re ambassador to the king , You’re a servant of the King, Jesus Christ is the king, Jesus is in your heart, You can befriend Jesus
A beautiful paper published by Eugene Braunwald
European Heart Journal, Volume 42, Issue 24, 21 June 2021, Pages 2327–2328, https://doi.org/10.1093/eurheartj/ehab264
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
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.
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
What is New in Electrophysiology Technologies-Samir Rafla.pptx
1. What is New in Electrophysiology Technologies
Innovations and Advances in Devices in Electrophysiology
Samir Morcos Rafla, FACC, FESC, FHRS
Emeritus professor of cardiology
Alexandria University
smrafla@yahoo.com
01001495577
Dr. Samir Rafla Lectures
International Webinar on Cardiology and Cardiovascular Medicine
2. • Leadless Pacemakers
• One of the biggest issues with
implantable EP devices is the
leads that connect the device to
the heart. Leads are frequently
cited as the weakest component
of pacing, implantable
cardioverter defibrillator (ICD) or
cardiac resynchronization
therapy (CRT) due to wearing
out or complications due to
infection.
Heart Rhythm: Volume 14, Issue
2, February 2017, Pages 294-299
3. Leadless Dual-Chamber Pacing: A Novel Communication Method for
Wireless Pacemaker Synchronization
The presented concept involves 2 leadless pacemakers that
communicate wirelessly with each other and thus enable
synchronized leadless dual-chamber pacing.
A novel technology is presented for pacemaker communication,
using the myocardium and blood as the transmission medium.
To date, 2 leadless PMs are commercially
available: Micra (Medtronic) and Nanostim (St.
Jude Medical). However, these devices have the
significant limitation of performing single-
chamber ventricular pacing only.
4. The presented wireless
communication method
may in the future also
enable leadless cardiac
resynchronization
therapy.
The concept proposed
involves multiple
implanted leadless PMs
that jointly act as a
leadless dual-chamber
PM system
5. 1.The primary advantage of a leadless pacemaker is
the elimination of several complications associated
with transvenous pacemakers and leads: pocket
infections, hematoma, lead dislodgment, and lead
fracture. The leadless pacemaker also has cosmetic
appeal because there is no chest incision or visible
pacemaker pocket. Battery life is approximately 5-15
years, comparable to that of a transvenous
pacemaker. At end of battery life, a leadless
pacemaker can be turned off and a new leadless or
traditional pacemaker implanted.
6. ECG Sequence of Leadless Dual-Chamber
Pacing
J A C C: V O L. 3 , NO. 6 , 2 0 1 8
7. Left ventricular pacing
with the WiSE-CRT
system (EBR Systems,
Sunnyvale, CA, USA).
Illustration of device
design and function.
Used with permission
from: Reddy VY, Miller
MA, Neuzil P, et al.
Cardiac
resynchronization
therapy with wireless
left ventricular
endocardial pacing: the
SELECT-LV study. J
Am Coll
Cardiol. 2017;69(17):21
19–2129.
8. • EBR Systems is developing the WiSE
CRT system, the first endocardial,
leadless CRT pacing system. It uses
an electrode about the size of a large
grain of rice that is implanted inside
the wall of the LV using transcatheter
delivery. A wireless ultrasound
transducer is surgically implanted
between the ribs to send ultrasound
energy to the electrode, which
converts the waves into electrical
energy for pacing, eliminating the
need for a battery or lead wire,
allowing the device to be very small.
This works as an adjunct device to
work in combination with an existing
connected pacemaker, ICD or CRT
device.
• The conventional system senses the
RV pacing and can work with the
WiSE system to synchronize the LV.
•
9. • Subcutaneous ICDs
• Boston Scientific introduced the first subcutaneous implantable
cardioverter defibrillator (S-ICD) system in 2009. Since then, there have
been many studies published showing the system delivers very effective
therapy and reduces the invasiveness of traditional ICD implants by
eliminating the leads to the heart. Instead, the system uses a lead placed
under the skin of the chest over the heart, eliminating transvenous leads
or the need for lead management later on.
• About 40 percent of the ICD market today is composed of cardiac
resynchronization therapy (CRT) systems with pacing. Of the remaining 60
percent, Boersma said between 30-50 percent would benefit from S-ICD
therapy if they do not have any need for pacing.
• It only requires two very small incisions with no need to create a pulse
generator pocket.
10. The NewPace Subcutaneous String
ICD in development eliminates the
implant of a can in a pocket, as all
the components, battery and the
lead are incorporated into the
single cable-like device.
The system consists of self-expanding,
partially insulated leads that are advanced
into the pericardium after obtaining
pericardial access. the partial insulation
directs the pacing vector towards the
myocardium, avoiding phrenic capture.
Defibrillation thresholds (DFTs) of as low as
2.5 Joules (J) were obtained. Reduction in
DFT to avoid defibrillation-related pain.
11.
12.
13. Eur Heart J, Volume 38, Issue 4, 21 January 2017, Pages 258–267, https://doi.org/10.1093/eurheartj/ehw353
The content of this slide may be subject to copyright: please see the slide notes for details.
Figure 1 The Lifevest Model 4000. The LifeVest 4000 model (A) Garment and
elastic belt with the connected monitor and ...
14. Current recommendations on the use of wearable cardioverter
defibrillators (WCDs)
Clas
s
Use of WCDs is reasonable when there is a clear indication for an
implanted/permanent device accompanied by a transient
contraindication or interruption in ICD care such as infection
IIa
Use of WCDs is reasonable as a bridge to more definitive therapy
such as cardiac transplantation
IIa
The use of WCDs may be reasonable when there is concern about
a heightened risk of SCD that may resolve over time or with the
IIb
15. Improved Ablation
Technologies
• HeartLight was granted FDA
clearance in 2016 for its laser
ablation balloon technology indicated
for pulmonary vein isolation to treat
AF. The system consists of a
compliant balloon that seats in the
ostia of the pulmonary veins and a
laser inside the catheter can be
rotated around to ablate the tissue. It
also has a camera inside the catheter
to offer direct visualization of the
ablation and location of the laser,
eliminating the need for electro-
mapping systems and cutting
procedural time. The lesions are
created with 20-30 second ablations.
About 25 ablations are needed to
isolate a pulmonary vein with lesion
overlap. The combination of the
balloon, camera and variable-energy,
steerable ablation is believed to be
able to eliminate the interoperator
16.
17. • A late-breaking HRS trial highlighted a first-in-human study for the
Biosense Webster RF balloon catheter in treating patients with AF. The
39-patient RADIANCE study showed it could uniformly achieve pulmonary
vein isolation (PVI) in all patients without the need for “touch-up” with a
focal ablation catheter. The system uses a balloon that is lined with several
electrodes. The energy level for each electrode can be tailored to prevent
damage to neighboring nerves or the esophagus.
18. Increasing Safety in Lead Extractions
• One of the biggest safety concerns in removing old device leads is the
possibility of tearing the superior vena cava (SVC). This requires
immediate emergency surgical repair to stop the bleeding and the
complication currently has a 50 percent mortality rate. However,
Spectranetics Bridge Occlusion Balloon, introduced in 2016, offers a new
safety net during procedures, allowing rapid inflation of an intravascular
balloon to seal the tear and allow the surgical team time to prep and
perform a repair without fear of the patient bleeding out. The device is
credited with saving about 20 lives in the past year since gaining market
clearance.
• the device is one of the most important new developments in lead
extraction technology and has become part of Cleveland Clinic’s lead
extraction protocol. He said the balloon offers a safety net to minimize the
effect of a potentially catastrophic SVC tear.
19. Replacing Holters With Wearable and Implantable
Devices
• vendors with simple, small,
wearable, stick-on Holter monitoring
systems that eliminate the need for
a bulky, belt-worn device and the
placement of multiple wire leads on
the patients. These new devices
offer a less expensive, even
disposable option to traditional,
durable Holter monitoring systems.
Some vendors offer the devices
themselves, others offer the devices
in connection with monitoring
services.
• Another monitoring technology are
implantable cardiac monitors
(ICMs). Biotronik, Medtronic and St.
Jude Medical offer monitors, which
are placed subcutaneously in the
chest using a simple, fast, in-office
procedure. The Medtronic Linq
device is of small size which can
easily be inserted under the
21. • REVEAL AF study showed
ICMs used for long-term, 24-
hour-a-day monitoring,
detected a high incidence of AF
in patients previously
undiagnosed but suspected to
be at high-risk for AF and
stroke. The study found that at
18 months, continuous
monitoring with either the
Medtronic Reveal XT or the
Reveal Linq resulted in an AF
detection rate of 29.3 percent
among previously undiagnosed
high-risk patients
22. New Electro-mapping Systems
• For years the EP mapping system market was dominated by Biosense
Webster and St. Jude Medical, but there were complaints from EPs that
there was little progress in advancing the technology to overcome some
of its limitations. This changed in 2014, when Boston Scientific
launched the Rhythmia mapping system. At HRS 2017, the updated
Rhythmia HDx was launched. The system can show lower voltages than
on previous-generation mapping systems. It uses a 64-electrode basket
catheter to create very detailed, high-density electro-maps with as many
as 50,000 to 60,000 points.
23.
24. The Biosense Webster multi-electrode balloon RF ablation
catheter. Each electrode can have varied power settings to
avoid damage to underlying tissues like the esophagus.
25. • A new technology that may offer a big reduction in
mapping/procedural times is the Acutus Medical AcQMap High
Resolution Imaging and Mapping System. It uses a basket catheter
with 48 electrodes combined with 48 tiny ultrasound transducers.
The basket can be manually rotated around inside the atrium to
rapidly “paint” a very accurate combined electro- and anatomical
map simultaneously in about five minutes.
26. • Improvements in mapping—seeing is believing
• Despite exponential improvements in mapping and ablation technology, the
success rates of catheter ablation for certain arrhythmias, such as persistent AF,
remain suboptimal.85 As compared with that of conditions with high success
rates with catheter ablation, such as atrioventricular nodal reentrant tachycardia,
our understanding of the mechanism underlying persistent AF is incomplete and
continues to evolve.
• Invasive rotor mapping. Focal impulse and rotor modulation (FIRM) using the
RhythmView™ system (Topera Medical, Palo Alto, CA, USA) was one of the first
commercially available electrogram mapping systems that demonstrated the
existence of drivers of AF in the form of rotors and focal sources in
humans. The authors used multielectrode basket catheters to map the atria and
proprietary computational algorithms to generate maps, ablating at the site of
local rotors or focal impulses. Observational single-center data from the authors
demonstrated 2.1 ± 1.0 sources or drovers per patient (70% rotors, 30% focal
impulses) that were stable for several minutes. Ablation at these sites resulted in
the termination or slowing of AF in 86% of patients.
• Vaidya et al. J Innov Cardiac Rhythm Manage. 2017;8(12):2943_–2955
27. • MRI To Guide Ablation Procedures
• iMRIcore is redesigning devices to make them safe for use in a
magnetic resonance imaging (MRI) environment to perform MRI-
guided ablation procedures. MRI offers many advantages over X-
ray angiography and traditional mapping systems. It can image
without any radiation, eliminating the need to wear heavy protective
aprons. Second, unlike angiography, it can image soft tissue and
visualize the tissue response to ablations and when a scar forms,
allowing EPs to see the pattern and effectiveness of their ablation
points and patterns.
28. • Netherlands Hospital to Install State-of-the-Art MRI Ablation Center
• Imricor announced the signing of a commercial agreement with the Haga Hospital
in The Hague, Netherlands to outfit a...
29. • Ultrasound Guidance in the EP Lab
• Two vendors have developed lightweight, compact, cart-based ultrasound
systems that allow high-quality intracardiac echocardiography (ICE) and
transesophageal echo (TEE) in the EP or cath lab. Both systems offer
many of the features of premium echocardiography systems.
• Siemens Healthineers released its new Acuson P500 ICE Edition compact
ultrasound system
30. • Saline Enhanced Radiofrequency Ablation May be an Effective
Method to Treat Ventricular Tachycardia
• May 8, 2020 – Results from a first-in-human early feasibility study (EFS)
using a saline enhanced radiofrequency (SER
31. • Pulsed Field Ablation Successfully Treats Atrial Fibrillation
• May 8, 2020 — A new clinical trial effectively uses pulsed field (PF) energy
to treat patients with persistent or par
32. • Noninvasive Radioablation Offers Long-term Benefits to High-risk
Heart Arrhythmia Patients
• September 17, 2019 — Treating high-risk heart patients with a single, high
dose of radiation therapy can dramatically
33. The ECG app can record your
heartbeat and rhythm using the
electrical heart sensor on Apple
Watch Series 4, Series 5, or
Series 6* and then check the
recording for atrial
fibrillation (AFib)
Apple Watch
Series
34. • Two latest generation smartwatches (Apple Watch and Samsung Galaxy
Watch) and their chargers result in no electromagnetic interference in
CIED recipients under either nominal or ‘worst-case scenario’
programming, suggesting the safety of their use by these patients
#Europace
35. • Summary : Advances in Devices in Electrophysiology
• New dual chamber leadless pacemaker
• The Biosense Webster multi-electrode balloon RF ablation catheter, a balloon that is lined with
several electrodes
• Subcutaneous ICDs the first endocardial, leadless CRT pacing system
• Improved Ablation Technologies
• Replacing Holters With Wearable and Implantable Devices
• Medtronic Reveal XT Remote monitoring
• New Electro-mapping Systems
• MRI To Guide Ablation Procedures: MRI offers many advantages over X-ray angiography
• Ultrasound Guidance in the EP Lab
• Apple Watch Series: Taking an ECG with the ECG app on Apple Watch Series
• Cardiac Contractility Modulation
36. Samir Rafla, FESC, FACC, FHRS
Prof. of Cardiology, Cardiology
Department, Alexandria University
smrafla@yahoo.com
01001495577
Dr. Samir Rafla Lectures
YouTube channel- Samir Rafla