Inui, Yuki; Kamakura, Yayoi; Fukada, Junko; Yoneda, Masahiko; Kataoka, Emiko; Usami, Yasuko; Sugiura, Miki; Nagatani, Tetsuya; Seki, Yukio; Hatano, Norikazu; Yasui, Keizo
Aspiration due to dysphagia is a factor associated with pneumonia during acute stroke. In such cases, it is likely that secretions in the pyriform sinuses enter the laryngeal inlet. The present study was based on the idea that it is possible to reduce aspiration pneumonia by periodically suctioning and removing such secretions (pyriform sinus suctioning), a study was conducted in a single facility. The incidence of pneumonia as a dependent variable was compared between before (control) and after (intervention group) intervention with pyriform sinus suctioning as an independent variable. With a view of unifying the quality and frequency of intervention, two programs to: initially confirm the safety of such suctioning; subsequently enhance/evaluate knowledge and skills related to the procedure (educational); and specify conditions for the implementation and criteria for determining its appropriateness (practical), were developed. The study involved 33 (mean age: 74.6 ± 12.4) and 30 (80.0 ± 8.8) control and intervention group members, respectively, 25 (83.3%) of the latter were treated with pyriform sinus suctioning for 5 days after a stroke. Pneumonia developed in 7 (21.2%) and 2 (6.7%) of the former and latter, respectively. As individuals with a Japan Coma Scale (JCS) score of III or a midline shift on head CT tend to develop pharyngeal dysphagia, the patients were also divided into 2 groups to compare the incidence of pneumonia based on the risk level: low: Japan Coma Scale scores of I-II without a midline shift on head CT; and high: scores of II-III with it. In the latter, the incidence after intervention was markedly lower (p = 0.06, φ = 0.326), while the former did not show changes (p = 0.574, φ = 0.066), supporting the effectiveness of pyriform sinus suctioning to prevent aspiration pneumonia among patients with a low risk level.
Oh, Seungjae; Wang, Semyung; Cho, Sungman
Highlights: • Development of Energy Efficiency Design Map. • Experimental validation of Energy Efficiency Design Map. • Suggestion regarding the Acoustically Supercharged Energy Efficiency. • Sensitivity analysis of the Energy Efficiency Ratio with respect to acoustic pressure. • Suggestion regarding the hybrid coupling method for acoustic analysis in compressor. - Abstract: The volumetric efficiency of the Internal Combustion (IC) engine and compressor can be increased by properly adjusting the acoustic resonance frequency of the suction muffler or the suction valve timing without any additional equipment or power source. This effect is known as acoustic supercharging. However, the energy efficiency has become more important than the volumetric efficiency because of the energy shortage issue and factors influencing consumers’ purchasing decisions. Therefore, methods for increasing the energy efficiency using the acoustic effect in the suction part of IC engine and compressor should be considered. In this study, a systematic method for improving the energy efficiency using the acoustic effect in the suction part of the compressor used in refrigerators and air conditioners was developed for the first time. This effect is named as the Acoustically Supercharged Energy Efficiency (ASEE). For the ASEE, first, a hybrid coupling method was suggested for the acoustical analysis in the suction part of the compressor. Next, an Energy Efficiency Design Map (EEDM) was proposed. This can serve as a design guide for suction mufflers in terms of the energy efficiency. Finally, sensitivity analyses of the Energy Efficiency Ratio (EER) and total massflow rate with respect to the acoustic pressure were conducted to identify the relationship between the acoustic pressure and the suction valve motion. This provides the physical background for the EEDM
Huang, Chunhua; Marina, Nephtali; Gilbey, Michael P
Microneurography has been used in humans to study sympathetic activity supplying targets within skeletal muscle and skin. Comparable animal studies are relatively few, probably due to the technical demands of traditional fibre picking techniques. Here we apply a simple suction electrode technique to record cutaneous (CVC) and muscle (MVC) vasoconstrictor activities and describe and investigate the basis of the frequency dependence of lung inflation related modulation. Hindlimb MVC and CVC activities were recorded concurrently. The magnitude of MVC and CVC activities at the lung inflation cycle frequency was significantly less at 2.0 Hz than at lung inflation cycle frequencies inflation cycle frequency was increased the coherence between lung inflation cycle or BP and MVC or CVC waveforms decreased. Consistent with the hypothesis that much of the coherence between lung inflation cycle and nerve activity waveforms is secondary to oscillating baroreceptor activity attributable to BP waves, partialization with the BP waveform significantly decreased the coherence between lung inflation cycle and nerve waveforms, and there was an absence of coherence between these waveforms following sinus and aortic denervation. Our data extend findings from other laboratories and establish the value of a suction electrode technique for recording MVC and CVC activities. Furthermore, our observations describe the rates of positive pressure ventilation that avoid strong and regular gating of sympathetic activity.
Inamasu, Joji; Nakatsukasa, Masashi; Tomiyasu, Kazuhiro; Mayanagi, Keita; Nishimoto, Masaaki; Oshima, Takeo; Yoshii, Masami; Miyatake, Satoru; Imai, Akira
Background Cardiovascular events while driving have occasionally been reported. In contrast, there have been few studies on stroke while driving. Aim The objectives of this study were to (1) report the frequency of stroke while driving and (2) evaluate its association with automobile accidents. Methods Clinical data prospectively acquired between January 2011 and December 2016 on 2145 stroke patients (1301 with ischemic stroke, 585 with intracerebral hemorrhage, and 259 with subarachnoid hemorrhage) were reviewed to identify patients who sustained a stroke while driving. The ratio of driving to performing other activities was evaluated for each stroke type. Furthermore, the drivers' response to stroke was reviewed to understand how automobile accidents occurred. Results Among the 2145 patients, 85 (63 ischemic stroke, 20 intracerebral hemorrhage, and 2 subarachnoid hemorrhage) sustained a stroke while driving. The ratio of driving to performing other activities was significantly higher in ischemic stroke (4.8%) than in intracerebral hemorrhage (3.4%) or subarachnoid hemorrhage (0.8%). A majority of drivers either continued driving or pulled over to the roadside after suffering a stroke. However, 14 (16%) patients were involved in automobile accidents. In most patients, an altered mental status due to severe stroke was the presumed cause of the accident. Conclusion Stroke occurred while driving in 4.0% of all strokes and accidents occurred in 16% of these instances.
van Dam, R P; Ponganis, P J; Ponganis, K V; Levenson, D H; Marshall, G
During diving, intermittent swim stroke patterns, ranging from burst/coast locomotion to prolonged gliding, represent potential energy conservation mechanisms that could extend the duration of aerobic metabolism and, hence, increase the aerobic dive limit (ADL, dive duration associated with onset of lactate accumulation). A 5.6 min ADL for emperor penguins had been previously determined with lactate measurements after dives of ADL(M), mean stroke frequency during travel segments was significantly less than that in dives Emperor penguins did not exhibit any significant (>10 s) periods of prolonged gliding during these shallow (1.6 s, and with lower stroke frequency associated with increased dive duration.
Gert J. Venter
Full Text Available Culicoides midges (Diptera: Ceratopogonidae, are involved in the transmission of various pathogens that cause important diseases of livestock worldwide. The use of insect repellents to reduce the attack rate of these insects on livestock could play an important role as part of an integrated control programme against diseases transmitted by these midges. The objective of this study was to determine whether high frequency sound has any repellent effect on Culicoides midges. The number of midges collected with 220 V Onderstepoort white light traps fitted with electronic mosquito repellents (EMRs, emitting 5-20 KHz multi-frequency sound waves, was compared with that of two untreated traps. Treatments were rotated in two replicates of a 4 x 4 randomised Latin square design. Although fewer midges were collected in the two traps fitted with EMRs, the average number collected over eight consecutive nights was not significantly different. The EMRs also had no influence on any of the physiological groups of Culicoides imicola Kieffer or the species composition of the Culicoides population as determined with light traps. The results indicate that high frequency sound has no repellent effect on Culicoides midges. There is therefore no evidence to support their promotion or use in the protection of animals against pathogens transmitted by Culicoides midges.
Gert J. Venter
Full Text Available Culicoides midges (Diptera: Ceratopogonidae, are involved in the transmission of various pathogens that cause important diseases of livestock worldwide. The use of insect repellents to reduce the attack rate of these insects on livestock could play an important role as part of an integrated control programme against diseases transmitted by these midges. The objective of this study was to determine whether high frequency sound has any repellent effect on Culicoides midges. The number of midges collected with 220 V Onderstepoort white light traps fitted with electronic mosquito repellents (EMRs, emitting 5-20 KHz multi-frequency sound waves, was compared with that of two untreated traps. Treatments were rotated in two replicates of a 4 x 4 randomised Latin square design. Although fewer midges were collected in the two traps fitted with EMRs, the average number collected over eight consecutive nights was not significantly different. The EMRs also had no influence on any of the physiological groups of Culicoides imicola Kieffer or the species composition of the Culicoides population as determined with light traps. The results indicate that high frequency sound has no repellent effect on Culicoides midges. There is therefore no evidence to support their promotion or use in the protection of animals against pathogens transmitted by Culicoides midges.
Ibsen, Lars Bo; Liingaard, Morten; Andersen, Lars
The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear...... viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three...
in a composite structure-foundation system. The work has been focused on one particular foundation type; the suction caisson. The frequency dependent stiffness (impedance) of the suction caisson has been investigated by means of a three-dimensional coupled Boundary Element/Finite Element model, where the soil...... is simplified as a homogenous linear viscoelastic material. The dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequencydependent coefficients corresponding to the different degrees of freedom. Comparisons with known analytical and numerical solutions indicate that the static...... been used to simulate the soil-structure interaction within a numerical finite element model of a Vestas V90 3.0 MW offshore wind turbine with a suction caisson foundation. The simulations of the soil-structure interaction by means of lumped-parameter model approximations of the impedance have shown...
Pedersen, P M; Jørgensen, H S; Kammersgaard, L P; Nakayama, H; Raaschou, H O; Olsen, T S
To determine the frequency of manual and oral apraxia in acute stroke and to examine the influence of these symptoms on functional outcome. Seven hundred seventy six unselected, acute stroke patients who were admitted within seven days of stroke onset with unimpaired consciousness were included. If possible, the patients were assessed for manual and oral apraxia on acute admission. Neurologic stroke severity including aphasia was assessed with the Scandinavian Stroke Scale, and activities of daily living function was assessed with the Barthel Index. All patients completed their rehabilitation in the same large stroke unit. Six hundred eighteen patients could cooperate with the apraxia assessments. Manual apraxia was found in 7% of subjects (10% in left and 4% in right hemispheric stroke; chi2 = 9.0; P = 0.003). Oral apraxia was found in 6% (9% in left and 4% in right hemispheric stroke; chi2 = 5.4; P = 0.02). Both manual and oral apraxia were related to increasing stroke severity, and manual, but not oral, apraxia was associated with increasing age. There was no gender difference in frequency of apraxia. Patients with either type of apraxia had temporal lobe involvement more often than patients without. When analyzed with multiple linear and logistic regression analyses, neither manual nor oral apraxia had any independent influence on functional outcome. Apraxia is significantly less frequent in unselected patients with acute stroke than has previously been assumed and has no independent negative influence on functional outcome.
Perera, Kanjana S.; Vanassche, Thomas; Bosch, Jackie; Swaminathan, Balakumar; Mundl, Hardi; Giruparajah, Mohana; Barboza, Miguel A.; O'Donnell, Martin J.; Gomez-Schneider, Maia; Hankey, Graeme J.; Yoon, Byung-Woo; Roxas, Artemio; Lavallee, Philippa; Sargento-Freitas, Joao; Shamalov, Nikolay; Brouns, Raf; Gagliardi, Rubens J.; Kasner, Scott E.; Pieroni, Alessio; Vermehren, Philipp; Kitagawa, Kazuo; Wang, Yongjun; Muir, Keith; Coutinho, Jonathan M.; Connolly, Stuart J.; Hart, Robert G.; Czeto, K.; Kahn, M.; Mattina, K. R.; Ameriso, S. F.; Pujol-Lereis, V.; Hawkes, M.; Pertierra, L.; Perera, N.; de Smedt, A.; van Dyck, R.; van Hooff, R. J.; Yperzeele, L.; Gagliardi, V. D. B.; Cerqueir, L. G.; Yang, X.; Chen, W.; Amarenco, P.; Guidoux, C.; Ringleb, P. A.; Bereczki, D.; Vastagh, I.; Canavan, M.; Toni, D.; Anzini, A.; Colosimo, C.; de Michele, M.; Di Mascio, M. T.; Durastanti, L.; Falcou, A.; Fausti, S.; Mancini, A.; Mizumo, S.; Uchiyama, S.; Kim, C. K.; Jung, S.; Kim, Y.; Kim, J. A.; Jo, J. Y.; Arauz, A.; Quiroz-Compean, A.; Colin, J.; Nederkoorn, P. J.; Marianito, V. P.; Cunha, L.; Santo, G.; Silva, F.; Coelho, J.; Kustova, M.; Meshkova, K.; Williams, G.; Siegler, J.; Zhang, C.; Gallatti, N.; Kruszewski, M.
Atrial fibrillation (AF) is increasingly recognized as the single most important cause of disabling ischemic stroke in the elderly. We undertook an international survey to characterize the frequency of AF-associated stroke, methods of AF detection, and patient features. Consecutive patients
Ibsen, Lars Bo; Liingaard, Morten; Andersen, Lars
This report concerns the dynamic soil-structure interaction of steel suction caissons applied as foundations for offshore wind turbines. An emphasis is put on torsional vibrations and coupled sliding/rocking motion, and the influence of the foundation geometry and the properties of the surrounding...... soil is examined. The soil is simplified as a homogenous linear viscoelastic material and the dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequency-dependent coefficients corresponding to the different degrees of freedom. The dynamic stiffness coefficients...
Liingaard, Morten; Andersen, Lars; Ibsen, Lars Bo
The dynamic response of offshore wind turbines is affected by the properties of the foundation and the subsoil. The aim of this paper is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigations include evaluation of the vertical...... and coupled sliding-rocking vibrations, influence of the foundation geometry and examination on the properties of the surrounding soil. The soil is simplified as a homogenous linear viscoelastic material and the dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequency...
Pedersen, P M; Jørgensen, H S; Kammersgaard, L P
To determine the frequency of manual and oral apraxia in acute stroke and to examine the influence of these symptoms on functional outcome.......To determine the frequency of manual and oral apraxia in acute stroke and to examine the influence of these symptoms on functional outcome....
Phillip, Dorte; Schytz, Henrik Winther; Iversen, Helle Klingenberg
patients admitted to the stroke unit with symptoms of ischemic stroke. 11/29 patients received thrombolytic therapy. NIRS examination was conducted 2 days (median time) from stroke onset. NIRS optodes were placed on each side of the head with a 3 cm source-detector distance. Using transfer function...
Crary, Michael A; Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael F
Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. In a cohort of 63 acute stroke cases, swallow frequency rates (swallows per minute [SPM]) were compared with stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with versus without clinically significant dysphagia. Receiver operating characteristic curve analysis was used to identify the optimal threshold in SPM, which was compared with a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was used to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. Receiver operating characteristic curve analysis yielded a threshold of SPM≤0.40 that identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5- to 10-minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel.
Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael
Background and Purpose Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. Methods In a cohort of 63 acute stroke cases swallow frequency rates (swallows per minute: SPM) were compared to stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with vs. without clinically significant dysphagia. ROC analysis was used to identify the optimal threshold in SPM which was compared to a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was employed to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. Results SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. ROC analysis yielded a threshold of SPM ≤ 0.40 which identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5 to 10 minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Conclusions Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel. PMID:24149008
Erdur, Hebun; Scheitz, Jan F; Ebinger, Martin; Rocco, Andrea; Grittner, Ulrike; Meisel, Andreas; Rothwell, Peter M; Endres, Matthias; Nolte, Christian H
We aimed to assess the risk of recurrent ischemic events during hospitalization for stroke or transient ischemic attack (TIA) with optimal current management and to identify associated risk factors. We performed a retrospective analysis of all patients treated for acute ischemic stroke or TIA in 3 stroke units between 2010 and 2013. Recurrent stroke was defined as new persisting (≥24 hours) neurological deficit occurring >24 hours after the index event and not attributable to other causes of neurological deterioration. Cox proportional hazard regression identified risk factors associated with recurrent stroke. The study included 5106 patients. During a median length of stay of 5 days (interquartile range, 4-8), stroke recurrence (or stroke after TIA) occurred in 40 patients (0.8%) and was independently associated with history of TIA, symptomatic carotid stenosis (≥70%), or other determined etiology. Patients with recurrent stroke and other determined etiology had cervical arterial dissection (n=2), primary angiitis of the central nervous system (n=1), giant cell arteritis (n=1), and lung cancer with nonbacterial thrombotic endocarditis (n=1). In patients with initial TIA or minor stroke (National Institutes of Health Stroke Scale ≤5) recurrence was associated additionally with pneumonia after the inciting ischemic event but before stroke recurrence. Patients with initial stroke and aphasia had a lower stroke recurrence rate and there were no recurrences in patients with lacunar stroke. Recurrence was associated with significantly higher in-hospital mortality (17.5% versus 3.1%; Pstroke recurrence was low with optimal current management. Patients with a history of TIA, severe symptomatic carotid stenosis, or uncommon causes of stroke were at higher risk. Pneumonia was associated with a higher risk of stroke recurrence in patients with initial TIA or minor stroke but not in the overall population studied. Aphasia may bias the detection rate by concealing new
Choi, Jae-Hwan; Kim, Hyun-Woo; Choi, Kwang-Dong; Kim, Min-Ji; Choi, Yu Ri; Cho, Han-Jin; Sung, Sang-Min; Kim, Hak-Jin; Kim, Ji-Soo; Jung, Dae-Soo
Dizziness/vertigo is a common symptom of posterior circulation stroke and usually accompanies other neurologic symptoms and signs. Although strokes involving the brainstem or cerebellum may produce isolated vestibular syndrome (isolated vertigo or imbalance), the overall frequency and involved structures of isolated vestibular syndrome in the posterior circulation stroke remain uncertain. Isolated vestibular syndrome occurs in approximately 25% of the patients with posterior circulation strok...
Gündoğdu, Aslı Aksoy; Kotan, Dilcan; Alemdar, Murat
Fabry disease (FD) is known as a rare cause of stroke. Recent studies suggested that FD is an underdiagnosed entity among young stroke patients. We aimed to investigate the frequency of FD in young cryptogenic stroke patients who lived in the City of Sakarya and to define the clinical features that help in recognizing patients with FD. Acute ischemic stroke patients aged 18-55 years who were admitted to our hospital between October 2013 and September 2016 were evaluated for inclusion. Patients with other recognized causes of stroke were excluded. The screening was performed for alpha-galactosidase A (α-Gal A) activity on dried blood spot, and DNA was sequenced for GLA mutation in patients with low plasma α-Gal A activity. Among the 484 acute ischemic stroke patients, 54 (24 male, 44.4%) young cryptogenic stroke patients were enrolled. The α-Gal A activity was detected as low in 3 patients. c.[680G > A] p.[R227Q] missense mutation was identified in 2 male patients. The frequency of FD was calculated as 3.7%. Our research is the first FD screening study in Turkish stroke patients. Our results underlined the importance of considering FD during the etiologic evaluation of young cryptogenic stroke patients as it is a rare but potentially treatable entity. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Choi, Jae-Hwan; Kim, Hyun-Woo; Choi, Kwang-Dong; Kim, Min-Ji; Choi, Yu Ri; Cho, Han-Jin; Sung, Sang-Min; Kim, Hak-Jin; Kim, Ji-Soo; Jung, Dae-Soo
Dizziness/vertigo is a common symptom of posterior circulation stroke and usually accompanies other neurologic symptoms and signs. Although strokes involving the brainstem or cerebellum may produce isolated vestibular syndrome (isolated vertigo or imbalance), the overall frequency and involved structures of isolated vestibular syndrome in the posterior circulation stroke remain uncertain. Isolated vestibular syndrome occurs in approximately 25% of the patients with posterior circulation stroke, and mostly involves the cerebellum, inferior or superior cerebellar peduncles, and caudal lateral or rostral dorsolateral medulla. The occasional negative neuroimaging in patients with acute isolated vascular vertigo highlights the importance of appropriate bedside evaluation in acute vestibular syndrome.
Full Text Available Claire Windsor,1 Emily Herrett,1 Liam Smeeth,1 Jennifer Kathleen Quint1,2 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 2Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK Background: Patients with chronic obstructive pulmonary disease (COPD have a higher risk of stroke than the general population. Chronic inflammation associated with COPD is thought to contribute to this risk. Exacerbations of COPD are associated with a rise in inflammation, suggesting that there may be an association between exacerbation frequency and the risk of stroke. This study examined that association.Methods: Using the UK Clinical Practice Research Datalink, COPD patients with a first stroke between January 2004 and December 2013 were identified as cases and matched on age, sex, and general practice to controls with COPD but without a stroke (6,441 cases and 19,323 controls. Frequent exacerbators (FEs were defined as COPD patients with ≥2 exacerbations, and infrequent exacerbators (IEs have ≤1 exacerbation in the year prior to their stroke. Conditional logistic regression was used to estimate the association between exacerbation frequency and stroke overall, and by stroke subtype (hemorrhagic, ischemic, or transient ischemic attack. Exacerbations were also categorized into 0, 1, 2, or ≥3 exacerbations in the year prior to stroke.Results: There was no evidence that FE had an increased odds of stroke compared to IE (OR [odds ratio] =0.95, 95% CI [confidence interval] =0.89–1.01. There was strong evidence that the risk of stroke decreased with each exacerbation of COPD experienced per year (Ptrend =0.003. In the subgroup analysis investigating stroke subtype, FE had 33% lower odds of hemorrhagic stroke than IE (OR =0.67, 95% CI =0.51–0.88, P=0.003. No association was found within other stroke types
Cox, William M.; Brown, Christopher S.; Dreschel, Thomas W.
Placing nutrient solution under suction increases growth. Foam plug seals growing stem of plant, making it possible to maintain suction in nutrient liquid around roots. Jar wrapped in black tape to keep out light. Potential use in terrestrial applications in arid climates or in labor-intensive agricultural situations.
Latini, Chiara; Zania, Varvara
Deeper water installations of offshore wind turbines may be supported by jacket structures. This study investigates the dynamic response of suction caissons for jackets by analysing 3D finite element models in the frequency domain. The numerical modelling was firstly validated by analytical...... solutions for pile foundations. Groups of crucial dimensionless parameters related to the soil profile and the foundation geometry are identified and their effects on the response of suction caissons are studied. Static stiffness coefficients are presented in a form of mathematical formulas obtained...... by fitting the numerical results, pertaining foundations with different slenderness ratios and embedded in different soil profiles. Sensitivity of the dynamic impedances of suction caissons on the skirt length was showed in this study. Moreover, the results for the suction caissons indicated that the overall...
Full Text Available Yanling Wang,1 Jihong Liu,1 Xuemei Wang,1 Zongjian Liu,2 Fengwu Li,1 Fenghua Chen,3 Xiaokun Geng,1 Zhili Ji,2 Huishan Du,1 Xiaoming Hu1,3 1Department of Neurology, China-America Institute of Neuroscience, 2Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Neurology, Pittsburgh Institute of Brain Disorders and Recovery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Background: Stroke has high mortality and morbidity. Biomarkers are required for to predict stroke outcomes, which could help clinicians to provide rationale approaches for patient management. The dynamic changes in circulating immune cells have been reported in stroke patients and animal models of stroke.Aim: The aim of this study was to explore biomarkers to predict stroke outcomes by investigating the relationship between the frequencies of circulating immune cells and stroke outcomes.Methods: In all, 50 acute ischemic stroke (AIS patients were enrolled. Their blood samples were collected upon hospital admission and on day 1 and day 7 after stroke, and the leukocyte subsets were analyzed by flow cytometry. The dynamic changes in some types of immune cells in the AIS course and their correlation with clinical parameters were analyzed. Blood samples from 123 age- and gender-matched healthy subjects were used as controls.Results: The proportions of T-lymphocytes and NK cells in stroke patients were significantly lower than in healthy controls. The frequencies of B- and T-lymphocytes were negatively correlated with stroke severity at onset, including neurological deficits as assessed by National Institutes of Health Stroke Scale (NIHSS, and infarct volume as measured by the diffusion-weighted images (DWIs of magnetic resonance (MR. Logistic regression analysis showed that modified Rankin scale (mRs scores, a score system for the long-term neurological dysfunctions, were negatively correlated
Crary, Michael A; Carnaby, Giselle D; Sia, Isaac
The aim of this study was to compare spontaneous swallow frequency analysis (SFA) with clinical screening protocols for identification of dysphagia in acute stroke. In all, 62 patients with acute stroke were evaluated for spontaneous swallow frequency rates using a validated acoustic analysis technique. Independent of SFA, these same patients received a routine nurse-administered clinical dysphagia screening as part of standard stroke care. Both screening tools were compared against a validated clinical assessment of dysphagia for acute stroke. In addition, psychometric properties of SFA were compared against published, validated clinical screening protocols. Spontaneous SFA differentiates patients with versus without dysphagia after acute stroke. Using a previously identified cut point based on swallows per minute, spontaneous SFA demonstrated superior ability to identify dysphagia cases compared with a nurse-administered clinical screening tool. In addition, spontaneous SFA demonstrated equal or superior psychometric properties to 4 validated, published clinical dysphagia screening tools. Spontaneous SFA has high potential to identify dysphagia in acute stroke with psychometric properties equal or superior to clinical screening protocols. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Latini, Chiara; Zania, Varvara; Cisternino, Michele
The promising potential for offshore wind market is on developing wind farms in deeper waters with bigger turbines. In deeper waters the design foundation configuration may consist of jacket structures supported by floating piles or by suction caissons. Taking the soil-structure interaction effects...... into consideration requires the prior estimation of the dynamic impedances of the foundation. Even though numerous studies exist for piles, only limited number of publications can be found for suction caissons subjected to dynamic loads. Therefore, the purpose of this study is to examine the dynamic response...... of this type of foundation using the finite element method (FEM) to account for the interaction with the soil. 3D numerical models for both the soil and the suction caisson are formulated in a frequency domain. The response of the soil surrounding the foundation is considered linear viscoelastic...
Offshore wind energy is a promising source of energy in the near future, and is rapidly becoming competitive with other power generating technologies. The continuous improvement in wind turbine technology means that the wind turbines have increased tremendously in both size and performance during the last 25 years. In order to reduce the costs, the overall weight of the wind turbine components is minimized, which means that the wind turbine structures become more flexible and thus more sensitive to dynamic excitation. Since the first resonance frequency of the modern offshore wind turbines is close to the excitation frequencies of the rotor system, it is of outmost importance to be able to evaluate the resonance frequencies of the wind turbine structure accurately as the wind turbines increase in size. In order to achieve reliable responses of the wind turbine structure during working loads it is necessary to account for the possibilities of dynamic effects of the soil-structure interaction. The aim of this thesis is to evaluate the dynamic soil-structure interaction of foundations for offshore wind turbines, with the intention that the dynamic properties of the foundation can be properly included in a composite structure-foundation system. The work has been focused on one particular foundation type; the suction caisson. The frequency dependent stiffness (impedance) of the suction caisson has been investigated by means of a three-dimensional coupled Boundary Element/Finite Element model, where the soil is simplified as a homogenous linear viscoelastic material. The dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequencydependent coefficients corresponding to the different degrees of freedom. Comparisons with known analytical and numerical solutions indicate that the static and dynamic behaviour of the foundation are predicted accurately with the applied model. The analysis has been carried out for different combinations of the
Hachet, Olivier; Guenancia, Charles; Stamboul, Karim; Daubail, Benoit; Richard, Carole; Béjot, Yannick; Yameogo, Valentin; Gudjoncik, Aurélie; Cottin, Yves; Giroud, Maurice; Lorgis, Luc
Stroke is a serious complication after acute myocardial infarction (AMI) and is closely associated with decreased survival. This study aimed to investigate the frequency, characteristics, and factors associated with in-hospital and postdischarge stroke in patients with AMI. Eight thousand four hundred eighty-five consecutive patients admitted to a cardiology intensive care unit for AMI, between January 2001 and July 2010. Stroke/transient ischemic attack were collected during 1-year follow-up. One hundred twenty-three in-hospital strokes were recorded: 65 (52.8%) occurred on the first day after admission for AMI, and 108 (87%) within the first 5 days. One hundred six patients (86.2%-incidence rate 1.25%) experienced in-hospital ischemic stroke, and 14 patients (11.4%-incidence rate 0.16%) were diagnosed with an in-hospital hemorrhagic stroke. In-hospital ischemic stroke subtypes according to the Trial of Org 10 172 in Acute Stroke Treatment (TOAST) classification showed that only 2 types of stroke were identified more frequently. As expected, the leading subtype of in-hospital ischemic stroke was cardioembolic stroke (n=64, 60%), the second was stroke of undetermined pathogenesis (n=38, 36%). After multivariable backward regression analysis, female sex, previous transient ischemic attack (TIA)/stroke, new-onset atrial fibrillation, left ventricular ejection fraction (odds ratio per point of left ventricular ejection fraction), and C-reactive protein were independently associated with in-hospital ischemic stroke. When antiplatelet and anticoagulation therapy within the first 48 hours was introduced into the multivariable model, we found that implementing these treatments (≥1) was an independent protective factor of in-hospital stroke. In-hospital hemorrhagic stroke was dramatically increased (5-fold) when thrombolysis was prescribed as the reperfusion treatment. However, the different parenteral anticoagulants were not predictors of risk in univariable analysis
Maheshwari, A. K.; Kumar, P.; Alam, M. T.; Aurangzeb, M.; Imran, K.; Masroor, M.; Parkash, J.
Objective: To determine the frequency of hyperthermia in acute ischemic stroke patients visiting a tertiary care hospital in a developing country. Study Design: Cross-sectional, observational study. Place and Duration of Study: Medical Wards of Civil Hospital, Karachi, from January to June 2013. Methodology: Patients aged = 18 years of either gender with acute ischemic stroke presenting within 24 hours of onset of symptoms were included. Written informed consent was obtained from all participants as well as approval of ethical review committee of the institute. Axillary temperature by mercury thermometer was monitored at the time of admission and after every 6 hours for 3 days. The data was analyzed using SPSS version 17.0 (SPSS Inc., IL, Chicago, USA). Result: A total of 106 patients of ischemic stroke were included. The mean age of enrolled participants was 60.1 ±9.5 years. Among these, 61 (57.5 percentage) were males and 45 (42.5 percentage) females. Among all patients, 51.9 percentage presented with loss of consciousness, 30.2 percentage with slurred speech, 77.4 percentage with limb weakness, and 9.4 percentage with decrease vision. A total of 17 (16 percentage) patients with ischemic stroke developed hyperthermia. When the prevalence of hyperthermia was stratified according to age, among patients of < 60 years of age, 26 percentage developed hyperthermia compared to 7.1 percentage in patients of = 60 years of age (p=0.008). On gender stratification, among male patients, 14.8 percentage developed hyperthermia compared to 17.8 percentage in female patients (p=0.43). Conclusion: It is concluded from this study that the frequency of hyperthermia in ischemic stroke was 16 percentage and it should be looked for as it has significant impact on the outcome. The hyperthermia was significantly more common in younger adults as compared to older adults. However, gender had no influence on the prevalence rate of hyperthermia. (author)
Wolff, Valérie; Armspach, Jean-Paul; Beaujeux, Rémy; Manisor, Monica; Rouyer, Olivier; Lauer, Valérie; Meyer, Nicolas; Marescaux, Christian; Geny, Bernard
Leading aetiologies of ischaemic stroke in young adults are cervico-cerebral arterial dissections and cardio-embolism, but the causes remain undetermined in a considerable proportion of cases. In a few reports, intracranial arterial stenosis has been suggested to be a potential cause of ischaemic stroke in young adults. The aim of our work was to evaluate the frequency, characteristics and risk factors of intracranial arterial stenosis in a prospective series of young ischaemic stroke patients. The study was based on a prospective consecutive hospital-based series of 159 patients aged 18-45 years who were admitted to our unit for an acute ischaemic stroke from October 2005 to December 2010. A structured questionnaire was used in order to assess common vascular risk factors such as hypertension, diabetes, hypercholesterolemia, use of tobacco, alcohol and illicit drugs, migraine, and, in women, oral contraceptive use. A systematic screening was performed, including the following: brain magnetic resonance imaging or, if not feasible, brain computed tomography scan, carotid and vertebral Duplex scanning and trans-cranial Doppler sonography, 3D time-of-flight magnetic resonance cerebral angiography or cerebral computed tomography angiography. Long-duration electrocardiography, trans-thoracic and trans-oesophageal echocardiography were performed and laboratory blood investigations were extensive. Urine samples were screened for cannabinoids, cocaine, amphetamine and methylene-dioxy-methamphetamine. When this initial work-up was inconclusive, trans-femoral intra-arterial selective digital subtraction angiography with reconstructed 3D images was performed. In this series, 49 patients (31%) had intracranial arterial stenosis. Other defined causes were found in 91 patients (57%), including cardio-embolism in 32 (20%), cervical dissection in 23 (14%), extracranial atherosclerosis in 7 (4%), haematological disorders in 7 (4%), small vessel disease in 1, and isolated patent
Full Text Available Objective To investigate the effects of swallowing training combined with low-frequency electrical stimulation on dysphagia after ischemic stroke. Methods A total of 68 patients with dysphagia after ischemic stroke were divided into control group (N = 34, receiving swallowing training and feeding strategies and combined treatment group (N = 34, receiving swallowing training, feeding strategies and low-frequency electrical stimulation. Video Fluoroscopic Swallowing Study (VFSS and Standardized Swallowing Assessment (SSA were used to evaluate the swallowing function of patients in 2 groups before and after 15 d of treatment. Results According to Oxfordshire Community Stroke Project (OCSP classification, 34 patients in control group were classified into 12 cases with total anterior circulation infarct (TACI, 8 cases with partial anterior circulation infarct (PACI, 10 cases with posterior circulation infarct (POCI and 4 cases with lacunar infarct (LACI; 34 patients in combined treatment group were classified into 10 cases with TACI, 7 cases with PACI, 11 cases with POCI and 6 cases with LACI. Compared with before treatment, the VFSS score increased (P = 0.003, 0.000, while SSA score decreased (P = 0.003, 0.000 in both groups. Compared with control group, the VFSS score increased (P = 0.004, while SSA score decreased (P = 0.020 in combined treatment group. Conclusions Swallowing training combined with low-frequency electrical stimulation can significantly improve the swallowing capacity of patients with acute ischemic stroke, and the effect is better than mere swallowing training. DOI: 10.3969/j.issn.1672-6731.2015.04.007
Maggiore, Salvatore Maurizio; Lellouche, François; Pignataro, Claudia; Girou, Emmanuelle; Maitre, Bernard; Richard, Jean-Christophe M; Lemaire, François; Brun-Buisson, Christian; Brochard, Laurent
Little is known about the incidence of and risk factors for adverse effects from endotracheal suctioning. We studied the incidence and risk factors, and evaluated the effect of suctioning practice guidelines. During a 3-month period, in 79 mechanically ventilated subjects, we recorded the adverse effects in 4,506 suctioning procedures. Then practice guidelines were implemented, and 1 year later, during another 3-month period, in 68 subjects, we recorded the adverse effects in 4,994 suctioning procedures. In the first period, adverse effects occurred frequently: oxygen desaturation in 46.8% of subjects and 6.5% of suctionings, hemorrhagic secretions in 31.6% of subjects and 4% of suctionings, blood pressure change in 24.1% of subjects and 1.6% of suctionings, and heart rate change in 10.1% of subjects and 1.1% of suctionings. After guidelines implementation, all complications, both separately and all together, were reduced. The incidence of all complications together decreased from 59.5% to 42.6% of subjects, and from 12.4% to 4.9% of procedures (both P 5 cm H2O was an independent risk factor for oxygen desaturation. Receiving > 6 suctionings per day was a risk factor for desaturation and hemorrhagic secretions. The use of guidelines was independently associated with fewer complications. Endotracheal suctioning frequently induces adverse effects. Technique, suctioning frequency, and higher PEEP are risk factors for complications. Their incidence can be reduced by the implementation of suctioning guidelines.
Rasaholiarison, Nomena Finiavana; Randrianasolo, Rahamefy Odilon; Rajaonarison, Lala Andriamasinavalona; Rakotomanana, Jenny Larissa; Razafimahefa, Julien; Tehindrazanarivelo, Alain Djacoba
Strokes of the perforating arteries are mainly arteriolopathies. They result in dementia and stroke recurrence. This study aimed to evaluate the frequency and characteristics of these strokes to better prevent these complications. We conducted a descriptive, retrospective study in the department of neurology at the Befelatanana general hospital, Antananarivo over the period 01 March-25 September 2015. All patients with abrupt neurological deficit and deep brain involvement on brain scanner were included in the study. The features of strokes involving the perforating arteries were collected. Data were processed with SPSS 20 software. Out of 172 patients with a stroke, 83(48.25%) had stroke involving the perforating arteries. Stroke involving the perforating arteries affected young people (65.06%) aged less than 65 years and preferentially the male population (61.44%). Haemorrhagic forms accounted for 67.46%. Thirty-one patients (37.34%) had stroke recurrences and, among them, almost a quarter had 2 recurrences (38.70%) in less than a year. All patients with recurrence had dysexecutive disorder (p < 0.0001) and poor antihypertensive medication adherence. Mortality accounted for only 6.02% in patients with onset of these strokes during hospitalization. Specific neurologic follow-up is necessary after a first stroke involving perforating arteries in order to make an early diagnosis of dementia and to prevent recurrences.
Objective: To find out the frequency of hyper-homocysteinaemia in ischaemic stroke patients and its relation with other risk factors. Methods: The cross-sectional study based on convenience sampling was conducted at the Civil Hospital, Karachi, from May to July 2012. It comprised ischaemic stroke patients selected from the Out Patient Department and Emergency Department. An overnight 8-hour fasting venous blood sample (4 ml in ethylenediamminetetraacetate) was drawn for analysis. Rest of the data was collected through a structured proforma and was analysed using SPSS 17.0. Results: The mean age of the 96 patients in the study was 64.9+-10.9 years (range: 40-85).Overall, 56(58.3%) cases had hyper-homocysteinemia. The frequency was significantly high in the age 60-79 age group (p<0.007). Conclusion: Hyper-homocysteinaemia, a modifiable risk factor, is associated with a high number of ischaemic stroke patients. Hence, steps should be taken to minimise this risk factor by screening and early intervention. (author)
Full Text Available Resting-state functional magnetic resonance imaging (R-fMRI has been intensively used to assess alterations of inter-regional functional connectivity in patients with stroke, but the regional properties of brain activity in stroke have not yet been fully investigated. Additionally, no study has examined a frequency effect on such regional properties in stroke patients, although this effect has been shown to play important roles in both normal brain functioning and functional abnormalities. Here we utilized R-fMRI to measure the amplitude of low-frequency fluctuations (ALFF and regional homogeneity (ReHo, two major methods for characterizing the regional properties of R-fMRI, in three different frequency bands (slow-5: 0.01-0.027 Hz; slow-4: 0.027-0.73 Hz; and typical band: 0.01-0.1 Hz in 19 stroke patients and 15 healthy controls. Both the ALFF and ReHo analyses revealed changes in brain activity in a number of brain regions, particularly the parietal cortex, in stroke patients compared with healthy controls. Remarkably, the regions with changed activity as detected by the slow-5 band data were more extensive, and this finding was true for both the ALFF and ReHo analyses. These results not only confirm previous studies showing abnormality in the parietal cortex in patients with stroke, but also suggest that R-fMRI studies of stroke should take frequency effects into account when measuring intrinsic brain activity.
Ibsen, Lars Bo; Liingaard, M.; Andersen, Lars
The dynamic response of offshore wind turbines are affected by the properties of the foundation and the subsoil. The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three-dimensional coupled Boundary Element/Finite Element model. Comparisons are made with known analytical and numerical solutions in order to evaluate the static and dynamic behaviour of the Boundary Element/Finite Element model. The vertical frequency dependent stiffness has been determined for different combinations of the skirt length, Poisson's ratio and the ratio between soil stiffness and skirt stiffness. Finally the dynamic behaviour at high frequencies is investigated. (au)
... adjust your treatment as needed. Rehabilitation After a stroke, you may need rehabilitation (rehab) to help you recover. Rehab may include working with speech, physical, and occupational therapists. Language, ... may have trouble communicating after a stroke. You may not be able to find the ...
Qurnell, F.D.; Peloquin, A.V.
An underwater suction device for collecting irradiated materials in a pool of water includes injection and suction tubes and a removable, disposable filter for capturing irradiated materials. Pressurized water is injected into the suction tube through a jet pump nozzle to establish a suction flow through the tube. The suction device is manoeuverable by a pole, which is pivotally connected to the suction device by a latching mechanism. (author)
Kafri, Mohannad W.; Myint, Phyo Kyaw; Doherty, Danielle; Wilson, Alexander Hugh; Potter, John F.; Hooper, Lee
Background Non-invasive methods for detecting water-loss dehydration following acute stroke would be clinically useful. We evaluated the diagnostic accuracy of multi-frequency bioelectrical impedance analysis (MF-BIA) against reference standards serum osmolality and osmolarity. Material/Methods Patients admitted to an acute stroke unit were recruited. Blood samples for electrolytes and osmolality were taken within 20 minutes of MF-BIA. Total body water (TBW%), intracellular (ICW%) and extracellular water (ECW%), as percentages of total body weight, were calculated by MF-BIA equipment and from impedance measures using published equations for older people. These were compared to hydration status (based on serum osmolality and calculated osmolarity). The most promising Receiver Operating Characteristics curves were plotted. Results 27 stroke patients were recruited (mean age 71.3, SD10.7). Only a TBW% cut-off at 46% was consistent with current dehydration (serum osmolality >300 mOsm/kg) and TBW% at 47% impending dehydration (calculated osmolarity ≥295–300 mOsm/L) with sensitivity and specificity both >60%. Even here diagnostic accuracy of MF-BIA was poor, a third of those with dehydration were wrongly classified as hydrated and a third classified as dehydrated were well hydrated. Secondary analyses assessing diagnostic accuracy of TBW% for men and women separately, and using TBW as a percentage of lean body mass showed some promise, but did not provide diagnostically accurate measures across the population. Conclusions MF-BIA appears ineffective at diagnosing water-loss dehydration after stroke and cannot be recommended as a test for dehydration, but separating assessment by sex, and using TBW as a percentage of lean body weight may warrant further investigation. PMID:23839255
Jackova, Jana; Sedova, Petra; Brown, Robert D; Bryndziar, Tomas; Zvolsky, Miroslav; Bednarik, Josef; Mikulik, Robert
Administration of evidence-based pharmacotherapy improves stroke outcome while the use of non-evidence-based medications may not be of benefit and leads to unnecessary patient care costs. The aim of our study was to determine the frequency of guideline-approved and guideline-disapproved pharmacotherapy use in acute stroke management in the Czech Republic (CR). Using the ICD-10 codes, 500 stroke and transient ischemic attack (TIA) patients were randomly selected (random selection of 10 hospitals and then 50 patients from each hospital) from the National Registry of Hospitalized Patients for strokes occurring in 2011. Discharge summaries were reviewed for medications prescribed during hospitalization and at discharge. Of the 500 requested discharge summaries, 484 were available for review (response rate 97%). Up to 479 (96%) summaries were sufficient for evaluation and of these, 393 were confirmed to have a stroke or TIA diagnosis. Brain imaging (computed tomography or magnetic resonance imaging) was performed in 97% of the 393 cases. Intravenous thrombolysis was administered to 7% of patients with ischemic stroke (rate was 0%-25% in different hospitals). Up to 97% of patients with ischemic events (TIA or ischemic stroke) were treated with antiplatelets or anticoagulants. At least 1 non-evidence-based medication was administered to 28% of the 393 patients (rate was 5%-89% in different hospitals). Guideline-disapproved pharmacotherapy is common in stroke and TIA patients in the CR and processes should be put into place to lessen the frequency of their use. The use of guideline-approved medications is also high and should be further promoted. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Yang, Lin; Dai, Meng; Xu, Canhua; Zhang, Ge; Li, Weichen; Fu, Feng; Shi, Xuetao; Dong, Xiuzhen
Frequency-difference electrical impedance tomography (fdEIT) reconstructs frequency-dependent changes of a complex impedance distribution. It has a potential application in acute stroke detection because there are significant differences in impedance spectra between stroke lesions and normal brain tissues. However, fdEIT suffers from the influences of electrode-skin contact impedance since contact impedance varies greatly with frequency. When using fdEIT to detect stroke, it is critical to know the degree of measurement errors or image artifacts caused by contact impedance. To our knowledge, no study has systematically investigated the frequency spectral properties of electrode-skin contact impedance on human head and its frequency-dependent effects on fdEIT used in stroke detection within a wide frequency band (10 Hz-1 MHz). In this study, we first measured and analyzed the frequency spectral properties of electrode-skin contact impedance on 47 human subjects' heads within 10 Hz-1 MHz. Then, we quantified the frequency-dependent effects of contact impedance on fdEIT in stroke detection in terms of the current distribution beneath the electrodes and the contact impedance imbalance between two measuring electrodes. The results showed that the contact impedance at high frequencies (>100 kHz) significantly changed the current distribution beneath the electrode, leading to nonnegligible errors in boundary voltages and artifacts in reconstructed images. The contact impedance imbalance at low frequencies (impedance has critical frequency-dependent influences on fdEIT and further studies on reducing such influences are necessary to improve the application of fdEIT in stroke detection.
Jensen, Jesper K.; Kristensen, Søren R.; Bak, Søren
Elevated levels of troponin have been reported in patients with acute ischemic stroke. In this prospective study, the prevalence and characteristics of troponin elevation were examined in 244 patients with acute ischemic stroke but without overt ischemic heart disease. Troponin T (TnT) and creatine...... for a mean of 19 +/- 7 months, with all-cause mortality as the clinical end point. Elevated levels of TnT (>0.03 micro g/L) and creatine kinase-MB (> or =10 micro g/L) were observed in 10% and 9% of patients, respectively. Patients with elevated TnT had higher frequencies of heart and/or renal failure....... Perfusion abnormalities on myocardial perfusion scintigraphy at rest were not more frequent or pronounced in patients with TnT levels of > or =0.10 micro g/L than in the control group. Only 7 patients (3%) had elevations of TnT or creatine kinase-MB and electrocardiographic changes suggesting acute...
Sato, Katsufumi; Watanuki, Yutaka; Takahashi, Akinori; Miller, Patrick J.O; Tanaka, Hideji; Kawabe, Ryo; Ponganis, Paul J; Handrich, Yves; Akamatsu, Tomonari; Watanabe, Yuuki; Mitani, Yoko; Costa, Daniel P; Bost, Charles-André; Aoki, Kagari; Amano, Masao; Trathan, Phil; Shapiro, Ari; Naito, Yasuhiko
It is obvious, at least qualitatively, that small animals move their locomotory apparatus faster than large animals: small insects move their wings invisibly fast, while large birds flap their wings slowly. However, quantitative observations have been difficult to obtain from free-ranging swimming animals. We surveyed the swimming behaviour of animals ranging from 0.5 kg seabirds to 30 000 kg sperm whales using animal-borne accelerometers. Dominant stroke cycle frequencies of swimming specialist seabirds and marine mammals were proportional to mass−0.29 (R2=0.99, n=17 groups), while propulsive swimming speeds of 1–2 m s−1 were independent of body size. This scaling relationship, obtained from breath-hold divers expected to swim optimally to conserve oxygen, does not agree with recent theoretical predictions for optimal swimming. Seabirds that use their wings for both swimming and flying stroked at a lower frequency than other swimming specialists of the same size, suggesting a morphological trade-off with wing size and stroke frequency representing a compromise. In contrast, foot-propelled diving birds such as shags had similar stroke frequencies as other swimming specialists. These results suggest that muscle characteristics may constrain swimming during cruising travel, with convergence among diving specialists in the proportions and contraction rates of propulsive muscles. PMID:17476766
Koyama, Soichiro; Tanabe, Shigeo; Takeda, Kazuya; Sakurai, Hiroaki; Kanada, Yoshikiyo
Neurophysiological studies in healthy subjects suggest that increased spinal inhibitory reflexes from the tibialis anterior (TA) muscle to the soleus (SOL) muscle might contribute to decreased spasticity. While 50 Hz is an effective frequency for transcutaneous electrical nerve stimulation (TENS) in healthy subjects, in stroke survivors, the effects of TENS on spinal reflex circuits and its appropriate frequency are not well known. We examined the effects of different frequencies of TENS on spinal inhibitory reflexes from the TA to SOL muscle in stroke survivors. Twenty chronic stroke survivors with ankle plantar flexor spasticity received 50-, 100-, or 200-Hz TENS over the deep peroneal nerve (DPN) of the affected lower limb for 30 min. Before and immediately after TENS, reciprocal Ia inhibition (RI) and presynaptic inhibition of the SOL alpha motor neuron (D1 inhibition) were assessed by adjusting the unconditioned H-reflex amplitude. Furthermore, during TENS, the time courses of spinal excitability and spinal inhibitory reflexes were assessed via the H-reflex, RI, and D1 inhibition. None of the TENS protocols affected mean RI, whereas D1 inhibition improved significantly following 200-Hz TENS. In a time-series comparison during TENS, repeated stimulation did not produce significant changes in the H-reflex, RI, or D1 inhibition regardless of frequency. These results suggest that the frequency-dependent effect of TENS on spinal reflexes only becomes apparent when RI and D1 inhibition are measured by adjusting the amplitude of the unconditioned H-reflex. However, 200-Hz TENS led to plasticity of synaptic transmission from the antagonist to spastic muscles in stroke survivors.
Sato, Katsufumi; Shiomi, Kozue; Watanabe, Yuuki; Watanuki, Yutaka; Takahashi, Akinori; Ponganis, Paul J.
It has been predicted that geometrically similar animals would swim at the same speed with stroke frequency scaling with mass−1/3. In the present study, morphological and behavioural data obtained from free-ranging penguins (seven species) were compared. Morphological measurements support the geometrical similarity. However, cruising speeds of 1.8–2.3 m s−1 were significantly related to mass0.08 and stroke frequencies were proportional to mass−0.29. These scaling relationships do not agree with the previous predictions for geometrically similar animals. We propose a theoretical model, considering metabolic cost, work against mechanical forces (drag and buoyancy), pitch angle and dive depth. This new model predicts that: (i) the optimal swim speed, which minimizes the energy cost of transport, is proportional to (basal metabolic rate/drag)1/3 independent of buoyancy, pitch angle and dive depth; (ii) the optimal speed is related to mass0.05; and (iii) stroke frequency is proportional to mass−0.28. The observed scaling relationships of penguins support these predictions, which suggest that breath-hold divers swam optimally to minimize the cost of transport, including mechanical and metabolic energy during dive. PMID:19906666
Kim, Seo Young; Shin, Sung Bong; Lee, Seong Jae; Kim, Tae Uk; Hyun, Jung Keun
To investigate the factors related to upper extremity functional improvement following inhibitory repetitive transcranial magnetic stimulation (rTMS) in stroke patients. Forty-one stroke patients received low-frequency rTMS over the contralesional hemisphere according to a standard protocol, in addition to conventional physical and occupational therapy. The rTMS-treated patients were divided into two groups according to their responsiveness to rTMS measured by the self-care score of the Korean version of Modified Barthel Index (K-MBI): responded group (n=19) and non-responded group (n=22). Forty-one age-matched stroke patients who had not received rTMS served as controls. Neurological, cognitive and functional assessments were performed before rTMS and 4 weeks after rTMS treatment. Among the rTMS-treated patients, the responded group was significantly younger than the non-responded group (51.6±10.5 years and 65.5±13.7 years, respectively; p=0.001). Four weeks after rTMS, the National Institutes of Health Stroke Scale, the Brunnstrom recovery stage and upper extremity muscle power scores were significantly more improved in the responded group than in the control group. Besides the self-care score, the mobility score of the K-MBI was also more improved in the responded group than in the non-responded group or controls. Age is the most obvious factor determining upper extremity functional responsiveness to low-frequency rTMS in stroke patients.
Hopfgartner, J.; Posch, S.; Zuber, B.; Almbauer, R.; Krischan, K.; Stangl, S.
Reed valves are widely used in hermetic reciprocating compressors and are responsible for a large part of the thermodynamic losses. Especially, the suction valve, which is opened nearly during the whole suction stroke, has a big potential for improvement. Usually, suction valves are opened only by vacuum created by the moving piston and should be closed before the compression stroke starts to avoid a reversed mass-flow through the valve. Therefore, the valves are prestressed, which results on the other hand in a higher flow resistance. In this work, a suction valve is investigated, which is not closed by the preload of the valve but by an electromagnetic coil located in the suction muffler neck. Shortly before the piston reaches its bottom dead centre, voltage is applied to the coil and a magnetic force is generated which pulls the valve shut. Thereby, the flow resistance through the valve can be reduced by changing the preload on the reed valve because it is no longer needed to close the valve. The investigation of this adapted valve and the electromagnetic coil is firstly done by numerical simulations including fluid structure interactions of the reed valves of a reciprocating compressor and secondly by experiments made on a calorimeter test bench.
Penzes, P.; Jensen, M.R.; Zania, Varvara
Suction caissons are being increasingly used as offshore foundation solutions in shallow and intermediate water depths. The convenient installation method through the application of suction has rendered this type of foundation as an attractive alternative to the more traditional monopile foundation for offshore wind turbines. The combined loading imposed typically to a suction caisson has led to the estimation of their bearing capacity by means of 3D failure envelopes. This study aims to anal...
National Aeronautics and Space Administration — A compact microgravity and hypogravity compatible vacuum device is proposed to provide medical suction and containment of extracted fluids. The proposed aspirator...
Van de Leur, JP; Zwaveling, JH; Loef, BG; Van der Schans, CP
Study objective: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in
Carey, Leeanne M; Matyas, Thomas A
Somatosensory loss following stroke is common, with negative consequences for functional outcome. However, existing studies typically do not include quantitative measures of discriminative sensibility. The aim of this study was to quantify the proportion of stroke patients presenting with discriminative sensory loss of the hand in the post-acute rehabilitation phase. Prospective cohort study of stroke survivors presenting for rehabilitation. Fifty-one consecutive patients admitted to a metropolitan rehabilitation centre over a continuous 12-month period who met selection criteria. Quantitative measures of touch discrimination and limb position sense, with high re-test reliability, good discriminative test properties and objective criteria of abnormality, were employed. Both upper limbs were tested, in counterbalanced order. Impaired touch discrimination was identified in the hand contralateral to the lesion in 47% of patients, and in the ipsilesional hand in 16%. Forty-nine percent showed impaired limb position sense in the contralesional limb and 20% in the ipsilesional limb. Sixty-seven percent demonstrated impairment of at least one modality in the contralesional limb. Ipsilesional impairment was less severe. Discriminative sensory impairment was quantified in the contralesional hand in approximately half of stroke patients presenting for rehabilitation. A clinically significant number also experienced impairment in the ipsilesional "unaffected" hand.
Background: Nasogastric suction is a common routine postoperative procedure in abdominal surgery. Yet there is little scientific justification for it. This paper reports a comparision of routine with selective postoperative nasogastric tube suction in evaluating patients undergoing laparotomy. Methods: This was a prospective ...
Tjelta, T.I.; Rusas, P. [Statoil a.s. (Norway); Edvardsen, G. [HEX a.s. (Norway)
Since the suction anchor is a recent development in its current use, this work provides a brief historical background. It is shown that the suction anchor throughout evolution today is a competitive foundation solution for many applications. Examples from these categories are included in this paper. Also several installation methods are discussed. 3 refs., 7 figs., 2 tabs.
Full Text Available Background: Endotracheal suctioning is often performed by nurses and beneficial for critically ill patients. Suctioning is essential for removing secretions, maintaining airway patency and prevent unexpected complications. Open suctioning is performed by disconnecting patients with the ventilator. Suctioning not only removed secretions in the airway but also oxygen. Suctioning must be done correctly, safely, effectively and efficiently to prevent unexpected events in critically ill patients. Objective: This study aimed to determine differences on cardiopulmonary parameters after open suction in critically ill patients Methods: The study design was comparatif cross sectional analytic approach, using one group pre test and post test. The sample of the research amounted to 34 people, using purposive sampling technique. Catheter size 14 Fr on ETT number 7 mm used in this research to performed endotracheal suctioning. Cardiopulmonary parameters (Heart rate/ HR, respiratory rate/RR, oxygen saturation/SpO2, systolic blood pressure/ SBP and diastolic blood pressure/DBP measured by pulse oxymeter and bedside monitor before suction and immediately thereafter. Results: The results showed increase average heart rate 6.412 (from 106.62 into 113.03, Respiratory rate has increased 4.971 (from 20.62 into 25.59, SpO2 decreased 1.68 (from 99.09 into 97.41, and systolic blood pressure increased 5.71 (from 118.29 into 124.00 after performed open suction. The results of paired t-test statistical analysis (for RR, HR obtained a < 0.05 (0.000, whereas Wilcoxon statistical analysis (for SpO2, SBP obtained a < 0.05 (0.000 and 0.001. So it can be said that the difference cardiopulmonary parameters was statistically significant after perfomed open suction in critically ill patients.
Sasaki, Nobuyuki; Hara, Takatoshi; Yamada, Naoki; Niimi, Masachika; Kakuda, Wataru; Abo, Masahiro
Although repetitive transcranial magnetic stimulation (rTMS) for hemiparesis is beneficial, so far no study has examined the usefulness of rTMS for apathy. Thirteen patients with chronic stroke were assigned randomly to 2 groups: rTMS group (n = 7) and sham stimulation group (n = 6). The patients received 5 sessions of either high-frequency rTMS over the region spanning from the dorsal anterior cingulate cortex (dACC) to medial prefrontal cortex (mPFC) or sham stimulation for 5 days. The severity of apathy was evaluated using the Apathy Scale (AS) and the severity of depression was evaluated using the Quick Inventory of Depressive Symptomatology (QIDS) serially before and after the 5-day protocol. The AS and QIDS scores were significantly improved in the rTMS group, although they were not changed in the sham stimulation group. The degree of change in the AS score was significantly greater in the rTMS group than that in the sham stimulation group. The degree of change in the QIDS score was greater in the rTMS group than that in the sham stimulation group, although the difference was not statistically significant. The application of high frequency rTMS over the dACC and mPFC may be a useful intervention for apathy due to stroke. © 2017 S. Karger AG, Basel.
Tatlisumak, Turgut; Putaala, Jukka; Innilä, Markus; Enzinger, Christian; Metso, Tiina M; Curtze, Sami; von Sarnowski, Bettina; Amaral-Silva, Alexandre; Jungehulsing, Gerhard Jan; Tanislav, Christian; Thijs, Vincent; Rolfs, Arndt; Norrving, Bo; Fazekas, Franz; Suomalainen, Anu; Kolodny, Edwin H
Mitochondrial diseases, predominantly mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS), may occasionally underlie or coincide with ischemic stroke (IS) in young and middle-aged individuals. We searched for undiagnosed patients with MELAS in a target subpopulation of unselected young IS patients enrolled in the Stroke in Young Fabry Patients study (sifap1). Among the 3291 IS patients aged 18-55 years recruited to the sifap1 study at 47 centers across 14 European countries, we identified potential MELAS patients with the following phenotypic features: (a) diagnosed cardiomyopathy or (b) presence of two of the three following findings: migraine, short stature (≤165 cm for males; ≤155 cm for females), and diabetes. Identified patients' blood samples underwent analysis of the common MELAS mutation, m.3243A>G in the MTTL1 gene of mitochondrial DNA. Clinical and cerebral MRI features of the mutation carriers were reviewed. We analyzed blood samples of 238 patients (177 with cardiomyopathy) leading to identification of four previously unrecognized MELAS main mutation carrier-patients. Their clinical and MRI characteristics were within the expectation for common IS patients except for severe hearing loss in one patient and hyperintensity of the pulvinar thalami on T1-weighted MRI in another one. Genetic testing for the m.3243A>G MELAS mutation in young patients with IS based on phenotypes suggestive of mitochondrial disease identifies previously unrecognized carriers of MELAS main mutation, but does not prove MELAS as the putative cause.
Sasaki, Nobuyuki; Mizutani, Saneyuki; Kakuda, Wataru; Abo, Masahiro
Recently, high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and low-frequency rTMS (LF-rTMS) are reported to improve motor function significantly in chronic hemiparetic stroke patients. However, few studies have investigated the safety and efficacy of these rTMS modalities introduced during the early phase of stroke. The purpose of this study was to clarify the rTMS modality that is more beneficial for upper limb hemiparesis in the early phase of stroke using a randomized controlled trial. Twenty-nine patients with a hemispheric stroke lesion in the early phase of stroke were examined. Patients were randomly assigned into 3 groups: the HF-rTMS group (10 Hz rTMS to the lesional hemisphere [n = 9]), the LF-rTMS group (1 Hz rTMS to the nonlesional hemisphere [n = 11]), and the sham stimulation group [n = 9]). Patients received sessions for 5 consecutive days. Grip strength and tapping frequency were assessed before and after the intervention. Motor improvement of the affected upper limb after intervention was compared among the 3 groups. All patients completed the 5-day protocol. Both the HF-rTMS and LF-rTMS groups had significant increases in both grip strength and tapping frequency. Comparison of the extent of improvement showed a more significant increase in grip strength and tapping frequency in the HF-rTMS group compared to the sham stimulation group (each P stimulation group. HF-rTMS applied to the lesional hemisphere in the early phase of stroke was more beneficial for motor improvement of the affected upper limb than LF-rTMS. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Holzman, Roi; Perkol-Finkel, Shimrit; Zilman, Gregory
Fish commonly use their lateral line system to detect moving bodies such as prey and predators. A remarkable case is the Mexican blind cavefish Astyanax fasciatus, which evolved the ability to detect non-moving obstacles. The swimming body of A. fasciatus generates fluid disturbances, the alteration of which by an obstacle can be sensed by the fish's lateral line system. It is generally accepted that these alterations can provide information on the distance to the obstacle. We observed that A. fasciatus swimming in an unfamiliar environment open and close their mouths at high frequency (0.7-4.5 Hz) in order to generate suction flows. We hypothesized that repeated mouth suction generates a hydrodynamic velocity field, which is altered by an obstacle, inducing pressure gradients in the neuromasts of the lateral line and corresponding strong lateral line stimuli. We observed that the frequency and rate of mouth-opening events varied with the fish's distance to obstacles, a hallmark of pulse-based navigation mechanisms such as echolocation. We formulated a mathematical model of this hitherto unrecognized mechanism of obstacle detection and parameterized it experimentally. This model suggests that suction flows induce lateral line stimuli that are weakly dependent on the fish's speed, and may be an order of magnitude stronger than the correspondent stimuli induced by the fish's gliding body. We illustrate that A. fasciatus can navigate non-visually using a combination of two deeply ancestral and highly conserved mechanisms of ray-finned fishes: the mechanism of sensing water motion by the lateral line system and the mechanism of generating water motion by mouth suction. © 2014. Published by The Company of Biologists Ltd.
Heidari, Mohammad; Shahbazi, Sara
Airway suctioning is one of the most common interventions for patients with respiratory disorders and having adequate knowledge in implementing this technique is quite crucial for nurses. To assess the nurses' awareness about principles of airway suctioning. This study was a cross-sectional study done on 85 staff nurses' in Vali-Asr hospital. Sampling was based on census data collection. A researcher made questionnaire was used for assessment of nurses' awareness about the principles of airway suctioning. The validity and reliability (Cronbach's alpha=0.78) of the questionnaire have been examined and proved. The level of nurses' awareness about airway suctioning was measured based on the questionnaire that includes demographic and specialty information in the form of eight questions of 3-selection-item. The maximum and minimum score of knowledge ranged between 0-8. The data obtained was statistically analysed using SPSS software Version 16.0 and was analysed using descriptive statistics and Pearson correlation coefficient. The results reveal that the nurses' awareness about principles of airway suctioning was average. There was a significant association between knowledge and gender of nurses (pprinciples of airway suctioning was more than men. The results indicate that nurses' awareness of airway suctioning technique was in an average state. Considering the importance of this technique and the effects this technique has on the patients' haemodynamic status, we recommend in-service courses.
Schinkel-Ivy, Alison; Singer, Jonathan C; Inness, Elizabeth L; Mansfield, Avril
To determine whether quiet standing measures at specific frequency levels (representative of reactive control) differed between individuals with stroke based on their ability to recover balance (Failed or Successful Responses to external perturbations). Individuals with stroke completed a clinical assessment, including 30 s of quiet standing and lean-and-release postural perturbations, at admission to in-patient rehabilitation. Quiet standing centre of pressure (COP) signals were calculated and discrete wavelet decomposition was performed. Net COP amplitude, between-limb synchronization, and ratios of individual-limb COP were determined for each frequency level of interest, and for the non-decomposed signal (all frequency levels). Outcome measures were compared between individuals who exhibited Failed and Successful Responses during (a) unconstrained and (b) encouraged-use lean-and-release trials. Individuals with Failed Responses during the unconstrained lean-and-release trials displayed greater net COP amplitude than those with Successful Responses, specifically within a frequency range of 0.40-3.20Hz. Reduced ability to recover balance among individuals with stroke may be reflected in impaired reactive control of quiet standing. These results provide insight into the mechanism by which reactive control of quiet standing is impaired in individuals with stroke, and may inform assessment and rehabilitation strategies for post-stroke reactive balance control. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Kubota, Yasuhiko; Iso, Hiroyasu; Tamakoshi, Akiko
The associations of bowel movement frequency and laxative use with cardiovascular disease (CVD) are unclear. A total of 72 014 subjects (29 668 men and 42 346 women) aged 40 to 79 years, without a history of CVD or cancer, completed a lifestyle questionnaire at baseline between 1988 and 1990 that included information on bowel movement frequency (daily, every 2-3 days, or once every 4 or more days) and laxative use (yes or no), and were followed-up until 2009. During the subjects' 1 165 569 person-years of follow-up, we documented 977 deaths from coronary heart disease (561 men and 416 women), 2024 from total stroke (1028 men and 996 women), 1127 from ischemic stroke (606 men and 521 women), and 828 from hemorrhagic stroke (388 men and 440 women). The prevalence of CVD risk factors, such as diabetes, stress, depression, and physical inactivity, was higher in laxative users and in those with a lower frequency of bowel movements. The multivariable HRs (95% confidence intervals [CIs]) of laxative users were as follows: 1.56 (95% CI, 1.21-2.03) for coronary heart disease and 1.37 (95% CI, 1.07-1.76) for ischemic stroke in men, and 1.27 (95% CI, 1.08-1.49) for total stroke, and 1.45 (95% CI, 1.17-1.79) for ischemic stroke in women. Similar results were observed even after the exclusion of deaths that occurred early in the follow-up period. A significant association between bowel movement frequency and mortality from CVD was not observed. Constipation could be a marker of exposure to CVD risk factors, and laxative use could be a risk factor for mortality from coronary heart disease and ischemic stroke.
Full Text Available Background: The associations of bowel movement frequency and laxative use with cardiovascular disease (CVD are unclear. Methods: A total of 72 014 subjects (29 668 men and 42 346 women aged 40 to 79 years, without a history of CVD or cancer, completed a lifestyle questionnaire at baseline between 1988 and 1990 that included information on bowel movement frequency (daily, every 2–3 days, or once every 4 or more days and laxative use (yes or no, and were followed-up until 2009. Results: During the subjects’ 1 165 569 person-years of follow-up, we documented 977 deaths from coronary heart disease (561 men and 416 women, 2024 from total stroke (1028 men and 996 women, 1127 from ischemic stroke (606 men and 521 women, and 828 from hemorrhagic stroke (388 men and 440 women. The prevalence of CVD risk factors, such as diabetes, stress, depression, and physical inactivity, was higher in laxative users and in those with a lower frequency of bowel movements. The multivariable HRs (95% confidence intervals [CIs] of laxative users were as follows: 1.56 (95% CI, 1.21–2.03 for coronary heart disease and 1.37 (95% CI, 1.07–1.76 for ischemic stroke in men, and 1.27 (95% CI, 1.08–1.49 for total stroke, and 1.45 (95% CI, 1.17–1.79 for ischemic stroke in women. Similar results were observed even after the exclusion of deaths that occurred early in the follow-up period. A significant association between bowel movement frequency and mortality from CVD was not observed. Conclusions: Constipation could be a marker of exposure to CVD risk factors, and laxative use could be a risk factor for mortality from coronary heart disease and ischemic stroke.
Vonck, D.; Goossens, R.H.M.; Flipsen, S.F.J.; Jakimowicz, J.J.; Van der Putten, E.P.W.
The device has a locking ring (5), a connector (6), and a contact body (1) with a suction foot and a suction mouth (8), where the mouth is surrounded by a rim (10), which is substantially located in a plane of the suction foot. A suction chamber (9) has a sieve-shaped inner wall (2) and a
National Aeronautics and Space Administration — An innovative Microgravity Compatible Medical Suction Device (MCMSD) is proposed for the efficient aspiration and containment of bodily fluids and vomitus in a...
Penzes, P.; Jensen, M.R.; Zania, Varvara
Suction caissons are being increasingly used as offshore foundation solutions in shallow and intermediate water depths. The convenient installation method through the application of suction has rendered this type of foundation as an attractive alternative to the more traditional monopile foundation...... for offshore wind turbines. The combined loading imposed typically to a suction caisson has led to the estimation of their bearing capacity by means of 3D failure envelopes. This study aims to analyse the behaviour of suction caissons for offshore wind turbines subjected to combined loading. Finite element...... models of the caisson-soil are developed in order to derive the failure envelopes considering both sand and clay profiles. The numerical modelling is being validated by the failure mechanisms reported in the literature for skirted foundations. The sensitivity of the load response curves on the selection...
Tihanyi, J; Di Giminiani, R; Tihanyi, T; Gyulai, G; Trzaskoma, L; Horváth, M
The objective of the study was to investigate the chronic effect of low frequency whole body vibration (WBV) on isometric and eccentric strength of knee extensors with different force exertion capacity. It was hypothesized that (1) four-week WBV intervention with the low frequency domain would enhance muscle strength and (2) the improvement would be more pronounced in the weaker muscle. To test our hypothesis twenty patients with acute stroke were recruited. Ten patients were randomly assigned to vibration and the remaining ten patients served for control.The patients in the vibration group received WBV with 20 Hz frequency three times per week standing on a vibration platform in half squat position meanwhile flexing and extending the joints and placing the weight from one leg to the other. Knee extensor strength was determined under isometric and eccentric contraction before and after WBV intervention. Myoelectrical activity (EMG) of the vastus lateralis muscle was also measured.Significant improvement was revealed in the vibration group only. The maximum isometric torque and EMG activity increased significantly for both paretic and non-paretic leg, but the improvement was threefold greater in the vibration group. No significant alteration was found in rate of torque development. Maximum eccentric torque and EMG increased significantly for the paretic leg only. Mechanical work enhanced significantly in the paretic side only.The results of our study indicate that the selection of the effective vibration frequency depends upon the physical condition of neuromuscular system. Low vibration frequency intervention can increase the strength in weak muscles due to neuromuscular impairment and restricted physical activity.
Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Umemori, Takuma
The purpose of this study was to clarify the safety, feasibility and efficacy of 6-Hz primed low-frequency repetitive transcranial magnetic stimulation (rTMS) applied with intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Eleven patients with history of stroke and upper limb hemiparesis (age at intervention: 61.0 ± 13.7 years, time after stroke onset: 70.2 ± 39.8 months) were studied. Each patient received 22 sessions of 6-Hz primed low-frequency rTMS (10-min 6-Hz priming stimulation followed by 20-min low-frequency rTMS of 1-Hz) applied to the non-lesional hemisphere plus intensive OT comprising 60-min one-to-one training and 60-min self-training during 15-day hospitalization. The motor function of the affected upper limb was evaluated by Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT) on the days of admission and discharge. All patients completed the 15-day protocol without any adverse effects. The treatment increased the FMA score (from 42.2 ± 6.9 to 45.6 ± 7.2 points, plow-frequency rTMS combined with intensive OT seems safe and a potentially useful therapeutic modality for upper limb hemiparesis after stroke.
Donald, K J; Robertson, V J; Tsebelis, K
To establish the levels of pressure used to perform tracheal suction (TS) and if they are affected by having a manometer visible in the suction circuit. A bench test evaluation of simulated tracheal suction. Physiotherapy department of a major teaching hospital in Melbourne, Australia. Sixty-four nurses and physiotherapists who regularly apply TS to patients in the intensive care units of this hospital. All subjects used both circuit A (without a visible manometer) and B (with a visible manometer) in a predetermined random order. For both, subjects adjusted the suction control tap to where they said a safe and effective pressure (set pressure) was delivered and then occluded the suction catheter as though suctioning (applied pressure). Subjects then completed a questionnaire on their current TS practise. All set pressures (mean = 228.57 mmHg) and all applied pressures (mean = 359. 52 mmHg) were significantly higher (P manometer (circuit A) were significantly higher (P manometer (circuit B) but the applied pressures were not significantly different (P =.166). Neither the investigator (P =.618) or the test order (P =.167) had a significant effect on the outcome. Questionnaire results showed 31 % of subjects considered 100-170 mmHg a safe and effective suction pressure whilst none reported using an objective means of measuring pressure. All pressures in both circuits were significantly higher than those recommended as safe in the literature. In addition, pressures were unaffected by the inclusion of a visible manometer in the suction circuit.
Zhang, Lan; Xing, Guoqiang; Shuai, Shiquan; Guo, Zhiwei; Chen, Huaping; McClure, Morgan A; Chen, Xiaojuan; Mu, Qiwen
This meta-analysis aimed to evaluate the therapeutic potential of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) over the contralesional hemisphere on upper limb motor recovery and cortex plasticity after stroke. Databases of PubMed, Medline, ScienceDirect, Cochrane, and Embase were searched for randomized controlled trials published before Jun 31, 2017. The effect size was evaluated by using the standardized mean difference (SMD) and a 95% confidence interval (CI). Resting motor threshold (rMT) and motor-evoked potential (MEP) were also examined. Twenty-two studies of 1 Hz LF-rTMS over the contralesional hemisphere were included. Significant efficacy was found on finger flexibility (SMD = 0.75), hand strength (SMD = 0.49), and activity dexterity (SMD = 0.32), but not on body function (SMD = 0.29). The positive changes of rMT (SMD = 0.38 for the affected hemisphere and SMD = -0.83 for the unaffected hemisphere) and MEP (SMD = -1.00 for the affected hemisphere and SMD = 0.57 for the unaffected hemisphere) were also significant. LF-rTMS as an add-on therapy significantly improved upper limb functional recovery especially the hand after stroke, probably through rebalanced cortical excitability of both hemispheres. Future studies should determine if LF-rTMS alone or in conjunction with practice/training would be more effective. This trial is registered with unique identifier CRD42016042181.
Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Ito, Hiroshi; Tominaga, Ayumi; Umemori, Takuma; Kameda, Yumi
To determine the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with occupational therapy (OT) on the spasticity of the hemiparetic upper limb after stroke. The study subjects were 39 post-stroke patients with spastic upper limb hemiparesis (age: 56.5 ± 16.0 years, time after onset: 50.3 ± 37.8 months). At admission, the severity of hemiparesis was categorized as Brunnstrom stage 3-5 for hand-fingers. During 15-day hospitalization, each patient received 22 sessions of low-frequency rTMS applied to the non-lesional hemisphere and OT (one-to-one training and self-training). The spasticity of finger and wrist flexors of the affected upper limb was evaluated using the modified Ashworth scale (MAS) on the day of admission and discharge and 4 weeks after discharge. Each subject underwent Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT). The low-frequency rTMS/OT protocol significantly decreased the MAS scores for both finger and wrist flexors at discharge and at 4 weeks after discharge. In addition, the low-frequency rTMS/OT protocol significantly increased the FMA score and shortened the WMFT performance time. The 15-day in-patient protocol of low-frequency rTMS/OT is potentially suitable for reducing spasticity as well as improving motor function on the affected upper limb after stroke.
Bentsen, Line; Christensen, Anders; Havsteen, Inger
BACKGROUND: Incidental findings of suspect lung opacities are common in computed tomography (CT)-based thorax examinations, especially in high-risk patients, such as stroke patients. Screening with CT of the thorax has detected lung cancer in approximately .31%-1.20% of high-risk populations....... The aim of the present study was to report the frequency of suspect lung opacities on routine acute stroke imaging. METHODS: Seven hundred and fifty-seven consecutive stroke patients evaluated for intravenous thrombolysis treatment within 4.5 hours of symptom debut, from June 2009 to December 2011, were...... suspect lung opacities were categorized as malignant and 3 suspect lung opacities were categorized as presumed malignant. This corresponds to an incidence of 1.1% (8 of 750). CONCLUSIONS: Malignant lung opacities were found in approximately 1% of this high-risk population, whereas our findings do...
Ibsen, Lars Bo; Liingaard, M.; Andersen, Lars
This report concerns the dynamic soil-structure interaction of steel suction caissons applied as foundations for offshore wind turbines. An emphasis is put on torsional vibrations and coupled sliding/rocking motion, and the influence of the foundation geometry and the properties of the surrounding soil is examined. The soil is simplified as a homogenous linear viscoelastic material and the dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequency-dependent coefficients corresponding to the different degrees of freedom. The dynamic stiffness coefficients for the skirted foundation are evaluated by means of a three-dimensional coupled boundary element/finite element model. Comparisons with known analytical and numerical solutions indicate that the static and dynamic behaviour of the foundation are predicted accurately with the applied model. The analysis has been carried out for different combinations of the skirt length and the Poisson's ratio of the subsoil. Finally, the high-frequency impedance has been determined for future use in lumped-parameter models of wind turbine foundations in aero-elastic codes. (au)
Kuibin, P.A.; Okulov, Valery; Pylev, I.M.
Within the framework of a model of a twisted flow of an inviscid incompressible liquid, we solve the problem of determining the frequency and amplitude of oscillations caused by the precession of a helical vortex core in the suction tube of a hydroturbine from the specified integral characteristics...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered suction pump. 878.4780 Section 878.4780...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4780 Powered suction pump. (a) Identification. A powered suction pump is a portable, AC-powered or compressed air-powered device intended to be...
Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Ito, Hiroshi; Tominaga, Ayumi
The combination treatment of low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy was applied with concomitant oral administration of levodopa in five post-stroke patients with upper limb hemiparesis (age at treatment: 56-66 years; interval between onset of stroke and treatment: 18-143 months) as a 15-day inpatient protocol. Daily levodopa administration of 100 mg was initiated 1 week before admission and continued until 4 weeks after discharge. Low-frequency rTMS of 1 Hz was applied to the contralesional hemisphere for 40 min daily (two 20-min sessions) combined with intensive occupational therapy consisting of 60-min one-on-one training and 60-min self-exercise. Motor function of the affected upper limb was serially evaluated with the Fugl-Meyer Assessment and the Wolf Motor Function Test. At the end of the treatment, all patients showed improved motor function in the affected upper limbs. In some patients, the improvement was maintained until 4 weeks after discharge. No patient showed any adverse effect from the intervention. Our proposed protocol featuring levodopa administration, low-frequency rTMS, and intensive occupational therapy could provide a safe and feasible intervention for upper limb hemiparesis after stroke.
Full Text Available Soil properties can completely change the ground motion characteristics as they travel from the bedrock to the surface because, soil as a low-pass filter, may amplify or deamplify seismic motions in some frequencies on the wave travelling path. Recent studies about the advanced unsaturated soil mechanics clearly shows that dynamic properties of soils, including small-strain shear modulus (Gmax, shear modulus reduction (G/Gmax, and damping ratio (D curves are affected by changes in the soil suction level. The current study present nonlinear time-dependent analysis of three different unsaturated soils available in the literature with different ranges of nonlinear behaviour that earlier have been studied on unsaturated dynamic models. Since, the earthquake intensity parameters can be used to describe the damage potential of an earthquake, the focus of this paper is to evaluate the impact of the suction variation on the engineering ground motion parameters, including peak values of strong motion, Vmax/Amax, root-mean-square acceleration, Arias intensity, characteristic intensity, cumulative absolute velocity, acceleration spectrum intensity, effective design acceleration, A95 parameter and predominant period separately under the near-field and the far-field seismicity categories.
Aşkın, Ayhan; Tosun, Aliye; Demirdal, Ümit Seçil
Repetitive transcranial magnetic stimulation (rTMS) was suggested as a preconditioning method that would increase brain plasticity and that it would be optimal to combine rTMS with intensive rehabilitation. To assess the efficacy of inhibitory rTMS on upper extremity motor recovery and functional outcomes in chronic ischemic stroke patients. In this randomized controlled trial, experimental group received low-frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT), and control group received PT. No statistically significant difference was found in baseline demographical and clinical characteristics of the subjects including stroke severity or severity of paralysis prior to intervention. There were statistically significant improvements in all clinical outcome measures except for the Brunnstrom Recovery Stages. Fugl-Meyer Assessment, Box and Block test, motor and total scores of Functional Independence Measurement (FIM), and Functional Ambulation Scale (FAS) scores were significantly increased in both groups, however, these changes were significantly greater in the rTMS group except for FAS score. FIM cognitive scores and standardized mini-mental test scores were significantly increased and distal and hand Modified Ashworth Scale scores were significantly decreased only in the rTMS group (p functional, and cognitive deficits in chronic stroke. Further studies with a larger number of patients with longer follow-up periods are needed to establish its effectiveness in stroke rehabilitation.
Bashir, Shahid; Vernet, Marine; Najib, Umer; Perez, Jennifer; Alonso-Alonso, Miguel; Knobel, Mark; Yoo, Woo-Kyoung; Edwards, Dylan; Pascual-Leone, Alvaro
The net effect of altered interhemispheric interactions between homologous motor cortical areas after unilateral stroke has been previously reported to contribute to residual hemiparesis. Using this framework, we hypothesized that navigated 1 Hz repetitive transcranial magnetic stimulation (rTMS) over the contralesional hemisphere would induce a stronger physiological and behavioural response in patients with residual motor deficit than in healthy subjects, because an imbalance in interhemispheric excitability may underlie motor dysfunction. Navigated rTMS was conducted in 8 chronic stroke patients (67.50±13.77 years) and in 8 comparable normal subjects (57.38±9.61 years). We evaluated motor function (Finger tapping, Nine Hole Peg test, Strength Index and Reaction Time) as well as the excitatory and inhibitory function (resting motor threshold, motor evoked potential amplitude, intra-cortical inhibition and facilitation, and silent period) of the stimulated and non-stimulated motor cortex before and after navigated rTMS. rTMS induced an increase in excitability in the ipsilesional (non-stimulated) motor cortex and led to improved performance in the finger tapping task and pinch force task. These physiological and behavioral effects were more prominent (or robust) in the group of stroke patients than in the control group. Navigated low-frequency rTMS involving precise and consistent targeting of the contralesional hemisphere in stroke patients enhanced the cortical excitability of the ipsilesional hemisphere and the motor response of the hemiparetic hand.
Full Text Available Abstract Background Both low-frequency repetitive transcranial magnetic stimulation (rTMS and intensive occupational therapy (OT have been recently reported to be clinically beneficial for post-stroke patients with upper limb hemiparesis. Based on these reports, we developed an inpatient combination protocol of these two modalities for the treatment of such patients. The aims of this pilot study were to confirm the safety and feasibility of the protocol in a large number of patients from different institutions, and identify predictors of the clinical response to the treatment. Methods The study subjects were 204 post-stroke patients with upper limb hemiparesis (mean age at admission 58.5 ± 13.4 years, mean time after stroke 5.0 ± 4.5 years, ± SD from five institutions in Japan. During 15-day hospitalization, each patient received 22 treatment sessions of 20-min low-frequency rTMS and 120-min intensive OT daily. Low-frequency rTMS of 1 Hz was applied to the contralesional hemisphere over the primary motor area. The intensive OT, consisting of 60-min one-to-one training and 60-min self-exercise, was provided after the application of low-frequency rTMS. Fugl-Meyer Assessment (FMA and Wolf Motor Function Test (WMFT were performed serially. The physiatrists and occupational therapists involved in this study received training prior to the study to standardize the therapeutic protocol. Results All patients completed the protocol without any adverse effects. The FMA score increased and WMFT log performance time decreased significantly at discharge, relative to the respective values at admission (change in FMA score: median at admission, 47 points; median at discharge, 51 points; p Conclusions The 15-day inpatient rTMS plus OT protocol is a safe, feasible, and clinically useful neurorehabilitative intervention for post-stroke patients with upper limb hemiparesis. The response to the treatment was not influenced by age or time after stroke onset. The
Long, Hua; Wang, Hongbin; Zhao, Chenguang; Duan, Qiang; Feng, Feng; Hui, Nan; Mao, Li; Liu, Huiling; Mou, Xiang; Yuan, Hua
Both high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and low-frequency rTMS (LF-rTMS) are reported to benefit upper limb motor function rehabilitation in patients with stroke. However, the efficacy of combining LF- and HF-rTMS (LF-HF rTMS) has not been adequately explored, especially in the early phase of stroke. To compare the effects of LF- and LF-HF rTMS on the upper limb motor function in the early phase post stroke. Sixty-two patients were randomly assigned to three groups: LF-rTMS group (1 Hz rTMS to the contralesional hemisphere), LF-HF rTMS group (1 Hz rTMS to the contralesional hemisphere followed by 10 Hz rTMS to the lesional hemisphere) and sham group. The patients received the same conventional rehabilitation accompanied with sessions of rTMS for 15 consecutive days. The upper limb motor function was evaluated using the Fugl-Meyer Assessment (FMA) and the Wolf Motor Function Test (WMFT) before the first session, after the last session, and at 3 months after the last session. All patients finished the study without any adverse reaction. Three groups exhibited improvement in terms of the FMA score and the log WMFT time at the end of the treatment and 3 months later. Better improvement was found in the LF-HF rTMS group than in the LF-rTMS and sham groups. The results indicated that both LF- and LF-HF rTMS were effective in promoting upper limb motor recovery in patients with acute stroke. Combining HF- and LF-rTMS protocol in the present study is tolerable and more beneficial for motor improvement than the unilateral use of LF-rTMS alone.
Safeer, M.; Tariq, M.; Rehman, U.U.
To study the risk factors of cerebral infarction in stroke patients. It is a descriptive hospital based study conducted at the Department of Medicine, Naseer Teaching Hospital, Peshawar from January 2005 to December 2005. One hundred patients of stroke with cerebral infarction confirmed on C.T. scan brain and more than twenty years of age were included. Risk factors for cerebral infarction were defined in terms of hypertension, diabetes mellitus, ischemic heart disease, smoking, dyslipidaemia, TIAs (transient ischemic attacks), carotid artery stenosis and family history of stroke. Data of 100 cases with cerebral infarction was recorded. Most of the patients had more than one risk factors for cerebral infarction. hypertension was commonest risk factor (55%), smoking (30%), ischemic heart disease (34%), diabetes mellitus) (26%), hyperlipedaemia (30%), atrial fibrillation (25%), carotid artery stenosis (27%), obesity (15%) and family history of stroke (12%). 39% of patients had physical inactivity. Males were slightly predominant than females (51% vs 49%) and mean age was 50 years. females were rather older with mean age of 53 years. Cerebral infarction accounts for 80% to 85% of cases of stroke, which is a common neurological disorder. It increases a burden of disability and misery for patients and their families. Most of the risk factors of cerebral infarction are modifiable, its prevention should be the main cause of concern for the community. (author)
Full Text Available Animal studies find that prenatal stress is associated with increased physiological and emotional reactivity later in life, mediated via fetal programming of the HPA axis through decreased glucocorticoid receptor (GR gene expression. Post-natal behaviours, notably licking and grooming in rats, cause decreased behavioural indices of fear and reduced HPA axis reactivity mediated via increased GR gene expression. Post-natal maternal behaviours may therefore be expected to modify prenatal effects, but this has not previously been examined in humans. We examined whether, according to self-report, maternal stroking over the first weeks of life modified associations between prenatal depression and physiological and behavioral outcomes in infancy, hence mimicking effects of rodent licking and grooming. From a general population sample of 1233 first time mothers recruited at 20 weeks gestation we drew a stratified random sample of 316 for assessment at 32 weeks based on reported inter-partner psychological abuse, a risk to child development. Of these 271 provided data at 5, 9 and 29 weeks post delivery. Mothers reported how often they stroked their babies at 5 and 9 weeks. At 29 weeks vagal withdrawal to a stressor, a measure of physiological adaptability, and maternal reported negative emotionality were assessed. There was a significant interaction between prenatal depression and maternal stroking in the prediction of vagal reactivity to a stressor (p = .01, and maternal reports of infant anger proneness (p = .007 and fear (p = .043. Increasing maternal depression was associated with decreasing physiological adaptability, and with increasing negative emotionality, only in the presence of low maternal stroking. These initial findings in humans indicate that maternal stroking in infancy, as reported by mothers, has effects strongly resembling the effects of observed maternal behaviours in animals, pointing to future studies of the epigenetic
Ye Weimin; Zhang Yawei; Chen Bao; Wang Min
Oedometer cells for unsaturated soils can be classified into two types, that is, conventional unsaturated oedometer cells (high-suction unsaturated oedometer cell, high-suction and high-pressure unsaturated oedometer cell) and temperature controlled unsaturated oedometer cells. Among them, the osmotic, vapor equilibrium and axis translation techniques are often employed for suction control. The thermostat bath method and thermostatically controlled heater method are commonly used for temperature control. The lever loading system, hydraulic loading system and air pressure loading system are commonly means used for vertical pressure. Combination of osmotic (or axis translation) technique with vapor equilibrium method employed for the full range suction control, thermostatically liquid temperature control method, and the hydraulic loading system, could be used for suction, temperature and loading control in the design for unsaturated oedometer cells in the future, which can be used for study of buffer/backfill materials under high-temperature, high pressure and full range suction conditions. (authors)
Marco Antonio Cavalcanti Garcia
Full Text Available Somatosensory electrical stimulation (SES has been proposed as an approach to treat patients with sensory-motor impairment such as spasticity. However, there is still no consensus regarding which would be the adequate SES parameters to treat those deficits. Therefore, the aim of this study was to evaluate the effects of applying SES over the forearm muscles at four different frequencies of stimulation (3, 30, 150, and 300 Hz and in two intervals of time (5′ and 30′ by means of transcranial magnetic stimulation and Hoffmann’s reflex (H-reflex in healthy volunteers (Experiments I and II. A group of stroke patients (Experiment III was also preliminary evaluated to ascertain SES effects at a low frequency (3 Hz applied for 30′ over the forearm spastic flexors muscles by measuring the wrist joint passive torque. Motor evoked potentials and the H-reflex were collected from different forearm and hand muscles immediately before and after SES and up to 5′ (Experiment I and 10′ (Experiments I and II later. None of the investigated frequencies of SES was able to operate as a key in switching modulatory effects in the central nervous system of healthy volunteers and stroke patients with spasticity.
Malloch, G; Highet, F; Kasprowicz, L; Pickup, J; Neilson, R; Fenton, B
The peach-potato aphid Myzus persicae (Sulzer) is an important vector of plant viruses. A network of suction traps collects aerial samples of this aphid in order to monitor and help predict its spatial distribution and likely impact on virus transmission in crops. A suction trap catch is thought to be a good representation of the total aphid pool. Sensitive molecular markers have been developed that determine the genetic composition of the M. persicae population. In Scotland, UK, these were applied to field collections revealing a limited number of clones. Molecular markers are less successful when applied to specimens that have been preserved in an ethanol-based trap fluid designed to preserve morphology. An assessment of different DNA extraction and PCR techniques is presented and the most efficient are used to analyse M. persicae specimens caught in the Dundee suction trap in 2001, a year when exceptionally high numbers were caught. The results reveal that the majority of the M. persicae caught belonged to two highly insecticide resistant clones. In addition, it was possible to compare the relative frequencies of genotypes caught in the trap with those collected at insecticide treated and untreated field sites in the vicinity. These results indicate that, in addition to suction trap data, the ability to sample field sites provides valuable early warning data which have implications for pest control and virus management strategies.
THOREL, L; GARNIER, J; RAULT, G; BISSON, A
The main theoretical methods used for designing suction caissons under vertical static loads are presented and discussed in this paper. Depending on the suction pressure developed under the head of the caisson and on the drainage conditions, three different failure mechanisms are usually taken into account. The lower limit of the bearing capacity is given by a sliding failure mechanism where no passive suction is generated. A reverse end bearing mechanism, which could happen when the caisson ...
Master's thesis in Offshore technology Floating units are dependent on reliable mooring systems to ensure safety during marine operations. Suction anchors have proved to be a technologically viable and cost-effective concept. They are capable of precision installation, re-use, and provide large resistive capacity. This thesis investigates load capacity and failure modes of suction anchors subjected to vertical, horizontal (lateral), and incline loading. Suction anchor design co...
... Month Infographic Stroke Hero F.A.S.T. Quiz Stroke Treatment Stroke used to rank fourth in leading causes of ... type of treatment depends on the type of stroke. Ischemic stroke happens when a clot blocks a ...
Tosun, Aliye; Türe, Sabiha; Askin, Ayhan; Yardimci, Engin Ugur; Demirdal, Secil Umit; Kurt Incesu, Tülay; Tosun, Ozgur; Kocyigit, Hikmet; Akhan, Galip; Gelal, Fazıl Mustafa
To assess the efficacy of inhibitory repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on upper extremity motor function in patients with acute/subacute ischemic stroke. Twenty-five ischemic acute/subacute stroke subjects were enrolled in this randomized controlled trial. Experimental group 1 received low frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT) including activities to improve strength, flexibility, transfers, posture, balance, coordination, and activities of daily living, mainly focusing on upper limb movements; experimental group 2 received the same protocol combined with NMES to hand extensor muscles; and the control group received only PT. Functional magnetic resonance imaging (fMRI) scan was used to evaluate the activation or inhibition of the affected and unaffected primary motor cortex. No adverse effect was reported. Most of the clinical outcome scores improved significantly in all groups, however no statistically significant difference was found between groups due to the small sample sizes. The highest percent improvement scores were observed in TMS + NMES group (varying between 48 and 99.3%) and the lowest scores in control group (varying between 13.1 and 28.1%). Hand motor recovery was significant in both experimental groups while it did not change in control group. Some motor cortex excitability changes were also observed in fMRI. LF-rTMS with or without NMES seems to facilitate the motor recovery in the paretic hand of patients with acute/subacute ischemic stroke. TMS or the combination of TMS + NMES may be a promising additional therapy in upper limb motor training. Further studies with larger numbers of patients are needed to establish their effectiveness in upper limb motor rehabilitation of stroke.
Full Text Available Small clinical trials have reported that low-frequency repetitive transcranial magnetic stimulation (rTMS might improve language recovery in patients with aphasia after stroke. However, no systematic reviews or meta-analyses studies have investigated the effect of rTMS on aphasia. The objective of this study was to perform a meta-analysis of studies that explored the effects of low-frequency rTMS on aphasia in stroke patients.We searched PubMed, CENTRAL, Embase, CINAHL, ScienceDirect, and Journals@Ovid for randomized controlled trials published between January 1965 and October 2013 using the keywords "aphasia OR language disorders OR anomia OR linguistic disorders AND repetitive transcranial magnetic stimulation OR rTMS". We used fixed- and random-effects models to estimate the standardized mean difference (SMD and a 95% CI for the language outcomes.Seven eligible studies involving 160 stroke patients were identified in this meta-analysis. A significant effect size of 1.26 was found for the language outcome severity of impairment (95% CI = 0.80 to 1.71 without heterogeneity (I2 = 0%, P = 0.44. Further analyses demonstrated prominent effects for the naming subtest (SMD = 0.52, 95% CI = 0.18 to 0.87, repetition (SMD = 0.54, 95% CI = 0.16 to 0.92, writing (SMD = 0.70, 95% CI = 0.19 to 1.22, and comprehension (the Token test: SMD = 0.58, 95% CI = 0.07 to 1.09 without heterogeneity (I2 = 0%. The SMD of AAT and BDAE comprehension subtests was 0.32 (95% CI = -0.08 to 0.72 with moderate heterogeneity (I2 = 32%,P = 0.22. The effect size did not change significantly even when any one trial was eliminated. None of the patients from the 7 included articles reported adverse effects from rTMS.Low-frequency rTMS with a 90% resting motor threshold that targets the triangular part of the right inferior frontal gyrus (IFG has a positive effect on language recovery in patients with aphasia following
Keskin, Mustafa; Sutcu, Mustafa; Cigsar, Bulent; Karacaoglan, Naci
The aim of gynecomastia surgery is to restore a normal chest contour with minimal signs of breast surgery. The authors examine the rate of complications in gynecomastia surgery when no closed-suction drains are placed. One hundred thirty-eight consecutive male patients who underwent gynecomastia surgery without drains were retrospectively analyzed to determine whether the absence of drains adversely affected patient outcomes. Patients were managed by ultrasonic-assisted liposuction both with and without the pull-through technique. The mean age of the patients was 29 years, and the mean volume of breast tissue aspirated was 350 mL per beast. Pull-through was needed in 23 cases. There was only 1 postoperative hematoma. These results are comparable with previously published data for gynecomastia surgery in which drains were placed, suggesting that the absence of drains does not adversely affect postoperative recovery. Routine closed-suction drainage after gynecomastia surgery is unnecessary, and it may be appropriate to omit drains after gynecomastia surgery.
Koyama, Soichiro; Tanabe, Shigeo; Takeda, Kazuya; Warashina, Hiroaki; Sakurai, Hiroaki; Kanada, Yoshikiyo; Okumura, Ryuji; Shinoda, Jun; Nagata, Junji; Kanno, Tetsuo
The case report describes the effects of 5 Hz repetitive transcranial magnetic stimulation (rTMS) combined with transcutaneous electrical stimulation (TES) in a patient with severe stroke. The patient was a 69-year-old male who was affected by a left middle cerebral artery infarction. The patient had no movement in his right hand. To assess the effects, cerebral blood flow and motor function were measured before and after treatment. This treatment delivered rTMS over the affected M1 with TES at the paretic wrist extensor muscles for 10 days. The regional cerebral blood flow (rCBF) in the entire brain was measured by positronemission tomography. To evaluate the motor function, the Fugl-Meyer assessment (FMA) was used. After treatment, the rCBF was increased (except for the stimulated region), and the FMA score was slightly improved. These results suggest the potential therapeutic use of rTMS combined with TES for recovery in severe stroke.
A break in the structural integrity of the palate leading to oro nasal communication is called palatal fistula, which may be due to a genetic defect such as cleft lip and palate, an infection such as osteomyelitis or traumainduced by wearing a maxillary complete denture with a suction cup. A suction cup because of its ...
This randomised controlled trial of 357 patients who had had an incomplete abortion compared suction curettage with conventional curettage for evacuation ofthe uterus. The 179 patients undergoing suction curettage had a significantly lower intra-operative blood loss (P < 0,0001) and a significantly higher mean ...
Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Takagishi, Toshimitsu; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Ito, Hiroshi; Tominaga, Ayumi
To clarify whether the efficacy of combined low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) depends on baseline severity of upper limb hemiparesis after stroke. Retrospective comparative study. Department of Rehabilitation Medicine at a university hospital. Fifty-two patients who had sustained a stroke and had upper limb hemiparesis (age: 57 ± 13 years; time after onset: 50 ± 33 months). Based on the Brunnstrom stage for hand-fingers at admission, patients were divided into a Stage 3 group (n = 13), a Stage 4 group (n = 20), and a Stage 5 group (n = 19). During a 15-day hospitalization, each patient underwent 22 sessions of 20-minute low-frequency rTMS that was applied to the non-lesional hemisphere and 120 minutes of intensive OT (one-on-one training and self-training). Motor function of the affected upper limb was evaluated with the Fugl-Meyer Assessment and the Wolf Motor Function Test (WMFT) on the days of admission and discharge. WMFT performance time data were log-transformed. The Fugl-Meyer Assessment score increased significantly in all patients (from 40.2 ± 12.2 to 43.4 ± 11.8 points, P low-frequency rTMS and intensive OT is potentially promising in improving motor function of the affected upper limb. The extent of motor improvement by the intervention seemed to be influenced by the severity of upper limb hemiparesis at study entry. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Full Text Available Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS combined with task-oriented training on the recovery of upper limb motor function of stroke patients. Methods A total of 42 patients with hemiplegia after stroke were randomly divided into control group (N = 20 and treatment group (N = 22. Control group received routine rehabilitation training and task-oriented training, and treatment group received low-frequency (1 Hz rTMS over the contralesional cortex addition to routine rehabilitation and task-oriented training. Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE and Wolf Motor Function Test (WMFT were used to evaluate upper limb motor function of all patients before treatment, after 4-week treatment and 3 months after treatment. The latency and central motor conduction time (CMCT of motor-evoked potential (MEP in the contralesional cortex were recorded and analyzed. Results Compared with control group, FMA-UE score (P = 0.006 and WMFT score (P = 0.024 were significantly increased in treatment group. There was significant difference in FMA-AUE score (P = 0.000 and WMFT score (P = 0.000 at different time points. Compared with before treatment, FMA-UE score (P = 0.000, for all and WMFT score (P = 0.000, for all of patients in both groups were all significantly increased after 4-week treatment and 3 months after treatment. Besides, FMA-UE score (P = 0.000, for all and WMFT score (P = 0.000, for all 3 months after treatment were higher than those after 4-week treatment. There was no statistically significant difference between 2 groups on the latency (P = 0.979 and CMCT (P = 0.807 of MEP before and after treatment, and so was the difference on the latency (P = 0.085 and CMCT (P = 0.507 of MEP in the contralesional cortex at different time points (before treatment, after 4-week treatment and 3 months after treatment. Conclusions Low-frequency rTMS over the contralesional cortex combined
Full Text Available The case report describes the effects of 5 Hz repetitive transcranial magnetic stimulation (rTMS combined with transcutaneous electrical stimulation (TES in a patient with severe stroke. The patient was a 69-year-old male who was affected by a left middle cerebral artery infarction. The patient had no movement in his right hand. To assess the effects, cerebral blood flow and motor function were measured before and after treatment. This treatment delivered rTMS over the affected M1 with TES at the paretic wrist extensor muscles for 10 days. The regional cerebral blood flow (rCBF in the entire brain was measured by positronemission tomography. To evaluate the motor function, the Fugl-Meyer assessment (FMA was used. After treatment, the rCBF was increased (except for the stimulated region, and the FMA score was slightly improved. These results suggest the potential therapeutic use of rTMS combined with TES for recovery in severe stroke.
Full Text Available Objective. To investigate whether prior treatment of atorvastatin reduces the frequency of hospital acquired pneumonia (HAP. Methods. Totally, 492 patients with acute ischemic stroke and Glasgow Coma Scale ≤ 8 were enrolled in this study. Subjects were assigned to prior atorvastatin treatment group (n=268, PG and no prior treatment group (n=224, NG. All the patients were given 20 mg atorvastatin every night during their hospital stay. HAP frequency and 28-day mortality were measured. Levels of inflammatory biomarkers [white blood cell (WBC, procalcitonin (PCT, tumor necrosis factor-alpha (TNF-α, and interleukin-6 (IL-6] were tested. Results. There was no significant difference in the incidence of HAP between PG and NG (25.74% versus. 24.55%, p>0.05 and 28-day mortality (50.72% versus 58.18%, p>0.05. However, prior statin treatment did modify the mortality of ventilator associated pneumonia (VAP (36.54% versus 58.14%, p=0.041 and proved to be a protective factor (HR, 0.564; 95% CI, 0.310~0.825, p=0.038. Concentrations of TNF-α and IL-6 in PG VAP cases were lower than those in NG VAP cases (p<0.01. Conclusions. Prior atorvastatin treatment in patients with ischemic stroke was associated with a lower concentration of IL-6 and TNF-α and improved the outcome of VAP. This clinical study has been registered with ChiCTR-ROC-17010633 in Chinese Clinical Trial Registry.
Manickavasagam, J; Jebreel, A
There has been a major evolution in laryngeal surgery, largely due to an improved understanding of disease pathogenesis and advances in technology, especially the introduction of lasers. Continuous laser plume evacuation during endolaryngeal surgery improves visualisation of the surgical field. Hence, microlaryngoscopes are fitted with smoke evacuation channels on their sides. We have devised a new, simple and efficient suction holder clip for endolaryngeal surgery that has distinct advantages over other suction holders.
Gonçalves, Roberta Lins; Tsuzuki, Lucila Midori; Carvalho, Marcos Giovanni Santos
Evidence-based practices search for the best available scientific evidence to support problem solving and decision making. Because of the complexity and amount of information related to health care, the results of methodologically sound scientific papers must be integrated by performing literature reviews. Although endotracheal suctioning is the most frequently performed invasive procedure in intubated newborns in neonatal intensive care units, few Brazilian studies of good methodological quality have examined this practice, and a national consensus or standardization of this technique is lacking. Therefore, the purpose of this study was to review secondary studies on the subject to establish recommendations for endotracheal suctioning in intubated newborns and promote the adoption of best-practice concepts when conducting this procedure. An integrative literature review was performed, and the recommendations of this study are to only perform endotracheal suctioning in newborns when there are signs of tracheal secretions and to avoid routinely performing the procedure. In addition, endotracheal suctioning should be conducted by at least two people, the suctioning time should be less than 15 seconds, the negative suction pressure should be below 100 mmHg, and hyperoxygenation should not be used on a routine basis. If indicated, oxygenation is recommended with an inspired oxygen fraction value that is 10 to 20% greater than the value of the previous fraction, and it should be performed 30 to 60 seconds before, during and 1 minute after the procedure. Saline instillation should not be performed routinely, and the standards for invasive procedures must be respected. PMID:26465249
Full Text Available Background and Purpose. Functional brain imaging studies with aphasia patients have shown increased cortical activation in the right hemisphere language homologues, which hypothetically may represent a maladaptive strategy that interferes with aphasia recovery. The aim of this study was to investigate whether low-frequency repetitive transcranial magnetic stimulation (rTMS over the Broca’s homologues in combination with speech/language therapy improves naming in early-stroke aphasia patients. Methods. 26 right-handed aphasic patients in the early stage (up to 12 weeks of a first-ever left hemisphere ischemic stroke were randomized to receive speech and language therapy combined with real or sham rTMS. Prior to each 45-minute therapeutic session (15 sessions, 5 days a week, 30 minutes of 1-Hz rTMS was applied. Outcome measures were obtained at baseline, immediately after 3 weeks of experimental treatment and 15 weeks; posttreatment using the Computerized Picture Naming Test. Results. Although both groups significantly improved their naming abilities after treatment, no significant differences were noted between the rTMS and sham stimulation groups. The additional analyses have revealed that the rTMS subgroup with a lesion including the anterior part of language area showed greater improvement primarily in naming reaction time 15 weeks after completion of the therapeutic treatment. Improvement was also demonstrated in functional communication abilities. Conclusions. Inhibitory rTMS of the unaffected right inferior frontal gyrus area in combination with speech and language therapy cannot be assumed as an effective method for all poststroke aphasia patients. The treatment seems to be beneficial for patients with frontal language area damage, mostly in the distant time after finishing rTMS procedure.
Kakuda, W; Abo, M; Momosaki, R; Yokoi, A; Fukuda, A; Ito, H; Tominaga, A; Umemori, T; Kameda, Y
For spastic upper limb hemiparesis after stroke, we developed triple-element protocol of botulinum toxin type A (BoNTA) injection, low-frequency repetitive transcranial magnetic stimulation (LF-rTMS), and intensive occupational therapy (OT). Aim. To investigate the safety and feasibility of the protocol. Design. A preliminary study. Setting. At a university hospital. Population. Fourteen post-stroke patients with spastic upper limb hemiparesis (mean age: 54.9±9.2 years, time after onset: 87.1±48.2 months, ±SD). In all patients, BoNTA was injected into spastic muscles of the affected upper limb (maximum total dose: 240 units). Four weeks later, they were hospitalized to receive 22 sessions of 20-min LF-rTMS and 120-min intensive OT daily over 15 days. Motor function of the affected upper limb was evaluated mainly using Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), motor activity log (MAL), and the severity of spasticity was measured with modified Ashworth scale (MAS) at BoNTA injection, discharge and four weeks post-discharge. All patients completed the protocol without any adverse effects. The FMA score and MAL scores, but not WMFT performance time, improved significantly at discharge. The MAS score of all examined muscles decreased significantly between BoNTA and discharge. The beneficial effect of the protocol on motor function and spasticity was almost maintained until four weeks after discharge. The protocol is safe and feasible, although further larger studies are needed to confirm its efficacy. The protocol is a potentially useful neurorehabilitative approach for this patient population.
... A.M. Editorial team. Related MedlinePlus Health Topics Hemorrhagic Stroke Ischemic Stroke Stroke Browse the Encyclopedia A.D. ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...
A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lost because of ... them relearn those skills. The effects of a stroke depend on which area of the brain was ...
Tramacere, F; Follador, M; Pugno, N M; Mazzolai, B
Octopus suckers are able to attach to all nonporous surfaces and generate a very strong attachment force. The well-known attachment features of this animal result from the softness of the sucker tissues and the surface morphology of the portion of the sucker that is in contact with objects or substrates. Unlike artificial suction cups, octopus suckers are characterized by a series of radial grooves that increase the area subjected to pressure reduction during attachment. In this study, we constructed artificial suction cups with different surface geometries and tested their attachment performances using a pull-off setup. First, smooth suction cups were obtained for casting; then, sucker surfaces were engraved with a laser cutter. As expected, for all the tested cases, the engraving treatment enhanced the attachment performance of the elastomeric suction cups compared with that of the smooth versions. Moreover, the results indicated that the surface geometry with the best attachment performance was the geometry most similar to octopus sucker morphology. The results obtained in this work can be utilized to design artificial suction cups with higher wet attachment performance.
Follador, M; Tramacere, F; Mazzolai, B
Suction cups are often found in nature as attachment strategy in water. Nevertheless, the application of the artificial counterpart is limited by the dimension of the actuators and their usability in wet conditions. A novel design for the development of a suction cup inspired by octopus suckers is presented. The main focus of this research was on the modelling and characterization of the actuation unit, and a first prototype of the suction cup was realized as a proof of concept. The actuation of the suction cup is based on dielectric elastomer actuators. The presented device works in a wet environment, has an integrated actuation system, and is soft. The dimensions of the artificial suction cups are comparable to proximal octopus suckers, and the attachment mechanism is similar to the biological counterpart. The design approach proposed for the actuator allows the definition of the parameters for its development and for obtaining a desired pressure in water. The fabricated actuator is able to produce up to 6 kPa of pressure in water, reaching the maximum pressure in less than 300 ms.
Follador, M; Tramacere, F; Mazzolai, B
Suction cups are often found in nature as attachment strategy in water. Nevertheless, the application of the artificial counterpart is limited by the dimension of the actuators and their usability in wet conditions. A novel design for the development of a suction cup inspired by octopus suckers is presented. The main focus of this research was on the modelling and characterization of the actuation unit, and a first prototype of the suction cup was realized as a proof of concept. The actuation of the suction cup is based on dielectric elastomer actuators. The presented device works in a wet environment, has an integrated actuation system, and is soft. The dimensions of the artificial suction cups are comparable to proximal octopus suckers, and the attachment mechanism is similar to the biological counterpart. The design approach proposed for the actuator allows the definition of the parameters for its development and for obtaining a desired pressure in water. The fabricated actuator is able to produce up to 6 kPa of pressure in water, reaching the maximum pressure in less than 300 ms. (paper)
Unexpected Improvement of Hand Motor Function with a Left Temporoparietal Low-Frequency Repetitive Transcranial Magnetic Stimulation Regime Suppressing Auditory Hallucinations in a Brainstem Chronic Stroke Patient
Full Text Available We here report paradoxical hand function recovery in a 61-year-old male tetra-paretic chronic patient following a stroke of the brainstem (with highly degraded right and abolished left-hand finger flexion/extension disabling him to manipulate objects who experienced insidious auditory hallucinations (AHs 4 years after such event. Symptomatic treatment for AHs was provided with periodical double sessions of low-frequency repetitive transcranial magnetic stimulation (rTMS (daily 1 Hz, 2 × 1,200 pulses interleaved by 1 h interval delivered to the left temporoparietal junction across two periods of 5 and 3 weeks, respectively. At the end of each stimulation period, AHs disappeared completely. Most surprisingly and totally unexpectedly, the patient experienced beneficial improvements of long-lasting impairments in his right-hand function. Detailed examination of onset and offset of rTMS stimulation regimes strongly suggests a temporal relation with the remission and re-appearance of AHs and also with a fragile but clinically meaningful improvements of right (but not left hand function contingent to the accrual of stimulation sessions. On the basis of post-recovery magnetic resonance imaging structural and functional evidence, mechanistic hypotheses that could subtend such unexpected motor recovery are critically discussed.
England, John Dwight (Inventor); Kelley, Anthony R. (Inventor); Cronise, Raymond J. (Inventor)
A safety system includes a sleeve fitted within a pool's suction line at the inlet thereof. An open end of the sleeve is approximately aligned with the suction line's inlet. The sleeve terminates with a plate that resides within the suction line. The plate has holes formed therethrough. A housing defining a plurality of distinct channels is fitted in the sleeve so that the distinct channels lie within the sleeve. Each of the distinct channels has a first opening on one end thereof and a second opening on another end thereof. The second openings reside in the sleeve. Each of the distinct channels is at least approximately three feet in length. The first openings are in fluid communication with the water in the pool, and are distributed around a periphery of an area of the housing that prevents coverage of all the first openings when a human interacts therewith.
Green, David Anthony
Severe meconium aspiration syndrome is difficult to manage and has a high mortality in developing countries. Guidelines are available for the initial management. If the infant has been born through particulate meconium and is not vigorous, an inspection of the vocal cords by laryngoscopy is recommended. If meconium is seen at the cords it should, ideally, be sucked out of the trachea using an endotracheal tube as a suction device. However, as this needs a way of applying suction directly to the endotracheal tube it can be problematic. Commercially available equipment does exist, but in a resource-scarce setting, its cost could be prohibitive. We have adapted cheap suction connectors which can be adapted for this purpose.
It concerns an experimental study of turbulent flow inside a pipe with rough and porous wall and suction applied through it. The first part recall the basic knowledge concerning the turbulent flow with roughness. In second part statistical equations of fluid wall stress are written in the case of a permeable rough wall, in order to underline the respective role played by viscosity and pressure terms. In the third part the dynamic equilibrium of the flow is experimentally undertaken in the smooth and rough range with and without wall suction. Some empirical formulae are proposed for the mean velocity profiles in the inertial range and for friction velocity with suction. In the case of the sand roughness used, it does not seem that critical Reynolds number of transition from smooth to rough range is varied [fr
Juan C Díaz Martínez
Full Text Available La taquicardia por reentrada nodal es la causa más común de taquicardia supraventricular paroxística; en aquellos pacientes en quienes el manejo farmacológico no es efectivo o deseado la ablación por radiofrecuencia es un excelente método terapéutico dada su alta tasa de curación. Aunque en términos generales dichos procedimientos son rápidos y seguros, se han descrito varias complicaciones entre las que sobresale el accidente cerebrovascular isquémico. Se presenta el caso de una paciente de 41 años con episodios de taquicardia por reentrada nodal a repetición, que fue llevada a ablación por radiofrecuencia. En el post-operatorio inmediato se evidenció déficit neurológico focal con isquemia en el territorio de la arteria cerebral media derecha, tras lo cual se realizó angiografía con intento de angioplastia y abxicimab y posteriormente infusión local de activador de plasminógeno tisular (rtPA con adecuado resultado clínico y angiográfico.Atrioventricular nodal reentry tachycardia is the most common type of paroxismal supraventricular tachycardia. In those patients in whom drug therapy is not effective or not desired, radio frequency ablation is an excellent therapeutic method. Although overall these procedures are fast and safe, several complications among which ischemic stroke stands out, have been reported. We present the case of a 41 year old female patient with repetitive episodes of tachycardia due to nodal reentry who was treated with radiofrequency ablation. Immediately after the procedure she presented focal neurologic deficit consistent with ischemic stroke in the right medial cerebral artery territory. Angiography with angioplastia and abxicimab was performed and then tissue plasminogen activator (rtPA was locally infused, with appropriate clinical and angiographic outcome.
Alinejad-Naeini, Mona; Mohagheghi, Parisa; Peyrovi, Hamid; Mehran, Abbas
reduced in cases with intervention. Conclusions: Given the multiplicity of endotracheal suctioning frequency and the impossibility of frequent use of pharmacological methods of pain relief, the facilitated tucking position can be used as a safe non-pharmacological method for procedural pain management. PMID:24999148
Alinejad-Naeini, Mona; Mohagheghi, Parisa; Peyrovi, Hamid; Mehran, Abbas
suctioning frequency and the impossibility of frequent use of pharmacological methods of pain relief, the facilitated tucking position can be used as a safe non-pharmacological method for procedural pain management.
Farmer, R.C.; Goldsmith, H.A.; Proudlove, M.J.
This invention concerns suction pads for supporting loads. Specifically, the suction pad is part of a pair of pads located at the ends of a bridge forming a vehicle for transporting instruments for the non-destructive testing of a large vessel intended to contain a fuel assembly for a nuclear reactor immersed in a liquid metal coolant. For example, the vehicle is of the type described in the French patent application filed this day under the heading 'Vehicle for transporting instruments for testing against a wall' [fr
Reed, H. L.; Nayfeh, A. H.
This paper addresses the stability of two-dimensional, incompressible boundary-layer flow over plates with suction through porous strips. The mean flow is calculated using linearized triple-deck, closed-form solutions. The stability results of the triple-deck theory are shown to be in good agreement with those of the interacting boundary layers. Then different configurations of number, spacing, and mass flow rate through such porous strips are analyzed and compared with nonsimilar uniform-suction stability results from the point of view of applicability to laminar flow control.
The difficulties encountered while utilising suction-cups, are mainly caused by the skirts. The skirts are more or less adaptable to the surface of the objects to be handled. The skirt of the device presented, is made out of a round supple elastic bag containing solid particles. By creating a vacuum in the bag, the particles become a solid entity. The bag filled with the particles becomes rigid and can take exactly the shape of the object to be lifted. By creating a second vacuum in the axis of the bag, the object can be lifted. Several suction-cups can be used simultaneously
Apr 2, 2011 ... Ischemic Stroke Registry yielded an incidence of 3.3 cases per 100 000 children per year, of ... Neonatal stroke. The newborn period confers the highest risk period for childhood ischaemic stroke. Focal patterns of ischaemic brain injury to the perinatal brain are .... family history of young stroke/ thrombosis.
Full Text Available A new instrument for suction rectal biopsy in infants suspected of having Hirschsprung′s disease is described that can be completely dismantled, physically cleaned, lubricated, and heat sterilised. Triple rectal suction biopsy instrument with the patent application, which involves (0.5 cm diameter suction of mucosa and sub-mucosa and provides taking three different biopsies within a 2 cm distant from each other with a single shot, instead of only one or taking a full layer biopsy under general anesthesia for the diagnosis of Hirschsprung disease. As a preliminary study, in the 36 and 12 biopsy materials taken from the rabbits and children, respectively, it was found that mucosa and sub-mucosa were sufficient and in all of the cross sections, parasympathetic nerve fibers, and ganglion cells were existed. A successful biopsy was usually achieved and no complications occurred.
Koohi, Nehzat; Vickers, Deborah; Warren, Jason; Werring, David; Bamiou, Doris-Eva
Approximately one in five stroke survivors suffer from difficulties with speech reception in noise, despite normal audiometry. These deficits are treatable with personal frequency-modulated systems (FMs). This study aimed to evaluate long-term benefits in speech reception in noise, after daily 10-week use of personal FMs, in non-aphasic patients with stroke with auditory processing deficits. This was a prospective non-randomised controlled trial study. Patients were allocated to an intervention care group or standard care subjects group according to their willingness to use the intervention or not. Tertiary care setting. Nine non-aphasic subjects with ischaemic stroke, normal/near-normal audiometry and auditory processing deficits and with reported difficulties understanding speech in background noise were recruited in the subacute stroke stage (3-12 months after stroke). Four patients (intervention care subjects) used the FMs in their daily life over 10 weeks. Five patients (standard care subjects) received standard care. All subjects were tested at baseline (visit 1) and 10 weeks later (visit 2) on a sentences in noise test with the FMs (aided) and without the FMs (unaided). Speech reception thresholds showed clinically and statistically significant improvements in intervention but not in standard care subjects at 10 weeks in aided and unaided conditions. 10-week use of FMs by adult patients with stroke may lead to benefits in unaided speech in noise perception. Our findings may indicate auditory plasticity type changes and require further investigation. Pre-results; NCT02889107. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Ågesen, Frederik Nybye; Risgaard, Bjarke; Zachariasardóttir, Sára
Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered...... contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke....... Increased awareness among healthcare professionals towards stroke symptoms in children and young adults may lead to earlier detection of stroke, and thereby potentially lowering the incidence of sudden death by stroke....
In a comprehensive laboratory study, different tests namely, unconfined compressive strength (UCS) at the end of freeze-thaw/wet-dry (F-T/W-D) cycles, resilient modulus (Mr) at the end of F-T/W-D cycles, vacuum saturation, tube suction, and moisture ...
Background: Closed suction drains are often needed in surgical practice. However, they are luxury in rural plastic surgery practice. This study highlights how syringes have become a reliable substitute. Materials and methods: This is a prospective study of the surgical outcome of patient who had various plastic surgical ...
Thygesen, Lisbeth Garbrecht; Hansen, Kurt Kielsgaard
The suction technique is a method from soil science that is used for the study of moisture storage capacity in porous construction materials at high relative humidity levels (above approximately 93%). The samples to be studied are placed in a pressurized container (an extractor) on a water...
Lijkendijk, Marike; Neckelmann, Kirsten; Licht, Peter B
was delegated to staff nurses: air leakage less than 20 mL/min for 6 hours regardless of fluid output, provided it was serous. The primary end point was fluid output after 24 and 48 hours. RESULTS: Mean fluid output was significantly higher with high suction after both 24 (338 ± 265 mL versus 523 ± 215 m...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vacuum-powered body fluid suction apparatus. 880... Personal Use Miscellaneous Devices § 880.6740 Vacuum-powered body fluid suction apparatus. (a) Identification. A vacuum-powered body fluid suction apparatus is a device used to aspirate, remove, or sample...
Boles, M. A.; Ramesh, K.; Hwang, D. P.
Analytical procedures used to evaluate the application of suction boundary-layer control (BLC) to subsonic V/STOL inlets are presented. These procedures have been used to analytically predict the optimum (minimum suction power required) location and extent for a suction slot of two different surface resistances within a subsonic V/STOL inlet. Results of this analytical study are presented.
Liu, Hanxiang; Reynolds, Gavin P; Wang, Wenmin; Wei, Xianwen
Uric acid has neuroprotective properties in experimental and clinical studies of neurodegenerative disease. It is, however, associated with increased risk of stroke, yet, despite some inconsistent findings, increasing evidence suggests it may also be related to improved stroke outcomes. We have determined whether there is an effect of plasma uric acid on the short-term outcome of stroke patients in a general hospital setting using the modified Rankin Scale (mRS). We also investigated the relationship of uric acid with other clinical correlates. Plasma uric acid was determined in 108 acute ischemic stroke patients and their mRS scores measured. Patients with a poor outcome (mRS > 2) had significantly lower uric acid than those with a better outcome; this remained after correcting for the effect of sex on uric acid concentrations. There was no significant association with other epidemiological factors or with cognitive function determined by Mini-Mental State Examination. An association between uric acid and the cerebral circulation was also found in which lower uric acid occurs with posterior artery involvement. These findings demonstrate in a naturalistic cohort of patients the association of uric acid with short-term disability following ischemic stroke. They also raise the question of whether uric acid may influence the regional brain involvement in stroke.
Gutzeit, Andreas [Clinical Research Unit of St. Anna Hospital Luzern, Institute of Radiology and Nuclear Medicine, Luzern (Switzerland); Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Cantonal Hospital, Department of Radiology, Winterthur (Switzerland); Roos, Justus E. [Duke University, Department of Radiology, Durham, NC (United States); Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Weymarn, Constantin von; Reischauer, Carolin; Froehlich, Johannes M. [Clinical Research Unit of St. Anna Hospital Luzern, Institute of Radiology and Nuclear Medicine, Luzern (Switzerland); Cantonal Hospital, Department of Radiology, Winterthur (Switzerland); Waelti, Stephan [Cantonal Hospital, Department of Radiology, Winterthur (Switzerland)
Optimal contrast within the pulmonary artery is achieved by the maximum amount of contrast-enhanced blood flowing through the superior vena cava (SVC), while minimum amounts of non-contrasted blood should originate from the inferior vena cava (IVC). This study aims to clarify whether ''suction against resistance'' might optimise this ratio. Phase-contrast pulse sequences on a 1.5T MRI magnet were used for flow quantification mean flow (mL/s), stroke volume (Vol) in the SVC and IVC in volunteers. Different breathing manoeuvers were analysed repeatedly: free breathing; inspiration; expiration; suction against resistance, and Valsalva. To standardise breathing commands, volunteers performed suction and Valsalva manoeuvers with an MR-compatible manometer.??Suction against resistance was associated with a significant drop of the IVC/SVC flow quotient (1.63 [range 1.3-2.0] p < 0.05 at -10 mmHg and 1.48 [1.1-1.9] p < 0.01 at -20 mmHg) corresponding to increased blood flow from SVC and diminished flow originating from the IVC. The remaining breathing commands (free breathing 2.2; inspiration 2.4; expiration 2.4; Valsalva 10 mmHg 2.3; Valsalva 20 mmHg 2.6; and Valsalva 30 mmHg 2.2) showed no differences (p > 0.05).??Suction against resistance caused a significant drop in the IVC/SVC quotient. Theoretically, this breathing manoeuver might significantly improve the enhancement characteristics of CT angiography. (orig.)
Mohd Azlan Ismail
Full Text Available This paper reviews the current research works on the end suction centrifugal pump coupled with induction generator running in turbine mode for microhydro application. The information can be used by practicing engineers, researchers, and plant managers to understand the potential of pump running as turbine. Review on experimental and simulation works was carried out encompassing end suction single stage low specific speed which is less than 10 kW. This is followed by review of their efficiency improvement through modifications. The results show that centrifugal pump can operate in turbine modes without any modification on mechanical components. However, to achieve the best efficiency point (BEP, it requires higher flow rate and head than pumping rating. Efficiency improvement is viable through geometric modification to improve hydraulic characteristic. The studies also show that pump as turbine (PAT can be directly coupled with modified induction motor as generator by adding capacitor and electric control system, regulating voltage and frequency at the output terminal. It was found that PAT offers the best low cost solution for microhydro application especially for third world countries that do not have local microhydro manufacturer.
... Workplace Giving Fundraise Planned Giving Corporate Giving Cause Marketing Join your team, your way! The Stroke Challenge ... Your Technology Guide High Blood Pressure and Stroke Importance of Physical Activity See More Multimedia Las minorías ...
... this page: //medlineplus.gov/ency/presentations/100218.htm Stroke - series—Part 1 To use the sharing features ... M. Editorial team. Related MedlinePlus Health Topics Ischemic Stroke A.D.A.M., Inc. is accredited by ...
Dao, Vinh N.T.; Morris, Peter H.; Dux, Peter F.
A clear fundamental understanding of suctions is crucial for the study of the behaviour of plastic cement mortar and concrete, including plastic shrinkage cracking. In this paper, the expression relating the change in free energy of the pore water with an isothermal change in pressure is first derived. Based upon definitions of suctions, it is then shown that total, matric, and osmotic suctions can all be expressed in the same thermodynamic form. The widely accepted, but not yet satisfactorily validated, assumption that the total suction comprises matric and osmotic components is then confirmed theoretically. The well-known Kelvin equation for matric suction, and Morse and van't Hoff equations for osmotic suction are subsequently derived from the corresponding thermodynamic equations. The applicability of latter two equations in evaluating the osmotic suctions of cement mortar and concrete is highlighted
Bogiatzi, Chrysi; Hackam, Daniel G; McLeod, A Ian; Spence, J David
Early diagnosis and treatment of a stroke improves patient outcomes, and knowledge of the cause of the initial event is crucial to identification of the appropriate therapy to maximally reduce risk of recurrence. Assumptions based on historical frequency of ischemic subtypes may need revision if stroke subtypes are changing as a result of recent changes in therapy, such as increased use of statins. We analyzed secular trends in stroke risk factors and ischemic stroke subtypes among patients with transient ischemic attack or minor or moderate stroke referred to an urgent transient ischemic attack clinic from 2002 to 2012. There was a significant decline in low-density lipoprotein cholesterol and blood pressure, associated with a significant decline in large artery stroke and small vessel stroke. The proportion of cardioembolic stroke increased from 26% in 2002 to 56% in 2012 (Prisk factors was observed, with a significant decline in stroke/transient ischemic attack caused by large artery atherosclerosis and small vessel disease. As a result, cardioembolic stroke/transient ischemic attack has increased significantly. Our findings suggest that more intensive investigation for cardiac sources of embolism and greater use of anticoagulation may be warranted. © 2014 American Heart Association, Inc.
England, John Dwight (Inventor); Kelley, Anthony R. (Inventor); Cronise, Raymond J. (Inventor)
A safety system includes a sleeve fitted within a pool's suction line at its inlet. The sleeve terminates with a plate that resides within the suction line. The plate has holes formed therethrough. A housing defining distinct channels is fitted in the sleeve so that the distinct channels lie within the sleeve. Each of the distinct channels has a first opening on one end thereof and a second opening on another end thereof. The second openings reside in the sleeve. The first openings are in fluid communication with the water in the pool, and are distributed around a periphery of an area of the housing that prevents coverage of all the first openings when a human interacts therewith. A first sensor is coupled to the sleeve to sense pressure therein, and a second pressure sensor is coupled to the plate to sense pressure in one of the plates' holes.
Nayfeh, A. H.; Reed, H. L.
Linear triple deck, closed form solutions for mean-flow quantities are developed for axisymmetric incompressible flow past a body with porous strips. The solutions account for upstream influence and are linear superpositions of the flow past the body without suction plus the perturbations due to the suction strips. Flow past the suctionless body is calculated using the Transition Analysis Program System, and a simple linear optimization scheme to determine number, spacing, and mass flow rate through the strips on an axisymmetric body is developed using the linear, triple-deck, closed-form solutions. The theory is demonstrated by predicting optimal strip distributions, and the effect of various adverse pressure-gradient situations on stability is studied.
A mathematical model describing the behaviour of caisson foundations for offshore wind turbines has been developed. The model has been verified and calibrated through laboratory and field work. Simultaneously, conceptual designs of wind turbine foundations incorporating suction caissons were studied using the same model. It was concluded that much of the seabed around Britain is well suited to the use of caissons and monopod and quadropod structures are superior to tripods. Although suction caissons are vulnerable to scour, rock dumping can largely eliminate this potential problem. The next phase will be to install a fully instrumented full-scale prototype to monitor the effects of wind and waves. The main contractor was SLP Engineering Limited and about 75 per cent of the funding came from the DTI.
Full Text Available Cryptogenic stroke is defined as brain infarction that is not attributable to a source of definite embolism, large artery atherosclerosis, or small artery disease despite a thorough vascular, cardiac, and serologic evaluation. Despite many advances in our understanding of ischemic stroke, cryptogenic strokes remain a diagnostic and therapeutic challenge. The pathophysiology of cryptogenic stroke is likely various. Probable mechanisms include cardiac embolism secondary to occult paroxysmal atrial fibrillation, aortic atheromatous disease or other cardiac sources, paradoxical embolism from atrial septal abnormalities such as patent foramen ovale, hypercoagulable states, and preclinical or subclinical cerebrovascular disease. Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. A significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging and improvement in our ability to detect paroxysmal atrial fibrillation in patients with cryptogenic stroke has strengthened the idea that these strokes are embolic in nature. a significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging.embolic stroke of undetermined sources(ESUS was planned for unifying embolic stroke of undetermined source. The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Therefore cryptogenic stroke is a diagnosis of exclusion. Compared with other stroke subtypes, cryptogenic stroke tends to have a better prognosis and lower long-term risk of recurrence.
Cerfontaine, Benjamin; Collin, Frédéric; Charlier, Robert
Suction caissons are hollow cylinders open towards the bottom currently used as anchors for deep water offshore facilities. They recently turned out to be advantageously exploited as foundation for offshore wind turbines in shallow water (Senders 2009). The Prevost model for cohesionless soils (Prevost 1985) is adapted for the modelling of their cyclic behaviour. It is able to reproduce plastic deformation in both loading and unloading, contractancy of the soil and pore pressure b...
Cerfontaine, Benjamin; Levasseur, Séverine; Collin, Frédéric; Charlier, Robert
Suction caisson are hollow cylinders open towards the bottom that are currently used as anchors for deep water offshore facilities. They recently turned out to be advantageously exploited as foundation for offshore wind turbines in shallow water (Senders 2009). The Prevost model for cohesionless soils (Prevost 1985) is currently used for the modelling of their cyclic behaviour. It’s able to reproduce plastic deformation in both loading and unloading, contractancy of the soil and p...
Hueckel, T.; Mielniczuk, B.; El-Youssoufi, S. M.
Continuum mechanics for unsaturated soils is based on the assumption of a one-to-one relationship betwee saturation degree and suction represented by the characteristic curve. Such curve commonly shows exceedingly high values of suction at saturation decreasing below 10%. We have performed a series of experiments on physical micro-structural models of 8-, 5, 4, 3, and 2-grain assemblies filled with water forming capillary, funicular and pendular bridges. Dynamic variables characterizing the evolution include: Laplace pressure, surface tension force, total intergralular force, contact angle and contact perimeter length. The Laplace pressure was calculated from the directly measured curvatures of interface surface for 2-grain bridges, and estimated from tomography stills for 3 grain bridges. The initial negative Laplace pressure (suction) as well as total intergranular force increase modestly at the begining of evaporation, but undergo an unstable decrease at the advanced stage, often with a jump in the force known as a Haines jumps since 1925. Laplace pressure turns into positive values prior to rupture for 2-grain bodies. For 3-grain bridges there is never an exceedingly high intergranular force of suction, reported in macro-scale experiments. For multiple-grain bodies there are two types of instabilities, depending on densitiy of the assembly and the Gaussian curvature (GC): at positive GC points it is thin-sheet instability, while at negative GC points instability is linked with air entry fingers, all associated with the split of assemblies into smaller isolated funicular, and eventually pendular bodies. The multi-grain bridges instabilities are linked to material drying cracking, the instabilities in 2 grain systems mean eventual loss of cohesion.
Full Text Available Background: Suction blister grafting is a useful modality of treatment of patients with resistant and stable vitiligo. However, there have been no detailed studies to find out the best donor site for blister formation. Methods: The study was conducted between the period of October 2004 and February 2005 in the dermatology department at a tertiary care center. Nine patients with vitiligo (focal vitiligo, 3; mucosal vitiligo, 2; acrofacial vitiligo, 2; vitiligo vulgaris, 1; and segmental vitiligo, 1 were selected for blister harvesting and grafting. The blisters were raised using the method described by Gupta et al. Results: Suction blisters were attempted to be raised at 52 sites, but only 38 blisters could be raised, 24 complete and 14 incomplete. Blisters were raised in all the three cases on the flexor aspect of the arm (100%, 15 of 17 cases (88.2% on the flexor aspect of the forearm, 4 of 5 cases (80% on the abdomen, 11 of 16 cases (68.7% on the anterolateral thigh, and less frequently over leg or foot. Complete blisters were formed in 13/15 cases (86.6% on the flexor aspect of the forearm, 6/11 cases (54.5% on the anterolateral thigh, and in all cases over leg. Conclusion: The flexor aspect of the forearm is a good site for suction blister harvesting.
Comparison the Effects of Shallow and Deep Endotracheal Tube Suctioning on Respiratory Rate, Arterial Blood Oxygen Saturation and Number of Suctioning in Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Trial
Full Text Available Introduction: Endotracheal tube suctioning is essential for improve oxygenation in the patients undergoing mechanical ventilation. There are two types of shallow and deep endotracheal tube suctioning. This study aimed to evaluate the effect of shallow and deep suctioning methods on respiratory rate (RR, arterial blood oxygen saturation (SpO2 and number of suctioning in patients hospitalized in the intensive care units of Al-Zahra Hospital, Isfahan, Iran. Methods: In this randomized controlled trial, 74 patients who hospitalized in the intensive care units of Isfahan Al-Zahra Hospital were randomly allocated to the shallow and deep suctioning groups. RR and SpO2 were measured immediately before, immediately after, 1 and 3 minute after each suctioning. Number of suctioning was also noted in each groups. Data were analyzed using repeated measures analysis of variance (RMANOVA, chi-square and independent t-tests. Results: RR was significantly increased and SpO2 was significantly decreased after each suctioning in the both groups. However, these changes were not significant between the two groups. The numbers of suctioning was significantly higher in the shallow suctioning group than in the deep suctioning group. Conclusion: Shallow and deep suctioning had a similar effect on RR and SpO2. However, shallow suctioning caused further manipulation of patient’s trachea than deep suctioning method. Therefore, it seems that deep endotracheal tube suctioning method can be used to clean the airway with lesser manipulation of the trachea.
Taniguchi, Yota; Kawakami, Shigeru; Fuchigami, Yuki; Oyama, Natsuko; Yamashita, Fumiyoshi; Konishi, Satoshi; Shimizu, Kazunori; Hashida, Mitsuru
We previously developed a suction-mediated transfection method in mice. The purpose of this study was to optimize the suction-mediated transfection conditions using a pressure-controlled computer system for efficient and safe kidney-targeted gene delivery in mice. Naked pCMV-Luc was injected into the tail vein in mice, and then the right kidney was suctioned by a device of the suction pressure-controlled system. The effects of renal transfection conditions, such as the suction pressure degree, suction pressure waveform and device area were evaluated by measuring luciferase expression. In addition, renal injury was examined. The renal suction-mediated transfection method at -30 kPa showed high transgene expression. The renal suction waveform did not affect the transfection activity. Under the optimized conditions, the high transgene expression was mostly observed at the renal suctioned site. The transfection conditions used did not induce histological defects or increases in two renal injury biomarkers (Kidney injury molecule-1 mRNA and Clusterin mRNA). We have clarified the transfection conditions for efficient and safe transfection in the kidney using the suction-mediated transfection method in mice.
Marshall, Christopher D.; Wieskotten, Sven; Hanke, Wolf; Hanke, Frederike D.; Marsh, Alyssa; Kot, Brian; Dehnhardt, Guido
The feeding kinematics, suction and hydraulic jetting capabilities of captive harbor seals (Phoca vitulina) were characterized during controlled feeding trials. Feeding trials were conducted using a feeding apparatus that allowed a choice between biting and suction, but also presented food that could be ingested only by suction. Subambient pressure exerted during suction feeding behaviors was directly measured using pressure transducers. The mean feeding cycle duration for suction-feeding events was significantly shorter (0.15±0.09 s; Pfeeding events (0.18±0.08 s). Subjects feeding in-water used both a suction and a biting feeding mode. Suction was the favored feeding mode (84% of all feeding events) compared to biting, but biting comprised 16% of feeding events. In addition, seals occasionally alternated suction with hydraulic jetting, or used hydraulic jetting independently, to remove fish from the apparatus. Suction and biting feeding modes were kinematically distinct regardless of feeding location (in-water vs. on-land). Suction was characterized by a significantly smaller gape (1.3±0.23 cm; Pfeeding events. Harbor seals displayed a wide repertoire of behaviorally flexible feeding strategies to ingest fish from the feeding apparatus. Such flexibility of feeding strategies and biomechanics likely forms the basis of their opportunistic, generalized feeding ecology and concomitant breadth of diet. PMID:24475170
Joubert, Jacques; Joubert, Lynette B; de Bustos, Elizabeth Medeiros; Ware, Dallas; Jackson, David; Harrison, Terrence; Cadilhac, Dominique
Stroke is a high-frequency disorder placing a significant burden on the health care systems, being the foremost cause of complex chronic disability in adults. Devising systems that can enhance the prevention of stroke recurrence is an important priority and challenge in both the developed and the developing world. The potential for recurrent stroke can be substantially reduced by effective management of vascular risk factors. Telestroke is a tool with potential application to improve risk management of stroke survivors. Lack of acknowledgment of existing practices as well as lack of awareness of potential financial barriers to diffusion of telestroke can lead to limited implementation. Telestroke offers service providers the opportunity to access large numbers of stroke survivors targeting secondary prevention. The ideal 'telestroke model' provides service support, education for the patient and caregiver, as well as integration of specialist and primary care services. Effective use of technological advances, with adequate recognition of the importance of human interaction in the long-term management of a largely elderly population of stroke survivors is challenging but possible. Telestroke should be systems- and not technology-driven. Barriers in the implementation of telestroke have been identified as insufficient planning of IT infrastructure, lack of long-term vision for sustainability, a lack of contextual perspective as well as poor communication across domains. Future telestroke models should provide effective action in an integrated model of care recognizing and involving all existing players and practices. (c) 2009 S. Karger AG, Basel.
Nowak, Dennis A; Grefkes, Christian; Dafotakis, Manuel; Eickhoff, Simon; Küst, Jutta; Karbe, Hans; Fink, Gereon R
Following the concept of interhemispheric competition, downregulation of the contralesional primary motor cortex (M1) may improve the dexterity of the affected hand after stroke. To determine the effects of 1-Hz repetitive transcranial magnetic stimulation (rTMS) of the contralesional M1 on movement kinematics and neural activation within the motor system in the subacute phase after subcortical stroke. Crossover investigation. A university hospital. Fifteen right-handed patients with impaired dexterity due to subcortical middle cerebral artery stroke received 1-Hz rTMS for 10 minutes applied to the vertex (control stimulation) and contralesional M1. For behavioral testing, patients performed finger and grasp movements with both hands at 2 baseline conditions, separated by 1 week, and following each rTMS application. For functional magnetic resonance imaging, patients performed hand grip movements with their affected or unaffected hand before and after each rTMS application. Application of rTMS to the contralesional M1 improved the kinematics of finger and grasp movements in the affected hand. At the neural level, rTMS applied to the contralesional M1 reduced overactivity in the contralesional primary and nonprimary motor areas. There was no significant correlation between the rTMS-induced reduction in blood oxygen level-dependent responses within the contralesional M1 and the degree of behavioral improvement of the affected hand. Overactivity of the contralesional dorsal premotor cortex, contralesional parietal operculum, and ipsilesional mesial frontal cortex at baseline predicted improvement of movement kinematics with the affected hand after rTMS of the contralesional M1. The functional magnetic resonance imaging data suggest that rTMS of the contralesional M1 may normalize neural activation within the cortical motor network after subcortical stroke. Identifying patients suitable for rTMS intervention based on individual patterns of cortical activation may help
Dorman, L. I.; Iucci, N.; Ptitsyna, N. G.; Villoresi, G.
We consider the influence of space storms as strong interplanetary shock waves causing great cosmic ray Forbush-decreases and big geomagnetic storms on the people health at the ground level We used data of more than 7 millions ambulance cases in Moscow and St Petersburg included information on daily numbers of the hard traffic accidents infarctions and brain strokes We found that during space storms the average daily numbers of hard traffic accidents with using ambulances as well as infarctions and brain strokes confirmed by medical personal increase by 17 4 pm 3 1 10 5 pm 1 2 and 7 0 pm 1 7 respectively We show that the forecasting of these dangerous apace phenomena can be done partly by using cosmic ray data on pre-increase and pre-decrease effects as well as on the change of 3-D cosmic ray anisotropy
Pedersen, Carsten M; Rosendahl-Nielsen, Mette; Hjermind, Jeanette
bleeding, infection, atelectasis, hypoxemia, cardiovascular instability, elevated intracranial pressure, and may also cause lesions in the tracheal mucosa. The aim of this article was to review the available literature regarding endotracheal suctioning of adult intubated intensive care patients......s, performing continuous rather than intermittent suctioning, avoiding saline lavage, providing hyperoxygenation before and after the suction procedure, providing hyperinflation combined with hyperoxygenation on a non-routine basis, always using aseptic technique, and using either closed or open...
Luckring, J. M.
A recent extension of the suction analogy for estimation of vortex loads on asymmetric configurations is reviewed. This extension includes asymmetric augmented vortex lift and the forward sweep effect on side edge suction. Application of this extension to a series of skewed wings has resulted in an improved estimating capability for a wide range of asymmetric flow situations. Hence, the suction analogy concept now has more general applicability for subsonic lifting surface analysis.
Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recovery ... LIVE AFTER A STROKE Most people will need stroke rehabilitation (rehab) to help them recover after they leave ...
Madsen, Søren; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo
Using large suction caissons for offshore wind turbines is an upcoming cost-effective technology also referred to as bucket foundations. During operation, the monopod bucket foundation is loaded by a large overturning moment from the wind turbine and the wave loads. However, during installation...... the suction caisson is loaded by external pressure (internal suction) due to evacuation of water inside the bucket and vertical forces due to gravity. The risk of structural buckling during installation of large-diameter suction caissons is addressed using numerical methods. Initial imperfect geometries...
THOREL, Luc; GARNIER, Jacques; RAULT, Gérard; DENDANI, Hédi; COLLIAT, JL
The preparation process of a deepwater Gulf of Guinea clay for modelling of 24 m long suction anchors at a scale of 1/100 in the LCPC centrifuge, the clay characteristics and the installation phase (self-weight and suction) are presented. Two types of caissons have been tested in each tub : one with stiffeners and the other without stiffener. The embedment ratio is close to the suction caisson's slenderness of 3. An analysis of the forces of suction and soil friction shows, as expected, hi...
John P. Micha
Conclusion: Since lymphedema often remains disabling and incurable following traditional therapy, suction-assisted lipectomy should be considered as an alternative when endeavoring to optimally manage this complication.
Song, Le-Ming; Deng, Xiao-Lin
Objective Flexible ureteroscopy is rapidly becoming a first line therapy for many patients with renal and ureteral calculi. Currently the medical infusion devices cannot monitor the renal pelvic pressure. We introduce a novel technique of flexible ureteroscopy with a suction system to treat upper urinary calculi and automatically control renal pelvic pressure. Methods We performed flexible URSs for patients with the help of a self-designed intelligent system including an irrigation and suctioning platform and a transparent ureteral access sheath (UAS) with a pressure-sensitive tip, which can precisely regulate the infusion flow and control the vacuum suctioning by computerized real-time recording and monitoring of RPP through pressure feedback, ensuring a stable RPP. The outer body diameter of the UAS was 15 F; the diameter of the working channel was 11.55 F; the length of the UAS was 20-45 cm. On the platform, RPP control value was set at −2 mmHg, RPP warning value was set at 20 mmHg, and RPP limit value was set at 30 mmHg. Intraoperatively, holmium laser was used to powderize the stone at 0.8 J/pulse with a frequency of 20 pulses/s (Lumenis, fiber diameter 200 um). In the process of powderizing lithotripsy using the laser, the scope body was moved back and forth slightly in an uninterrupted fashion in the sheath, with a distance of about 2-3 mm, to facilitate small gravel particles inside the sheath gap to be sucked out automatically. Gravel particles larger than sheath gap but less than UAS in diameter were sucked out by withdrawing the scope intermittently without a need of stone basketing. We retrospectively reviewed 37 patients with renal or ureteral calculus received the flexible URS from November 2014 to January 2015. Results The procedure was successfully performed in all patients with a clear operating field view. The mean stone size was 15.9±5.2 mm (rang: 8-35 mm). The mean operative time was 24.8±15.9 [13-49] min. The stone-free rates at
Rasmussen, Torben Valdbjørn
This poster presents a new radon sub-slab suctioning system. This system makes use of a grid of horizontal pressurised air ducts located within the lower part of the rigid insulation layer of the ground floor slab. For this purpose a new system of prefabricated lightweight elements is introduced....... The system is shown to be effective in preventing radon from polluting the indoor air by introducing low pressure in the horizontal grid of air ducts. How to implement and use the system in an effective way is described....
Full Text Available We propose a safe, simple, and novel method to harvest fat using a standard liposuction cannula and a Redivac or alternative closed-suction drain. The authors have used this technique for both 'dry' and 'wet' liposuction. This technique is both easy to perform and cost-effective whilst providing both a silent and relatively atraumatic fat harvest. The lower negative pressure compared with traditional harvesting systems likely preserves fat integrity for lipofilling. This method maximises resources already held within a hospital environment.
Full Text Available Auditory hallucinations are uncommon phenomena which can be directly caused by acute stroke, mostly described after lesions of the brain stem, very rarely reported after cortical strokes. The purpose of this study is to determine the frequency of this phenomenon. In a cross sectional study, 641 stroke patients were followed in the period between 1996–2000. Each patient underwent comprehensive investigation and follow-up. Four patients were found to have post cortical stroke auditory hallucinations. All of them occurred after an ischemic lesion of the right temporal lobe. After no more than four months, all patients were symptom-free and without therapy. The fact the auditory hallucinations may be of cortical origin must be taken into consideration in the treatment of stroke patients. The phenomenon may be completely reversible after a couple of months.
... unique for each person. Although a majority of functional abilities may be restored soon after a stroke, recovery is an ongoing process. Effects of a Stroke Weakness (hemiparesis) or paralysis (hemiplegia) on one side of the body that may affect the whole ...
... of 3 and 10. In those with SCD, ischemic strokes most often occur in children under the age of 15 and adults over the age of 30, while hemorrhagic strokes most often occur in young adults between the ages of 20 and 30. ...
Tuntiyatorn, Lojana; Saksornchai, Pichaya; Tunlayadechanont, Supoch
Stroke is a clinically syndrome of a sudden onset of neurological deficit in a vascular cause. Stroke mimics is the non-vascular disorders with stroke-like clinical symptoms. It is important to distinguish true stroke from mimics since treatment plan may differ To determine the incidence of the stroke mimics and identify their etiologies. All non-contrast head CT of the patients with clinically diagnosed stroke who immediately received imaging upon arrival at the emergency department of the university hospital were retrospectively reviewed in 12-month period between January 1 and December 31, 2008. Medical records, laboratory results, MRI, and 6-month clinical follow-up records were reviewed for final diagnosis. Seven hundred four patients were included in this study, including 363 (51.5%) men and 341 (48.5%) women with range in age from 24 to 108 years. Amongst those, 417 (59.2%) were ischemic stroke, 80 (11.40%) were hemorrhagic stroke, 186 (26.4%) were stroke-mimics, and 21 (3%) were inconclusive. The etiologies among stroke-mimics were metabolic/intoxication (35, 18.8%), sepsis (28, 15.0%), seizure (21, 11.3%), syncope (20, 10.8%), subdural hemorrhage (14, 7.5%), vertigo (11, 6.0%), brain tumor (10, 5.30%), central nervous system infection (5, 2.7%), others (26, 14.0%), and unspecified (16, 8.6%). Incidence rates and etiologies of the stroke mimics were similar to the western reports. However the frequency of each mimic was not.
Full Text Available The temperature of the flue-gas in the post combustion zone of a waste to energy (WTE plant has to be maintained within a fairly narrow range of values, the minimum of which is prescribed by the European Waste Directive 2000/76/CE, whereas the maximum value must be such as to ensure the preservation of the materials and the energy efficiency of the plant. A high degree of accuracy in measuring and controlling the aforementioned temperature is therefore required. In almost the totality of WTE plants this measurement process is carried out by using practical industrial thermometers, such as bare thermocouples and infrared radiation (IR pyrometers, even if affected by different physical contributions which can make the gas temperature measurements incorrect. The objective of this paper is to analyze errors and uncertainties that can arise when using a bare thermocouple or an IR pyrometer in a WTE plant and to provide a method for the in situ calibration of these industrial sensors through the use of suction pyrometers. The paper describes principle of operation, design, and uncertainty contributions of suction pyrometers, it also provides the best estimation of the flue-gas temperature in the post combustion zone of a WTE plant and the estimation of its expanded uncertainty.
Rinaldi, Fabio; Najafi, Behzad
The temperature of the flue-gas in the post combustion zone of a waste to energy (WTE) plant has to be maintained within a fairly narrow range of values, the minimum of which is prescribed by the European Waste Directive 2000/76/CE, whereas the maximum value must be such as to ensure the preservation of the materials and the energy efficiency of the plant. A high degree of accuracy in measuring and controlling the aforementioned temperature is therefore required. In almost the totality of WTE plants this measurement process is carried out by using practical industrial thermometers, such as bare thermocouples and infrared radiation (IR) pyrometers, even if affected by different physical contributions which can make the gas temperature measurements incorrect. The objective of this paper is to analyze errors and uncertainties that can arise when using a bare thermocouple or an IR pyrometer in a WTE plant and to provide a method for the in situ calibration of these industrial sensors through the use of suction pyrometers. The paper describes principle of operation, design, and uncertainty contributions of suction pyrometers, it also provides the best estimation of the flue-gas temperature in the post combustion zone of a WTE plant and the estimation of its expanded uncertainty.
Dave, Mital H; Frotzler, Angela; Madjdpour, Caveh; Koepfer, Nelly; Weiss, Markus
Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. High-volume low pressure tube cuffs of 7.5 mm internal diameter (ID) were placed in a 22 mm ID artificial trachea connected to a test lung. Positive pressure ventilation (PPV) with 15 cm H₂O peak inspiratory pressure and 5 cm H₂O positive end-expiratory pressure (PEEP) was used. A closed tracheal suction system (CTSS) catheter (size 14Fr) was attached to the tracheal tube and suction was performed for 5, 10, 15, or 20 seconds under 200 or 300 cm H₂O suction pressures. Amount of fluid (mL) aspirated along the tube cuff and the airway pressure changes were recorded for each suction procedure. Fluid aspiration during different suction conditions was compared using Kruskal-Wallis and Mann-Whitney test (Bonferroni correction [α = .01]). During 10, 15, and 20 seconds suction, airway pressure consistently dropped down to -8 to -13 cm H₂O (P aspiration was never observed under PPV + PEEP but occurred always during suctioning. Aspiration along the tube cuff was higher with -300 cm H₂O than with -200 cm H₂O suction pressure (P aspiration of fluid occurs along the tracheal tube cuff during suction with the closed tracheal suction system. © SAGE Publications 2011.
Stroke; Acute Stroke; Acute Brain Injury; Ischemic Stroke; Hemorrhagic Stroke; Transient Ischemic Attack; Subarachnoid Hemorrhage; Cerebral Ischemia; Cerebral Infarction; Cerebral Stroke; Venous Sinus Thrombosis, Cranial
Langhorne, P.; Bernhardt, J.; Kwakkel, G.
Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially
Kounis Georgios A
Full Text Available Abstract Background The purpose of this study is to evaluate the use of Tono-Pen XL in measuring IOP during the application of a suction ring in rabbit eyes with manometrically controlled IOP. Methods Tono-Pen XL was calibrated against direct manometry in 10 rabbit eyes. A suction ring was then applied in 4 rabbit eyes and the IOP was determined manometrically during suction ring application at 350 mmHg vacuum pressure. Finally, in 6 catheterized rabbit eyes the IOP was measured with Tono-Pen XL during suction ring application at suction vacuum from 350 to 650 mmHg, while keeping actual IOP stable at 30 mmHg and 60 mmHg. Results Linear regression analysis revealed that the Tono-pen XL was reliable for IOPs between 10 and 70 mmHg (R2 = 0.9855. Direct manometry during suction ring application showed no statistically significant variation of Tono-Pen XL readings when the incanulation manometry intraocular pressure changed from 30 mmHg to 60 mmHg and no statistically significant correlation between suction vacuum and IOP measurements. Conclusion Tono-Pen XL measurements are unreliable during the application of a suction ring on living rabbit eyes even when the actual IOP is forced to be within the validated range of Tono-Pen XL measurements. This inaccuracy is probably related to altered corneal and scleral geometry and stress.
Charisis, Spyridon K; Ginis, Harilaos S; Kounis, Georgios A; Tsilimbaris, Miltiadis K
The purpose of this study is to evaluate the use of Tono-Pen XL in measuring IOP during the application of a suction ring in rabbit eyes with manometrically controlled IOP. Tono-Pen XL was calibrated against direct manometry in 10 rabbit eyes. A suction ring was then applied in 4 rabbit eyes and the IOP was determined manometrically during suction ring application at 350 mmHg vacuum pressure. Finally, in 6 catheterized rabbit eyes the IOP was measured with Tono-Pen XL during suction ring application at suction vacuum from 350 to 650 mmHg, while keeping actual IOP stable at 30 mmHg and 60 mmHg. Linear regression analysis revealed that the Tono-pen XL was reliable for IOPs between 10 and 70 mmHg (R2 = 0.9855). Direct manometry during suction ring application showed no statistically significant variation of Tono-Pen XL readings when the incanulation manometry intraocular pressure changed from 30 mmHg to 60 mmHg and no statistically significant correlation between suction vacuum and IOP measurements. Tono-Pen XL measurements are unreliable during the application of a suction ring on living rabbit eyes even when the actual IOP is forced to be within the validated range of Tono-Pen XL measurements. This inaccuracy is probably related to altered corneal and scleral geometry and stress.
... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange (oxygenator...
Jia, Xiaohan; Zhao, Bin; Feng, Jianmei; Zheng, Sulu; Peng, Xueyuan
Highlights: • An investigation focusing on suction heating of a BOG compressor is carried out. • There is frost on the cylinder cover as the compressor at lower suction temperature. • The suction and discharge flow rate decrease with rising suction temperature. • The volumetric efficiency has a maximum value with increasing suction temperature. • The temperature coefficient increased with suction temperature or rotational speed. - Abstract: One of the key components of a liquefied natural gas (LNG) receiving terminal is the boil-off gas (BOG) compressor, which is used to pump out the BOG from the LNG storage tank to ensure safety in the transportation and receiving systems. Owing to the ultra-low suction temperature, the heat exchange between the intake gas and the cylinder, piston, and cylinder cover cannot be ignored as in normal conditions. This paper presents an investigation focusing on suction heating of the BOG compressor. A finite element model with dynamic mesh was established to simulate the suction process. At the same time, a performance test rig was built to study the characteristics of the BOG compressor under low suction temperature conditions and verify the numerical model. Consequently, the results of the simulation were in good agreement with experimental results. Both results implied that the temperature of cylinder surface increased starting from the cylinder cover to the crankcase. In addition, at lower suction temperature, the temperature difference between various points on the cylinder surface and cylinder cover was much larger than that at higher suction temperature. With increasing suction temperature, the temperature coefficient increased markedly, and the difference between gas temperatures at the beginning and end of the suction process, as well as the compressor flow rate, decreased significantly; however, the volumetric efficiency increased first and then decreased. Furthermore, the temperature coefficient clearly increased
Cheng, Ivy K. Y.; Chan, Karen M. K.; Wong, C. S.; Cheung, Raymond T. F.
Background: There is growing evidence of potential benefits of repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of dysphagia. However, the site and frequency of stimulation for optimal effects are not clear. Aims: The aim of this pilot study is to investigate the short-term effects of high-frequency 5 Hz rTMS applied to…
Reynolds, G. A.; Saric, W. S.; Reed, H. L.; Nayfeh, A. H.
Low turbulence tunnel experiments on the stability and transition of 2 D boundary layers on flat plates with and without suction are described. A number of general suction cases are discussed. Test results showed that the maximum stabilization occurred when the suction was moved toward the Branch I neutral point. An analytical study of the stability of two dimensional, incompressible boundary layer flows over plates with suction through porous strips was performed. The mean flow was calculated using linearized triple deck, closed form solutions. The stability results of the triple deck theory are shown to be in good agreement with those of the interacting boundary layers. An analytical optimization scheme for the suction configuration was developd. Numerical calculations were performed corresponding to the experimental configurations. In each case, the theory correctly predicts the experimental results.
El Hajjar, A.; Chauhan, P.; Prime, N.; Plé, O.
Rammed earth, in the current environmental situation, is an alternative construction technique which can help in reducing energy and raw material consumption owing to its “sustainable” characteristics. To fully understand its behavior and properties, recent scientific investigations consider it as a compacted unsaturated material with suction as its one of the main sources of strength. Eathern constructions face, over their lifetime, variations in the suction state which have a significant impact on their mechanical characteristics. In the present contribution, unconfined compression tests are performed, with and without unload-reload cycles, on homogeneously compacted samples subjected to various suction conditions. This study shows that both the unconfined compressive strength and Young modulus reduce with the reduction of suction states. Suction also seems to influence the amount of plastic strains and damage phenomenon. Indeed, the soils analyzed are slightly active and shows both plasticity behavior and damage phenomenon.
Kim, H U; Yun, S K
Suction devices for epidermal grafting need a suction pump to provide a negative pressure. The authors have developed a suction device in which a syringe and a manometer are employed to provide a negative pressure. The purpose of this study was to evaluate the efficacy of our suction device in vitiligo patients. The suction device was used to obtain epidermal blisters from the donor site. A CO2 laser was employed to remove the depigmented epidermis. The blister roofs of the donor site were harvested and were placed onto the recipient area. Ten patients with stable vitiligo were treated by epidermal grafting. Epidermal blisters were produced by suction in all patients. Also, all 10 patients regained repigmentation. Our suction blister device is simple and inexpensive to make, and it may become an alternative to the other suction devices.
The IMPACT Instrumentation, Inc., Continous Oropharyngeal Tracheal Suction, model 308ME13 is a portable self contained, general purpose, medical suction apparatus designed for removing secretions from the upper airway...
Hamedani, Ali G; Cole, John W; Cheng, Yuching; Sparks, Mary J; O'Connell, Jeffrey R; Stine, Oscar C; Wozniak, Marcella A; Stern, Barney J; Mitchell, Braxton D; Kittner, Steven J
Factor V Leiden (FVL) has been associated with ischemic stroke in children but not in adults. Although the FVL mutation is associated with increased risk for venous thrombosis, its association with ischemic stroke in young adults remains uncertain. Therefore, we examined the association between FVL and ischemic stroke in participants of the Genetics of Early Onset Stroke (GEOS) study. A population-based case control study identified 354 women and 476 men 15 to 49 years of age with first-ever ischemic stroke and 907 controls. Participant-specific data included vascular risk factors, FVL genotype and, for cases, the ischemic stroke subtype by modified Trial of ORG 10172 in Acute Stroke criteria. Logistic regression was used to calculate odds ratios for the entire population and for subgroups stratified by risk factors and ischemic stroke subtype. The frequency of the FVL mutation was similar between ischemic stroke patients (3.6%; 95% confidence interval [CI] 2.5%-5.1%) and nonstroke controls (3.8%; 95% CI 2.7%-5.2%). This frequency did not change significantly when cases were restricted to patients with stroke of undetermined etiology (4.1%; 95% CI 2.6%-6.4%). Among young adults, we found no evidence for an association between FVL and either all ischemic stroke or the subgroup with stroke of undetermined etiology. Published by Elsevier Inc.
Stroke in childhood has gained increasingly more attention and is accepted as an important disease in childhood. The reasons for this severe event and the consequences for the rest of the life are totally different than for adults. This is also true for the diagnosis and therapy. This paper gives a comprehensive overview on the characteristics of pediatric stroke to assist radiologists in making a rapid and safe diagnosis in order to identify the underlying disease. (orig.) [de
A technique of ambulatory abortion for first trimester pregnancies by vacuum suction curettage under local anesthesia with intracervical block is described. The apparatus and relevant problems are discussed. A shortened speculum devised by the author and considered an improvement for this procedure, and a simplified sterile field are described. The complication rate of 0.48% based on 5641 reported cases is very low: there were no deaths, two cases of uterine perforation, 14 of incomplete abortion, 20 of infection, 1 of depression, no cervical lacerations; 27 patients were hospitalized. The advantages of this method are safety, simplicity, minimal blood loss and immediate recovery. It is preferable to the usual dilatation and curettage, does not require general anesthesia and can be used in small clinics or in hospitals on an ambulatory basis. PMID:4758593
Full Text Available Suction blister grafting is a simple modality of treatment of patients with resistant and stable vitiligo. But raising the blisters may be time consuming and transferring to the recipient site may be difficult as the graft is ultrathin. By doing some modifications we can make the technique simpler and easier. We can decrease the blister induction time by intradermal injection of saline, exposure to Wood′s lamp, intrablister injection of saline. By these methods we can decrease the blister induction time from 2-3 hrs to 45-90 minutes. After harvesting the graft, it can be transferred to the recipient area by taking the graft on a sterile glass slide, on the gloved finger, rolling the graft over a sterile syringe and then spreading on the recipient area, or taking on the sterile wrapper of paraffin dressing and then placing over the recipient area.
Rasmussen, Torben Valdbjørn
of prefabricated lightweight elements were introduced and demonstrated. The principle was demonstrated on a concrete ground slab floor with a concrete slab on top of a thermal insulation layer above a capillary-breaking layer mounted on stable ground. The thermal insulation and the capillary-breaking layer......A new principle for radon protection, using a system containing a horizontal grid of air ducts pressurised within the rigid insulation material, was presented. The principle was based on the principles for pressure reduction of the zone underneath the ground floor construction. A new element...... consisted of a rigid insulation material. The new solution integrates the capillary-breaking layer and a pressure reduction zone,denoted the radon–suctioning layer, in one element. The new solution introduces the radonsuctioning layer as a horizontal grid of air ducts with low pressure to catch air...
Nayfeh, A. H.; Reed, H. L.; Ragab, S. A.
This paper addresses the steady, incompressible, two-dimensional flow past a flat plate with suction through porous strips. Closed-form solutions for each flow quantity are developed in the context of linearized triple-deck theory using Fourier transforms. To demonstrate the validity of these closed-form solutions, we compare the wall shear stress and pressure coefficients and the streamwise velocity profiles from the linearized theory with those obtained by the numerical integration of both interacting and nonsimilar boundary-layer equations. The agreement between the linearized triple-deck and interacting boundary-layer equations is good; however, the nonsimilar boundary layers, which fail to account for upstream influence, are shown to be in poor agreement with both interacting boundary layers and the linearized triple deck. The linearized closed-form solutions will therefore be very useful in future stability calculations.
The influence of the inlet end upon the initiation of the transition regime has been specified. The intermittency factor is determined by way of a method providing informations about the energetical aspect of the transition phenomenon. A detailed study of the evolution of the pressure drop was carried out. The study of an equivalent Strouhal number enables to specify when turbulence is fully developed. The observation of the evolution of turbulent streaks all along the pipe, together with the measure of the propagation velocity of their fronts, enable to describe the evolution from laminar to turbulent flow. The importance of the tube length is pointed out. At last, the influence of suction at each of the steps of this study is specified [fr
... Stroke Association.org Professionals for Stroke Association.org Shop for Stroke Association.org Support for Stroke Association. ... a wheelchair accessible or modified van, truck or car can provide the assurance you need to feel ...
Full Text Available The RNG k-ε turbulence model combined with cavitation model was used to simulate unsteady cavitating flows inside a double-suction centrifugal pump under different flow rate conditions based on hexahedral structured grid. The numerical external characteristic performances agree well with the experimental performances. The predicted results show that the turbulence kinetic energy and the turbulence dissipation rate inside the impeller at design flow rate are lower than those at other off-design flow rates, which are caused by various vortexes. Based on frequency-domain analyses in the volute casing, the blade passing frequency is the dominant one of the pressure fluctuations except the vicinity of volute tongue for all operating cases, and the dominant frequency near the volute tongue ranges from 0 to 0.5 times the blade passing frequency for other off-design points, while the blade passing one near the volute tongue is the dominant one of the pressure fluctuations at design point. The increase of flow rate reduces the pressure fluctuations amplitude. For cavitation cases, the blade loading of the middle streamline increases a bit during the initial stage, but, for serious cavitation, the blade loading near the blade inlet reduces to 0 and even negative values, and the serious cavitation bubbles block the blade channels, which results in a sharp drop in pump head. Under noncavitation condition, the predicted power related to the pressure in the impeller channels increases from the inlet to the exit, while, under different cavitation conditions at the design flow rate, these power-transformation distributions in the impeller channels show that these power conversions are affected by the available NPSHa and the corresponding work in leading regions of the blades increases increases gradually a bit, and then it increases sharply in the middle regions, but it decreases in the blade trailing regions and is greatly influenced by secondary flows.
M. Taheri Rezgh Abadi
Full Text Available Aims: Patients undergoing artificial ventilation require tracheal tube suction because of inability to clear their effective airways, which is usually a painful process for the patients. The aim of this study was to investigate the effect of spike lavender’s inhalant on pain during tracheal tube suctioning in ICU intubated patients. Materials & Methods: In this double-blinded randomized clinical trial, 60 intubated patients hospitalized in ICU of Shahid Modarres Hospital of Kashmar City, Iran, in 2017 were selected by available and simple sampling method, and were randomly divided into 2 control and case groups (each 30 individuals. Before the standard suctioning process, the test group patients received inhalant of 2% spike lavender for 5 minutes and the control group received inhalant of distilled water. The level of pain was recorded before and during tracheal tube suctioning. Data were analyzed by SPSS 16 software using independent T, paired T, Fisher and Mann-Whitney U tests. Findings: There was no significant difference in pain score before tracheal tube suction between 2 groups (p>0.05. However, there were significant differences between the level of pain during tracheal tube suctioning and the pain was increased in both groups, but this increase was significantly higher in the control group (p<0.001. Conclusion: Spike lavender’s inhalant is effective on pain reduction during suctioning process of ICU intubated patients.
Acikgoz, Ayfer; Yildiz, Suzan
This experimental study was conducted to compare the effects of open and closed suctioning systems on pain in newborns receiving ventilation support. The study sample consisted of 42 babies (23 female, 16 male) hospitalized in the unit between December 2010 and December 2011 who met the selection criteria established for the study. Using the random sampling method, 20 of the babies were included in the closed suctioning system group and the remaining 22 were analyzed in the open suctioning system group. The data collection tools of the study were intervention monitoring form, data collection form, and documentation of the personal information on the babies; and the Neonatal Pain, Agitation, and Sedation Scale (N-PASS) evaluated the babies' pain responses. The data were evaluated using SPSS 15 software. Most neonates were born preterm (≤37 weeks' gestation at birth; 69% [n = 29]). The mean (SD) birth weight, gestational age, and intensive care unit stay were 1.82 kg (1.1 kg), 31.9 (5.3) weeks, and 25.3 (2.9) calendar days, respectively. Results of the study revealed no statistically significant difference between the open suctioning and closed suctioning groups (p = .194). However, the N-PASS pain scores obtained before and during the suctioning processes were significantly different (p pain during the suctioning process, according to N-PASS scores, and although not significant statistically, the level of pain felt during open suctioning was observed to be slightly higher compared with closed suctioning. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Rawat, Abhishek; Zhi Lang, Lin; Baille, Wiebke
Bentonite-sand mixture is one of the candidate sealing/ buffer material for landfills, hazardous and high level radioactive waste repository. The long term satisfactory performance of bentonite sand mixture in terms of load bearing function, sealing function and buffer function is governed by hydro-mechanical response of material under elevated temperature conditions. The suction-water content relationship is one of the key parameter, which govern the thermo-hydro-mechanical behavior of compacted bentonite-sand mixture. This paper presents brief review of suction water content relationships of bentonite-sand mixture considering temperature effects. Numerous parametric models or equations have been developed for representing the soil water characteristics curve i.e. SWCC for isothermal conditions. The most frequently used equations for representing the SWCC are the van Genuchten (1980) and Fredlund and Xing (1994) SWCC equations. Various researchers (Romero et al. 2000; Villar and Lloret, 2004; Tang and Cui, 2005; Agus, 2005; Arifin, 2008) have reported the temperature effect on the water retention behavior of compacted bentonite-sand mixtures. The testing program, results and major conclusions made by above mentioned researchers were discussed in this paper. The changes in hydro-mechanical behavior due to elevated temperature are also discussed based on the suction components of soil which are influenced by temperature. As a general conclusion, total suction of the bentonite-sand mixtures is a function of mixture water content and mixture bentonite content or collectively a function of bentonite water content both at room temperature and at elevated temperature. At a constant temperature, different techniques for measuring suction results in different values of suction depending on accuracy of the sensor and calibration technique used as founded earlier by Agus (2005). The change in total suction due to change in temperature lower than 100 degree C is reversible
Davies, K; Bulsara, M; Ramelet, A S; Monteroso, L
To establish criterion-related construct validity and test-retest reliability for the Endotracheal Suction Assessment Tool© (ESAT©). Endotracheal tube suction performed in children can significantly affect clinical stability. Previously identified clinical indicators for endotracheal tube suction were used as criteria when designing the ESAT©. Content validity was reported previously. The final stages of psychometric testing are presented. Observational testing was used to measure construct validity and determine whether the ESAT© could guide 'inexperienced' paediatric intensive care nurses' decision-making regarding endotracheal tube suction. Test-retest reliability of the ESAT© was performed at two time points. The researchers and paediatric intensive care nurse 'experts' developed 10 hypothetical clinical scenarios with predetermined endotracheal tube suction outcomes. 'Experienced' (n=12) and 'inexperienced' (n=14) paediatric intensive care nurses were presented with the scenarios and the ESAT© guiding decision-making about whether to perform endotracheal tube suction for each scenario. Outcomes were compared with those predetermined by the 'experts' (n=9). Test-retest reliability of the ESAT© was measured at two consecutive time points (4 weeks apart) with 'experienced' and 'inexperienced' PIC nurses using the same scenarios and tool to guide decision-making. No differences were observed between endotracheal tube suction decisions made by 'experts' (n=9), 'inexperienced' (n=14) and 'experienced' (n=12) nurses confirming the tool's construct validity. No differences were observed between groups for endotracheal tube suction decisions at T1 and T2. Criterion-related construct validity and test-retest reliability of the ESAT© were demonstrated. Further testing is recommended to confirm reliability in the clinical setting with the 'inexperienced' nurse to guide decision-making related to endotracheal tube suction. This article is protected by copyright
Introduction: The present study was designed to determine the relative frequency of previously diagnosed and undiagnosed hypertension in first stroke in order to evaluate if previous diagnosis of hypertension can prevent stroke. Patients and Methods: One hundred and twenty nine first stroke patients presenting at the ...
Stuart, Hannah S.
© 2014 IEEE. Fingertip suction is investigated using a compliant, underactuated, tendon-driven hand designed for underwater mobile manipulation. Tendon routing and joint stiffnesses are designed to provide ease of closure while maintaining finger rigidity, allowing the hand to pinch small objects, as well as secure large objects, without diminishing strength. While the hand is designed to grasp a range of objects, the addition of light suction flow to the fingertips is especially effective for small, low-friction (slippery) objects. Numerical simulations confirm that changing suction parameters can increase the object acquisition region, providing guidelines for future versions of the hand.
Correia Pinto, Oriana Horta Rendeiro; Ribeiro, Lúcia
Introduction: Several behavioural changes can occur as a consequence of stroke. A large number of studies have evaluated the frequency and severity of post-stroke depression, apathy and alexithymia that result from stroke, however the published data is contradictory.Aims: The aim of this article is to present a literature review of the concepts of depression, apathy and alexithymia and post-stroke neuroanatomical findings that support these psychopathological observations.Methods:...
Mørch, Sofie Søndergaard; Andersen, Johnny Dohn Holmgren; Bestle, Morten Heiberg
and mortality. This case report describes two Danish patients diagnosed with heat stroke syndrome during a heat wave in the summer of 2014. Both patients were morbidly obese and had several predisposing illnesses. However since heat stroke is a rare condition in areas with temperate climate, they were...... not diagnosed until several days after admittance; hence treatment with cooling was delayed. Both patients were admitted to the intensive care unit, where they were treated with an external cooling device and received treatment for complications. Both cases ended fatally. As global warming continues, more heat...
O'Neal, Wesley T; Qureshi, Waqas T; Judd, Suzanne E; Bowling, C Barrett; Howard, Virginia J; Howard, George; Soliman, Elsayed Z
It is unclear if patients who have atrial fibrillation (AF) have a greater fall risk compared with those in the general population and if falls increase mortality beyond that observed in AF. A total of 24,117 (mean age 65 ± 9.3 years; 55% women; 38% black) participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were included. AF was identified from baseline electrocardiogram data and by self-reported history. Falls were considered present if participants reported ≥2 falls within the year before the baseline examination. Logistic regression was used to examine the relationship between prevalent AF and falls. Cox regression was used to examine the risk of death in those with AF and falls, separately and in combination, compared with those without either condition. A total of 2,007 participants (8.3%) had baseline AF and 1,655 (6.7%) reported falls. A higher prevalence of falls was reported in those with AF (n = 209; 10%) than those without AF (n = 1,446; 6.5%; p history of AF or falls, the concomitant presence of AF and falls (hazard ratio [HR] 2.12, 95% CI 1.64 to 2.74) was associated with a greater risk of death than AF (HR 1.44, 95% CI 1.28 to 1.62) or falls (HR 1.61, 95% CI 1.42 to 1.82). In conclusion, patients with AF are more likely to report a history of falls in REGARDS. Additionally, participants with AF who report falls have an increased risk of death than those with either condition in isolation. Copyright © 2015 Elsevier Inc. All rights reserved.
Kuratani, F.; Ogawa, T. [Hyogo University of Teacher Education, Hyogo (Japan); Yamamoto, S.
In order to improve the performance of a multiblade fan, the effects of three types of suction cones of the fan casing on the fan efficiency and noise are investigated experimentally. The first type of the suction cone is the insertion type, which is inserted into the inside of the fan impeller. The second type is the extrusion type, which extrudes outside from the casing surface. The third type is the combination type of two types. The results of those three types are compared with those of the commonly used suction cone. The followings are made clear: (1) The insertion type and the extrusion type are effective in improving the efficiency and reducing noise. (2) The optimal lengths of the insertion and the extrusion exist. (3) The combination type is more effective in improving the efficiency. (4) The combination type with the skewed cutoff of the fan casing shows the best effect. (author)
Full Text Available Abstract Background To evaluate whether the volume of blood suctioned during vacuum-assisted breast biopsy (VABB is associated with hematoma formation and progression, patient's age and histology of the lesion. Findings 177 women underwent VABB according to standardized protocol. The volume of blood suctioned and hematoma formation were noted at the end of the procedure, as did the subsequent development and progression of hematoma. First- and second-order logistic regression was performed, where appropriate. Cases with hematoma presented with greater volume of blood suctioned (63.8 ± 44.7 cc vs. 17.2 ± 32.9 cc; p Conclusion The likelihood of hematoma is increasing along with increasing amount of blood suctioned, reaching a plateau approximately at 80 cc of blood lost.
Koteras, Aleksandra Katarzyna; Ibsen, Lars Bo; Clausen, Johan Christian
and different boundaries. The flow of pore water is studied for homogenous sand, sand overlaid by impermeable layer and sand situated above impermeable layer. In all three cases the seepage analysis gives the required information on the critical suction pressure and on the distribution of excess pore pressure...... around the bucket skirt. The exceedance of critical suction might lead to installation failure due to formation of piping channels, which break the hydraulic seal between the skirt and soil. The excess pore pressure arising due to applied suction changes the effective stress, hence the penetration...... resistance of soil. Therefore, both matters are important for the design. The results show that the appearance of the impermeable layer above or below sand affects the excess pore pressure in this layer. Moreover, it has been found that the appearance of impermeable layer increases the allowable suction...
Christopher D Marshall
Full Text Available The feeding kinematics, suction and hydraulic jetting capabilities of captive harbor seals (Phoca vitulina were characterized during controlled feeding trials. Feeding trials were conducted using a feeding apparatus that allowed a choice between biting and suction, but also presented food that could be ingested only by suction. Subambient pressure exerted during suction feeding behaviors was directly measured using pressure transducers. The mean feeding cycle duration for suction-feeding events was significantly shorter (0.15±0.09 s; P<0.01 than biting feeding events (0.18±0.08 s. Subjects feeding in-water used both a suction and a biting feeding mode. Suction was the favored feeding mode (84% of all feeding events compared to biting, but biting comprised 16% of feeding events. In addition, seals occasionally alternated suction with hydraulic jetting, or used hydraulic jetting independently, to remove fish from the apparatus. Suction and biting feeding modes were kinematically distinct regardless of feeding location (in-water vs. on-land. Suction was characterized by a significantly smaller gape (1.3±0.23 cm; P<0.001 and gape angle (12.9±2.02°, pursing of the rostral lips to form a circular aperture, and pursing of the lateral lips to occlude lateral gape. Biting was characterized by a large gape (3.63±0.21 cm and gape angle (28.8±1.80°; P<0.001 and lip curling to expose teeth. The maximum subambient pressure recorded was 48.8 kPa. In addition, harbor seals were able to jet water at food items using suprambient pressure, also known as hydraulic jetting. The maximum hydraulic jetting force recorded was 53.9 kPa. Suction and hydraulic jetting where employed 90.5% and 9.5%, respectively, during underwater feeding events. Harbor seals displayed a wide repertoire of behaviorally flexible feeding strategies to ingest fish from the feeding apparatus. Such flexibility of feeding strategies and biomechanics likely forms the basis of their
Full Text Available Mesozoic marine reptiles and modern marine mammals are often considered ecological analogs, but the extent of their similarity is largely unknown. Particularly important is the presence/absence of deep-diving suction feeders among Mesozoic marine reptiles because this would indicate the establishment of mesopelagic cephalopod and fish communities in the Mesozoic. A recent study suggested that diverse suction feeders, resembling the extant beaked whales, evolved among ichthyosaurs in the Triassic. However, this hypothesis has not been tested quantitatively. We examined four osteological features of jawed vertebrates that are closely linked to the mechanism of suction feeding, namely hyoid corpus ossification/calcification, hyobranchial apparatus robustness, mandibular bluntness, and mandibular pressure concentration index. Measurements were taken from 18 species of Triassic and Early Jurassic ichthyosaurs, including the presumed suction feeders. Statistical comparisons with extant sharks and marine mammals of known diets suggest that ichthyosaurian hyobranchial bones are significantly more slender than in suction-feeding sharks or cetaceans but similar to those of ram-feeding sharks. Most importantly, an ossified hyoid corpus to which hyoid retractor muscles attach is unknown in all but one ichthyosaur, whereas a strong integration of the ossified corpus and cornua of the hyobranchial apparatus has been identified in the literature as an important feature of suction feeders. Also, ichthyosaurian mandibles do not narrow rapidly to allow high suction pressure concentration within the oral cavity, unlike in beaked whales or sperm whales. In conclusion, it is most likely that Triassic and Early Jurassic ichthyosaurs were 'ram-feeders', without any beaked-whale-like suction feeder among them. When combined with the inferred inability for dim-light vision in relevant Triassic ichthyosaurs, the fossil record of ichthyosaurs does not suggest the
Motani, Ryosuke; Ji, Cheng; Tomita, Taketeru; Kelley, Neil; Maxwell, Erin; Jiang, Da-yong; Sander, Paul Martin
Mesozoic marine reptiles and modern marine mammals are often considered ecological analogs, but the extent of their similarity is largely unknown. Particularly important is the presence/absence of deep-diving suction feeders among Mesozoic marine reptiles because this would indicate the establishment of mesopelagic cephalopod and fish communities in the Mesozoic. A recent study suggested that diverse suction feeders, resembling the extant beaked whales, evolved among ichthyosaurs in the Triassic. However, this hypothesis has not been tested quantitatively. We examined four osteological features of jawed vertebrates that are closely linked to the mechanism of suction feeding, namely hyoid corpus ossification/calcification, hyobranchial apparatus robustness, mandibular bluntness, and mandibular pressure concentration index. Measurements were taken from 18 species of Triassic and Early Jurassic ichthyosaurs, including the presumed suction feeders. Statistical comparisons with extant sharks and marine mammals of known diets suggest that ichthyosaurian hyobranchial bones are significantly more slender than in suction-feeding sharks or cetaceans but similar to those of ram-feeding sharks. Most importantly, an ossified hyoid corpus to which hyoid retractor muscles attach is unknown in all but one ichthyosaur, whereas a strong integration of the ossified corpus and cornua of the hyobranchial apparatus has been identified in the literature as an important feature of suction feeders. Also, ichthyosaurian mandibles do not narrow rapidly to allow high suction pressure concentration within the oral cavity, unlike in beaked whales or sperm whales. In conclusion, it is most likely that Triassic and Early Jurassic ichthyosaurs were 'ram-feeders', without any beaked-whale-like suction feeder among them. When combined with the inferred inability for dim-light vision in relevant Triassic ichthyosaurs, the fossil record of ichthyosaurs does not suggest the establishment of modern
tion (Figures 3 and 4). Water uptake was 17.9,. 8.4 and 6.3 % for CSH-9; 26.6, 18 and 15 % for ICSV-112 respectively at a matric suction of 0, 0.1 and 10 kPa. •. ; ." F"'. " :, ~ 1 t. ' . .'.' , ': ... : :Pi,s~U~sion. , ", ;'. ,:'~ T~esti;t ofge~ination was significantly deiayed by'.an i~cre~se in filter paper matric suction for all cultivars for both ...
Valizadeh, Leila; Janani, Raheleh; Janani, Leila; Galechi, Fatemeh
Background: The vital issue of protecting the airway and maintaining ventilation in preterm infants makes tracheal suctioning an important procedure. The decision to use closed or open endotracheal suction method depends on the clinical status of infants and the nurses’ skills and preferences. Objectives: The current study aimed to compare the two methods based on the perceptions of the nurses working in Neonatal Intensive Care Units (NICU). Patients and Methods: A comparative-descriptive stu...
Kung, Theodore A; Kong, Sarah W; Aliu, Oluseyi; Azizi, Jahan; Kai, Salim; Cederna, Paul S
To investigate the isolated and combined effects of vacuum suctioning and strategic drape tenting on oxygen concentration in an experimental setting. Experimental. Clinical simulation center of a university-affiliated hospital. Mannequin simulation of a patient undergoing facial surgery under sedation anesthesia. Supplemental oxygen was delivered via nasal cannula. Vacuum suctioning and strategic drape tenting. The experimental trials entailed measuring oxygen concentration around the nasal cannula continuously either in the presence or absence of a standard operating room vacuum suction system and strategic tenting of surgical drapes. The primary outcome was the time required for oxygen concentration to reach 21%. In the control group (without suction or strategic tenting), a mean time of 180 seconds elapsed until the measured oxygen concentration reached 21% after cessation of oxygen delivery. Use of a vacuum suction device alone (110 seconds; P vacuum suction device during surgery will lower local oxygen concentration, and this in turn may decrease the risk of operating room fires. Although strategic tenting of surgical drapes has a theoretical benefit to decreasing the pooling of oxygen around the surgical site, further investigation is necessary before its routine use is recommended. Copyright © 2016 Elsevier Inc. All rights reserved.
Pekkan, Kerem; Chang, Brian; Uslu, Fazil; Mani, Karthick; Chen, Chia-Yuan; Holzman, Roi
The hydrodynamics of suction feeding is critical for the survival of fish larvae; failure to capture food during the onset of autonomous feeding can rapidly lead to starvation and mortality. Fluid mechanics experiments that investigate the suction feeding of suspended particles are limited to adult fishes, which operate at large Reynolds numbers. This manuscript presents the first literature results in which the external velocity fields generated during suction feeding of early zebrafish larvae (2500-20,000 μm total length) are reported using time-resolved microscopic particle image velocimetry. For the larval stages studied, the maximum peak suction velocity of the inflow bolus is measured at a finite distance from the mouth tip and ranges from 1 to 8 mm/s. The average pressure gradient and the velocity profile proximal to the buccal (mouth) cavity are calculated, and two distinct trends are identified. External recirculation regions and reverse flow feeding cycles are also observed and quantified. One of the unresolved questions in fish suction feeding is the shape and dynamics of the buccal cavity during suction feeding; optical coherence tomography imaging is found to be useful for reconstructing the mouth kinematics. The projected area of the mouth cavity during the feeding cycle varies up to 160 and 22 % for the transverse and mid-sagittal planes, respectively. These findings can inspire novel hydrodynamically efficient biomedical and microfluidic devices.
Full Text Available Background : Stroke is one of the most common causes of disabilities and death all over the world. The mortality rate of stroke is predicted to be doubled by 2030 in the Middle East countries. Nutrition is an effective strategy in prevention and management of stroke. This study assessed the relationship between various protein types and stroke risk. Materials and Methods: This hospital-based case-control study was performed in a University hospital. The data regarding consumption of usual food intake of 69 cases (46 men and 23 women and 60 controls (30 men and 30 women was collected with a food frequency questionnaire (FFQ. The mean consumption of red and white meat and vegetable and processed proteins consumption were compared between two groups. Results: The percent of total of daily protein intake were lower in patients with stroke in both sexes (25.92% vs 30.55% in men and 30.7% vs 31.14% in women. Conclusion: Lower protein consumption may be observed in patients with stroke patients in both sex.
Venediger, Herbert J
This report discusses different types of two-stroke engines as well as the three most important design factors: volume of scavenge and charge delivery, scavenging process (scavenging result), and result of charge. Some of the types of engines discussed include: single cylinder with crank-chamber scavenge pump and auxiliary suction piston linked to working connecting rod; and two cylinder engines with a rotary scavenge pump arrangement. Three and four cylinder engines are also discussed in various designs.
Berglund, Annika; von Euler, Mia; Schenck-Gustafsson, Karin; Castrén, Maaret; Bohm, Katarina
To evaluate symptoms presented by the caller during emergency calls regarding stroke, and to assess if symptoms in the Face-Arm-Speech-Time Test (FAST) are related to identification of stroke. Emergency calls to the Emergency Medical Communication Center (EMCC) concerning patients discharged with stroke diagnosis in a large teaching hospital in Stockholm, Sweden, in January-June 2011. The emergency calls of 179 patients who arrived at hospital by ambulance, and who were discharged with a stroke diagnosis and consented to participate were included in the study. Frequencies of stroke symptoms presented and a comparison of symptoms presented in calls with dispatch code stroke or other dispatch code. Of the 179 emergency calls analysed, 64% were dispatched as 'Stroke'. FAST symptoms, that is, facial or arm weakness or speech disturbances, were presented in 64% of the calls and were spontaneously revealed in 90%. Speech disturbance was the most common problem (54%) in all calls, followed by fall/lying position (38%) and altered mental status (27%). For patients with dispatch codes other than stroke, the dominating problem presented was a fall or being in a lying position (66%), followed by speech disturbance (31%) and altered mental status (25%). Stroke-specific symptoms were more common in patients dispatched as stroke. FAST symptoms were reported in 80% of patients dispatched as stroke compared with 35% in those dispatched as something else. This study implicates that fall/lying position and altered mental status could be considered as possible symptoms of stroke during an emergency call. Checking for FAST symptoms in these patients might uncover stroke symptoms. Future studies are needed to evaluate if actively asking for FAST symptoms in emergency calls presenting falls or a lying position can improve the identification of stroke. Stroke2010/703-31/2. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence
Hoffmann, Sarah; Harms, Hendrik; Ulm, Lena; Nabavi, Darius G; Mackert, Bruno-Marcel; Schmehl, Ingo; Jungehulsing, Gerhard J; Montaner, Joan; Bustamante, Alejandro; Hermans, Marcella; Hamilton, Frank; Göhler, Jos; Malzahn, Uwe; Malsch, Carolin; Heuschmann, Peter U; Meisel, Christian; Meisel, Andreas
Stroke-associated pneumonia is a frequent complication after stroke associated with poor outcome. Dysphagia is a known risk factor for stroke-associated pneumonia but accumulating evidence suggests that stroke induces an immunodepressive state increasing susceptibility for stroke-associated pneumonia. We aimed to confirm that stroke-induced immunodepression syndrome is associated with stroke-associated pneumonia independently from dysphagia by investigating the predictive properties of monocytic HLA-DR expression as a marker of immunodepression as well as biomarkers for inflammation (interleukin-6) and infection (lipopolysaccharide-binding protein). This was a prospective, multicenter study with 11 study sites in Germany and Spain, including 486 patients with acute ischemic stroke. Daily screening for stroke-associated pneumonia, dysphagia and biomarkers was performed. Frequency of stroke-associated pneumonia was 5.2%. Dysphagia and decreased monocytic HLA-DR were independent predictors for stroke-associated pneumonia in multivariable regression analysis. Proportion of pneumonia ranged between 0.9% in the higher monocytic HLA-DR quartile (≥21,876 mAb/cell) and 8.5% in the lower quartile (≤12,369 mAb/cell). In the presence of dysphagia, proportion of pneumonia increased to 5.9% and 18.8%, respectively. Patients without dysphagia and normal monocytic HLA-DR expression had no stroke-associated pneumonia risk. We demonstrate that dysphagia and stroke-induced immunodepression syndrome are independent risk factors for stroke-associated pneumonia. Screening for immunodepression and dysphagia might be useful for identifying patients at high risk for stroke-associated pneumonia.
Truelsen, Thomas; Krarup, Lars-Henrik
This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....
Cristiani Nadya Pramasari
Full Text Available Latar belakang. Pemasangan suction cup pada gigi tiruan lengkap rahang atas merupakan salah satu cara untuk meningkatkan referensi. Kondisi vakum oleh karena suction cup ini dalam waktu jangka panjang dan tidak terkontrol mengakibatkan nekrosis jaringan yaitu adanya perforasi palatum. Tujuan. Melaporkan rekonstruksi penutupan perforasi palatum sebagai komplikasi penggunaan gigi tiruan lengkap rahang atas dengan suction cup. Laporan Kasus. Pada tanggal 11 September 2012 seorang pria berusia 64 tahun datang ke Poliklinik Bedah Mulut RSUP dr. Sardjito Yogyakarta dengan keluhan terdapat lubang pada langit-langit. Pasien menggunakan gigi palsu buatan tukang gigi dengan perekat berbahan karet pada langit-langit selama 5 tahun. Selama penggunaan gigi palsu pasien sering mengalami sakit dan pembengkakan di langit-langit sampai keluar nanah dan akhirnya terbentuk lubang sehingga jika minum air keluar dari hidung. Pemeriksaan rontgen oklusal rahang atas tampak adanya resorbsi regio palatum durum. Rekonstruksi menggunakan teknik push back modifikasi dilakukan untuk penutupan perforasi palatum di bawah anestesi umum. Kesimpulan. Suction cup pada gigi tiruan lengkap rahang atas mengakibatkan kerusakan jaringan lunak dan jaringan keras rongga mulut. Perforasi palatum yang diakibatkan oleh suction cup ini dapat dilakukan rekonstruksi dengan teknik push back dengan hasil yang cukup optimal. Background. Suction cups are used to get retention of the complete dentures. The uncontrolled constant vacuum created by the suction cup induces necrosis of tissues and perforation ofpalate. Objective. To report reconstruction for palatal perforation closure as a complication due to prolonged use of maxillary denture with suction cup. Case Report. A 64 years old male patient came to the Department of Oral Surgery, Sardjito General Hospital Yogyakarta on September 11, 2012 with the complaint of hole in his palate. He was wearing dentures for the past 5 years. He also
Watmuff, Jonathan H.
This report covers the period forming the first year of the project. The aim is to experimentally investigate the effects of suction as a technique for Laminar Flow Control. Experiments are to be performed which require substantial modifications to be made to the experimental facility. Considerable effort has been spent developing new high performance constant temperature hot-wire anemometers for general purpose use in the Fluid Mechanics Laboratory. Twenty instruments have been delivered. An important feature of the facility is that it is totally automated under computer control. Unprecedently large quantities of data can be acquired and the results examined using the visualization tools developed specifically for studying the results of numerical simulations on graphics works stations. The experiment must be run for periods of up to a month at a time since the data is collected on a point-by-point basis. Several techniques were implemented to reduce the experimental run-time by a significant factor. Extra probes have been constructed and modifications have been made to the traverse hardware and to the real-time experimental code to enable multiple probes to be used. This will reduce the experimental run-time by the appropriate factor. Hot-wire calibration drift has been a frustrating problem owing to the large range of ambient temperatures experienced in the laboratory. The solution has been to repeat the calibrations at frequent intervals. However the calibration process has consumed up to 40 percent of the run-time. A new method of correcting the drift is very nearly finalized and when implemented it will also lead to a significant reduction in the experimental run-time.
I. V. Filippov
Full Text Available In case consumers have a significant need in the compressed air, the use of turbochargers is a promising direction. The turbocharger operation is largely defined by its running conditions, namely parameters of the intake air and cooling conditions.The paper presents the results of experimental studies of turbochargers type 4CI 425MX4 of series "CENTAC" manufactured by INGERSOL-RAND, which were performed under industrial conditions in a mountainous area with difficult climatic conditions. There were, essentially, no researches of running turbochargers in mountainous areas. The combination of low atmospheric pressure, high temperature of intake air, and specific cooling conditions causes abnormal mode of turbocharger operation. The results of theoretical studies of such modes are found only in N.M. Barannikov’s work while there is no mentioned empirical research at all.Experimental studies were conducted under industrial conditions in the form of passive experiment. All measurements were carried out using a standard measuring system included in the system of compressor monitor and control. During the experimental studies temperature regimes at the turbocharger stage were controlled, and turbocharger pressure ratio and weight output were determined.The results of the research can be formulated as follows:- highland conditions and seasonal variations of atmospheric air have a negative impact on the operation of the turbochargers;- specific work value as an indicator of the economical efficiency exceeds that of the nameplate by 12...21 % depending on the climatic conditions.The problem of functioning normalization of the turbochargers seems to be relevant not only for the considered type of compressor, but also for that of the less power. It is proposed to consider two ways:- installation of the fifth additional stage;- mechanical pressurization in the suction pipe by means of blowers of high power.To make final decision it is necessary to conduct
Proton resonance frequency chemical shift thermometry: experimental design and validation toward high-resolution noninvasive temperature monitoring and in vivo experience in a nonhuman primate model of acute ischemic stroke.
Dehkharghani, S; Mao, H; Howell, L; Zhang, X; Pate, K S; Magrath, P R; Tong, F; Wei, L; Qiu, D; Fleischer, C; Oshinski, J N
Applications for noninvasive biologic temperature monitoring are widespread in biomedicine and of particular interest in the context of brain temperature regulation, where traditionally costly and invasive monitoring schemes limit their applicability in many settings. Brain thermal regulation, therefore, remains controversial, motivating the development of noninvasive approaches such as temperature-sensitive nuclear MR phenomena. The purpose of this work was to compare the utility of competing approaches to MR thermometry by using proton resonance frequency chemical shift. We tested 3 methodologies, hypothesizing the feasibility of a fast and accurate approach to chemical shift thermometry, in a phantom study at 3T. A conventional, paired approach (difference [DIFF]-1), an accelerated single-scan approach (DIFF-2), and a new, further accelerated strategy (DIFF-3) were tested. Phantom temperatures were modulated during real-time fiber optic temperature monitoring, with MR thermometry derived simultaneously from temperature-sensitive changes in the water proton chemical shift (∼0.01 ppm/°C). MR thermometry was subsequently performed in a series of in vivo nonhuman primate experiments under physiologic and ischemic conditions, testing its reproducibility and overall performance. Chemical shift thermometry demonstrated excellent agreement with phantom temperatures for all 3 approaches (DIFF-1: linear regression R(2) = 0.994; P thermometry and present in vivo applications under physiologic and ischemic conditions in a primate stroke model. © 2015 by American Journal of Neuroradiology.
Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert
Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
Schobeiri, M. T.; Ozturk, B.; Ashpis, David E.
The paper experimentally studies the effects of periodic unsteady wake flow and different Reynolds numbers on boundary layer development, separation and re-attachment along the suction surface of a low pressure turbine blade. The experimental investigations were performed on a large scale, subsonic unsteady turbine cascade research facility at Turbomachinery Performance and Flow Research Laboratory (TPFL) of Texas A&M University. The experiments were carried out at Reynolds numbers of 110,000 and 150,000 (based on suction surface length and exit velocity). One steady and two different unsteady inlet flow conditions with the corresponding passing frequencies, wake velocities, and turbulence intensities were investigated. The reduced frequencies chosen cover the operating range of LP turbines. In addition to the unsteady boundary layer measurements, surface pressure measurements were performed. The inception, onset, and the extent of the separation bubble information collected from the pressure measurements were compared with the hot wire measurements. The results presented in ensemble-averaged, and the contour plot forms help to understand the physics of the separation phenomenon under periodic unsteady wake flow and different Reynolds number. It was found that the suction surface displayed a strong separation bubble for these three different reduced frequencies. For each condition, the locations defining the separation bubble were determined carefully analyzing and examining the pressure and mean velocity profile data. The location of the boundary layer separation was dependent of the Reynolds number. It is observed that starting point of the separation bubble and the re-attachment point move further downstream by increasing Reynolds number from 110,000 to 150,000. Also, the size of the separation bubble is smaller when compared to that for Re=110,000.
Full Text Available This poem playfully addresses the slippery nature of linguistic signification, employing humour and sarcasm in presenting a wide range of human experience. It ironical twists -- and "strokes" (read ambiguously as both a giving a punishment and erotic pleasuring -- move from the naming of location through international discourse of capital to the crumbling relationships between nation states. It reading of the signs of language is tied to the unease and fracture in cultural and political experience.
Bentes, Carla; Martins, Hugo; Peralta, Ana Rita; Casimiro, Carlos; Morgado, Carlos; Franco, Ana Catarina; Fonseca, Ana Catarina; Geraldes, Ruth; Canhão, Patrícia; Pinho E Melo, Teresa; Paiva, Teresa; Ferro, José M
Cerebrovascular disease is the leading cause of epilepsy in adults, although post-stroke seizures reported frequency is variable and few studies used EEG in their identification. To describe and compare EEG and clinical epileptic manifestations frequency in patients with an anterior circulation ischaemic stroke. Prospective study of acute anterior circulation ischaemic stroke patients, consecutively admitted to a Stroke Unit over 24 months and followed-up for 1 year. All patients underwent standardized clinical and diagnostic assessment. Seizure occurrence was clinically evaluated during hospitalization and by a telephone interview at 6 months and a clinical appointment at 12 months after stroke. Video-EEG was performed in the first 72 h (1st EEG), daily after the 1st EEG for the first 7 days after the stroke, or later if neurological worsening, at discharge, and at 12 months. 151 patients were included (112 men) with a mean age of 67.4 (11.9) years. In the 1st year after stroke, 38 patients (25.2%) had an epileptic seizure. During hospitalization, 27 patients (17.9%) had epileptiform activity (interictal or ictal) in the EEG, 7 (25.9%) of them electrographic seizures. During the first week after stroke, 22 (14.6%) patients had a seizure and 4 (2.6%) non-convulsive status epilepticus criteria. Five (22.7%) acute symptomatic seizures were exclusively electrographic. At least one remote symptomatic seizure occurred in 23 (16%) patients. In the first 7 days after stroke, more than one-fifth of patients with seizures had exclusively electrographic seizures. Without a systematic neurophysiological evaluation the frequency of post-stroke seizures are clinically underestimated.
Khatar, Mahnaz; Mohammadi, Mohammad Hossein; Shekari, Farid
The effect of soil matric suction (2-33 kPa) and salinity (soil solution electrical conductivity 0.7-8 dS m-1 for bean and 2-20 dS m-1 for wheat) on some physiological characteristics of bean and wheat in a clay loam soil under greenhouse condition was investigated. The results showed that the leaf chlorophyll content index and potassium concentration decrease under salinity stress and increase with matric suction from 2 to 33 kPa suction for both plants. The wheat chlorophyll content index declines during the stress spell but bean chlorophyll content index remains nearly constant. The lowest values of the content of soluble sugars and the highest values of leaf proline content are observed at2 kPa matric suction (highest aeration stress) for bean and wheat. As matric suction increases from 2 to 6 kPa, the soluble sugars increases and proline content decreases significantly and then soluble sugars decreases and proline content increases until 10 kPa suction, and the soluble sugars remains nearly constant at the higher matric suctions for both plants. While the electrical conductivity effect on the soluble sugars is not significant, the values of proline content for both crop increase significantly with electrical conductivity. It was shown that the aeration stress can result in more considerable and rapid physiological responses, in comparison with salinity stress. There is a strong correlation between wheat and bean chlorophyll content index and potassium concentration under salinity and aeration stresses.
... die within minutes. Strokes happen more in some populations and geographic areas. Stroke death declines have stalled in 3 out of every 4 states. Blacks have the highest stroke death rates among all ...
... Issue Past Issues Special Section Two Kinds of Stroke Past Issues / Summer 2007 Table of Contents For ... are often a warning sign for future strokes. Stroke Can Affect Anyone Award-winning actress Julie Harris ...
... Stories Stroke Heroes Among Us Healthy Living After Stroke Nutrition Good nutrition is one way to reduce ... the hospital. Thank goodness, she did. Subscribe to Stroke Connection Get quarterly digital issues plus our monthly ...
Stroke is an acute, neurological dysfunction of vascular origin with sudden occurrence and it influences physical, cognitive and psychological functions. Initial treatment aims at eliminating or reducing the brain damage. Soon, however, the influence of the stroke on the entire life of stroke survivors has to be considered. This thesis explores the meaning of life after stroke to 19 elderly stroke survivors during the first year post stroke. Survivors were interviewed twice and the interviews...
... Simple Techniques Can Help Memory after a Stroke Self-Esteem after Stroke Cognitive Challenges After Stroke Depression Trumps ... spasticity), fatigue and more. Let's Talk About Stroke Fact Sheets Our stroke fact sheets cover treatments, recovery, ...
Chen, Xiao-Bing; Wang, You-Xin; Jiang, Hua; Liao, Dai-Xiang; Yu, Jun-Hui; Luo, Cheng-Hua
To evaluate the efficacy of gracilis muscle transposition and postoperative salvage irrigation-suction in the treatment of complex rectovaginal fistulas (RVFs) and rectourethral fistulas (RUFs). Between May 2009 and March 2012, 11 female patients with complex RVFs and 8 male patients with RUFs were prospectively enrolled. Gracilis muscle transposition was undertaken in all patients and postoperative wound irrigation-suction was performed in patients with early leakage. Efficacy was assessed in terms of the success rate and surgical complications. SF-36 quality of life (QOL) scores and Wexner fecal incontinence scores were compared before and after surgery. The fistulas healed in 14 patients after gracilis muscle transposition; the initial healing rate was 73.7%. Postoperative leakage occurred and continuous irrigation-suction of wounds was undertaken in 5 patients: 4 healed and 1 failed, and postoperative fecal diversions were performed for the patient whose treatment failed. At a median follow-up of 17 mo, the overall healing rate was 94.7%. Postoperative complications occurred in 4 cases. Significant improvement was observed in the quality outcomes framework scores (P irrigation-suction-assisted healing group. Gracilis muscle transposition and postoperative salvage wound irrigation-suction gained a high success rate in the treatment of complex RVFs and RUFs. QOL and fecal incontinence were significantly improved after the successful healing of RVFs and RUFs.
Taylor, A. H.; Jackson, L. R.; Huffman, J. K.
An experimental investigation was conducted in the Langley high-speed 7- by 10-foot wind tunnel to determine the aerodynamic performance of suction applied near the wing tips above the trailing edge of a 60 deg swept Gothic wing. Moveable suction inlets were symmetrically mounted in the proximity of the trailing edge, and the amount of suction was varied to maximize wing lift. Tests were conducted at Mach 0.15, 0.30, and 0.45, and the angle of attack was varied from -4 to 50 deg. The suction augmentation increases the lift coefficient over the entire range of angle of attack. The lift improvement exceeds the unaugmented wing lift by over 20%. Moreover, the augmented lift exceeds the lift predicted by vortex lattice theory to 30 deg angle of attack. Suction augmentation is postulated to strengthen the vortex system by increasing its velocity and making it more concentrated. This causes the vortex breakdown to be delayed to a higher angle of attack
Full Text Available Wall climbing robots using negative pressure suction always employ air pumps which have great noise and large volume. Two prototypes of bio-inspired miniature suction cup actuated by shape memory alloy (SMA are designed based on studying characteristics of biologic suction apparatuses, and the suction cups in this paper can be used as adhesion mechanisms for miniature wall climbing robots without air pumps. The first prototype with a two-way shape memory effect (TWSME extension TiNi spring imitates the piston structure of the stalked sucker; the second one actuated by a one way SMA actuator with a bias has a basic structure of stiff margin, guiding element, leader and elastic element. Analytical model of the second prototype is founded considering the constitutive model of the SMA actuator, the deflection of the thin elastic plate under compound load and the thermo-dynamic model of the sealed air cavity. Experiments are done to test their suction characteristics, and the analytical model of the second prototype is simulated on Matlab/simulink platform and validated by experiments.
Lehmkuhl, Jan, E-mail: firstname.lastname@example.org [RWTH Aachen University, Aachen (Germany); Kelm, Stephan, E-mail: email@example.com [Forschungszentrum Jülich GmbH, Jülich (Germany); Bucci, Matteo [Commissariat à l’énergie atomique et aux énergies alternatives, Paris (France); Allelein, Hans-Josef [RWTH Aachen University, Aachen (Germany); Forschungszentrum Jülich GmbH, Jülich (Germany)
Highlights: • Assessment of wall functions for single phase condensation models for large scale application. • Identification of modeling errors related to standard log-law due to buoyancy and wall normal mass transfer (suction). • Modeling of wall normal mass transfer by literature formulation (Sucec, 1999) and in-house approach (FIBULA). • Validation against isothermal Favre experimental data. • Comparison against reference fine grid solution for condensing conditions. - Abstract: To simulate wall condensation on containment scale with CFD methods at reasonable computational cost, a single phase approach has to be applied and wall functions have to be used. However, standard wall functions were derived for flows without heat and mass transfer and their fundamental simplifications are not appropriate to deal with condensation. This paper discusses the limitations of standard wall functions and proposes two wall functions for the momentum equation dealing with mass transfer normal to the sheared wall (suction). The first proposed suction wall function is an algebraic modification based on the standard wall function concept. The second proposed wall function is an in-house developed suction wall function with the potential to cover also heat and mass transfer effects by storing the complex solutions of the RANS-Equations in a lookup table. The wall function approaches are compared to experimental results for boundary layer flows with suction and to the reference results obtained using a refined grid in order to resolve the condensing boundary layer.
Pragnya S. Kanade
Full Text Available Wound filters are quite popular in the domestic water purification systems. The performance of these filters is based on the distinctive yarn and winding variables. Yarn used for filtration application is normally produced on DREF spinning system. Several researchers have reported the influence of DREF spinning variables on yarn properties. However none of them are in context of filtration application. Since elucidation of influence of winding parameters on the filter performance has already been reported; it thus becomes intriguing to explore the influence of spinning suction pressure on filtration behavior. Yarn spun at different suction pressures was used to produce wound filter cartridges, keeping winding variables unchanged. Filters wound using yarn spun at higher spinning suction pressure resulted in greater pressure drop but showed better micron rating. However the pressure drop encountered also affects the retention capacity of the wound filter. The outcome of this study helps in establishing the relation between spinning suction pressure and performance parameters of wound filters. Design expert® software was used to develop regression equations to predict performance of wound filter for the given spinning suction pressure which is of practical significance for yarn and filter manufacturers, without performing filter test.
Sant, K D; Bapat, S L
Amongst the mechanical cryocoolers in use, Stirling cycle cryocoolers exhibit the desirable features such as high efficiency, low specific power consumption, small size and mass and large mean time before failure. Stirling cycle cryocooler of Alpha configuration exhibits better theoretical performance as compared to Gamma. However, the theory could not be put into practice due to unavailability of compatible drive mechanism for Alpha cryocooler providing large stroke to diameter ratio. The concept of novel compact drive mechanism can be made functional to operate miniature Alpha Stirling cryocoolers. It allows the use of multicylinder system while converting rotary motion to reciprocating. This permits the drive mechanism to be employed for driving different configurations of Stirling cryocooler simultaneously. This drive is capable of providing large stroke to diameter ratio compared to other drive mechanisms generally in use for the purpose. A stroke to diameter ratio of three is chosen in the present work and the drive dimensions are calculated for four piston-cylinder arrangements with 90° phase difference between adjacent arrangements providing two Alpha Stirling cryocoolers working simultaneously. It has to be noted that the coolers operate at half the frequency of the motor used. As the two coolers operate at phase difference of 180°, during compression stroke of one unit, the suction stroke occurs for the other unit. Due to power output of second unit, the combined peak torque requirement falls by 26.81% below the peak torque needed when one unit is operated separately. This allows for use of a comparatively lower torque motor. The practicability of the drive ensuring smooth operation of the system is decided based on comparison between torque availability from the motor and torque requirement of the complete unit.The second order method of cyclic (or thermodynamic) analysis provides a simple computational procedure useful for the design of Stirling
Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.
Luger, Sebastian; Hohmann, Carina; Kraft, Peter; Halmer, Ramona; Gunreben, Ignaz; Neumann-Haefelin, Tobias; Kleinschnitz, Christoph; Walter, Silke; Haripyan, Veronika; Steinmetz, Helmuth; Foerch, Christian; Pfeilschifter, Waltraud
Direct oral anticoagulants (DOAC) are alternatives to the use of vitamin K antagonists (VKA) as oral anticoagulant therapies to prevent stroke in patients with atrial fibrillation. We assembled a representative secondary prevention cohort from four tertiary care stroke centers to identify factors that independently influence therapeutic decision making 1) not to anticoagulate with either VKA or DOAC and 2) to use DOAC if the patient appears suitable for oral anticoagulant therapy. We identified all patients discharged with the diagnoses 'ischemic stroke' (ICD-10 code I63) or 'transient ischemic attack' (G45) in combination with 'atrial fibrillation' (I48) during 1 year. We performed binary logistic regression analyses to identify factors independently influencing the aforementioned decisions. Our cohort comprised 758 patients. At discharge from the stroke service, 374 patients (49·3%) received oral anticoagulant therapy. Older age, severe stroke, poor recovery in the acute phase, and higher serum creatinine were independent factors to withhold oral anticoagulant therapy, whereas prior oral anticoagulant therapy favored the decision to anticoagulate. Among patients who were anticoagulated, prescription was balanced for VKA (50·3%) and DOAC (49·7%). Renal function and prior oral anticoagulant therapies were the most important factors in this decision. Shortly after their marketing, DOAC are used as frequently as VKA for secondary stroke prevention in patients with atrial fibrillation. The decision between VKA and DOAC is mainly determined by the patient's renal function and the absence or presence of prior oral anticoagulant therapy. © 2014 World Stroke Organization.
Auditing the frequency and the clinical and economic impact of testing for Fabry disease in patients under the age of 70 with a stroke admitted to Saint Vincent's University Hospital over a 6-month period.
Lambe, J; Noone, I; Lonergan, R; Tubridy, N
Fabry disease is an X-linked recessive lysosomal storage disorder that provokes multi-organ morbidity, including early-onset stroke. Worldwide prevalence may be greater than previously estimated, with many experiencing first stroke prior to diagnosis of Fabry disease. The aim of this study is to screen a cohort of stroke patients under 70 years of age, evaluating the clinical and economic efficacy of such a broad screening programme for Fabry disease. All stroke patients under 70 years of age who were entered into the Saint Vincent's University Hospital stroke database over a 6-month period underwent enzyme analysis and/or genetic testing as appropriate for Fabry disease. Patients' past medical histories were analysed for clinical signs suggestive of Fabry disease. Cost-effectiveness analysis of testing was performed and compared to overall economic impact of young stroke in Ireland. Of 22 patients tested for Fabry disease, no new cases were detected. Few clinical indicators of Fabry disease were identified at the time of testing. Broad screening programmes for Fabry disease are highly unlikely to offset the cost of testing. The efficacy of future screening programmes will depend on careful selection of an appropriate patient cohort of young stroke patients with multi-organ morbidity and a positive family history.
Trivedi, Megh M; Ryan, Kathleen A; Cole, John W
Prior studies indicate that young African-Americans (AA) have a greater frequency of ischemic stroke than similarly aged European-Americans (EA). We hypothesized that differences in stroke subtype frequency mediated through sex and differing risk factor profiles may play a role in ethnicity-specific stroke. Utilizing our biracial young-onset stroke population, we explored these relationships. Fifty nine hospitals in the Baltimore-Washington area participated in a population-based study of young-onset stroke in men (218-AA, 291-EA) and women (219-AA, 222-EA) aged 16-49. Data on age, sex, ethnicity and stroke risk factors (hypertension (HTN) and smoking) were gathered through standardized interview. A pair of vascular neurologists adjudicated each case to determine TOAST subtype. Logistic regression analyses evaluating for differences in stroke risk factors by TOAST subtype were performed. Analyses controlling for age and sex demonstrated that AA were more likely to have a lacunar stroke than EA (OR = 1.61; 95% CI = 1.12-2.32; p = 0.011) when utilizing the other TOAST subtypes as the reference group. This effect was mediated by HTN, which increases the risk of lacunar stroke (OR = 2.03; 95% CI = 1.38-2.98; p = 0.0003) and large artery stroke (OR = 1.70; 95% CI = 1.01-2.88; p = 0.048) when controlling for sex, ethnicity, and age. Cases below age 40 were more likely to have a cardioembolic stroke than those above age 40 (OR = 1.62; 95% CI = 1.15-2.27; p = 0.006), controlling for sex and ethnicity. Lastly, current smokers were more likely to have a large artery stroke than non-smokers (OR = 1.79; 95% CI = 1.08-2.98; p = 0.024). Our population-based data demonstrate ethnic differences in ischemic stroke subtypes. These findings may help clarify mechanisms of stroke in young adults which may in part be driven by ethnic-specific differences in early-onset traditional risk factors, thereby indicating differing emphasis on workup and prevention.
...The Food and Drug Administration (FDA) is classifying the non- powered suction apparatus device intended for negative pressure wound therapy (NPWT) into class II (special controls). The special control that will apply to the device is the guidance document entitled ``Class II Special Controls Guidance Document: Non-Powered Suction Apparatus Device Intended for Negative Pressure Wound Therapy.'' The agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is publishing a notice of availability for the guidance document entitled ``Class II Special Controls Guidance Document: Non-Powered Suction Apparatus Device Intended for Negative Pressure Wound Therapy.''
Inagaki, K; Funaki, J; Hirata, K
In order to get accurate measurements of air entrainment in a suction sump, we design some new simple bubble sensors, which can detect the existence of air bubbles inside a suction pipe with no disturbances by the sensors and with a fine spatial resolution. We force on an intermittency factor γ, that is, an occurrence-time ratio of the air entrainment, and compare the result by the present sensor with those by conventional two methods; namely, visual and auditory ones. As a result, we show the criteria which specify lower-accuracy conditions in the conventional methods. By the visual method, the accuracy of the γ becomes low, when γ is less than 0.05. By the auditory method, the accuracy of γ becomes low, when the submergence depth S of the suction pipe is close to the critical one S c .
Proton Resonance Frequency Chemical Shift Thermometry: Experimental Design and Validation Towards High-Resolution Non-Invasive Temperature Monitoring, and in vivo Experience in a Non-human Primate Model of Acute Ischemic Stroke
Dehkharghani, Seena; Mao, Hui; Howell, Leonard; Zhang, Xiaodong; Pate, K S; Magrath, P R; Tong, Frank; Wei, L; Qiu, D; Fleischer, C; Oshinski, J N
BACKGROUND AND PURPOSE Applications for non-invasive biological temperature monitoring are widespread in biomedicine, and of particular interest in the context of brain temperature regulation, where traditionally costly and invasive monitoring schemes limit their applicability in many settings. Brain thermal regulation therefore remains controversial, motivating the development of non-invasive approaches such as temperature-sensitive NMR phenomena. The purpose of this work was to compare the utility of competing approaches to MR thermometry (MRT) employing proton resonance frequency chemical shift. Three methodologies were tested, hypothesizing the feasibility of a fast and accurate approach to chemical shift thermometry, in a phantom study at 3.0 Tesla. MATERIALS AND METHODS A conventional, paired approach (DIFF-1), an accelerated single-scan approach (DIFF-2), and a new, further accelerated strategy (DIFF-3) were tested. Phantom temperatures were modulated during real-time fiber optic temperature monitoring, with MRT derived simultaneously from temperature-sensitive changes in the water proton chemical shift (~0.01 ppm/°C). MRT was subsequently performed in a series of in vivo non-human primate experiments under physiologic and ischemic conditions testing its reproducibility and overall performance. RESULTS Chemical shift thermometry demonstrated excellent agreement with phantom temperatures for all three approaches (DIFF-1 linear regression R2=0.994, p<0.001, acquisition time 4 min 40 s; DIFF-2 R2=0.996, p<0.001, acquisition time 4 min; DIFF-3 R2=0.998, p<0.001, acquisition time 40 s). CONCLUSION These findings confirm the comparability in performance of three competing approaches MRT, and present in vivo applications under physiologic and ischemic conditions in a primate stroke model. PMID:25655874
Kammersgaard, L P; Jørgensen, H S; Nakayama, H
Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...
First aid Stroke: First aid Stroke: First aid By Mayo Clinic Staff A stroke occurs when there's bleeding into your brain or when blood flow to your ... cells start dying. Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is ...
Ana María Nápoles Quintero; Omaida Borroto Abal; Nora Sexto Delgado; Anay Valladares González; Raúl López Fernández; Lourdes Martínez Casanova
Bakground: Digital suction is a pernicious habit that can produce not only alterations of dental-facial's structures, but also of child's social relationships and its self-esteem. Objective: To evaluate the existent relationship between finger suction habit in children and family functionality. Method: An analytic study of cases and controls was carried out, in girls and boys of 5th and 6th levels in 8 day-care centres belonging to Area II of Cienfuegos municipality during the course 2005-200...
R. A. Hamid
Full Text Available This paper considers the extended problem of the thermosolutal Marangoni forced convection boundary layer by Pop et al. (2001 when the wall is permeable, namely, there is a suction or injection effect. The governing system of partial differential equations is transformed into a system of ordinary differential equations, and the transformed equations are solved numerically using the shooting method. The effects of suction or injection parameter f0 on the velocity, temperature, and concentration profiles are illustrated and presented in tables and figures. It is shown that dual solutions exist for the similarity parameter β less than 0.5.
Hamid Reza Hemmati
Results: No adverse event including hematoma, seroma or wound infection occurred in either group with or without closed suction drainage in the first 10 days after surgery. Only one patient carried wound infection during days 10 to 15 following operation who was in the group with closed drainage (P=1.00. Conclusion: In this study, Seroma and hematoma was not observed in patients with and without closed suction drainage. To avoid drains' complications, indiscriminate use of antibiotics, prolonged hospital stay, we do not recommend the use of drains in this type of surgery.
Full Text Available OBJECTIVE: To evaluate whether external suction is more advantageous than water seal in patients undergoing selective pulmonary resection (SPR for lung neoplasm. SUMMARY OF BACKGROUND DATA: Whether external suction should be routinely applied in postoperative chest drainage is still unclear, particularly for lung neoplasm patients. To most surgeons, the decision is based on their clinical experience. METHODS: Randomized control trials were selected. The participants were patients undergoing SPR with lung neoplasm. Lung volume reduction surgery and pneumothorax were excluded. Suction versus non-suction for the intervention. The primary outcome was the incidence of persistent air leak (PAL. The definition of PAL was air leak for more than 3-7 days. The secondary outcomes included air leak duration, time of drainage, postoperative hospital stay and the incidence of postoperative pneumothorax. Studies were identified from literature collections through screening. Bias was analyzed and meta-analysis was used. RESULTS: From the 1824 potentially relevant trials, 6 randomized control trials involving 676 patients were included. There was no difference between external suction and water seal in decreasing the incidence of PAL [95% confidence interval (CI 0.81-2.16; z = 1.10; P = 0.27]. Regarding secondary outcomes, there were no differences in time of drainage (95% CI-0.36-1.56, P = 0.22, postoperative hospital stay (95% CI -.31-.54, P = 0.87 or incidence of postoperative pneumothorax (95% CI 0.18-.02, P = 0.05 between external suction and water seal. CONCLUSIONS: For participants, no differences are identified in terms of PAL incidence, drainage time, length of postoperative hospital stay or incidence of postoperative pneumothorax between external suction and water seal. The bias analysis should be emphasized. To the limitations of the bias and methodological differences among the included studies, we have no recommendation on
de Rezende, Rebeca Maffra; Luz, Flávio Barbosa
Suction curettage is a dermatologic surgery technique for the treatment of axillary hyperhidrosis, which is becoming more popular. Objective: The purpose of this study is to describe the current technique of removal of axillary sweat glands, and evaluate its efficacy and safety. Conclusion: Suction-curettage of sweat glands is a minimally invasive surgical technique that is easy to perform, safe, has high rates of success and relatively few side-effects. It is generally well tolerated by patients and requires shorter time away from daily activities, when compared with other surgical modalities. PMID:25387499
Sørensen, Emil Smed; Clausen, Johan Christian; Damkilde, Lars
The tensile resistance of a suction bucket is investigated using three different numerical formulations. The first formulation utilizes the three-field u-p-U formulation accounting for solid and fluid displacements, u and U, as well as the pore-fluid pressure, p. The two other formulations comprise...... the simpler u-p formulation in its dynamic and quasi-static form, accounting only for solid displacement and pore-fluid pressure. As basis for comparison, the tensile resistance of a single suction bucket is investigated using a velocity-driven model for a wide range of velocities. It is found, that the quasi...
Manzotti, E.; Vaitkunaite, Evelina; Ibsen, Lars Bo
on the structure is resisted by push-pull loads on the vertical axis of each suction caisson. Relevant works where this situation is examined by means of laboratory testing are summarized in this article, then different conclusions are followed by discussion and comparison. In the initial theoretical section......, an overview of phenomena related with the case of study is presented. Drained and undrained condition, liquefaction and suction are examined from the theoretical point of view for mechanisms related to the case of study....
Madsen, Søren; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo
Using large suction caissons for offshore wind turbines is an upcoming technology also referred to as bucket foundations. During operation the bucket foundation is loaded by a large overturning moment from the wind turbine and the wave loads. However, during installation the bucket is loaded...... cylindrical monopod foundation made of steel. In this paper, an alternative design/shape of the suction caisson, having a smaller risk of buckling under high pressure is presented. The risk of structural buckling is addressed using numerical methods to determine the buckling pressures of the re...
Full Text Available Cerebrovascular diseases which called as stroke causes severe mortality and morbidity. Stoke is the third cause of death and first cause of the sequela among in its disorder group. Stroke with a 80-85% has the most frequency and the most cause of death in among the neurological disorders. Besides its lethal effects, sequela of stroke also cause physiological problems on individuals, families and social groups, it also brings some economic problems. [Archives Medical Review Journal 2010; 19(2.000: 85-140
... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... after a Stroke Adapting the Home after a Stroke Caregiver Introduction What is Aphasia? Stroke Recovery Guides ...
Woods, Katharine S; Defarges, Alice M N; Abrams-Ogg, Anthony C G; Dobson, Howard; Viel, Laurent; Brisson, Brigitte A; Bienzle, Dorothee
To compare the diagnostic quality of bronchoalveolar lavage (BAL) fluid acquired from healthy dogs by manual aspiration via polyethylene tubing (MAPT) and via suction pump aspiration (SPA) with a suction trap connection. 12 healthy adult Beagles. BAL was performed with bronchoscopic guidance in anesthetized dogs. The MAPT was performed with a 35-mL syringe attached to polyethylene tubing wedged in a bronchus via the bronchoscope's biopsy channel. The SPA was performed with 5 kPa of negative pressure applied to the bronchoscope's suction valve via a suction trap. The MAPT and SPA techniques were performed in randomized order on opposite caudal lung lobes of each dog. Two 1 mL/kg lavages were performed per site. Samples of BAL fluid were analyzed on the basis of a semiquantitative quality scale, percentage of retrieved fluid, and total nucleated and differential cell counts. Results were compared with Wilcoxon signed rank tests. Percentage of BAL fluid retrieved (median difference, 16.2%), surfactant score (median difference, 1), and neutrophil count (median difference, 74 cells/μL) were significantly higher for SPA than for MAPT. A higher BAL fluid epithelial cell score was obtained via MAPT, compared with that for samples obtained via SPA (median difference, 1). Results indicated that in healthy dogs, SPA provided a higher percentage of BAL fluid retrieval than did MAPT. The SPA technique may improve the rate of diagnostic success for BAL in dogs, compared with that for MAPT. Further evaluation of these aspiration techniques in dogs with respiratory tract disease is required.
Full Text Available Background. Previous studies have suggested that black populations have more small-vessel and fewer cardioembolic strokes. We sought to analyze racial differences in ischemic stroke subtype employing a comprehensive diagnostic workup with magnetic resonance-imaging-(MRI- based evaluation including diffusion-weighted imaging (DWI. Methods. 350 acute ischemic stroke patients admitted to an urban hospital with standardized comprehensive diagnostic evaluations were retrospectively analyzed. Ischemic stroke subtype was determined by three Trial of Org 10172 in Acute Stroke Treatment (TOAST classification systems. Results. We found similar proportions of cardioembolic and lacunar strokes in the black and white cohort. The only subtype category with a significant difference by race was “stroke of other etiology,” more common in whites. Black stroke patients were more likely to have an incomplete evaluation, but this did not reach significance. Conclusions. We found similar proportions by race of cardioembolic and lacunar strokes when employing a full diagnostic evaluation including DWI MRI. The relatively high rate of cardioembolism may have been underappreciated in black stroke patients when employing a CT approach to stroke subtype diagnosis. Further research is required to better understand the racial differences in frequency of “stroke of other etiology” and explore disparities in the extent of diagnostic evaluations.
Full Text Available The transient analysis was carried out to investigate the dynamic stress and vibration of volute casing for a large double-suction centrifugal pump by using the transient fluid-structure interaction theory. The flow pulsations at flow rate ranging from 60% to 100% of the nominal flow rate (Qd were taken as the boundary conditions for FEM analysis of the pump volute casing structure. The results revealed that, for all operating conditions, the maximum stress located at the volute tongue region, whereas the maximum vibration displacement happened close to the shaft hole region. It was also found that the blade passing frequency and its harmonics were dominant in the variations of dynamic stress and vibration displacement. The amplitude of the dominant frequency for the maximum stress detected at 0.6 Qd was 1.14 times that at Qd, lower than the related difference observed for pressure fluctuations (3.23 times. This study provides an effective method to quantify the flow-induced structural dynamic characteristics for a large-scale double-suction pump. It can be used to direct the hydraulic and structural design and stable operation, as well as fatigue life prediction for large-scale pumps.
Adverse Effects ................................................................................................................................. 33...hospital suctioning of primarily mechanically ventilated patients. There were no high-quality reports focusing on prehospital or emergency care in the...the adverse effects of suction and related safety concerns. There are no randomized controlled trials or other high-quality evidence that addresses
Salih, Mustafa A.; Al-Jarallah, Ahmed A.; Kentab, Anal Y.; Al-Nasser, Mohammad N.; Bahakim, Hassan M.; Kurban, Khadija M.; Zahraa, Jihad N.; Nasir, Ali A.; Abdel-Gader, Abdel-Galil M.; Alorainy, Ibrahim A.; Hassan, Hamdy H.; Kabiraj, Mohammad M.; Khoja, Waleed A.
To describe the epidemiology and clinical features of stroke in a prospective and retrospective cohort of Saudi children and ascertain the causes, pathogenesis, and risk factors. The Retrospective Study Group (RSG) included children with stroke who were evaluated at the Division of Pediatric Neurology, or admitted to King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the period July 1992 to February 2001. The Prospective Study Group (PSG) included those seen between February 2001 and March 2003. During the combined study periods of 10 years and 7 months, 117 children (61 males and 56 females, aged one month-12 years) were evaluated; the majority (89%) of these were Saudis. The calculated annual hospital frequency rate of stroke was 27.1/100,000 of the pediatric (1month-12 years) population The mean age at onset of the initial stroke in the 104 Saudi children was 27.1 months (SD=39.3 months) median and median was 6 months. Ischemic strokes accounted for the majority of cases (76%). Large-vessel infarcts (LVI, 51.9%) were more common than small-vessel lacunar lesions (SVLL, 19.2%). Five patients (4.8%) had combined LVI and SVLL. Intracranial hemorrhage was less common (18.2%), whereas sinovenous thrombosis was diagnosed in 6 (5.8%) patients. A major risk factor was identified in 94 of 104 (89.4%) Saudi children. Significantly more hematologic disorders and coagulopathies were identified in the PSG compared to the RSG (p=0.001), reflecting a better yield following introduction of more comprehensive hematologic and cogulation laboratory tests during the prospective study period. Hematologic disorders were the most common risk factor (46.2%); presumed perinatal ischemic cerebral injury was risk factor in 23 children (22.1) and infectious and inflammatory disorders of the circulatory system in 18 (17.3%). Congenital and genetic cerebrovascular anomalies were the underlying cause in 7 patients (6.7%) and
Hemorrhagic stroke in children occurs more frequently than is commonly appreciated. There are important differences in the factors associated with hemorrhagic stroke in children when compared with adults. These differences likely play a role in the different outcomes, which tend to worsen with age. In this review, we describe the estimated frequency, clinical presentation, acute management of hemorrhagic stroke, and an overview of rehabilitation techniques. We identify key topics for future b...
Pasic, Zejneba; Smajlovic, Dzevdet; Dostovic, Zikrija; Kojic, Biljana; Selmanovic, Senada
Sleep disorders (SD) after stroke (stroke) are common occurrences, and most often in sleep apnea, insomnia and daytime sleepiness. GOALS. Research goals were to determine the types of SD and their frequency in patients with stroke in relation to the type of stroke and side of lesion. The study analyzed 200 patients with acute stroke hospitalized in the Clinic of Neurology, University Clinical Centre Tuzla in the period from 1st August 2007 to 1st June 2008. All patients have confirmed the existence of stroke by computerized tomography. SD was verified according to the General Curriculum of sleep, the Berlin questionnaire and Epvort scale. Stroke, by type, were divided into hemorrhagic and ischemic, and the localization of the stroke to right and left cerebral hemispheres. Of the total number of respondents, 78% had SD. Very serious level of SD had 42% of respondents, 20% moderate, and 16% of medium-severe degree. There was no statistically significant differences in the frequency of SD among patients with ischemic and hemorrhagic stroke (76.8%: 82.5%, p = 0.58). In relation to the side of lesion there was more patient with SD and stroke in the right cerebral hemisphere, but there were no statistically significant differences (39.5%: 33%, p = 0.1). According Epvort scale sleep apnea and snoring was present in 86%, daytime sleepiness in 49.5% and narcolepsy 0.5%. Sleep disturbance as a neuropsychological disorder has a significant incidence in the acute phase of stroke. SD is slightly more common in hemorrhagic stroke and stroke in the right hemisphere. Sleep Apnea and snoring are the most common types of SD in patients with stroke.
Transient bacteremia is induced by adenoidectomy when the integrity of the nasopharyngeal membrane is broken. The aim of this study was to determine the incidence of bacteremia in patients undergoing adenoidectomy, to identify the causative organisms, and to compare the incidences of bacteremia between the two techniques suction diathermy and curettage.
Wolf, Karen McKinney; Roach, Antionette Andolfatto
The handbook presents California guidelines for training school personnel to provide skilled nursing procedures such as tracheostomy suctioning and misting for students with special health needs. The workbook begins with an overview of the anatomy and function of the respiratory system, specifically breathing mechanics. Part 2 considers the…
Axillary hyperhidrosis is a common and most distressing problem, which can be addressed by a variety of treatment modalities. To assess the value of tumescent suction curettage in the treatment of axillary hyperhidrosis. 63 patients (39 female, 25 male; mean age 30.3 +/- 7.6 years) with axillary hyperhidrosis were enrolled in the study. All patients were treated in an outpatient setting with tumescent suction curettage of the axillary cavity, using two entry sites. The results were evaluated with the iodine-starch test after 4 weeks and after 6 months. Two years after the procedure, patient satisfaction was evaluated as 'satisfied', 'partially satisfied' or 'dissatisfied'. None of the patients had early postoperative complications of infection or seroma. All patients had a marked reduction of hyperhidrosis after 4 weeks, confirmed by the iodine-starch test. After 6 months, 15 patients had high sweat rates and asked for repeat surgery. Two years after the procedure, 49 patients were satisfied, 11 patients were partially satisfied and 3 patients were dissatisfied. Tumescent suction curettage is a safe and effective treatment of axillary hyperhidrosis resulting in a high level of patient satisfaction. Some patients will need repeat surgery. Suction curettage, however, should not be used as the first line of treatment in axillary hyperhidrosis.
Full Text Available The effect of the pore fluid compressibility on liquefaction has been studied by various authors. But few papers have been published about the role of suction in cyclic behavior of unsaturated soils. Most of these works use Skempton coefficient B as a reference in terms of saturation degree to analyze their results. The use of B in experimental conditions is convenient, but is not accurate when studying liquefaction behavior, since effects of suction are neglected. In this paper, the influence of saturation degree on mechanical behavior of a soil under dynamic loads is studied. Cyclic undrained triaxial tests were performed on sand samples, under various levels of saturation. Soil-water characteristic curve was used, in order to study influence of suction. The first results confirm that when the degree of saturation decreases, the resistance increases. Initial positive suction tends to stiffen the soil. It also appears that the presence of air delays the occurrence of liquefaction, but doesn’t prevent it. Indeed, liquefaction is observed, whether the soil is saturated or not.
Meng, G; Tan, L; Cao, S L; Jian, W; Liu, W W; Jiang, D J
Cavitation is an unsteady phenomenon, which is nearly inevitable in pumps. It would degrade the pump performance, generate vibrations and noises, and even erode pump flow passage components. The double suction centrifugal pump at design flow rate and large flow rate is numerically simulated using the k-ω turbulence model and the mass transport cavitation model. As a result, the calculated variation of pump head with pump inlet pressure agreed well with the experimental data. The results demonstrate that the numerical model and method can accurately predict the cavitation flows in a double suction centrifugal pump. The cavitation characteristics are analysed in great details. In addition, based on the calculation results, the reason that the plunge of pump head curve is revealed. It is found that the steep fall of pump head happens when the cavity reaches the blade to blade throat and the micro-vortex group appears at the back of the blade suction side. At the same time, this practice can provide guidance for the optimal design of double suction pumps
Sun, Jun; Li, Chun-jie; Li, Bo; Gao, Qing-hong; Men, Yi; Li, Long-jiang
To evaluate the efficacy and safety of closed suction drainage for prevention of postoperative complications after parotidectomy. Pubmed, Cochrane Controlled Trials Register, Embase, Open Sigle, CBM, VIP and Wanfang database were searched electronically from the date of their establishment to May 10,2013. Hand-searching covering 19 relevant Chinese journals were also performed, and the literature of randomized controlled trials comparing closed suction drainage and open drainage for prevention of postoperative complications after parotidectomy were included. Risk of bias assessment, which was suggested by Cochrane handbook for systematic reviewers of intervention review, and data extraction of included studies were delivered by two reviewers in duplicate; and meta analysis was performed with Revman 5.2 software. Ten randomized controlled trials were included. All studies had unclear risk of bias. When compared with open drainage, closed suction drainage showed a significant advantage on reducing postoperative complications (salivary fistula/effusion, edema) after parotidectomy; it also improved clinical comprehensive effect and patients' quality of life (P<0.05). To a certain extent, closed suction drainage has better efficacy and safety than controls in preventing postoperative complications after parotidectomy. However, as the quality of some included studies is limited, more randomized controlled trials are needed to reinforce the conclusion.
A film model is described for free convective heat transfer and friction in the presence of wall suction or injection. The analysis yields a thermal correction factor, which appears to be the classical (Ackermann) expression, and a novel friction correction factor, derived here for the first time.
Takahashi, Hidekazu; Haraguchi, Naotsugu; Nishimura, Junichi; Hata, Taishi; Matsuda, Chu; Yamamoto, Hirofumi; Mizushima, Tsunekazu; Mori, Masaki; Doki, Yuichiro; Nakajima, Kiyokazu
Modern electrosurgical tools have a specific coagulation mode called "soft coagulation". However, soft coagulation has not been widely accepted for surgical operations. To optimize the soft coagulation environment, we developed a novel suction device integrated with an electrosurgical probe, called the "Suction ball coagulator" (SBC). In this study, we aimed to optimize the SBC design with a prototyping process involving a bench test and preclinical study; then, we aimed to demonstrate the feasibility, safety, and potential effectiveness of the SBC for laparoscopic surgery in clinical settings. SBC prototyping was performed with a bench test. Device optimization was performed in a preclinical study with a domestic swine bleeding model. Then, SBC was tested in a clinical setting during 17 clinical laparoscopic colorectal surgeries. In the bench tests, two tip hole sizes and patterns showed a good suction capacity. The preclinical study indicated the best tip shape for accuracy. In clinical use, no device-related adverse event was observed. Moreover, the SBC was feasible for prompt hemostasis and blunt dissections. In addition, SBC could evacuate vapors generated by tissue ablation using electroprobe during laparoscopic surgery. We successfully developed a novel, integrated suction/coagulation probe for hemostasis and commercialized it.
Dixen, Figen Hatipoglu; Sumer, B. Mutlu; Fredsøe, Jørgen
When a stone/armor layer on a sand bed is exposed to flow, the sand underneath will be agitated by the flow turbulence. When the flow velocity reaches a critical value, the sand will be sucked (winnowed out) from between the armor blocks. In a previous investigation, we studied suction removal of...
Lupea, C.; Thijssen, R.; Van Tol, A.F.
Offshore wind turbine projects have been characterised by an increase in costs, sizes and distances from shore, EWEA 2012 This created a need of investigating the adequacy of alternative and more fìnancially attractive foundation types such as suction caissons. Within a multi-footing configuration,
Li, Da-yong; Zhang, Yu-kun; Feng, Ling-yun; Guo, Yan-xue
Monotonic lateral load model tests were carried out on steel skirted suction caissons embedded in the saturated medium sand to study the bearing capacity. A three-dimensional continuum finite element model was developed with Z_SOIL software. The numerical model was calibrated against experimental results. Soil deformation and earth pressures on skirted caissons were investigated by using the finite element model to extend the model tests. It shows that the "skirted" structure can significantly increase the lateral capacity and limit the deflection, especially suitable for offshore wind turbines, compared with regular suction caissons without the "skirted" at the same load level. In addition, appropriate determination of rotation centers plays a crucial role in calculating the lateral capacity by using the analytical method. It was also found that the rotation center is related to dimensions of skirted suction caissons and loading process, i.e. the rotation center moves upwards with the increase of the "skirted" width and length; moreover, the rotation center moves downwards with the increase of loading and keeps constant when all the sand along the caisson's wall yields. It is so complex that we cannot simply determine its position like the regular suction caisson commonly with a specified position to the length ratio of the caisson.
Koteras, Aleksandra Katarzyna; Ibsen, Lars Bo
in appendix. Main report includes also main findings and comparisons of tests. Similar work on the seepage analysis for installation of bucket foundation has been performed based on numerical results. Tests results obtained in laboratory campaign are compared with numerical findings in order to improve...... the design method for installation of the suction bucket foundation...
Humaidan, Hani; Yassi, Nawaf; Weir, Louise; Davis, Stephen M; Meretoja, Atte
Only 37 cases of stroke during or soon after long-haul flights have been published to our knowledge. In this retrospective observational study, we searched the Royal Melbourne Hospital prospective stroke database and all discharge summaries from 1 September 2003 to 30 September 2014 for flight-related strokes, defined as patients presenting with stroke within 14days of air travel. We hypothesised that a patent foramen ovale (PFO) is an important, but not the only mechanism, of flight-related stroke. We describe the patient, stroke, and flight characteristics. Over the study period, 131 million passengers arrived at Melbourne airport. Our centre admitted 5727 stroke patients, of whom 42 (0.73%) had flight-related strokes. Flight-related stroke patients were younger (median age 65 versus 73, p<0.001), had similar stroke severity, and received intravenous thrombolysis more often than non-flight-related stroke patients. Seven patients had flight-related intracerebral haemorrhage. The aetiology of the ischaemic strokes was cardioembolic in 14/35 (40%), including seven patients with confirmed PFO, one with atrial septal defect, four with atrial fibrillation, one with endocarditis, and one with aortic arch atheroma. Paradoxical embolism was confirmed in six patients. Stroke related to air travel is a rare occurrence, less than one in a million. Although 20% of patients had a PFO, distribution of stroke aetiologies was diverse and was not limited to PFO and paradoxical embolism. Copyright © 2016 Elsevier Ltd. All rights reserved.
Aarnio, Karoliina; Joensuu, Heikki; Haapaniemi, Elena; Melkas, Susanna; Kaste, Markku; Tatlisumak, Turgut; Putaala, Jukka
Cancer is a risk factor for ischemic stroke. Little is known about cancer among young adults with ischemic stroke. We studied the frequency of cancer and its association with long-term risk of death among young patients with first-ever ischemic stroke. 1002 patients aged 15 to 49 years, registered in the Helsinki Young Stroke Registry, and with a median follow-up of 10.0 years (interquartile range 6.5-13.8) after stroke were included. Historical and follow-up data were derived from the Finnish Care Register and Statistics Finland. Survival between groups was compared with the Kaplan-Meier life-table method, and Cox proportional hazard models were used to identify factors associated with mortality. One or more cancer diagnosis was made in 77 (7.7%) patients, of whom 39 (3.9%) had cancer diagnosed prestroke. During the poststroke follow-up, 41 (53.2%) of the cancer patients died. Median time from prestroke cancer to stroke was 4.9 (1.0-9.5) years and from stroke to poststroke cancer was 6.7 (2.7-10.9) years. Poststroke cancer was associated with age>40 years, heavy drinking, and cigarette smoking. The cumulative mortality was significantly higher among the cancer patients (68.6%, 95% confidence interval 52.0%-85.3%) compared with patients without cancer (19.7%, 95% confidence interval 16.3%-23.2%). Active cancer at index stroke, melanoma, and lung/respiratory tract cancer had the strongest independent association with death during the follow-up when adjusted for known poststroke mortality prognosticators. Cancer, and especially active cancer and no other apparent cause for stroke, is associated with unfavorable survival among young stroke patients. © 2015 American Heart Association, Inc.
Sassa, Shinji; Yang, Soonbo; Watabe, Yoichi; Kajihara, Naoto; Takada, Yoshitake
Sandy beach ecology has progressed rapidly with the emergence of several theories developed on the basis of understanding of hydrodynamic and morphodynamic processes on sandy beach habitats. However, the possible role of dynamic geophysical processes in the sediments remains poorly understood. The present study aims to explore the role of such geophysical processes in the sediments in forming the habitat environment and how they influence the species distributions. We conducted sets of integrated observations and surveys on intertidal and supratidal geophysical environments and the distributions of three amphipod and isopod species at four exposed sandy beaches located on the Japan Sea coast of Niigata Prefecture, Japan. The field results combined with a series of laboratory soil tests demonstrate that suction governed the variability of habitat environments observed, involving the degree of saturation, density, and hardness of the cross-shore intertidal and supratidal sediments, depending on the severity of the suction-dynamics-induced sediment compaction. While the observed species abundances were consistent with existing theories relating to intertidal and supratidal species, the observed magnitudes of suction were responsible for the distribution limits of the amphipods Haustorioides japonicus and Talorchestia brito and the isopod Excirolana chiltoni manifested consistently throughout the different beaches. The results of controlled laboratory experiments and field tests further revealed three distinctive suction-induced mechanisms, associated with their burrowing and physiology and the stability of the burrows. The novel role of such suction-induced geophysical processes in forming the habitat environment and influencing the species distributions may advance our understanding of sandy beach ecology in intertidal and supratidal zones.
Lorenz, Laila; Maxfield, Dominic A; Dawson, Jennifer A; Kamlin, C Omar F; McGrory, Lorraine; Thio, Marta; Donath, Susan M; Davis, Peter G
Leak around the face mask is a common problem during neonatal resuscitation. A newly designed face mask using a suction system to enhance contact between the mask and the infant's face might reduce leak and improve neonatal resuscitation. The aim of the study is to determine whether leak is reduced using the suction mask (Resusi-sure mask) compared with a conventional mask (Laerdal Silicone mask) in a manikin model. Sixty participants from different professional categories (neonatal consultants, fellows, registrars, nurses, midwives and students) used each face mask in a random order to deliver 2 min of positive pressure ventilation to a manikin. Delivered airway pressures were measured using a pressure line. Inspiratory and expiratory flows were measured using a flow sensor, and expiratory tidal volumes and mask leaks were derived from these values. A median (IQR) leak of 12.1 (0.6-39.0)% was found with the conventional mask compared with 0.7 (0.2-4.6)% using the suction mask (p=0.002). 50% of the participants preferred to use the suction mask and 38% preferred to use the conventional mask. There was no correlation between leak and operator experience. A new neonatal face mask based on the suction system reduced leak in a manikin model. Clinical studies to test the safety and effectiveness of this mask are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Davies, Kylie; Bulsara, Max K; Ramelet, Anne-Sylvie; Monterosso, Leanne
Endotracheal tube suction performed in children can affect clinical stability. Previous research has identified clinical indicators used to perform endotracheal suction. These were used to develop the Endotracheal Suction Assessment Tool © (ESAT © ). This study sought to evaluate the degree to which the ESAT © items as a whole constitute an operational definition of the construct used to determine whether a paediatric intensive care nurse should perform the endotracheal tube suction procedure. Lynn's process for calculation of content validity and scale content validity index using a team of expert reviewers was adopted. Experts were drawn from paediatric intensive care units in Australia (n=6), United Kingdom (n=1), Switzerland (n=1) and Canada (n=1). These experts established the content validity index of the Endotracheal Suction Assessment Tool © using a minimum preset a-priori criterion agreement of 0.78 and a scale content validity index of 0.8. Scale content validity index was used to enhance the interpretability of the content validity data. All 15 items achieved the preset a-priori agreement for apparent internal consistency. Minor adjustments were required to improve the clarity of four items. The content validity index ranged from 0.8 to 1.0 and scale content validity index ranged from 0.9 to 1.0 for all items. Item and scale content validity indexes of the tool were established. Further psychometric testing for construct validity and stability over time is required to establish clinical utility of the tool and practice of novice paediatric intensive care nurses and other PIC health professionals. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
... Risks for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and strokes ... the Centers for Disease Control and Prevention: Heart Disease Stroke High Blood Pressure Cholesterol Salt Video: Know Your ...
Saeed, E.; Ali, R.; Din, M.J.U.; Saeed, A.; Jadoon, R.J.
Background: Stroke is a common neurological disease that results in significant mortality and morbidity globally. Several risk factors have been identified for stroke among which hyperlipidaemia is one of the modifiable risk factors. Recent clinical trials have shown a reduction in ischemic stroke for patients taking lipid lowering medications. Therefore, the aim of this study was to find out the frequency of hypercholesterolemia in patients of ischemic stroke in Hazara region. Method: This cross sectional study was carried out in the Medical Department of Ayub Teaching Hospital, Abbottabad. Ninety patients of stroke confirmed as ischemic by CT scan brain were enrolled in the study after informed consent. The frequency of hypercholesterolemia in patients was recorded. Results: There were 55 (61.1 percentage) males. The mean age of patients was 64.4±11.5 years. The mean serum cholesterol in all patients was 4.16±1.1 mmol/l. The mean serum cholesterol of male patients was 4.3±1.2 mmol/l and 4.0±10.9 mmol/l in the case of females. Conclusions: Hypercholesterolemia could not be established as a major risk factor for stroke in our setup through this study that allude to the fact that other risk factors might be contributing more to the incidence of cerebrovascular accident in our population. (author)
Kessner, Simon S; Bingel, Ulrike; Thomalla, Götz
In the past years, there have been increasing research activities focusing on somatosensory symptoms following stroke. However, as compared to the large number of clinical and neuroimaging studies on motor symptoms, the number of studies tracing somatosensory symptoms after stroke and their recovery is rather small. It is an ongoing discussion, to which extent somatosensory deficits after stroke influence patient's long-term outcome in motor and sensory performance and functional independence in activities of daily living. Modern brain imaging techniques allow for studying the impact of stroke lesion localization and size on acute and persisting clinical impairment. Here, we review the literature on somatosensory symptoms after stroke. We summarize epidemiological information on frequency and characteristics of somatosensory symptoms affecting all parts of the body in the acute and chronic stage of stroke. We further give an overview of brain imaging studies of stroke affecting the somatosensory system. Finally, we identify open questions which need to be addressed in future research and summarize the implications for clinical practice.
Carod-Artal, F J
Almost three out of every four people in the world who suffer a fatal stroke live in developing countries. A number of different tropical diseases may appear in Europe in the coming years as a consequence of the demographic change that is being brought about by migratory flows. We review the main infectious causes of strokes in the tropics. There are estimated to be 500 million cases of malaria every year. Cerebral malaria can cause cerebral oedema, diffuse or focal compromise of the subcortical white matter and cortical, cerebellar and pontine infarctions. Chagas disease is an independent risk factor for stroke in South America. At least 20 million people have the chronic form of Chagas disease. The main prognostic factors for Chagas-related stroke are the presence of apical aneurysms, arrhythmia and heart failure. Vascular complications of neurocysticercosis include transient ischemic attacks, ischemic strokes due to angiitis and intracranial haemorrhages. The frequency of cerebral infarction associated with neurocysticercosis varies between 2% and 12%. Gnathostomiasis is a cause of subarachnoid haemorrhage in south-east Asia. Other less common causes of stroke are viral haemorrhagic fevers due to arenavirus and flavivirus. Several diseases that are endemic in the tropics can be responsible for up to 10% of the cases of strokes in adults.
Pagliara, Domenico; Maxia, Sara; Faenza, Mario; Dessena, Lidia; Campus, GianVittorio; Rubino, Corrado
Placement of suction drainage in submuscular pockets is routinely performed in breast reconstruction. Days of drain permanence (DDP) are associated with hospital stay and related health care costs. The aims of this study are to retrospectively compare data related to DDP and total drainage volume between high and low vacuum suction drainage groups and to identify correlations with patient or surgery-related factors. We retrospectively analyzed data of 100 patients undergoing immediate or delayed breast reconstruction with expanders and implants. We considered 2 groups depending on suction pressure applied by 2 different surgical teams: group A (number, 50 patients) with high vacuum suction and group B (number, 50 patients) with low vacuum suction. Days of drain permanence was not significantly different between group A and group B (P = 0.451). The same was found for total drainage volume (P = 0.183). The distribution of DDP was statistically different only between patients with or without intraoperative bleeding in group A (P = 0.005) and smoking or nonsmoking patients in group A (P = 0.045). Statistical significance was kept in multivariate regression. There is no significant difference in DDP and total drainage volume using low or high vacuum suction drainage in breast reconstruction. The only factors affecting drainage permanence were intraoperative filling of expander, smoking, and intraoperative bleeding. Therefore, we can reduce the DDP, avoiding overfilling of expander and using of high vacuum suction in nonsmoking patients and in patients with significant intraoperative bleeding.
Matsuzono, Kosuke; Yokota, Chiaki; Takekawa, Hidehiro; Okamura, Tomonori; Miyamatsu, Naomi; Nakayama, Hirofumi; Nishimura, Kunihiro; Ohyama, Satoshi; Ishigami, Akiko; Okumura, Kosuke; Toyoda, Kazunori; Miyamoto, Yoshihiro; Minematsu, Kazuo
Educating the youth about stroke is a promising approach for spreading stroke knowledge. The aim of this study was to verify communication of stroke knowledge to parents by educating junior high school students about stroke. We enrolled 1127 junior high school students (age, 13-15 years) and their parents in the Tochigi prefecture, Japan. All students received a stroke lesson, watched an animated cartoon, and read the related Manga comic as educational aids. The students took back home the Manga and discussed what they learned with their parents. Questionnaires on stroke knowledge were given to all at baseline and immediately after the lesson. A total of 1125 students and 915 parents answered the questionnaires. In the students, the frequency of correct answers increased significantly for all questions on stroke symptoms except for headache, and for all questions on risk factors after the lesson. In the parents, the correct answer rates increased for stroke symptoms except for headache and numbness in one side of the body, and for all questions on risk factors except for hypertension. Ninety-one percent of students and 92.7% of parents correctly understood the Face, Arm, Speech, and Time (FAST) mnemonic after the lesson. Improvement of stroke knowledge immediately after the stroke lesson was observed in parents as well as their children, which indicated that our teaching materials using the Manga was effective in delivering the stroke knowledge to parents through their children. © 2014 American Heart Association, Inc.
Norup, Anne; Guldberg, Anne-Mette; Friis, Claus Radmer
OBJECTIVE: To describe the work of an interdisciplinary visual team in a stroke unit providing early identification and assessment of patients with visual symptoms, and secondly to investigate frequency, type of visual deficits after stroke and self-evaluated impact on everyday life after stroke...
Wu, Yue; Zhu, Liangfan; Luo, Yun
The blood pump has become a possible solution to heart diseases. For the prevention of device failure and hemocompatibility problems, a rotary pump with suspended bearing is a preferred solution. In our previous work, a novel injection suspension method has been introduced to levitate the rotor. The suspension method is totally passive. This study aims to apply this suspension method to a double-suction pump, and the property of the pump was investigated using computational fluid dynamics (CFD) methods. The flow field of the pump is simulated based on the SST k-ω turbulent model. The characteristic curves of the pump were calculated. At the nominal working point of 5 L/min, 100 mm Hg, the suspension force acting on the rotor was detected, which could reach 0.46 N with a gap of 150 µm. We compared the pump with a previously developed single-suction injection pump to evaluate the blood compatibility of the double-suction design. The average scalar shear stress values were 3.13 Pa for the double-suction pump and 7.10 Pa for the single-suction pump. Larger volumes in the single-suction pump were exposed to shear stresses higher than 10 Pa. Thresholds for the von Willebrand factor cleavage, platelet activation, and hemolysis were defined to be 9 Pa, 50 Pa, and 150 Pa, respectively. The volume fractions for the double-suction pump are lower for all thresholds. The normalized index of hemolysis (NIH) values for the two pumps were calculated to be 0.008 g/100 L and 0.016 g/100 L. Results proved that the double-suction pump has a better hemocompatibility compared with the single-suction pump. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
... 9-1-1. Which of the following are risk factors for stroke? High blood pressure Heart disease Smoking High cholesterol Diabetes Show Answer All of these are risk factors for stroke. If you smoke - quit. If you have high ...
... Thromboembolism Aortic Aneurysm More The Heart and Stroke Encyclopedia Click a letter below to get a brief ... of cardiovascular terms from our Heart and Stroke Encyclopedia and get links to in-depth information. A ...
... Resources Submit A Story Edit Module Show Tags Stroke Rehabilitation Two-Part Series Making the Best Decisions at ... first part of a two-part series on stroke rehab, we offer guidance for the decision-making process ...
... your friend. Being around friends can help with healing. Preventing Strokes Some strokes can be prevented in ... Why Does Hair Turn Gray? What Are Wrinkles? Alzheimer Disease Your Brain & Nervous System Why Exercise Is ...
... News About Neurology Image Library Search The Internet Stroke Center Trials Registry Clinical Trials Interventions Conditions Sponsors ... a clinical trial near you Welcome to the Stroke Trials Registry Our registry of clinical trials in ...
The purpose of this study is therefore to determine the frequency of major depression among patients who developed stroke from hypertension. Methods: This is a retrospective study. Thirty four patients who developed stroke from severe hypertension were included. Using Diagnostic Statistical Manual (DSM) IV criteria, the ...
Padberg, Inken; Knispel, Petra; Zöllner, Susanne; Sieveking, Meike; Schneider, Alice; Steinbrink, Jens; Heuschmann, Peter U; Wellwood, Ian; Meisel, Andreas
Previous studies examining social work interventions in stroke often lack information on content, methods and timing over different phases of care including acute hospital, rehabilitation and out-patient care. This limits our ability to evaluate the impact of social work in multidisciplinary stroke care. We aimed to quantify social-work-related support in stroke patients and their carers in terms of timing and content, depending on the different phases of stroke care. We prospectively collected and evaluated data derived from a specialized "Stroke-Service-Point" (SSP); a "drop in" center and non-medical stroke assistance service, staffed by social workers and available to all stroke patients, their carers and members of the public in the metropolitan region of Berlin, Germany. Enquiries from 257 consenting participants consulting the SSP between March 2010 and April 2012 related to out-patient and in-patient services, therapeutic services, medical questions, medical rehabilitation, self-help groups and questions around obtaining benefits. Frequency of enquiries for different topics depended on whether patients were located in an in-patient or out-patient setting. The majority of contacts involved information provision. While the proportion of male and female patients with stroke was similar, about two thirds of the carers contacting the SSP were female. The social-work-related services provided by a specialized center in a German metropolitan area were diverse in terms of topic and timing depending on the phase of stroke care. Targeting the timing of interventions might be important to increase the impact of social work on patient's outcome.
Stern Barney J
Full Text Available Abstract Background Neuroserpin, primarily localized to CNS neurons, inhibits the adverse effects of tissue-type plasminogen activator (tPA on the neurovascular unit and has neuroprotective effects in animal models of ischemic stroke. We sought to evaluate the association of neuroserpin polymorphisms with risk for ischemic stroke among young women. Methods A population-based case-control study of stroke among women aged 15–49 identified 224 cases of first ischemic stroke (47.3% African-American and 211 age-matched control subjects (43.1% African-American. Neuroserpin single nucleotide polymorphisms (SNPs chosen through HapMap were genotyped in the study population and assessed for association with stroke. Results Of the five SNPs analyzed, the A allele (frequency; Caucasian = 0.56, African-American = 0.42 of SNP rs6797312 located in intron 1 was associated with stroke in an age-adjusted dominant model (AA and AT vs. TT among Caucasians (OR = 2.05, p = 0.023 but not African-Americans (OR = 0.71, p = 0.387. Models adjusting for other risk factors strengthened the association. Race-specific haplotype analyses, inclusive of SNP rs6797312, again demonstrated significant associations with stroke among Caucasians only. Conclusion This study provides the first evidence that neuroserpin is associated with early-onset ischemic stroke among Caucasian women.
Wolff, Valérie; Jouanjus, Emilie
cannabinoids, the low frequency of neurovascular complications after their use may be due to a genetic predisposition to their neurovascular toxicity in some individuals. Further studies should focus on this point. More importantly however, this low frequency may be underestimated because the drug consumption may not be systematically researched, neither by questioning nor by laboratory screening. Besides this vascular role of cannabinoids in the occurrence of stroke, a cellular effect of cannabis on brain mitochondria was recently suggested in an experimental study. One of the mechanisms involved in young cannabis users with stroke may be the generation of reactive oxygen species leading to an oxidative stress, which is a known mechanism in stroke in humans. It is useful to inform the young population about the real potential risk of using cannabinoids. We suggest to systematically ask all young adults with stroke about their drug consumption including cannabinoids, to screen urine for cannabis or to include a specific diagnostic test to detect synthetic cannabinoids, and to obtain non-invasive intracranial arterial investigations (i.e. CT-angiography or cerebral MRA) in order to search for cerebral vasoconstriction. However, several questions remained unresolved and further research is still needed to assess the pathophysiological mechanisms involved in young cannabinoids users with stroke. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy". Copyright © 2017 Elsevier Inc. All rights reserved.
Gschwendtner, A; Dichgans, M
Stroke is one of the most widespread causes of mortality und disability worldwide. Around 80 % of strokes are ischemic and different forms of intracranial bleeding account for the remaining cases. Monogenic stroke disorders are rare but the diagnosis may lead to specific therapeutic consequences for the affected patients who are predominantly young. In common sporadic stroke, genetic factors play a role in the form of susceptibility genes. Their discovery may give rise to new therapeutic options in the future.
Jordan M.D., Lori C.; Hillis M.D., Argye E.
Hemorrhagic stroke accounts for approximately half of stroke in childhood. Unlike arterial ischemic stroke, there are no consensus guidelines to assist in the evaluation and treatment of these children. We review the literature on the evaluation, treatment, etiology and neurologic outcome of hemorrhagic stroke in children. Important differences between pediatric and adult hemorrhage are highlighted, as treatment guidelines for adults may not be applicable in all cases. Needed future research ...
Full Text Available Several comorbidities are associated to migraine.Recent meta-analyses have consistently demonstrated a relationship between migraine and stroke, which is well-defined for ischaemic stroke and migraine with aura, even stronger in females on oral contraceptives or smokers. However, there seems to be no clear-cut association between stroke in migraineurs and the common vascular risk factors, at least in the young adult population. Migraineurs also run an increased risk of hemorrhagic stroke, while the association between migraine and cardiovascular disease remains poorly defined.Another aspect is the relationship between migraine and the presence of silent brain lesions. It has been demonstrated that there is an increased frequency of ischaemic lesions in the white matter of migraineurs, especially silent infarcts in the posterior circulation territory in patients with at least 10 attacks per month. Although there is a higher prevalence of patent foramen ovale (PFO in migraineurs, the relationship between migraine and PFO remains controversial and PFO closure is not a recommended procedure to prevent migraine. As an increased frequency of cervical artery dissections has been observed in migrainous patients, it has been hypothesized that migraine may represent a predisposing factor for cervical artery dissection. There still remains the question as to whether migraine should be considered a true vascular disease or if the comorbidity between migraine and cerebrovascular disease may have underlying shared risk factors or pathophysiological mechanisms. Although further studies are required to clarify this issue, current evidence supports a clinical management where MA patients should be screened for other concomitant vascular risk factors and treated accordingly.
Full Text Available Pregnancy resulting from the implantation of an embryo within a scar of a previous Caesarean section is extremely rare. The diagnosis and treatment of Caesarean scar pregnancies (CSPs are challenging and the optimal course of treatment is still to be determined. We report a case series of six patients with CSPs who presented to the Royal Hospital in Muscat, Oman, between October 2012 and April 2014. All of the patients were successfully treated with systemic methotrexate and five patients underwent suction evacuation either before or after the methotrexate administration. The patients were followed up for a period of 6–9 weeks after treatment and recovered completely without any significant complications. Suction evacuation with methotrexate can therefore be considered an effective treatment option with good maternal outcomes.
Full Text Available In order to study the influence of splitter blades on double suction centrifugal pumps two impellers with and without splitter blades were investigated numerically and experimentally. Three-dimensional turbulence simulations with and without full cavitation model were applied to simulate the flow in the two pumps with different impellers. The simulation results agreed with the experiment results and the internal flows were analyzed. Both the numerical and experimental results show that by adding splitter blades the hydraulic performance and the cavitation performance of the pump are improved. The pump efficiency is increased especially at high flow rate condition. The pump high efficiency area is extended dramatically. At the same time since the splitter blades share some part of the blade loading, the pump critical NPSH value is decreased. Obvious pressure increase and velocity decrease at blade suction surface near leading edge were observed in the pump impeller with splitter blades. And the pump cavitation performance was improved consequently.
Full Text Available This work is the final step of a research project that aims at evaluating the possibility of delaying the surge of a centrifugal compressor stage using a boundary-layer suction technique. It is based on Reynolds-Averaged Navier-Stokes numerical simulations. Boundary-layer suction is applied within the radial vaned diffuser. Previous work has shown the necessity to take into account the unsteady behavior of the flow when designing the active flow control technique. In this paper, a multislot strategy is designed according to the characteristics of the unsteady pressure field. Its implementation results in a significant increase of the stable operating range predicted by the unsteady RANS numerical model. A hub-corner separation still exists further downstream in the diffuser passage but does not compromise the stability of the compressor stage.
Leng, H F; Wang, F J; Zhang, Z C; Yao, Z F; Zhou, P J
Secondary flow is one of the main reasons for low efficiency in double suction centrifugal pump. In a 3-D inverse design method, the pump blade could be designed by a specified loading distribution to control the flow field in pump. In order to study the influence of loading distribution on secondary flow of a double suction centrifugal pump, the external characteristics and the internal flow field of the pump with three kinds of loading distributions are analysed by using CFD approach. According to the simulation results, it is found that the form of fore-loading distribution at shroud and aft-loading distribution at hub could improve the optimal efficiency and broaden the high efficiency area of the pump. Furthermore, the secondary flow in impeller exit region and volute could be significantly suppressed if the slope of loading distribution curve of shroud is set to be −0.7
Full Text Available A suction casting process for fabricating Zr55Cu30Al10Ni5 bulk metallic glass microcomponent using silicon micromold has been studied. A complicated BMG microgear with 50 μm in module has been cast successfully. Observed by scanning electron microscopy and laser scanning confocal microscopy, we find that the cast microgear duplicates the silicon micromold including the microstructure on the surface. The amorphous state of the microgear is confirmed by transmission election microscopy. The nanoindentation hardness and elasticity modulus of the microgear reach 6.5 GPa and 94.5 GPa. The simulation and experimental results prove that the suction casting process with the silicon micromold is a promising one-step method to fabricate bulk metallic glass microcomponents with high performance for applications in microelectromechanical system.
Koteras, Aleksandra Katarzyna
of suction under the bucket lid or by applying additional force through the hydraulic piston, forcing the bucket to penetrate into the soil. Tests for uninstallation are performed also with the use of water pressure, as a reverse process to the suction installation. Both installation and uninstallation tests......This technical report describes the set-up and the test procedures for installation and uninstallation of medium-scale model of bucket foundation that can be performed in the geotechnical part of laboratory in Aalborg University. The installation of bucket foundation can be tested with the use......) and loading frame used for those tests have been already used for axially static and cyclic loading of piles (Thomassen, 2015a) and for axially static and cyclic loading of bucket foundation (Vaitkunaite et al., 2015)....
Delay chamber is a tank to delay flow that located in the primary cooling suction side of RSG-GAS. A void occurred when operation reactor caused by too high the delta P at inlet suction pump. The condition may be avoided by using one line mode of the cooling flow. The analysis show that void volume in the delay chamber is occurred because the coolant negative pressure lowers the saturation pressure should be avoided though decreasing the delta P until about 0.1 bar at about 45 exp 0 C. Solution suggested are to use bypass flow from the spent fuel to the delay chamber. Coolant temperature can be also decreased by decreasing the power level of the reactor as well as improving the heat exchanger and cooling tower performances
Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj
between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death.......5%) or 1 month (6.9%), respectively. After the age of 60 years, women had more severe strokes than men. Up to ages in the mid-60s, no difference in the risk of death from stroke was seen between the 2 sexes. For people aged >65 years, however, the risk gradually became greater in men than in women...
Harinaldi, Budiarso, Warjito, Kosasih, Engkos A.; Tarakka, Rustan; Simanungkalit, Sabar P.
Today research trend in car aerodynamics are carried out from the point of view of the durable development. Some car companies have the objective to develop control solution that enable to reduce the aerodynamic drag of vehicle. It provides the possibility to modify the flow separation to reduce the development of the swirling structures around the vehicle. In this study, a family van is modeled with a modified form of Ahmed's body by changing the orientation of the flow from its original form (modified/reversed Ahmed Body). This model is equipped with a suction on the rear side to comprehensively examine the pressure field modifications that occur. The investigation combines computational and experimental work. The computational simulation used is k-epsilon flow turbulence model. The reversed Ahmed body used in the investigation has slant angle (φ) 35° at the front part. In the computational work, meshing type is tetra/hybrid element with hex core type and the grid number is more than 1.7 million in order to ensure detail discretization and more accurate calculation results. The boundary condition is upstream velocity of 11.1 m/s. Mean free stream at far upstream region is assumed in a steady state condition and uniform. The suction velocity is set at 1 m/s. Meanwhile in the experimental work a reversed Ahmed model is tested in a controlled wind tunnel experiments. The main measurement is the drag aerodynamic measurement at rear of the body of the model using strain gage. The results show that the application of a suction in the rear part of the van model give the effect of reducing the wake and the vortex is formed. Aerodynamic drag reduction close to 24% for the computational approach and 14.8% for the experimental approach by introducing a suction have been obtained.
Manzotti, E.; Vaitkunaite, Evelina; Ibsen, Lars Bo
Wind energy obtained by means of wind turbine has been proved to be a concrete resource of green energy. Development of such structures requires research on offshore construction, since this is the direction for future improvement on this field. Wind turbines are relatively light and slender devices usually installed in farms, therefore many inexpensive foundations are needed. Suction Bucket foundations are a suitable option for this purpose, but for large scale utilization more research is r...
Tishchenko, Galina; Hilke, R.; Albrecht, W.; Schauer, Jan; Luetzow, K.; Pientka, Zbyněk; Bleha, Miroslav
Roč. 30, č. 1 (2003), s. 57-68 ISSN 1383-5866 R&D Projects: GA MŠk ME 105; GA AV ČR KSK4050111 Grant - others:GA-(DE) TSR-096-97 Institutional research plan: CEZ:AV0Z4050913 Keywords : purification of colloid suspensions * diafiltration with suction * membrane characteristics Subject RIV: CD - Macromolecular Chemistry Impact factor: 1.355, year: 2003
Full Text Available Stroke is a huge public health problem because of its high morbidity and disability. The epidemiology of stroke is of relevance to construct practical paradigms to tackle this major health issue in the community. Recent data have shown that about 72-86% of strokes are ischemic, 9-18% are due to hemorrhage (intracerebral of subarachnoid and the rest are undefined. The risk factors for stroke are multiple and combined. At present, stroke is no more considered as unavoidable and untreatable. It is an emergency and specialized units and teams improve outcome and lower costs. Death related to stroke is declining in many countries and in both sexes. This decrease in multifactorial. The detection and more effective treatment of hypertension may play an important factor, as well as the improved medical care and improvement in diagnostic procedures. While stroke incidence appears stable and stroke mortality is slowly declining, the absolute magnitude of stroke is likely to grow over the next 30 years. as the population ages, the absolute number of stroke victims and demands on healthcare and other support systems is likely to increase substantially in the future. Keeping this in perspective, this chapter shall focus on the epidemiology of stroke in the world and in Indian, in particular.
Wildenschild, Cathrine; Mehnert, Frank; Thomsen, Reimar Wernich
BACKGROUND: The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry...... (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]). METHODS: Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients...... in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke...
M V Padma Srivastav
Full Text Available Circadian variations in conjunction with sleep-related heart rhythm changes and sleepdisordered breathing (SDB are contributing risk factors for stroke. Strong scientificevidence now exists indicating that SDB contributes to systemic hypertension, aprominent risk factor for stroke, and compelling circumstantial evidence is presentsuggesting that SDB raises the risk for development of stroke through other circulatorymechanisms as well. Preliminary evidence indicates that post-stroke patients have ahigher prevalence of SDB, which is likely to compromise their rehabilitation outcomes.Since SDB is modifiable with the application of CPAP and other treatment modalities,there is practical value in investigating patients at risk of stroke or post stroke forpresence of SDB. Successful application of CPAP or BiPAP therapy may improve theoutcome in both instances.Key words : Sleep, Stroke, SDB, CPAP
Baik, Sangyul; Kim, Da Wan; Park, Youngjin; Lee, Tae-Jin; Ho Bhang, Suk; Pang, Changhyun
Adhesion strategies that rely on mechanical interlocking or molecular attractions between surfaces can suffer when coming into contact with liquids. Thus far, artificial wet and dry adhesives have included hierarchical mushroom-shaped or porous structures that allow suction or capillarity, supramolecular structures comprising nanoparticles, and chemistry-based attractants that use various protein polyelectrolytes. However, it is challenging to develop adhesives that are simple to make and also perform well—and repeatedly—under both wet and dry conditions, while avoiding non-chemical contamination on the adhered surfaces. Here we present an artificial, biologically inspired, reversible wet/dry adhesion system that is based on the dome-like protuberances found in the suction cups of octopi. To mimic the architecture of these protuberances, we use a simple, solution-based, air-trap technique that involves fabricating a patterned structure as a polymeric master, and using it to produce a reversed architecture, without any sophisticated chemical syntheses or surface modifications. The micrometre-scale domes in our artificial adhesive enhance the suction stress. This octopus-inspired system exhibits strong, reversible, highly repeatable adhesion to silicon wafers, glass, and rough skin surfaces under various conditions (dry, moist, under water and under oil). To demonstrate a potential application, we also used our adhesive to transport a large silicon wafer in air and under water without any resulting surface contamination.
Mankowski, Jennifer L; Kingston, Jessica; Moran, Thomas; Nager, Charles W; Lukacz, Emily S
To estimate the efficacy of paracervical compared with intracervical administration of local anesthesia during first-trimester suction curettage. A double-blind, randomized controlled trial comparing paracervical with intracervical lidocaine was performed in women undergoing elective first-trimester suction curettage with conscious sedation. Pain was assessed at baseline, with dilation, and with curettage using a 10-cm visual analog scale (VAS). Assuming a minimal clinically important difference in pain score of 1.6 cm and a mean pain score (+/-standard deviation [SD]) of 4.7 (+/-2.9) cm for paracervical block, 120 patients would provide 80% power with an alpha of .05. For the 132 women randomly assigned, no significant differences in VAS scores (mean+/-SD) were observed between paracervical and intracervical blocks during dilation (2.6+/-2.3 compared with 2.8+/-2.2, P=.72) or curettage (3.9+/-2.9 compared with 3.3+/-2.5, P=.16). For women undergoing first-trimester suction curettage with conscious sedation, there was no clinically meaningful difference in pain relief between paracervical and intracervical lidocaine. Providers should feel confident that both techniques provide equally effective and acceptable analgesia.
Yen, J.; Murphy, D. W.; Fan, L.; Skipper, A.; Webster, D. R.
Copepods, which sense their fluid environment with long, setae-bearing antennules, often serve as prey to fish. The fluid disturbance created by fish feeding is a combination of a bow wave created by swimming towards the prey with an open mouth and a sudden, high speed flow into the fish's mouth created by suction. The sensitivity and reaction of copepods to the dynamic, high acceleration flow created by a suction feeding fish have not been well explored. In the present study, a suction feeding piscine predator mimic is developed and tested with copepods from a fish-containing (marine) environment (Calanus finmarchicus) and with copepods from a fish-less (alpine lake) environment (Hesperodiaptomus shoshone). Flow fields created by the impulsive siphon are measured with a high-speed tomographic particle image velocimetry (PIV) system. Escape success and kinematics of the two species are compared. Finally, using volumetric flow measurements, the hydrodynamic signal measured along each copepod's antennules at the time point of escape is compared between species.
Bristow, P C; Halfacree, Z J; Baines, S J
To report indications for use and complications associated with commonly used closed active suction wound drains in a large number of clinical cases. Retrospective review of medical case records (from 2004 to 2010) for dogs and cats that had a closed active suction drain placed into a wound. Only the four most common drain types were included: Mini Redovac®, Redovac®, Jackson Pratt® and Wound Evac®. Two hundred and fifty-three drains were placed in 33 cats and 195 dogs. Mini Redovac drains were used most frequently in cats (76 · 5%) and Redovac drains in dogs (54 · 3%). The infection rate for clean surgeries in dogs was 15 · 6% (unattainable in cats). Major complications occurred in four dogs; minor complications occurred in 12 drains in cats (35 · 3%), and in 74 drains in dogs (33 · 8%). There was no statistically significant association between the type of drain and complication rate for either species. Although closed active suction drains can be used with low risk of major complications, they lead to a high rate of infection in clean surgeries in dogs. It is recommended that such drains are kept in place for the shortest time possible and that strict asepsis is adhered to both during placement and management. © 2015 British Small Animal Veterinary Association.
Full Text Available Background: Negative pressure wound therapy (NPWT is an established modality in the treatment of chronic wounds, open fractures, and post-operative wound problems. This method has not been widely used due to the high cost of equipment and consumables. This study demonstrates an indigenously developed apparatus which gives comparable results at a fraction of the cost. Readily available materials are used for the air-tight dressing. Materials and Methods: Equipment consists of suction apparatus with adjustable pressure valve set to a pressure 125-150 mmHg. An electronic timer switch with a sequential working time of 5 min and a standby time of 3 min provides the required intermittent negative pressure. Readily available materials such as polyvinyl alcohol sponge, suction drains and steridrapes were used to provide an air tight wound cover. Results: A total of 90 cases underwent 262 NPWT applications from 2009 to 2014. This series, comprised of 30 open fractures, 21 post-operative and 39 chronic wounds. The wound healing rate in our study was comparable to other published studies using NPWT. Conclusion: The addition of electronic timer switch will convert a suction apparatus into NPWT machine, and the results are equally effective compared to more expensive counter parts. The use of indigenous dressing materials reduces the cost significantly.
Li, Xiaojun; Yu, Benxu; Ji, Yucheng; Lu, Jiaxin; Yuan, Shouqi
Centrifugal pumps are often used in operating conditions where they can be susceptible to premature failure. The cavitation phenomenon is a common fault in centrifugal pumps and is associated with undesired effects. Among the numerous cavitation detection methods, the measurement of suction pressure fluctuation is one of the most used methods to detect or diagnose the degree of cavitation in a centrifugal pump. In this paper, a closed loop was established to investigate the pump cavitation phenomenon, the statistical parameters for PDF (Probability Density Function), Variance and RMS (Root Mean Square) were used to analyze the relationship between the cavitation performance and the suction pressure signals during the development of cavitation. It is found that the statistical parameters used in this research are able to capture critical cavitation condition and cavitation breakdown condition, whereas difficult for the detection of incipient cavitation in the pump. At part-load conditions, the pressure fluctuations at the impeller inlet show more complexity than the best efficiency point (BEP). Amplitude of PDF values of suction pressure increased steeply when the flow rate dropped to 40 m3/h (the design flow rate was 60 m3/h). One possible reason is that the flow structure in the impeller channel promotes an increase of the cavitation intensity when the flow rate is reduced to a certain degree. This shows that it is necessary to find the relationship between the cavitation instabilities and flow instabilities when centrifugal pumps operate under part-load flow rates.
Rani B. Fritz
Full Text Available We report on a case of a patient with an early diagnosed cornual ectopic pregnancy following failed methotrexate treatment. The patient was subsequently taken to the operating room for a laparoscopic guided transcervical suction curettage of the cornual ectopic. The surgery was successful and the patient was followed up until her urine pregnancy test was negative. We conclude that in properly selected patients, cornual ectopic pregnancy may be treated with transcervical suction curettage.
Full Text Available Abstract Background The established treatment for bacterial arthritis of the knee joint is arthroscopic surgery with irrigation and debridement. The aim of this article is to summarize the relevant data in treating bacterial arthritis of the knee joint, and based on these findings to present a novel irrigation suction system, tested in a cadaver study, as an additional tool in the postoperative treatment phase of arthroscopic surgery for knee joint infections. Method The novel automated irrigation-suction system presented here was compared to conventional continuous suction irrigation in a total of six knee joints. All knee joints were filled with 80 ml methylene blue stain and rinsed by two different methods. Fluid specimens were taken after ten and twenty minutes to be compared by photometric extinction measurement at a wave length of 500 nm. Results After ten minutes, the average extinction was e1C = 0.8 for the continuous suction irrigation and e1N = 0.4 for the novel irrigation-suction system. After twenty minutes, we recorded an average extinction of e2C = 0.3 for continuous suction irrigation and e2N = 0.001 for the novel irrigation-suction system. The students t-test revealed superior results after ten and twenty minutes of washing out the knee joints with a p Conclusion A novel irrigation-suction system may be an effective tool for postoperative knee joint irrigation in arthroscopic therapy for bacterial arthritis of the knee. Further animal studies are needed to verify the effects in vivo.
Nangia, Sushma; Pal, Mansi M; Saili, Arvind; Gupta, Usha
Evidence about IP-OP suction and selective tracheal intubation in meconium stained neonates is from developed countries. Little information is available about their role in developing countries with high incidence of meconium staining and MAS. This randomized trial was planned to evaluate the effectiveness of IP-OP suction in meconium stained term neonates on prevention of MAS and reduction of its severity. Out of 540 meconium stained full term, cephalic presentation, singleton neonates without major congenital malformations born from June'08 to January'09, 31 were excluded and 509 randomized. In the intervention group IP-OP suction was done at the time of delivery of head using a 10 Fr suction catheter with a negative pressure of 100 mmHg. No IP-OP suction was performed in control group. All neonates with MSAF were assessed as vigorous or non-vigorous after birth and provided care as per NRP guidelines 2005. Two hundred and fifty three neonates were randomized to IP-OP suction and 256 to no IP-OP suction. Eighty-two neonates (16%) developed MAS, the primary outcome parameter, with 40 infants in the intervention group (15.8%) and 42 (16.4%) in the non-intervention group (RR 0.86, 95% CI 0.60-1.54). Incidence of severe MAS was comparable (3.55% vs. 2.34%) (P value=0.40). Other variables like requirement of oxygen >48 h (9.8% vs. 10.5%) and mortality (2.7% vs. 1.7%) were also comparable. IP-OP suctioning did not reduce the incidence or severity of MAS even in a setting of high incidence of MAS in a developing country. The mortality in two groups was comparable. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Forgoston, Eric; Tumin, Anatoli; Ashpis, David E.
An analysis of the optimal control by blowing and suction in order to generate stream- wise velocity streaks is presented. The problem is examined using an iterative process that employs the Parabolized Stability Equations for an incompressible uid along with its adjoint equations. In particular, distributions of blowing and suction are computed for both the normal and tangential velocity perturbations for various choices of parameters.
Full Text Available The incidence of seizures in relation to stroke is 8.9%, with a frequency of 10.6 and 8.6% in haemorrhagic and ischaemic stroke, respectively. In subarachnoid haemorrhage the incidence is 8.5%. Due to the fact that infarcts are significantly more frequent than haemorrhages, seizures are mainly related to occlusive vascular disease of the brain. The general view is to consider stroke-related seizures as harmless complications in the course of a prolonged vascular disease involving the heart and brain. Seizures can be classified as those of early and those of late onset in a paradigm comparable to post-traumatic epilepsy, with an arbitrary dividing point of two weeks after the event. Most early-onset seizures occur during the first day after the stroke. Late-onset seizures occur three times more often than early-onset ones. A first late-onset epileptic event is most likely to take place between six months and two years after the stroke. However, up to 28% of patients develop their first seizure several years later. Simple partial seizures, with or without secondary generalisation, account for about 50% of total seizures, while complex partial spells, with or without secondary generalisation, and primary generalised tonic–clonic insults account for approximately 25% each. Status epilepticus occurs in 12% of stroke patients, but the recurrence rate after an initial status epilepticus is not higher than after a single seizure. Inhibitory seizures, mimicking transient ischaemic attacks, are observed in 7.1% of cases. The only clinical predictor of late-onset seizures is the initial presentation of partial anterior circulation syndrome due to a territorial infarct. Patients with total anterior circulation syndrome have less chance of developing epileptic spells, not only due to their shorter life expectancy but also due to the fact that the large infarcts are sharply demarcated in these patients. The optimal timing and type of antiepileptic drug
Manning, K; Birkenheuer, A J; Briley, J; Montgomery, S A; Harris, J; Vanone, S L; Gookin, J L
Megaesophagus carries a poor to guarded prognosis due to death from aspiration pneumonia. Options for medical management of regurgitation are limited to strategic oral or gastrostomy tube feeding. To describe the use and efficacy of intermittent esophageal suctioning to prevent regurgitation and associated episodes of aspiration pneumonia in dogs with megaesophagus. Four dogs with acquired idiopathic megaesophagus and recurrent aspiration pneumonia. Retrospective review of medical records of dogs with megaesophagus in which intermittent suctioning of esophageal content was employed for management of recurrent aspiration pneumonia. Intermittent suctioning of the esophagus was initiated in 4 dogs after failure of strict gastrostomy tube feeding failed to prevent regurgitation and repeated episodes of aspiration pneumonia. Suctioning was accomplished by esophagostomy tube in 3 dogs and per os in 1 dog. After initiation of esophageal suctioning, dogs survived for a median of 13.5 additional months (range, 10-30 months) during which time 2 dogs had no additional episodes of aspiration pneumonia and 2 dogs had infrequent episodes of pneumonia, but aspiration was suspected to be a contributing factor in their death. Complications included clogging of the esophagostomy tube, esophagostomy site infections, and esophagitis. Use of intermittent esophageal suctioning in dogs with megaesophagus that continue to regurgitate despite gastrostomy tube feedings can reduce or abolish clinical episodes of aspiration pneumonia. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Kakuda, Wataru; Abo, Masahiro; Sasanuma, Jinichi; Shimizu, Masato; Okamoto, Takatsugu; Kimura, Chikou; Kakita, Kiyohito; Hara, Hiroyoshi
Several years ago, we proposed a combination protocol of repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Subsequently, the number of patients treated with the protocol has increased in Japan. We aimed to present the latest data on our proposed combination protocol for post-stroke upper limb hemiparesis as a result of a multi-institutional study. After confirming that a patient met the inclusion criteria for the protocol, they were scheduled to receive the 15-day inpatient protocol. In the protocol, two sessions of 20-min rTMS and 120-min occupational therapy were provided daily, except for Sundays and the days of admission/discharge. Motor function of the affected upper limb was evaluated by the Fugl-Meyer assessment (FMA) and Wolf motor function test (WMFT) at admission/discharge and at 4 weeks after discharge if possible. A total of 1725 post-stroke patients were studied (mean age at admission 61.4 ± 13.0 years). The scheduled 15-day protocol was completed by all patients. At discharge, the increase in FMA score, shortening in performance time of WMFT, and increase in functional ability scale (FAS) score of WMFT were significant (FMA score 46.8 ± 12.2 to 50.9 ± 11.4 points, p upper limb hemiparesis after stroke, although its efficacy should be confirmed in a randomized controlled study.
Anderson, N.E.; Bonita, R.; Broad, J.B.
Studies of acute stroke management in stroke units and tertiary referral hospitals may not accurately reflect practice within the population. Reliable information on the management of stroke within a population is sparse. The aims of this study was to compare clinical practice in acute stroke management in Auckland with guidelines for the management and treatment of stroke in other countries; to provide a baseline measure against which future changes in management can be evaluated. All new stroke events in Auckland residents in 12 months were traced through multiple case finding sources. For each patient, a record of investigations and treatment during the first week of hospital admission was kept. One thousand eight hundred and three stroke events (including subarachnoid haemorrhages) occurred in 1761 patients in one year. Twenty-seven per cent of all events were managed outside hospital and 73% of the stroke events were treated in an acute hospital. Of the 1242 stroke events admitted to an acute hospital in the first week, only 6% were managed on the neurology and neurosurgery ward, 83% were managed by a general physician or geriatrician and 42% had computed tomography (CT). Of 376 validated ischaemic strokes, 44% were treated with aspirin and 12% with intravenous heparin. Of the 690 unspecified strokes (no CT or autopsy), 38% received aspirin and 0.5% heparin. The 28 day in-hospital case fatality for all stroke events admitted to an acute hospital during the first week was 25%. It was concluded that in Auckland, management of acute stroke differed from clinical guidelines in the high proportion of patients managed in the community, the low rate of neurological consultation, and the low frequency of CT scanning. Despite these deficiencies in management, the 28 day hospital case fatality in Auckland was similar to other comparable studies which had a high proportion of cases evaluated by a neurologist and CT. (authors)
Álvarez-Velasco, Rodrigo; Masjuan, Jaime; DeFelipe, Alicia; Corral, Iñigo; Estévez-Fraga, Carlos; Crespo, Leticia; Alonso-Cánovas, Araceli
Stroke on board aircraft has been reported in retrospective case series, mainly focusing on economy class stroke syndrome. Data on the actual incidence, pathogenesis, and prognosis of stroke in commercial flights are lacking. A prospective registry was designed to include all consecutive patients referred from an international airport (40 million passengers a year) to our hospital with a diagnosis of ischemic stroke or transient ischemic attack and onset of symptoms during a flight or immediately after landing. Forty-four patients (32 ischemic strokes and 12 transient ischemic attacks) were included over a 76-month period (January 2008 to April 2014). The estimated incidence of stroke was 1 stroke in 35 000 flights. Pathogeneses of stroke or transient ischemic attack were atherothrombotic in 16 (36%), economy class stroke syndrome in 8 (18%), cardioembolic in 7 (16%), arterial dissection in 4 (9%), lacunar stroke in 4 (9%), and undetermined in 5 (12%) patients. Carotid stenosis >70% was found in 12 (27%) of the patients. Overall prognosis was good, and thrombolysis was applied in 44% of the cases. The most common reason for not treating patients who had experienced stroke onset midflight was the delay in reaching the hospital. Only 1 patient with symptom onset during the flight prompted a flight diversion. We found a low incidence of stroke in the setting of air travel. Economy class stroke syndrome and arterial dissection were well represented in our sample. However, the main pathogenesis was atherothrombosis with a high proportion of patients with high carotid stenosis. © 2016 American Heart Association, Inc.
Full Text Available Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injectors are at risk of infections endocarditis, which carries risk for both ischemic and hemorrhagic stroke. Cerebral or subarachnoid hemorrhage usually occurs after rupture of a septic (mycotic aneurysm. Heroine users can are also at risk for hemorrhagic stroke secondary to liver failure with deranged clotting and to heroin nephropathy with uremia or malignant hypertension. In some heroin users the drug it self is directly causal due to vasculitis, hypersensitivity and immunologic changes. Embolization of foreign material to brain due to mixed of heroine with quinine can cause cerebral embolism. AMPHETAMINE AND other psychostimulants: In abuser of amphetamine hemorrhagic stroke can occur, oral, intravenous, nasal, and inhalational routes of administration have been reported. Most were chronic user, but in several patients, stroke followed a first exposure. Some of amphetamine induced intracranial hemorrhages are secondary to acute hypertension, some to cerebral vacuities, and some to a combination of two. Decongestants and diet pills: Phenylpropanolamine (PPA, an amphetamine – like drug, in decongestants and diet pills, induce acute hypertension, sever headache, psychiatric symptoms, seizures and hemorrhagic stroke. Ephedrine and pseudo ephedrine are present in decongestants and bronchodilators and induce headache, tachyarrhythmia, hypertensive emergency, and hemorrhagic and occlusive stroke. Ecstasy, 3,4 Methylenedioxymethamphetamin (MDMA with amphetamine like can
Ganesalingam, Jeban; Buddha, Sandeep; Carlton-Jones, Anoma L; Nicholas, Richard
Vasculitis is a rare, but treatable condition that can present to hyperacute stroke units. Thrombolysis does not treat the underlying pathology, and a rapidly evolving clinical picture drives clinical decision often before all the investigation results are available.
Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.
Grace Vincent-Onabajo; Taritei Moses
Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke?whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk fac...
Mattle, Heinrich P.; Brainin, Michael; Chamorro, Angel; Diener, Hans Christoph; Hacke, Werner; Leys, Didier; Norrving, Bo; Ward, Nick
The European Stroke Organisation (ESO) held its first European Stroke Science Workshop in Garmisch-Partenkirchen, Germany (15-17 December 2011). Stroke experts based in Europe were invited to present and discuss their current research. The scope of the workshop was to review the most recent findings of selected topics in stroke, to exchange ideas, to stimulate new research and to enhance collaboration between European stroke research groups. Seven scientific sessions were held, each starting with a keynote lecture to review the state of the art of the given topic, followed by 4 or 5 short presentations by experts. They were asked to limit their presentations to 10 slides containing only recent information. The meeting was organized by the executive committee of the ESO (Heinrich Mattle, chairman, Michael Brainin, Angel Chamorro, Werner Hacke, Didier Leys) and supported by the European Stroke Conference (Michael Hennerici). In this article we summarize the main contents of this successful workshop. PMID:22836350
Full Text Available Objectives: to check the consequences of poststroke dysphagia and to reflect on the nurse’s intervention in dysphagia rehabilitation. Methodology: it was performed a systematic literature review of the topic in question; research based on international databases EBSCOhost, LILACS, SciELO.We were able to identify some studies publications between 2006 and 2014. We intend to answer the guiding question: What are the consequences of dysphagia in the patient after stroke? » Results vs. Discussion: after a thorough analysis, we have selected 11 articles and found that the most frequent consequences of dysphagia are the pulmonary complications by saliva and/or food suction. The nurse specialist still has a barely visible role, but his/her interventions are critical in these patients rehabilitation. Conclusions: rehabilitation is essential to avoid the consequences of poststroke dysphagia. The rehabilitation process must go through a multidisciplinary team of which nurses are an integral and essential part.
Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Koehrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Warach, Steven
The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke
Inamasu, Joji; Tomiyasu, Kazuhiro; Miyatake, Satoru; Mayanagi, Keita; Yoshii, Masami; Nakatsukasa, Masashi
While autonomic imbalance during defecation/micturition can cause hemodynamic instability, stroke occurring in the toilet has rarely been investigated. The objective of the present study was to clarify the frequency and clinical characteristics of toilet-related stroke. Clinical data prospectively acquired between January 2011 and December 2015 on 1939 patients with acute stroke (1224 cerebral infarctions [CI], 505 intracerebral hemorrhages [ICH] and 210 subarachnoid hemorrhages [SAH]) were reviewed to identify patients with a toilet-related stroke. For each stroke type, the ratios of stroke occurring during defecation/micturition to those occurring during other activities were calculated. Subsequently, how patients with toilet-related stroke were brought to medical attention was investigated. Whether older patients (aged >65 years) had an elevated ratio of toilet-related stroke was investigated in each stroke type. A total of 108 patients (41 CI, 37 ICH and 30 subarachnoid hemorrhages) sustained a stroke in the toilet. The ratio of toilet-related stroke was highest in subarachnoid hemorrhages (14.3%), followed by ICH (7.3%). Circadian differences existed among the three stroke types: toilet-related CI were more likely to occur in the night-time than ICH. Patients with toilet-related CI were significantly more likely to sustain cardioembolic stroke. In all three stroke types, toilet-related stroke in CI, but not in hemorrhagic strokes. The toilet is a closed space where stroke occurs disproportionately frequently. Effort to reduce the incidence of toilet-related strokes is warranted, as early patient detection is not always feasible. Geriatr Gerontol Int 2018; 18: 250-255. © 2017 Japan Geriatrics Society.
Andersen, Klaus Kaae; Olsen, Tom Skyhøj
Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied the ...... the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke)....
Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.
Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....
Full Text Available Abstract Background Stroke is the third leading cause of death in developed countries and the leading cause of long-term disability worldwide. A series of national stroke audits in the UK highlighted the differences in stroke care between hospitals. The study aims to describe variation in outcomes following stroke and to identify the characteristics of services that are associated with better outcomes, after accounting for case mix differences and individual prognostic factors. Methods/Design We will conduct a cohort study in eight acute NHS trusts within East of England, with at least one year of follow-up after stroke. The study population will be a systematically selected representative sample of patients admitted with stroke during the study period, recruited within each hospital. We will collect individual patient data on prognostic characteristics, health care received, outcomes and costs of care and we will also record relevant characteristics of each provider organisation. The determinants of one year outcome including patient reported outcome will be assessed statistically with proportional hazards regression models. Self (or proxy completed EuroQol (EQ-5D questionnaires will measure quality of life at baseline and follow-up for cost utility analyses. Discussion This study will provide observational data about health service factors associated with variations in patient outcomes and health care costs following hospital admission for acute stroke. This will form the basis for future RCTs by identifying promising health service interventions, assessing the feasibility of recruiting and following up trial patients, and provide evidence about frequency and variances in outcomes, and intra-cluster correlation of outcomes, for sample size calculations. The results will inform clinicians, public, service providers, commissioners and policy makers to drive further improvement in health services which will bring direct benefit to the patients.
Josse, Gwendal; Douki, Thierry; Le Digabel, Jimmy; Gravier, Eleonore; Questel, Emmanuel
The formation of DNA photoproducts caused by solar UVR exposure needs to be investigated in-vivo and in particular in order to assess sunscreens' level of protection against solar genotoxicity. The study's purposes were: i) to evaluate if the roof of suction blisters is an appropriate sampling method for measuring photoproducts, and ii) to measure in-vivo sunscreen protection against cyclobutane pyrimidine dimers. Skin areas on the interior forearms of eight healthy volunteers were exposed in-vivo to 2 MED of simulated solar radiation (SSR) and to 15 MED on a sunscreen protected area. After irradiation, six suction blisters were induced and the blister roofs were collected. Analysis of SSR-induced CPDs was performed by two independent methods: a chromatography coupled to mass spectroscopy (HPLC-MS/MS) approach and a 3D-imaging of CPD immunostaining by multiphoton microscopy on floating epidermal sheets. HPLC-MS/MS analyses showed that SSR-unexposed skin presented no CPD dimers, whereas 2 MED SSR-exposed skin showed a significant number of TT-CPD. The sunscreen covered skin exposed to 15 MED appeared highly protected from DNA damage, as the amount of CPD-dimers remained below the detection limit. The multiphoton-immunostaining analysis consistently showed that no CPD staining was observed on the non-SSR-exposed skin. A significant increase of CPD staining intensity and number of CPD-positive cells were observed on the 2 MED SSR-exposed skin. Sunscreen protected skin presented a very low staining intensity and the number of CPD-positive cells remained very close to non-SSR-exposed skin. This study showed that suction blister samples are very appropriate for measuring CPD dimers in-vivo, and that sunscreens provide high protection against UVR-induced DNA damage. Copyright © 2017 Elsevier B.V. All rights reserved.
Otani, Naoki; Morimoto, Yuji; Fujii, Kazuya; Toyooka, Terushige; Wada, Kojiro; Mori, Kentaro
Endoscopy can observe the anatomical components in a deeply located and/or hidden area during neurosurgical procedures under the operating microscope. We have newly developed a flexible ultrathin endoscope integrated with irrigation suction apparatus (FUEISA) to visualize deeply located and/or hidden areas for assisting microneurosurgery. The present study investigated the usefulness of the FUEISA system for direct clipping surgery of cerebral aneurysms. Twenty-one patients underwent microneurosurgery assisted with the FUEISA system for direct clipping of cerebral aneurysms. The flexible ultrathin endoscope (outer diameter 0.75mm) consists of an image guide (6000 dpi) and a light guide, integrated with the irrigation suction apparatus. This endoscopic system was inserted before and after clipping to observe the anatomical conditions surrounding the lesions. In all cases, handling and operation of the FUEISA was technically successful during the surgical procedure. The ultrathin endoscope was adequately integrated with the irrigation suction apparatus in all cases. General anatomy visualization including the lenticulostriate arteries, medial striate arteries, and/or internal carotid artery perforators was possible, and the correct clip positioning and vessel conditions were easily checked. The endoscope revealed that the clip had been positioned incorrectly in one case. No complications associated with the endoscopic system occurred. The FUEISA system can be applied with safe manipulation, which was remarkably useful for confirmation of the presence of perforators and cranial nerves behind the lesions, particularly anatomical components located in deep and/or hidden areas during clipping of cerebral aneurysms. Copyright © 2017 Elsevier Inc. All rights reserved.
P Martin Sander
Full Text Available BACKGROUND: Ichthyosaurs were an important group of Mesozoic marine reptiles and existed from the Early Triassic to the early Late Cretaceous. Despite a great diversity in body shapes and feeding adaptations, all share greatly enlarged eyes, an elongated rostrum with numerous conical teeth, and a streamlined body. METHODOLOGY/PRINCIPAL FINDINGS: Based on new material from China and the restudy of Shastasaurus pacificus, we here reinterpret the classical large-bodied Late Triassic ichthyosaur genus Shastasaurus to differ greatly from the standard ichthyosaurian body plan, indicating much greater morphological diversity and range of feeding adaptations in ichthyosaurs than previously recognized. Phylogenetic analysis indicates a monophyletic clade consisting of the giant Shonisaurus sikanniensis, Guanlingsaurus liangae, and Shastasaurus pacificus to which the genus name Shastasaurus is applied. Shastasaurus liangae comb. nov. is from the Late Triassic (Carnian Xiaowa Formation of Guizhou Province, southwestern China. The species combines a diminutive head with an entirely toothless and greatly reduced snout. The species also has by far the highest vertebral count among ichthyosaurs (86 presacral vertebrae and >110 caudal vertebrae, a count that is also very high for tetrapods in general. A reduced toothless snout and a diminutive head is also apparently present in the giant S. sikanniensis and presumably in S. pacificus. CONCLUSIONS/SIGNIFICANCE: In analogy to many modern odontocetes, Shastasaurus is interpreted as a specialized suction feeder on unshelled cephalopods and fish, suggesting a unique but widespread Late Triassic diversification of toothless, suction-feeding ichthyosaurs. Suction feeding has not been hypothesized for any of the other diverse marine reptiles of the Mesozoic before, but in Shastasaurus may be linked to the Late Triassic minimum in atmospheric oxygen.
Ishikawa, Hiroshi; Unno, Youichi; Omoto, Akiko; Shozu, Makio
To report the results of local injection of diluted vasopressin followed by suction curettage as a conservative treatment for women with cervical ectopic pregnancy, who wish to preserve their future fertility. This was a retrospective chart review in a university hospital and a municipal hospital. We injected diluted vasopressin (Pitressin R, total amount of 4-10 units) transvaginally into the cervix surrounding the gestational sac, but not directly into the gestational sac, and/or the lower segment of the uterine body under transvaginal ultrasonographic guidance. After cessation of fetal heartbeats, we aspirated the conceptus by performing suction curettage. We injected additional vasopressin into the gestational sac in cases with a viable fetus after the initial injection. Forced contraction of the cervical smooth muscle facilitated removal of the conceptus with minimal blood loss during curettage. We measured operative time, total blood loss, complications, and the need for additional treatment. We included 11 women. Mean patient age, gestational age, and serum human chorionic gonadotrophin (hCG) at the intervention were 31.2±6.4years, 6.0±0.6 weeks, and 18,370±21,570 IU/L, respectively. Mean size of the gestational sac was 19.6±9.5mm. The uterus was successfully preserved without any complications in all patients. All procedures were completed within 15min except for the first case (range: 5-33min). In 4 cases, the conceptus containing a gestational sac was spontaneously extruded en bloc from the external os after the injection. Additional systematic methotrexate administration was required in one case because of remaining villi at the implantation site with persistence of serum hCG levels after the procedure. Local injection of diluted vasopressin and subsequent suction curettage is a feasible conservative treatment for cervical ectopic pregnancy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Sharma, Gaurav M.; Palekar, Gauresh; Tanna, Dilip D.
Purpose: The age-old practice of closed suction drain following orthopedic procedures has been challenged since past few decades. Our aim was to assess the effectiveness of closed suction drain after total knee arthroplasty. Materials and methods: One hundred twenty patients (135 knees) with primary Total Knee Arthroplasty were divided into a study group (no drain) and a control group (drain used). Inclusion criteria were grade 3 and grade 4 osteoarthritis of the knee. Revision cases and rheumatoid arthritis were excluded. Parameters assessed were pain, pre and post-op Hb, dressing change, early infection, ecchymosis and duration of stay. Results were calculated using Western Ontario and McMaster Universities Osteoarthritis Index and Oxford Knee scoring systems at two weeks, six months and one year. Results: Mean age was 72.03 ± 6.68 in study group and 71.38 ± 7.02 in control group. Pre and post op Hb was 12.1678 ± 1.3220 (study group), 12.1803 ± 1.2717 (control group) and 9.8373 ± 1.5703 (study group), 9.7918 ± 1.4163 (control group). There was one case of early infection in both groups which was controlled by oral antibiotics. Change of dressing and ecchymosis were more in the study group. Duration of hospital stay was more in the control group p < 0.0006 (statistically significant). Conclusion: There is no added advantage of closed suction drain over no drain usage and this practice can safely be brought to a halt. PMID:27855775
Stahl, Stephanie M; Yaggi, H Klar; Taylor, Stanley; Qin, Li; Ivan, Cristina S; Austin, Charles; Ferguson, Jared; Radulescu, Radu; Tobias, Lauren; Sico, Jason; Vaz Fragoso, Carlos A; Williams, Linda S; Lampert, Rachel; Miech, Edward J; Matthias, Marianne S; Kapoor, John; Bravata, Dawn M
The literature about the relationship between obstructive sleep apnea (OSA) and stroke location is conflicting with some studies finding an association and others demonstrating no relationship. Among acute ischemic stroke patients, we sought to examine the relationship between stroke location and the prevalence of OSA; OSA severity based on apnea-hypopnea index (AHI), arousal frequency, and measure of hypoxia; and number of central and obstructive respiratory events. Data were obtained from patients who participated in a randomized controlled trial (NCT01446913) that evaluated the effectiveness of a strategy of diagnosing and treating OSA among patients with acute ischemic stroke and transient ischemic attack. Stroke location was classified by brain imaging reports into subdivisions of lobes, subcortical areas, brainstem, cerebellum, and vascular territory. The association between acute stroke location and polysomnographic findings was evaluated using logistic regression for OSA presence and negative binomial regression for AHI. Among 73 patients with complete polysomnography and stroke location data, 58 (79%) had OSA. In unadjusted models, no stroke location variable was associated with the prevalence or severity of OSA. Similarly, in multivariable modeling, groupings of stroke location were also not associated with OSA presence. These results indicate that OSA is present in the majority of stroke patients and imply that stroke location cannot be used to identify a group with higher risk of OSA. The results also suggest that OSA likely predated the stroke. Given this high overall prevalence, strong consideration should be given to obtaining polysomnography for all ischemic stroke patients. Published by Elsevier B.V.
Chen, Wen-Li; Li, Hui; Hu, Hui
An experimental investigation was conducted to assess the effectiveness of a suction flow control method for vortex-induced vibration (VIV) suppression. The flow control method uses a limited number of isolated suction holes to manipulate the vortex shedding in the wake behind a circular cylinder in order to reduce the unsteadiness of the dynamic wind loads acting on the cylinder. The experimental study was performed at Re ≈ 3.0 × 104, i.e., in the typical Reynolds number range of VIV for the cables of cable-stayed bridges. In addition to measuring the surface pressure distributions to determine the resultant dynamic wind loads acting on the test model, a digital particle image velocimetry system was used to conduct detailed flow field measurements to reveal the changes in the shedding process of the unsteady wake vortex structures from the test model with and without the suction flow control. The effects of important controlling parameters (i.e., the azimuthal locations of the suction holes in respect to the oncoming airflow, the spanwise spacing between the suction holes, and the suction flow rate through the suction holes) on the wake flow characteristics, the surface pressure distributions, and the resultant dynamic wind loads were assessed quantitatively. While a higher suction flow rate and smaller spanwise spacing between the suction holes were beneficial to the effectiveness of the suction flow control, the azimuthal locations of the suction holes were found to be very critical for reducing the fluctuating amplitudes of the dynamic wind loads acting on the test model using the suction flow control method. With the suction holes located at the proper azimuthal locations on the test model (i.e., at the azimuthal angle of θ = 90° and 270° for the present study), the characteristics of the wake flow behind the test model were found to change significantly along the entire span of the test model, even though only a limited number of the isolated suction
Tuttolomondo, Antonino; Casuccio, Alessandra; Buttà, Carmelo; Pecoraro, Rosaria; Di Raimondo, Domenico; Della Corte, Vittoriano; Arnao, Valentina; Clemente, Giuseppe; Maida, Carlo; Simonetta, Irene; Miceli, Giuseppe; Lucifora, Benedetto; Cirrincione, Anna; Di Bona, Danilo; Corpora, Francesca; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio
Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke. To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study. The type of acute ischemic stroke was classified according to the TOAST criteria. All patients admitted to our ward with acute ischemic stroke completed a 137-item validated food-frequency questionnaire adapted to the Sicilian population. A scale indicating the degree of adherence to the traditional Mediterranean Diet was used (Me-Di score: range 0-9). 198 subjects with acute ischemic stroke and 100 control subjects without stroke. Stroke subjects had a lower mean Mediterranean Diet score compared to 100 controls without stroke. We observed a significant positive correlation between Me-Di score and SSS score, whereas we observed a negative relationship between Me-Di score and NIHSS and Rankin scores. Subjects with atherosclerotic (LAAS) stroke subtype had a lower mean Me-Di score compared to subjects with other subtypes. Multinomial logistic regression analysis in a simple model showed a negative relationship between MeDi score and LAAS subtype vs. lacunar subtype (and LAAS vs. cardio-embolic subtype). Patients with lower adherence to a Mediterranean Diet are more likely to have an atherosclerotic (LAAS) stroke, a worse clinical presentation of ischemic stroke at admission and a higher Rankin score at discharge. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Judd, Suzanne E; Gutiérrez, Orlando M.; Newby, PK; Howard, George; Howard, Virginia J; Locher, Julie L; Kissela, Brett M; Shikany, James M
Background and Purpose Black Americans and residents of the Southeastern United States, are at increased risk of stroke. Diet is one of many potential factors proposed that might explain these racial and regional disparities. Methods Between 2003–2007, the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study enrolled 30,239 black and white Americans aged 45 years or older. Dietary patterns were derived using factor analysis and foods from food frequency data. Incident strokes were adjudicated using medical records by a team of physicians. Cox proportional hazards models were used to examine risk of stroke. Results Over 5.7 years, 490 incident strokes were observed. In a multivariable-adjusted analysis, greater adherence to the Plant-based pattern was associated with lower stroke risk (HR=0.71; 95% CI=0.56–0.91; ptrend=0.005). This association was attenuated after addition of income, education, total energy intake, smoking, and sedentary behavior. Participants with a higher adherence to the Southern pattern experienced a 39% increased risk of stroke (HR=1.39; 95% CI=1.05, 1.84), with a significant (p = 0.009) trend across quartiles. Including Southern pattern in the model mediated the black-white risk of stroke by 63%. Conclusions These data suggest that adherence to a Southern style diet may increase the risk of stroke while adherence to a more plant-based diet may reduce stroke risk. Given the consistency of finding a dietary impact on stroke risk across studies, discussing nutrition patterns during risk screening may be an important step in reducing stroke. PMID:24159061
Fair, C.E.; Cook, M.E.; Huber, K.A.; Rohde, R.
The mechanical and hydraulic design features of the 85,000-gpm, single-stage, single-suction pump test article, which is designed to circulate liquid-sodium coolant in the intermediate heat-transport system of a Large-Scale Liquid Metal Fast Breeder Reactor (LS-LMFBR), are described. The design and analytical considerations used to satisfy the pump performance and operability requirements are presented. The validation of pump hydraulic performance using a hydraulic scale-model pump is discussed, as is the featute test for the mechanical-shaft seal system
Kiørboe, Thomas; Møhlenberg, F.
The concentration of suspended material in the immediate vicinity of an operating sand suction dredge in the Oresund was 3-5000mg/l. Concentrations > 100 mg/l were restricted to a downstream distance of .apprx. 150m and ambient levels were reached within .apprx. 1 km of the dredge. The natural...... variation in the concentration of suspended material was between 0-6 mg/l during 3/4 yr. Deleterious effects to flora and fauna of concentrations > 100 mg/l were of limited interest, due to the restricted area impacted by high concentration. Significant, negative effects of concentrations
S. A. Shehzad
Full Text Available Effect of mass transfer in the magnetohydrodynamic flow of a Casson fluid over a porous stretching sheet is addressed in the presence of a chemical reaction. A series solution for the resulting nonlinear flow is computed. The skin friction coefficient and local Sherwood number are analyzed through numerical values for various parameters of interest. The velocity and concentration fields are illustrated for several pertinent flow parameters. We observed that the Casson parameter and Hartman number have similar effects on the velocity in a qualitative sense. We further analyzed that the concentration profile decreases rapidly in comparison to the fluid velocity when we increased the values of the suction parameter.
Salamonsen, Robert Francis; Lim, Einly; Moloney, John; Lovell, Nigel Hamilton; Rosenfeldt, Franklin L
This study in five large greyhound dogs implanted with a VentrAssist left ventricular assist device focused on identification of the precise site and physiological changes induced by or underlying the complication of left ventricular suction. Pressure sensors were placed in left and right atria, proximal and distal left ventricle, and proximal aorta while dual perivascular and tubing ultrasonic flow meters measured blood flow in the aortic root and pump outlet cannula. When suction occurred, end-systolic pressure gradients between proximal and distal regions of the left ventricle on the order of 40-160 mm Hg indicated an occlusive process of variable intensity in the distal ventricle. A variable negative flow difference between end systole and end diastole (0.5-3.4 L/min) was observed. This was presumably mediated by variable apposition of the free and septal walls of the ventricle at the pump inlet cannula orifice which lasted approximately 100 ms. This apposition, by inducing an end-systolic flow deficit, terminated the suction process by relieving the imbalance between pump requirement and delivery from the right ventricle. Immediately preceding this event, however, unnaturally low end-systolic pressures occurred in the left atrium and proximal left ventricle which in four dogs lasted for 80-120 ms. In one dog, however, this collapse progressed to a new level and remained at approximately -5 mm Hg across four heart beats at which point suction was relieved by manual reduction in pump speed. Because these pressures were associated with a pulmonary capillary wedge pressure of -5 mm Hg as well, they indicate total collapse of the entire pulmonary venous system, left atrium, and left ventricle which persisted until pump flow requirement was relieved by reducing pump speed. We suggest that this collapse caused the whole vascular region from pulmonary capillaries to distal left ventricle to behave as a Starling resistance which further reduced right
Onuf, Christopher P.; Chapman, Duane C.; Rizzo, William M.
Collection of sediment cores in depths of 1-5 m is difficult with traditional sampling gear. Here we describe three suction coring devices constructed with readily available plumbing supplies and parts easily made from acrylic plastic and silicone sealant. The samplers have been used successfully in sediments ranging from coarse sands and shell hash to muds, highly organic deposits, and dense clays. Successful applications have ranged from contaminants analysis, toxicity testing, seagrass mapping, and assessment of sediment-microfloral interactions to sampling the infauna of surf-swept beaches.
Full Text Available In this study, the seasonal flight activity of the Phlaeothripidae (Thysanoptera species was studied by using suction trap, in South-East Hungary, in the years 2000 and 2004 from April to October. The flight period of two dominant species, namely Haplothrips angusticornis Priesner and Haplothrips aculeatus Fabricius (Thysanoptera: Phlaeothripidae, was observed in high number in Europe. Also, it was the first record of mass flight observation of H. angusticornis. In addition, the effect of meteorological factors, such as temperature, sunshine duration, relative humidity, air pressure, and their influences, were evaluated.
Full Text Available Reducing friction resistance and aerodynamic heating has important engineering significance to improve the performances of super/hypersonic aircraft, so the purpose of transition control and turbulent drag reduction becomes one of the cutting edges in turbulence research. In order to investigate the influences of wall cooling and suction on the transition process and fully developed turbulence, the large eddy simulation of spatially evolving supersonic boundary layer transition over a flat-plate with freestream Mach number 4.5 at different wall temperature and suction intensity is performed in the present work. It is found that the wall cooling and suction are capable of changing the mean velocity profile within the boundary layer and improving the stability of the flow field, thus delaying the onset of the spatial transition process. The transition control will become more effective as the wall temperature decreases, while there is an optimal wall suction intensity under the given conditions. Moreover, the development of large-scale coherent structures can be suppressed effectively via wall cooling, but wall suction has no influence.
Anesthetic methods, apparatus, and respiratory care patterns have changed greatly in the past several decades. New scrutiny must be applied to patterns of carbon dioxide absorber consumption in the canisters in anesthesia circuits. Fine examination may be performed by extracting absorber granules by suction to avoid jumbling the granules in the canister. However, a general surgical suction apparatus has too narrow suction tubes, a low flow volume and too large reservoir bottles. We constructed a reservoir bottle of 1.5 l to trap the granules. The bottle is closed with an easily removable lid penetrated by inlet (with a larger diameter) and outlet cannulas. A conventional heat and moisture exchange filter is affixed to the outlet to prevent contamination of the suction system by alkaline absorber dust. Suction may be applied by a vacuum cleaner with a higher flow rate. Traditional recommendation to use baffles along the inside wall of the canister to prevent "channeling of exhaled gases by the wall effect" may turn out to be misleading.
Mansoor, J.; Ahmed, M.
To determine the efficacy of low pressure vs high vacuum suction drains after modified radical mastectomy in terms of earlier removal and its impact on duration of hospital stay. Study Design: A randomized clinical trial. Place and Duration of Study: The study was conducted at Military Hospital Rawalpindi and CMH Peshawar over a period of 12 months from March 2010 to March 2011. Patients and Methods: Sixty trucut/biopsy proven, early invasive breast cancer patients undergoing modified radical mastectomy were randomized into groups A (n=30) and B (n=30) to receive high vacuum (400 mm Hg) suction drains or low vacuum suction drains (200 mm Hg) at completion of operation. Drains were recharged to the specified pressure daily and drain output was recorded. Drains were removed when the daily drainage reduced to 30 ml. Results: 28 patients in group A and 27 patients in group B were finally included in the study. Mean hospital stay in low vacuum suction group was 4.96 ± 0.898 days which was 32.9% shorter than 7.39 ± 1.397 days for high pressure suction group (p< 0.005). Conclusion: The use of low vacuum vs high vacuum drains after modified radical mastectomy reduces the hospital stay significantly. (author)
Full Text Available The effects of wall suction on the entropy generation rate in a two-dimensional steady film condensation flow on a horizontal tube are investigated theoretically. In analyzing the liquid flow, the effects of both the gravitational force and the viscous force are taken into account. In addition, a film thickness reduction ratio, Sf, is introduced to evaluate the effect of wall suction on the thickness of the condensate layer. The analytical results show that, the entropy generation rate depends on the Jakob number Ja, the Rayleigh number Ra, the Brinkman number Br, the dimensionless temperature difference ψ, and the wall suction parameter Sw. In addition, it is shown that in the absence of wall suction, a closed-form correlation for the Nusselt number can be derived. Finally, it is shown that the dimensionless entropy generation due to heat transfer, NT, increases with an increasing suction parameter Sw, whereas the dimensionless entropy generation due to liquid film flow friction, NF, decreases.
Friction Model, are implemented as user defined material models in the commercial finite element program ABAQUS. The simulated tests are partly pullout tests, subsequent cyclic loading, partly drained tests on buckets subject to vertical, horizontal and moment loading. The numerical analyses are capable...
Parra, Olga; Arboix, Adrià
The association between sleep-disordered breathing (SDB) and cardiovascular risk has been the focus of attention in recent years. Sleep disorders are emerging risk factors for cardiovascular disease and have been related to the whole spectrum of stroke, including transient ischemic attack, ischemic cerebral infarction and intracerebral haemorrhage. It has been shown that lacunar stroke or lacunar infarctions affecting the internal capsule or the protuberance are associated with a higher frequency of SDB. Acute stroke patients with associated SDB have a worse prognosis and a higher mortality as compared to patients with first-ever stroke without SDB. Preliminary studies provide evidence of the usefulness of treatment with continuous positive airway pressure when SDB is present in stroke patients.
Fu, Ying; Liu, Qiang; Anrather, Josef
Inflammatory and immune responses in the brain can shape the clinical presentation and outcome of stroke. Approaches for effective management of acute stroke are sparse and many measures for brain protection fail, but our ability to modulate the immune system and modify the disease progression of multiple sclerosis is increasing. As a result, immune interventions are currently being explored as therapeutic interventions in acute stroke. In this Review, we compare the immunological features of acute stroke with those of multiple sclerosis, identify unique immunological features of stroke, and consider the evidence for immune interventions. In acute stroke, microglia activation and cell death products trigger an inflammatory cascade that damages vessels and the parenchyma within minutes to hours of the ischaemia or haemorrhage. Immune interventions that restrict brain inflammation, vascular permeability and tissue oedema must be administered rapidly to reduce acute immune-mediated destruction and to avoid subsequent immunosuppression. Preliminary results suggest that the use of drugs that modify disease in multiple sclerosis might accomplish these goals in ischaemic and haemorrhagic stroke. Further elucidation of the immune mechanisms involved in stroke is likely to lead to successful immune interventions. PMID:26303850
Andrews, Glenda; Halford, Graeme S.; Shum, David; Maujean, Annick; Chappell, Mark; Birney, Damian
The research examined relational processing following stroke. Stroke patients (14 with frontal, 30 with non-frontal lesions) and 41 matched controls completed four relational processing tasks: sentence comprehension, Latin square matrix completion, modified Dimensional Change Card Sorting, and n-back. Each task included items at two or three…
... Event Join a Stroke Challenge Team Comeback Trail Tell Your Story Community Presentations Faces of Stroke Volunteer With Us ... in a video presentation. Watch Video ... to feel the right side of her body. Kathryn’s friends performed the FAST exam and soon ...
Jarenwattananon, A.; Khandji, A.; Brust, J.C.M.
Since the development of cerebral angiography 60 years ago, there has been a proliferation of increasingly sophisticated, expensive, and, fortunately, safe imaging techniques for patients with cerebrovascular disease. In addition, occlusive and hemorrhagic stroke are now recognized as having a wide variety of possible causes. This chapter addresses the different imaging options available for particular kinds of stroke
Buchinger, Mikael; Durigen, Susan; Dahl, Johan Rambech
The paper presents a preliminary investigation into aspects of the game of golf. A series of models is proposed for the golf stroke, the momentum transfer between club and ball and the flight of the ball.Numerical and asymptotic solutions are presented reproducing many of the features observed...... in the golf stroke of a professional golfer....
Baldwin, Kathleen; Orr, Sean; Briand, Mary; Piazza, Carolyn; Veydt, Annita; McCoy, Stacey
Stroke is the third most common cause of death in the United States and is the number one cause of long-term disability. Legislative mandates, largely the result of the American Heart Association, American Stroke Association, and Brain Attack Coalition working cooperatively, have resulted in nationwide standardization of care for patients who experience a stroke. Transport to a skilled facility that can provide optimal care, including immediate treatment to halt or reverse the damage caused by stroke, must occur swiftly. Admission to a certified stroke center is recommended for improving outcomes. Most strokes are ischemic in nature. Acute ischemic stroke is a heterogeneous group of vascular diseases, which makes targeted treatment challenging. To provide a thorough review of the literature since the 2007 acute ischemic stroke guidelines were developed, we performed a search of the MEDLINE database (January 1, 2004-July 1, 2009) for relevant English-language studies. Results (through July 1, 2009) from clinical trials included in the Internet Stroke Center registry were also accessed. Results from several pivotal studies have contributed to our knowledge of stroke. Additional data support the efficacy and safety of intravenous alteplase, the standard of care for acute ischemic stroke since 1995. Due to these study results, the American Stroke Association changed its recommendation to extend the time window for administration of intravenous alteplase from within 3 hours to 4.5 hours of symptom onset; this recommendation enables many more patients to receive the drug. Other findings included clinically useful biomarkers, the role of inflammation and infection, an expanded role for placement of intracranial stents, a reduced role for urgent carotid endarterectomy, alternative treatments for large-vessel disease, identification of nontraditional risk factors, including risk factors for women, and newly published pediatric stroke guidelines. In addition, new devices for
Johnsen, Søren Paaske; Ingeman, Annette; Hundborg, Heidi Holmager
AIM OF DATABASE: The aim of the Danish Stroke Registry is to monitor and improve the quality of care among all patients with acute stroke and transient ischemic attack (TIA) treated at Danish hospitals. STUDY POPULATION: All patients with acute stroke (from 2003) or TIA (from 2013) treated...... at Danish hospitals. Reporting is mandatory by law for all hospital departments treating these patients. The registry included >130,000 events by the end of 2014, including 10,822 strokes and 4,227 TIAs registered in 2014. MAIN VARIABLES: The registry holds prospectively collected data on key processes...... of care, mainly covering the early phase after stroke, including data on time of delivery of the processes and the eligibility of the individual patients for each process. The data are used for assessing 18 process indicators reflecting recommendations in the national clinical guidelines for patients...
Dawson, Ang; Cloud, Geoffrey C; Pereira, Anthony C; Moynihan, Barry J
Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George's Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings. From 2,305 admissions, 555 stroke mimic diagnoses were identified (24.2%) and 72% of stroke mimics had at least one stroke risk factor. Common mimic diagnoses were headache, seizure and syncope. Medically unexplained symptoms and decompensation of underlying conditions were also common. Median length of stay was 1 day; a diagnosis of dementia (p=0.028) or needing MRI (p=0.006) was associated with a longer stay. Despite emergency department assessment by specialist clinicians and computed tomography brain, one in four suspected stroke patients admitted to hospital had a non-stroke diagnosis. Stroke mimics represent a heterogeneous patient group with significant impacts on stroke services. Co-location of stroke and acute neurology services may offer advantages where service reorganisation is being considered. © Royal College of Physicians 2016. All rights reserved.
Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a ...
The perception of patients to stroke is variable. The aim of this study was to determine the perception of stroke among stroke patients. The study was carried out between January 2004 - December 2004 on all the patients presenting with features of stroke at the Federal Medical Center Ido, Nigeria. Data were collected by ...
Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microbleeds, cognitive impairment, and carotid atherosclerosis. CKD is prevalent in acute stroke patients; patients with estimated glomerular filtration rate stroke patients and 39% of total intracerebral hemorrhage patients in our institute. Acute and chronic management of stroke are influenced by CKD. Therapeutic effects of several antithrombotic and thrombolytic agents, including recently-developed novel oral anticoagulants, are affected by renal function. Moreover, reduced glomerular filtration rate is independently associated with increased 1- and 10-year mortalities in the end. Stroke also has deep relationships with end-stage kidney disease. Stroke occurs much more commonly in dialysis patients than general population or CKD patients without need for dialysis. The triggers of ischemic and hemorrhagic stroke in patients with end-stage kidney disease include special characteristics unique to dialysis, such as drastic hemodynamic change, dialysate and anticoagulants, and vascular calcification. As cohorts of dialysis patients become older, more hypertensive, and more diabetic than before, stroke become more prevalent and more serious events in dialysis clinics. Now, clinicians should have much interest in the association between CKD and cerebrovascular diseases, so-called the cerebro-renal interaction. Copyright © 2013 S. Karger AG, Basel.
Threapleton, DE; Burley, VJ; Greenwood, DC; Cade, JE
BACKGROUND: Stroke risk is modifiable through many risk factors, one being healthy dietary habits. Fibre intake was associated with a reduced stroke risk in recent meta-analyses; however, data were contributed by relatively few studies, and few examined different stroke types. METHODS: A total of 27 373 disease-free women were followed up for 14.4 years. Diet was assessed with a 217-item food frequency questionnaire and stroke cases were identified using English Hospital Episode Statistics an...
Mohammadein, S A
The concentration distribution around a growing nitrogen gas bubble in the blood and other bio tissues of divers who ascend to surface too quickly is obtained by Mohammadein and Mohamed model (2010) for variant and constant ambient pressure through the decompression process. In this paper, the growing of gas bubbles and concentration distribution under the effect of suction process are studied as a modification of Mohammadein and Mohamed model (zero suction). The growth of gas bubble is affected by ascent rate, tissue diffusivity, initial concentration difference, surface tension and void fraction. Mohammadein and Mohamed model (2010) is obtained as a special case from the present model. Results showed that, the suction process activates the systemic blood circulation and delay the growth of gas bubbles in the bio tissues to avoid the incidence of decompression sickness (DCS). Copyright © 2014 Elsevier Inc. All rights reserved.
Lo, S; Rowe-Jones, J
Keypoints * Adenoid ablation using suction diathermy is associated with a number of difficulties, mainly associated with the use of the mirror. Transoral and transnasal 0 degree endoscopes have also been utilised but again have limitations. We describe a technique that overcomes the above problems. * A prospective case series of patients undergoing suction diathermy adenoidectomy under direct vision using a transoral 45 degree endoscope connected to a monitor was conducted, performed by surgical trainees and under direct supervision of the consultant trainer (J.R.-J.). * Intra-operatively, trainees had to demonstrate to the trainer the appropriate anatomy, completed adenoid ablation, and haemostasis. * Fifty-six cases have been performed. In every case, it was possible for the trainer to monitor the trainee's technique throughout the entire procedure. No complications have been reported. * We describe a modified technique which overcomes the disadvantages previously encountered by conventional suction diathermy adenoid ablation.
Full Text Available Abstract Background Suction drains are routinely used after modified radical mastectomy and are an important factor contributing to increased hospital stay as the patients are often discharged only after their removal. Amongst various factors that influence the amount of postoperative drainage, the negative suction pressure applied to the drain has been reported to be of great significance. While a high negative suction pressure is expected to drain the collection and reduce the dead space promptly, it may also prevent the leaking lymphatics from closing and lead to increased drainage from the wound. Against this background a prospective randomized clinical study was conducted to compare the amount and duration of drainage between a half negative suction and full vacuum suction drainage in patients following modified radical mastectomy. The associated postoperative morbidity was also compared between the two groups. Methods 85 FNAC (fine needle aspiration cytology proven cases of locally advanced breast cancer were randomized. (Using randomly ordered sealed envelops, which were opened immediately before the closure of the wound in to 50 patients with full vacuum suction (pressure = 700 g/m2 and 35 cases in to half vacuum suction drainage (pressure = 350 g/m2 groups. The two groups were comparable in respect of age, weight, and technique of operation and extent of axillary dissection. Surgery was performed by the same surgical team comprising of five surgeons (two senior and three resident surgeons using a standardized technique with electrocautery. External compression dressing was provided over the axilla for first 48 hrs and following that patients were encouraged to do active and passive shoulder exercises. The outcomes measured were postoperative morbidity and the length of hospital stay. Statistical methods used: Descriptive studies were performed with SPSS version 10 and group characteristics were compared using student t-test. Results
Full Text Available The compacted bentonite which has typical couple problem associated to thermal - hydration - mechanical – chemical (THMC consist of one component of engineered barrier. Recently, the couple THMC formulation modelling suggested by some researchers can be predicted basically phenomena for engineered barrier that approach to correct evaluate satisfied facilities. The compacted bentonite is essentially unsaturated condition, some behaviors for bentonite has similar or close with generally expansive unsaturated soils. Therefore, hydrations have given significant influence on deformation of compacted bentonite such as swelling. There are many researches for swelling behavior of compacted bentonite within soaking. Extended theoretical or experimental investigations for unsaturated soil mechanics are possible to describe the strength-deformation behavior of compacted bentonite with suction controlling principle. A new method of determining the failure phase such as great axis deformation and destructions like strip of surface in the laboratory is described and the creep behavior of compacted bentonite is considered under maintain of high relative humidity environment. The creep deformation measured using improved cyclic relative humidity control apparatus in terms of specific suction control technique.
Kolb, Gregory J [Albuquerque, NM
A suction-recirculation device for stabilizing the flow of a curtain of blackened heat absorption particles falling inside of a solar receiver with an open aperture. The curtain of particles absorbs the concentrated heat from a solar mirror array reflected up to the receiver on a solar power tower. External winds entering the receiver at an oblique angle can destabilize the particle curtain and eject particles. A fan and ductwork is located behind the back wall of the receiver and sucks air out through an array of small holes in the back wall. Any entrained particles are separated out by a conventional cyclone device. Then, the air is recirculated back to the top of the receiver by injecting the recycled air through an array of small holes in the receiver's ceiling and upper aperture front wall. Since internal air is recirculated, heat losses are minimized and high receiver efficiency is maintained. Suction-recirculation velocities in the range of 1-5 m/s are sufficient to stabilize the particle curtain against external wind speeds in excess of 10 m/s.
Clark, Cari Jo; Guo, Hongfei; Lunos, Scott; Aggarwal, Neelum T; Beck, Todd; Evans, Denis A; Mendes de Leon, Carlos; Everson-Rose, Susan A
Greater social cohesion is related to lower rates of coronary heart disease, but its relation to stroke risk is unstudied. This study examined whether neighborhood social cohesion was protective against stroke mortality and incidence. Data come from 5789 participants (60% female; 62% black; mean age, 74.7 years) in a longitudinal study of chronic diseases in the elderly. Stroke mortality, ascertained through December 31, 2007, was verified through the National Death Index; 186 stroke deaths were identified in 11 years of follow-up. Stroke incidence was determined in a subset (N=3816) with linkage to Medicare claims files; 701 first-ever strokes were identified. Cohesion was measured by 6 items assessing frequency of contact and social interactions with neighbors; items were z-scored and averaged. Individual scores were averaged across 82 census block groups, forming a neighborhood-level measure of social cohesion. Marginal Cox proportional hazard models tested the association of neighborhood-level cohesion with stroke mortality and incidence. Each 1-point increase in cohesion related to a 53% reduced risk of stroke mortality (hazard ratio, 0.47; 95% CI, 0.24 to 0.90), adjusting for relevant covariates, including sociodemographics, known stroke risk factors, and neighborhood-level socioeconomic status. A race×cohesion interaction (P=0.04) revealed cohesion was protective in whites (hazard ratio, 0.34; 95% CI, 0.17 to 0.67) but not blacks (hazard ratio, 1.17; 95% CI, 0.35 to 3.86). Cohesion was unrelated to stroke incidence (P>0.5). Neighborhood-level social cohesion was independently protective against stroke mortality. Research is needed to further examine observed race differences and pathways by which cohesion is health-protective.
Dichgans, Martin; Planas, Anna M.; Biessels, Geert Jan|info:eu-repo/dai/nl/165576367; van der Worp, Bart|info:eu-repo/dai/nl/189855010; Sudlow, Cathie; Norrving, B.; Lees, Kennedy; Mattle, Heinrich P.
Lake Eibsee, Garmisch-Partenkirchen, November 19 to 21, 2015: The European Stroke Organization convened >120 stroke experts from 27 countries to discuss latest results and hot topics in clinical, translational, and basic stroke research. Since its inception in 2011, the European Stroke Science
Hemorrhagic stroke in children occurs more frequently than is commonly appreciated. There are important differences in the factors associated with hemorrhagic stroke in children when compared with adults. These differences likely play a role in the different outcomes, which tend to worsen with age. In this review, we describe the estimated frequency, clinical presentation, acute management of hemorrhagic stroke, and an overview of rehabilitation techniques. We identify key topics for future basic and clinical research. Findings from future studies will help improve our ability to optimize treatment for and long-term rehabilitation of these patients. PMID:21633104
Wade, D T; Hewer, R L
Actual functional performance of 976 acute stroke patients was assessed using the Barthel index: the data were analysed to determine the frequency of disability after stroke, the validity of the Barthel index, and the recovery seen. At 6 months, over 45% of survivors were functionally independent. Validity of the Barthel index was confirmed: it related as expected with motor loss and factor analysis showed a single major factor. The items of the Barthel index form an hierarchical scale. There...
M. H. Harirchian
Full Text Available Numerous etiologies are responsible for cases of stroke in young adults. This study reviews the causes of two types of stroke (ischemic and intracerebral hemorrhage in young adults aged 15 to 40years, admitted to our center (a tertiary care center from 1997 to 2002. The purpose of this study is to determine the relative frequency of causes of stroke in young adults and compare this with published data in the literature. Using the codes 46.0 to 46.8 of the International Classification of Diseases- 10th Edition (ICD-10, cases were identified from the records of the stroke patients admitted in Imam Khomeini Hospital and the data were collected from their files using a comprehensive questionnaire. Forty-two cases of ischemic stroke (62% and 26 cases of intracerebral hemorrhage (38% were identified. The leading cause of ischemic stroke was cardioembolism (38.1%, followed by atherosclerosis in 5 cases (11.9%. Among cardiac causes infarction was attributable to consequences of rheumatic heart disease in 8 cases. In 3 cases a cessation or decrease in dose of warfarin was followed directly by an ischemic stroke. The most leading cause of intracerebral hemorrhage was hypertension (30.8%. Other causes were anticoagulant therapy, intratumoral hemorrhage, aplastic anemia, leukemia, arteriovenous malformations, and chronic active hepatitis. In conclusion, cardioembolism and hypertension were the most leading causes of ischemic and hemorrhagic stroke in young adults admitted in our hospital.
M. V. Zamergrad
Full Text Available Differential diagnosis of new-onset acute vestibular vertigo is chiefly made between vestibular neuronitis and stroke. Dizziness in stroke is usually accompanied by other focal neurological symptoms of brainstem and cerebellar involvement. However, stroke may appear as isolated vestibular vertigo in some cases. An analysis of history data and the results of neurovestibular examination and brain magnetic resonance imaging allows stroke to be diagnosed in patients with acute isolated dizziness. The treatment of patients with stroke-induced dizziness involves a wide range of medications for the reduction of the degree of dizziness and unsteadiness and for the secondary prevention of stroke. Vestibular rehabilitation is an important component of treatment. The paper describes an observation of a patient with poorly controlled hypertension, who developed new-onset acute systemic dizziness. Vestibular neuronitis might be presumed to be a peripheral cause of vestibular disorders, by taking into account the absence of additional obvious neurological symptoms (such as pareses, defective sensation, diplopia, etc. and the nature of nystagmus. However, intention tremor in fingernose and heel-knee tests on the left side, a negative Halmagyi test, and results of Romberg’s test could suggest that stroke was a cause ofdizziness.
Carod-Artal, Francisco Javier; Casanova Lanchipa, Jardiel Omar; Cruz Ramírez, Luis Miguel; Pérez, Noelia Sánchez; Siacara Aguayo, Fátima M; Moreno, Isabel Gómez; Romero, Lourdes Gómez; Coral, Luciene Ferreira; Trizotto, Daniele Stieven; Moreira, Clarissa Menezes
With the increase in life expectancy worldwide, changes in stroke subtypes and burden of stroke population are expected in both developing and developed countries. Prevalence of stroke subtypes and comorbidity in ischemic stroke patients was assessed in Brasilia, Brazil, and Cuenca, Spain. This was an international (Brazilian-Spanish) cross-sectional study. Stroke subtypes were assessed by means of Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. Modified Rankin scale was used to measure functional recovery and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) was used to assess comorbidity. A total of 500 patients (mean age 66.2 ± 16.4 years; 48% female; 48.2% Spanish) were included in the study. Spanish patients were significantly older than Brazilian ones (76.4 ± 11.2 versus 56.7 ± 14.6 years; P < .0001). Prevalence of ischemic cardiopathy (20.3% versus 6.2%) and atrial fibrillation (25.7% versus 6.6%) was significantly higher in Spanish stroke patients, whereas they less frequently used tobacco (28.3% versus 52.9%); P less than .0001. Prevalence of stroke subtypes in Spanish and Brazilian stroke patients was: stroke of undetermined etiology (58.1% versus 32.4%), cardioembolism (24.5% versus 11.6%), lacunar infarct (11.6% versus 25.5%), atherothrombotic (3.7% versus 19.7%), and other causes (2.1% versus 10.8%); P less than .0001. The Spanish sample had a significantly higher frequency of comorbidities. The CIRS-G total score and CIRS-G mean number of affected organs significantly increased with age, and correlated with the level of functional dependence as measured by Rankin scale (rS = 0.50; P = .0005). Spanish stroke people had a higher frequency of comorbid conditions, atrial fibrillation, and cardioembolism and these facts were associated with age. Atherothrombotic and lacunar strokes were more common in the younger Brazilian stroke population. Copyright © 2014 National Stroke Association. Published by Elsevier
Rost, Natalia S
Understanding the genetic architecture of cerebrovascular disease holds promise of novel stroke prevention strategies and therapeutics that are both safe and effective. Apart from a few single-gene disorders associated with cerebral ischemia or intracerebral hemorrhage, stroke is a complex genetic phenotype that requires careful ascertainment and robust association testing for discovery and validation analyses. The recently uncovered shared genetic contribution between clinically manifest stroke syndromes and closely related intermediate cerebrovascular phenotypes offers effective and efficient approaches to complex trait analysis. Copyright © 2013 Elsevier Inc. All rights reserved.
Jennum, Poul; Iversen, Helle K; Ibsen, Rikke
. The attributable cost of direct net health care costs after the stroke (general practitioner services, hospital services, and medication) and indirect costs (loss of labor market income) were €10,720, €8,205 and €7,377 for patients, and €989, €1,544 and €1.645 for their partners, over and above that of controls......BACKGROUND: To estimate the direct and indirect costs of stroke in patients and their partners. DESCRIPTION: Direct and indirect costs were calculated using records from the Danish National Patient Registry from 93,047 ischemic, 26,012 hemorrhagic and 128,824 unspecified stroke patients...
Full Text Available Penyakit stroke merupakan penyebab kematian dan kecacatan kronik yang paling tinggi pada kelompok umur diatas usia 45 tahun terbanyak di Indonesia. Tujuan penelitian ini untuk mengidentifikasi determinan utama yang berhubungan dengan penyakit stroke pada masyarakat di kelurahan Kebon Kalapa Bogor. Analisis lanjut terhadap 1.912 responden subset baseline data penelitian “Studi Kohort Faktor Risiko Penyakit Tidak Menular” Data dikumpulkan dengan metode wawancara pada penduduk tetap di kelurahan Kebon Kalapa, Kecamatan Bogor Tengah, Bogor tahun 2012. Diagnosis stroke berdasarkan anamnesis dan pemeriksaan dokter spesialis syaraf. Variabel independen meliputi karakteristik sosiodemografi, status kesehatan dan perilaku berisiko. Data dianalisis dengan uji regresi logistik ganda. Penyakit stroke ditemukan pada 49 (2,6% orang. Determinan utama stroke meliputi hipertensi (OR = 4,20; IK 95% = 2,20 – 8,03, penyakit jantung koroner (OR = 2,74; IK 95% = 1,51 – 4,99, diabetes melitus (OR = 2,89; IK 95% = 1,47 – 5,64, dan status ekonomi miskin (OR = 1,83 ; IK 95% = 1,03 – 3,33. Pencegahan penyakit stroke dilakukan dengan peningkatan edukasi (kampanye/penyuluhan melalui pengendalian faktor risiko utama yaitu hipertensi dan pencegahan terjadinya penyakit degeneratif lain yaitu penyakit jantung koroner dan diabetes melitus. Stroke disease is the leading cause of death and chronic disabi lity in most over the age of 45 years in Indonesia. The aim of study was to identify the major determinants of stroke disease in Kebon Kalapa community in Bogor. A deep analyze was conducted in 1.912 respondents based on the subset of baseline data “Risk Factors Cohort Study of Non Communicable Diseases.” Data was collected by interviews on Kebon Kalapa community, Bogor in 2012. Stroke diagnosis was determined by anamnesis and neu-rological examination with specialist. Independent variables were sociodemographic characteristics, health status and risk behavior
Lee, Mi Ji; Lee, Chungbin; Chung, Chin-Sang
Migraine and stroke are common neurovascular disorders which share underlying physiological processes. Increased risks of ischemic stroke, hemorrhagic stroke, and subclinical ischemic lesions have been consistently found in migraineurs. Three possible associations are suggested. One is that underlying pathophysiology of migraine can lead to ischemic stroke. Second, common comorbidities between migraine and stroke can be present. Lastly, some syndromes can manifest with both migraine-like head...
Full Text Available Background and Objectives: Since hospitalized patients intubated in the intensive care unit are not able to discharge secretions and require periodic suctioning and require periodic suctioning that is associated with different adverse effects, this study aimed to compare the effects of open endotracheal suction with two catheter sizes of 12 and 14 on the levels of pain and discharge in patients admitted to intensive care. Methods: In this clinical trial, 36 patients in one group underwent suction with catheters of two sizes, 12 and 14. Pain level in the first to third episodes, was assessed based on the CPOT criteria. The secretions output after the suctioning was collected in wing container and weighed on scales. Data were analyzed using paired t-test and analysis of variance. Results: In this study, pain during suctioning in the third episode, had the highest score, which was significantly different between large and small catheters (p=0.000. The secretion drainage after suctioning by large catheter was more and significantly statistically different (p=0.000. Conclusion: Based on the findings of this study, in patients with high pulmonary secretions, larger suction catheter is recommended to facilitate the discharge, but on the other hand, due to feeling pain caused by large catheter, use of small catheter is recommended for better control of intracranial pressure and pain levels.
Threapleton, D E; Burley, V J; Greenwood, D C; Cade, J E
Stroke risk is modifiable through many risk factors, one being healthy dietary habits. Fibre intake was associated with a reduced stroke risk in recent meta-analyses; however, data were contributed by relatively few studies, and few examined different stroke types. A total of 27,373 disease-free women were followed up for 14.4 years. Diet was assessed with a 217-item food frequency questionnaire and stroke cases were identified using English Hospital Episode Statistics and mortality records. Survival analysis was applied to assess the risk of total, ischaemic or haemorrhagic stroke in relation to fibre intake. A total of 135 haemorrhagic and 184 ischaemic stroke cases were identified in addition to 138 cases where the stroke type was unknown or not recorded. Greater intake of total fibre, higher fibre density and greater soluble fibre, insoluble fibre and fibre from cereals were associated with a significantly lower risk for total stroke. For total stroke, the hazard ratio per 6 g/day total fibre intake was 0.89 (95% confidence intervals: 0.81-0.99). Different findings were observed for haemorrhagic and ischaemic stroke in healthy-weight or overweight women. Total fibre, insoluble fibre and cereal fibre were inversely associated with haemorrhagic stroke risk in overweight/obese participants, and in healthy-weight women greater cereal fibre was associated with a lower ischaemic stroke risk. In non-hypertensive women, higher fibre density was associated with lower ischaemic stroke risk. Greater total fibre and fibre from cereals are associated with a lower stroke risk, and associations were more consistent with ischaemic stroke. The different observations by stroke type, body mass index group or hypertensive status indicates potentially different mechanisms.
Parker, Martyn J; Roberts, Chris P; Hay, Douglas
The use of closed-suction drainage systems after total joint replacement is a common practice. The theoretical advantages for the use of drains is a reduction in the occurrence of wound hematomas and infection. The aim of this meta-analysis was to determine, on the basis of the evidence from randomized controlled trials, the advantages and adverse effects of surgical drains. All randomized trials, as far as we know, that compared patients managed with closed-suction drainage systems and those managed without a drain following elective hip and knee arthroplasty were considered. The trials were identified with use of searches of the Cochrane Collaboration with no restriction on languages or source. Two authors independently extracted the data, and the methods of all identified trials were assessed. Eighteen studies involving 3495 patients with 3689 wounds were included in the analysis. The pooled results indicated that there was no significant difference between the wounds treated with a drain and those treated without a drain with respect to the occurrence of wound infection (relative risk, 0.73; 95% confidence interval, 0.47 to 1.14), wound hematoma (relative risk, 1.73; 95% confidence interval, 0.74 to 4.07), or reoperations for wound complications (relative risk, 0.52; 95% confidence interval, 0.13 to 1.99). A drained wound was associated with a significantly greater need for transfusion (relative risk, 1.43; 95% confidence interval, 1.19 to 1.72). Reinforcement of wound dressings was required more frequently in the group managed without drains. No difference between the groups was seen with respect to limb-swelling, venous thrombosis, or hospital stay. Studies to date have indicated that closed suction drainage increases the transfusion requirements after elective hip and knee arthroplasty and has no major benefits. Further randomized trials with use of larger numbers of patients with full reporting of outcomes are indicated before the absence of any benefit
Acar, Dursun; Alpar, Bedri; Ozeren, Sinan
The laminar flow comes to the fore with the disappearance of the several other directions in the internal displacements in the water current. Due to the dominant speed direction during the straightforward motion of the ship, the underwater hull is associated with the continuous flow of laminar currents. The open marine environment acts as a compressible liquid medium because of the presence of many variables about water volume overflow boundaries where the ship is associated. Layers of water rising over the sea surface due to ship's body and the propeller's water push provides loss of liquid lifting force for the ship. These situations change the well-known sea-floor morphology and reliable depth limits, and lead to probable accidents. If the ship block coefficient for the front side is 0.7 or higher, the "squat" will be more on the bow, because the associated factor "displacement volume" causes to the low-pressure environment due to large and rapid turbulence. Thus, the bow sinks further, which faced with liquid's weaker lift force. The vessels Gerardus Mercator, Queen Elizabeth and Costa Concordia had accidents because of unified reasons of squat, fast water mass displacement by hull push and propeller suction interaction. In the case of water mass displacement from the bow side away, that accident occurred in 2005 by the vessel Gerardus Mercator with excessive longitudinal trim angularity in the shallow water. The vessel Costa Concordia (2012), voluminous water displaced from the rear left side was an important factor because of the sharp manoeuvre of that the captain made before the accident. Observations before the accident indicate that full-speed sharp turn provided listed position for the ship from left (port side) in the direction of travel before colliding and then strike a rock on the sloping side of the seabed. The reason why the ship drifted to the left depends mainly the water discharge occurred at the left side of the hull during left-hand rudder
... Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of getting ... disease or condition. This article discusses the risk factors for stroke and things you can do to ...
... negotiate the provision of reasonable accommodations in the workplace. When can a stroke patient begin rehabilitation? Rehabilitation ... at home gives people the advantage of practicing skills and developing compensatory strategies in the context of ...
The author reflects on foreign-language learning by his EFL students as well as his own foreign-language learning. He concludes by musing on the possible and fantastical devastation on language-ability wrought by strokes.
Olsen, T S; Høgenhaven, H; Thage, O
Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients...... with other severe diseases. Cerebral angiography, CT, and EEG were performed in all patients. The patients were followed clinically for 2 to 4 years. Seven patients (9%) developed epilepsy. Of 23 patients with lesions involving the cortex, 6 (26%) developed epilepsy. Of 54 patients in whom the cortex...... was not involved, only 1 (2%) developed epilepsy. Patients with persisting paresis and cortical involvement seem to be at particularly high risk of developing epilepsy, as 50% of such patients (6 of 12) developed the disease....
Makomela, N M
By means of a multispiral computer and magnetic resonance tomography 211 patients with an ischemic stroke, 109 patients with hemorrhagic stroke, 41 patients with an arterial hypertensia, 43 patients with aneurism, 58 patients with discirculation encephalopathy, 125 patients with ischemic illness of heart, practically healthy 62 have been observed. The author found high frequency of pathological deformations of carotid and vertebral arteries of not closed arterial circle, calcification of the pineal body and vascular plexus of lateral ventricles. cysts of maxillary sinuses of patients with stroke in comparison with patients at risk of the development of stroke and practically healthy subjects.
Gutzeit, Andreas; Froehlich, Johannes M; Wälti, Stephan; Roos, Justus E; Meissnitzer, Matthias; Hergan, Klaus; von Weymarn, Constantin; Czell, David; Goyen, Matthias; Reischauer, Carolin
Our aim was to prospectively investigate whether the recently introduced suction/inspiration against resistance breathing method leads to higher computed tomography (CT) contrast density in the pulmonary artery compared to standard breathing. The present study was approved by the Medical Ethics committee and all subjects gave written informed consent. Fifteen patients, each without suspicious lung emboli, were randomly assigned to four different groups with different breathing maneuvers (suction against resistance, Valsalva, inspiration, expiration) during routine CT. Contrast enhancement in the central and peripheral sections of the pulmonary artery were measured and compared with one another. Peripheral enhancement during suction yielded increased mean densities of 138.14 Hounsfield units (HU) (p = 0.001), compared to Valsalva and a mean density of 67.97 HU superior to inspiration (p = 0.075). Finally, suction in comparison to expiration resulted in a mean increase of 30.51 HU (p = 0.42). Central parts of pulmonary arteries presented significantly increased enhancement values (95.74 HU) for suction versus the Valsalva technique (p = 0.020), while all other mean densities were in favour of suction (versus inspiration: p = 0.201; versus expiration: p = 0.790) without reaching significance. Suction/Inspiration against resistance is a promising technique to improve contrast density within pulmonary vessels, especially in the peripheral parts, in comparison to other breathing maneuvers. • Suction/Inspiration against resistance is promising to improve contrast density within the pulmonary artery. • Patients potentially suffering pulmonary embolism are able to follow suction/inspiration against resistance. • Contrast density after suction is superior in comparison to other breathing maneuvers.
Stroke is a major cause of morbidity and mortality but the brain and other relevant tissues are often examined only cursorily when stroke patients come to autopsy. The pathological findings and clinical implications vary according to the type of stroke and its location and cause. Large ischaemic strokes are usually associated with atherosclerosis of extracranial or major intracranial arteries but can be caused by dissection. Most small cerebral infarcts are caused by arteriosclerosis or, in the elderly, cerebral amyloid angiopathy (CAA). However, vasculitides and coagulopathies can cause a range of different patterns of ischaemic (and, occasionally, haemorrhagic) stroke. Global brain ischaemia, caused by severe hypotension or raised intracranial pressure, produces damage that is accentuated in certain regions and neuronal populations and may be confused with hypoglycaemic injury. The main cause of subarachnoid haemorrhage is a ruptured berry aneurysm but CAA, arteriovenous malformations and infective aneurysms are occasionally responsible. These can also cause parenchymal brain haemorrhage, although this most often complicates hypertensive small vessel disease. Sometimes the haemorrhage arises from a neoplasm. Performing an adequate autopsy in stroke requires proper preparation, awareness of the likely pathological processes, familiarity with intracranial vascular anatomy, careful gross examination and dissection, and appropriate use of histology. © 2010 Blackwell Publishing Limited.
Full Text Available Mohammad Obadah Nakawah, Eugene C Lai Stanely H. Appel Department of Neurology, Houston Methodist Neurological Institute, Houston, TX, USA Abstract: Strokes, whether ischemic or hemorrhagic, are among the most common causes of secondary movement disorders in elderly patients. Stroke-related (vascular movement disorders, however, are uncommon complications of this relatively common disease. The spectrum of post-stroke movement disorders is broad and includes both hypo- and hyperkinetic syndromes. Post-stroke dyskinesias are involuntary hyperkinetic movements arising from cerebrovascular insults and often present with mixed phenotypes of hyperkinesia which can sometimes be difficult to classify. Nevertheless, identification of the most relevant motor phenotype, whenever possible, allows for a more specific phenomenological categorization of the dyskinesia and thus helps guide its treatment. Fortunately, post-stroke dyskinesias are usually self-limiting and resolve within 6 to 12 months of onset, but a short-term pharmacotherapy might sometimes be required for symptom control. Functional neurosurgical interventions targeting the motor thalamus or globus pallidus interna might be considered for patients with severe, disabling, and persistent dyskinesias (arbitrarily defined as duration longer than 12 months. Keywords: vascular dyskinesia, stroke, movement disorders
Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin
AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death...... comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization...... of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention. RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start...
Alberts, Mark J
Stroke is a common and serious disease. Most studies have shown that basic public knowledge about what a stroke is, symptoms of a stroke, and the proper reaction to a stroke is quite deficient. The fact that a stroke affects cognitive, communicative, and motor functions may partially explain the poor reaction to acute stroke symptoms. Several educational studies, using diverse formats and messaging paradigms, have been shown to positively affect public knowledge of stroke symptoms. Such efforts have often used mass media public education campaigns with an emphasis on recognizing symptoms of an acute stroke. Some have been able to demonstrate an increase in the chance of patients (or by-standers) calling 911 and seeking emergency care. However, many programs were of brief duration, and their long-term benefits are uncertain. Continual educational efforts will be needed to improve stroke knowledge and increase the percentage of patients who seek emergency care. © 2012 New York Academy of Sciences.
Gu, Beom W.; Choi, Su Y.; Yim, Man S.; Rim, Chun T. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)
It becomes evident that severe accidents may occur by unexpected disasters such as tsunami, heavy flood, or terror. Once radioactive material is released from NPP through severe accidents, there are no ways to prevent the released radioactive gas spreading in the air. As a remedy for this problem, the idea on the portable filtered air suction system (PoFASS) for the prevention of released radioactive gas under severe accidents was proposed. In this paper, the conceptual design of a PoFASS focusing on the number of robot fingers and robot arm rods are proposed. In order to design a flexible robot suction nozzle, mathematical models for the gaps which represent the lifted heights of extensible covers for given convex shapes of pipes and for the covered areas are developed. In addition, the system requirements for the design of the robot arms of PoFASS are proposed, which determine the accessible range of leakage points of released radioactive gas. In this paper, the conceptual designs of the flexible robot suction nozzle and robot arm have been conducted. As a result, the minimum number of robot fingers and robot arm rods are defined to be four and three, respectively. For further works, extensible cover designs on the flexible robot suction nozzle and the application of the PoFASS to the inside of NPP should be studied because the radioactive gas may be released from connection pipes between the containment building and auxiliary buildings.
Kelly, Enda G
The routine use of drains in surgery has been dogmatically instituted in some disciplines. Orthopaedic surgery is one such sub-speciality. The use of postoperative closed suction drainage in total hip arthroplasty (THA) has become increasingly controversial with multiple randomised control trials performed to assess the benefit to outcome in THA. The hypothesis of this systematic review is that closed suction drainage does not infer a benefit and increase transfusion requirements of primary total hip arthroplasty patients. A systematic review and meta-analysis was conducted adhering to the PRISMA guidelines. A search of the available literature was performed on PubMed, Cochrane Central Registry of Controlled Trials, MEDLINE (OVID) and EMBASE using a combination of MeSH terms and Boolean operators. All data analysis was performed using the Cochrane Collaboration\\'s Review Manager 5.1. Sixteen studies (n=2705) were included in the analysis. Post-operative closed suction drainage was found to increase total blood loss and blood transfusion requirements (p<0.05). Surgical site infection demonstrated no significant difference between the two groups (p=0.82). No significant difference in haematoma formation between groups (p=0.19) was elicited. The routine use of closed suction drainage systems post primary hip arthroplasty is not supported by this meta-analysis. However, the heterogeneity between studies does limit the accuracy of the meta-analysis.
Elbers, A.R.W.; Meiswinkel, R.
The suction light trap (LT) is a standard tool used to capture Culicoides biting midges, when estimating abundances, and mapping species ranges. The exact range of attraction of the LT is in dispute, however, with several studies indicating the range to vary widely, between 4 and 50 m. In this
Full Text Available This paper is to present the optimization processing of the landmark suction cap with NX software 7.5. It has been done the modeling CAD of the landmark 3D. It has been projected the technology to execution CAM of the landmark where they revealed aspects of processing sequence and technological parameters.
Brunelli, Stefano; Delussu, Anna Sofia; Paradisi, Francesco; Pellegrini, Roberto; Traballesi, Marco
The two passive vacuum suspension systems currently available in total surface-bearing sockets are the hypobaric Iceross Seal-In(®) and the suction suspension system. The purpose of this study was to compare the effect of the hypobaric Iceross Seal-In(®) liner with that of the suction suspension system for quality of life, pistoning, and prosthesis efficiency in unilateral transtibial amputees. Single-group repeated measures. Ten amputees were enrolled. The pistoning test, used to compare vertical movement of the stump within the socket, and the energy cost of walking test were carried out when the amputees were wearing the suction suspension system and after 2, 5, and 7 weeks of Seal-In® X5 use. The Prosthesis Evaluation Questionnaire and the Houghton Scale Questionnaire of perceived mobility and quality of life with the prosthesis, and the Timed Up&Go Test and the Locomotor Capability Index for functional mobility were also administered at the beginning and end of the study. The hypobaric Iceross Seal-In® X5 led to significant pistoning reduction and improvement on the Houghton Scale Questionnaire and 3 of 9 domains of the Prosthesis Evaluation Questionnaire. No statistical changes were observed in functional mobility or the energy cost of walking tests. Replacing the suction suspension system with the hypobaric Iceross Seal-In® X5 improves quality of life in transtibial amputees.
Mehlsen, J; Himmelstrup, H; Himmelstrup, Bodil
The present study reports on the effects of a physical treatment modality in patients with intermittent claudication. During this treatment a major part of the skin surface is subjected to intermittent suction and pressure. In a previous, preliminary study the authors found a beneficial effect...... participated in an open trial investigating the possible effects of the treatment on platelet aggregation and fibrinolysis. Pain-free and maximal walking distances were measured on a treadmill, and systolic blood pressure was measured on the upper limb, the ankle, and the first toe bilaterally. The threshold...... for adenosine diphosphate (ADP)-induced platelet aggregation was tested, and the fibrinolytic activity was estimated from the euglobulin clot lysis time. Active treatment resulted in significant improvements in pain-free and maximal walking distances, whereas no changes could be found during placebo...
S. Mohammed Ibrahim
Full Text Available The combined effects of radiation and mass transfer on a steady MHD two-dimensional Marangoni convection flow over a flat surface in presence of Joule heating and viscous dissipation under influence of suction and injection is studied numerically. The general governing partial differential equations are transformed into a set of nonlinear ordinary differential equations by using unique similarity transformation. Numerical solutions of the similarity equations are obtained using the Runge-Kutta method along with shooting technique. The effects of governing parameters on velocity, temperature, and concentration as well as interface velocity, the surface temperature gradient, and the surface concentration gradient were presented in graphical and tabular forms. Comparisons with previously published work are performed and the results are found to be in excellent agreement.
Gemmell, Brad J.; Colin, Sean P.; Costello, John H.; Dabiri, John O.
A central and long-standing tenet in the conceptualization of animal swimming is the idea that propulsive thrust is generated by pushing the surrounding water rearward. Inherent in this perspective is the assumption that locomotion involves the generation of locally elevated pressures in the fluid to achieve the expected downstream push of the surrounding water mass. Here we show that rather than pushing against the surrounding fluid, efficient swimming animals primarily pull themselves through the water via suction. This distinction is manifested in dominant low-pressure regions generated in the fluid surrounding the animal body, which are observed by using particle image velocimetry and a pressure calculation algorithm applied to freely swimming lampreys and jellyfish. These results suggest a rethinking of the evolutionary adaptations observed in swimming animals as well as the mechanistic basis for bio-inspired and biomimetic engineered vehicles.
Glebe, Ulrich; Baio, Joe E; Árnadóttir, Líney; Siemeling, Ulrich; Weidner, Tobias
Subphthalocyaninatoboron complexes with six long-chain alkylthio substituents in their periphery are applicable for the formation of self-assembled monolayers (SAMs) on gold. Such films are prepared from solution with the axially chlorido-substituted derivatives and characterised by near-edge X-ray absorption fine structure (NEXAFS) spectroscopy, X-ray photoelectron spectroscopy (XPS) and time-of-flight secondary ion mass spectrometry (ToF-SIMS). The results are in accord with the formation of SAMs assembled by the chemisorption of both covalently bound thiolate-type as well as coordinatively bound thioether units. The adsorbate molecules adopt an essentially flat adsorption geometry on the substrate, resembling a suction pad on a surface. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Full Text Available Foreign bodies are extremely rare in preterm neonates. The majority are iatrogenic. We describe a neonate of 27 weeks gestation who was found to have an 18 mm long suction catheter at the right main bronchi after resuscitation in another hospital. It was first detected by chest X-ray after endotracheal intubation. Repeat X-ray revealed the catheter moved to the stomach and migrated to the lower gastrointestinal tract in a few hours. The patient was treated conservatively and the catheter was passed out on day 14. Newborn resuscitation may result in iatrogenic foreign body in neonates. Serious complications such as respiratory compromise, perforations or abscess may occur. Early referral to a specialized tertiary center with pediatric surgical service is recommended. We hope our experience demonstrated the importance of preventing iatrogenic foreign body in clinical setting. Access to endoscopic instrumentation for foreign body removal in preterm neonates should be available at all times.
Nielsen, Anders Wedel; Sumer, B. Mutlu; Fredsøe, Jørgen
When a sediment beach covered by stones or an armor layer is exposed to breaking waves, the turbulence generated by the breaking waves can cause mobilization and removal of the sediment underneath the stones. In two earlier studies by the Technical University of Denmark (DTU)-group, the suction...... removal of sediments from between armor blocks has dealt with the case of steady current and nonbreaking waves. The present study is an extension of these studies and the results will be presented in a similar way. The critical conditions for removal of sediment are determined. It is found that the onset...... number for removal of sediment as function of d=D and ξ is determined for the range 0.001 armor stones...
Miyamoto, M.I.; Santos, F.S.; Bolfarini, C.; Botta Filho, W.J.; Kiminami, C.S.
To select new alloys with high glass forming ability (GFA) to present amorphous structure in millimeter scale, several semi-empirical models have been developed. In the present work, a new alloy, Ni 50 Nb 28 Zr 22 d, was designed based on the combination of topological instability lambda (A) criterion and electronegativity difference (Δe). The alloy was rapidly solidified in a bulk wedge sample by cooper mold suction casting in order to investigate its amorphization. The sample was characterized by the combination of scanning electron microscopy (MEV), X-ray diffraction (XRD) and differential scanning calorimeter (DSC). For the minimum thickness of 200 μm analyzed, it was found that the alloy did not show a totally amorphous structure. Factor such as low cooling rate, existence of oxides on the surface of the elements and presence of oxygen in the atmosphere of equipment did not allowed the achievement of higher amorphous thickness. (author)
Couto, Javier A; Maclellan, Reid A; Greene, Arin K
Vascular anomalies and related conditions cause overgrowth of tissues. The purpose of this study was to determine the efficacy and safety of liposuction techniques for pediatric overgrowth diseases. Patients treated between 2007 and 2015 who had follow-up were reviewed. Seventeen patients were included; the median age was 12.7 years. The causes of overgrowth included infiltrating lipomatosis (n = 7), capillary malformation (n = 6), hemihypertrophy (n = 1), infantile hemangioma (n = 1), lipedema (n = 1), and macrocephaly-capillary malformation (n = 1). Forty-seven percent had enlargement of an extremity, 41 percent had facial hypertrophy, and 12 percent had expansion of the trunk. All subjects had a reduction in the size of the overgrown area and improved quality of life. Suction-assisted tissue removal is an effective technique for reducing the volume of the subcutaneous compartment for patients with pediatric overgrowth diseases. Therapeutic, IV.
Huertas, Víctor; Bellwood, David R
Of the 6,000 reef fish species, only 128 feed on corals [1,2]. Despite being widely available on tropical reefs, corals appear to represent a particularly challenging trophic resource, with mucus- and nematocyst-laden tissues spread over a sharp coral skeleton. Here we report that coral-feeding tubelip wrasses use highly modified lips to suck material from the coral surface. These lips have a specialized mushroom-like lamellar epithelium that secretes mucus. This mucus may facilitate suction and reduce damage by nematocysts in a manner akin to anemonefishes. The remarkable lip specializations observed in tubelip wrasses highlight the potential role of soft tissues in shaping the trophic ability of fishes. Copyright © 2017 Elsevier Ltd. All rights reserved.
Škerlavaj, A.; Morgut, M.; Jošt, D.; Nobile, E.
In this study, the objective of the optimization of a double-suction pump is the maximization of its hydraulic efficiency. The optimization is performed, by means of the modeFRONTIER optimization platform, in steps. At first, by means of a DOE (Design of Experiments) strategy, the design space is explored, using a parameterized CAD representation of the pump. Suitable metamodels (surrogates or Response Surfaces), which represent an economical alternative to the more expensive 3D CFD model, are built and tested. Among different metamodels, the evolutionary design, radial basis function and the stepwise regression models seem to be the most promising ones. Finally, the stepwise regression model, trained on a set of 200 designs and constructed with only five the most influential input design parameters, was chosen as a potentially applicable metamodel.
Levine, Deborah A.; Kabeto, Mohammed; Langa, Kenneth M.; Lisabeth, Lynda D.; Rogers, Mary A.M.; Galecki, Andrzej T.
Background and Purpose It is unknown whether blacks’ elevated risk of dementia is because of racial differences in acute stroke, the impact of stroke on cognitive health, or other factors. We investigated whether racial differences in cognitive decline are explained by differences in the frequency or impact of incident stroke between blacks and whites, controlling for baseline cognition. Methods Among 4908 black and white participants aged ≥65 years free of stroke and cognitive impairment in the nationally representative Health and Retirement Study with linked Medicare data (1998–2010), we examined longitudinal changes in global cognition (modified version of the Telephone Interview for Cognitive Status) by race, before and after adjusting for time-dependent incident stroke followed by a race-by-incident stroke interaction term, using linear mixed-effects models that included fixed effects of participant demographics, clinical factors, and cognition, and random effects for intercept and slope for time. Results We identified 34 of 453 (7.5%) blacks and 300 of 4455 (6.7%) whites with incident stroke over a mean (SD) of 4.1 (1.9) years of follow-up (P=0.53). Blacks had greater cognitive decline than whites (adjusted difference in modified version of the Telephone Interview for Cognitive Status score, 1.47 points; 95% confidence interval, 1.21 to 1.73 points). With further adjustment for cumulative incidence of stroke, the black–white difference in cognitive decline persisted. Incident stroke was associated with a decrease in global cognition (1.21 points; Pstroke on cognition did not statistically differ by race (P=0.52). Conclusions In this population-based cohort of older adults, incident stroke did not explain black–white differences in cognitive decline or impact cognition differently by race. PMID:25999389
Figueroa, A.; Tindall, J. A.; Friedel, M. J.
Concentration of delO18 in water samples extracted by suction lysimeters is compared to samples obtained by methods of centrifugation and azeotropic distillation. Intact soil cores (30 cm diameter by 40 cm height) were extracted from two different sites. Site 1 was rapid infiltration basin number 50, near Altamonte Springs in Seminole County, Florida on properties belonging to the Walt Disney World Resort Complex. Site 2 was the Missouri Management System Evaluation Area (MSEA) near Centralia in Boone County, Missouri. The delO18 water was analyzed on a mass spectrophotometer. Potassium Bromide (KBr) was also used as a tracer and analyzed by ion chromatography. A portion of the data obtained was modeled using CXTFIT. Water collected by centrifugation and azeotropic distillation data were about 2-5% more negative than that collected by suction lysimeter values from the Florida (sandy) soil and about 5-7 % more negative from the Missouri (well structured clay) soil. Results indicate that the majority of soil water in well structured soil is strongly bound to soil grain surfaces and is not easily sampled by suction lysimeters. Also, it is plausible that evaporation caused some delO18 enrichment in the suction lysimeters. Suction lysimeters preferentially sampled water held at lower matric potentials, which may not represent total soil water. In cases where a sufficient volume of water has passed through the soil profile and displaced all previous pore water, suction lysimeters will however collect a representative sample of all the water at that depth interval. It is suggested that for stable isotope studies monitoring precipitation and soil water, suction lysimeters be installed at shallow depths (10 cm). Samples should also be coordinated with precipitation events. The CXTFIT program worked well for Florida soils (a more homogeneous sand), but gave poor performance for Missouri soils (well structured clays) except for deeper depths where clay structure was less
Al-Khaled, Mohamed; Matthis, Christine; Binder, Andreas; Mudter, Jonas; Schattschneider, Joern; Pulkowski, Ulrich; Strohmaier, Tim; Niehoff, Torsten; Zybur, Roland; Eggers, Juergen; Valdueza, Jose M; Royl, Georg
Dysphagia is associated with poor outcome in stroke patients. Studies investigating the association of dysphagia and early dysphagia screening (EDS) with outcomes in patients with acute ischemic stroke (AIS) are rare. The aims of our study are to investigate the association of dysphagia and EDS within 24 h with stroke-related pneumonia and outcomes. Over a 4.5-year period (starting November 2007), all consecutive AIS patients from 15 hospitals in Schleswig-Holstein, Germany, were prospectively evaluated. The primary outcomes were stroke-related pneumonia during hospitalization, mortality, and disability measured on the modified Rankin Scale ≥2-5, in which 2 indicates an independence/slight disability to 5 severe disability. Of 12,276 patients (mean age 73 ± 13; 49% women), 9,164 patients (74%) underwent dysphagia screening; of these patients, 55, 39, 4.7, and 1.5% of patients had been screened for dysphagia within 3, 3 to 72 h following admission. Patients who underwent dysphagia screening were likely to be older, more affected on the National Institutes of Health Stroke Scale score, and to have higher rates of neurological symptoms and risk factors than patients who were not screened. A total of 3,083 patients (25.1%; 95% CI 24.4-25.8) had dysphagia. The frequency of dysphagia was higher in patients who had undergone dysphagia screening than in those who had not (30 vs. 11.1%; p dysphagia had a higher rate of pneumonia than those without dysphagia (29.7 vs. 3.7%; p dysphagia was associated with increased risk of stroke-related pneumonia (OR 3.4; 95% CI 2.8-4.2; p dysphagia was independently correlated with an increase in mortality (OR 3.2; 95% CI 2.4-4.2; p Dysphagia exposes stroke patients to a higher risk of pneumonia, disability, and death, whereas an EDS seems to be associated with reduced risk of stroke-related pneumonia and disability. © 2016 S. Karger AG, Basel.
Full Text Available Automobile aerodynamic studies are typically undertaken to improve safety and increase fuel efficiency as well as to find new innovation in automobile technology to deal with the problem of energy crisis and global warming. Some car companies have the objective to develop control solutions that enable to reduce the aerodynamic drag of vehicle and significant modification progress is still possible by reducing the mass, rolling friction or aerodynamic drag. Some flow control method provides the possibility to modify the flow separation to reduce the development of the swirling structures around the vehicle. In this study, a family van is modeled with a modified form of Ahmed's body by changing the orientation of the flow from its original form (modified/reversed Ahmed body. This model is equipped with a suction on the rear side to comprehensively examine the pressure field modifications that occur. The investigation combines computational and experimental work. Computational approach used a commercial software with standard k-epsilon flow turbulence model, and the objectives was to determine the characteristics of the flow field and aerodynamic drag reduction that occurred in the test model. Experimental approach used load cell in order to validate the aerodynamic drag reduction obtained by computational approach. The results show that the application of a suction in the rear part of the van model give the effect of reducing the wake and the vortex formation. Futhermore, aerodynamic drag reduction close to 13.86% for the computational approach and 16.32% for the experimental have been obtained.
Deschka, Heinz; Erler, Stefan; El-Ayoubi, Lemir; Vogel, Cordula; Vöhringer, Luise; Wimmer-Greinecker, Gerhard
Deep sternal wound infections are significant and severe complications following cardiac surgery and substantially influence perioperative morbidity and mortality. We present the experience of our department using two different surgical treatments over a three-year period. Between January 2009 and December 2011, a total of 3274 cardiac procedures with complete median sternotomy were performed in our department. In 94 patients (3%), a deep sternal wound infection occurred, including sternal instability with consecutive surgical treatment. The patients either received wound debridement with sternum refixation and suction-irrigation drainage (SID; n = 72) or sternum refixation only (RF; n = 22) if there was sternal instability with limited signs of infection. SID was routinely installed for 7 days: the irrigation solution contained neomycin. In all cases, swabs were taken and analysed. The different methods were evaluated in respect of their clinical outcomes. The success rate-defined as single, uncomplicated procedure-of the SID treatment was 74%, compared with 59% of the isolated sternum refixation. Complications included continuous infection, recurrence of sternal instability and wound necrosis. Eighty-eight percent of the swabs in the SID group were positive, compared with 32% in the sternal refixation only group. The dominating pathogenic germs were coagulase-negative staphylococci and staphylococcus aureus. Mortality was 10% for the SID group and 5% for the RF group. Contrary to accepted opinion, the suction-irrigation drainage is an appropriate therapy for deep sternal wound infections. Nevertheless, deep sternal wound infections after cardiac surgery remain severe complications and are related to increased morbidity and mortality.
Hariri, Mitra; Darvishi, Leila; Maghsoudi, Zahra; Khorvash, Fariborz; Aghaei, Mahmud; Iraj, Bijan; Ghiasvand, Reza; Askari, Gholamreza
Stroke is a leading cause of death. Current therapeutic strategies have been unsuccessful. Several studies have reported benefits on reducing stroke risk and improving the poststroke associated functional declines in patients who ate foods rich in fruits and vegetables. Their potential protective effects may be due to their antioxidants, calcium, potassium, riboflavine, peridoxin, riboflavin contents. Folic acid, peridoxin, and riboflavin are all cofactors in hyperhomocysteinemia as a stroke risk factor.Studies suggest that oxidative stress plays important roles in pathogenesis of ischemic cerebral injury and higher intake of antioxidants has been associated with a lower stroke risk. The aim of this study was to examine if the dietary intake of vegetables and fruits in patients with stroke were comparatively worse than those in patients without stroke. In this case control study, 93 stroke patients admitted to Alzahra hospital were matched for age and sex with 60 patients who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated food frequency questionnaire.Food intakes were compared between two groups and with recommended value. Mean daily intake of vegetable and fruits was more in male with stroke than male without stroke as well as calorie intake from vegetables and fruit was higher in male with stroke.Mean daily intake of vegetable and fruits were lower in women with stroke than women without stroke as well as calorie intake from vegetables and fruit was lower in women with stroke. Our findings suggest that increased vegetable and fruits intake may be associated with decreased risk of stroke.
Rossiter, Holly E; Borrelli, Mimi R; Borchert, Robin J; Bradbury, David; Ward, Nick S
Mirror therapy is a new form of stroke rehabilitation that uses the mirror reflection of the unaffected hand in place of the affected hand to augment movement training. The mechanism of mirror therapy is not known but is thought to involve changes in cerebral organization. We used magnetoencephalography (MEG) to measure changes in cortical activity during mirror training after stroke. In particular, we examined movement-related changes in the power of cortical oscillations in the beta (15-30 Hz) frequency range, known to be involved in movement. Ten stroke patients with upper limb paresis and 13 healthy controls were recorded using MEG while performing bimanual hand movements in 2 different conditions. In one, subjects looked directly at their affected hand (or dominant hand in controls), and in the other, they looked at a mirror reflection of their unaffected hand in place of their affected hand. The movement-related beta desynchronization was calculated in both primary motor cortices. Movement-related beta desynchronization was symmetrical during bilateral movement and unaltered by the mirror condition in controls. In the patients, movement-related beta desynchronization was generally smaller than in controls, but greater in contralesional compared to ipsilesional motor cortex. This initial asymmetry in movement-related beta desynchronization between hemispheres was made more symmetrical by the presence of the mirror. Mirror therapy could potentially aid stroke rehabilitation by normalizing an asymmetrical pattern of movement-related beta desynchronization in primary motor cortices during bilateral movement. © The Author(s) 2014.
... How is a ministroke different from a regular stroke? Answers from Jerry W. Swanson, M.D. When ... brain, spinal cord or retina, which may cause stroke-like symptoms but does not damage brain cells ...
Sisto, Sue Ann; Forrest, Gail F; Glendinning, Diana
Hemiparesis is the primary physical impairment underlying functional disability after stroke. A goal of rehabilitation is to enhance motor skill acquisition, which is a direct result of practice. However, frequency and duration of practice are limited in rehabilitation. Virtual reality (VR) is a computer technology that simulates real-life learning while providing augmented feedback and increased frequency, duration, and intensity of practiced tasks. The rate and extent of relearning of motor tasks could affect the duration, effectiveness, and cost of patient care. The purpose of this article is to review the use of VR training for motor rehabilitation after stroke.
Dong, Yi; Cao, Wenjie; Cheng, Xin; Fang, Kun; Zhang, Xiaolong; Gu, Yuxiang; Leng, Bing; Dong, Qiang
Intravenous thrombolysis and intra-arterial thrombectomy are now the standard therapies for patients with acute ischemic stroke. In-house strokes have often been overlooked even at stroke centers and there is no consensus on how they should be managed. Perioperative stroke happens rather frequently but treatment protocol is lacking, In China, the issue of in-house strokes has not been explored. The aim of this study is to explore the current management of in-house stroke and identify the common risk factors associated with perioperative strokes. Altogether, 51,841 patients were admitted to a tertiary hospital in Shanghai and the records of those who had a neurological consult for stroke were reviewed. Their demographics, clinical characteristics, in-hospital complications and operations, and management plans were prospectively studied. Routine laboratory test results and risk factors of these patients were analyzed by multiple logistic regression model. From January 1, 2015, to December 31, 2015, over 1800 patients had neurological consultations. Among these patients, 37 had an in-house stroke and 20 had more severe stroke during the postoperative period. Compared to in-house stroke patients without a procedure or operation, leukocytosis and elevated fasting glucose levels were more common in perioperative strokes. In multiple logistic regression model, perioperative strokes were more likely related to large vessel occlusion. Patients with perioperative strokes had different risk factors and severity from other in-house strokes. For these patients, obtaining a neurological consultation prior to surgery may be appropriate in order to evaluate the risk of perioperative stroke. Copyright © 2017. Published by Elsevier Inc.
Kraywinkel, Klaus; Heidrich, Jan; Heuschmann, Peter U; Wagner, Markus; Berger, Klaus
Abstract Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. S...
Williams, Olajide; DeSorbo, Alexandra; Noble, James; Gerin, William
Low thrombolysis rates for acute ischemic stroke are linked to delays in seeking immediate treatment due to low public stroke awareness. We aimed to assess whether "Child-Mediated Stroke Communication" could improve stroke literacy of parents of children enrolled in a school-based stroke literacy program called Hip Hop Stroke. Parents of children aged 9 to 12 years from 2 public schools in Harlem, New York City, were recruited to participate in stroke literacy questionnaires before and after their child's participation in Hip Hop Stroke, a novel Child-Mediated Stroke Communication intervention delivered in school auditoriums. Parental recall of stroke information communicated through their child was assessed 1-week after the intervention. Fifth and sixth grade students (n=182) were enrolled into Hip Hop Stroke. One hundred two parents were approached in person to participate; 75 opted to participate and 71 completed both the pretest and post-test (74% response rate and 95% retention rate). Parental stroke literacy improved after the program; before the program, 3 parents of 75 (3.9%) were able to identify the 5 cardinal stroke symptoms, distracting symptom (chest pains), and had an urgent action plan (calling 911) compared with 21 of 71 parents (29.6%) postintervention (P<0.001). The FAST mnemonic was known by 2 (2.7%) of participants before the program versus 29 (41%) after program completion (P<0.001). Knowledge of stroke signs and symptoms remains low among residents of this high-risk population. The use of Child-Mediated Stroke Communication suggests that school children aged 9 to 12 years may be effective conduits of critical stroke knowledge to their parents.
Lindsay, Patrice; Furie, Karen L.; Davis, Stephen M.; Donnan, Geoffrey A.; Norrving, Bo
Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention,...
Shimizu, Kazunori; Kawakami, Shigeru; Hayashi, Kouji; Kinoshita, Hideyuki; Kuwahara, Koichiro; Nakao, Kazuwa; Hashida, Mitsuru; Konishi, Satoshi
We have developed an in vivo transfection method for naked plasmid DNA (pDNA) and siRNA in mice by using a tissue suction device. The target tissue was suctioned by a device made of polydimethylsiloxane (PDMS) following the intravenous injection of naked pDNA or siRNA. Transfection of pDNA encoding luciferase was achieved by the suction of the kidney, liver, spleen, and heart, but not the duodenum, skeletal muscle, or stomach. Luciferase expression was specifically observed at the suctioned region of the tissue, and the highest luciferase expression was detected at the surface of the tissue (0.12±0.03 ng/mg protein in mice liver). Luciferase expression levels in the whole liver increased linearly with an increase in the number of times the liver was suctioned. Transfection of siRNA targeting glyceraldehyde 3-phosphate dehydrogenase (GAPDH) gene significantly suppressed the expression of GAPDH mRNA in the liver. Histological analysis shows that severe damage was not observed in the suctioned livers. Since the suction device can be mounted onto the head of the endoscope, this method is a minimally invasive. These results indicate that the in vivo transfection method developed in this study will be a viable approach for biological research and therapies using nucleic acids. PMID:22844458
Gutzeit, Andreas; Froehlich, Johannes M.; Weymarn, Constantin von; Goyen, Matthias; Waelti, Stephan; Roos, Justus E.; Meissnitzer, Matthias; Hergan, Klaus; Czell, David; Reischauer, Carolin
Our aim was to prospectively investigate whether the recently introduced suction/inspiration against resistance breathing method leads to higher computed tomography (CT) contrast density in the pulmonary artery compared to standard breathing. The present study was approved by the Medical Ethics committee and all subjects gave written informed consent. Fifteen patients, each without suspicious lung emboli, were randomly assigned to four different groups with different breathing maneuvers (suction against resistance, Valsalva, inspiration, expiration) during routine CT. Contrast enhancement in the central and peripheral sections of the pulmonary artery were measured and compared with one another. Peripheral enhancement during suction yielded increased mean densities of 138.14 Hounsfield units (HU) (p = 0.001), compared to Valsalva and a mean density of 67.97 HU superior to inspiration (p = 0.075). Finally, suction in comparison to expiration resulted in a mean increase of 30.51 HU (p = 0.42). Central parts of pulmonary arteries presented significantly increased enhancement values (95.74 HU) for suction versus the Valsalva technique (p = 0.020), while all other mean densities were in favour of suction (versus inspiration: p = 0.201; versus expiration: p = 0.790) without reaching significance. Suction/Inspiration against resistance is a promising technique to improve contrast density within pulmonary vessels, especially in the peripheral parts, in comparison to other breathing maneuvers. (orig.)
Full Text Available We have developed an in vivo transfection method for naked plasmid DNA (pDNA and siRNA in mice by using a tissue suction device. The target tissue was suctioned by a device made of polydimethylsiloxane (PDMS following the intravenous injection of naked pDNA or siRNA. Transfection of pDNA encoding luciferase was achieved by the suction of the kidney, liver, spleen, and heart, but not the duodenum, skeletal muscle, or stomach. Luciferase expression was specifically observed at the suctioned region of the tissue, and the highest luciferase expression was detected at the surface of the tissue (0.12±0.03 ng/mg protein in mice liver. Luciferase expression levels in the whole liver increased linearly with an increase in the number of times the liver was suctioned. Transfection of siRNA targeting glyceraldehyde 3-phosphate dehydrogenase (GAPDH gene significantly suppressed the expression of GAPDH mRNA in the liver. Histological analysis shows that severe damage was not observed in the suctioned livers. Since the suction device can be mounted onto the head of the endoscope, this method is a minimally invasive. These results indicate that the in vivo transfection method developed in this study will be a viable approach for biological research and therapies using nucleic acids.
Gutzeit, Andreas [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Kantonsspital Winterthur, Department of Radiology, Winterthur (Switzerland); Froehlich, Johannes M.; Weymarn, Constantin von; Goyen, Matthias [Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Waelti, Stephan [Cantonal Hospital St. Gallen, Department of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Roos, Justus E. [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Meissnitzer, Matthias; Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Czell, David [Cantonal Hospital Winterthur, Department of Neurology, Winterthur (Switzerland); Reischauer, Carolin [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland)
Our aim was to prospectively investigate whether the recently introduced suction/inspiration against resistance breathing method leads to higher computed tomography (CT) contrast density in the pulmonary artery compared to standard breathing. The present study was approved by the Medical Ethics committee and all subjects gave written informed consent. Fifteen patients, each without suspicious lung emboli, were randomly assigned to four different groups with different breathing maneuvers (suction against resistance, Valsalva, inspiration, expiration) during routine CT. Contrast enhancement in the central and peripheral sections of the pulmonary artery were measured and compared with one another. Peripheral enhancement during suction yielded increased mean densities of 138.14 Hounsfield units (HU) (p = 0.001), compared to Valsalva and a mean density of 67.97 HU superior to inspiration (p = 0.075). Finally, suction in comparison to expiration resulted in a mean increase of 30.51 HU (p = 0.42). Central parts of pulmonary arteries presented significantly increased enhancement values (95.74 HU) for suction versus the Valsalva technique (p = 0.020), while all other mean densities were in favour of suction (versus inspiration: p = 0.201; versus expiration: p = 0.790) without reaching significance. Suction/Inspiration against resistance is a promising technique to improve contrast density within pulmonary vessels, especially in the peripheral parts, in comparison to other breathing maneuvers. (orig.)
Williams, Olajide; DeSorbo, Alexandra; Noble, James; Gerin, William
Background and Purpose Low thrombolysis rates for acute ischemic stroke is linked to delays in seeking immediate treatment due to low public stroke awareness. We aimed to assess whether “Child-Mediated Stroke Communication” (CMSC) could improve stroke literacy parents of children enrolled in a school-based stroke literacy program called Hip Hop Stroke (HHS). Methods Parents of children aged 9 to 12 years from two public schools in Harlem, NYC, were recruited to participate in stroke literacy questionnaires before and after their child’s participation in HHS, a novel CMSC intervention delivered in school auditoriums. Parental recall of stroke information communicated through their child was assessed 1-week following the intervention. Results Fifth and Sixth grade students (n =182) were enrolled into HHS. 102 parents were approached in person to participate; 75 opted to participate and 71 completed both pretest and post-test (74% response rate and 95% retention rate). Parental stroke literacy improved after the program: before the program, 3 parents of 75 (3.9%) were able to identify the five cardinal stroke symptoms, distracting symptom (chest pains), and had an urgent action plan (calling 911), compared to 21 of 71 parents (29.6%) post-intervention (pstroke signs and symptoms remains low among residents of this high-risk population. The use of Child-Mediated Stroke Communication suggests that schoolchildren aged 9-12 may be effective conduits of critical stroke knowledge to their Parents. PMID:22033995
De Keyser, J; Sulter, G.
In some stroke units continuous monitoring of blood pressure, electrocardiogram, body temperature, and oxygen saturation has become an integral part of the management of acute stroke. In addition, regular measurements of blood glucose are performed. Stroke units equipped with such monitoring
... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes, Heart Disease, and Stroke Having diabetes means that ... help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood ...
Andersen, Klaus Kaae; Olsen, Tom Skyhøj
. Data include age, gender, civil status, stroke severity, computed tomography, and cardiovascular risk factors. Patients were followed up to 9·8 years (median 2·6 years). We used Cox regression models to compare risk of death and readmission for recurrent stroke in the four body mass index groups......BACKGROUND: Although associated with excess mortality and morbidity, obesity is associated with lower mortality after stroke. The association between obesity and risk of recurrent stroke is unclear. AIMS: The study aims to investigate the association in stroke patients between body mass index...... and risk of death and readmission for recurrent stroke. METHODS: An administrative Danish quality-control registry designed to collect a predefined dataset on all hospitalized stroke patients in Denmark 2000–2010 includes 45 615 acute first-ever stroke patients with information on body mass index in 29 326...
Craig A. Press
Full Text Available Investigators from the Vascular Effects of Infection in Pediatric Stroke (VIPS group studied the risk of arterial ischemic stroke (AIS associated with minor infection and routine childhood vaccinations.
Comparison of tissue plasminogen activator administration management between Telestroke Network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany.
Audebert, Heinrich J; Kukla, Christian; Vatankhah, Bijan; Gotzler, Berthold; Schenkel, Johannes; Hofer, Stephan; Fürst, Andrea; Haberl, Roman L
Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and 110 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P=0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.
Sujatha; Ramalingam; Vinodkumar; Vasumathi; Valarmathi; Anu
BACKGROUND Ischemic strokes account for >80% of total stroke events. Biochemical modalities like serum uric acid, ESR, CRP, Serum Fibrinogen will be a low cost and useful way to predict functional outcome after ischemic stroke. The Barthel ADL index it is an ordinal scale helping us to measure performances in ADL-activities in daily living. The present study aims to study the Biochemical parameters Uric Acid, CRP, ESR and Fibrinogen in Ischemic Stroke patients and to assess fu...
Are simple strokes unique to the artist or designer who renders them? If so, can this idea be used to identify authorship or to classify artistic drawings? Also, could training methods be devised to develop particular styles? To answer these questions, we propose the Stroke Authorship Recognition (SAR) approach, a novel method that distinguishes the authorship of 2D digitized drawings. SAR converts a drawing into a histogram of stroke attributes that is discriminative of authorship. We provide extensive classification experiments on a large variety of data sets, which validate SAR\\'s ability to distinguish unique authorship of artists and designers. We also demonstrate the usefulness of SAR in several applications including the detection of fraudulent sketches, the training and monitoring of artists in learning a particular new style and the first quantitative way to measure the quality of automatic sketch synthesis tools. © 2015 The Eurographics Association and John Wiley & Sons Ltd.
As there appeared to be a need for personal accounts of stroke experiences, a book called "Speaking about Stroke" was written for stroke patients and their caregivers. For the past two years, a questionnaire was sent to the people who had ordered the book, to gain an insight into the characteristics
... stroke. High blood pressure increases your risk of stroke four to six times. Heart disease, especially a condition ... leading cause of serious, long-term adult disability. Four million Americans are living with the effects of stroke. The length of time to recover from a ...
Lim, Chun; Alexander, Michael P.
Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there…
Stroke is a personal, familial, and social disaster. It is the third cause of death worldwide, the first cause of acquired disability, the second cause of dementia, and its cost is astronomic. The burden of stroke is likely to increase given the aging of the population and the growing incidence of many vascular risk factors. Prevention of stroke includes--as for all other diseases--a "mass approach" aiming at decreasing the risk at the society level and an individual approach, aiming at reducing the risk in a given subject. The mass approach is primarily based on the identification and treatment of vascular risk factors and, if possible, in the implementation of protective factors. These measures are the basis of primary prevention but most of them have now been shown to be also effective in secondary prevention. The individual approach combines a vascular risk factor modification and various treatments addressing the specific subtypes of stroke, such as antiplatelet drugs for the prevention of cerebral infarction in large and small artery diseases of the brain, carotid endarterectomy or stenting for tight carotid artery stenosis, and oral anticoagulants for the prevention of cardiac emboli. There is a growing awareness of the huge evidence-to-practice gap that exists in stroke prevention largely due to socio-economic factors. Recent approaches include low cost intervention packages to reduce blood pressure and cheap "polypills" combining in a single tablet aspirin and several drugs to lower blood pressure and cholesterol. Polypill intake should however not lead to abandon the healthy life-style measures which remain the mainstay of stroke prevention.
Lin, Jianwen; Chen, Yicong; Wen, Hongmei; Yang, Zhiyun; Zeng, Jinsheng
Upper facial dysfunction is not generally considered a feature of central facial paralysis after unilateral hemispheric stroke; however, weakness of eye closure (WEC) has been observed in some cases. We aimed to investigate the frequency and characteristics of WEC in unilateral stroke and its association with stroke prognosis. Patients with unilateral stroke and central facial paralysis were prospectively recruited within 7 days of onset. Facial paralysis was evaluated via the fourth item in the National Institute of Health Stroke Scale (NIHSS-4) and the Japan Facial Score (JFS) on admission, and at days 7, 14, 21, and 30 after stroke. Eye closure strength was measured daily using an ergometer for 30 days after stroke. Primary outcome was assessed using the modified Rankin Scale (mRS) at 90 and 180 days. Univariate and multivariate analyses were performed to investigate risk factors of WEC. WEC was identified in 16 of 242 patients (6.6%). Baseline characteristics, stroke risk factors, and lesion volume were not significantly different between patients with and patients without WEC. Patients with WEC featured higher NIHSS-4 scores and lower JFS between admission and at 21 days after stroke. Severe central facial paralysis (odds ratio [OR] = 8.1, 95% confidence interval [CI] = 2.3-28.6, P = .001) and right hemispheric stroke (OR = 13.7, 95% CI = 3.7-51.2, P WEC. At 180 days after stroke, patients with WEC demonstrated a lower rate of functional independence (mRS = 0-2: 37.5% versus 72.1%, P WEC, which predicts a worse functional outcome at 180 days after unilateral stroke, demonstrates an association with severe central facial paralysis and right hemispheric stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Chun, Ho-Yan Yvonne; Whiteley, William N; Dennis, Martin S; Mead, Gillian E; Carson, Alan J
Anxiety after stroke is common and disabling. Stroke trialists have treated anxiety as a homogenous condition, and intervention studies have followed suit, neglecting the different treatment approaches for phobic and generalized anxiety. Using diagnostic psychiatric interviews, we aimed to report the frequency of phobic and generalized anxiety, phobic avoidance, predictors of anxiety, and patient outcomes at 3 months poststroke/transient ischemic attack. We followed prospectively a cohort of new diagnosis of stroke/transient ischemic attack at 3 months with a telephone semistructured psychiatric interview, Fear Questionnaire, modified Rankin Scale, EuroQol-5D5L, and Work and Social Adjustment Scale. Anxiety disorder was common (any anxiety disorder, 38 of 175 [22%]). Phobic disorder was the predominant anxiety subtype: phobic disorder only, 18 of 175 (10%); phobic and generalized anxiety disorder, 13 of 175 (7%); and generalized anxiety disorder only, 7 of 175 (4%). Participants with anxiety disorder reported higher level of phobic avoidance across all situations on the Fear Questionnaire. Younger age (per decade increase in odds ratio, 0.64; 95% confidence interval, 0.45-0.91) and having previous anxiety/depression (odds ratio, 4.38; 95% confidence interval, 1.94-9.89) were predictors for anxiety poststroke/transient ischemic attack. Participants with anxiety disorder were more dependent (modified Rankin Scale score 3-5, [anxiety] 55% versus [no anxiety] 29%; P anxiety] 19.5, 10-27 versus [no anxiety] 0, 0-5; P Anxiety after stroke/transient ischemic attack is predominantly phobic and is associated with poorer patient outcomes. Trials of anxiety intervention in stroke should consider the different treatment approaches needed for phobic and generalized anxiety. © 2018 The Authors.
Bang, Oh Young; Seok, Jin Myoung; Kim, Seon Gyeong; Hong, Ji Man; Kim, Hahn Young; Lee, Jun; Chung, Pil-Wook; Park, Kwang-Yeol; Kim, Gyeong-Moon; Chung, Chin-Sang; Lee, Kwang Ho
Background Cancer and ischemic stroke are two of the most common causes of death among the elderly, and associations between them have been reported. However, the main pathomechanisms of stroke in cancer patients are not well known, and can only be established based on accurate knowledge of the characteristics of cancer-related strokes. We review herein recent studies concerning the clinical, laboratory, and radiological features of patients with cancer-related stroke. Main Contents This revi...
Full Text Available OBJECTIVE: In this study, frequency of temporary hyperglycemia and effects of the hyperglycemia on the severity and prognosis of stroke were examined in patients with acute ischaemic stroke. MATERIAL and METHODS: One hundred patients, who applied for acute ischaemic stroke and met the inclusion criteria, were included in the study. Patients were diveded into three groups: normoglycemic, temporary hyperglycemic and diabetes mellitus (DM, according to the baseline blood glucose, fasting blood glucose, oral glucose tolerance test (OGTT test and HbA1c value. These groups’ National Institue of Stroke Scale (NIHSS, Fugl–Meyer (FM and Functional Independence Measure (FIM scores were measured at baseline and at the 3rd month of the follow up; then, these data were compared in terms of the severity and prognosis of stroke. In addition, according to the fasting blood glucose, hyperglycemic and normoglycemic patients becoming permanent diabetics were evaluated. ANOVA, Paired t test and Mann-Whitney U tests were used in the statistical analyses. RESULTS: Of the patients 52 were normoglycemic, 21 were hyperglycemic and 27 were diabetic. At the 3rd month of the follow up, 28 patients died. Three patients with temporary hyperglycemia became permanent DM. At baseline, severity of stroke as measured by NIHSS, FM and FIM scores was lower, which was statistically significant (p0.05. Each of the three groups showed significant improvements at the 3rd month after stroke (p<0.05. Normoglycemia group showed the more improvement than diabetic group. CONCLUSION: In this study, it was concluded that temporary hyperglycemia was not infrequent in patients with ischaemic stroke, and that all forms of hyperglycemia played negative role in the severity and prognosis of stroke. It was determined that follow up of temporary hyperglycemia was important for secondary care of these patients.
Thijs, Vincent; Grittner, Ulrike; Dichgans, Martin; Enzinger, Christian; Fazekas, Franz; Giese, Anne-Katrin; Kessler, Christof; Kolodny, Edwin; Kropp, Peter; Martus, Peter; Norrving, Bo; Ringelstein, Erich Bernd; Rothwell, Peter M; Schmidt, Reinhold; Tanislav, Christian; Tatlisumak, Turgut; von Sarnowski, Bettina; Rolfs, Arndt
Family history of stroke is an established risk factor for stroke. We evaluated whether family history of stroke predisposed to certain stroke subtypes and whether it differed by sex in young patients with stroke. We used data from the Stroke in Fabry Patients study, a large prospective, hospital-based, screening study for Fabry disease in young patients (aged stroke in whom cardiovascular risk factors and family history of stroke were obtained and detailed stroke subtyping was performed. A family history of stroke was present in 1578 of 4232 transient ischemic attack and ischemic stroke patients (37.3%). Female patients more often had a history of stroke in the maternal lineage (P=0.027) than in the paternal lineage. There was no association with stroke subtype according to Trial of Org 10172 in Acute Stroke Treatment nor with the presence of white matter disease on brain imaging. Patients with dissection less frequently reported a family history of stroke (30.4% versus 36.3%; P=0.018). Patients with a parental history of stroke more commonly had siblings with stroke (3.6% versus 2.6%; P=0.047). Although present in about a third of patients, a family history of stroke is not specifically related to stroke pathogenic subtypes in patients with young stroke. Young women with stroke more often report stroke in the maternal lineage. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583. © 2015 American Heart Association, Inc.
Ko, Darae; Thigpen, Jonathan L; Otis, James A; Forster, Kristen; Henault, Lori; Quinn, Emily; Tripodis, Yorghos; Berger, Peter B; Limdi, Nita; Hylek, Elaine M
Statin pretreatment has been associated with reduced infarct volume in nonlacunar strokes. The effect of statins on functional outcomes of strokes related to atrial fibrillation (AF) is unknown. We aimed to define the influence of prestroke statin use on functional outcome in AF. We assembled a cohort of consecutive ischemic stroke patients from 2006 to 2010. All patients underwent CT or MRI and were adjudicated by site investigators. AF was confirmed by electrocardiogram in 100% of patients. Site neurologists blinded to the study hypothesis affirmed the type of stroke and assessed the severity of disability at the time of hospital discharge. The frequency of death at 30-days was calculated. Ischemic stroke (n=1030) resulted in a severe neurological deficit or death (modified Rankin scale ≥4) at 30days in 711 patients (69%). Using multivariable logistic regression models adjusting for factors associated with statin treatment and factors associated with functional outcome, prestroke statin use was associated with a 32% reduction in frequency of severe stroke (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.50-0.92; P=0.011). Other independent factors associated with severe stroke included older age, female sex, non-White race, diabetes mellitus, prior ischemic stroke, prior venous thromboembolism, and dementia. Ischemic strokes in AF are associated with high mortality and morbidity. Statin use at time of stroke onset among patients with AF was associated in this study with less severe stroke and warrant validation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Hong, Yan; Yang, Xun; Zhao, Wenjuan; Zhang, Xianghui; Zhao, Junli; Yang, Yuanju; Ning, Xianjia; Wang, Jinghua; An, Zhongping
Atrial fibrillation (AF) significantly increases the risk of stroke and disease burden and is an established predictor of poor outcomes after stroke. However, data regarding sex differences in long-term outcomes following stroke in patients with AF are scarce. We thus aimed to assess these differences. We recruited 951 consecutive patients with acute ischemic stroke and non-valvular atrial fibrillation (NVAF) treated at three hospitals in Tianjin, China, from January 2006 to September 2014. Information regarding stroke subtype, severity, risk factors, and outcomes (mortality, dependency, and recurrence) at 3, 12, and 36 months after stroke was recorded. The prevalence of NVAF was 8.4% overall, with a higher frequency in women than in men (11.3 vs. 6.9%, P disease burden in women.
Campbell, Bryan A.; Applin, Zachary T.; Kemmerly, Guy T.; Coe, Paul L., Jr.; Owens, D. Bruce; Gile, Brenda E.; Parikh, Pradip G.; Smith, Don
A wind tunnel investigation of a leading edge boundary layer control system was conducted on a High Speed Civil Transport (HSCT) configuration in the Langley 14- by 22-Foot Subsonic Tunnel. Data were obtained over a Mach number range of 0.08 to 0.27, with corresponding chord Reynolds numbers of 1.79 x 10(exp 6) to 5.76 x 10(exp 6). Variations in the amount of suction, as well as the size and location of the suction area, were tested with outboard leading edge flaps deflected 0 and 30 deg and trailing-edge flaps deflected 0 and 20 deg. The longitudinal and lateral aerodynamic data are presented without analysis. A complete tabulated data listing is also presented herein.
Yang, Yang; Shi, Yu-Zhi; Zhang, Ning; Wang, Shuo; Ungvari, Gabor S; Ng, Chee H; Wang, Yi-Long; Zhao, Xing-Quan; Wang, Yong-Jun; Wang, Chun-Xue; Xiang, Yu-Tao
Few studies on suicidal ideation have been conducted in post-stroke patients in China. This national study examined suicidal ideation at 1-year post-stroke and explored its demographic and clinical correlates. A total of 1418 patients with ischemic stroke were included in 56 hospitals nationwide. Demographic, clinical characteristics and neuro-imaging information were collected with standardized instruments, including assessment of stroke severity, depression, cognitive impairment, stroke recurrence, physical disability and insomnia. Suicidal ideation was measured using item 3 of the Hamilton Rating Scale for Depression. The frequency of suicidal ideation in this study was 6.6%. Multivariate analyses revealed that disability (OR=2.07, 95% CI=1.09-3.05), stroke recurrence (OR=4.13, 95% CI=1.74-9.77) and insomnia early (OR=1.87, 95% CI=1.03-3.39), middle (OR=2.66, 95% CI=1.46-4.85) and late (OR=2.35, 95% CI=1.31-4.19) at the 1-year follow-up and post-stroke depression (OR=2.16, 95% CI=1.23-3.82) were significantly associated with post-stroke suicidal ideation. Post-stroke depression, disability, insomnia and stroke recurrence are possible risk factors of suicidal ideation that warrant attention in clinical practice. Copyright © 2016 Elsevier Inc. All rights reserved.
Gaynor, Eva Joan; Geoghegan, Sheena Elizabeth; O'Neill, Desmond
stroke is predominantly a disease of older people. While age bias has been demonstrated in studies of pharmacological therapeutic interventions in stroke, the extent of discrimination by age in stroke rehabilitation studies is unknown. The aim of this study was to systematically review the literature to assess the extent of ageism in stroke rehabilitation studies. all randomised control trials (RCT) on stroke rehabilitation entered in the Cochrane database which reported mean age were included. Patient gender and exclusion criteria were also recorded. of 241 RCT's identified, 182 were eligible for inclusion. The mean age of all patients was 64.3, almost a decade younger than those seen by stroke physicians in daily practice in global terms, and 11-12 years younger than encountered in hospital practice in the British Isles. Almost half (46%) of trials excluded patients with cognitive impairment, almost one-quarter (23%) patients with dysphasia and one-eighth (13%) excluded patients with multiple strokes. we have identified a clear difference in the mean age of those included in stroke rehabilitation studies compared with the international mean age of stroke. In addition, a quarter of trials excluded dysphasic patients which may indicate omission of more severe strokes. This means that the evidence base for stroke rehabilitation is deficient in terms of matching the characteristics of patients encountered in clinical practice, and a more representative sample of older people and those with significant disability must be included in future trials.
Ingolfsdottir, Harpa Maria; Thomasen, Per Caye
We report the case of a patient admitted with aphasia, treated for a stroke. Subsequently, it was revealed that the symptoms were caused by complicated otitis media with localized meningitis. This case draws attention to the possible intracranial spread of infection when neurological symptoms occur...
Bousser, M.G.; Baron, J.C.; Chiras, J.
Lasting neurological deficits, though most infrequent, do occur in migrainous subjects and are well documented by clinical angiographic computed tomographic (CT scan) and even pathological studies. However the mechanism of cerebral ischemia in migraine remains widely unknown and the precise role of migraine in the pathogenesis of ischemic strokes is still debated. (orig./MG)
Kelly, W. F.; Roussak, J.
Jogging is a form of physical exercise that has stimulated the imagination of the public as shown by recent appearance of its own journal (Jogging Magazine, Editor J. Bryant). We wish to report the unusual complication of an acute stroke sustained during jogging.
Kelly, W. F.; Roussak, J.
Jogging is a form of physical exercise that has stimulated the imagination of the public as shown by recent appearance of its own journal (Jogging Magazine, Editor J. Bryant). We wish to report the unusual complication of an acute stroke sustained during jogging. Images p229-a Fig. 1 PMID:7448490
Haast, R.A.M.; Gustafson, D.R.; Kiliaan, A.J.
Sex differences in stroke are observed across epidemiologic studies, pathophysiology, treatments, and outcomes. These sex differences have profound implications for effective prevention and treatment and are the focus of this review. Epidemiologic studies reveal a clear age-by-sex interaction in
Matric suction is a soil parameter which influences the behaviour of unsaturated soils in both terms of shear strength and permeability. It is a necessary aspect to know the variation of matric suction in unsaturated soil zone for solving geotechnical issues like unsaturated soil slopes stability or bearing capacity for unsaturated foundation ground. Mathematical expression of the dependency between soil moisture content and it’s matric suction (soil water characteristic curve) has a powerful character of nonlinearity. This paper presents two methods to determine the variation of matric suction along the depth included between groundwater level and soil level. First method is an analytical approach to emphasize one direction steady state unsaturated infiltration phenomenon that occurs between the groundwater level and the soil level. There were simulated three different situations in terms of border conditions: precipitations (inflow conditions on ground surface), evaporation (outflow conditions on ground surface), and perfect equilibrium (no flow on ground surface). Numerical method is finite element method used for steady state, two-dimensional, unsaturated infiltration calculus. Regarding boundary conditions there were simulated identical situations as in analytical approach. For both methods, was adopted the equation proposed by van Genuchten-Mualen (1980) for mathematical expression of soil water characteristic curve. Also for the unsaturated soil permeability prediction model was adopted the equation proposed by van Genuchten-Mualen. The fitting parameters of these models were adopted according to RETC 6.02 software in function of soil type. The analyses were performed in both methods for three major soil types: clay, silt and sand. For each soil type were concluded analyses for three situations in terms of border conditions applied on soil surface: inflow, outflow, and no flow. The obtained results are presented in order to highlight the differences
Woods, K S; Defarges, A M N; Abrams-Ogg, A C G; Viel, L; Brisson, B A; Bienzle, D
Different aspiration techniques to retrieve bronchoalveolar lavage fluid (BALF) affect sample quality in healthy dogs. Studies evaluating these techniques in dogs with respiratory disease are lacking. To compare sample quality of BALF acquired by manual aspiration (MA) and suction pump aspiration (SPA). Eighteen client-owned dogs with respiratory disease. Randomized, blinded prospective clinical trial. Manual aspiration was performed with a 35-mL syringe attached directly to the bronchoscope biopsy channel and SPA was performed with a maximum of 50 mmHg negative pressure applied to the bronchoscope suction valve using the suction trap connection. Both aspiration techniques were performed in each dog on contralateral lung lobes, utilizing 2 mL/kg lavage volumes per site. Samples of BALF were analyzed by percentage of retrieved infusate, total nucleated cell count (TNCC), differential cell count, semiquantitative assessment of slide quality, and diagnosis score. Data were compared by paired Student's t-test, Wilcoxon signed-rank test, chi-squared test, and ANOVA. Cohen's kappa coefficient was used to assess agreement. The percentage of retrieved BALF (P = .001) was significantly higher for SPA than MA. Substantial agreement was found between cytologic classification of BALF obtained with MA and SPA (kappa = 0.615). There was no significant difference in rate of definitive diagnosis achieved with cytologic assessment between techniques (P = .78). Suction pump aspiration, compared to MA, improved BALF retrieval, but did not significantly affect the rate of diagnostic success of bronchoalveolar lavage (BAL) in dogs with pulmonary disease. Copyright © 2014 by the American College of Veterinary Internal Medicine.
may be used to turn samples in situ, without opening the chamber as shown in Fig. 2.2. Fig. 2.3 illustrates the operation principles of...without opening the chamber. Fig. 2.3. Schematics of the key component of the suction casting technique and its operation principle . Final progress...35, 8630, (1987).  L. F. Kiss , G. Huhn, T. Kemeny, J. Balogh, D. Kaptas, “Magnetic properties of Fe-Zr metastable phases”, J. Magn. Magn. Mater
Full Text Available Possibility of realization is shown and the control system of a difference of pressure between an exit and an input of the compressor of the heat pump on carbon dioxide working at variable thermal load, and discharge and suction pressures by means of two control valves connected in series is developed. On an example a flow coefficient calculation procedure of control valves is shown.
M N Vijai
Full Text Available Background and Aims: Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP. Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Methods: Group I (n = 50 patients were intubated with HiLo Evac™ endotracheal (ET tube with facility for sub-glottic suctioning, and Group II (n = 50 patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher′s exact test, as appropriate, to analyse the significance of difference between the two groups. Results: The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021. Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001 and ICU stay (8.33 vs. 6.33; P = 0.001 on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006 with lower incidence of mortality (36% vs. 48%; P = 0.224 in the Group I. Conclusion: Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.
Vijai, M N; Ravi, Parli R; Setlur, Rangaraj; Vardhan, Harsh
Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP). Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Group I (n = 50) patients were intubated with HiLo Evac™ endotracheal (ET) tube with facility for sub-glottic suctioning, and Group II (n = 50) patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU) stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher's exact test, as appropriate, to analyse the significance of difference between the two groups. The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021). Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001) and ICU stay (8.33 vs. 6.33; P = 0.001) on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006) with lower incidence of mortality (36% vs. 48%; P = 0.224) in the Group I. Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.
Anbar, Tag; Zuel-Fakkar, Nehal Mohamed; Matta, Mary Fikry; Arbab, Mai Mohammed Ibrahim
Vitiligo is the most prevalent acquired pigmentary disorder as a result of destruction of melanocytes. Several studies have reported increased serum levels of homocysteine (Hcy) in vitiligo patients which may be the result of decreased Vitamin B12 and folic acid levels. In addition, homocystinuria is associated with pigmentary dilution. On the other hand, other studies reported normal serum homocysteine levels. Our aim was to study the Hcy level in active vitiligo patients both in serum and in suction blister fluid obtained from the lesional skin. A total of 30 patients with active vitiligo of both sexes and 30 healthy volunteers were enrolled in this study. Sera from the blood and from lesional induced bullae were obtained from the patients and controls and were assayed for Hcy by enzyme-linked immunosorbent assay (ELISA). The collected data were analyzed by SPSS version 17. There were no significant differences in the serum levels of Hcy between patients and healthy controls, however, the increase in Hcy level was highly statistically significant in the patients' lesional induced bulla compared to the healthy controls. There was no significant difference in Hcy levels between males and females and between patients with negative or positive family histories of vitiligo. The presence of a high homocysteine level in active vitiligo lesions points to a local event occurring in this lesion, which is not reflected as an increase in the patient's serum level.
Choi, Insub; Kim, JunHee; Kim, Ho-Ryong
A full-scale experimental test was conducted to analyze the composite behavior of insulated concrete sandwich wall panels (ICSWPs) subjected to wind pressure and suction. The experimental program was composed of three groups of ICSWP specimens, each with a different type of insulation and number of glass-fiber-reinforced polymer (GFRP) shear grids. The degree of composite action of each specimen was analyzed according to the load direction, type of the insulation, and number of GFRP shear grids by comparing the theoretical and experimental values. The failure modes of the ICSWPs were compared to investigate the effect of bonds according to the load direction and type of insulation. Bonds based on insulation absorptiveness were effective to result in the composite behavior of ICSWP under positive loading tests only, while bonds based on insulation surface roughness were effective under both positive and negative loading tests. Therefore, the composite behavior based on surface roughness can be applied to the calculation of the design strength of ICSWPs with continuous GFRP shear connectors.
Full Text Available A full-scale experimental test was conducted to analyze the composite behavior of insulated concrete sandwich wall panels (ICSWPs subjected to wind pressure and suction. The experimental program was composed of three groups of ICSWP specimens, each with a different type of insulation and number of glass-fiber-reinforced polymer (GFRP shear grids. The degree of composite action of each specimen was analyzed according to the load direction, type of the insulation, and number of GFRP shear grids by comparing the theoretical and experimental values. The failure modes of the ICSWPs were compared to investigate the effect of bonds according to the load direction and type of insulation. Bonds based on insulation absorptiveness were effective to result in the composite behavior of ICSWP under positive loading tests only, while bonds based on insulation surface roughness were effective under both positive and negative loading tests. Therefore, the composite behavior based on surface roughness can be applied to the calculation of the design strength of ICSWPs with continuous GFRP shear connectors.
Lee, Harry; Wen, Baole; Doering, Charles
The rate of viscous energy dissipation ɛ in incompressible Newtonian planar Couette flow (a horizontal shear layer) imposed with uniform boundary injection and suction is studied numerically. Specifically, fluid is steadily injected through the top plate with a constant rate at a constant angle of injection, and the same amount of fluid is sucked out vertically through the bottom plate at the same rate. This set-up leads to two control parameters, namely the angle of injection, θ, and the Reynolds number of the horizontal shear flow, Re . We numerically implement the `background field' variational problem formulated by Constantin and Doering with a one-dimensional unidirectional background field ϕ(z) , where z aligns with the distance between the plates. Computation is carried out at various levels of Re with θ = 0 , 0 .1° ,1° and 2°, respectively. The computed upper bounds on ɛ scale like Re0 as Re > 20 , 000 for each fixed θ, this agrees with Kolmogorov's hypothesis on isotropic turbulence. The outcome provides new upper bounds to ɛ among any solution to the underlying Navier-Stokes equations, and they are sharper than the analytical bounds presented in Doering et al. (2000). This research was partially supported by the NSF Award DMS-1515161, and the University of Michigan's Rackham Graduate Student Research Grant.
Ray, Richard; Bene, Katalin
The soil-water characteristic curve (SWCC) is an important piece of information for understanding unsaturated soil behavior. With few exceptions, most of the SWCCs are developed as discrete points and are typically generated under drying path. This study presents results from automated tests that typically draw suction values to about 1 bar. Tempe cells are used with the axis translation method to generate the curves. Soils tested include fine sand, silty, and clayey sands. While a typical test starts in a saturated state and generates a drying curve, the test can be reversed any number of times to produce hysteresis behavior. Another advantage to the method is time efficiency since a curve with thousands of data points are produced in less than a week. However, careful consideration has to be made with regard to extraction rate, especially as the specimen becomes dryer. Several data sets are presented illustrating good and problematic behavior as well as hysteresis. Some suggestions are given concerning the selection of extraction rates or adjusting curves to account for extraction rate effects.
Tang, B.; Wang, Y. S.; Ji, S. Z.
The seeding raising technology of the hole tray assembly line is an important part of modern agriculture. The 2BSL-320 vegetable seeders with air-suction drum type are implements that are used to fill nutritional soil and press a hole in a float tray to sow seeds precisely. It can complete the whole process of putting down the tray, bedding the soil, scraping the soil, pressing a hole, sowing the seeds, compacting the soil, watering and putting away the tray by one time. Based on the introduction of the structure and working principle of the implement’s critical components, in order to improve the seeding efficiency and the seeding accuracy of the seeders, the response surface tests and the group experiments were carried out in this paper. And the MATLAB tool box was used to conduct fitting and optimization analysis of the test results, also the rationality of the optimization results was validated by experiments, which had provided a theoretical basis for the design of operation parameters in the vegetable seeders and had improved the seeding efficiency and quality.
Board, W J; Street, G M; Caspers, C
Daily volume loss of the stump leads to a poor fit of the prosthetic socket. A method of preventing this volume loss and maintaining a good fit was developed. A vacuum (-78 kPa) was drawn on the expulsion port of a total surface-bearing suction socket to hold the liner tightly against the socket. Stump volume of 10 trans-tibial amputees was measured prior to and immediately after a 30 minute walk with normal and vacuum socket conditions. Under the normal condition, the limb lost an average of 6.5% of its volume during the walk. In contrast, with the liner held tightly by vacuum, the limb gained an average of 3.7% in volume. It is believed that the difference observed between conditions resulted from a greater negative pressure developed during the swing phase of gait with the vacuum condition. X-rays revealed that the limb and tibia pistoned 4 mm and 7 mm less, respectively, under the vacuum condition. The combination of reduced pistoning and maintenance of volume is thought to account for the more symmetrical gait observed with the vacuum.
Beil, Tracy L; Street, Glenn M; Covey, Steven J
Interface pressures were measured during ambulation with a normal total-surface weight-bearing suction socket and a vacuum-assisted socket. The vacuum-assisted socket has been shown to eliminate daily volume loss. Urethane liners were instrumented with five force-sensing resistors to measure positive pressures and one air pressure sensor at the distal end of the liner to document negative pressures. Nine unilateral transtibial amputees participated in the study. The vacuum-assisted socket created significantly lower positive-pressure impulse (42.8, 39.6 kPa x s) and peak pressures (83.5, 80.0 kPa) during the stance phase. The pressure impulse (-10.5, -13.3 kPa x s), average (-21.2, -26.5 kPa), and peak (-28.5, -36.3 kPa) negative pressures during swing phase were significantly greater in magnitude with the vacuum-assisted socket. We believe that lower positive pressures seen during stance using the vacuum-assisted socket reduces the fluid forced out and greater negative pressures seen during swing increases the amount of fluid drawn into the limb, thereby preventing volume loss.
Sarfo, Fred Stephen; Nichols, Michelle; Qanungo, Suparna; Teklehaimanot, Abeba; Singh, Arti; Mensah, Nathaniel; Saulson, Raelle; Gebregziabher, Mulugeta; Ezinne, Uvere; Owolabi, Mayowa; Jenkins, Carolyn; Ovbiagele, Bruce
Disability-adjusted life-years lost after stroke in Low & Middle-Income Countries (LMICs) is almost seven times those lost in High-income countries. Although individuals living with chronic neurological and mental disorders are prone to stigma, there is a striking paucity of literature on stroke-related stigma particularly from LMICs. To assess the prevalence, severity, determinants and psycho-social consequences of stigma among LMIC stroke survivors. Between November 2015 and February 2016, we conducted a cross-sectional survey of 200 consecutive stroke survivors attending a neurology clinic in a tertiary medical center in Ghana. The validated 8-Item Stigma Scale for Chronic Illness (SSCI-8) questionnaire was administered to study participants to assess internalized and enacted domains of stigma at the personal dimension with further adaptation to capture family and community stigma experienced by stroke participants. Responses on the SSCI-8 were scored from 1 to 5 for each item, where 1=never, 2=rarely, 3=sometimes, 4=often and 5=always with a score range of 8-40. Demographic and clinical data on stroke type and severity as well as depression and Health-Related Quality of Life indicators were also collected. Predictors of stroke-related stigma were assessed using Linear Models (GLM) via Proc GENMOD in SAS 9.4. 105 (52.5%) subjects recruited were males and the mean±SD age of stroke survivors in this survey was 62.0±14.4years. Mean SSCI-8 score was highest for personal stigma (13.7±5.7), which was significantly higher than family stigma (11.9±4.6; p=0.0005) and social/community stigma (11.4±4.4; pstigma. A graded increase in scores on the Geriatric Depression Scale and Centre for Epidemiological Studies-Depression scale was observed across the three categories. Living in an urban setting was associated with higher SSCI-8 scores. Moreover, stroke subjects with more severe post-stroke residual symptom deficits reported a significantly higher frequency of stigma
Yang, Yang; Shi, Yu-Zhi; Zhang, Ning; Wang, Shuo; Ungvari, Gabor S; Ng, Chee H; Wang, Yi-Long; Zhao, Xing-Quan; Wang, Yong-Jun; Wang, Chun-Xue; Xiang, Yu-Tao
Few studies on long-term functional outcome have been conducted in post-stroke patients in China. The objective of this study was to conduct a nationwide survey in China to investigate the 5-year prevalence of post-stroke disability and its correlation factors. A total of 893 patients with ischemic stroke were included. Demographic, clinical and neuro-imaging information were collected with standardized instruments that assessed stroke severity, depression, cognitive impairment, stroke recurrence and physical disability. Disability was assessed with the modified Ranking Score (mRS), of which a cutoff score ≥2 indicates disability. Statistical analysis included chi-square tests, two independent samples t-tests, Mann-Whitney U test and multiple logistic regression analysis. The frequency of disability in this study population was 45%. Multivariate analyses revealed that older age, lower education level, previous history of stroke, stroke severity at admission, depression, cognitive impairment at 3 months, and stroke recurrence within 5 years follow up were all significantly associated with post-stroke disability. The disability rate in 5-year post-stroke was high in Chinese patients. Treatment of depression, secondary prevention of stroke and rehabilitation may benefit disabled patients with stroke in China.
Voelkel, Nicolas; Hubert, Nikolai Dominik; Backhaus, Roland; Haberl, Roman Ludwig; Hubert, Gordian Jan
Intravenous thrombolysis (IVT) is beneficial in reducing disability in selected patients with acute ischemic stroke. There are numerous contraindications to IVT. One is recent surgery. The aim of this study was to analyze the safety of IVT in patients with postoperative stroke. Data of consecutive IVT patients from the Telemedical Project for Integrative Stroke Care thrombolysis registry (February 2003 to October 2014; n=4848) were retrospectively searched for keywords indicating preceding surgery. Patients were included if surgery was performed within the last 90 days before stroke. The primary outcome was defined as surgical site hemorrhage. Subgroups with major/minor surgery and recent/nonrecent surgery (within 10 days before IVT) were analyzed separately. One hundred thirty-four patients underwent surgical intervention before IVT. Surgery had been performed recently (days 1-10) in 49 (37%) and nonrecently (days 11-90) in 85 patients (63%). In 86 patients (64%), surgery was classified as major, and in 48 (36%) as minor. Nine patients (7%) developed surgical site hemorrhage after IVT, of whom 4 (3%) were serious, but none was fatal. One fatal bleeding occurred remotely from surgical area. Rate of surgical site hemorrhage was significantly higher in recent than in nonrecent surgery (14.3% versus 2.4%, respectively, odds ratio adjusted 10.73; 95% confidence interval, 1.88-61.27). Difference between patients with major and minor surgeries was less distinct (8.1% and 4.2%, respectively; odds ratio adjusted 4.03; 95% confidence interval, 0.65-25.04). Overall in-hospital mortality was 8.2%. Intracranial hemorrhage occurred in 9.7% and was asymptomatic in all cases. IVT may be administered safely in postoperative patients as off-label use after appropriate risk-benefit assessment. However, bleeding risk in surgical area should be taken into account particularly in patients who have undergone surgery shortly before stroke onset. © 2017 American Heart Association, Inc.
Hakimi, Ryan; Garg, Ankur
Hemorrhagic stroke comprises approximately 15% to 20% of all strokes. This article provides readers with an understanding of the indications and significance of various neuroimaging techniques available for patients presenting with hemorrhagic strokes of distinct causes. The most common initial neuroimaging study is a noncontrast head CT, which allows for the identification of hemorrhage. Once an intracranial hemorrhage has been identified, the pattern of blood and the patient's medical history, neurologic examination, and laboratory studies lead the practitioner to pursue further neuroimaging studies to guide the medical, surgical, and interventional management. Given that hemorrhagic stroke constitutes a heterogeneous collection of diagnoses, the subsequent neuroimaging pathway necessary to better evaluate and care for these patients is variable based on the etiology.With an increasing incidence and prevalence of atrial fibrillation associated with the aging population and the introduction of three new direct factor Xa inhibitors and one direct thrombin inhibitor to complement vitamin K antagonists, oral anticoagulant use continues to increase. Patients on oral anticoagulants have a sevenfold to tenfold increased risk for intracerebral hemorrhage (ICH). Furthermore, patients who have an ICH associated with oral anticoagulant use have a higher mortality rate than those with primary ICH. Despite the reduced incidence of hypertension-related ICH over the past decade, it is expected that the incidence of ICH will continue to increase. Neuroimaging studies are integral to the identification of hemorrhagic stroke, determination of the underlying etiology, prevention of hematoma expansion, treatment of acute complications, and treatment of the underlying etiology, if indicated. Neuroimaging is essential for prognostication and thus directly impacts patient care.
Full Text Available Objective The aim of this project was to complete an analysis of monograph and audiovisual items held in the Central Coast Health Service (CCHS Libraries and containing information relevant to the treatment of acute stroke. Acute stroke is treated by multidisciplinary teams of clinicians based at two hospitals within the CCHS. The adequacy of the library collection was measured by subject coverage and age. Methods The methodology used consisted of three main steps: a literature review; design, administration, and analysis of a questionnaire to members of the CCHS Acute Stroke Team; and an analysis of the libraries’ collections. The research project utilised project management methodology and an evidence based librarianship framework. Results The questionnaire revealed that electronic resources were by far the most frequently used by participants, followed in order by print journals, books, interlibrary loan articles, and audiovisual items. Collection analysis demonstrated that the monograph and audiovisual collections were adequate in both scope and currency to support the information needs of Acute Stroke Team members, with the exception of resources to support patient education. Conclusion The researchers developed recommendations for future collection development in the area of acute stroke resources. Conducting this project within the evidence based librarianship framework helped to develop library staff members’ confidence in their ability to make future collection development decisions, informed by the target group’s information needs and preferences. The collection analysis methodology was designed to be replicated, and new specialist groups within the client base of the library will be targeted to repeat the collection analysis process.
Zhen, Zuo Jun; Lai, Eric C H; Lee, Qing Han; Chen, Huan Wei; Lau, Wan Yee; Wang, Feng Jie
The aim of this study was to evaluate the efficacy of a closed suction irrigation method for the management of infected laparotomy wounds. This is a retrospective study on consecutive patients with infected laparotomy wounds managed in a single tertiary referral hospital from January 2004 to March 2009. The wounds were laid open, debrided and cleansed with hydrogen peroxide, povidone iodine and normal saline. The wounds were either conventionally treated with normal saline dressings followed by secondary suturing when healthy granulation tissues were formed (the Control group) or by the closed suction irrigation method after suturing the wound (the Study Group). There were 70 patients in the Study Group and 60 patients in the Control Group. The hospital stay (mean ± SD, 9.2 ± 0.1 vs. 20.5 ± 0.6 days, P irrigation method for infected laparotomy wounds. The closed suction irrigation method decreased hospital stay and allowed early rehabilitation. The findings of our study need to be substantiated in large-scale randomized controlled trials. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Hassan, Marwan A.; Ismail, Mohd A. M.
The point of this review is to depict the impact of various inflow discharge rate releases on the instruments of matric suction and volumetric water content during an experimental test of spatial overtopping failure at school of civil engineering in universiti Sains of Malaysia. A dry sand dike was conducted inside small flume channel with twelve sensors of tensiometer and Time-Domain Reflectometer (TDR). Instruments are installed in the soil at different locations in downstream and upstream slopes of the dike for measuring the response of matric suction and volumetric water content, respectively. Two values of inflow discharge rates of 30 and 40 L/min are utilized as a part of these experiments to simulate the effectiveness of water reservoirs in erosion mechanism. The outcomes demonstrate that the matric suction and volumetric water content are decreased and increased, respectively for both inflow discharges. The higher inflow discharges accelerate the saturation of dike soil and the erosion process faster than that for the lower inflow discharges.
Full Text Available An analysis has been performed to study magneto-hydrodynamic (MHD squeeze flow between two parallel infinite disks where one disk is impermeable and the other is porous with either suction or injection of the fluid. We investigate the combined effect of inertia, electromagnetic forces, and suction or injection. With the introduction of a similarity transformation, the continuity and momentum equations governing the squeeze flow are reduced to a single, nonlinear, ordinary differential equation. An approximate solution of the equation subject to the appropriate boundary conditions is derived using the homotopy perturbation method (HPM and compared with the direct numerical solution (NS. Results showing the effect of squeeze Reynolds number, Hartmann number and the suction/injection parameter on the axial and radial velocity distributions are presented and discussed. The approximate solution is found to be highly accurate for the ranges of parameters investigated. Because of its simplicity, versatility and high accuracy, the method can be applied to study linear and nonlinear boundary value problems arising in other engineering applications.
Full Text Available Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. Results: The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. Conclusions: The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C. Keywords: Pipelle Suction Curette, Dilatation and Curettage, Premenopause, Postmenopause.
Methods: Participants were 77 stroke survivors (60 males; 17 females) recruited consecutively from a teaching hospital. Participants completed the Beck ... Decline in libido and coital frequency were reported by >70% and in erection, ejaculation and orgasm by >60% of participants. Participants' with erectile dysfunction ...
Full Text Available At the present time, there has been an increase in the frequency of ischemic and hemorrhagic stroke in children. The clinical picture of the disease has similar features to the one of viral encephalitis. Differential diagnosis is necessary to choose correct treatment tactics.
Bettger, Janet Prvu; Li, Zixiao; Xian, Ying; Liu, Liping; Zhao, Xingquan; Li, Hao; Wang, Chunxue; Wang, Chunjuan; Meng, Xia; Wang, Anxin; Pan, Yuesong; Peterson, Eric D; Wang, Yilong; Wang, Yongjun
Background Stroke rehabilitation improves functional recovery among stroke patients. However, little is known about clinical practice in China regarding the assessment and provision of rehabilitation among patients with acute ischemic stroke. Aims We examined the frequency and determinants of an assessment for rehabilitation among acute ischemic stroke patients from the China National Stroke Registry II. Methods Data for 19,294 acute ischemic stroke patients admitted to 219 hospitals from June 2012 to January 2013 were analyzed. The multivariable logistic regression model with the generalized estimating equation method accounting for in-hospital clustering was used to identify patient and hospital factors associated with having a rehabilitation assessment during the acute hospitalization. Results Among 19,294 acute ischemic stroke patients, 11,451 (59.4%) were assessed for rehabilitation. Rates of rehabilitation assessment varied among 219 hospitals (IQR 41.4% vs 81.5%). In the multivariable analysis, factors associated with increased likelihood of a rehabilitation assessment ( p stroke, higher NIHSS on admission, receipt of a dysphagia screen, deep venous thrombosis prophylaxis, carotid vessel imaging, longer length of stay, and treatment at a hospital with a higher number of hospital beds (per 100 units). In contrast, patients with a history of atrial fibrillation and hospitals with higher number of annual stroke discharges (per 100 patients) were less likely to receive rehabilitation assessment during the acute stroke hospitalization. Conclusions Rehabilitation assessment among acute ischemic stroke patients was suboptimal in China. Rates varied considerably among hospitals and support the need to improve adherence to recommended care for stroke survivors.
Teimourian, B; Adham, M N; Gulin, S; Shapiro, C
Suction lipectomy is designed to reduce subcutaneous fat. It is strictly a procedure for the removal of localized fat and body contouring in selected patients and is not a substitute for weight reduction. The technique and the complications associated with the procedure were reviewed in more than 200 patients. Suction lipectomy was performed on fresh cadavers to study the nature of the fibrous tissue and to better understand why the procedure has proved safe.
Masjuan, J; Gállego Culleré, J; Ignacio García, E; Mira Solves, J J; Ollero Ortiz, A; Vidal de Francisco, D; López-Mesonero, L; Bestué, M; Albertí, O; Acebrón, F; Navarro Soler, I M
Organisational capacity in terms of resources and care circuits to shorten response times in new stroke cases is key to obtaining positive outcomes. This study compares therapeutic approaches and treatment outcomes between traditional care centres (with stroke teams and no stroke unit) and centres with stroke units. We conducted a prospective, quasi-experimental study (without randomisation of the units analysed) to draw comparisons between 2 centres with stroke units and 4 centres providing traditional care through the neurology department, analysing a selection of agreed indicators for monitoring quality of stroke care. A total of 225 patients participated in the study. In addition, self-administered questionnaires were used to collect patients' evaluations of the service and healthcare received. Centres with stroke units showed shorter response times after symptom onset, both in the time taken to arrive at the centre and in the time elapsed from patient's arrival at the hospital to diagnostic imaging. Hospitals with stroke units had greater capacity to respond through the application of intravenous thrombolysis than centres delivering traditional neurological care. Centres with stroke units showed a better fit to the reference standards for stroke response time, as calculated in the Quick study, than centres providing traditional care through the neurology department. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
Gustavo W. Kuster
Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.
Full Text Available According to the considerable effects of the loading frequency on the cyclic behaviour of the soils and lack of the sufficient and precise data in this field for the unsaturated soils, more attention needs to be paid to the experimental investigations in various loading paths and frequencies. Meanwhile the unsaturated cyclic tests require advanced equipment and need more precision and time. In this paper, the results of two groups of tests which were performed on an unsaturated fine grained soil in the same initial condition are presented and compared during specific stress paths (pre-cycles of loading and during cycles. The tests are performed using the same suction-controlled cyclic triaxial apparatus in the same stress path before loading cycles, but two conditions of the cyclic loading frequencies (slow cyclic tests with the constant suction condition during the cycles and rapid cyclic tests with the unsteady suction condition during the cyclic path. The results show that increase in the loading frequency leads to the considerable increase in the shear modulus of the samples in the same strain levels.
... Home Current Issue Past Issues Special Section Understanding Stroke Know Stroke • Know the Signs • Act in Time Past Issues / ... Julie Harris, and motivational speaker David Layton. Preventing Stroke "Until I had my stroke, I didn't ...
Full Text Available Objective: The objective of our study was to assess the pain associated with suctioning in preterm neonates on assisted ventilation and comparing the use of expressed breast milk (EBM, sucrose, and swaddling to alleviate pain. Methods: Study design: A randomized controlled clinical trial. Inclusion Criteria: Preterm neonates on assisted ventilation. Exclusion Criteria: Major congenital anomalies and severe encephalopathy. Study Duration and Site: 6 months in level III neonatal Intensive Care Unit. In the first phase, we used premature infant pain profile (PIPP score to assess pain associated with suctioning in preterm neonates on assisted ventilation. In the second phase, the effect of EBM, swaddling, and sucrose on pain relief during suctioning in neonates on assisted ventilation was assessed. Results: There was a significant increase in pain associated with suctioning in preterm neonates on assisted ventilation (preprocedure PIPP score 7.90 ± 2.50; procedural PIPP score 13.63 ± 2.57; P < 0.05. The postintervention mean procedural PIPP score was not significantly different between the EBM, swaddling, and sucrose groups (P = 0.24. Conclusions: Suctioning is painful for preterm neonates on assisted ventilation. There was no difference between EBM, swaddling, and sucrose in relieving pain associated with suctioning.
Akazawa, Yohei; Ishida, Takefumi; Baba, Atsushi; Hiroma, Takehiko; Nakamura, Tomohiko
To evaluate the impact of suction technique on the rate of meconium removal, oxygenation, and hemodynamics in an animal experimental model of meconium aspiration syndrome (MAS). MAS was induced in ventilated rabbits using 3.5 ml/kg of 20% human meconium. Tracheal suction with either catheter suction (CS) or meconium aspirator (MA) was performed after meconium instillation. Percentage of meconium collection rate, PaO(2) trends for 2h after tracheal suction, and acute-phase SpO(2) trends were compared between CS and the other three groups, the tube was withdrawn while meconium was aspirated with an MA, then the trachea was reintubated 5, 10 or 15s after suctioning of meconium. Percentage of meconium collection rate and PaO(2) showed no significant differences between groups. The MA group taking 15s for reintubation after meconium suctioning, showed a significantly lower acute-phase SpO(2) than the CS group (Por=90% was also longer in the MA group taking 15s for reintubation than in the CS group (Pmeconium with less impact on desaturation compared with meconium aspiration in an animal model of MAS. Intratracheal CS may be benefit to remove meconium in non-vigorous infants with meconium-stained amniotic fluid at birth. Copyright 2010 Elsevier Ltd. All rights reserved.
Мaya P. Danovska
Full Text Available Background and purposes: Anomic aphasia is common in patients with left hemispheric strokes. The purpose of this study was to explore the verbal production of ischemic stroke patients with anomic aphasia. Contingent and methods: Fifty ischemic stroke patients admitted to the Neurology Clinic of University Hospital Pleven were studied by neuropsychological battery and CT scan of the brain. Verbal productivity changes found were analyzed in relation to the speech recovery education. Results: All the patients showed lower scores at all nominative and reproductive speech subtests. Discussion: Among the ischemic stroke patients with mild anomic aphasia comparatively great was the percentage of low frequency word actualization and verbal fluency impairment. The usage of nominatives in speech expression of ischemic stroke patients is less as compared with that one of predicatives. Actualization of particles, unions, prepositions and interjections was comparatively high thus compensating the difficulty in choice of a definite lexical number. Conclusion: Future studies on testing of verbal choice in ischemic stroke patients should confirm its practical significance for the assessment of speech disorders concerning a special speech- recovery education.
Full Text Available Stroke scales can be classified as clinicometric scales and functional impairment, handicap scales. All studies describing stroke scales were reviewed by internet searching engines with the final search performed on January 1, 2013. The following string of keywords was entered into search engines; stroke, scale, score and disability. Despite advantages of modified National Institute of Health Stroke Scale and Scandinavian stroke scale comparing to the NIHSS, including their simplification and less inter-rater variability; most of the stroke neurologists around the world continue using the NIHSS. The modified Rankin scale (mRS and Barthel index (BI are widely used functional impairment and disability scales. Distinction between grades of mRS is poorly defined. The Asian stroke disability scale is a simplified functional impairment, handicap scale which is as valid as mRS and BI. At the present time, the NIHSS, mRS and BI are routine stroke scales because physicians have used to work with these scales for more than two decades, although it could not be an acceptable reason. On the other side, results of previous stroke trials, which are the basis of stroke management guidelines are driven using these scales.
Mehdi, Z; Birns, J; Bhalla, A
To provide a comprehensive review of the current evidence on post-stroke urinary incontinence. An electronic database search was performed to identify relevant studies and review articles related to Urinary Incontinence (UI) in the stroke population between the years 1966 and 2012. Urinary incontinence following stroke is a common problem affecting more than one-third of acute stroke patients and persisting in up to a quarter at 1 year. It is well established that this condition is a strong marker of stroke severity and is associated with poorer functional outcomes and increased institutionalisation and mortality rates compared with those who remain continent. Despite evidence linking better outcomes to those patients who regain continence, the results of national audits have demonstrated that the management of UI following stroke is suboptimal, with less than two-thirds of stroke units having a documented plan to promote continence. Current evidence supports a thorough assessment to categorise the type and severity of post-stroke urinary incontinence. An individually tailored, structured management strategy to promote continence should be employed. This has been associated with better stroke outcomes and should be the aim of all stroke health professionals. © 2013 John Wiley & Sons Ltd.
Amaricai, Elena; Poenaru, Dan V
Stroke is a leading cause of disability and a major public health problem. To determine frequency and degree of post-stroke depression (PSD) and its impact on functioning in young and adult stroke patients in a rehabilitation unit. The study included 72 stroke patients (aged 29-59 years) who were attending rehabilitation. The patients were assessed for depressive symptoms by Beck Depression Inventory (BDI), and their functioning by using the Stroke Impact Scale (SIS) and the Barthel Index of Activities of Daily Living (ADL). Forty-eight patients had different degrees of depression: borderline clinical depression (13.8%), moderate depression (34.7%), severe depression (15.2%) or extreme depression (2.9%). There were no significant differences of BDI scores in 30-39, 40-49 and 50-59 years groups. Statistically significant correlations were between BDI score and SIS score, between BDI score and ADL index, and between SIS score and ADL index in men, women and total study patients. More than half of the PSD patients had a moderate degree of depression. Significant correlations were noticed between depressive symptoms and functional status evaluated both by an instrument of assessing stroke impact upon general health and an instrument for assessing the everyday activities.
Alijan Ahmadi Ahangar
Full Text Available Background: Stroke is the leading cause of serious long-term disability. In recent studies hyponatremia as a risk factor for stroke. Methods: This cross-sectional descriptive study was to evaluate serum zinc level in serum sodium over the first 24 hours after the onset of stroke. Different intensities were determined on Stroke Scale NIH (National Institute of Health (mild 4-1 and (average moderate 15-5 and (moderate to severe 20-16 and (extreme severe 42- 21. Determination intensity of stroke after admission and discharge with Modified Rankin Scale and Barthel index. Blood serum concentrations of sodium 0.5 mL of venous blood were taken and sodium serum level was performed with Latex particle agglutination test in Ayatollah Rouhani Hospital. That normal range was defined 136-146 meq / L Findings: 125 patients were entered into this study; the prevalence of hyponatremia in female was 70% vs 60% in male. Of stroke patients included in this study 66% of them had hyponatremia and the frequency of hyponatremia in ischemic and hemorrhagic was 82% and 63%, respectively. Increase in hyponatremia with disability period of admission had statistically significant (10(12 mild vs 40(32 moderate, 32(25.6 severe, p=0.01 also with disability before discharge (24(19.2 mild, 26(20.8 moderate, 32(25.6 severe, p=0.03. Conclusions: Hyponatremia can effect on severity of the stroke and can be considered as a predictor of increased stroke severity and disability at admission and discharge.
Sheila Cristina Ouriques Martins
Full Text Available The second part of these Guidelines covers the topics of antiplatelet, anticoagulant, and statin therapy in acute ischemic stroke, reperfusion therapy, and classification of Stroke Centers. Information on the classes and levels of evidence used in this guideline is provided in Part I. A translated version of the Guidelines is available from the Brazilian Stroke Society website (www.sbdcv.com.br.
Full Text Available Heat stroke is the most complicated and dangerous amongst heat injuries that can lead to irreversible injury and even death with itself or with creating predisposibility to different diseases. The following case report depicts a patient who presented primarily with impairment of consciousness after walking 45 km in the summer heat to cross the Syria-Turkey border and later syncope. This case report aims to highlight the possibility of higher co-incidence with heat stroke and stroke.
Rodgers, Helen; Dennis, Martin; Cohen, David; Rudd, Anthony
the National Service Framework for Older People requires every general hospital which cares for stroke patients to introduce a specialist stroke service by 2004. to describe the organisation and staffing of specialist hospital-based stroke services in the UK. a national postal survey of consultant members of the British Association of Stroke Physicians (BASP) seeking details of the provision of neurovascular clinics, acute stroke units (ASUs), stroke rehabilitation units (SRUs), and the organisation and staffing of these services. the response rate was 91/126 (72%). Fifty-four neurovascular clinics, 40 ASUs and 68 SRUs were identified. Neurovascular clinics used a number of strategies to maintain rapid access and 30 (56%) were run by a single consultant. Only 50% ASUs usually admitted patients within 24 h of stroke. As the number of beds available on ASUs and SRUs did not reflect the total number of stroke in-patients, 21 (53%) ASUs and 45 (79%) SRUs had admission criteria. Training opportunities were limited: 37% ASUs and 82% SRUs had no specialist registrar. The therapy sessions (1 session=half a day) available per bed per week on a SRU were: physiotherapy 0.8; occupational therapy 0.6; speech and language therapy 0.25. significant development is needed to achieve the NSF target for hospital-based stroke services as few Trusts currently have all components in place and even when available not all stroke patients have access to specialist care. Stroke specialists will be required to run these services but training opportunities are currently limited. Stroke unit therapy staffing levels were lower than was available in randomised controlled trials.
Full Text Available The deterioration of the balance between direct and indirect ways in the basal ganglia causes chorea. The lesions of contralateral basal ganglia, thalamus or the connection of them all together are responsible for this. Chorea can be observed during the course of metabolic and vascular diseases, neurodegenerative or hereditary diseases. Hyperkinetic movement disorders after acute ischemic stroke are reported as rare; however, hemichorea is the most frequent developing disorder of hyperkinetic movement as a result of cerebrovascular disease. In this case report, we presented two case who applied us with choreiform movements in his left half of the body after acute thalamic stroke. [Cukurova Med J 2016; 41(0.100: 29-32
Cigarette smoking is a risk factor for the brain infarction (lacunar and atherothrombotic brain infarction) and subarachnoid hemorrhage. Not only active smoking but also passive smoking and smokeless tobacco products pose a risk. The risk after smoking cessation for 5-10 years is equal to that faced by a non-smoker. Many patients continue smoking even after an attack of stroke; therefore, support measures to enforce nonsmoking are required in this high-risk population. We offer nonsmoking support using the 5A approach, and assess the nonsmoking stage (precontemplation, contemplation, preparation, action, and maintenance). We also administer medical therapy for smoking cessation when the patients find it difficult to quit smoking on their own accord. Nicotine dependency needs a follow-up like that required for other risk factors in the primary and secondary prevention of the stroke because smoking is a chronic disease that tends to recur.
Faiman, Roy; Cuño, Ruben; Warburg, Alon
The efficacy of three suction traps for trapping phlebotomine sand flies (Diptera: Psychodidae) was compared. Traps were baited with Co(2) and used without any light source. CO(2)-baited CDC traps were evaluated either in their standard downdraft orientation or inverted (iCDC traps). Mosquito Magnet-X (MMX) counterflow geometry traps were tested in the updraft orientation only. Both updraft traps (iCDC and MMX) were deployed with their opening ∼10 cm from the ground while the opening of the downdraft (CDC) trap was ∼40 cm above ground. Comparisons were conducted in two arid locations where different sand fly species prevail. In the Jordan Valley, 3,367 sand flies were caught, 2,370 of which were females. The predominant species was Phlebotomus (Phlebotomus) papatasi, Scopoli 1786 (>99%). The updraft-type traps iCDC and MMX caught an average of 118 and 67.1 sand flies per trap night, respectively. The CDC trap caught 32.9 sand flies on average per night, significantly less than the iCDC traps. In the Judean desert, traps were arranged in a 3 × 3 Latin square design. A total of 565 sand flies were caught, 345 of which were females. The predominant species was P. (Paraphlebotomus) sergenti Parrot 1917 (87%). The updraft traps iCDC and MMX caught an average of 25.6 and 17.9 sand flies per trap per night, respectively. The CDC trap caught 7.8 sand flies on average per night, significantly less than the iCDC traps. The female to male ratio was 1.7 on average for all trap types. In conclusion, updraft traps deployed with their opening close to the ground are clearly more effective for trapping sand flies than downdraft CDC traps in open habitats.