Background
Cerebral vein thrombosis is a rare cause of stroke with significant risk of death and long-term dependency. Anticoagulation has been associated with better long-term prognosis, and vitamin ...K antagonists are usually prescribed in this setting.
Aim
The aim of this study was to present a series of 15 cerebral vein thrombosis patients treated with dabigatran.
Methods
Retrospective study of clinical, imaging, and follow-up characterization of all patients admitted with cerebral vein thrombosis and treated with dabigatran in a tertiary neurology department between June 2011 and December 2013 was conducted. Complications and adverse effects were recorded. Modified Rankin Scale was used to assess clinical severity; excellent outcome was defined as modified Rankin Scale at six-months of 0 to 1. Recanalization was assessed with an angiographic method (computer tomography, magnetic resonance imaging, or digital subtraction angiography).
Results
Eighteen patients were admitted for cerebral vein thrombosis. Dabigatran was started in 11 patients, and warfarin was started in 7. Four patients on warfarin were switched to dabigatran because of adverse effects at 0·5, 1, 3·5, and 4 months. A total of 15 patients were treated with dabigatran with median follow-up time of 19 months. Excellent outcome was observed in 87% of patients and recanalization in 80%.
Conclusions
We report the largest series of cerebral vein thrombosis patients treated with dabigatran. Clinical outcome was excellent in most patients and not different from other studies. Dabigatran could possibly be considered an alternative to warfarin; nevertheless, further prospective assessment with randomized controlled studies is warranted.
The prevention of recurrent hepatitis B virus (HBV) infection after orthotopic liver transplantation (OLT) with hepatitis B immunoglobulin (HBIG) is expensive and requires indefinite parenteral ...administration. Lamivudine is a nucleoside analogue capable of inhibiting HBV replication. The aim of this study is to determine the efficacy of lamivudine in the prevention of recurrent HBV infection after a course of HBIG in patients who were hepatitis B surface antigen (HBsAg) positive and hepatitis Be antigen (HBeAg) negative before OLT. Patients at high risk for recurrent HBV infection (HBeAg positive and HBV DNA positive) were excluded. Thirty HBsAg-positive, HBeAg-negative patients underwent OLT from January 1993 to June 1997. All 30 patients were administered HBIG after OLT and, after 2 years, were given the option of continuing with HBIG or switching to lamivudine. Five patients were excluded: 3 patients were lost to follow-up and 2 patients died of technical complications. Three patients terminated HBIG therapy at 8, 24, and 29 months after OLT, and reinfection with HBV occurred in 1 patient. Six patients elected to continue HBIG therapy for life; 1 patient died of melanoma and the remaining 5 patients are HBsAg negative, with an average follow-up of 73 months. Sixteen patients were converted to lamivudine after a course of HBIG, and all 16 patients are HBsAg negative, with an average follow-up of 51 months after OLT. Five patients have been on lamivudine monotherapy for more than 24 months. These results suggest that lamivudine administered after a posttransplantation course of HBIG can effectively prevent the recurrence of HBV infection in patients who are HBsAg positive and HBeAg negative before OLT. (Liver Transpl 2000;6:434-439.)
In this paper, a PVC filled with a biodegradable polymer, such as polyhydroxybutyrate, was investigated. Polyhydroxybutyrate is a natural biopolymer, but its use limits its high cost. These polymeric ...composites were obtained by rolling. Thermal and thermomechanical properties of polymer composites based on PVC containing various amounts of polyhydroxybutyrate are studied. It has been determined by differential scanning calorimetry method that the glass transition temperature of PVC decreases with increasing percentage of polyhydroxybutyrate filling. For these composite materials, the TMA method yields flow curves, thermomechanical curves. It is determined that unfilled PVC shows a slight deformation and the smallest irreversible deformation. With an increase in the PHB content, both elastic deformation and a viscous flow increase in polymer composites, i.e. with increasing the proportion of polyhydroxybutyrate in the mixture, the elastic properties of the composite increase. Thus, in general, the addition of polyhydroxybutyrate does not significantly impair the performance properties of the resulting composite materials.
The purpose of this study was to identify risk factors that may predict heart failure with reduced ejection fraction (HFrEF) following orthotopic liver transplantation (OLT) and associated mortality.
...HFrEF following OLT is a poorly understood phenomenon, reported in 3% to 7% of transplanted patients.
This is a retrospective analysis of 176 consecutive patients who underwent OLT from 2010 to 2017. Multivariate logistic regression was used to identify associations between cardiovascular risk factors and perioperative variables with post-OLT HFrEF, defined as reduction in left ventricular ejection fraction of at least 10% and left ventricular ejection fraction less than or equal to 40% with acute heart failure symptoms. Multivariate cox proportional hazards regression (with inverse probability weighting by propensity scores) was used to evaluate effects of HFrEF on 1-year mortality.
Of the176 patients, 14% developed HFrEF with a median of 5 days. History of heart failure (OR 10.99, 2.15–56.09; P = .04) and intraoperative transfusion of greater than 11 units of packed red blood cells (OR 3.377, 1.025–11.13; P = .045) were associated with increased incidence of HFrEF. Pre-transplant hemoglobin greater than 8.5 g/dL (OR 0.252, CI 0.0954- 0.665; P = .05) was protective against HFrEF. Thirty-three percent of HFrEF group died within 1 year (HR 7.36, 2.57–21.12; P < .001).
The incidence of acute HFrEF post-OLT is 14% and is associated with a 7-fold increase in 1-year mortality. Cirrhotic cardiomyopathy and stress-induced cardiomyopathy maybe the underlying mechanisms. Our study identified risk factors associated with post-OLT HFrEF and should provide additional guidance for risk stratification of patients undergoing OLT.
Seismic refraction velocity-versus depth models can complement our understanding of natural soils beneath flood protection levees at locations between geotechnical sites. Levee failures in New ...Orleans in 2005 are attributable in part to poor understanding of sediments between geotechnical sites. To a first order, subsurface fluvial–deltaic facies in the lower Mississippi delta plain correlate with general geotechnical properties of water content and cohesive strength, but are too laterally variable to be easily predicted from geotechnical sites spaced 100m apart.
An artificial earthen levee, suitable for seismic investigation, lies ~15km S of the city of New Orleans, Louisiana. Values of shear-wave velocity (VSH) versus depth (0–20m) are derived by forward-ray-trace models of seismic refraction arrivals which match key boundaries identified at (geotechnical) cone-penetration testing sites, spaced at 300m apart. In particular, a 100-m section along the levee crest shows continuous cracks which are as much as 10cm wide, and 30cm deep at their northern end. Cracking may relate to high strain, induced by variable near-surface subsidence of organic-rich sediments. Topographic cross-sections across the levee show variable differential subsidence of 1–2m. Based on effective medium theory, VP- and VSH-versus-depth profiles indicate unexpectedly greater saturation and lower shear moduli on the unprotected levee side adjacent to the cracks.
Integration of geophysical, sedimentary and topographic data, even if only at a few locations can help locate anomalous zones in sub-levee soil between geotechnical boring sites. Future preventive monitoring of flood-protection barriers stands to benefit greatly from integrated data sets “ground truthed” to geotechnical data.
•Seismic monitoring of natural soils beneath man-made levees complements CPT data.•Large VP/VS ratios (8–9) indicate proximity to full saturation.•Differential compaction of organic-rich materials may distress levee.
The objective of the present study was to determine the diet composition and feeding habits of the crocodile shark,
Pseudocarcharias kamoharai
, in Ecuadorian waters, Southeast Pacific Ocean, at a ...general level, as well as by sex, year, and sexual maturity stage. A total of 401 individuals with their respective stomachs were sampled in the Santa Rosa fishery port, Ecuador; 200 were females and 201 males, with a total length (TL) between 50 to 117 cm and 72.5 to 100 cm, respectively. The number of stomach contents analyzed in this study was sufficient to describe the diet of
P. kamoharai
, as the asymptote was reached at 100 digestive tracts. A total of 24 prey species were identified, out of which 16 were cephalopods and eight bony fishes. The main identified prey species were the cockeyed squid,
Histioteuthis heteropsis
, the sharpear enope squid,
Ancistrocheirus lesueurii
, the purpleback flying squid,
Sthenoteuthis oualaniensis
, the Jumbo flying squid,
Dosidicus gigas
, and the neon flying squid,
Ommastrephes bartramii
.
Pseudocarcharias kamoharai
was considered a specialist predator that preferred five prey species (Bi = 0.09), and differences were observed by sex, years, and maturity stages. The trophic overlap was high in both females and males (
Cλ
= 0.98) between the years 2012–2013 and 2017–2018 (
Cλ
= 0.91), as well as between immature and mature individuals (
Cλ
= 0.95). The trophic level was
Tl
k
= 4.37, which indicates that this species is a quaternary consumer or a tertiary carnivore.
The purpose of this study was to examine students' computer attitudes and experience, as well as students' perceptions about the use of two specific software applications (Google Drive Spreadsheets ...and Arquimedes) in the Building Engineering context. The relationships among these variables were also examined. Ninety-two students took part in this study. Results suggest that students hold favourable computer attitudes. Moreover, it was found a significant positive relationship among students' attitudes and their computer experience. Findings also show that students find Arquimedes software more useful and with higher output quality than Google Drive Spreadsheets, while the latter is perceived to be easier to use. Regarding the relationship among students' attitudes towards the use of computers and their perceptions about the use of both software applications, only a significant positive relationship in the case of Arquimedes was found. Findings are discussed in terms of its implications for practice and further research.
Zinc oxide nanoparticles (ZnO) are a promising material for a variety of applications due to their unique characteristics and properties, including optical, chemical, semiconductor and piezoelectric. ...A lot of scientific papers are devoted to the antibacterial action of ZnO nanoparticles. As the main mechanism responsible for the antimicrobial action of ZnO in modern studies, photocatalytic generation of hydrogen peroxide H2O2 is indicated. In addition, in a number of studies it was found that the slowing of bacterial growth upon contact with ZnO is due to the penetration of nanoparticles and the subsequent destruction of the cell membrane. The size effect of antibacterial activity of ZnO nanoparticles has not been fully established and opinions differ on this score: it was shown in that smaller ZnO nanoparticles have a higher toxicity, however, Franklin et al showed that the antimicrobial effect of ZnO is not depends on the size of the nanoparticles. As shown by the studies described in previous works, polymeric nanocomposites based on acrylates with ZnO nanoparticles show pronounced antifungal and antibacterial activity. However, some antifungal activity is also manifested by a polymer matrix based on acrylate monomers that does not contain ZnO nanoparticles. This work is devoted to the study of chemical processes of hydration of nanocomposite polymeric materials with and without ZnO nanoparticles introduced. Polymer matrices based on UV-polymerization acrylates of 2-Carboxyethyl acrylate (2Carb, Aldrich No. 552348) and Bisphenol A glycerolate (1 glycerol / phenol) diacrylate (Bis A, Aldrich No. 411167) were investigated. As filler, ZnO (local Russian supplier REACHEM, powder) was used. Polymer matrices of two-component composition were synthesized, one with the inclusion of ZnO nanoparticles, the other without them. The IR spectra of the resulting composites, as well as the IR spectra of the substances released into the water from the polymer matrixes, were analyzed. Study of IR spectra allows us to conclude that when placing the composite with ZnO nanoparticles in the water, more monomers and monomer salts are released into the aqueous medium, and an increased release of the carboxylate anion occurs as compared to the polymer that does not contain ZnO nanoparticles, which exhibit antifungal properties. Thus, this polymer composite is promising for applications in medicine, cosmetology and paint and varnish manufacture.
The WHO Framework Convention on Tobacco Control (WHO FCTC) is the United Nations tobacco control treaty, fostering public health in previously neglected areas. 179 countries as well as the ...European Union are WHO FCTC Parties, and it comprises both the Northern and Southern hemispheres. Intergovernmental and non-governmental organizations are active observers. It is a powerful alliance for a serious problem – the huge global epidemic caused by tobacco...
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