A single left coronary artery is a very rare anomaly in which only the left coronary artery arises from the aortic trunk by a single coronary ostium and supplies the entire heart. The present report ...is one of the few describing a patient with an anomalous right coronary artery originating from the middle of the left anterior descending artery. The patient presented with acute myocardial infarction with the culprit lesion on the left circumflex artery. Multivessel angioplasty was successfully performed in a two-step approach: the first for the culprit lesion and the second on the anomalous coronary artery. Decisions about treatment modalities for an anomalous coronary artery should be made only after considering the patient’s clinical characteristics and performing additional imaging diagnostics with a clearly defined coronary anatomy.
Manifestations of Lyme carditis Kostić, Tomislav; Momčilović, Stefan; Perišić, Zoran D ...
International journal of cardiology,
04/2017, Volume:
232
Journal Article
Peer reviewed
Abstract The first data of Lyme carditis, a relatively rare manifestation of Lyme disease, were published in eighties of the last century. Clinical manifestations include syncope, light-headedness, ...fainting, shortness of breath, palpitations, and/or chest pain. Atrioventricular (AV) electrical block of varying severity presents the most common conduction disorder in Lyme carditis. Although is usually mild, AV block can fluctuates rapidly and progress from a prolonged P-R interval to a His-Purkinje block within minutes to hours and days. Rarely, Lyme disease may be the cause of endocarditis, while some studies and reports, based on serological and/or molecular investigations, have suggested possible influence of Borrelia burgdorferi on degenerative cardiac valvular disease. Myocarditis, pericarditis, pancarditis, dilated cardiomyopathy, and heart failure have also been described as possible manifestations of Lyme carditis. The clinical course of Lyme carditis is generally mild, short term, and in most cases, completely reversible after adequate antibiotic treatment.
Background Venous ulcers are a major health problem because of their high prevalence and associated high cost of care. Compression therapy is the most widely used treatment for this condition. The ...vast majority of published articles on compression therapy present the results in the treatment of venous ulcers usually up to 15 to 20 cm2 . However, there are no published data in English medical literature on the efficacy of compression therapy in the treatment of extensive venous ulcers (ulcers >20 cm2 of more than 6 months’ duration) with regard to healing rate, time to healing, and recurrence rate at 12 months after healing. Methods A total of 138 patients with extensive venous ulceration (ulceration surface, 20-210 cm2 ; duration, 7 months to 28 years) were randomized into 2 groups: (1) a treatment group (72 patients who were treated by using a multilayer bandaging system with the Tubulcus (a heelless open-toed elastic compression device knitted in tubular form) and elastic bandages and (2) a control group (66 patients treated with a multilayer bandaging system with elastic bandages only). The patients were treated on an ambulatory basis; the primary end point of the study was complete ulcer healing at 500 days. The secondary end point was to assess the ulcer recurrence rate during continuation of below-knee compression of different degrees of compression. In the treatment group, patients were instructed to continue to wear the Tubulcus (35 mm Hg), and patients in the control group were instructed to wear compression stockings with compression of 20 to 25 mm Hg. The exclusion criteria from the study were heart insufficiency with an ejection fraction <35, an ankle-brachial pressure index less than 0.8, and pregnancy. Results The cumulative healing rate was 93% in the treatment group and was 51% in the control group ( P < .001). The median healing time in the treatment group was 133 days (range, 28 to 464 days), and in the control group it was 211 days (range, 61 to 438 days). The recurrence rate at 12 months in the treatment group was 24% (16/67) and was 53% (18/34) in the control group ( P < .05). After additional compression treatment with the same treatment protocol, all 16 recurrent ulcers in the treatment group healed. In the control group, the healing rate of recurrent ulcers was 89% (16/18). Conclusions This study suggests that for extensive venous ulceration, multilayer compression therapy with the Tubulcus provides an extremely high healing rate. Compression of more than 30 mm Hg results in decreased ulcer recurrence. However, recurrence cannot be completely avoided.
This paper describes one recursive model of the Phase Locked Loop (PLL) of the second order based on the measurement and processing of the time difference between the input and output periods. The ...stability and the other conditions, under which the described system can have the properties of a PLL, are investigated using the Z transform analyses. Computer simulation of PLL is introduced in order to give better insight into the PLL characteristics and to confirm the mathematical analyses too. Made analysis shows that PLL is suitable for the wide range of applications. For the corresponding system parameters, PLL possesses the power noise rejection ability. For some other system parameters this PLL possesses the power tracking ability. It can also be used for the measurement of the period of the input signal in the noise environment. The oscilloscope picture of the input and output signals recorded on the realized PLL is presented. Index Terms-Digital circuits, feedback circuits, frequency locked loops, phase locked loops.
Series of novel dual-sensitive poly(2-hydroxypropyl acrylate/itaconic acid) hydrogels were designed as multifunctional drug delivery system which can provide several advantages including drug ...protection, self-regulated oscillatory release and targeted delivery to a single entity. The hydrogels were synthesized by the free-radical crosslinking copolymerization and evaluated as carriers for hydrophobic drug, Oxaprozin, with specific controlled release properties. Structural, morphological, thermal, surface charge, swelling and antimicrobial properties of the hydrogels were investigated for unloaded and Oxaprozin-loaded samples. Swelling studies demonstrated pH- and temperature-sensitivity of drug-free and drug-loaded P(HPA/IA) hydrogels. The results of swelling and oscillatory swelling, and swelling behavior of drug-free, and drug-loaded hydrogels in simulated gastrointestinal conditions, and in vitro Oxaprozin release studies confirmed these hydrogels as a highly effective colon-specific drug delivery system with excellent performance of long-term controlled release. These unique properties make the P(HPA/IA) hydrogels highly attractive materials for developing multifunctional drug delivery systems.
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•Novel dual-sensitive hydrogels by the free-radical crosslinking polymerization.•Volume phase transition temperatures in physiologically relevant temperature range.•Design of multifunctional drug delivery system.•Overcoming serious side effects of drug in upper gastrointestinal tract.•Long-term controlled release of hydrophobic drug, Oxaprozin.
This paper describes a powerful digital time and/or phase shifter of pulse rates, based on Time Recursive Processing. It can function either as a time shifter or as a phase shifter. The circuit can ...generate precise shifting for a pulse rate with a constant input period, but it is also capable to shift a pulse rate whose period is a ramp function. Besides that, the shifter can be used in tracking and prediction applications. The shifter is described by recursive equations as a linear discrete system. All mathematical analyses are made using the Z transform. Computer simulations are employed to prove the correctness of the mathematical analysis. The realization of the shifter is described and, to demonstrate the shifter functioning, actual oscilloscope screenshots are presented.
During the last two decades, interest in bio-based polymers, especially in bio-based composite materials, has grown as a result of environmental concerns. In this paper new composites obtained from ...fully bio-based unsaturated polyester resin (UPR) and waste poly(ethylene terephthalate) (PET) were studied for the first time. The composites were prepared by crosslinking the UPR in the presence of functionalized PET particles (3, 6 and 9 wt%), using dimethyl itaconate as reactive diluent. The results showed that the incorporation of the PET particles led to the increase in mechanical properties. However, higher PET loading caused a decrease in the mechanical properties of the composites because of the PET particle agglomeration.
This paper describes one new approach to frequency locked loop (FLL), which is based on the time non-recursive processing of input periods. System parameters are defined by the ratio of frequencies. ...The conditions, under which the described system can have the properties of a FLL, are analyzed. All math analyses were made by the use of Z transform approach. It was shown that FLL is extremely fast and that it is suitable for usage in different predicting, tracking and modulation applications, for the measurements of frequency and for other applications. The FLL realization in the technique of standard integrated circuits is described. The oscilloscope picture, made on the realized 8 bit model, is presented. Analysis in frequency domain was made using Matlab tools.
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