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embolism</title> <meta name="description" content="Search results for: pulmonary embolism"> <meta name="keywords" content="pulmonary embolism"> <meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1, maximum-scale=1, user-scalable=no"> <meta charset="utf-8"> <link href="https://cdn.waset.org/favicon.ico" type="image/x-icon" rel="shortcut icon"> <link href="https://cdn.waset.org/static/plugins/bootstrap-4.2.1/css/bootstrap.min.css" rel="stylesheet"> <link href="https://cdn.waset.org/static/plugins/fontawesome/css/all.min.css" rel="stylesheet"> <link href="https://cdn.waset.org/static/css/site.css?v=150220211555" rel="stylesheet"> </head> <body> <header> <div class="container"> <nav class="navbar navbar-expand-lg navbar-light"> <a class="navbar-brand" href="https://waset.org"> <img src="https://cdn.waset.org/static/images/wasetc.png" alt="Open Science Research Excellence" title="Open Science Research Excellence" /> </a> <button class="d-block d-lg-none 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action="https://publications.waset.org/abstracts/search"> <div id="custom-search-input"> <div class="input-group"> <i class="fas fa-search"></i> <input type="text" class="search-query" name="q" placeholder="Author, Title, Abstract, Keywords" value="pulmonary embolism"> <input type="submit" class="btn_search" value="Search"> </div> </div> </form> </div> </div> <div class="row mt-3"> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Commenced</strong> in January 2007</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Frequency:</strong> Monthly</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Edition:</strong> International</div> </div> </div> <div class="col-sm-3"> <div class="card"> <div class="card-body"><strong>Paper Count:</strong> 295</div> </div> </div> </div> <h1 class="mt-3 mb-3 text-center" style="font-size:1.6rem;">Search results for: pulmonary embolism</h1> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">235</span> Thulium Laser Vaporisation and Enucleation of Prostate in Patients on Anticoagulants and Antiplatelet Agents</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Abdul%20Fatah">Abdul Fatah</a>, <a href="https://publications.waset.org/abstracts/search?q=Naveenchandra%20Acharya"> Naveenchandra Acharya</a>, <a href="https://publications.waset.org/abstracts/search?q=Vamshi%20Krishna"> Vamshi Krishna</a>, <a href="https://publications.waset.org/abstracts/search?q=T.%20Shivaprasad"> T. Shivaprasad</a>, <a href="https://publications.waset.org/abstracts/search?q=Ramesh%20Ramayya"> Ramesh Ramayya </a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Significant number of patients with bladder outlet obstruction due to BPH are on anti-platelets and anticoagulants. Prostate surgery in this group of patients either in the form of TURP or Open prostatectomy is associated with increased risk of bleeding complications requiring transfusions, packing of the prostatic fossa or ligation or embolization of internal iliac arteries. Withholding of antiplatelets and anticoagulants may be associated with cardiac and other complications. Efficacy of Thulium Laser in the above group of patients was evaluated in terms of peri-operative, postoperative and delayed bleeding complications as well as cardiac events in peri-operative and immediate postoperative period. Methods: 217 patients with a mean age of 68.8 years were enrolled between March 2009 and March 2013 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), PSA values, urine analysis and urine culture, uroflowmetry. The post operative complications in the form of drop in hemoglobin level, transfusion rates, post –operative cardiac events within a period of 30 days, delayed hematuria and events like deep vein thrombosis and pulmonary embolism were noted. Results: Our data showed a better post-operative outcome in terms of, postoperative bleeding requiring intervention 7 (3.2%), transfusion rate 4 (1.8%) and cardiac events within a period of 30 days 4(1.8%), delayed hematuria within 6 months 2(0.9 %) compared other series of prostatectomies. Conclusion: The thulium LASER prostatectomy is a safe and effective option for patients with cardiac comorbidties and those patients who are on antiplatelet agents and anticoagulants. The complication rate is less as compared to larger series reported with open and transurethral prostatectomies. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=thulium%20laser" title="thulium laser">thulium laser</a>, <a href="https://publications.waset.org/abstracts/search?q=prostatectomy" title=" prostatectomy"> prostatectomy</a>, <a href="https://publications.waset.org/abstracts/search?q=antiplatelet%20agents" title=" antiplatelet agents"> antiplatelet agents</a>, <a href="https://publications.waset.org/abstracts/search?q=bleeding" title=" bleeding"> bleeding</a> </p> <a href="https://publications.waset.org/abstracts/2182/thulium-laser-vaporisation-and-enucleation-of-prostate-in-patients-on-anticoagulants-and-antiplatelet-agents" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/2182.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">393</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">234</span> Covid-19 Pandemic: Another Lesson Learned by a Military Hospital</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Mariana%20Floria">Mariana Floria</a>, <a href="https://publications.waset.org/abstracts/search?q=Elena-Diana%20N%C4%83fureanu"> Elena-Diana Năfureanu</a>, <a href="https://publications.waset.org/abstracts/search?q=Diana-Mihaela%20G%C4%83l%C4%83%C5%A3anu"> Diana-Mihaela Gălăţanu</a>, <a href="https://publications.waset.org/abstracts/search?q=Anca-Ecaterina%20Grumeza"> Anca-Ecaterina Grumeza</a>, <a href="https://publications.waset.org/abstracts/search?q=Cristina%20Gorea-Boc%C3%AEnc%C4%83"> Cristina Gorea-Bocîncă</a>, <a href="https://publications.waset.org/abstracts/search?q=Diana-Elena%20Iov"> Diana-Elena Iov</a>, <a href="https://publications.waset.org/abstracts/search?q=Aurelian-Corneliu%20Moraru"> Aurelian-Corneliu Moraru</a>, <a href="https://publications.waset.org/abstracts/search?q=Drago%C8%99-Marian%20Popescu"> Dragoș-Marian Popescu</a> </p> <p class="card-text"><strong>Abstract:</strong></p> SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=Covid-19" title="Covid-19">Covid-19</a>, <a href="https://publications.waset.org/abstracts/search?q=costs" title=" costs"> costs</a>, <a href="https://publications.waset.org/abstracts/search?q=hospital%20stay" title=" hospital stay"> hospital stay</a>, <a href="https://publications.waset.org/abstracts/search?q=military%20hospital" title=" military hospital"> military hospital</a> </p> <a href="https://publications.waset.org/abstracts/146164/covid-19-pandemic-another-lesson-learned-by-a-military-hospital" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/146164.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">178</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">233</span> A Significant Clinical Role for the Capitalbio™ DNA Microarray in the Diagnosis of Multidrug-Resistant Tuberculosis in Patients with Tuberculous Spondylitis Simultaneous with Pulmonary Tuberculosis in High Prevalence Settings in China</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Wenjie%20Wu">Wenjie Wu</a>, <a href="https://publications.waset.org/abstracts/search?q=Peng%20Cheng"> Peng Cheng</a>, <a href="https://publications.waset.org/abstracts/search?q=Zehua%20Zhang"> Zehua Zhang</a>, <a href="https://publications.waset.org/abstracts/search?q=Fei%20Luo"> Fei Luo</a>, <a href="https://publications.waset.org/abstracts/search?q=Feng%20Wu"> Feng Wu</a>, <a href="https://publications.waset.org/abstracts/search?q=Min%20Zhong"> Min Zhong</a>, <a href="https://publications.waset.org/abstracts/search?q=Jianzhong%20Xu"> Jianzhong Xu</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: There has been limited research into the therapeutic efficacy of rapid diagnosis of spinal tuberculosis complicated with pulmonary tuberculosis. We attempted to discover whether the utilization of a DNA microarray assay to detect multidrug-resistant spinal tuberculosis complicated with pulmonary tuberculosis can improve clinical outcomes. Methods: A prospective study was conducted from February 2006 to September 2015. One hundred and forty-three consecutive culture–confirmed, clinically and imaging diagnosed MDR-TB patients with spinal tuberculosis complicated by pulmonary tuberculosis were enrolled into the study. The initial time to treatment for MDR-TB, the method of infection control, radiological indicators of spinal tubercular infectious foci, culture conversion, and adverse drug reactions were compared with the standard culture methods. Results: Of the total of 143 MDR-TB patients, 68 (47.6%) were diagnosed by conventional culture methods and 75 (52.4%) following the implementation of detection using the DNA microarray. Patients in the microarray group began rational use of the second-line drugs schedule more speedily than sufferers in the culture group (17.3 vs. 74.1 days). Among patients were admitted to a general tuberculosis ward, those from the microarray group spent less time in the ward than those from the culture group (7.8 vs. 49.2 days). In those patients with six months follow-up (n=134), patients in the microarray group had a higher rate of sputum negativity conversion at six months (89% vs. 73%). In the microarray group, the rate of drug adverse reactions was significantly lower (22.2% vs. 67.7%). At the same time, they had a more obvious reduction of the area with spinal tuberculous lesions in radiological examinations (77% vs. 108%). Conclusions: The application of the CapitalBio™ DNA Microarray assay caused noteworthy clinical advances including an earlier time to begin MDR-TB treatment, increased sputum culture conversion, improved infection control measures and better radiographical results <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title="tuberculosis">tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=multidrug-resistant" title=" multidrug-resistant"> multidrug-resistant</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculous%20spondylitis" title=" tuberculous spondylitis"> tuberculous spondylitis</a>, <a href="https://publications.waset.org/abstracts/search?q=DNA%20microarray" title=" DNA microarray"> DNA microarray</a>, <a href="https://publications.waset.org/abstracts/search?q=clinical%20outcomes" title=" clinical outcomes"> clinical outcomes</a> </p> <a href="https://publications.waset.org/abstracts/63965/a-significant-clinical-role-for-the-capitalbio-dna-microarray-in-the-diagnosis-of-multidrug-resistant-tuberculosis-in-patients-with-tuberculous-spondylitis-simultaneous-with-pulmonary-tuberculosis-in-high-prevalence-settings-in-china" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/63965.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">288</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">232</span> Efficiency of Treatment in Patients with Newly Diagnosed Destructive Pulmonary Tuberculosis Using Intravenous Chemotherapy</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=M.%20Kuzhko">M. Kuzhko</a>, <a href="https://publications.waset.org/abstracts/search?q=M.%20Gumeniuk"> M. Gumeniuk</a>, <a href="https://publications.waset.org/abstracts/search?q=D.%20Butov"> D. Butov</a>, <a href="https://publications.waset.org/abstracts/search?q=T.%20Tlustova"> T. Tlustova</a>, <a href="https://publications.waset.org/abstracts/search?q=O.%20Denysov"> O. Denysov</a>, <a href="https://publications.waset.org/abstracts/search?q=T.%20Sprynsian"> T. Sprynsian</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: The aim of the research was to determine the effectiveness of chemotherapy using intravenous antituberculosis drugs compared with their oral administration during the intensive phase of treatment. Methods: 152 tuberculosis patients were randomized into 2 groups: Main (n=65) who received isoniazid, ethambutol and sodium rifamycin intravenous + pyrazinamide per os and control (n=87) who received all the drugs (isoniazid, rifampicin, ethambutol, pyrazinamide) orally. Results: After 2 weeks of treatment symptoms of intoxication disappeared in 59 (90.7±3.59 %) of patients of the main group and 60 (68.9±4.9 %) patients in the control group, p<0.05. The mean duration of symptoms of intoxication in patients main group was 9.6±0.7 days, in control group – 13.7±0.9 days. After completing intensive phase sputum conversion was found in all the patients main group and 71 (81.6±4.1 %) patients control group p < 0.05. The average time of sputum conversion in main group was 1.6±0.1 months and 1.9±0.1 months in control group, p > 0.05. In patients with destructive pulmonary tuberculosis time to sputum conversion was 1.7±0.1 months in main group and 2.2±0.2 months in control group, p < 0.05. The average time of cavities healing in main group was 2.9±0.2 months and 3.9±0.2 months in the control group, p < 0.05. Conclusions: In patients with newly diagnosed destructive pulmonary tuberculosis use of isoniazid, ethambutol and sodium rifamycin intravenous in the intensive phase of chemotherapy resulted in a significant reduction in terms of the disappearance of symptoms of intoxication and sputum conversion. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=intravenous%20chemotherapy" title="intravenous chemotherapy">intravenous chemotherapy</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=treatment%20efficiency" title=" treatment efficiency"> treatment efficiency</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis%20drugs" title=" tuberculosis drugs"> tuberculosis drugs</a> </p> <a href="https://publications.waset.org/abstracts/61715/efficiency-of-treatment-in-patients-with-newly-diagnosed-destructive-pulmonary-tuberculosis-using-intravenous-chemotherapy" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/61715.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">202</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">231</span> A Case of Severe Iatrogenic Cushing’s Syndrome Followed by Adrenal Crisis, Multifocal Pneumonia, Sepsis, Pulmonary Embolism and Prolonged Adrenal Insufficiency</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Jelena%20Maletkovic">Jelena Maletkovic</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Endogenous Cushing’s syndrome is a rare disease, but iatrogenic or drug related Cushing syndrome from glucocorticoid products is commonly seen in clinical practice. With high dose and long term use of glucocorticoids, patients can develop isolated hypothalamic-pituitary-adrenal (HPA) suppression, or HPA axis suppression can be accompanied by overt iatrogenic Cushing’s syndrome. This is a rare case where severe Cushing’s syndrome developed from an unknown medication and was followed by severe and prolonged adrenal insufficiency and multiple potentially fatal complications. Case: This is a 37-year-old woman who is presented to Emergency Room (ER) with shortness of breath and chest pain. Four months prior to this presentation the patient was a generally healthy woman who was looking for improvement in her appearance and visited local Rejuvenation Clinic. After initial consultation with a nurse, she was contacted by a physician over the phone and was advised to start taking multiple injectable medications that will arrive by mail. Medications without any labels on bottles were delivered and the patient started daily intramuscular injections. Over the next two months, she noticed rounding of her face and swelling around her eyes. She gained 20 pounds, mostly abdominal fat and became extremely fatigued. Her muscles on legs were visibly decreasing in size and she felt significant muscle weakness. Unexplained bruising occurred. She started growing hair on face and developed secondary amenorrhea. New severe back pain started. She developed depression and headaches. Finally, over a few days, a number of red-purple stretch marks that were sensitive and painful appeared over her abdomen, upper part of arms and legs. She then became suspicious that these dramatic symptoms are caused by injectable medication and she discontinued injections. Over the next few days she presented to ER with low blood pressure and oxygen saturation of 75%. Studies revealed extensive pneumonia as well as multiple pulmonary emboli. Her white blood count was elevated with 32 000 and she also had acute kidney failure on admission. She was treated for sepsis and was also given stress dose steroids. Steroids were tapered over 48 hours and discontinued. After being discharged to home, on her first visit to endocrinology clinic she had undetectable ACTH of < 2pg/mL and undetectable 8am cortisol of < 0.2mcg/dL. She did not respond to an intramuscular injection of cosyntropin 250mcg and her repeated cortisol after 60 minutes was only 1mcg/dL. The patient was diagnosed with adrenal insufficiency and was started on hydrocortisone 20mg+10mg. It took close to 2 years of slow tapering for recovery of this patient’s HPA axis and resolve all the sequelae from Cushing’s syndrome. Conclusion: Misuse and abuse of glucocorticoids have been present almost since these medications were discovered. This is a rare case where not only severe Cushing’s syndrome in full clinical picture developed but also the patient suffered multiple potentially fatal complications and prolonged adrenal insufficiency. Visits to herbal, rejuvenation, esthetic, and similar clinics are becoming more and more popular and physicians need to be aware of possible non-benign nature of medications that their patients may be using. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=iatrogenic" title="iatrogenic">iatrogenic</a>, <a href="https://publications.waset.org/abstracts/search?q=Cushing%27s%20syndrome" title=" Cushing's syndrome"> Cushing's syndrome</a>, <a href="https://publications.waset.org/abstracts/search?q=adrenal%20crisis" title=" adrenal crisis"> adrenal crisis</a>, <a href="https://publications.waset.org/abstracts/search?q=steroid%20abuse" title=" steroid abuse"> steroid abuse</a> </p> <a href="https://publications.waset.org/abstracts/80761/a-case-of-severe-iatrogenic-cushings-syndrome-followed-by-adrenal-crisis-multifocal-pneumonia-sepsis-pulmonary-embolism-and-prolonged-adrenal-insufficiency" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/80761.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">168</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">230</span> A Joinpoint Regression Analysis of Trends in Tuberculosis Notifications in Two Urban Regions in Namibia</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Anna%20M.%20N.%20Shifotoka">Anna M. N. Shifotoka</a>, <a href="https://publications.waset.org/abstracts/search?q=Richard%20Walker"> Richard Walker</a>, <a href="https://publications.waset.org/abstracts/search?q=Katie%20Haighton"> Katie Haighton</a>, <a href="https://publications.waset.org/abstracts/search?q=Richard%20McNally"> Richard McNally</a> </p> <p class="card-text"><strong>Abstract:</strong></p> An analysis of trends in Case Notification Rates (CNR) can be used to monitor the impact of Tuberculosis (TB) control interventions over time in order to inform the implementation of current and future TB interventions. A retrospective analysis of trends in TB CNR for two urban regions in Namibia, namely Khomas and Erongo regions, was conducted. TB case notification data were obtained from annual TB reports of the national TB programme, Ministry of Health and Social Services, covering the period from 1997 to 2015. Joinpoint regression was used to analyse trends in CNR for different types of TB groups. A trend was considered to be statistically significant when a p-value was less than 0.05. During the period under review, the crude CNR for all forms of TB declined from 808 to 400 per 100 000 population in Khomas, and from 1051 to 611 per 100 000 population in Erongo. In both regions, significant change points in trends were observed for all types of TB groups examined. In Khomas region, the trend for new smear positive pulmonary TB increased significantly by an annual rate of 4.1% (95% Confidence Interval (CI): 0.3% to 8.2%) during the period 1997 to 2004, and thereafter declined significantly by -6.2% (95%CI: -7.7% to -4.3%) per year until 2015. Similarly, the trend for smear negative pulmonary TB increased significantly by 23.7% (95%CI: 9.7 to 39.5) per year from 1997 to 2004 and thereafter declined significantly by an annual change of -26.4% (95%CI: -33.1% to -19.8%). The trend for all forms of TB CNR in Khomas region increased significantly by 8.1% (95%CI: 3.7 to 12.7) per year from 1997 to 2004 and thereafter declined significantly a rate of -8.7% (95%CI: -10.6 to -6.8). In Erongo region, the trend for smear positive pulmonary TB increased at a rate of 1.2% (95%CI: -1.2% to 3.6%) annually during the earlier years (1997 to 2008), and thereafter declined significantly by -9.3% (95%CI: -13.3% to -5.0%) per year from 2008 to 2015. Also in Erongo, the trend for all forms of TB CNR increased significantly by an annual rate of 4.0% (95%CI: 1.4% to 6.6%) during the years between 1997 to 2006 and thereafter declined significantly by -10.4% (95%CI: -12.7% to -8.0%) per year during 2006 to 2015. The trend for extra-pulmonary TB CNR declined but did not reach statistical significance in both regions. In conclusion, CNRs declined for all types of TB examined in both regions. Further research is needed to study trends for other TB dimensions such as treatment outcomes and notification of drug resistant TB cases. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=epidemiology" title="epidemiology">epidemiology</a>, <a href="https://publications.waset.org/abstracts/search?q=Namibia" title=" Namibia"> Namibia</a>, <a href="https://publications.waset.org/abstracts/search?q=temporal%20trends" title=" temporal trends"> temporal trends</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a> </p> <a href="https://publications.waset.org/abstracts/109510/a-joinpoint-regression-analysis-of-trends-in-tuberculosis-notifications-in-two-urban-regions-in-namibia" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/109510.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">153</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">229</span> Design and Development of an Expanded Polytetrafluoroethylene Valved Conduit with Sinus of Valsalva</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Munirah%20Ismail">Munirah Ismail</a>, <a href="https://publications.waset.org/abstracts/search?q=Joon%20Hock%20Yeo"> Joon Hock Yeo</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Babies born with Tetralogy of Fallot, a congenital heart defect, are required to undergo reconstruction surgery to create a valved conduit. As the child matures, the partially reconstructed pulmonary conduit increases in diameter, while the size of the reconstructed valve remains the same. As a result, follow up surgery is required to replace the undersized valve. Thus, in this project, we evaluated the in-vitro performance of a bi-leaflet valve design in terms of percentage regurgitation with increasing artery (conduit) diameters. Results revealed percentage regurgitations ranging from 13% to 34% for conduits tested. It was observed that percentage of regurgitation increased exponentially with increasing diameters. While the amount of regurgitation may seem severe, it is deemed acceptable, and this valve could potentially reduce the frequency of re-operation in the lifetime of pediatric patients. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20heart%20valve" title="pulmonary heart valve">pulmonary heart valve</a>, <a href="https://publications.waset.org/abstracts/search?q=tetralogy%20of%20fallot" title=" tetralogy of fallot"> tetralogy of fallot</a>, <a href="https://publications.waset.org/abstracts/search?q=expanded%20polytetrafluoroethylene%20valve" title=" expanded polytetrafluoroethylene valve"> expanded polytetrafluoroethylene valve</a>, <a href="https://publications.waset.org/abstracts/search?q=pediatric%20heart%20valve%20replacement" title=" pediatric heart valve replacement"> pediatric heart valve replacement</a> </p> <a href="https://publications.waset.org/abstracts/86145/design-and-development-of-an-expanded-polytetrafluoroethylene-valved-conduit-with-sinus-of-valsalva" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/86145.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">173</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">228</span> Effects of Lung Protection Ventilation Strategies on Postoperative Pulmonary Complications After Noncardiac Surgery: A Network Meta-Analysis of Randomized Controlled Trials</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ran%20An">Ran An</a>, <a href="https://publications.waset.org/abstracts/search?q=Dang%20Wang"> Dang Wang</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Mechanical ventilation has been confirmed to increase the incidence of postoperative pulmonary complications (PPCs), and several studies have shown that low tidal volumes combined with positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RM) reduce the incidence of PPCs. However, the optimal lung-protective ventilatory strategy remains unclear. Methods: Multiple databases were searched for randomized controlled trials (RCTs) published prior to October 2023. The association between individual PEEP (iPEEP) or other forms of lung-protective ventilation and the incidence of PPCs was evaluated by Bayesian network meta-analysis. Results: We included 58 studies (11610 patients) in this meta-analysis. The network meta-analysis showed that low ventilation (LVt) combined with iPEEP and RM was associated with significantly lower incidences of PPCs [HVt: OR=0.38 95CrI (0.19, 0.75), LVt: OR=0.33, 95% CrI (0.12, 0.82)], postoperative atelectasis, and pneumonia than was HVt or LVt. In abdominal surgery, LVT combined with iPEEP or medium-to-high PEEP and RM were associated with significantly lower incidences of PPCs, postoperative atelectasis, and pneumonia. LVt combined with iPEEP and RM was ranked the highest, which was based on SUCRA scores. Conclusion: LVt combined with iPEEP and RM decreased the incidences of PPCs, postoperative atelectasis, and pneumonia in noncardiac surgery patients. iPEEP-guided ventilation was the optimal lung protection ventilation strategy. The quality of evidence was moderate. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=protection%20ventilation%20strategies" title="protection ventilation strategies">protection ventilation strategies</a>, <a href="https://publications.waset.org/abstracts/search?q=postoperative%20pulmonary%20complications" title=" postoperative pulmonary complications"> postoperative pulmonary complications</a>, <a href="https://publications.waset.org/abstracts/search?q=network%20meta-analysis" title=" network meta-analysis"> network meta-analysis</a>, <a href="https://publications.waset.org/abstracts/search?q=noncardiac%20surgery" title=" noncardiac surgery"> noncardiac surgery</a> </p> <a href="https://publications.waset.org/abstracts/186731/effects-of-lung-protection-ventilation-strategies-on-postoperative-pulmonary-complications-after-noncardiac-surgery-a-network-meta-analysis-of-randomized-controlled-trials" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/186731.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">35</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">227</span> A Study of 3 Different Reintroduction Regimens in Anti-Tubercular Therapy-Induced Hepatitis in Extra-Pulmonary Tuberculosis</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Alpana%20Meena">Alpana Meena</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=anti-tubercular%20therapy%20induced%20hepatotoxicity" title="anti-tubercular therapy induced hepatotoxicity">anti-tubercular therapy induced hepatotoxicity</a>, <a href="https://publications.waset.org/abstracts/search?q=extra-pulmonary%20tuberculosis" title=" extra-pulmonary tuberculosis"> extra-pulmonary tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=reintroduction%20regimens" title=" reintroduction regimens"> reintroduction regimens</a>, <a href="https://publications.waset.org/abstracts/search?q=risk%20factors" title=" risk factors"> risk factors</a> </p> <a href="https://publications.waset.org/abstracts/38323/a-study-of-3-different-reintroduction-regimens-in-anti-tubercular-therapy-induced-hepatitis-in-extra-pulmonary-tuberculosis" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/38323.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">299</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">226</span> Analysis of Sickle Cell Disease and Maternal Mortality in United Kingdom</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Basma%20Hassabo">Basma Hassabo</a>, <a href="https://publications.waset.org/abstracts/search?q=Sarah%20Ahmed"> Sarah Ahmed</a>, <a href="https://publications.waset.org/abstracts/search?q=Aisha%20Hameed"> Aisha Hameed</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=incidence" title="incidence">incidence</a>, <a href="https://publications.waset.org/abstracts/search?q=maternal%20mortality" title=" maternal mortality"> maternal mortality</a>, <a href="https://publications.waset.org/abstracts/search?q=sickle%20cell%20disease%20%28SCD%29" title=" sickle cell disease (SCD)"> sickle cell disease (SCD)</a>, <a href="https://publications.waset.org/abstracts/search?q=uk" title=" uk"> uk</a> </p> <a href="https://publications.waset.org/abstracts/42903/analysis-of-sickle-cell-disease-and-maternal-mortality-in-united-kingdom" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/42903.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">237</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">225</span> Effects of Zinc and Vitamin A Supplementation on Prognostic Markers and Treatment Outcomes of Adults with Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Fasil%20Wagnew">Fasil Wagnew</a>, <a href="https://publications.waset.org/abstracts/search?q=Kefyalew%20Addis%20Alene"> Kefyalew Addis Alene</a>, <a href="https://publications.waset.org/abstracts/search?q=Setegn%20Eshetie"> Setegn Eshetie</a>, <a href="https://publications.waset.org/abstracts/search?q=Tom%20Wingfield"> Tom Wingfield</a>, <a href="https://publications.waset.org/abstracts/search?q=Matthew%20Kelly"> Matthew Kelly</a>, <a href="https://publications.waset.org/abstracts/search?q=Darren%20Gray"> Darren Gray</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Undernutrition is a major and under-appreciated risk factor for TB, which is estimated to be responsible for 1.9 million TB cases per year globally. The effectiveness of micronutrient supplementation on TB treatment outcomes and its prognostic markers such as sputum conversion and serum zinc, retinol, and hemoglobin levels has been poorly understood. This systematic review and meta-analysis aimed to determine the association between zinc and vitamin A supplementation and TB treatment outcomes and its prognostic markers. Methods: A systematic literature search for randomized controlled trials (RCTs) was performed in PubMed, Embase, and Scopus databases. Meta-analysis with a random effect model was performed to estimate risk ratio (RR) and mean difference (MD), with a 95% confidence interval (CI), for dichotomous and continuous outcomes, respectively. Results: Our search identified 2,195 records. Of these, nine RCTs consisting of 1,375 participants were included in the final analyses. Among adults with pulmonary TB, zinc (RR: 0.94, 95%CI: 0.86, 1.03), vitamin A (RR: 0.90, 95%CI: 0.80, 1.01), and combined zinc and vitamin A (RR: 0.98, 95%CI: 0.89, 1.08) supplementation were not significantly associated with TB treatment success. Combined zinc and vitamin A supplementation was significantly associated with increased sputum smear conversion at 2 months (RR: 1.16, 95%CI: 1.03, 1.32), serum zinc levels at 2 months (MD of 0.86umol/l, 95% CI: 0.14, 1.57), serum retinol levels at 2 months (MD: 0.06umol/l, 95 % CI: 0.04, 0.08) and 6 months (MD: 0.12umol/l, 95 % CI: 0.10, 0.14), and serum hemoglobin level at 6 months (MD: 0.29 ug/dl, 95% CI: 0.08 to 0.51), among adults with TB. Conclusions: Providing zinc and vitamin A supplementation to adults with pulmonary TB during treatment may increase early sputum smear conversion, serum zinc, retinol, and hemoglobin levels. However, the use of zinc, vitamin A, or both were not associated with TB treatment success. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=zinc%20and%20vitamin%20A%20supplementation" title="zinc and vitamin A supplementation">zinc and vitamin A supplementation</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=treatment%20outcomes" title=" treatment outcomes"> treatment outcomes</a>, <a href="https://publications.waset.org/abstracts/search?q=meta-analysis" title=" meta-analysis"> meta-analysis</a>, <a href="https://publications.waset.org/abstracts/search?q=RCT" title=" RCT"> RCT</a> </p> <a href="https://publications.waset.org/abstracts/154612/effects-of-zinc-and-vitamin-a-supplementation-on-prognostic-markers-and-treatment-outcomes-of-adults-with-pulmonary-tuberculosis-a-systematic-review-and-meta-analysis" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/154612.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">171</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">224</span> Proportion and Factors Associated with Presumptive Tuberculosis among Suspected Pediatric Tuberculosis Patients</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Naima%20Nur">Naima Nur</a>, <a href="https://publications.waset.org/abstracts/search?q=Safa%20Islam"> Safa Islam</a>, <a href="https://publications.waset.org/abstracts/search?q=Saeema%20Islam"> Saeema Islam</a>, <a href="https://publications.waset.org/abstracts/search?q=Md.%20Faridul%20Alam"> Md. Faridul Alam</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: The worldwide increase in pediatric presumptive tuberculosis (TB) is the most life-threatening challenge in effectively controlling TB. The objective of this study was to determine the proportion of presumptive TB and the factors associated with it. Methods: A cross-sectional study was conducted between March and November 2013 at ICDDR-Bangladesh. Two hundred twelve pulmonary and extra-pulmonary specimens were collected from 84 suspected pediatric patients diagnosed with TB based on their clinical symptoms/radiological findings. Presumptive TB and confirmed TB were considered presumptive TB and non-presumptive TB and were isolated by smear-microscopy, culture, and GeneXpert. Logistic regression was used to analyze associations between outcome and predictor variables. Results: The proportion of presumptive TB was 85.7%, and 14.3% of non-presumptive TB. In presumptive TB, vaccine scars, family TB history, and school-going children were 16.6%, 33.3%, and 56.9%, respectively. In contrast, vaccine scars and family TB history were 8.3%, and school-going children were 58.3% in non-presumptive TB. Significant factors did not appear in the logistic regression analysis. Conclusion: Despite the high proportion of presumptive TB, there was no statistically significant between presumptive TB and non-presumptive TB. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=presumptive%20tuberculosis" title="presumptive tuberculosis">presumptive tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=confirmed%20tuberculosis" title=" confirmed tuberculosis"> confirmed tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=patient%27s%20characteristics" title=" patient's characteristics"> patient's characteristics</a>, <a href="https://publications.waset.org/abstracts/search?q=diagnosis" title=" diagnosis"> diagnosis</a> </p> <a href="https://publications.waset.org/abstracts/183139/proportion-and-factors-associated-with-presumptive-tuberculosis-among-suspected-pediatric-tuberculosis-patients" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/183139.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">49</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">223</span> Case Report on Anaesthesia for Ruptured Ectopic with Severe Pulmonary Hypertension in a Mute Patient</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Pamela%20Chia">Pamela Chia</a>, <a href="https://publications.waset.org/abstracts/search?q=Tay%20Yoong%20Chuan"> Tay Yoong Chuan</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20hypertension" title="pulmonary hypertension">pulmonary hypertension</a>, <a href="https://publications.waset.org/abstracts/search?q=case%20report" title=" case report"> case report</a>, <a href="https://publications.waset.org/abstracts/search?q=warfarin%20reversal" title=" warfarin reversal"> warfarin reversal</a>, <a href="https://publications.waset.org/abstracts/search?q=emergency%20surgery" title=" emergency surgery"> emergency surgery</a> </p> <a href="https://publications.waset.org/abstracts/102081/case-report-on-anaesthesia-for-ruptured-ectopic-with-severe-pulmonary-hypertension-in-a-mute-patient" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/102081.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">220</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">222</span> Anti-tuberculosis, Resistance Modulatory, Anti-pulmonary Fibrosis and Anti-silicosis Effects of Crinum Asiaticum Bulbs and Its Active Metabolite, Betulin</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Theophilus%20Asante">Theophilus Asante</a>, <a href="https://publications.waset.org/abstracts/search?q=Comfort%20Nyarko"> Comfort Nyarko</a>, <a href="https://publications.waset.org/abstracts/search?q=Daniel%20Antwi"> Daniel Antwi</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Drug-resistant tuberculosis, together with the associated comorbidities like pulmonary fibrosis and silicosis, has been one of the most serious global public health threats that requires immediate action to curb or mitigate it. This prolongs hospital stays, increases the cost of medication, and increases the death toll recorded annually. Crinum asiaticum bulb (CAE) and betulin (BET) are known for their biological and pharmacological effects. Pharmacological effects reported on CAE include antimicrobial, anti-inflammatory, anti-pyretic, anti-analgesic, and anti-cancer effects. Betulin has exhibited a multitude of powerful pharmacological properties ranging from antitumor, anti-inflammatory, anti-parasitic, anti-microbial, and anti-viral activities. This work sought to investigate the anti-tuberculosis and resistant modulatory effects and also assess their effects on mitigating pulmonary fibrosis and silicosis. In the anti-tuberculosis and resistant modulatory effects, both CAE and BET showed strong antimicrobial activities (31.25 ≤ MIC ≤ 500) µg/ml against the studied microorganisms and also produced significant anti-efflux pump and biofilm inhibitory effects (ρ < 0.0001) as well as exhibiting resistance modulatory and synergistic effects when combined with standard antibiotics. Crinum asiaticum bulbs extract and betulin were shown to possess anti-pulmonary fibrosis effects. There was an increased survival rate in the CAE and BET treatment groups compared to the BLM-induced group. There was a marked decrease in the levels of hydroxyproline and collagen I and III in the CAE and BET treatment groups compared to the BLM-treated group. The treatment groups of CAE and BET significantly downregulated the levels of pro-fibrotic and pro-inflammatory cytokine concentrations such as TGF-β1, MMP9, IL-6, IL-1β and TNF-alpha compared to an increase in the BLM-treated groups. The histological findings of the lungs suggested the curative effects of CAE and BET following BLM-induced pulmonary fibrosis in mice. The study showed improved lung functions with a wide focal area of viable alveolar spaces and few collagen fibers deposition on the lungs of the treatment groups. In the anti-silicosis and pulmonoprotective effects of CAE and BET, the levels of NF-κB, TNF-α, IL-1β, IL-6 and hydroxyproline, collagen types I and III were significantly reduced by CAE and BET (ρ < 0.0001). Both CAE and BET significantly (ρ < 0.0001) inhibited the levels of hydroxyproline, collagen I and III when compared with the negative control group. On BALF biomarkers such as macrophages, lymphocytes, monocytes, and neutrophils, CAE and BET were able to reduce their levels significantly (ρ < 0.0001). The CAE and BET were examined for anti-oxidant activity and shown to raise the levels of catalase (CAT) and superoxide dismutase (SOD) while lowering the level of malondialdehyde (MDA). There was an improvement in lung function when lung tissues were examined histologically. Crinum asiaticum bulbs extract and betulin were discovered to exhibit anti-tubercular and resistance-modulatory properties, as well as the capacity to minimize TB comorbidities such as pulmonary fibrosis and silicosis. In addition, CAE and BET may act as protective mechanisms, facilitating the preservation of the lung's physiological integrity. The outcomes of this study might pave the way for the development of leads for producing single medications for the management of drug-resistant tuberculosis and its accompanying comorbidities. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=fibrosis" title="fibrosis">fibrosis</a>, <a href="https://publications.waset.org/abstracts/search?q=crinum" title=" crinum"> crinum</a>, <a href="https://publications.waset.org/abstracts/search?q=tuberculosis" title=" tuberculosis"> tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=antiinflammation" title=" antiinflammation"> antiinflammation</a>, <a href="https://publications.waset.org/abstracts/search?q=drug%20resistant" title=" drug resistant"> drug resistant</a> </p> <a href="https://publications.waset.org/abstracts/168189/anti-tuberculosis-resistance-modulatory-anti-pulmonary-fibrosis-and-anti-silicosis-effects-of-crinum-asiaticum-bulbs-and-its-active-metabolite-betulin" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/168189.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">83</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">221</span> Patients with Chronic Obstructive Pulmonary Feelings of Uncertainty</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Kyng%C3%A4s%20Helvi">Kyngäs Helvi</a>, <a href="https://publications.waset.org/abstracts/search?q=Patala-Pudas"> Patala-Pudas</a>, <a href="https://publications.waset.org/abstracts/search?q=Kaakinen%20Pirjo"> Kaakinen Pirjo</a> </p> <p class="card-text"><strong>Abstract:</strong></p> It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=adherence" title="adherence">adherence</a>, <a href="https://publications.waset.org/abstracts/search?q=COPD" title=" COPD"> COPD</a>, <a href="https://publications.waset.org/abstracts/search?q=disease-management" title=" disease-management"> disease-management</a>, <a href="https://publications.waset.org/abstracts/search?q=uncertainty" title=" uncertainty"> uncertainty</a> </p> <a href="https://publications.waset.org/abstracts/46875/patients-with-chronic-obstructive-pulmonary-feelings-of-uncertainty" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/46875.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">239</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">220</span> Collagen Deposition in Lung Parenchyma Driven by Depletion of LYVE-1+ Macrophages Protects Emphysema and Loss of Airway Function</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Yinebeb%20Mezgebu%20Dagnachew">Yinebeb Mezgebu Dagnachew</a>, <a href="https://publications.waset.org/abstracts/search?q=Hwee%20Ying%20Lim"> Hwee Ying Lim</a>, <a href="https://publications.waset.org/abstracts/search?q=Liao%20Wupeng"> Liao Wupeng</a>, <a href="https://publications.waset.org/abstracts/search?q=Sheau%20Yng%20Lim"> Sheau Yng Lim</a>, <a href="https://publications.waset.org/abstracts/search?q=Lim%20Sheng%20Jie%20Natalie"> Lim Sheng Jie Natalie</a>, <a href="https://publications.waset.org/abstracts/search?q=Veronique%20Angeli"> Veronique Angeli</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Collagen is essential for maintaining lung structure and function, and its remodeling has been associated with respiratory diseases, including chronic obstructive pulmonary disease (COPD). However, the cellular mechanisms driving collagen remodeling and the functional implications of this process in the pathophysiology of pulmonary diseases remain poorly understood. Using a mouse model of Lyve-1 expressing macrophage depletion, we found that the absence of this subpopulation of tissue-resident macrophage led to the preferential deposition of type I collagen fibers around the alveoli and bronchi in the steady state. Further analysis by polarized light microscopy revealed that the collagen fibers accumulating in the lungs depleted of Lyve-1+ macrophages were thicker and crosslinked. A decrease in MMP-9 gene expression and proteolytic activity, together with an increase in Col1a1, Timp-3 and Lox gene expression, accompanied the collagen alterations. Next, we investigated the effect of the collagen remodeling on the pathophysiology of COPD and airway function in mouse lacking Lyve-1+ macrophage exposed chronically to cigarette smoke (CS), a well-established animal model of COPD. We showed that the deposition of collagen protected mouse against the destruction of alveoli (emphysema) and bronchi thickening after CS exposure and prevented loss of airway function. Thus, we demonstrate that interstitial Lyve-1+ macrophages regulate the composition, amount, and architecture of the collagen network in the lungs and that such collagen remodeling functionally impacts the development of COPD. This study further supports the potential of targeting collagen as a promising approach to treating respiratory diseases. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=lung" title="lung">lung</a>, <a href="https://publications.waset.org/abstracts/search?q=extracellular%20matrix" title=" extracellular matrix"> extracellular matrix</a>, <a href="https://publications.waset.org/abstracts/search?q=chronic%20obstructive%20pulmonary%20disease" title=" chronic obstructive pulmonary disease"> chronic obstructive pulmonary disease</a>, <a href="https://publications.waset.org/abstracts/search?q=matrix%20metalloproteinases" title=" matrix metalloproteinases"> matrix metalloproteinases</a>, <a href="https://publications.waset.org/abstracts/search?q=collagen" title=" collagen"> collagen</a> </p> <a href="https://publications.waset.org/abstracts/187346/collagen-deposition-in-lung-parenchyma-driven-by-depletion-of-lyve-1-macrophages-protects-emphysema-and-loss-of-airway-function" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/187346.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">37</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">219</span> Effects of Bone Marrow Derived Mesenchymal Stem Cells (MSC) in Acute Respiratory Distress Syndrome (ARDS) Lung Remodeling</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Diana%20Islam">Diana Islam</a>, <a href="https://publications.waset.org/abstracts/search?q=Juan%20Fang"> Juan Fang</a>, <a href="https://publications.waset.org/abstracts/search?q=Vito%20Fanelli"> Vito Fanelli</a>, <a href="https://publications.waset.org/abstracts/search?q=Bing%20Han"> Bing Han</a>, <a href="https://publications.waset.org/abstracts/search?q=Julie%20Khang"> Julie Khang</a>, <a href="https://publications.waset.org/abstracts/search?q=Jianfeng%20Wu"> Jianfeng Wu</a>, <a href="https://publications.waset.org/abstracts/search?q=Arthur%20S.%20Slutsky"> Arthur S. Slutsky</a>, <a href="https://publications.waset.org/abstracts/search?q=Haibo%20Zhang"> Haibo Zhang</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: MSC delivery in preclinical models of ARDS has demonstrated significant improvements in lung function and recovery from acute injury. However, the role of MSC delivery in ARDS associated pulmonary fibrosis is not well understood. Some animal studies using bleomycin, asbestos, and silica-induced pulmonary fibrosis show that MSC delivery can suppress fibrosis. While other animal studies using radiation induced pulmonary fibrosis, liver, and kidney fibrosis models show that MSC delivery can contribute to fibrosis. Hypothesis: The beneficial and deleterious effects of MSC in ARDS are modulated by the lung microenvironment at the time of MSC delivery. Methods: To induce ARDS a two-hit mouse model of Hydrochloric acid (HCl) aspiration (day 0) and mechanical ventilation (MV) (day 2) was used. HCl and injurious MV generated fibrosis within 14-28 days. 0.5x106 mouse MSCs were delivered (via both intratracheal and intravenous routes) either in the active inflammatory phase (day 2) or during the remodeling phase (day 14) of ARDS (mouse fibroblasts or PBS used as a control). Lung injury accessed using inflammation score and elastance measurement. Pulmonary fibrosis was accessed using histological score, tissue collagen level, and collagen expression. In addition alveolar epithelial (E) and mesenchymal (M) marker expression profile was also measured. All measurements were taken at day 2, 14, and 28. Results: MSC delivery 2 days after HCl exacerbated lung injury and fibrosis compared to HCl alone, while the day 14 delivery showed protective effects. However in the absence of HCl, MSC significantly reduced the injurious MV-induced fibrosis. HCl injury suppressed E markers and up-regulated M markers. MSC delivery 2 days after HCl further amplified M marker expression, indicating their role in myofibroblast proliferation/activation. While with 14-day delivery E marker up-regulation was observed indicating their role in epithelial restoration. Conclusions: Early MSC delivery can be protective of injurious MV. Late MSC delivery during repair phase may also aid in recovery. However, early MSC delivery during the exudative inflammatory phase of HCl-induced ARDS can result in pro-fibrotic profiles. It is critical to understand the interaction between MSC and the lung microenvironment before MSC-based therapies are utilized for ARDS. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=acute%20respiratory%20distress%20syndrome%20%28ARDS%29" title="acute respiratory distress syndrome (ARDS)">acute respiratory distress syndrome (ARDS)</a>, <a href="https://publications.waset.org/abstracts/search?q=mesenchymal%20stem%20cells%20%28MSC%29" title=" mesenchymal stem cells (MSC)"> mesenchymal stem cells (MSC)</a>, <a href="https://publications.waset.org/abstracts/search?q=hydrochloric%20acid%20%28HCl%29" title=" hydrochloric acid (HCl)"> hydrochloric acid (HCl)</a>, <a href="https://publications.waset.org/abstracts/search?q=mechanical%20ventilation%20%28MV%29" title=" mechanical ventilation (MV) "> mechanical ventilation (MV) </a> </p> <a href="https://publications.waset.org/abstracts/22549/effects-of-bone-marrow-derived-mesenchymal-stem-cells-msc-in-acute-respiratory-distress-syndrome-ards-lung-remodeling" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/22549.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">670</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">218</span> Manufacturing an Eminent Mucolytic Medicine Using an Efficient Synthesis Path</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Farzaneh%20Ziaee">Farzaneh Ziaee</a>, <a href="https://publications.waset.org/abstracts/search?q=Mohammad%20Ziaee"> Mohammad Ziaee</a> </p> <p class="card-text"><strong>Abstract:</strong></p> N-acetyl-L-cysteine (NAC) is a well-known mucolytic agent, and recently its efficacy has been examined for the prevention and remediation of several diseases such as lung infections caused by Coronavirus. Also, it is administrated as the main antidote in paracetamol overdose and is effective for the treatment of idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD). This medicine is used as an antioxidant to prevent diabetic kidney disease (nephropathy). In this study, a method for the acylation of amino acids is employed to manufacture this drug in a height yield. Regarding this patented path, NAC can be made in a single batch step at ambient pressure and temperature. Moreover, this study offers a technique to make peptide bonds which is of interest for pharmaceutical and medicinal industries. The separation process was undertaken using appropriate solvents to achieve an excellent purification level. The synthesized drug was characterized via proton nuclear magnetic resonance (1H NMR), high-performance liquid chromatography (HPLC), Fourier transform infrared spectroscopy (FT-IR), elemental analysis, and melting point. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=N-acetylcysteine" title="N-acetylcysteine">N-acetylcysteine</a>, <a href="https://publications.waset.org/abstracts/search?q=synthesis" title=" synthesis"> synthesis</a>, <a href="https://publications.waset.org/abstracts/search?q=mucolytic%20medication" title=" mucolytic medication"> mucolytic medication</a>, <a href="https://publications.waset.org/abstracts/search?q=lung%20anti-inflammatory" title=" lung anti-inflammatory"> lung anti-inflammatory</a>, <a href="https://publications.waset.org/abstracts/search?q=COVID-19" title=" COVID-19"> COVID-19</a>, <a href="https://publications.waset.org/abstracts/search?q=antioxidant" title=" antioxidant"> antioxidant</a>, <a href="https://publications.waset.org/abstracts/search?q=pharmaceutical%20supplement" title=" pharmaceutical supplement"> pharmaceutical supplement</a>, <a href="https://publications.waset.org/abstracts/search?q=characterization" title=" characterization"> characterization</a> </p> <a href="https://publications.waset.org/abstracts/140565/manufacturing-an-eminent-mucolytic-medicine-using-an-efficient-synthesis-path" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/140565.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">192</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">217</span> Hyper-Immunoglobulin E (Hyper-Ige) Syndrome In Skin Of Color: A Retrospective Single-Centre Observational Study</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Rohit%20Kothari">Rohit Kothari</a>, <a href="https://publications.waset.org/abstracts/search?q=Muneer%20Mohamed"> Muneer Mohamed</a>, <a href="https://publications.waset.org/abstracts/search?q=Vivekanandh%20K."> Vivekanandh K.</a>, <a href="https://publications.waset.org/abstracts/search?q=Sunmeet%20Sandhu"> Sunmeet Sandhu</a>, <a href="https://publications.waset.org/abstracts/search?q=Preema%20Sinha"> Preema Sinha</a>, <a href="https://publications.waset.org/abstracts/search?q=Anuj%20Bhatnagar"> Anuj Bhatnagar</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=absolute%20eosinophil%20count" title="absolute eosinophil count">absolute eosinophil count</a>, <a href="https://publications.waset.org/abstracts/search?q=atopic%20dermatitis" title=" atopic dermatitis"> atopic dermatitis</a>, <a href="https://publications.waset.org/abstracts/search?q=eczematous%20rash" title=" eczematous rash"> eczematous rash</a>, <a href="https://publications.waset.org/abstracts/search?q=hyper-immunoglobulin%20E%20syndrome" title=" hyper-immunoglobulin E syndrome"> hyper-immunoglobulin E syndrome</a>, <a href="https://publications.waset.org/abstracts/search?q=pulmonary%20infection" title=" pulmonary infection"> pulmonary infection</a>, <a href="https://publications.waset.org/abstracts/search?q=serum%20IgE" title=" serum IgE"> serum IgE</a>, <a href="https://publications.waset.org/abstracts/search?q=skin%20of%20color" title=" skin of color"> skin of color</a> </p> <a href="https://publications.waset.org/abstracts/143963/hyper-immunoglobulin-e-hyper-ige-syndrome-in-skin-of-color-a-retrospective-single-centre-observational-study" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/143963.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">138</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">216</span> Current Applications of Artificial Intelligence (AI) in Chest Radiology</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Angelis%20P.%20Barlampas">Angelis P. Barlampas</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Learning Objectives: The purpose of this study is to inform briefly the reader about the applications of AI in chest radiology. Background: Currently, there are 190 FDA-approved radiology AI applications, with 42 (22%) pertaining specifically to thoracic radiology. Imaging findings OR Procedure details Aids of AI in chest radiology1: Detects and segments pulmonary nodules. Subtracts bone to provide an unobstructed view of the underlying lung parenchyma and provides further information on nodule characteristics, such as nodule location, nodule two-dimensional size or three dimensional (3D) volume, change in nodule size over time, attenuation data (i.e., mean, minimum, and/or maximum Hounsfield units [HU]), morphological assessments, or combinations of the above. Reclassifies indeterminate pulmonary nodules into low or high risk with higher accuracy than conventional risk models. Detects pleural effusion . Differentiates tension pneumothorax from nontension pneumothorax. Detects cardiomegaly, calcification, consolidation, mediastinal widening, atelectasis, fibrosis and pneumoperitoneum. Localises automatically vertebrae segments, labels ribs and detects rib fractures. Measures the distance from the tube tip to the carina and localizes both endotracheal tubes and central vascular lines. Detects consolidation and progression of parenchymal diseases such as pulmonary fibrosis or chronic obstructive pulmonary disease (COPD).Can evaluate lobar volumes. Identifies and labels pulmonary bronchi and vasculature and quantifies air-trapping. Offers emphysema evaluation. Provides functional respiratory imaging, whereby high-resolution CT images are post-processed to quantify airflow by lung region and may be used to quantify key biomarkers such as airway resistance, air-trapping, ventilation mapping, lung and lobar volume, and blood vessel and airway volume. Assesses the lung parenchyma by way of density evaluation. Provides percentages of tissues within defined attenuation (HU) ranges besides furnishing automated lung segmentation and lung volume information. Improves image quality for noisy images with built-in denoising function. Detects emphysema, a common condition seen in patients with history of smoking and hyperdense or opacified regions, thereby aiding in the diagnosis of certain pathologies, such as COVID-19 pneumonia. It aids in cardiac segmentation and calcium detection, aorta segmentation and diameter measurements, and vertebral body segmentation and density measurements. Conclusion: The future is yet to come, but AI already is a helpful tool for the daily practice in radiology. It is assumed, that the continuing progression of the computerized systems and the improvements in software algorithms , will redder AI into the second hand of the radiologist. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=artificial%20intelligence" title="artificial intelligence">artificial intelligence</a>, <a href="https://publications.waset.org/abstracts/search?q=chest%20imaging" title=" chest imaging"> chest imaging</a>, <a href="https://publications.waset.org/abstracts/search?q=nodule%20detection" title=" nodule detection"> nodule detection</a>, <a href="https://publications.waset.org/abstracts/search?q=automated%20diagnoses" title=" automated diagnoses"> automated diagnoses</a> </p> <a href="https://publications.waset.org/abstracts/169791/current-applications-of-artificial-intelligence-ai-in-chest-radiology" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/169791.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">72</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">215</span> Comparison of Multivariate Adaptive Regression Splines and Random Forest Regression in Predicting Forced Expiratory Volume in One Second</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=P.%20V.%20Pramila">P. V. Pramila </a>, <a href="https://publications.waset.org/abstracts/search?q=V.%20Mahesh"> V. Mahesh </a> </p> <p class="card-text"><strong>Abstract:</strong></p> Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients esulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF 25, PEF,FEF 25-75, FEF50, and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF 25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects). It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=FEV" title="FEV">FEV</a>, <a href="https://publications.waset.org/abstracts/search?q=multivariate%20adaptive%20regression%20splines%20pulmonary%20function%20test" title=" multivariate adaptive regression splines pulmonary function test"> multivariate adaptive regression splines pulmonary function test</a>, <a href="https://publications.waset.org/abstracts/search?q=random%20forest" title=" random forest"> random forest</a> </p> <a href="https://publications.waset.org/abstracts/27603/comparison-of-multivariate-adaptive-regression-splines-and-random-forest-regression-in-predicting-forced-expiratory-volume-in-one-second" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/27603.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">310</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">214</span> Management of Caverno-Venous Leakage: A Series of 133 Patients with Symptoms, Hemodynamic Workup, and Results of Surgery</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Allaire%20Eric">Allaire Eric</a>, <a href="https://publications.waset.org/abstracts/search?q=Hauet%20Pascal"> Hauet Pascal</a>, <a href="https://publications.waset.org/abstracts/search?q=Floresco%20Jean"> Floresco Jean</a>, <a href="https://publications.waset.org/abstracts/search?q=Beley%20Sebastien"> Beley Sebastien</a>, <a href="https://publications.waset.org/abstracts/search?q=Sussman%20Helene"> Sussman Helene</a>, <a href="https://publications.waset.org/abstracts/search?q=Virag%20Ronald"> Virag Ronald</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Caverno-venous leakage (CVL) is devastating, although barely known disease, the first cause of major physical impairment in men under 25, and responsible for 50% of resistances to phosphodiesterase 5-inhibitors (PDE5-I), affecting 30 to 40% of users in this medication class. In this condition, too early blood drainage from corpora cavernosa prevents penile rigidity and penetration during sexual intercourse. The role of conservative surgery in this disease remains controversial. Aim: Assess complications and results of combined open surgery and embolization for CVL. Method: Between June 2016 and September 2021, 133 consecutive patients underwent surgery in our institution for CVL, causing severe erectile dysfunction (ED) resistance to oral medical treatment. Procedures combined vein embolization and ligation with microsurgical techniques. We performed a pre-and post-operative clinical (Erection Harness Scale: EHS) hemodynamic evaluation by duplex sonography in all patients. Before surgery, the CVL network was visualized by computed tomography cavernography. Penile EMG was performed in case of diabetes or suspected other neurological conditions. All patients were optimized for hormonal status—data we prospectively recorded. Results: Clinical signs suggesting CVL were ED since age lower than 25, loss of erection when changing position, penile rigidity varying according to the position. Main complications were minor pulmonary embolism in 2 patients, one after airline travel, one with Factor V Leiden heterozygote mutation, one infection and three hematomas requiring reoperation, one decreased gland sensitivity lasting for more than one year. Mean pre-operative pharmacologic EHS was 2.37+/-0.64, mean pharmacologic post-operative EHS was 3.21+/-0.60, p<0.0001 (paired t-test). The mean EHS variation was 0.87+/-0.74. After surgery, 81.5% of patients had a pharmacologic EHS equal to or over 3, allowing for intercourse with penetration. Three patients (2.2%) experienced lower post-operative EHS. The main cause of failure was leakage from the deep dorsal aspect of the corpus cavernosa. In a 14 months follow-up, 83.2% of patients had a clinical EHS equal to or over 3, allowing for sexual intercourse with penetration, one-third of them without any medication. 5 patients had a penile implant after unsuccessful conservative surgery. Conclusion: Open surgery combined with embolization for CVL is an efficient approach to CVL causing severe erectile dysfunction. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=erectile%20dysfunction" title="erectile dysfunction">erectile dysfunction</a>, <a href="https://publications.waset.org/abstracts/search?q=cavernovenous%20leakage" title=" cavernovenous leakage"> cavernovenous leakage</a>, <a href="https://publications.waset.org/abstracts/search?q=surgery" title=" surgery"> surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=embolization" title=" embolization"> embolization</a>, <a href="https://publications.waset.org/abstracts/search?q=treatment" title=" treatment"> treatment</a>, <a href="https://publications.waset.org/abstracts/search?q=result" title=" result"> result</a>, <a href="https://publications.waset.org/abstracts/search?q=complications" title=" complications"> complications</a>, <a href="https://publications.waset.org/abstracts/search?q=penile%20duplex%20sonography" title=" penile duplex sonography"> penile duplex sonography</a> </p> <a href="https://publications.waset.org/abstracts/147056/management-of-caverno-venous-leakage-a-series-of-133-patients-with-symptoms-hemodynamic-workup-and-results-of-surgery" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/147056.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">150</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">213</span> Mycobacterium Genome Extraction from Lymph Nodes of Sarcoidosis Cases Using Transbronchial Needle Aspiration: A Cross-Sectional Descriptive Essay On 1223 Patients</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Atefeh%20Abedini">Atefeh Abedini</a>, <a href="https://publications.waset.org/abstracts/search?q=Pegah%20Soltani"> Pegah Soltani</a>, <a href="https://publications.waset.org/abstracts/search?q=Arda%20Kiani"> Arda Kiani</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Sarcoidosis and Tuberculosis are both considered granulomatous chronic diseases with some similar pulmonary and extra-pulmonary manifestations. It is hypothesized that given these morphological similarities, the genome of mycobacterium could have an impact on the development of Sarcoidosis. Identifying the potential correlation of these diseases may assist in the management of sarcoidosis. Herein, we aimed to inspect the lymph node biopsy of sarcoidosis patients for the existence of the HSP-65 mycobacterium DNA sequence. Methods: This cross-sectional survey was conducted on 1188 Sarcoidosis patients without active/latent tuberculosis infection who were diagnosed in Masih Daneshvari Hospital in Tehran, Iran, from January 2020 to January 2022. Trans-bronchial needle aspiration (TBNA) was performed due to bilateral hilar lymphadenopathy to take a specimen. Results: The under-evaluated patients were mainly women (N=815 (68.6%)), none-smoker (N=1016 (85.5%)), and middle-aged (50.1 (SD=4.22)) with average angiotensin-converting enzyme (ACE) index of 75.6 (SD=6.42). Dyslipidemias (n=314 (26.4%), Hypertension (n=295 (24.8%)), Diabetes mellitus (n=131 (11.0%)), and chronic heart diseases (n=97 (8.2%)) had the highest prevalence between comorbidities. Skin lesions (n= 655 (55.1%)), ophthalmic (n=341 (28.7%)), and cardiac involvement (n=229 (19.3%)) were obtained as the most common extra-pulmonary characteristics of the patients. Amongst 1188 enrolled patients who were not afflicted with Mycobacterium tuberculosis based on smear/culture essay, clinical symptoms, and Chest x-ray screening, 121 (10.2%) cases had detectable amplified DNA for Mycobacterium Tuberculosis extracted from mediastinal lung lymph nodes. Conclusion: In this survey, the mycobacterium genome was detected in almost 1 per 10 case biopsies of sarcoidosis. The remarkable number of cases (n=1188) evaluated in this study was the strength of this study which supported the hypothesis regarding sarcoidosis and mycobacterium genome correlation. Further investigation, such as case-control surveys, is required to better clarify this association. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=mycobacterium%20tuberculosis" title="mycobacterium tuberculosis">mycobacterium tuberculosis</a>, <a href="https://publications.waset.org/abstracts/search?q=sarcoidosis" title=" sarcoidosis"> sarcoidosis</a>, <a href="https://publications.waset.org/abstracts/search?q=genome" title=" genome"> genome</a>, <a href="https://publications.waset.org/abstracts/search?q=DNA" title=" DNA"> DNA</a>, <a href="https://publications.waset.org/abstracts/search?q=trans-bronchial%20needle%20aspiration" title=" trans-bronchial needle aspiration"> trans-bronchial needle aspiration</a> </p> <a href="https://publications.waset.org/abstracts/187424/mycobacterium-genome-extraction-from-lymph-nodes-of-sarcoidosis-cases-using-transbronchial-needle-aspiration-a-cross-sectional-descriptive-essay-on-1223-patients" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/187424.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">31</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">212</span> Surface Acoustic Waves Nebulisation of Liposomes Manufactured in situ for Pulmonary Drug Delivery</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=X.%20King">X. King</a>, <a href="https://publications.waset.org/abstracts/search?q=E.%20Nazarzadeh"> E. Nazarzadeh</a>, <a href="https://publications.waset.org/abstracts/search?q=J.%20Reboud"> J. Reboud</a>, <a href="https://publications.waset.org/abstracts/search?q=J.%20Cooper"> J. Cooper</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Pulmonary diseases, such as asthma, are generally treated by the inhalation of aerosols that has the advantage of reducing the off-target (e.g., toxicity) effects associated with systemic delivery in blood. Effective respiratory drug delivery requires a droplet size distribution between 1 and 5 µm. Inhalation of aerosols with wide droplet size distribution, out of this range, results in deposition of drug in not-targeted area of the respiratory tract, introducing undesired side effects on the patient. In order to solely deliver the drug in the lower branches of the lungs and release it in a targeted manner, a control mechanism to produce the aerosolized droplets is required. To regulate the drug release and to facilitate the uptake from cells, drugs are often encapsulated into protective liposomes. However, a multistep process is required for their formation, often performed at the formulation step, therefore limiting the range of available drugs or their shelf life. Using surface acoustic waves (SAWs), a pulmonary drug delivery platform was produced, which enabled the formation of defined size aerosols and the formation of liposomes in situ. SAWs are mechanical waves, propagating along the surface of a piezoelectric substrate. They were generated using an interdigital transducer on lithium niobate with an excitation frequency of 9.6 MHz at a power of 1W. Disposable silicon superstrates were etched using photolithography and dry etch processes to create an array of cylindrical through-holes with different diameters and pitches. Superstrates were coupled with the SAW substrate through water-based gel. As the SAW propagates on the superstrate, it enables nebulisation of a lipid solution deposited onto it. The cylindrical cavities restricted the formation of large drops in the aerosol, while at the same time unilamellar liposomes were created. SAW formed liposomes showed a higher monodispersity compared to the control sample, as well as displayed, a faster production rate. To test the aerosol’s size, dynamic light scattering and laser diffraction methods were used, both showing the size control of the aerosolised particles. The use of silicon superstate with cavity size of 100-200 µm, produced an aerosol with a mean droplet size within the optimum range for pulmonary drug delivery, containing the liposomes in which the medicine could be loaded. Additionally, analysis of liposomes with Cryo-TEM showed formation of vesicles with narrow size distribution between 80-100 nm and optimal morphology in order to be used for drug delivery. Encapsulation of nucleic acids in liposomes through the developed SAW platform was also investigated. In vitro delivery of siRNA and DNA Luciferase were achieved using A549 cell line, lung carcinoma from human. In conclusion, SAW pulmonary drug delivery platform was engineered, in order to combine multiple time consuming steps (formation of liposomes, drug loading, nebulisation) into a unique platform with the aim of specifically delivering the medicament in a targeted area, reducing the drug’s side effects. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=acoustics" title="acoustics">acoustics</a>, <a href="https://publications.waset.org/abstracts/search?q=drug%20delivery" title=" drug delivery"> drug delivery</a>, <a href="https://publications.waset.org/abstracts/search?q=liposomes" title=" liposomes"> liposomes</a>, <a href="https://publications.waset.org/abstracts/search?q=surface%20acoustic%20waves" title=" surface acoustic waves"> surface acoustic waves</a> </p> <a href="https://publications.waset.org/abstracts/84617/surface-acoustic-waves-nebulisation-of-liposomes-manufactured-in-situ-for-pulmonary-drug-delivery" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/84617.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">124</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">211</span> Ex-vivo Bio-distribution Studies of a Potential Lung Perfusion Agent</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Shabnam%20Sarwar">Shabnam Sarwar</a>, <a href="https://publications.waset.org/abstracts/search?q=Franck%20Lacoeuille"> Franck Lacoeuille</a>, <a href="https://publications.waset.org/abstracts/search?q=Nadia%20%20Withofs"> Nadia Withofs</a>, <a href="https://publications.waset.org/abstracts/search?q=Roland%20Hustinx"> Roland Hustinx</a> </p> <p class="card-text"><strong>Abstract:</strong></p> After the development of a potential surrogate of MAA, and its successful application for the diagnosis of pulmonary embolism in artificially embolized rats’ lungs, this microparticulate system were radiolabelled with gallium-68 to synthesize 68Ga-SBMP with high radiochemical purity >99%. As a prerequisite step of clinical trials, 68Ga- labelled starch based microparticles (SBMP) were analysed for their in-vivo behavior in small animals. The purpose of the presented work includes the ex-vivo biodistribution studies of 68Ga-SBMP in order to assess the activity uptake in target organs with respect to time, excretion pathways of the radiopharmaceutical, %ID/g in major organs, T/NT ratios, in-vivo stability of the radiotracer and subsequently the microparticles in the target organs. Radiolabelling of starch based microparticles was performed by incubating it with 68Ga generator eluate (430±26 MBq) at room temperature and pressure without using any harsh reaction condition. For Ex-vivo biodistribution studies healthy White Wistar rats weighing between 345-460 g were injected intravenously 68Ga-SBMP 20±8 MBq, containing about 2,00,000-6,00,000 SBMP particles in a volume of 700µL. The rats were euthanized at predefined time intervals (5min, 30min, 60min and 120min) and their organ parts were cut, washed, and put in the pre-weighed tubes and measured for radioactivity counts through automatic Gamma counter. The 68Ga-SBMP produced >99% RCP just after 10-20 min incubation through a simple and robust procedure. Biodistribution of 68Ga-SBMP showed that initially just after 5 min post injection major uptake was observed in the lungs following by blood, heart, liver, kidneys, bladder, urine, spleen, stomach, small intestine, colon, skin and skeleton, thymus and at last the smallest activity was found in brain. Radioactivity counts stayed stable in lungs with gradual decrease with the passage of time, and after 2h post injection, almost half of the activity were seen in lungs. This is a sufficient time to perform PET/CT lungs scanning in humans while activity in the liver, spleen, gut and urinary system decreased with time. The results showed that urinary system is the excretion pathways instead of hepatobiliary excretion. There was a high value of T/NT ratios which suggest fine tune images for PET/CT lung perfusion studies henceforth further pre-clinical studies and then clinical trials should be planned in order to utilize this potential lung perfusion agent. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=starch%20based%20microparticles" title="starch based microparticles">starch based microparticles</a>, <a href="https://publications.waset.org/abstracts/search?q=gallium-68" title=" gallium-68"> gallium-68</a>, <a href="https://publications.waset.org/abstracts/search?q=biodistribution" title=" biodistribution"> biodistribution</a>, <a href="https://publications.waset.org/abstracts/search?q=target%20organs" title=" target organs"> target organs</a>, <a href="https://publications.waset.org/abstracts/search?q=excretion%20pathways" title=" excretion pathways"> excretion pathways</a> </p> <a href="https://publications.waset.org/abstracts/128551/ex-vivo-bio-distribution-studies-of-a-potential-lung-perfusion-agent" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/128551.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">173</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">210</span> Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=S.%20Moustafa%20El%20Shanawany">S. Moustafa El Shanawany</a>, <a href="https://publications.waset.org/abstracts/search?q=I.%20Labib%20Salem"> I. Labib Salem</a>, <a href="https://publications.waset.org/abstracts/search?q=F.%20Mohamed%20Magdy%20Badr%20El%20Dine"> F. Mohamed Magdy Badr El Dine</a>, <a href="https://publications.waset.org/abstracts/search?q=H.%20Tag%20El%20Deen%20Abd%20Allah"> H. Tag El Deen Abd Allah</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=BOBI" title="BOBI">BOBI</a>, <a href="https://publications.waset.org/abstracts/search?q=burns" title=" burns"> burns</a>, <a href="https://publications.waset.org/abstracts/search?q=FLAMES" title=" FLAMES"> FLAMES</a>, <a href="https://publications.waset.org/abstracts/search?q=scoring%20systems" title=" scoring systems"> scoring systems</a>, <a href="https://publications.waset.org/abstracts/search?q=outcome" title=" outcome"> outcome</a> </p> <a href="https://publications.waset.org/abstracts/79416/predicting-mortality-among-acute-burn-patients-using-bobi-score-vs-flames-score" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/79416.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">335</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">209</span> Relationships of Functional Status and Subjective Health Status among Stable Chronic Obstructive Pulmonary Disease Patients Residing in the Community</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Hee-Young%20Song">Hee-Young Song</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background and objectives: In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations proposed a multidimensional assessment of patients’ conditions that included both functional parameters and patient-reported outcomes, with the aim to provide a comprehensive assessment of the disease, thus meeting both the needs of the patient and the role of the physician. However, few studies have evaluated patient-reported outcomes as well as objective functional assessments among individuals with chronic obstructive pulmonary disease (COPD) in clinical practice in Korea. This study was undertaken to explore the relationship between functional status assessed by the 6-minute walking distance (MWD) test and subjective health status reported by stable patients with COPD residing in community. Methods: A cross-sectional descriptive study was conducted with 118 stable COPD patients aged 69.4 years old and selected by a convenient sampling from an outpatient department of pulmonology in a tertiaryhospitals. The 6-MWD test was conducted according to standardized instructions. Participants also completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI). Medical records were reviewed to obtain disease-related characteristics including duration of the disease and forced expiratory volume in 1 second (FEV1). Data were analyzed using PASW statistics 20.0. Results: Mean FEV1% of participants was 63.51% and mean 6-MWD and CAT scores were 297.54m and 17.7, respectively. The 6-MWD and CAT showed significant negative correlations (r= -.280, p=.002); FEV1 and CAT did as well correlations (r= -.347, p < .001). Conclusions: Findings suggest that the better functional status an individual with COPD has, the better subjective health status is, and provide the support for using patient-reported outcomes along with functional parameters to facilitate comprehensive assessment of COPD patients in real clinical practices. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=chronic%20obstructive%20pulmonary%20disease" title="chronic obstructive pulmonary disease">chronic obstructive pulmonary disease</a>, <a href="https://publications.waset.org/abstracts/search?q=COPD%20assessment%20test" title=" COPD assessment test"> COPD assessment test</a>, <a href="https://publications.waset.org/abstracts/search?q=functional%20status" title=" functional status"> functional status</a>, <a href="https://publications.waset.org/abstracts/search?q=patient-reported%20outcomes" title=" patient-reported outcomes"> patient-reported outcomes</a> </p> <a href="https://publications.waset.org/abstracts/81539/relationships-of-functional-status-and-subjective-health-status-among-stable-chronic-obstructive-pulmonary-disease-patients-residing-in-the-community" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/81539.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">366</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">208</span> Size and Content of the Doped Silver Affected the Pulmonary Toxicity of Silver-Doped Nano-Titanium Dioxide Photocatalysts and the Optimization of These Two Parameters</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Xiaoquan%20Huang">Xiaoquan Huang</a>, <a href="https://publications.waset.org/abstracts/search?q=Congcong%20Li"> Congcong Li</a>, <a href="https://publications.waset.org/abstracts/search?q=Tingting%20Wei"> Tingting Wei</a>, <a href="https://publications.waset.org/abstracts/search?q=Changcun%20Bai"> Changcun Bai</a>, <a href="https://publications.waset.org/abstracts/search?q=Na%20Liu"> Na Liu</a>, <a href="https://publications.waset.org/abstracts/search?q=Meng%20Tang"> Meng Tang</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Silver is often doped on nano-titanium dioxide photocatalysts (Ag-TiO₂) by photodeposition method to improve their utilization of visible-light while increasing the toxicity of TiO₂。 However, it is not known what factors influence this toxicity and how to reduce toxicity while maintaining the maximum catalytic activity. In this study, Ag-TiO₂ photocatalysts were synthesized by the photodeposition method with different silver content (AgC) and photodeposition time (PDT). Characterization and catalytic experiments demonstrated that silver was well assembled on TiO₂ with excellent visible-light catalytic activity, and the size of silver increased with PDT. In vitro, the cell viability of lung epithelial cells A549 and BEAS-2B showed that the higher content and smaller size of silver doping caused higher toxicity. In vivo, Ag-TiO₂ catalysts with lower AgC or larger silver particle size obviously caused less pulmonary pro-inflammatory and pro-fibrosis responses. However, the visible light catalytic activity decreased with the increase in silver size. Therefore, in order to optimize the Ag-TiO₂ photocatalyst with the lowest pulmonary toxicity and highest catalytic performance, response surface methodology (RSM) was further performed to optimize the two independent variables of AgC and PDT. Visible-light catalytic activity was evaluated by the degradation rate of Rhodamine B, the antibacterial property was evaluated by killing log value for Escherichia coli, and cytotoxicity was evaluated by IC50 to BEAS-2B cells. As a result, the RSM model showed that AgC and PDT exhibited an interaction effect on catalytic activity in the quadratic model. AgC was positively correlated with antibacterial activity. Cytotoxicity was proportional to AgC while inversely proportional to PDT. Finally, the optimization values were AgC 3.08 w/w% and PDT 28 min. Under this optimal condition, the relatively high silver proportion ensured the visible-light catalytic and antibacterial activity, while the longer PDT effectively reduced the cytotoxicity. This study is of significance for the safe and efficient application of silver-doped TiO₂ photocatalysts. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=Ag-doped%20TiO%E2%82%82" title="Ag-doped TiO₂">Ag-doped TiO₂</a>, <a href="https://publications.waset.org/abstracts/search?q=cytotoxicity" title=" cytotoxicity"> cytotoxicity</a>, <a href="https://publications.waset.org/abstracts/search?q=inflammtion" title=" inflammtion"> inflammtion</a>, <a href="https://publications.waset.org/abstracts/search?q=fibrosis" title=" fibrosis"> fibrosis</a>, <a href="https://publications.waset.org/abstracts/search?q=response%20surface%20methodology" title=" response surface methodology"> response surface methodology</a> </p> <a href="https://publications.waset.org/abstracts/163273/size-and-content-of-the-doped-silver-affected-the-pulmonary-toxicity-of-silver-doped-nano-titanium-dioxide-photocatalysts-and-the-optimization-of-these-two-parameters" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/163273.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">69</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">207</span> Extra-Pulmonary Mycoplasma Pneumoniae Infection in a Healthy 25-Year-Old Female: A Case Report</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Minna%20Chang">Minna Chang</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: M. pneumoniae is a respiratory pathogen, which commonly causes upper and lower respiratory infections. It primarily affects children and young adults. Respiratory symptoms are well recognized, but extrapulmonary involvement is also common. Other systems that have been implicated in the disease include: skin, mucus membranes, central, peripheral nervous systems, cardiovascular, haematological, renal, and musculoskeletal systems. Here, we report a case of an otherwise healthy, young female with M. pneumonia, who presented with right upper quadrant abdominal pain. Case presentation: a healthy 25-year-old female was referred to A&E by her general practitioner, after presenting with fever, malaise, and right upper quadrant pain. M. pneumoniae was confirmed retrospectively by serology. The patient made a full recovery after a six-day course of doxycycline 100mg. Conclusion: M. pneumonia is a well-established cause of respiratory infections in children and young adults. Febrile illness with multisystem involvement, even in the absence of respiratory symptoms, should raise suspicion of M. pneumoniae infection in healthy, young adults. Our case illustrates the multi-system involvement of M. pneumoniae, which was initially missed, due to paucity of respiratory symptoms at presentation. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=infectious%20diseases" title="infectious diseases">infectious diseases</a>, <a href="https://publications.waset.org/abstracts/search?q=mycoplasma%20pneumoniae" title=" mycoplasma pneumoniae"> mycoplasma pneumoniae</a>, <a href="https://publications.waset.org/abstracts/search?q=respiratory%20infections" title=" respiratory infections"> respiratory infections</a>, <a href="https://publications.waset.org/abstracts/search?q=extra-pulmonary%20manifestations" title=" extra-pulmonary manifestations"> extra-pulmonary manifestations</a> </p> <a href="https://publications.waset.org/abstracts/128786/extra-pulmonary-mycoplasma-pneumoniae-infection-in-a-healthy-25-year-old-female-a-case-report" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/128786.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">143</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">206</span> The Effects of Red Onion Extract (Allium ascalonicum L.) in the Pulmonary Histopathological Lesions of Layer Chickens at 47 Days Old Raised in the Battery Cage</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=R.%20N.%20Nataria">R. N. Nataria</a>, <a href="https://publications.waset.org/abstracts/search?q=A.%20D.%20Paryuni"> A. D. Paryuni</a>, <a href="https://publications.waset.org/abstracts/search?q=R.%20Wasito"> R. Wasito</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Layer farms in Indonesia have still obstacles to increasing their productivity, especially due to poultry diseases. The red onion (Allium ascalonicum L.) is a plant that contains flavonoid and saponin. Flavonoid is useful as anti-inflammatory and antioxidant while saponin is useful as antivirus, anti-inflammatory, antifungal, and immunomodulator. This study aimed to know and determine the effect of onion extracts to pulmonary histopathological lesions in layer chickens which raised in the battery cage. This study used eighteen layer chickens at seventeen days old. The eighteen layer chickens were divided into three groups of six each, namely without administration of red onion extract (Group I), with administration red onion extract through drinking water (Group II) and with administration red onion extract peroral (Group III). Every ten days, six chickens were necropsied and then the lungs were processed for histopathological preparations and stained with routine hematoxylin and eosin. The results showed that the lungs of the Group I had severe congestion and diffuse hemorrhages. In Group II, lungs had moderate congestion and hemorrhages. In group III, lungs had mild congestion and hemorrhages. It is concluded, that red onion extract apparently has reduced the lungs lesions in layer chickens. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=histopathological%20lesions" title="histopathological lesions">histopathological lesions</a>, <a href="https://publications.waset.org/abstracts/search?q=layers" title=" layers"> layers</a>, <a href="https://publications.waset.org/abstracts/search?q=lungs" title=" lungs"> lungs</a>, <a href="https://publications.waset.org/abstracts/search?q=poultry%20diseases" title=" poultry diseases"> poultry diseases</a>, <a href="https://publications.waset.org/abstracts/search?q=red%20onion%20extract" title=" red onion extract"> red onion extract</a> </p> <a href="https://publications.waset.org/abstracts/50327/the-effects-of-red-onion-extract-allium-ascalonicum-l-in-the-pulmonary-histopathological-lesions-of-layer-chickens-at-47-days-old-raised-in-the-battery-cage" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/50327.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">448</span> </span> </div> </div> <ul class="pagination"> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=2" rel="prev">&lsaquo;</a></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=1">1</a></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=2">2</a></li> <li class="page-item active"><span class="page-link">3</span></li> <li class="page-item"><a class="page-link" href="https://publications.waset.org/abstracts/search?q=pulmonary%20embolism&page=4">4</a></li> <li class="page-item"><a class="page-link" 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