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Leadless Cardiac Pacemaker: Does Anatomical Position at Implant Affect Long-Term Electrical Performance?

Journal of Biomedical Science and Engineering 2017年第11期10卷 500-508页

作者： John Ip Abdul R. Safadi Randy Ip Matthew Gaskill rajesh Banker Derek Exner Srinivas Dukkipati Mayer Rashtian Imran Niazi Cardiac Electrophysiology Department Michigan State University Lansing USA Cardiac Electrophysiology Department Premier Cardiology Inc Newport Beach USA Cardiac Electrophysiology Department Foothills Medical Centre Calgary Canada Cardiac Electrophysiology Department Mount Sinai Hospital New York USA Cardiac Electrophysiology Department Huntington Memorial Hospital Pasadena USA Cardiac Electrophysiology Department Aurora Medical Group Milwaukee USA

Background: The Nanostim {trade mark, serif} Leadless Cardiac Pacemaker (LCP) has been shown to be safe and effective in human clinical trials. Since there is little information on the effect of implant location on LCP performance, the aim of this study was to determine whether anatomic position affects the long-term pacing performance of the LCP. Methods: Patients who enrolled in the Leadless II IDE Clinical Trial and had finished 6 months follow up (n = 479) were selected for the study. The implanting investigators determined the LCP final position under fluoroscope, which was categorized into three groups: RV apex (RVA, n = 174), RV apical septum (RVAS, n = 101), and RV septum (RVS, n = 204) (Figure 1). Data on capture threshold (at a 0.4 ms pulse width), R-wave amplitude and impedance were analyzed at implant, hospital discharge and 2 weeks, 6 weeks, 3 months and 6 months post-implant. Results: At implant, the mean capture thresholds in the RVA, RVAS and RVS were 0.77 ± 0.45, 0.81 ± 0.61 and 0.78 ± 0.59 volts, respectively. R-wave amplitudes were 8.0 ± 3.0 mV, 7.7 ± 2.9 mV and 7.6 ± 2.9 mV, respectively. Impedance values were 727 ± 311, 765 ± 333, and 677 ± 227 respectively. There were no differences among the 3 implant locations in capture threshold or R-wave amplitudes at 6 months (P > 0.06);however, all 3 performance parameters significantly improved over time (P < 0.001). Conclusions: The LCP implant location does not affect capture thresholds or R-wave amplitudes at 6 months, and there is little effect on impedance. Although implant location does not appear to be a predictor of electrical performance, additional long-term data will help guide optimal implant location.

关键词： Pacing Lead Location Leadless Pacing Lead Impedance Pacing Threshold R-Wave Amplitude

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Global variation in skin injures and skincare practices in extremely preterm infants

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World Journal of Pediatrics 2023年第2期19卷 139-157页

作者： Pranav Jani Umesh Mishra Julia Buchmayer rajesh Maheshwari Daphne D’Çruz Karen Walker Duygu Gözen Krista Lowe Audrey Wright James Marceau Mihaela Culcer Archana Priyadarshi Adrienne Kirby James EMoore Ju Lee Oei Vibhuti Shah Umesh Vaidya Abdelmoneim Khashana Sunit Godambe Fook Choe Cheah Wen-Hao Zhou Xiao-Jing Hu Muneerah Satardien Faculty of Medicine and Health The University of SydneySydneyNSWAustralia Department of Neonatology Westmead HospitalWestmeadNSW2145Australia Comprehensive Center for Pediatrics Department of Pediatrics and Adolescent MedicineDivision of NeonatologyPediatric Intensive Care and NeuropediatricsMedical University of ViennaViennaAustria Department of Newborn Care Royal Prince Alfred HospitalCamperdownNSWAustralia Council of International Neonatal Nurses BostonMAUSA The George Institute for Global Health SydneyNSWAustralia Sydney Institute for Women Children and Their FamiliesSydneyNSWAustralia Pediatric Nursing Department Florence Nightingale Faculty of Nursingİstanbul University-CerrahpaşaIstanbulTurkey The National Health and Medical Research Council Clinical Trials Centre University of SydneySydneyNSWAustralia Connecticut Children’s Division of Neonatal-Perinatal Medicine Connecticut Children’s Medical CenterHartfordCTUSA UCONN School of Medicine FarmingtonCTUSA The Royal Hospital for Women RandwickNSWAustralia School of Women’s and Children’s Health University of New South WalesRandwickNSWAustralia Department of Paediatrics and Institute of Health Policy Management and EvaluationMount Sinai HospitalTorontoCanada Department of Pediatrics King Edward Memorial HospitalPuneIndia Pediatrics Suez Canal UniversityIsmailiaEgypt Divisional Director for Clinical Governance Women’sChildren’s and Clinical SupportImperial College Healthcare NHS TrustLondonUK Department of Pediatrics Faculty of MedicineUniversiti KebangsaanBangiMalaysia Hospital Canselor Tuanku Muhriz Jalan Yaacob LatifBandar Tun RazakKuala LumpurMalaysia Department of Neonatology and Vice President Children’s Hospital of Fudan UniversityShanghaiChina Vice Director of Nursing Department Children’s Hospital of Fudan UniversityShanghaiChina Department of Paediatrics and Child Health Tygerberg HospitalCape TownSouth Africa University of Stellenbosch Cape TownSouth Africa

Background Globally,are skincare practices and skin injuries in extremely preterm infants comparable?This study describes skin injuries,variation in skincare practices and investigates any association between *** A web-based survey was conducted between February 2019 and August *** skin injuries and describing skincare practices in extremely preterm infants were the main *** association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for *** Responses from 848 neonatal intensive care units,representing all geographic regions and income status groups were *** dermatitis(331/840,39%)and medical adhesive-related skin injuries(319/838,38%)were the most common *** a local skincare guideline reduced skin injuries[medical adhesive-related injuries:adjusted odds ratios(aOR)=0.63,95%confidence interval(CI)=0.45–0.88;perineal injuries:aOR=0.66,95%CI=0.45–0.96;local skin infections:OR=0.41,95%CI=0.26–0.65;chemical burns:OR=0.46,95%CI=0.26–0.83;thermal burns:OR=0.51,95%CI=0.27–0.96].Performing skin assessments at least every four hours reduced skin injuries(abrasion:aOR=0.48,95%CI=0.33–0.67;pressure:aOR=0.51,95%CI=0.34–0.78;diaper dermatitis:aOR=0.71,95%CI=0.51–0.99;perineal:aOR=0.52,95%CI=0.36–0.75).Regional and resource settings-based variations in skin injuries and skincare practices were *** Skin injuries were common in extremely preterm *** in practice and improved surveillance appears to reduce the occurrence of these *** evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.

关键词： Extremely premature infants Injuries Neonatal intensive care unit Skin care Wounds

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CSF Rhinorrhoea with Encephalocele through Sternberg’s Canal: Our Experience

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第1期4卷 50-54页

作者： Reshma Hanwate Vandana Thorawade Mohan Jagade Anoop Attakil Kartik Parelkar Madhavi Pandare R. V. Natraj rajesh Kar Department of ENT Grant Government Medical College & Sir J J Hospital Mumbai India

Spontaneous cerebrospinal fluid rhinorrhoea with encephalocele restricted to the sphenoid sinus is rare clinical finding. As of today, only 17 cases encephalocele protruding through the Sternberg’s canal and extending into the lateral recess of sphenoid sinus, have been described in literature. Patients presenting with this special clinical entity usually do not have any history of trauma, tumour or iatrogenic injury. Thus the lesions are considered to originate from a congenital bony defect in the lateral wall of the sphenoid sinus, first described by Sternberg in 1888 as the lateral craniopharyngeal canal (Sternberg’s canal). In our experience each patient of spontaneous CSF rhinorrhea should have suspicion of intrasphenoid encephalocele though cribriform plate is a common site. Endoscopic tranasnasal approach is one of the best modalities for such cases.

关键词： CSF Rhinorrhoea Sternberg’s Canal Encephalocele

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Audiological Evaluation in Goitrous Hypotyhroidism

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第5期2卷 201-206页

作者： M. K. Aggarwal Gautam Bir Singh Ranjan K. Nag S. K. Singh rajesh Kumar Mayank Yadav Institute of Medical Sciences BHU Varanasi India Lady Hardinge Medical College & Associated Hospitals New Delhi India

Objective: To determine the incidence of deafness in patients suffering from goiterous hypothyroidism exclusively and to evaluate the role of L-thyroxine therapy in improving the hearing in this group of patients. Study Design: A prospective cohort study. Materials and Methods: Hearing status was evaluated in a sample size of 100 consecutive patients reporting to the ENT/Endocrinology department of Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP with the diagnosis of goitrous hypothyroidism. The study group included patients in the age group of 5 to 65 years belonging to either sex. Patients with detected hearing loss were categorized into group A, and all other patients were designated group B. L-Thyroxine treatment for goitrous hypothyroidism was initiated in all the cases. At the end of 6 months, a repeat audiogram was done in all the patients in order to evaluate the efficacy of the said treatment protocol on the hearing in these patients. The data were tabulated and statistically analysed using Paired Students “t” test. Results: An overall 39% hearing loss was observed in patients with goitrous hypothyroidism. 15% cases had sensorineural hearing loss, 13% had mixed hearing loss and 8% had a conductive hearing loss. A statistically significant hearing improvement was recorded in this study by L-thyroxine treatment in group-A, and no deterioration of hearing was recorded in group-B. Conclusions: The incidence of sensorineural hearing is less in patients with goitrous hypothyroidism (15%) as compared with the overall incidence of sensorineural hearing loss reported for hypothyroidism (30%-40%). Further, there is a definitive improvement in hearing with the use of L-thyroxine treatment of goitrous hypothyroidism.

关键词： Hypothyroidism Goitre Hearing Loss L-Thyroxine Treatment

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Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample

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World Journal of Cardiology 2019年第5期11卷 137-148页

作者： Rupak Desai Tarang Parekh Hemant Goyal Hee Kong Fong Dipen Zalavadia Nanush Damarlapally Rajkumar Doshi Sejal Savani Gautam Kumar rajesh Sachdeva Division of Cardiology Atlanta VA Medical Center Decatur GA 30033 United States Division of Cardiology Morehouse School of Medicine Atlanta GA 30310 United States Department of Health Administration and Policy George Mason University Fairfax VA 22030 United States Department of Internal Medicine Macon University School of Medicine Macon GA 31207 United States Department of Internal Medicine University of Missouri-Columbia Columbia MO 65212 United States Department of Internal Medicine The Wright Center for Graduate Medical Education Scranton PA 18503 United States Department of Health Sciences Coleman College of Health Sciences Houston TX 77030 United States Department of Internal Medicine University of Nevada School of Medicine Reno NV 89557 United States Public Health New York University New York NY 10010 United States Division of Cardiology Emory University School of Medicine Atlanta GA 30322 United States

BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome (ACS)-related hospitalizations and post-revascularization is inadequate. AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations, subsequent healthcare burden and predictors of post-revascularization inpatient mortality. METHODS We used the national inpatient sample (2010-2014) to identify the ACS and goutrelated hospitalizations, relevant comorbidities, revascularization and postrevascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality. RESULTS We identified 3144744 ACS-related hospitalizations, of which 105198 (3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac (3.2% vs 2.9%), respiratory (3.5% vs 2.9%), and hemorrhage (3.1% vs 2.7%) were higher whereas all-cause mortality was lower (2.2% vs 3.0%) in the ACSgout cohort (P < 0.001). An older age (OR 15.63, CI: 5.51-44.39), non-elective admissions (OR 2.00, CI: 1.44-2.79), lower household income (OR 1.44, CI: 1.17- 1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization (P < 0.001). Odds of post-revascularization inhospital mortality were lower in Hispanics (OR 0.45, CI: 0.31-0.67) and Asians (OR 0.65, CI: 0.45-0.94) as compared to white (P < 0.001). However, postoperative complications significantly raised mortality odds. Mean length of stay, transfer to other facilities, and hospital charges were higher in the ACS-gout cohort. CONCLUSION Although gout was not independently associated with an increased risk of postrevas

关键词： Gout Serum uric acid Acute coronary syndrome Unstable angina Myocardial infarction Revascularization Percutaneous coronary intervention Coronary artery bypass grafting In-hospital outcomes

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Interpretation of Dune Genesis from Sedimentogical Data and Ground Penetrating Radar (GPR) Signatures: A Case Study from Ashirmata Dune Field, Mandvi Beach, Gujarat, India

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International Journal of Geosciences 2012年第4期3卷 772-779页

作者： Deshraj Trivedi Koravangatt Devi Ilya Buynevich P. Srinivasan K. Ravisankar Vipul Silwal D. Sengupta rajesh R. Nair Indian Institute of Technology Structural Engineering Research Centre Temple University

The coastal dunes located near the Ashirmata region, south of Mandvi beach lies near the straight coast have been stud-ied by making use of sedimentological information and Ground Penetrating Radar (GPR) data. Sedimentological analy-sis reveals the NNW-SSE trending longitudinal dunes consists of well sorted fine sands with unimodal distribution pos-sibly formed by constant wind gust and also the point out to the origin of sediments from single source;mostly the sediments derived from Indus delta transported to beach by long shore drift and tidal waves, carried inland by local on-shore winds. The radargram confirms, the homogenous sand layers with paleosols at shallow depth slip faces are proba-bly formed due to extreme storm activity of Recent.

关键词： Coastal Dune Ashirmata Region Sedimentogical Analysis Ground Penetrating Radar Paleosol

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滴水之恩

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海外英语 2003年第5期 26-27页

作者：杰克

　　滴水之恩,涌泉相报.当这个世界被越来越多的冷漠充斥,当人们感慨真情难觅时,本文以女主人公的坎坷经历向人们展示了"人间自有真情在"的美好一面.……

关键词：女主人公坎坷经历滴水

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Dyke swarms: keys to paleogeographic reconstructions

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Science Bulletin 2016年第21期61卷 1669-1671页

作者：彭澎 Richard E.Erns 侯贵廷 Ulf S?derlund 张拴宏 Michael Hamilton 徐义刚 Steven Denyszyn Daniel Mège Sergei Pisarevsky rajesh Srivastava Timothy M.Kusky State Key Laboratory of Lithospheric Evolution Institute of Geology and Geophysics Chinese Academy of Sciences Department of Earth Sciences Carleton University School of Earth and Space Sciences Peking University Department of Geology Lund University Institute of Geomechanics Chinese Academy of Geological Sciences Department of Earth Sciences University of Toronto Guangzhou Institute of Geochemistry Chinese Academy of Sciences Centre for Exploration Targeting School of Earth and Environment The University of Western Australia Space Research Centre Polish Academy of Sciences Department of Applied Geology Curtin University Institute of Science Banaras Hindu University Center for Global Tectonics College of Earth Sciences China University of Geosciences

The Seventh International Dyke Conference （IDC7） was hosted by the State Key Laboratory of Lithospheric Evolution, Institute of Geology and Geophysics, Chinese Academy of Sciences, in Beijing on August 18-20, 2016. Approximately 140 participants from 19 countries of all inhabited continents attended the meeting. 133 selected abstracts published in Acta Geologica Sinica （Vol 90, Supp 1） are representative of the range of recent advances in the field. The IDCs are the highest-ranked international conferences on dyke research （including geological, geophysical and geochemical aspects）. IDC7 continued the every-5-year tradition started in Mississauga （near Toronto） Canada in 1985, that was inspired by the classic paper of Halls （1982） .

关键词：岩墙群 IDC 钥匙

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Prolonged Middle Ear Ventilation by Cartilage-Grommet Tympanoplasty

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第1期4卷 13-17页

作者： Kartik Parelkar Smita Nagle Mohan Jagade Vandana Thorawade Poonam Khairnar Anoop Attakil Madhavi Pandare Rajanala Nataraj Reshma Hanwate rajesh Kar Department of ENT Grant Government Medical College & Sir J J Group of Hospitals Mumbai India

In 1994, the American Otological Society reported favourable experience with composite cartilage shield tympanoplasty. The tragal cartilage with a grommet inserted in it was used for tympanoplasty in our patient with unilateral CSOM, supposedly because of severe chronic eustachian tube dysfunction. The marriage of cartilage tympanoplasty with grommet insertion was aimed to add the advantages and abolish the disadvantages of both the procedures. In 1990 Lary Hall first introduced the “long term ventilation of the middle ear” with a T-tube placed in the tragal cartilage perichondrium composite island graft. T-tube insertion in the cartilage has been described. But insertion of the Indian Sheperds grommet (ventilation tube) in the cartilage graft as described in this case and its technique are possibly the first of its kinds in literature. The report is aimed to ignite innovation of newer and better techniques of cartilage tympanoplasty.

关键词： Tragal Cartilage Grommet Tympanoplasty

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人工全膝关节置换后股骨假体角度的CT影像学评估:股骨外上髁线参照与间隙平衡技术的对比研究(英文)

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中国矫形外科杂志 2008年第12期16卷 908-912页

作者： Shrinand V Vaidya Aditya V Maheshwari rajesh M Gadhiya Vaibhav Bagaria Amar S Ranawat Chitranjan S Ranawat 印度孟买爱德华七世纪念医院骨科美国纽约市Lenox Hill医院Ranawat骨科中心

[目的]虽然人工全膝关节置换术中假体旋转定位的重要性已得到公认,但术中以哪条轴线为参照能够更加精确的保证股骨假体的旋转定位,目前尚存争议。研究表明股骨外上髁线(TEA)与膝关节屈曲轴线平行,但这一轴线术中难以精确确定。本文采用... 详细信息

[目的]虽然人工全膝关节置换术中假体旋转定位的重要性已得到公认,但术中以哪条轴线为参照能够更加精确的保证股骨假体的旋转定位,目前尚存争议。研究表明股骨外上髁线(TEA)与膝关节屈曲轴线平行,但这一轴线术中难以精确确定。本文采用间隙平衡技术(BG),对比TEA技术在股骨假体实际旋转角度测量的差异。[方法]30例人工全膝关节置换分为2组(每组15膝),分别采用TEA和BG技术,术后行CT扫描测量股骨假体旋转角度并行膝关节学会评分(KSS)。[结果]BG组中股骨假体平均外旋角度为2.7°±1.1°,TEA组为5.6°±1.6°(P=0.001)。术后KSS功能评分改善BG组高于TEA组(P=0.002),但两组的KSS膝评分无显著性差异(P=0.39)。[结论]研究表明,与BG技术相比,术中应用TEA参照确定股骨假体的旋转定位可导致股骨假体的过度外旋,其术后KSS功能评分亦较差。

关键词：全膝关节置换股骨假体旋转外上髁线间隙平衡技术屈膝间隙技术间隙张力技术韧带平衡软组织平衡

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