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Mcintyre Hewitt posted an update 6 months ago
This review aimed to summarize the evidence on the risk of thromboembolism associated with carotid and aortic atherosclerosis in patients with AF, and the potential impact of their inclusion in current stroke risk stratification scores.
MEDLINE, Web of Science and EMBASE were systematically searched to identify all published studies providing relevant data through 28 February 2021.
We identified 10 eligible studies. There was high heterogeneity across studies, precluding a meta-analysis. Carotid stenosis was not associated with incident ischemic stroke in three prospective studies, including the SPAF II trial and the ROCKET-AF trial. An association between carotid stenosis and thromboembolism was found in two studies, with a potential reporting bias due to their retrospective design. The evidence suggesting that carotid plaque predicts stroke or transient ischemic attack in AF patients were more consistent in the four studies evaluating this association. this website The inclusion of carotid plaque and carotid intima-media thickness (cIMT) into stroke risk stratification tools for AF patients improved their performance. Data on the association of aortic plaque with thromboembolism is scarce in patients with AF. The two studies reporting on this association suggest that aortic plaque alone does not predict incident ischemic stroke.
Available data suggest an association of carotid atherosclerosis with the risk of stroke and transient ischemic attack in patients with AF. Future studies should evaluate whether incorporating cIMT and characteristics of carotid and aortic plaques into scoring systems would improve stroke prediction and prevention in patients with AF.
Available data suggest an association of carotid atherosclerosis with the risk of stroke and transient ischemic attack in patients with AF. Future studies should evaluate whether incorporating cIMT and characteristics of carotid and aortic plaques into scoring systems would improve stroke prediction and prevention in patients with AF.
Case-fatality of Intracerebral hemorrhage (ICH) has been reported to have improved in some areas recently. Previous reports have shown that in Finland ICH survival has improved already from the 1980s. We aimed to investigate if this trend has continued and to assess possible predictors for death.
All patients hospitalized for ICH in Finland in 2004-2018 over 16years of age were identified from a national registry. Survival was analyzed using the national causes of death registry with median follow-up of 5.1years (max 15.0years).
20,391 persons with ICH (53.5% men) were identified. Patient age increased during the study period with men being younger than women. One-month case-fatality was 28.4% and decreased during the study period. One-month and long-term case-fatality increased with patient age. Five-year survival was over 64% in patients <65years of age and<33% in those >75years of age. In a multivariate analysis patient age, sex, comorbidity burden and diagnoses of atrial fibrillation, hypertension and coagulopathy were all independently associated with both 30-day and long-term survival. Survival was better in men than women at all time points but in the multivariate analysis male sex was associated with a slightly higher risk (hazard ratio 1.10, 95% CI 1.06-1.14) of death in the long-term follow-up. Compared to general population, excess case-fatality was high and highly age-dependent in both sexes.
Case-fatality of hospital-treated ICH has continued to decrease in Finland. Prognosis is strongly associated with patient age and more modestly with patient sex and comorbidities.
Case-fatality of hospital-treated ICH has continued to decrease in Finland. Prognosis is strongly associated with patient age and more modestly with patient sex and comorbidities.This study was completed to understand the resilience of an ion exchange (IEX) process for its ability to remove variable ammonium (NH4+-N) loads) and to prove its environmental benefits through a life cycle assessment (LCA). The tertiary 10 m3/day demonstration scale IEX was fed with variable NH4+-N concentrations ( less then 0.006-26 mg NH4+-N /L) naturally found in municipal wastewater. Zeolite-N was used as ion exchange media and regeneration was completed with 10% potassium chloride (KCl). The influent NH4+-N concentration impacted the ion exchange capacity, which ranged from 0.9-17.7 mg NH4+-N/g media. When the influent concentration was less then 2.5 mg NH4+-N/L, the Zeolite-N released NH4+-N (up to 12%). However, the exchange increased up to 62% when the influent NH4+-N load peaked, confirming the resilience of the process. A 94% regeneration efficiency was obtained with fresh regenerant, however, with the increase of the mass of NH4+-N on the media, the regeneration efficiency decreased. An optimisation of the volume of brine and regeneration contact time is suggested. To further measure the benefits of the IEX process, an LCA was conducted, for a 10,000 population equivalent reference scenario, and compared with traditional nitrification-denitrification WWTP. The LCA revealed that IEX with regenerant re-use and NH4+-N recovery through a membrane stripping process resulted in reductions of 25% cumulative energy demand; 66% global warming potential and 62% marine eutrophication potential, when compared to traditional WWTP. This work demonstrated that the IEX process is an efficient and an environmentally benign technology that can be widely applied in WWTPs.Mercury is one of the most common heavy metals and a major environmental pollutant that affects ecosystems. Since mercury and its compounds are toxic to humans, even at low concentrations, it is very important to monitor mercury contamination in water and foods. Although conventional mercury detection methods, including inductively coupled plasma mass spectrometry, atomic absorption spectroscopy, and gas chromatography-mass spectrometry, exhibit excellent sensitivity and accuracy, they require operation by an expert in a sophisticated and fully controlled laboratory environment. To overcome these limitations and realize point-of-care testing, many novel methods for direct sample analysis in the field have recently been developed by improving the speed and simplicity of detection. Commonly, these unconventional sensors rely on colorimetric, fluorescence, or electrochemical mechanisms to transduce signals from mercury. In the case of colorimetric and fluorescent sensors, benchtop methods have gradually evolved through technology convergence to give standalone platforms, such as paper-based assays and lab-on-a-chip systems, and portable measurement devices, such as smartphones.
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