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1.
Sci Total Environ ; 761: 144121, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33360127

RESUMO

Groundwater supplies drinking water for over one-third of all Americans. However, with aquifers stressed by overdraft, contamination from land use, and the hydrologic impacts of climate change, identifying reliable sources for new wells is increasingly challenging. Well forecasting is a process in which potential groundwater resources are evaluated for a location of interest. While this process forecasts the depth of each aquifer for a given location, it takes historical groundwater well data from nearby locations into account. Conventionally, well forecasting is done by geological survey professionals by manually analyzing the well data and, that makes the process both time and resource-intensive. This study presents a novel web application that performs well forecasting for any location within the state of Iowa in a matter of seconds utilizing client-side computing instead of expensive professional labor. The web application generates well forecasts by triangulating millions of combinations of historical aquifer depth data of nearby wells stored in a state-level database. The proposed web system also provides water quality information for arsenic, nitrate, and bacteria (total c and fecal coliform) on the same interface with forecasts. The system is open to the public and is aimed to provide a go-to tool for homeowners, well drillers and, authorities to help inform decision-making regarding groundwater well development and water quality monitoring efforts.


Assuntos
Ciência de Dados , Água Subterrânea , Poluentes Químicos da Água , Monitoramento Ambiental , Humanos , Internet , Iowa , Poluentes Químicos da Água/análise , Poços de Água
2.
Water Sci Technol ; 82(12): 2635-2670, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33341760

RESUMO

The global volume of digital data is expected to reach 175 zettabytes by 2025. The volume, variety and velocity of water-related data are increasing due to large-scale sensor networks and increased attention to topics such as disaster response, water resources management, and climate change. Combined with the growing availability of computational resources and popularity of deep learning, these data are transformed into actionable and practical knowledge, revolutionizing the water industry. In this article, a systematic review of literature is conducted to identify existing research that incorporates deep learning methods in the water sector, with regard to monitoring, management, governance and communication of water resources. The study provides a comprehensive review of state-of-the-art deep learning approaches used in the water industry for generation, prediction, enhancement, and classification tasks, and serves as a guide for how to utilize available deep learning methods for future water resources challenges. Key issues and challenges in the application of these techniques in the water domain are discussed, including the ethics of these technologies for decision-making in water resources management and governance. Finally, we provide recommendations and future directions for the application of deep learning models in hydrology and water resources.


Assuntos
Aprendizado Profundo , Recursos Hídricos , Mudança Climática , Hidrologia
3.
J Infect Chemother ; 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33183964

RESUMO

Hydatid cyst is a common infestation caused by helminths in humans and usually involves the liver and lungs. Primarily, cases of hydatid cysts in the thigh muscles are extremely rare and are generally in the form of case reports. It is an important disease due to its insidious course, its confusion with other soft tissue pathologies, delay in diagnosis and painstaking surgery. In our study, the largest case series in the literature, the clinical stages of the diagnosis, treatment and follow-up of 9 hydatid cysts that develop primarily in the thigh muscles were evaluated. The risk of recurrence in primary hydatid cyst of the thigh can be reduced with rapid diagnosis, careful preoperative planning, complete surgical resection by avoiding cyst rupture and concomitant anthelmintic chemotherapy.

4.
J Card Surg ; 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33124733

RESUMO

BACKGROUND: Transannular patch, which results in pulmonary insufficiency (PI), is usually required during repair of tetralogy of fallot (TOF). In this study, we compared three types of pulmonary valve reconstruction techniques during transannular repair of TOF. METHODS: Between February 2014 and January 2018, 50 patients with TOF underwent primary repair with transannular patch. These patients were divided into three groups. In Group 1, (n = 15), a single gluteraldehyde-treated autologous pericardial patch (standard method) was reconstructed as monocusp. In Group 2, (n = 16) Nunn's bileaflet pulmonary valve reconstruction technique was used with pericardial patch. In Group 3, (n = 19), Nunn's bileaflet technique was performed with expanded polytetrafluoroethylene membrane. The outcomes of the patients and early and midterm competency of the pulmonary valves were analyzed. RESULTS: These techniques were significantly effective in early postoperative period. Freedom from moderate to severe PI were 73.3%; 100% and 89.4%, respectively. Mortality, duration of intensive care unit and hospital stay were similar between the groups. The mean follow-up period was 17.5 ± 13.0 (3-57) months. Freedom from moderate to severe PI decreased to 40%; 81.2% and 73.7%, respectively at the end of the follow-up period. Presence of moderate to severe PI was significantly higher in Group 1 (p = .018 between Groups 1 and 2, p = .048 between Groups 1 and 3). CONCLUSION: All three pulmonary valve reconstruction techniques provided competent pulmonary valves. Nunn's bileaflet technique had better outcome at midterm. It has a potential to delay right ventricular dysfunction at long-term.

5.
Indian J Thorac Cardiovasc Surg ; 36(3): 251-252, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-33061135

RESUMO

Association of interrupted aortic arch with aortic atresia as a variant of hypoplastic left heart syndrome (HLHS) is extremely rare and could not be compatible with life without a reliable source for cerebral and coronary blood flow. The patient with a large collateral artery between the descending aorta and the right subclavian artery is presented.

6.
Cardiol Young ; : 1-11, 2020 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-32880245

RESUMO

OBJECTIVE: We aimed to determine the early and midterm outcomes of ductal stenting in neonates with ductal-dependent pulmonary blood flow. METHODS: Between January, 2014 and July, 2018, 102 patients who underwent 115 cardiac catheterisation procedures for ductal stent implantation in our department were retrospectively reviewed. The age of the neonates ranged from 3 to 30 days (median: 11 days) and their weights ranged from 1.8 to 5.8 kg (mean, 2.8 ± 0.53 kg). Fifty-two patients had functional single ventricle and 50 had biventricular physiology. Thirty-one patients' weights were <2,500 g (30.3%). The patent ductus arteriosus was vertical in 60 patients (58.8%). The mean ductal length was 12.4 ± 4.1 mm (range, 7.8-23 mm), and the mean narrowest ductal diameter was 2.1 ± 0.7 mm (range, 1.2-3.4 mm). RESULTS: The technical success rate was 85.2%. Procedure-related mortality occurred in three patients (2.9%). After the procedure, the aortic oxygen saturation increased from a mean of 73.1 ± 6.2% to a mean of 90.4 ± 4.3% (p < 0.001), and the ductus diameter increased from a mean of 2.1 ± 0.7 mm to a mean of 4.2 ± 0.9 mm (p < 0.001). Either transcatheter or surgical reinterventions were required in 35 patients (34.3%) during the follow-up period after a median of 101 days (2-356 days). Thirty-three patients (32.3%) were bridged to surgical repair after a median of 288 days (163-650 days). The median duration of palliation with ductal stents was 210 days (range, 2-525 days). CONCLUSION: Ductus arteriosus stenting may be a reasonable and effective alternative to surgery for the initial palliation procedure in neonates with ductus-dependent pulmonary flow.

7.
Eur J Orthop Surg Traumatol ; 30(8): 1447-1451, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32591912

RESUMO

BACKGROUND: Metastatic spinal lesions are diseases that impair the quality of life and require early diagnosis and treatment. The count of spinal metastasis patients rises day by day. Increased life expectancy has increased the incidence of cancer, making metastases more observable. The aim of our study was to investigate how the quality of life is affected in the patient group with vertebral fracture due to spinal metastases of multiple myeloma and undergoing vertebroplasty and kyphoplasty. MATERIALS AND METHODS: Forty-two patients with fracture due to spinal metastasis and adequate follow-up between the years of 2011 and 2018 were included in the study. Patients were listed according to their primary malignancy and metastases. The effect of vertebroplasty and kyphoplasty was investigated by evaluating preoperative and postoperative VAS and Oswestry Disability Index scores. All patients' radiographic kyphosis angle, compression ratio and wedging index were calculated before operation and after operation. RESULTS: A total of 76 vertebrae were operated in 42 patients. Significant differences were found in the comparison of preoperative and postoperative quality of life according to VAS and Oswestry Disability Index scores in the patients undergoing vertebroplasty, kyphoplasty or both procedures after spinal metastases (VAS; p = 0.0001, ODI; p = 0.002/0.0001). There were statistically significant differences in preoperative local kyphosis angle, compression ratio and wedging index and post-op local kyphosis angle, compression ratio and wedging index (p = 0.001). CONCLUSION: Vertebroplasty and kyphoplasty, minimally invasive procedures performed after spinal metastases, improve the quality of life of the patients.

8.
Sci Total Environ ; 728: 138895, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32361365

RESUMO

With increasing population and human intervention on the natural environment, hazards are a growing threat, coming in many forms, including floods, droughts, soil erosion, and water pollution. A key approach to mitigate hydrological disaster risk at the community level is informed planning with decision support systems. The literature shows emerging efforts on multi-hazard decision support systems for hydrological disasters and demonstrates the need for an engaging, accessible, and collaborative serious game environment facilitating the relationship between the environment and communities. In this study, a web-based decision support tool (DST) was developed for hydrological multi-hazard analysis while employing gamification techniques to introduce a competitive element. The serious gaming environment provides functionalities for intuitive management, visualization, and analysis of geospatial, hydrological, and economic data to help stakeholders in the decision-making process regarding hydrological hazard preparedness and response. Major contributions of the presented DST include involving the community in environmental decision making by reducing the technical complexity required for analysis, increasing community awareness for the environmental and socio-economic consequences of hydrological hazards, and allowing stakeholders to discover and discuss potential trade-offs to hazardous scenarios considering the limitations in budget, regulations, and technicality. The paper describes the software design approaches and system architecture applied for a modular, secure, and scalable software as well as the framework's intuitive web-based user interfaces for real-time and collaborative data analysis and damage assessment. Finally, a case study was conducted to demonstrate the usability of DST in a formal setting and to measure user satisfaction with surveys.

9.
J Environ Manage ; 255: 109887, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31785462

RESUMO

The paper presents a web-based application developed as a medium for executing a serious game to enhance multi-jurisdictional collaborative planning and decision making for mitigation of multiple hazards related to water (i.e., floods, soil erosions, water quality). The gaming application is integrated into the Iowa Watershed Decision Support System (IoWaDSS) designed to serve as a comprehensive multi-sectoral data repository along with the simulation results of process modeling to educate and inform communities on the status of their watersheds during extreme conditions. The interactive serious gaming application was devised to encourage public engagement, facilitate communication and positive relationship between watershed communities, and make the decision process more attractive and transparent for the stakeholders. The web environment offers easily-accessible, user-friendly interfaces that match the skills and knowledge level of a non-technical user. Developed with adaptive design and flexible architecture, the gaming application is generalizable and extendable to support hazard mitigation in other watersheds.


Assuntos
Solo , Qualidade da Água , Internet , Iowa , Comportamento Social
10.
Sci Total Environ ; 692: 806-817, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31539987

RESUMO

Sediment accumulation at culverts involves large-scale and interlinked environmental processes that are difficult to address with experimental or physical modeling methods. This article presents an alternative data-driven investigation for shedding insights into these processes. Accordingly, a web-based geovisual analytics application, the IowaDOT platform, was developed, which allows users to explore the complex processes associated with the sediment deposition at culverts. The platform provides systematic procedures for (1) collecting and integrating analytical variables into a single dataset, (2) quantifying the degree of culvert sedimentation using time series of aerial images, (3) identifying drivers that contribute to culvert sedimentation processes from a variety of culvert structural and upstream landscape characteristics using a tree-based feature selection algorithm, and (4) facilitating the understanding of complex spatial and relational patterns of culvert sedimentation processes using multivariate geovisualizations supported by a self-organizing map (SOM). As the outcomes of this study, these patterns identify culvert sedimentation-prone regions in Iowa and quantify empirical relationships between the drivers and culvert sedimentation degrees. A simple evaluation of the platform was performed to assess the usefulness and user satisfaction of the tool by professional users, and positive feedbacks are received.

11.
World J Pediatr Congenit Heart Surg ; 10(4): 426-432, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31307296

RESUMO

BACKGROUND: Single-stage biventricular repair remains a challenging and difficult decision in high-risk newborns and early infants with the presence of left ventricular outflow tract obstruction (LVOTO) or borderline hypoplasia of the left ventricle (LV). METHODS: Six high-risk patients underwent the initial hybrid procedure (bilateral pulmonary banding + ductal stenting) for staged biventricular repair. Their median age was 17 days (range: 7-55 days). The diagnosis was interrupted aortic arch (IAA), ventricular septal defect (VSD), and LVOTO (n = 3); IAA and VSD (n = 1); and aortic annular hypoplasia, aortic arch hypoplasia, VSD, and LVOTO (n = 1). The last patient had borderline LV with large atrial septal defect (ASD) and aortic arch hypoplasia. The patient with borderline LV had also ASD closure with small fenestration. RESULTS: One patient died of sepsis after the hybrid procedure. Other patients underwent biventricular repair 8 to 13 months later. Three patients had conventional repair with conal septum resection. The other patient with IAA, in whom LVOTO was considered nonresectable, underwent Yasui operation. The last patient with borderline LV had enough development of left heart structures during follow-up and underwent aortic arch repair. One patient who had conal septum resection died after biventricular repair. One patient needed a tracheostomy; four patients were discharged uneventfully and their clinical conditions were good on postoperative year 1. CONCLUSION: Staged biventricular repair with the initial hybrid procedure may be a feasible and safe alternative in high-risk neonates and early infants. Hybrid intervention may provide the development of cardiac structures in time and a better evaluation for the possibility of biventricular repair in borderline patients.


Assuntos
Coartação Aórtica/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Comunicação Interventricular/cirurgia , Ventrículos do Coração/cirurgia , Obstrução do Fluxo Ventricular Externo/cirurgia , Coartação Aórtica/complicações , Coartação Aórtica/diagnóstico , Ecocardiografia , Feminino , Comunicação Interventricular/complicações , Comunicação Interventricular/diagnóstico , Ventrículos do Coração/anormalidades , Humanos , Lactente , Recém-Nascido , Masculino , Obstrução do Fluxo Ventricular Externo/diagnóstico , Obstrução do Fluxo Ventricular Externo/etiologia
12.
Environ Sci Pollut Res Int ; 26(32): 32723-32733, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30847818

RESUMO

This study investigated the applicability of self-forming hollow fiber dynamic membrane (DM) as a low-cost alternative to ultrafiltration (UF) membrane. A hollow fiber polyester fabric was used as a support material to form the DM layer. Submerged DM and UF hollow fiber membrane were placed in the same reactor in order to compare the treatment and filtration performance of each membrane. Morphological analyses were also carried out for DM surface. The system was operated continuously at a flux of 5 L/m2 h for 85 days. High COD removal efficiency and total suspended solids (TSS) rejection were achieved by the DM. Transmembrane pressure (TMP) of the DM was higher in comparison to the UF membrane, which was related with the formation of cake layer in DM. DM technology can be used as an alternative to UF membrane for municipal wastewater treatment.


Assuntos
Membranas Artificiais , Eliminação de Resíduos Líquidos , Reatores Biológicos , Filtração , Ultrafiltração , Águas Residuárias , Purificação da Água
13.
Turk Gogus Kalp Damar Cerrahisi Derg ; 27(4): 471-477, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32082912

RESUMO

Background: In this study, we aimed to investigate the incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection. Methods: Between December 2010 and December 2016, a total of 40 patients (25 males, 15 females; mean age 45±41 days; range, 2 days to 6 months) who underwent total anomalous pulmonary venous connection repair were retrospectively analyzed. Results: Eighteen (45%) of the patients were supracardiac, seven (17.5%) were cardiac, eight (20%) were infracardiac, and seven (17.5%) were mixed-type anomaly. Twelve patients (30%) had obstruction of the pulmonary venous pathways. Hospital mortality was seen in three patients (7.5%). All of non-survivors received emergent surgery and the causes of death were sepsis and multiple organ failure. A total of 23 complications were seen in 20 patients (50%) mainly delayed sternal closure (n=11; 27.5%) and prolonged mechanical ventilation (n=6; 15%). The mean follow-up was 12.2±9.6 (range, 1 to 36) months in all patients, except one. Pulmonary vein stenosis developed in three patients (8.3%) after repair. All of them underwent sutureless repair. Conclusion: Total anomalous pulmonary venous connection can be repaired with low mortality and morbidity rates and favorable mid-term outcomes. Close follow-up is necessary due to the risk of development of pulmonary vein stenosis. Sutureless repair may provide relief in such cases.

14.
Turk Gogus Kalp Damar Cerrahisi Derg ; 28(2): 282-293, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32551158

RESUMO

Background: In this study, we present the outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants. Methods: In this study, a total of 97 pediatric patients who were operated due to hypoplastic left heart syndrome and its variants between March 2011 and October 2018 were retrospectively analyzed. Thirty-two of the patients (28 males, 4 females; median age 5 days; range, 1 to 25 days) underwent Norwood Stage I operation (Group N), while the remaining 65 patients (44 males, 21 females; median age 6 days; range, 1 to 55 days) underwent a hybrid procedure (Group H). Both treatment strategies were compared. Results: The median body weight in Group H was significantly lower and the number of patients with a low birth weight (<2,500 g) was significantly higher than Group N (p=0.002 and 0.004, respectively). The postoperative early mortality rate was similar between the groups. Univariate and multivariate analyses revealed that the need for preoperative mechanical ventilation was a significant factor for mortality (p=0.004 and 0.003, respectively). Syndromic appearance was also a significant factor the multivariate analysis (p=0.03). There was a statistically significant difference between the groups in terms of the inter-stage mortality rates (p=0.0045). Second-stage procedure was performed in 32 patients. The early mortality rate after the Glenn operation was 7.6%. Six patients died after comprehensive Stage II operation. Five patients underwent biventricular repair and 8 patients had third-stage fenestrated extracardiac Fontan operation (Group N, n=7 and Group H, n=1). The Kaplan-Meier survival curve demonstrated that Group N had a higher survival rate at both one and five years than Group H, although the difference was not statistically significant (p=0.15). Subgroup analysis showed that the Norwood procedure with Sano modification had the highest survival rate with 40% at five years. Conclusion: Our study results show that patients undergoing the Norwood procedure have a more uneventful course of inter-stage period and Stage II and III, despite drawbacks early after Stage I procedure. Based on our experiences, we recommend performing the hybrid intervention in patients with a poor clinical condition and a body weight of <2,500 g.

15.
Anesth Essays Res ; 12(1): 273-275, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29628596

RESUMO

Neurofibromatosis type 1 (NF1) is an autosomal-dominant neuroectodermal hereditary disorder, in which spinal skeletal deformities are one of the manifestations. Pectus carinatum, temporomandibular joint dysfunction, and kyphoscoliosis can be seen with this genetic disorder which can lead to cardiorespiratory system problems and can cause difficulty in airway management. We present the anesthetic management of a NF1 patient with a sharp thoracolumbar dystrophic kyphoscoliosis who have been posted for emergency cesarean section as a result of fetal distress. The operation was successfully performed with subarachnoid block. This case highlights the anesthetic challenges and the significance of early planning anesthetic technique.

16.
Turk Gogus Kalp Damar Cerrahisi Derg ; 26(3): 365-369, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32082765

RESUMO

Background: In this study, we aimed to evaluate the outcomes of truncus arteriosus repair in patients undergoing Rastelli type truncus arteriosus. Methods: A total of 13 patients (7 males, 6 females; median age 37 days; range, 16 to 60 days) underwent repair of truncus arteriosus using Contegra conduits between January 2011 and March 2 017. P reoperative d iagnosis w as t runcus a rteriosus type 1 (Edwards-Collett) in eight, type 2 in three, type 3 in one, and type 4 in one patient. Contegra conduits used for operations were 14 mm (n=5), 12 mm (n=7), and 16 mm (n=1). Results: Early death was seen in two patients (15.4%). The median intensive care and hospital stays were 10 (range, 6 to 14) and 20 (range, 14 to 41) days, respectively. The median follow-up was 36 (range, 2 to 66) months. In four patients (31%), the conduit sizes severely increased during follow-up and reached 23 mm in two patients and 20 mm in one patient, and 18 mm in the other patient. Three patients had moderate distal conduit stenosis. Moderate pulmonary insufficiency was detected in four patients and severe pulmonary insufficiency in one patient. Two patients had moderate truncal valve insufficiency and one patient had moderate residual ventricular septal defect. None of the patients needed reoperation. Conclusion: Contegra conduit is a good alternative for repair of truncus arteriosus in infants; however close follow-up is necessary, as distal conduit stenosis and conduit dilatation may develop.

17.
Turk Gogus Kalp Damar Cerrahisi Derg ; 26(3): 370-374, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32082766

RESUMO

Background: In this study, we analyzed the impact of pulmonary valve-sparing techniques on early and midterm postoperative results of tetralogy of Fallot repair. Methods: A total of 64 patients diagnosed with tetralogy of Fallot, who underwent total correction operation by the same surgeon between November 2010 and September 2015 were included in this retrospective study. Mean age of the patients was 20.0±14.2 months (5.5-96 months). Forty patients (62.5%) were male. Thirty two of the patients (50%) were under one year of age. Pulmonary valve-sparing techniques were performed in 29 patients (Group 2), while transannular patch was applied in the remaining 35 patients (Group 1). Pericardial monocusp valve was constructed in 15 patients in Group 1. In Group 2, pulmonary valve-sparing techniques were transatrial repair in nine patients; transatrial-transpulmonary in eight, infundibular patch in eight, and infundibular-pulmonary patch in four patients. Results: There was no early postoperative mortality in Group 2. Five patients (14.2%) in Group 1 died in the early postoperative period (p=0.058). Pulmonary monocusp insertion was performed in 2 (13.3%) of these patients (p=1). The causes of mortality were sudden cardiac arrest (n=2), multiorgan failure (n=1), low cardiac output (n=1), and neurological complications (n=1). Five patients in Group 1 required extracorporeal membrane oxygenation support (ECMO). Three of them were separated from ECMO and two of the patients that were separated were discharged uneventfully. Total postoperative morbidity rate was significantly higher in Group 1 (51.4% vs. 6.8%) (p=0.0001). Morbidity rate was significantly lower in patients with pulmonary monocusp insertion than patients in the same group without a monocusp (p=0.0176). Forty nine (83%) of the patients were followed up for a median of 6.5 (1-24) months. While free pulmonary regurgitation was detected in all non-monocusp patients in Group 1, pulmonary regurgitation was absent or mild in Group 2. Twelve (80%) of the patients in Group 1 who had monocusp insertion were followed up. Only two of these patients had free pulmonary regurgitation (16.6%). The rest of them had mild (n=6) or mildmoderate pulmonary regurgitation (n=4). Conclusion: Mortality and morbidity rates are lower when pulmonary valvesparing techniques are used in repair of tetralogy of Fallot. Monocusp pulmonary valve insertion may improve results in patients who require transannular patch repair. It is suggested that every effort should be made to achieve a competently working pulmonary valve during repair.

18.
Ann Vasc Surg ; 46: 368.e13-368.e17, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28890061

RESUMO

Atherosclerosis is a systemic disease, and multiarterial involvement is common. Involvement of all the supra-aortic arteries may occur in the same patient making cerebral revascularization challenging. In this report, we present complete supra-aortic revascularization, that is, revascularization of the bilateral common carotid and subclavian arteries in a 51-year-old male patient with occluded brachiocephalic trunk, left subclavian artery, and proximally stenotic left common carotid artery. A temporary ascending aorta to left external carotid artery bypass provided meticulous cerebral protection with pulsatile cerebral flow in the presence of a proximal arterial clamp; hence, a neurologically uneventful procedure during bilateral common carotid artery revascularization.


Assuntos
Aorta/cirurgia , Implante de Prótese Vascular , Artéria Carótida Primitiva/cirurgia , Artéria Carótida Externa/cirurgia , Estenose das Carótidas/cirurgia , Transtornos Cerebrovasculares/prevenção & controle , Endarterectomia das Carótidas , Veia Safena/transplante , Artéria Subclávia/cirurgia , Aorta/diagnóstico por imagem , Aorta/fisiopatologia , Implante de Prótese Vascular/efeitos adversos , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Carótida Primitiva/fisiopatologia , Artéria Carótida Externa/diagnóstico por imagem , Artéria Carótida Externa/fisiopatologia , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/fisiopatologia , Circulação Cerebrovascular , Transtornos Cerebrovasculares/etiologia , Transtornos Cerebrovasculares/fisiopatologia , Angiografia por Tomografia Computadorizada , Endarterectomia das Carótidas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/fisiopatologia , Resultado do Tratamento , Grau de Desobstrução Vascular
19.
Waste Manag Res ; 36(2): 131-139, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29228879

RESUMO

This article estimates greenhouse gas emissions and global warming factors resulting from collection of municipal solid waste to the transfer stations or landfills in Istanbul for the year of 2015. The aim of this study is to quantify and compare diesel fuel consumption and estimate the greenhouse gas emissions and global warming factors associated with municipal solid waste collection of the 39 districts of Istanbul. Each district's greenhouse gas emissions resulting from the provision and combustion of diesel fuel was estimated by considering the number of collection trips and distances to municipal solid waste facilities. The estimated greenhouse gases and global warming factors for the districts varied from 61.2 to 2759.1 t CO2-eq and from 4.60 to 15.20 kg CO2-eq t-1, respectively. The total greenhouse gas emission was estimated as 46.4E3 t CO2-eq. Lastly, the collection data from the districts was used to parameterise a collection model that can be used to estimate fuel consumption associated with municipal solid waste collection. This mechanistic model can then be used to predict future fuel consumption and greenhouse gas emissions associated with municipal solid waste collection based on projected population, waste generation, and distance to transfer stations and landfills. The greenhouse gas emissions can be reduced by decreasing the trip numbers and trip distances, building more transfer stations around the city, and making sure that the collection trucks are full in each trip.


Assuntos
Gases de Efeito Estufa , Eliminação de Resíduos , Efeito Estufa , Resíduos Sólidos , Turquia
20.
Turk Kardiyol Dern Ars ; 45(6): 538-540, 2017 Sep.
Artigo em Turco | MEDLINE | ID: mdl-28902645

RESUMO

Pulmonary arteriovenous malformation, which is defined as the presence of an ab-normal connection between the pulmonary artery and pulmonary vein, is rarely seen. Although it generally presents as a congenital condition, it may be accompanied by hereditary hemorrhagic telangiectasia. Clinical signs vary according to the amount of shunt in proportion to the number and size of the fistulae. Patients may present with cyanosis and respiratory trouble. If the disease remains untreated, it may result in cardiac failure and ineffective endocarditis, thereby leading to the rupture of the an-eurysmal fistula. Transcatheter embolization of abnormal vascular connection is the current treatment method in this disease. This article describes the case of an 8½-year-old child. He was presented with the symptom of getting tired quickly. Transcutaneous oxygen saturation of 75%, and pulmonary arteriovenous malfor-mation was detected in his examination. Successful transcatheter fistula embolization was performed.


Assuntos
Malformações Arteriovenosas/complicações , Cianose/etiologia , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Criança , Ecocardiografia , Embolização Terapêutica/métodos , Feminino , Humanos , Dispositivo para Oclusão Septal
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