Faint Pulse Research Articles

A case of anaphylactic shock to human fibrinogen infusion during cardiac surgery

Human fibrinogen (FIB) has been clinically proven to be considerably effective for the treatment of postoperative bleeding, with reported cases of allergic reactions to human FIB being rare. Here, we report a case of an anaphylactic shock in 27-year-old patients with rheumatic heart valve disease who received a human FIB infusion during mitral valve replacement, aortic valve replacement, and tricuspid valve-shaping surgery. The patients showed generalised profuse sweating, a barely noticeable skin rash, faint pulse, systolic pressure < 50 mmHg, and a heart rate of 71 beats/min. We share insights from a case of severe allergy to human FIB infusion during cardiac surgery, through which we have gained experience in the processes of diagnosing and treating. This report aims to provide a preliminary summary of the characteristics of this case to serve as a reference for fellow clinicians.

Sandwich Structure-based of Zinc Nanoparticle-enhanced Flexible Sensor

ABSTRACT Piezoresistive materials have excellent deformation response behavior, and their applications have expanded to include flexible sensors for human health monitoring. Existing studies have shown that by modifying the metal nanoparticles, sensors’ piezoresistive responses can be improved. As a result, in order to improve the detection ability of the chopped carbon fiber/polydimethylsiloxane (CCF/PDMS) composite for deformation behavior, zinc nanoparticles were used to modify the interlayer CCF at the microscopic scale, and systematic tests on the properties of the modified devices were conducted in this study. The results revealed that the resistance noise of the unmodified device was 60 ± 2 Ω, which dropped to 5 ± 2 Ω after modification, representing a reduction of up to 91.7%. When the device was modified with zinc nanoparticles for 180 seconds, its maximum signal-to-noise ratio was 16, which was doubled when compared to the unmodified device. The pressure sensitivity can reach 0.00788 ± 0.00041 kPa−1, demonstrating excellent durability and outstanding stability (over 5000 cycles). The prepared sensor demonstrated exceptional monitoring capability of faint pulse characteristic waves, which contributed to a thorough understanding of the piezoresistive response performance of human health monitoring sensors and the optimization design of microstructures in advanced CCF/PDMS composite materials.

Postoperative brachial artery entrapment associated with pediatric supracondylar fracture of the humerus: a case report

BackgroundSeverely displaced supracondylar fractures of the humerus in children are frequently associated with complications including neurovascular injuries, non-union, or compartment syndrome. In the current literature, no report exists about postoperative brachial artery entrapment in combination with an inconspicuous preoperative neurovascular examination.Case presentationWe present a case of a 6-year-old white boy with a pulseless radial and ulnar artery after open reduction and internal fixation of a severely displaced supracondylar fracture of his right humerus (Gartland type III) using four K-wires. Remarkably, the preoperative neurovascular examination was inconspicuous. Doppler ultrasound of his brachial artery revealed no pulse when his elbow was in flexion and a faint pulse when it was in full extension 10 hours postoperatively. Revision surgery was performed immediately. On intraoperative examination, a kinking of his brachial artery caused by an entrapment of the tunica externa in the reduced fracture was seen and the artery was released by microsurgical arteriolysis immediately. At the final follow-up examination, positive palpable pulse with good capillary filling and, according to Flynn’s criteria, an excellent recovery of elbow function was observed 3 months postoperatively.ConclusionsThis case demonstrates a rare complication of postoperative artery entrapment with inconspicuous preoperative neurovascular examination. It strongly emphasizes the need for a standardized postoperative neurovascular assessment with fully flexed as well as fully extended elbow.

Short delays and low pulse amplitudes produce widespread activation in the target-distance processing area of auditory cortex of the mustached bat.

While approaching an object, echolocating bats decrease the amplitude of their vocalizations. This behavior is known as "echo-level compensation." Here, the activation pattern of the cortical FM-FM (frequency modulated) area of the mustached bat is assessed by using acoustic stimuli that correspond to sonar signals and their echoes emitted during echo-level compensation behavior. Activation maps were calculated from the delay response areas of 86 cortical neurons, and these maps were used to explore the topography of cortical activation during echolocation and its relation to the bats' cortical "chronotopy." Chronotopy predicts short echo-delays to be represented by rostral auditory cortex neurons while caudal neurons represent long echo-delays. The results show that a chronotopic activation of the cortex is evident only at loud pulse amplitudes [80-90 dB sound pressure level (SPL)]. In response to fainter pulse levels (60-70 dB SPL), as those produced as the animals zoom-in on targets, chronotopic activation of the cortex becomes less clear because units throughout the FM-FM area start firing, especially in response to short echo-delays. The fact that cortical activity is more widespread in response to combinations of short echo-delays and faint pulse amplitudes could represent an adaptation that enhances cortical activity in the late stages of echo-level compensation.

The Myth of Mental Illness Revisited: Language Matters

The safety of the American public has been violated by a mental health treatment enterprise that is badly broken because it is based on a fundamentally flawed model of understanding distress and dysfunction. The system has generated language that has caused serious confusion among the public as well as the providers of mental health services. And language matters. Psychologists have drifted from their core identity and contributed significantly to this system by embracing the illness model as if it was their own. In their philosophical confusion feeding a myopic neuroscience zeitgeist, proponents of this flawed model and broken system have minimized the influence of psychological factors and emboldened a psychopharmaceutical industry that is now dangerously in control of the country’s mental health needs. Unless psychologists scrutinize the language on which they have become dependent and the practices dictated by that language, the broken system will be irreparable and the level of harm perpetrated on the American public will escalate from dangerous to perilous. Psychology is a unique basic science discipline among the mental health professions, and there is a faint pulse in the scientist–practitioner model of clinical psychology suggesting perhaps a glimmer of hope. Historians will not be kind to this era, and psychology will be found deeply culpable unless a major paradigm shift is achieved soon. Change cannot be accomplished without a complete rejection of the illness model and action to replace it in similar fashion to what is already under way in Great Britain.

Quantum optics. All-optical routing of single photons by a one-atom switch controlled by a single photon.

The prospect of quantum networks, in which quantum information is carried by single photons in photonic circuits, has long been the driving force behind the effort to achieve all-optical routing of single photons. We realized a single-photon-activated switch capable of routing a photon from any of its two inputs to any of its two outputs. Our device is based on a single atom coupled to a fiber-coupled, chip-based microresonator. A single reflected control photon toggles the switch from high reflection (R ~ 65%) to high transmission (T ~ 90%), with an average of ~1.5 control photons per switching event (~3, including linear losses). No additional control fields are required. The control and target photons are both in-fiber and practically identical, making this scheme compatible with scalable architectures for quantum information processing.

You made my heart stop

Okay, you are employed as an associate in any type of group practice you want to envision. One day, you are covering the office because the owner/orthodontist is away, and you hear a commotion in the reception area. When you go to see what's happening, you find that Mr Eclair, the father of a patient in the office, is lying on the floor with his eyes open; he is breathing heavily, and has a pale face and a faint pulse. You immediately tell the front desk to call 911 and ask whether there is an emergency kit in the office and, if so, to bring it out; you also ask the others in the reception area whether anyone there has medical training.

Discursive Resilience

Discursive Resilience

Smart CMOS image sensor for lightning detection and imaging

We present a CMOS image sensor dedicated to lightning detection and imaging. The detector has been designed to evaluate the potentiality of an on-chip lightning detection solution based on a smart sensor. This evaluation is performed in the frame of the predevelopment phase of the lightning detector that will be implemented in the Meteosat Third Generation Imager satellite for the European Space Agency. The lightning detection process is performed by a smart detector combining an in-pixel frame-to-frame difference comparison with an adjustable threshold and on-chip digital processing allowing an efficient localization of a faint lightning pulse on the entire large format array at a frequency of 1 kHz. A CMOS prototype sensor with a 256×256 pixel array and a 60 μm pixel pitch has been fabricated using a 0.35 μm 2P 5M technology and tested to validate the selected detection approach.

Successive transradial access for coronary procedures: Experience of Quebec Heart-Lung Institute

Transradial approach (TRA) for cardiac catheterizations and interventions improves clinical outcomes compared with transfemoral access, and its use is increasing worldwide. However, there are limited data on successive use of same artery for repeat procedures. Between May 2010 and May 2011, all consecutive patients undergoing a repeat TRA procedure (≥2) were retrospectively identified. Success rates and reasons for failure to use ipsilateral radial artery for repeat access were identified. A total of 519 patients underwent 1,420 procedures. In 480 patients (92%), right radial artery was used as initial access, and left radial artery, in 39 patients. All patients underwent ≥2 procedures; 218 patients, ≥3; 87 patients, ≥4; 39 patients, ≥5; 19 patients, ≥6; 11 patients, ≥7; and 5 patients, ≥8 procedures. Two patients had, respectively, 9 and 10 procedures. The success rate for second attempt was 93%, 81% for third, and declining to 60% for ≥8. Linear regression analysis estimated a 5% failure rate for each repeat attempt (R(2) = 0.87, P = .007). The main reason for failure was related to clinical radial artery occlusion (RAO) including absent or faint pulse, poor oximetry, and failed puncture. All patients with clinical RAO were asymptomatic. By multivariate analysis, female gender (odds ratio [OR] 3.08, 95% CI 1.78-5.39, P < .0001), prior coronary artery bypass graft (OR 5.26, 95% CI 2.67-10.42, P < .0001), and repeat radial access (OR 2.14, 95% CI 1.70-2.76, P < .0001) were independent predictors of radial access failure. Successive TRA is both feasible and safe in most cases for up to 10 procedures. However, failure rate for TRA increases with successive procedures, primarily due to clinical RAO. Strategies to minimize the risks of chronic clinical RAO and allow repeat use of ipsilateral radial artery need to be further defined.

Unusual sites of metastatic involvement: intracardiac metastasis from laryngeal carcinoma

Cardiac metastatic squamous cell laryngeal carcinoma is rare. We report the case of a 49-year-old man with recurrent squamous laryngeal carcinoma presenting with right leg acute ischaemia and large mobile right and left cardiac masses. The patient has history of laryngeal squamous cell cancer surgically treated with total laryngectomy, thyroidectomy, and tracheostomy 2 years ago. He was admitted to our intensive care unit with acute right leg pain, left sided chest pain, hypotension 92/55, and tachycardia 112 bpm. On physical exam, he had a faint pulse of his right Posterior Tibial artery with a cold foot, but no discoloration. Heart sounds were normal with no murmur. Initial workup showed a Troponin of 0.27. An electrocardiogram showed sinus tachycardia, with inverted T waves in the Infero-lateral leads. Emergent surgical thrombectomy was done on his right leg with restoration of arterial blood flow to the affected limb. An echocardiogram showed a preserved left ventricular function with multiple areas of echogenic masses in all four cardiac chambers located at the annulus of the tricuspid valve, the right ventricular free wall and along the inter-ventricular septum. No intracardiac shunt was detected by contrast study. Computed tomography scan of the heart confirmed the presence of multiple exophytic intracardiac masses within the left atrium, the right ventricle, interventricular septum, and lateral free wall of the left ventricle. Immunohistochemical staining with cytokeratin of the emboli was consistent with malignant squamous cell carcinoma consistent with metastases of his known laryngeal squamous cell cancer.

A Guide to the Classics: The Skepticism of Professor Oakeshott

P OLITICAL PHILOSOPHY MAY NOT HAVE given up ghost as some of weary affirm. If a faint pulse can still be detected it is because of energies of a few suggestive thinkers. One of most interesting of them and certainly least known is Professor Michael Oakeshott. His writing is scant but provocative. Experience and Its Modes (1933) was praised by R. G. Collingwood as the high water mark of English thought upon history . The introduction to Blackwell edition of Hobbes' Leviathan was soon acclaimed a brilliant essay. Political Education (1951), his inaugural address at London School of Economics where to chagrin of socialists he succeeded late Professor Laski, was honored by a leading article in Times Literary Supplement, and drew retorts cavalier iconoclast from Mr. R. H. S. Crossman and Proust of political science from Mr. H. G. Nicholas. Although Oakeshott's critics have been numerous, few have succeeded in penetrating his cosmos of ideas. This perhaps has been due to occasionally esoteric qualities of his artistry and to his failure to draw together tangled skeins of his thought. Moreover he is a conservative whose conservatism defies customary classification. Unlike neo-Burkians who have appeared in England and America since last war, he has shown little sympathy for mysticism of natural law or idea of a program for conservatism, preferring to call it an attitude or state of mind. An early Hegelianism lends credence to opinion that he is a kind of Anglicized existentialist. But his position is apparently even more ambiguous because of his sympathy for speculative moderation of David Hume, a fact that might make him intellectually more congenial to London School than to Carlton Club. Before political ideas of Professor Oakeshott can be appraised every effort should be made to determine their exact nature. The task here, therefore, is primarily to understand rather than to criticize. What is he attempting to say? One clue seems to be a