Stress Test Results Research Articles

Cardiac evaluation for end-stage kidney disease patients on the transplant waitlist: a single-center cohort study.

BackgroundCardiac evaluation before deceased donor kidney transplant (DDKT) remains a matter of debate. Data on Asian countries and countries with prolonged waiting times are lacking. This study aimed to assess the outcomes of patients referred for DDKT after a cardiac evaluation at an Asian tertiary transplant center.MethodsThis single-center retrospective review analyzed patients who were referred for waitlist placement and underwent cardiac stress testing between January 2009 and December 2015. Patients with cardiac symptoms were excluded. The primary outcome was three-point major adverse cardiovascular events (MACE), a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death.ResultsOf 468 patients referred for DDKT, 198 who underwent cardiac stress testing (myocardial perfusion studies in 159 patients and stress echocardiography in 39 patients) were analyzed. MACE occurred in 20.7% of the patients over a median follow-up of 4.6 years. Cardiac stress tests were positive for ischemia in 19.7% of the patients. Coronary angiography was performed in 63 patients, including 29 patients with diabetic kidney disease and negative cardiac stress tests. Significant coronary artery disease (CAD) was detected in 27 patients (42.8%), of whom 18 underwent revascularization. MACE was associated with significant CAD on coronary angiography in the multivariable analysis. Cardiac stress test results were not associated with MACE. Amongst diabetic patients who had negative cardiac stress tests, 37.9% had significant CAD on coronary angiography.ConclusionsThe cardiovascular disease burden is significant amongst DDKT waitlist candidates. Pretransplant cardiac screening may identify patients with significant CAD at higher risk of MACE.

Ischemia With Nonobstructive Coronary Arteries: Insights From the ISCHEMIA Trial

BackgroundIschemia with nonobstructive coronary arteries (INOCA) is common clinically, particularly among women, but its prevalence among patients with at least moderate ischemia and the relationship between ischemia severity and non-obstructive atherosclerosis severity are unknown. ObjectivesThe authors investigated predictors of INOCA in enrolled, nonrandomized participants in ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches), sex differences, and the relationship between ischemia and atherosclerosis in patients with INOCA. MethodsCore laboratories independently reviewed screening noninvasive stress test results (nuclear imaging, echocardiography, magnetic resonance imaging or nonimaging exercise tolerance testing), and coronary computed tomography angiography (CCTA), blinded to results of the screening test. INOCA was defined as all stenoses <50% on CCTA in a patient with moderate or severe ischemia on stress testing. INOCA patients, who were excluded from randomization, were compared with randomized participants with ≥50% stenosis in ≥1 vessel and moderate or severe ischemia. ResultsAmong 3,612 participants with core laboratory-confirmed moderate or severe ischemia and interpretable CCTA, 476 (13%) had INOCA. Patients with INOCA were younger, were predominantly female, and had fewer atherosclerosis risk factors. For each stress testing modality, the extent of ischemia tended to be less among patients with INOCA, particularly with nuclear imaging. There was no significant relationship between severity of ischemia and extent or severity of nonobstructive atherosclerosis on CCTA. On multivariable analysis, female sex was independently associated with INOCA (odds ratio: 4.2 [95% CI: 3.4-5.2]). ConclusionsAmong participants enrolled in ISCHEMIA with core laboratory-confirmed moderate or severe ischemia, the prevalence of INOCA was 13%. Severity of ischemia was not associated with severity of nonobstructive atherosclerosis. (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches [ISCHEMIA]; NCT01471522)

Characterization of Biodegradable Composites from Polypropylene, Polypropylene Grafted Maleic Anhydride, and Durian Seed Starch

The characterization of biodegradable composite from durian seed starch that is mixed polypropylene, and polypropylene grafted maleic anhydride has been done. The stages of this preparation were, the first had prepared durian seed starch, the second had the process of grafting maleic anhydride into polypropylene and the third had made of composite with the composition of PP:PP-g-MA: DSS (7:0.5:0.2); (7:0.5:0.3); (7:0.5:0.4); (7:0.5:0.5); (7:0.5:0.6) (w/w). The biodegradable composites obtained were characterized by tensile strength, surface morphology analysis by SEM, differential thermal analysis (DTA), analysis in nature with the ability to decompose biodegradable test, and functional groups analysis by FTIR spectroscopy. The results showed that the biodegradable composites have the best properties in the ratio of PP:PP-g-MA: DSS was (7:0.5:0.5) (w/w) with the test results of tensile stress is 12.556 N/m2, and the elongation is 8.600%, the images on a few flat surfaces and improved homogeneity, temperature change, and strong group interactions as well as having good biodegradable properties.

Influence of pin profile on formability of friction stir-welded aluminum tailor-welded blanks: an experimental and finite element simulation analysis

In sheet metal forming processes, the forming limit diagram is frequently employed as a criterion for predicting necking initiation. This is one of the most useful and effective methods for the evaluation of the formability of tailor-welded blanks. The goal of this study was to determine the formability of friction stir-welded (FSW) aluminium alloy 6061-temper 6 (AA6061-T6) and aluminium alloy 2017-temper 6 (AA2017-T6) by employing five dissimilar tool pin profiles. To evaluate the limiting dome height, five different combinations of dissimilar blanks were used in experimental and simulation experiments. Material characteristics such as density, elastic modulus, and all multilinear behaviors of blanks were manually assigned for simulation from the test results of true stress versus true strain plots. The punch with die supports was considered as a rigid body, whereas the metallic blanks were considered as plastic material. To carry out the simulation, the entire blank was divided into three zones. The results obtained from the experimental and simulation results showed that the straight square tool pin profile is the optimal tool pin profile for the formability of FSW AA6061-T6 and AA2017-T6. The tested height values obtained from the limiting dome height were 20.5 and 20.9 mm in experimentation and simulation, respectively. The straight cylindrical tool pin profile exhibited the worst formability properties in both experimentation and simulation.

Prognostic Role of Cardiac Power in a Large Cohort of Patients with Normal Ejection Fraction Referred for Dobutamine Stress Echocardiography

Cardiac power reflects cardiac performance in terms of energy transferred by the left ventricle to the aorta per unit time. Peak stress cardiac power has been shown to predict outcomes in patients with reduced left ventricular ejection fraction (LVEF) and, more recently, in patients with normal LVEF referred for exercise stress echocardiography. The aim of this study was to evaluate the prognostic significance of cardiac power in patients with normal LVEF referred for dobutamine stress echocardiography. Data were studied from 15,576 patients with LVEF ≥ 50% and no significant valvular or right ventricular dysfunction who underwent dobutamine stress echocardiography. Cardiac power at rest and peak stress and power reserve (peak stress minus rest power) were calculated and normalized to left ventricular mass. Outcome end points were all-cause mortality and new-onset heart failure (HF). The mean age was 66±13years, and 49% patients were women. Resting and peak stress power/mass were 0.7±0.2 and 1.6±0.6W/100g left ventricular myocardium, respectively. During follow-up (median, 3.3years; interquartile range, 0.7-7.3years), 2,278 patients died and 2,137 developed HF. After adjusting for age, sex, comorbidities, and stress test results, lower peak stress power/mass was independently associated with mortality (adjusted hazard ratio, highest vs lowest quartile, 0.84; 95% CI, 0.74-0.95; P=.004) and HF at follow-up (adjusted hazard ratio, 0.67; 95% CI, 0.59-0.76; P&lt;.0001). Power reserve showed similar associations with outcomes. Assessment of cardiac power during dobutamine stress echocardiography in patients with normal LVEF provides valuable prognostic information regarding risk for mortality and future HF, in addition to stress test results. It is an important research tool to study cardiac performance, and the development of risk scores incorporating this novel index could be considered after further validation in prospective studies.

Development of Wide-Angle Short-Wave Pass Thin Film Based on the Ultra-Thin Silicate Glass.

With the rapid development of laser medicine, there are higher requirements placed on the performance of optical components in various medical systems. This paper is aimed at exploring the critical optical devices of medical equipment for treating periodontitis and gingivitis. The cathode sputtering method was used to produce the wide-angle short-wave pass filter, and a hundreds grid fastness test was conducted to detect the occurrence of film peeling. Considering the results of SEM, transmission spectrum, and stress test of the sample, an analysis was conducted as to the cause of poor bonding force for the film. By increasing the amount of argon gas and adjusting the baking temperature, the problem of film peeling was resolved. Besides, a short-wave pass filter film with good bonding and low roughness was obtained to meet the requirements of laser medical equipment.

Non Stress Test as a Predictor of Maternal and Fetal Outcome in Patients Presenting with Reduced Fetal Movement at Term.

Establishing the predictive utility of Non stress test could be helpful to improve perinatal outcome especially in countries like Nepal, with heavy workload and limited resources. The aim of the study was to assess association between Non stress test abnormalities and fetal outcome in terms of Apgar score and newborn intensive care unit admission rate for patient with decreased fetal movement. The study included total 54 women with decreased fetal movement at term without any pregnancy complication not in labor admitted to paropakar maternity and women's hospital, Thapathali, Kathmandu from June 2020 to December 2020. Non stress test was done for 20 to 40 minutes and the readings were categorized in to three groups. The results were compared to see the relationship between normal, suspicious and abnormal Non stress test result in terms of mode of delivery, Apgar score, neonatal resuscitation and need for neonatal intensive care unit newborn intensive care unit admission. Total 54 cases remained under inclusion criteria were included in this study. Mode of delivery on the basis of Non stress test result shows that 31.48% with abnormal Non stress test had a Lower segment Caesarian section, 1.8% had instrumental vaginal delivery and 14.8% had spontaneous vaginal delivery. While in reassuring Non stress test group 20.4% had spontaneous vaginal, 0% had Lower segment Caesarian section and 1.85% had instrumental vaginal delivery. There is statistically significant relationship between Non stress test result and Apgar score. In reactive Non stress test result only5.4% required neonatal resuscitation. However, in persistently non-reassuring or abnormal Non stress test result, 62.1% require neonatal resuscitation. Similarly, in reactive Non stress test result none of the neonate required newborn intensive care unit admission. However, in persistently non-reassuring or abnormal Non stress test result 46.1% neonates require newborn intensive care unit admission. There were 9 neonatal mortalities from abnormal Non stress test result. We concluded that the Non stress test is a good predictor of maternal and fetal outcome detecting fetal hypoxia already present or likely to develop in patient presenting with reduced fetal movement in term pregnancies without complication.

Study on Dynamic Performance of Standard Sand Based on KTL Dynamic Triaxial Apparatus

The determination of dynamic properties is of great scientific significance to the constitutive modeling and parameter determination of large deformation for sand liquefaction. For Fujian standard sand, a new high-precision KTL bidirectional dynamic triaxial test system was used to carry out liquefaction tests under equal consolidation and different equal amplitude cyclic stresses. The dynamic characteristics of Fujian standard sand, such as dynamic stress and dynamic strain test results, pore water pressure model, effective stress path, and stress-strain relationship curve, were studied. The main results are as follows: the whole vibration process of the sample could be basically divided into four stages: the greater the dynamic stress is, the easier the sample is to liquefy. With the increasing vibration times, the samples under different dynamic stress amplitudes meet the qualitative analysis of the first three stages of liquefaction; that is, the pore water pressure increases rapidly at the beginning of vibration, and the growth is stable in the middle stage. When the effective pore water pressure increases to 60 kPa, it begins to increase sharply and finally reaches the effective confining pressure, and then, the soil sample liquefies. The axial strain begins to accumulate in the compression direction and gradually increases. After liquefaction, the strain accumulates in the tensile direction in equal amplitude. During the whole vibration process, the axial strain of the sample can develop greatly in the tensile and compressive direction. Under the action of different cyclic stresses, the stress path of the soil sample tends to zero, and the rate of effective stress state varies greatly, indicating that the dynamic stress has a great influence on the dynamic liquefaction process of Fujian standard sand. In the dynamic triaxial test of standard sand, the difference in dynamic stress amplitude will lead to great changes in the stress-strain relationship curve. But it has little effect on the analysis of liquefaction dynamic characteristics of sand.

Withdrawn as Duplicate: Bank Stress Testing: Public Interest or Regulatory Capture?

Abstract We test whether measures of influence on regulators affect stress test outcomes. The large trading banks—those most plausibly ‘Too Big to Fail’ – face the toughest tests. Supervisory stress tests have a greater effect on large trading banks’ portfolios; the large banks respond by making more conservative (initial) capital plans; and, despite their more conservative capital plans, the large banks still fail their tests more frequently than other banks. In contrast, while we find little evidence that political or regulatory connections affect the quantitative element of the stress tests, these connected banks do face less scrutiny under its qualitative dimension.

The role of ginger’s extract and N-acetylcysteine against docetaxel-induced oxidative stress and genetic disorder

Oxidative stress plays a prominent role in expanding toxicity and various diseases. This study investigated the potential protective effects of ginger (Zingiber officinale) rhizome extract and NAC on docetaxel induced genotoxicity and oxidative stress. The antioxidant power of NAC and ginger extract on the genetic toxicity induced by docetaxel was assessed by micronucleus test. The ROS test with DCFH reagent was used to assess the reactive oxygen species. The thiobarbituric acid method was used to evaluate the amount of MDA produced by docetaxel. The amounts of phenol and flavonoids in the ginger extracts were also evaluated. The amount of phenol in the ginger extract was 0.886 mg of gallic acid per gram of dry extract. The amount of flavonoids were 0.242 mg/mL of quercetin per gram of dry extract. As shown by the micronucleus results, concentrations of 100 and 500 μM NAC and all concentrations of the ginger extract significantly reduced the number of micronuclei produced by docetaxel. On the other hand, the results of oxidative stress tests (ROS and LPO) showed that docetaxel in HGF cells increased the production of ROS and LPO, and the concentrations of ginger extract and NAC decreased oxidative stress in HGF cells in a dose-dependent manner. The results indicate that using these two antioxidants helps inhibit genetic toxicity and oxidative stress caused by docetaxel.

Startup Process Optimization of Hydropower Unit Based on Stress Measurement of Francis Turbine Runner

The energy efficiency characteristics of the turbine, cavitation performance of the runner, and operation stability of the unit are the three major concerns of a hydropower field, the latter two factors leading to the units’ cavitation and stability problems under some operation conditions and fatigue failure of the runner blades, which are the main causes of structural and mechanical failure for the hydropower units. In this article, three conventional unit startup processes are introduced, and combined with the optimal impulse control strategy, an optimized unit startup method is proposed. As the optimal guide vane opening adjustment setting value is obtained by solving the planned startup control strategy, 3D modeling and CFD simulation are carried out, then the equivalent stress characteristics are obtained by finite element calculation when the unit is running from startup to no load at a rated speed on three different startup modes. At last, the dynamic stress tests of the runner blade are performed at the hydropower station by using wireless acquisition and transmission technology, and the peak value and characteristics of the dynamic and static stresses of the blade under different startup processes are obtained. In this, the validity of the model analysis is proved by the comparison between the simulation calculation and the measured results, and the effectiveness of the startup control strategy is proved by combining the runner blade dynamic stress simulation, calculation, and the field dynamic stress test results. The optimization method of the startup process proposed in the article can alleviate the abnormal vibration of the unit and provide a basis for long-term stable operation of the hydropower unit.

Bank Stress Testing: Public Interest or Regulatory Capture?

AbstractWe test whether measures of influence on regulators affect stress-test outcomes. The large trading banks—those most plausibly Too Big to Fail—face the toughest tests. Supervisory stress tests have a greater effect on large trading banks’ portfolios; the large banks respond by making more conservative (initial) capital plans; and, despite their more conservative capital plans, the large banks still fail their tests more frequently than other banks. In contrast, while we find little evidence that political or regulatory connections affect the quantitative element of the stress tests, these connected banks do face less scrutiny under its qualitative dimension.

Automation Reduces Human Error in Influx Detection and Well Control

This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 208784, “Reducing Human Error Through Automatic Kick Detection, Space Out, and Dynamic Well Monitoring,” by Francesco Curina, Elia Abdo, SPE, and Hadi Mustapha, SPE, Drillmec. The paper has not been peer reviewed. Influx detection and well control are critical situations where the traditional human reaction has been the accepted standard for years. This paper discusses the results of the driller stress tests and the implementation of a system to assist the operator in kick detection, space out, and preparation for well shut-in. The system implements dynamic well monitoring to reduce the risk of false alarms. The objective is to prove how automation helps mitigate human factors. Operator Stress Test To design an automation system, the first step is to understand which parts of the operation require automation. To do this, a stress test was conducted on a number of drillers to identify periods during well control where stress levels were higher than usual. The indices used were based on two parameters: the body temperature and the sudomotor activity. The two parameters can be used to assign a stress index for the operator. The operators were tested using a well-control simulator and an internationally recognized standard well-control exercise. The test procedure was as follows: The operator would start performing a standard drilling operation while monitoring parameters. Once the kick occurs, the driller should be able to identify it using the correct parameters, perform a space out operation, and shut down the equipment. He should then, perform a flow check, and, if the check is positive, he should shut in the well. In one representative test, the operator was not able to instantaneously identify the influx. Once he did identify the kick, his stress levels increased, hitting the maximum stress index value of five (5). The period of relatively low stress that followed is a natural physiological reaction that usually occurs after a shocking event. During this stretch of time, the operator did not yet move to mitigate the situation. The operator then proceeded to conduct a space out per standard procedure. The constantly high stress level seen during the space out operation confirms a previously proposed theory that this operation is accompanied by a wide margin for errors and a high risk factor. With the space out completed, the operator stopped the rotation of the drill string, shut off the pumps, and conducted a flow check. Then he proceeded to shut in the well by closing the annular blowout preventer (BOP). In this specific trial, the annular BOP was configured to develop a leak. When the operator activated the annular BOP and proceeded with a flow check, the stress levels increased for a short duration while he was analyzing the parameters. The operator understood the faulty BOP element and proceeded to close the second element. In this case, the operator correctly performed the procedure; however, it took him some time to reach a conclusion and perform the needed process. The results of the tests clearly identify two moments where the driller either made mistakes, had a slow reaction time, or had a decreased clarity of mind caused by high level of stress.

Study on the Law of Rock Anelastic Recovery and the Characteristics of In Situ Stress Field of 2000 m Deep Stratum in Metal Mines of Coastal Area

In situ stress field in deep strata is dominated by self-weight stress and tectonic stress, which is the dynamic source of a series of mining dynamic disasters such as rock burst, mine earthquake, and collapse. To develop deep resources and build deep engineering construction, the distribution characteristics of the in situ stress field must first be ascertained, so as to provide a basic basis for the engineering surrounding rock support design and disaster risk prevention and control. In this paper, taking the Sanshandao Gold Mine in the coastal area as the engineering background, in the early stage of the construction of the 2000 m deep shaft, the anelastic strain recovery method was used to measure the deep in situ stress field. The laws and characteristics of hysteretic elastic recovery of rock at different depths are obtained through experiments, and the effects of temperature, time, and other factors on strain recovery are revealed. The in situ stress test results are basically consistent with the traditional test methods. This method has low operational complexity and better application effect in deep formations. The research has accumulated test experience and basis for carrying out in situ stress measurement in the range of 2000 m and even deeper.

Stress as a modifier of the effects of technogenic and radiation exposure within low doses area

Introduction. Currently, the influence of the psychoemotional state of a person on the results of exposure to exogenous damaging factors is well studied. However, until now, this circumstance has been taken into account when assessing the stochastic effects of radiation. The work is devoted to analyzing the influence of the psychoemotional state of a person (stress) on the results of irradiation in the range of 10-1000 mGy. Materials and methods. The results of our research and literature data on the effects of chemical and radiation factors, taking into account the level of stress, on the health of the studied cohorts are summarized. Results. The article summarizes the results of our studies of the effects of genome instability in adults and children from large and small industrial cities of Russia and Kazakhstan, taking into account the severity of stress. It was shown that the genotoxic effects of exogenous toxic and radiation factors acting, including in vitro, were comparable with the degree of severity of stress determined using standard psychological tests. The main damaging factor in the groups of liquidators was the state of pronounced maladaptive stress. The study established that to assess the stochastic effects of training and their relationship with the dose, it is also necessary to allocate a group of adaptive and maladaptive stress based on the results of stress testing. The differences in the results can be 2-3 times. The authors propose a new approach to stress assessment, which provides an adequate forecast of possible changes in the individual sensitivity of the genome to the action of exogenous toxic and genotoxic factors, including ionizing radiation. Conclusion. The peculiarities of the body’s perception of weak stressors of a physical nature should be taken into account when analyzing the medical consequences of exposure to ionizing radiation. To quantify the stochastic effects of the effectiveness of protective measures, it is proposed to use a coefficient that considers the impact of stress - the stress coefficient (SC), and its value, before conducting clarifying studies, should be taken equal to 2.

When banks punch back: Macrofinancial feedback loops in stress tests

In the presence of adverse macroeconomic shocks, simultaneous capital losses in multiple banks can prompt them to contract their balance sheets. These bank responses generate externalities that propagate in the form of macrofinancial feedback loops. This paper develops a credit response and externalities analysis model (CREAM) that integrates a disaggregated banking sector into an otherwise standard macroeconomic structural vector autoregressive model. It shows that accounting for macrofinancial feedback loops can significantly affect macroeconomic outcomes and bank-specific stress test results. The heterogeneity in bank lending responses matters: it determines how each bank fares under adverse conditions and the external effects that banks impose on each other and on economic activity. The model can thus be used to assess the contributions of individual banks to systemic risk along the time dimension.

Gender-Associated Outcomes Following Percutaneous Coronary Intervention With a Third-Generation, Ultrathin-Strut Drug-Eluting Stent: A Real-World, Single-Center Experience.

IntroductionIn recent years, the new third-generation ultrathin bioresorbable-polymer sirolimus-eluting stent (BP-SES), characterized by some of the thinnest struts among commercially available devices (60–80 μm) and an amorphous silicon carbide coating, has been introduced for the treatment of coronary artery disease (CAD). The present study aimed to assess different clinical outcomes and safety of this drug-eluting stent in male and female patients in a real-world setting.MethodsThe present study is a retrospective analysis including all patients treated with BP-SES between January 2017 and December 2019 at a single high-volume center. Follow-up data, including stress test results and clinical setting, were collected during outpatient visits or by telephone contact. Patients symptomatic for angina or with a positive stress test were addressed to CT scan/coronary angiogram. The main study outcome was target lesion failure (TLF), defined as a composite of cardiovascular death, target vessel myocardial infarction, or target lesion revascularization.ResultsOverall, 66 (15.9%) female and 349 (84.1%) male patients were included; women were older (median age 70 vs. 66, P = 0.003) and with a lower body mass index (BMI) (25.0 vs. 26.1, P = 0.010) compared to men, with no other relevant differences in baseline characteristics. Indication for percutaneous coronary intervention (PCI) was acute coronary syndrome in 86 (20.7%) of the cases, with no significant differences between male and female patients. A total of 558 lesions were treated with BP-SES stents, 90 in women and 468 in men (1.36 vs. 1.34 lesions per patient, P = 0.83); cumulative stent length (33.6 vs. 38.4 mm, P = 0.078), and mean stent diameter (2.92 vs. 3.0 mm, P = 0.39) did not differ in women compared to men. Technical and clinical successes were achieved in all patients. Stent thrombosis (ST) occurred in 2 (0.5%) patients, both men. TLF occurred in 10 (2.9%) men and 2 (3.0%) women after a median follow-up of 402 days, without significant differences at log-rank analysis (2.34 events per 100 patient-years in men, 2.53 in women; P = 0.80).ConclusionUltrathin struts BP-SES showed to be a safe and effective option for the treatment of CAD in both women and men, with a very low ST rate and favorable long-term outcomes.

Left ventricular regional longitudinal strain assessed during speckle-tracking stress echocardiography with physical exercise may identify severe coronary artery disease

Abstract Funding Acknowledgements Type of funding sources: None. Background. Assessment of global longitudinal strain of the left ventricular (LV) myocardium during stress echocardiography showed promising results in diagnosing transient myocardial ischemia. Regional longitudinal strain (RLS) allows to evaluate LV systolic function more precisely. However, due to the heterogeneity of LV segments contraction, an isolated assessment of LV RLS values can be challenging. We suggest that evaluation of the mean LV RLS values for the basal, middle and apical regions of the LV during stress echocardiography may be more useful in clinical setting. Aim of the study. The aim of the study was to determine the diagnostic capabilities of the LV RLS assessed during stress echocardiography with exercise on the treadmill in defining the presence and significance of coronary artery disease (CAD). Methods. The study included 132 patients (65.0 ± 9.3 years, 85 men) with known or suspected CAD. All patients underwent speckle-tracking stress echocardiography with exercise on the treadmill. At rest and after treadmill test all patients were measured for the values of LV RLS using the AFI (Automated functional imaging) algorithm. The LV RLS values for basal, middle and apical regions were calculated as the ratio of the sum of LV RLS values of the segments of each region to the number of segments. Segments of the LV were represented with the standard 17-segment model of the LV, 1-6 segments were assigned as basal segments; 7-12 segments as middle segments and 13-17 as apical segments (Picture 1). All patients underwent coronary angiography; the severity of CAD was assessed using the Gensini score. According to the results of coronary angiography, patients were divided into 3 groups: group 1 – 42 patients without CAD, group 2 – 63 patients with moderate CAD (&amp;lt;34 points on the Gensini score) and group 3 – 27 patients with severe CAD (≥ 35 points on the Gensini score). Results. At rest LV RLS values in basal, middle and apical regions did not significantly differ between the groups. Picture 2 shows that after the load, LV RLS values in basal, middle and apical regions in patients with severe CAD were significantly lower than in groups of patients without CAD and with moderate CAD. The values of LV RLS in patients with severe CAD decreased in all regions after the load, while in patients without CAD and with moderate CAD, LV RLS values increased in middle and apical regions and decreased in basal region. Conclusion. In patients with severe CAD (≥ 35 points on the Gensini score) after the load on the treadmill LV RLS values in all regions were significantly lower than in patients without CAD and with moderate CAD. Thus, LV RLS assessed during speckle-tracking stress echocardiography on the treadmill may be useful in identifying patients with severe CAD. Abstract Figure. Picture 1. 17-segment model of the LV Abstract Figure. Picture 2. Results of stress test

How Did Banks and Investors Respond to the 2020 Stress Test Results?

How Did Banks and Investors Respond to the 2020 Stress Test Results?

CLINICAL RESULTS AND PATIENT SATISFACTION OF TRANSOBTURATOR TAPE SURGERY IN PATIENTS WITH STRESS URINARY INCONTINENCE

Aim: In this retrospective study, we aimed to evaluate the surgical results, complications and patient satisfaction of the transobturator tape (TOT) operation in patients with stress urinary incontinence (SUI). Method: Incontinence type and duration, demographic information, menopause status, operation time , additional surgeries, preoperative and postoperative daily pad amount, Q type and stress test results, amount of residual urine after voiding, quality of life questionnaire Urinary Distress Inventory- 6 and Incontinence Impact Questionnaire-7 (UDI-6 and IIQ-7) results, intraoperative and postoperative complications of 156 patients were recorded. The success of the operation was evaluated in 3 groups as complete recovery, partial recovery and failure. Results: Complete or partial recovery was achieved in 146 patients (93.58%) after TOT operation. Success of operation was considered as failure in 10 (6.41%) patients. Complications were observed in 20 patients. These were bleeding more than 200 ml in 2 (1.28%), vaginal perforation in 2 (1.28%), de novo urge incontinence in 6 (3.84%), perineal pain in 2 (1.28%), dyspareunia in 2 (1.28%), mesh erosion in 4 (2.56%), urinary difficulty in 1 (0.64%), and bladder perforation in 1 (0.64%) patient. Conclusion: TOT procedure can be preferred as the surgical treatment of stress urinary incontinence, with high success and low complication rates, in line with the literature.