Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a working diagnosis in about 10% of cases presenting with symptoms suggestive of acute myocardial ischaemia and no significant atherosclerotic plaques in coronary angiography. It is a heterogenous clinical entity with a complex aetiology and always requires a challenging work-up. The final diagnosis may confirm any coronary pathology (dissection, spasm, thrombus) or significantly differ from the previous one (myocarditis, takotsubo cardiomyopathy). This paper focuses on the current knowledge on MINOCA, guidelines on the management of patients, and indicates new research areas to further elucidate this issue. The most important message is that MINOCA is a serious condition with outcomes at least as serious as in myocardial infarction resulting from coronary atherosclerosis. Streszczenie Zawał serca bez istotnych zmian w nasierdziowych tętnicach wieńcowych (MINOCA) to robocze rozpoznanie ustalane w ok. 10% przypadków, w których w koronarografii nie stwierdza się istotnych zwężeń miażdżycowych, a objawy kliniczne silnie sugerują podłoże niedokrwienne. Choroba stanowi istotne wyzwanie diagnostyczne ze względu na heterogenną etiologię i zawsze wymaga uważnego podejścia. Ostateczna diagnoza może potwierdzić przyczynę wieńcową (dysekcja, skurcz, zakrzep) lub znacznie różnić się od wstępnego rozpoznania (zapalenie mięśnia serca, kardiomiopatia takotsubo). W artykule przedstawiono zarys współczesnej wiedzy na temat MINOCA, obowiązujące zalecenia dotyczące diagnostyki i terapii oraz wskazano nowe kierunki badań niezbędnych do pełnego wyjaśnienia tego zagadnienia. Najważniejszym przesłaniem pracy jest wniosek, że mimo braku zwężeń w tętnicach wieńcowych MINOCA jest zespołem chorobowym o rokowaniu co najmniej tak poważnym jak w zawale serca o podłożu miażdżycowym.
BCM changes are typical for some chronic diseases, such as AIDS or cancer. Subjective global nutrition assessment (SGA) is the gold standard for determining nutritional status. ConclusionsThe phase angle value allows you to track the nutrition of the body as well as monitor recovery and physical fitness. Keeping BCM at the right level has a positive effect on your health. Maintaining BCM is a major goal in all types of nutrition therapies. FFMI allows observation of the effects of treatment, disease or aging patients.
Microprocessors and microcontrollers is a course that demands concurrent delivery of pragmatic and dogmatic approaches to the students in order to ensure effective learning. Online sessions and active learning for such courses pose challenges to both teachers and students, especially during this pandemic period. In order to combat these challenges, and to kindle the interest among the students in learning the course, a new methodology which supports blended learning through virtual experience is presented in this paper. The proposed methodology was implemented for the third year engineering students of circuit branches. This paper highlights the effectiveness of using open source emulating environments like Edsim51 and EMU8086 for providing a virtual laboratory experience to the students. These virtual environment provides a complete visualization of the internal functionality of the microprocessor/microcontroller architecture, and also enhances practical exposure of the students. In order to further augment the students' affinity towards the course, the teacher adopts different pedagogical approaches, which is best suited for ICT based blended learning in the online teaching environment. The assessment of this virtual experience is carried out using different online assessment components such as quizzes, assignments as concept maps/videos shared by the students, mini projects etc. Based on the assessment results, an analysis is carried out and it shows significant improvement in student engagement, in depth understanding of the course and improvement in programming skills of the students. Thus, this experience not only acts as a countermeasure to the lack of real time laboratory sessions but also promotes 'understanding by doing', which seems almost impossible during this pandemic situation.
IntroductionStroke is a very serious health problem. Its typical consequences include chronic physical and mental disability, more than half of all patients who survived stroke are dependent, depending on the help of other people even in everyday activities. Stroke is the death of parts of this organ as a result of stopping the blood supply to the brain tissue. There are two main types of stroke: ischemic and hemorrhagic. Aim The aim of the study is to analyze treatment methods and diagnose stroke.Material and method Review of available literature on the subject.ResultsIschemic stroke (about 4/5 of stroke cases) occurs when an artery supplying some part of the brain with blood becomes obstructed, i.e. blood does not flow through it or it flows from insufficient amount so that brain cells receive as much as they need. Atherosclerosis is the most common cause of narrowing or blockage of the artery. Hemorrhagic stroke (about 1/5 of stroke cases) occurs as a result of a cerebral artery wall rupture and blood spilling out of the vessel, as a result of which the blood does not reach the brain tissue in the area supplied by the ruptured artery. The blood escaping from the damaged vessel destroys the surrounding nervous tissue and causes an increase in pressure inside the skull, which disrupts the functioning of the entire brain. Hemorrhagic strokes are divided into intracerebral hemorrhages andsubarachnoid hemorrhage.According to the World Health Organization, around 15 million cases of stroke are diagnosed worldwide each year. Of this group, approximately 5 million die and another 5 million suffer from permanent disability. ConclusionsAnyone suspected of having a stroke should be taken to hospital immediately and under specialist medical care. Stroke is a medical emergency and the chances of recovery are greater the sooner treatment is started. Stroke, as the most important cause of chronic disability, is a disease that heavily burden the budget of healthcare systems.
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