The power of feedback.

Cause, conseguenze e strategie di mitigazione Proponiamo il primo di una serie di articoli in cui affronteremo l’attuale problema dei mutamenti climatici. Presentiamo il documento redatto, votato e pubblicato dall’Ipcc - Comitato intergovernativo sui cambiamenti climatici - che illustra la sintesi delle ricerche svolte su questo tema rilevante.

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Climate Change 2007: The Physical Science Basis.

2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular riskThe Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)

Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The Guidelines presented here refer to the management of patients with CCS. The natural history of CCS is illustrated in Figure 1.

/pdf/2019-esc-guidelines-for-the-diagnosis-and-management-of-5b7mv2v506.pdf

2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes.

The talk with present the key results of the IPCC Working Group III 5th assessment report. Concluding four years of intense scientific collaboration by hundreds of authors from around the world, the report responds to the request of the world's governments for a comprehensive, objective and policy neutral assessment of the current scientific knowledge on mitigating climate change. The report has been extensively reviewed by experts and governments to ensure quality and comprehensiveness.

Climate change 2014 - Mitigation of climate change

Background: Patent Ductus Arteriosus (PDA) is a common congenital disorder. As an isolated lesion, PDA constitutes 6 to 11% of all congenital heart disease. PDA needs closure to eliminate pulmonary over circulation leading to volume overload of left ventricle, pulmonary vascular obstructed disease.Methods: This retrospective study was carried out in pediatric cardiology unit of Institute of Postgraduate Medical Education and Research, Kolkata from September 2005 to August 2016, which included 503 patients.Results: Device closure was attempted in 492 patient’s Procedural success was achieved in 85% cases on table, in who check aortogram revealed complete closure of PDA. In 15% cases, residual shunt was present. In 12% of cases, residual shunt disappeared during follow-up echocardiogram over 6-month follow-up. In 3% cases, small shunt remained at 6-month and 1-year follow up.Conclusion: Transcatheter closure of PDA by duct occluder is safe and effective with good mid-term outcome. The optimum assessment of ductul size and anatomy is crucial for optimum device size, which prevents residual shunt, device embolization and protrusion.

Transcatheter closure of patent ductus arteriosus using duct occluder: an eleven-year experience from a single tertiary cardiac center

The air quality of a city can be assessed by applying a computational modelling approach. However, one of the most critical issues faced while running air quality models is based on the meteorological model setup, which can significantly affect simulations over a coastal urban area with complex terrain. Thus, this study evaluates the performance of the Weather Research and Forecasting (WRF) model using urban canopy model schemes considering three different model heights (4, 10, and 20 m), and updated land use and cover data (ESA-CCI). The one-year simulation results, based on the observed surface parameters (wind speed and direction, temperature, humidity, and precipitation) over the Metropolitan Region of Vitória (MRV), Southeast of Brazil, showed that the WRF model systematically overpredicted temperature and wind speed, and underestimated humidity, especially during the autumn and winter seasons. However, a significant improvement was obtained using the building effect parameterisation (BEP) formulation to emulate meteorological variables over urban surfaces, especially for wind speed. For temperature and relative humidity, the use of BEP did not show appreciable improvement because the BULK scheme (the control experiment) had a similar performance. The land-use dataset changes showed minimal impact on the representation of urban surfaces; however, significant differences were observed in natural/vegetated areas. The different land covers impacted the surface meteorological parameters, such as temperature and precipitation. However, due to the low coverage of monitoring stations in the countryside area, it was insufficient to determine whether the performance of the WRF model is favoured by the land-use update. • One-year high-resolution WRF-urban modelling application in a Brazilian coastal urban area. • The impact of land use, urban canopy schemes, and model height was evaluated in the WRF model results. • The advanced urban canopy scheme improved near-surface wind speed description. • Simulations at finer resolutions close to the ground do not outperform those at coarser resolutions. 

Coastal-urban meteorology: A sensitivity study using the WRF-urban model

Erythema multiforme (EM) is an acute, self-limited, usually mild, and often relapsing mucocutaneous syndrome. It occurs predominantly in younger age group with slight male preponderance. The classical cutaneous target lesions and mucosal bullae or erosions are clinical manifestations of EM. Drug induced oral EM a rare clinical entity which involves only the lips and oral mucosa without skin involvement. These lesions are difficult in diagnosing with other oral ulcerative lesions with similar clinical manifestations. Here we are reporting a case of phenylbutazone induced oral EM. The causality of phenylbutazone in the reaction was “probable” as per Naranjo scale and seriousness of the reaction was “prolonged hospitalization”. The patient was managed by immediate withdrawal of the suspected drug along with conservative managements to prevent secondary infections. The patient was discharged successfully after 15 days of admission.

/pdf/a-case-of-drug-induced-oral-erythema-multiforme-1igicj6y.pdf

A case of drug induced oral erythema multiforme

Assessment of Effectiveness of DRASTIC Model

Pencil push-up therapy vs. office-based orthoptic therapy in emmetropes with asthenopic symptoms due to convergence insufficiency: A randomized controlled trial

Prashant Kumar

Papers

Transcatheter closure of patent ductus arteriosus using duct occluder: an eleven-year experience from a single tertiary cardiac center

Coastal-urban meteorology: A sensitivity study using the WRF-urban model

A case of drug induced oral erythema multiforme

Assessment of Effectiveness of DRASTIC Model

Pencil push-up therapy vs. office-based orthoptic therapy in emmetropes with asthenopic symptoms due to convergence insufficiency: A randomized controlled trial