Many older patients are not being aggressively managed for hypertension. Healthcare providers are often hesitant to start or even aggressively titrate antihypertensive medication, especially in the aged. Multiple studies have demonstrated that morbidity and mortality can be significantly reduced by appropriate intervention in all age groups. There are some clinical situations, however, where the provider must approach cautiously, such as in patients with a wide pulse pressure or those with a propensity toward adverse reactions. The data are clear that in the United States, undertreatment, rather than overtreatment, appears to be the issue. This article reviews studies that support the aggressive treatment of hypertension. The nuances of aging, which often influence the healthcare provider's treatment decisions, are also discussed. Suggestions for reasonable approaches to these difficult cases will be considered.

Cardiovascular disease (CVD) is the leading cause of death worldwide. The risks for women increase at the onset of menopause. A central feature in CVD patients is excessive sympathetic stimulation of beta-adrenergic receptors (β-ARs). Both clinical and animal studies show that estrogen loss and age exacerbate cardiac β-AR signaling and contractile function. We, therefore, examined the hypothesis that prolonged estrogen deficiency followed by chronic sympathetic injury worsens left ventricular cardiac function in the aged female heart. Bilateral ovariectomy (OVX) or SHAM surgery was performed in female mice at 2.5 months of age and infused with Isoproterenol (ISO; 400μg/kg/h) at 12 months (12M) post OVX for 3 days to induce chronic sympathetic stimulation. Transthoracic two-dimensional M-mode echocardiography was used to measure left ventricular (LV) wall thickness and left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD), percent fractional shortening (%FS), and ejection fraction (EF). Animal body weight was measured to calculate the heart-body ratio, followed by the removal of the heart, left lung, and uterus during euthanasia. Tissue samples were treated with wheat germ agglutinin staining to measure cardiac myocyte cross-sectional area (hypertrophy). Results show that prolonged ovariectomy increased mortality in mice treated with ISO post-ovariectomy (OVX +ISO) compared to the SHAM+ISO group. Echocardiography imaging demonstrated a smaller systolic diameter and increased contractility in the ISO and ISO+OVX groups. OVX, ISO, and ISO+OVX treatment had a significant decrease in LVESD versus SHAM and OVX groups. The LVEDD resulted in a significant decrease with ISO treatment compared to the SHAM group, and no significant difference was observed between the OVX and ISO+OVX groups compared to the SHAM. Percent FS presented a significant increase in cardiac function in OVX, ISO, and ISO+OVX groups compared to the SHAM. There was an increased %FS in the ISO+OVX compared to the OVX group, and no significant difference between the ISO+OVX and ISO treatment groups. Percent EF significantly increased in the OVX, ISO, and ISO+OVX treatment groups from the SHAM and OVX group, and no significant difference between the ISO+OVX and ISO treatment groups. OVX increased left ventricular mass compared to SHAM. While ISO treatment did not increase LV mass ISO+OVX treatment group significantly increased in LV mass when compared to the ISO treatment group. There was no significant difference in the left ventricular mass between the ISO+OVX vs. OVX group. There was no significant difference in cardiac myocyte cross-sectional area in the SHAM, OVX vs ISO groups. There was however a significant increase in myocyte cross-sectional area in the ISO+OVX group compared to OVX treatment and ISO groups. The results presented here show that estrogen loss impairs left ventricular cardiac function and increases remodeling in response to β-AR stimulation and that prolonged estrogen loss may blunt the sympathetic response in the heart. These results highlight the importance of the long-term effects of estrogen loss during menopause in the treatment and management of heart disease.

The integral image representation of an image is important for a large number of modern image processing algorithms. Integral image representations can reduce computation and increase the operating speed of certain algorithms, improving real-time performance. Due to increasing demand for real-time image processing performance, an integral image architecture capable of accelerating the calculation based on the amount of available resources is presented. Use of the proposed accelerator allows for subsequent stages of a design to have data sooner and execute in parallel. It is shown here how, with some additional resources used in the Field Programmable Gate Array (FPGA), a speed increase is obtained by using a one-dimensional Systolic Array (SA) approach. Additionally, extra guidelines are given for further research in this area.

A Case Report of Catastrophic Antiphospholipid Syndrome with Libman-Sacks Presenting as Interstitial Pneumonia Chassidy Sumler Martin, MS, Rocco Cannistraro, MD Antiphospholipid syndrome (APS) is an autoimmune condition characterized by vascular thromboses and a positive antiphospholipid antibody. Catastrophic antiphospholipid syndrome (CAPS) is a rare disease that often results in death. CAPS is the most severe form of APS, which can develop in a short period of time and occurs in less than 1% of people with APS. CAPS involves multiple organs simultaneously with diffuse microvascular and macrovascular involvement. Here, we present a case of catastrophic antiphospholipid syndrome presenting as interstitial pneumonia that rapidly progressed to acute renal failure, acute ischemic cerebral infarcts, cardiac valvular vegetations, and heart failure. This case report aims to bring awareness of prompt medical suspicion and treatment of CAPS in hopes of improving disease outcomes.

No description available.

Brainstem Auditory Evoked Potentials (BAEP) contain valuable information about the condition of the neural fibers associated with the auditory pathways. Extraction of this information is a difficult task due to contamination by on-going scalp EEG. This thesis reviews the current processing techniques and introduces adaptive noise cancellation (ANC) using systolic arrays as an alternative to existing technology. Q-R decomposition theory is reviewed and an explanation of the mechanics of systolic adaptive noise cancellation (SANC) is presented. A modified Given's rotation algorithm is derived resulting in a saving of up to 2/3 in memory requirements. Real data were collected in the laboratory. Real and simulated data were processed to determine the characteristics and effectiveness of adaptive noise cancellation strategies. Successful ANC of BAEP was performed on simulated data using a number or signal-to-noise ratios (S/N), data sequence lengths, reference signals and filter parameter values. We conclude that systolic arrays are a very powerful and appropriate technique for the extraction or BAEPs. Correlation studies indicated that the pre-stimulus EEG signal is inadequately correlated to the primary signal for successful ANC or BAEP in real data. A multi-channel collection scheme is outlined for future collection or Evoked Potential data. A summary or experimental results is presented to address the problem or data collection and signal processing optimization. / Thesis / Master of Engineering (MEngr)

No / This paper presents a novel and hardware-efficient architecture for power-of-two FFT processors. The proposed design is based on the phase-amplitude splitting technique which converts a DFT to cyclic convolutions and additions. The cyclic convolutions are implemented with a filter-like structure and the additions are computed with several stages of butterfly processing units. The proposed architecture requires no multiplier, and comparisons with other designs show it can save up to 39% total equivalent gates for an 8-bit 16-point FPGA-based FFT processor.

International Telemetering Conference Proceedings / October 28-31, 1996 / Town and Country Hotel and Convention Center, San Diego, California / Improved processing techniques, particularly with respect to parallel computing, are the underlying focus in computer science, engineering, and industry today. Semiconductor technology is fast approaching device physical limitations. Further advances in computing performance in the near future will be realized by improved problem-solving approaches. An important issue in parallel processing is how to effectively utilize parallel computers. It is estimated that many modern supercomputers and parallel processors deliver only ten percent or less of their peak performance potential in a variety of applications. Yet, high performance is precisely why engineers build complex parallel machines. Cumulative performance losses occur due to mismatches between applications, software, and hardware. For instance, a communication system's network bandwidth may not correspond to the central processor speed or to module memory. Similarly, as Internet bandwidth is consumed by modern multimedia applications, network interconnection is becoming a major concern. Bottlenecks in a distributed environment are caused by network interconnections and can be minimized by intelligently assigning processing tasks to processing elements (PEs). Processing speeds are improved when architectures are customized for a given algorithm. Parallel processing techniques have been ineffective in most practical systems. The coupling of algorithms to architectures has generally been problematic and inefficient. Specific architectures have evolved to address the prospective processing improvements promised by parallel processing. Real performance gains will be realized when sequential algorithms are efficiently mapped to parallel architectures. Transforming sequential algorithms to parallel representations utilizing linear dependence vector mapping and subsequently configuring the interconnection network of a systolic array will be discussed in this paper as one possible approach for improved algorithm/architecture symbiosis.

Orientador: Paulo Sergio Patto dos Santos / Resumo: A lidocaína é um fármaco versátil muito utilizado na rotina clínica. No entanto, há poucos estudos que avaliam os seus efeitos sobre o coração. Para esta finalidade, a ecocardiografia transtorácica é uma ferramenta que possibilitava a avaliação das funções sistólica e diastólica em tempo real. Como este estudo, objetivou-se avaliar os efeitos da infusão contínua de lidocaína sobre as funções sistólica e diastólica do ventrículo esquerdo de coelhos hígidos sedados com midazolam. Para tanto, foram utilizados dez coelhos da raça Nova Zelândia, quatro machos e seis fêmeas, com idade de nove meses, pesando 3,2 ± 0,3 kg, sendo todos os animais sedados com midazolam na dose de 1 mg/kg pela via intramuscular e submetidos a dois tratamentos experimentais (controle e lidocaína) com intervalo mínimo de sete dias entre os tratamentos. No tratamento controle (TC) administrou-se solução de cloreto de sódio a 0,9% (0,05 mL/kg) em bolus seguida de infusão contínua na taxa de 5 mL/hora; no tratamento lidocaína (TL) administrou-se primeiramente um bolus de lidocaína a 2% sem vasoconstritor na dose de 1 mg/kg seguido de infusão contínua na taxa de 50 µg/kg/minuto, sendo mantidos os mesmos volumes administrados para ambos os tratamentos. As principais variáveis analisadas foram: frequência cardíaca (FC), pressão arterial média (PAM), índice de resistência vascular periférica (IRVP), índice cardíaco Doppler (ICD), fração de encurtamento (FEC), fração de ejeção (FEJ), velocidade da onda S′ e relaç... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Lidocaine is a versatile drug widely used in clinical practice. However, there are few studies that evaluate its effects on the heart. For this purpose, transthoracic echocardiography is a tool that allows an evaluation of the systematic and diastolic units in real time. The aim of the study was evaluate the effects of continuous rate infusion of lidocaine on systolic and diastolic functions of the left ventricle of healthy rabbits sedated with midazolam. Ten New Zealand rabbits, four males and six females, aged nine months, weighing 3.2 ± 0.3 kg were sedated with midazolam at the dose of 1 mg/kg intramuscularly and submitted to two experimental treatments (control and lidocaine) with a minimum interval of seven days. In the control treatment (CT), 0.9% sodium chloride solution (0.05 mL.kg-1 ) was administered in bolus followed by continuous infusion at a rate of 5 mL.hour-1 ; a 2% lidocaine bolus without vasoconstrictor at the dose of 1 mg.kg-1 followed by continuous infusion at the rate of 50 μg.kg-1 .minute-1 was first given in lidocaine treatment (LT). The main variables analyzed were: heart rate (HR), mean arterial pressure (MAP), peripheral vascular resistance index (PVR), Doppler cardiac index (DCI), shortening fraction (FEC), ejection fraction (EFJ), velocity of the wave S 'and relation E'/A'. All parameters were evaluated before the onset of the bolus (MB) and 20, 40 and 60 minutes after the start of continuous rate infusion (M20, M40 and M60). The studied variables ... (Complete abstract click electronic access below) / Mestre

Background: Hypertension is defined as an elevated systolic blood pressure (SBP ≥ 140 mmHg), or an elevated diastolic blood pressure (DBP ≥ 90 mmHg). The prevalence of hypertension is high in obese population. The potential effects of inadequate calcium intake on hypertension are receiving growing attention. The aim of the study was to examine the association between calcium intake and hypertension among obese adults. Methods: A total of 14,856 obese adults aged 20 years or older were obtained from the 1999-2010 National Health and Nutrition Examination Survey. Analysis of variance was used to examine if there was a relationship between calcium intake and blood pressure, SBP or DBP. Multiple logistic regressions were used to examine the association between calcium intake and hypertension after adjusting for potential confounders (energy intake, age, race, education level, alcohol use, smoking, and diabetes). Results: Prevalence of hypertension decreased with an increasing quartile of calcium intake (p < 0.0001). Multiple logistic regression showed that lowest quartile of calcium intake was associated with an increased risk of elevated SBP and elevated DBP (Odds Ratio (OR) =1.332, 95% Confidence Interval (CI): 1.084-1.636; OR=1.700, 95% CI: 1.234-2.342, respectively). Compared with adults in the highest quartile of calcium intake, those in lowest quartile had 1.4 times increased risk of hypertension (OR=1.400, 95% CI: 1.157-1.694). Conclusion: Our study provides support of research perspective that inadequate calcium intake may increase the risk of hypertension, high SBP, or high BDP among obese adults. Further studies are needed to understand physiological mechanism. Increasing the calcium intake in obese adults can be considered as a strategy to prevent hypertension.