Safety and efficacy of Everolimus-Eluting bioabsorbable Polymer-Coated stent in patients with long coronary lesions: The EVOLVE 48 study.

OBJECTIVES: The EVOLVE 48 study evaluated the safety and effectiveness of the SYNERGY 48 mm stent for the treatment of long lesions. BACKGROUND: Clinical evidence supporting the use of very long stents during percutaneous coronary intervention (PCI) is limited. The bioabsorbable polymer SYNERGY stent has shown good long-term data in a broad population of patients undergoing PCI. METHODS: Patients with lesion length >34- ≤44 mm and reference vessel diameter (RVD) ≥2.5- ≤ 4.0 mm were enrolled in this prospective, multicenter, single-arm study. The primary endpoint was 12-month target lesion failure (TLF; composite of target lesion revascularization [TLR], target-vessel myocardial infarction [TV-MI], or cardiac death) compared to a prespecified performance goal (PG). RESULTS: A total of 100 patients with mean lesion length of 35.34 ± 7.15 mm (26 patients with lesion length > 40 mm) and mean RVD 2.72 ± 0.44 mm were enrolled. Moderate to severe calcification was present in 30% of the patients and 89% had pre-TIMI flow grade 3. The rates of technical and clinical procedural success were 100%. One-year TLF was observed in 4.1% patients compared to a prespecified PG of 19.5% (95% upper confidence bound = 9.1%; p < 0.0001). Cardiac death and TLR were each observed in one patient, and TV-MI in two patients treated with SYNERGY 48 mm stent. Between the 1-2-year timeframe, TV-MI occurred in one additional patient. None of the patients experienced a definite or probable stent thrombosis through 2 years. CONCLUSIONS: PCI of long coronary lesions with the 48 mm SYNERGY stent demonstrated good procedural and clinical outcomes through 2 years, supporting its clinical safety and efficacy.

Artificial Intelligence (AI) in Pharmacy: An Overview of Innovations.

Artificial Intelligence (AI) emerged as an intervention for data and number-related problems. This breakthrough has led to several technological advancements in virtually all fields from engineering to architecture, education, accounting, business, health, and so on. AI has come a long way in healthcare, having played significant roles in data and information storage and management - such as patient medical histories, medicine stocks, sale records, and so on; automated machines; software and computer applications like diagnostic tools such as MRI radiation technology, CT diagnosis and many more have all been created to aid and simplify healthcare measures. Inarguably, AI has revolutionized healthcare to be more effective and efficient and the pharmacy sector is not left out. During the past few years, a considerable amount of increasing interest in the uses of AI technology has been identified for analyzing as well as interpreting some important fields of pharmacy like drug discovery, dosage form designing, polypharmacology, and hospital pharmacy. Given the growing importance of AI, we wanted to create a comprehensive report which helps every practicing pharmacist understand the biggest breakthroughs which are assisted by the deployment of this field.

Image classification by addition of spatial information based on histograms of orthogonal vectors.

The Bag-of-Visual-Words (BoVW) model is widely used for image classification, object recognition and image retrieval problems. In BoVW model, the local features are quantized and 2-D image space is represented in the form of order-less histogram of visual words. The image classification performance suffers due to the order-less representation of image. This paper presents a novel image representation that incorporates the spatial information to the inverted index of BoVW model. The spatial information is added by calculating the global relative spatial orientation of visual words in a rotation invariant manner. For this, we computed the geometric relationship between triplets of identical visual words by calculating an orthogonal vector relative to each point in the triplets of identical visual words. The histogram of visual words is calculated on the basis of the magnitude of these orthogonal vectors. This calculation provides the unique information regarding the relative position of visual words when they are collinear. The proposed image representation is evaluated by using four standard image benchmarks. The experimental results and quantitative comparisons demonstrate that the proposed image representation outperforms the existing state-of-the-art in terms of classification accuracy.

Content Based Image Retrieval by Using Color Descriptor and Discrete Wavelet Transform.

Due to recent development in technology, the complexity of multimedia is significantly increased and the retrieval of similar multimedia content is a open research problem. Content-Based Image Retrieval (CBIR) is a process that provides a framework for image search and low-level visual features are commonly used to retrieve the images from the image database. The basic requirement in any image retrieval process is to sort the images with a close similarity in term of visually appearance. The color, shape and texture are the examples of low-level image features. The feature plays a significant role in image processing. The powerful representation of an image is known as feature vector and feature extraction techniques are applied to get features that will be useful in classifying and recognition of images. As features define the behavior of an image, they show its place in terms of storage taken, efficiency in classification and obviously in time consumption also. In this paper, we are going to discuss various types of features, feature extraction techniques and explaining in what scenario, which features extraction technique will be better. The effectiveness of the CBIR approach is fundamentally based on feature extraction. In image processing errands like object recognition and image retrieval feature descriptor is an immense among the most essential step. The main idea of CBIR is that it can search related images to an image passed as query from a dataset got by using distance metrics. The proposed method is explained for image retrieval constructed on YCbCr color with canny edge histogram and discrete wavelet transform. The combination of edge of histogram and discrete wavelet transform increase the performance of image retrieval framework for content based search. The execution of different wavelets is additionally contrasted with discover the suitability of specific wavelet work for image retrieval. The proposed algorithm is prepared and tried to implement for Wang image database. For Image Retrieval Purpose, Artificial Neural Networks (ANN) is used and applied on standard dataset in CBIR domain. The execution of the recommended descriptors is assessed by computing both Precision and Recall values and compared with different other proposed methods with demonstrate the predominance of our method. The efficiency and effectiveness of the proposed approach outperforms the existing research in term of average precision and recall values.

Refractory Case of Takayasu Arteritis in a Young Woman: A Clinical Challenge.

Takayasu arteritis (TA) is an idiopathic chronic inflammatory vasculitis of the aorta and its main branches, which if not treated can lead to severe vascular damage and fatal vascular events. Glucocorticoids (GCs) are the mainstay of the therapy of TA but a significant proportion of patients tend to experience flare-ups when their GCs are tapered. We report a case of a 42-year-old female with TA, diagnosed according to the 1990 American College of Rheumatology Criteria for TA. Cardiovascular assessment showed normal carotid upstrokes with bilateral carotid bruits and soft right and left subclavian bruits with weak peripheral pulses. A computed tomography (CT) aortogram of the chest showed severe stenosis of bilateral subclavian arteries and mild stenosis of right and left common carotid arteries at the origin. A CT aortogram of the abdomen showed an occluded left renal artery, a very small left kidney, and mild narrowing of the abdominal aorta below the level of renal arteries.  She was initially managed with GCs along with immunosuppressive therapy including methotrexate, azathioprine, and cyclophosphamide, but her disease remained active. She was then sequentially treated with inhibitor etanercept (ETN), inhibitor tocilizumab (TCZ) and monoclonal anti-CD20 antibody rituximab (RTX), and in spite of aggressive biologic therapy she continued to have active disease. To the best of our knowledge, this is the first case of refractory TA treated sequentially with three different biologic drugs.

Low-molecular-weight-heparins as periprocedural anticoagulation for patients on long-term warfarin therapy: a standardized bridging therapy protocol.

BACKGROUND: Over 2 million patients in North America are on warfarin anticoagulation therapy for prevention of thromboembolism. Suspension of warfarin therapy is often required to prepare patients for invasive procedures or surgeries. To protect these patients against thromboembolism while they are off warfarin, shorter-acting parenteral agents such as low-molecular-weight heparins (LMWHs) are often used. We conducted a retrospective observational study of our anticoagulation clinic patients to assess the safety and efficacy of LMWHs using a standardized protocol for periprocedural anticoagulation therapy. METHODS: We included 69 consecutive patients who required interruption of their long-term warfarin therapy between August 2001 and August 2002, and were deemed by the treating physician to be at high enough risk for perioperative thromboembolism to justify bridging anticoagulation. We used a standard bridging therapy protocol in our anticoagulation clinic. Sixty-six patients received enoxaparin and three patients received tinzaparin for a mean duration of 7.7 days postoperatively. Outcomes were assessed for 30 days post-procedure. Safety outcomes included major bleeding and minor bleeding. Efficacy outcomes included thromboembolic event or death. RESULTS: There were two major bleeding events, one minor bleeding event, and no cases of thromboembolism. Twelve patients experienced some bruising around the injection site. CONCLUSIONS: LMWH administration using our standard outpatient bridging protocol for perioperative anticoagulation appears to be relatively safe and efficacious, offering an alternative to inpatient administration of intravenous unfractionated heparin (UFH). Our study provides additional evidence to the limited published observational data regarding the safety and efficacy of LMWH as bridging therapy in the perioperative and periprocedural setting. Large, multicenter, randomized controlled trials are necessary to fully assess the safety and efficacy of LMWH for perioperative anticoagulation.We conducted a retrospective observational study of 69 consecutive anticoagulation clinic patients on warfarin between August 2001 and August 2002, who were undergoing a procedure or surgery. The study was done to assess the safety and efficacy of an outpatient LMWH bridging protocol. Sixty-six patients received enoxaparin and three patients received tinzaparin for a mean duration of 3 days preoperatively and 7.7 days postoperatively. Outcomes were assessed for 30 days post-procedure. Safety outcomes included major bleeding and minor bleeding. Efficacy outcomes included thromboembolic event or death. There were two major bleeding events, one minor bleeding event, and no cases of thromboembolism. Twelve patients experienced some bruising around the injection site.