BACKGROUND One of the major perioperative complications for coronary artery bypass graft(CABG)is stroke.The risk of perioperative stroke after CABG is approximately 2%.Carotid stenosis(CS)is considered an independent ...BACKGROUND One of the major perioperative complications for coronary artery bypass graft(CABG)is stroke.The risk of perioperative stroke after CABG is approximately 2%.Carotid stenosis(CS)is considered an independent predictor of perioperative stroke risk in CABG patients.The optimal management of such patients has been a source of controversy.One of the possible surgical options is synchronous carotid endarterectomy(CEA)and CABG.Here,we have presented 4 cases of successful synchronous CEA and CABG.Our center’s experience with 4 cases of significant carotid artery stenosis,which were successfully managed with combined CEA and CABG,are detailed.The first case was a female who presented for CABG after a ST-elevation myocardial infarction.She had right internal carotid artery(ICA)occlusion and 90%left ICA stenosis.The second case was a male who was electively admitted for CABG.It was discovered that he had left ICA occlusion and 90%right ICA stenosis.The third case was a male with a history of stroke,two months prior to admission.He presented with non-ST-elevation myocardial infarction.Preoperatively,it was discovered that he had>90%right ICA stenosis.The final case was a male who was electively admitted for CABG.It was discovered that he had bilateral>90%ICA stenosis.We have also reviewed the current evidence and guidelines for managing CS in patients undergoing CABG.CONCLUSION Our case series demonstrated that synchronous CEA and CABG was safe.A multicenter study with additional patients is needed.It is necessary for clinicians to screen for CS in high-risk patients with features.展开更多
The revolution of computing and networks could revolutionise terrorism in the same way that it has brought about changes in other aspects of life. The modern technological era has faced countries with a new set of sec...The revolution of computing and networks could revolutionise terrorism in the same way that it has brought about changes in other aspects of life. The modern technological era has faced countries with a new set of security challenges. There are many states and potential adversaries, who have the potential and capacity in cyberspace, which makes them able to carry out cyber-attacks in the future. Some of them are currently conducting surveillance, gathering and analysis of technical information, and mapping of networks and nodes and infrastructure of opponents, which may be exploited in future conflicts. This paper uses qualitative data to develop a conceptual framework for awareness of cyberterrorism threat from the viewpoint of experts and security officials in critical infrastructure. Empirical data collected from in-depth interviews were analysed using grounded theory approach. This study applied to Saudi Arabia as a case study.展开更多
文摘BACKGROUND One of the major perioperative complications for coronary artery bypass graft(CABG)is stroke.The risk of perioperative stroke after CABG is approximately 2%.Carotid stenosis(CS)is considered an independent predictor of perioperative stroke risk in CABG patients.The optimal management of such patients has been a source of controversy.One of the possible surgical options is synchronous carotid endarterectomy(CEA)and CABG.Here,we have presented 4 cases of successful synchronous CEA and CABG.Our center’s experience with 4 cases of significant carotid artery stenosis,which were successfully managed with combined CEA and CABG,are detailed.The first case was a female who presented for CABG after a ST-elevation myocardial infarction.She had right internal carotid artery(ICA)occlusion and 90%left ICA stenosis.The second case was a male who was electively admitted for CABG.It was discovered that he had left ICA occlusion and 90%right ICA stenosis.The third case was a male with a history of stroke,two months prior to admission.He presented with non-ST-elevation myocardial infarction.Preoperatively,it was discovered that he had>90%right ICA stenosis.The final case was a male who was electively admitted for CABG.It was discovered that he had bilateral>90%ICA stenosis.We have also reviewed the current evidence and guidelines for managing CS in patients undergoing CABG.CONCLUSION Our case series demonstrated that synchronous CEA and CABG was safe.A multicenter study with additional patients is needed.It is necessary for clinicians to screen for CS in high-risk patients with features.
文摘The revolution of computing and networks could revolutionise terrorism in the same way that it has brought about changes in other aspects of life. The modern technological era has faced countries with a new set of security challenges. There are many states and potential adversaries, who have the potential and capacity in cyberspace, which makes them able to carry out cyber-attacks in the future. Some of them are currently conducting surveillance, gathering and analysis of technical information, and mapping of networks and nodes and infrastructure of opponents, which may be exploited in future conflicts. This paper uses qualitative data to develop a conceptual framework for awareness of cyberterrorism threat from the viewpoint of experts and security officials in critical infrastructure. Empirical data collected from in-depth interviews were analysed using grounded theory approach. This study applied to Saudi Arabia as a case study.
