Parametric geometry modeling of the carotid artery bifurcation: the need for new flow metrics
Although well established correlations now exist between regions of reversed flow and sites of arterial disease [1], little evidence is available for methodologies that systematically compare how geometrical differences affect such relationships. Drawing on techniques developed in aerodynamic design, a parametric tuning-fork geometry model of the carotid artery bifurcation - based on the glass models described in [2] - is here employed to investigate the impact of bulb size and the angle of the internal carotid artery (ICA) on time-averaged shear stress. Since we seek to directly compare the effect of varying these geometric parameters, we demonstrate the need for a new metric, the integral of negative mean shear stress (INMSS), to highlight the stronger correlation between the extent of reversed flow and bulb width relative to the angle of the ICA.
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To vaccinate or not to vaccinate.
This paper discusses the issue of vaccination for HIV-positive persons. It notes that live virus or live bacteria vaccines with the exception of measles- mumps-rubella should never be given to individuals with HIV infection. All other live vaccines are considered harmful to individuals with HIV including Bacille-Calmette-Guerin oral polio vaccine oral typhoid vaccine varicella- zoster vaccine and yellow fever vaccine. On the other hand the pneumococcal vaccine is considered standard care for individuals with HIV. The influenza vaccine should also be considered to prevent clinical syndromes that may mimic more serious opportunistic infections. The flu shot is administered annually. Health care providers recommend that flu shot should be administered sooner rather than later that flu season especially as it takes 4 weeks for the vaccine to become fully effective. The pneumococcal vaccine only needs to be given every 5 years the tetanus booster should be given every 10 years and the hepatitis A and B and measles vaccines only need to be given once.