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Use of Midodrine in Heart Failure: Two Case Reports and a Review of the Literature
Get PDFHypotension in patients with heart failure is much more frequent in daily clinical practice than the 10–15% reported in clinical trials. In patients with heart failure with reduced ejection fraction (HFrEF), hypotension frequently limits the initiation and up-titration of guideline-directed medical therapy (GDMT). Midodrine is a peripheral alpha-1 agonist and a vasopressor anti-hypotensive agent approved for the treatment of orthostatic hypotension. We describe two cases where midodrine was prescribed in patients with HFrEF and hypotension
Clostridioides difficile Bacteraemia and Septic Arthritis in a Sickle Cell Disease Patient
Get PDFExtra-colonic Clostridioides difficile infection is rare. Here we describe a sickle cell disease patient with avascular necrosis who presented with persistent bacteraemia due to C. difficile and septic arthritis in a native knee joint, which responded very well to medical and surgical treatment but recurred multiple times within weeks of the cessation of antibiotics
Refractory Peritonitis and Small Bowel Ileus: A Case of Encapsulating Peritoneal Sclerosis Secondary to Mycobacterium abscessus Peritonitis
Get PDFIntroduction: Complications of peritoneal dialysis (PD) such as exit-site infections and PD peritonitis are common reasons for admission to General Internal Medicine wards. Culprit organisms range from typical skin flora to rarer complicated atypical organisms such as non-tuberculous mycobacteria. Encapsulating peritoneal sclerosis (EPS) is a rarer complication of PD characterized by peritoneal inflammation, ileus and fibrosis with high morbidity, few management options, and poor prognosis. Case Description: We report the case of a patient with a history of end-stage renal disease on peritoneal dialysis who presented with undifferentiated peritonitis and ileus refractory to standard antimicrobial therapy. Subsequent ascitic cultures were positive for Mycobacterium abscessus, and CT imaging was consistent with EPS. To date, EPS secondary to M. abscessus peritonitis has not previously been described.Discussion and Conclusion: This report describes the diagnostic process and treatment offered to this patient and his treatment outcomes over 8 months. It highlights the importance of prompt identification of patients at risk, timely eradication of high-risk pathogens, and transition to haemodialysis to limit morbidity and improve patient prognosis
UV completion and not quite black holes
No full textWhen it comes to black holes, the Einstein action gives us little choice. But the Einstein action should eventually be subsumed into a UV complete theory of gravity, and such a theory may provide an alternative description for what
we know of as black holes. We consider the horizonless solutions called 2-2-holes that emerge from quadratic gravity. Within a Planck length of the would-be horizon,
strong gravity and high curvatures quickly turn on. These solutions are very close to being completely black, but not quite. An ideal probe to test for not quite black holes are the low frequency gravitational waves that are excited in and around them when they are newly formed, as in the merger events observed by LIGO. We identify the generic features of the resulting gravitational wave echoes. We also consider how it is that quadratic gravity can provide a local quantum field theory for gravity
Limiting curvature models of gravity
No full textIn this paper we discuss a limiting curvature condition and its application to cosmological and black hole solutions
A Case of Spontaneous Renal Haemorrhage (Wunderlich Syndrome) in an Anticoagulated Patient
Get PDFSpontaneous renal haemorrhage is a rare but severe condition known as Wunderlich syndrome (WS). The classic presentation includes sudden-onset flank pain, a palpable flank mass and hypovolaemic shock (Lenk’s triad). WS can be due to neoplasms, vascular diseases, cystic rupture, coagulopathies and infections. A contrast-enhanced CT scan of the abdomen is mandatory for diagnosis. Surgery is reserved for haemodynamically unstable patients and those with neoplastic disease. We describe a case of WS in an anticoagulated patient with chronic atrial fibrillation, diabetes mellitus type 2 and hypertension, who developed acute renal failure and severe anaemia, that completely resolved with conservative treatment and discontinuation of anticoagulation therapy
La gestione dei beni inventariabili del centro Interdipartimentale per l'Etica e l'Integrità nella Ricerca nel sistema SIGLA: stato dell'arte
Get PDFLa realizzazione di questo rapporto tecnico nasce dalla necessità di tracciare le modalità di gestione dei beni di competenza del CID Ethics, inventariati nel sistema contabile “Sistema Informativo per la Gestione delle Linee di Attività” (SIGLA), strumento utilizzato per la pianificazione e il controllo dell’uso delle risorse nell’ambito delle attività dell’Ente, in particolare delle attività di ricerca. I soggetti che implementano tale pianificazione e controllo sono l’Amministrazione centrale e le sedi periferiche (Istituti/Aree di Ricerca) del Consiglio Nazionale delle Ricerche (CNR)
Trasferimento di innovazione per la valorizzazione del castagno da frutto
Get PDFIl volume raccoglie vari contributi (autori: Andrea Becchimanzi, Marina Maura Calandrelli, Mario Conti, Emiddio de Franciscis di Casanova, Luigi De Masi, Flora Della Valle, Franco Di Pippo, Elvira Ferrara, Rosario Nicoletti, Angelina Nunziata, Milena Petriccione, Giulia Verrilli) di partecipanti al progetto "CASTARRAY", coordinato dal Consiglio per la ricerca in agricoltura e l’analisi dell’economia agraria (Crea) e di cui il Cnr è partner, le cui attività sono state finanziate dalla Regione Campania in attuazione del Piano di Sviluppo Rurale (PSR) 2014-2020. L'obiettivo è quello di contribuire a tutelare il grande giacimento di risorse genetiche insito nella castanicoltura campana, e ad introdurre innovazioni sostenibili nella gestione degli impianti già esistenti o da realizzarsi, quale volano di sviluppo per il comparto nevralgico dell’agricoltura campana sia in termini economici che per i suoi insostituibili riverberi ambientali, paesaggistici e di difesa idrogeologica
Robustness of a quasicrystalline higher-order topological insulator
No full textIt was recently discovered that quasicrystalline systems may provide a platform for the realisation of higher order topological insulators, where the topological phase is protected by spatial symmetries. In this paper I focus on a specific model and study the robustness of its topological phase against perturbations of the protecting symmetry. This is done both by varying the shape of the sample and by
deforming the lattice. While signatures of the higher order topological phase can persist, the effects of an even slight symmetry breaking are significant
Study of the 12C + 16O fusion via the Trojan Horse Method
No full textThe 12C + 16O fusion reaction plays a role in the later stages of carbon burning, influencing the evolution of both massive stars and Type Ia Supernovae: when most of the carbon is depleted, by the main fusion reaction 12C + 12C,
the abundance of 16O nuclei is significantly higher. Therefore 12C + 16O can indeed have a strong impact on the process. In this brief contribution, preliminary data analysis results of a new indirect measurement of the 12C + 16O, performed at astrophysical energies via the Trojan Horse Method, will be presented and discussed