170,338 research outputs found
Erectile Dysfunction in Heart Failure: Correlation with Severity, Exercise Performance, Comorbidities, and Heart Failure Treatment
No full textIntroduction. Erectile dysfunction (ED) is frequent in males with chronic heart failure (HF) with a severe impact on quality of life for many individuals. The correlation of ED with age and HF severity, comorbidity, and treatment is unclear. Aim. We evaluated the correlation between ED and HF severity, treatment, and comorbidity. Methods. One hundred one HF patients aged 10 mL/min/kg. On multivariable analysis, only age, diabetes, use of diuretics, and hemoglobin are related to ED. Apostolo A, Vignati C, Brusoni D, Cattadori G, Contini M, Veglia F, Magri D, Palermo P, Tedesco C, Doria E, Fiorentini C, Montorsi P, and Agostoni P. Erectile dysfunction in heart failure: Correlation with severity, exercise performance, comorbidities, and heart failure treatment. J Sex Med 2009;6:2795-2805
GERDA and LEGEND: Probing the Neutrino Nature and Mass at 100 meV and beyond
No full textThe Gerda (GERmanium Detector Array) project, located at Laboratori Nazionali del Gran Sasso (LNGS), was started in 2005, a few years after the claim of evidence for the neutrinoless double beta decay (0νββ) of 76Ge to the ground state of 76Se: it is an ultra-rare process whose detection would directly establish the Majorana nature of the neutrino and provide a measurement of its mass and mass hierarchy. The aim of Gerda was to confirm or disprove the claim by an increased sensitivity experiment. After establishing the new technology of Ge detectors operated bare in liquid Argon and since 2011, Gerda efficiently collected data searching for 0νββ of 76Ge, first deploying the 76Ge-enriched detectors from two former experiments and later new detectors with enhanced signal-to-background rejection, produced from freshly 76Ge-enriched material. Since then, the Gerda setup has been upgraded twice, first in 2013–2015 and later in 2018. The period before 2013 is Phase I and that after 2015 is Phase II. Both the Gerda setup and the analysis tools evolved along the project lifetime, allowing to achieve the remarkable average energy resolution of ∼3.6 and ∼2.6 keV for Coaxial Germanium (Coax) detectors and for Broad Energy Germanium (BEGe), respectively, and the background index of 5.2−1.3+1.6 · 10−4 cts/(keV·kg·yr) in a 230 keV net range centered at Qββ. No evidence of the 0νββ decay at Qββ = 2039.1 keV has been found, hence the limit of 1.8·1026 yr on the half-life (T1/20ν) at 90% C.L. was set with the exposure of 127.2 kg·yr. The corresponding limit range for the effective Majorana neutrino mass mee has been set to 79–180 meV. The Gerda performances in terms of background index, energy resolution and exposure are the best achieved so far by 76Ge double beta decay experiments. In Phase II, Gerda succeeded in operating in a background free regime and set a world record. In 2017, the Legend Collaboration was born from the merging of the Gerda and Majorana Collaborations and resources with the aim to further improve the Gerda sensitivity. First, the Legend200 project, with a mass of up to 200 kg of 76Ge-enriched detectors, aims to further improve the background index down to 10−3 cts/(keV·kg·yr) to explore the Inverted Hierarchy region of the neutrino mass ordering, then the Legend1000 (1 ton of 76Ge-enriched) will probe the Normal Hierarchy. In this paper, we describe the Gerda experiment, its evolution, the data analysis flow, a selection of its results and technological achievements, and finally the design, features and challenges of Legend, the Gerda prosecutor
Measuring cardiac output during cardiopulmonary exercise testing
No full textCardiac output is a key parameter in the assessment of cardiac function, and its measurement is fundamental to the diagnosis, treatment, and prognostic evaluation of all heart diseases. Until recently, cardiac output determination during exercise had been only possible through invasive methods, which were not practical in the clinical setting. Because V O2 is cardiac output times arteriovenous content difference, evaluation of cardiac output is usually included in its measurement. Because of the difficulty of directly measuring peak exercise cardiac output, indirect surrogate parameters have been proposed, but with only modest clinical usefulness. Direct measurement of cardiac output can now be made by several noninvasive techniques, such as rebreathing inert gases, impedance cardiology, thoracic bioreactance, estimated continuous cardiac output technology, and transthoracic echocardiography coupled to cardiopulmonary exercise testing, which allow more definitive results and better understanding of the underlying physiopathology
Should we add antiplatelet agents to current deep venous thrombosis treatments? A Cochrane Review summary with commentary
No full textBACKGROUND: Venous thromboembolism (VTE) is an important complication in rehabilitation practice despite preventive measures. The management can be complicated because patients may have co-existing cardiovascular comorbidities. OBJECTIVE: To assess the effects of antiplatelet agents in addition to current best medical practice (BMP) compared to current BMP (with or without placebo) for the treatment of deep venous thrombosis (DVT).METHODS: A summary of the Cochrane Review by Flumignan et al. (2022), with comments from a rehabilitation perspective.RESULTS: The review included six studies with 1625 eligible participants, with data up to 37.2 months of follow-up. When used after standard initial treatment with anticoagulants, antiplatelet agents such as aspirin in addition to BMP, may reduce recurrence of DVT or pulmonary embolism, when compared to BMP plus placebo in a chronic DVT setting and there may be a lower risk for post-thrombotic syndrome in patients with acute DVT. There is no clear difference in side effects, major bleeding, or pulmonary embolism (PE) with the use of antiplatelet agents.CONCLUSION: Adding antiplatelet agents to standard anticoagulation treatment in patients with VTE could provide benefit without increasing risks in selected patient groups. However, high quality studies with a long-term follow up are needed, including patients in rehabilitation settings
A medicine for tall, white, blond-haired and blue-eyed, middle-aged, physically active, rich males?
No full textMeasurements of radioactivity of ancient roman lead to be used as schield in search of rare events
No full textExercise and heart failure: an update
No full textThe present update is dedicated to the evolution of the interaction between heart failure (HF) and exercise and how the scientific community has handled it. Indeed, on the one hand, HF is a leading cause of morbidity and mortality with a stable prevalence from 1998 onward varying between 6.3% and 13.3%. On the other hand, exercise is seen as a diagnostic and prognostic tool as well as a therapeutic intervention in chronic HF. More precisely, the knowledge, the clinical application, and the research interest on the mutual interactions between exercise and HF have different phases in disease progression: Before HF onset (past): exercise provides protective benefit in preventing HF (primary prevention). With HF present: exercise improvement with training provides benefits in HF (secondary prevention). The prediction of future in HF patients: exercise impairment, as a leading characteristic of HF, is used as a prognostic factor
Evaluation of exercise performance after cardiac resynchronization therapy in heart failure patients
No full textINTRODUCTION
More than one third of the patients with congestive heart failure presents ventricular conduction delay which results in a decrease in heart’s contractility and reduced oxygen consumption (VO2). Those patients have more symptoms, worse clinical prognosis and the risk of death is higher. Biventricular pacing of the left and right ventricle simultaneously improves ventricular coordination, hemodynamics and peak VO2 increases significantly during cardiopulmonary exercise testing. Based on Fick’s law, peak VO2 depends on cardiac output and the arteriovenous content difference [C(a-v)O2].
METHODS
We have enrolled in our clinical trial 104 patients who were meeting the criteria of the European Society of Cardiology from 2016 for the implantation of the biventricular cardiac resynchronization therapy.
A total 14 patients refused to participate in the study and the remaining 90 patients were analyzed based on clinical, electrocardiographic and echocardiographic evaluation, non-invasive inert gas rebreathing method before implantation of CRT and 9±5 months after the implantation.
RESULTS AND CONCLUSIONS
Functional NYHA class has improved significantly from 2.5±0.5 to 1.97±0.44; as well as all echocardiographic parameters: LV ejection fraction has improved from 29.1±7 % to 35.6±9 %; LV end-diastolic volume has decreased from 212.8±69 mL to 188±70 mL; LV end-systolic volume has decreased from 152.5±59 mL to 125.2±60 mL. At peak exercise we have achieved a significant improvement of peak VO2 from 1065±338 mL/min to 1171.1±369 mL/min which relates to an improvement of cardiac output from 6.09±1.9 L/min to 6.93±2.2 L/min; while the arteriovenous O2 content difference has remained unchanged. The results from the study suggest that CRT is a useful therapeutic modality to preserve or improve cardiac function and submaximal and maximal exercise capacity in patients with heart failure and intraventricular conduction delay.
OBJECTIVE: to evaluate exercise performance after cardiac resynchronization therapy (CRT) in heart failure patients and to analyze the effects of biventricular PM therapy in the pathophysiology of heart failure
Improvement of the GERDA ge detectors energy resolution by an optimized digital signal processing
No full textThe GERmanium Detector Array (Gerda) at the Gran Sasso Underground Laboratory (LNGS) searches for the neutrinoless double beta decay ( 0νββ ) of76 Ge. Germanium detectors made of material with an enriched76 Ge fraction act simultaneously as sources and detectors for this decay. During Phase I of theexperiment mainly refurbished semi-coaxial Ge detectors from former experiments were used. For the upcoming Phase II, 30 new76 Ge enriched detectors of broad energy germanium (BEGe)-type were produced. A subgroup of these detectors has already been deployed in Gerda during Phase I. The present paper reviews the complete production chain of these BEGe detectors including isotopic enrichment, purification, crystal growth and diode production. The efforts in optimizing the mass yield and in minimizing the exposure of the76 Ge enriched germanium to cosmic radiation during processing are described. Furthermore, characterization measurements in vacuum cryostats of the first subgroup of seven BEGe detectors and their long-term behavior in liquid argon are discussed. The detector performance fulfills the requirements needed for the physics goals of Gerda Phase II
Single-transistor option for high-resolution gamma-ray spectroscopy in hostile environments
No full textWe designed and realized a low-noise charge preamplifier for HPGe (High Purity Germanium) gamma-ray detectors, able to operate at a distance of 3 to 6 m from the detector. One transistor only is placed in close proximity to the detector. Such a setup is required in applications where the detector works in hostile environments that could damage or destroy the electronic circuitry. Using 3 m RG62 cables and a 23 pF detector capacitance we obtained a noise of ~1.07 keV fwhm at 2 μs shaping time, so fully compatible with gamma-spectroscopy requirements. By compensating the preamplifier so as to completely eliminate the ringings in its response function we obtained a rise-time of ~46ns with 3 m cables and of ~80ns with 5 m cables. With a different approach, or using a lower compensation capacitance and eliminating the ringings through a numerical post filter, we obtained a faster rise time of ~33 ns, with a detector-preamplifier distance of 5 m, while maintaining the low-noise performance. This latter setup is adequate for spectroscopy and tracking of gamma rays with segmented HPGe detectors
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