2,394 research outputs found
Arresto cardiaco e cure post arresto cardiaco in ambito cardiologico
No full textINTRODUCTION: Cardiac arrest (CA) is a dramatic clinical event due to an absence of mechanical myocardial contraction. Without an emergency intervention it is characterized by high mortality and morbidity. High quality cardiopulmonary resuscitation (CPR) and early defibrillation are the only factors able to reduce neurological damage. The following phases of advanced resuscitation may include different strategies to improve neurological recovery but they are less important than the early phases.
AIM OF THE STUDY: the aim of this PhD was to examine, from an epidemiological point of view, the impact of CA, the organization of out-of-hospital care, the implementation of post CA care and, consequently, the survival rate of post CA patients in Italy and in Veneto region. One of the most important aims was to determine early parameters related with good neurological outcome in post CA patients. In addition to this we investigate the utility and feasibility of mechanical chest compression devices. Furthermore, in resuscitated patients, the effect of temperature changes on coronary flow velocity by transthoracic echocardiography was investigated.
METHODS: the first part of the research (epidemiological) was based on the revision of scientific studies published in PubMed. The survey of therapeutic hypothermia in Intensive Care Units and in Emergency Services was based on a questionnaire/telephonic interview. The second part (clinical research) was based on database analysis of CA patients admitted in Intensive Cardiac Care Units in University Hospital of Padua (for early neurological predictors and coronary blood flow velocity) and in the regional Hospital of Treviso (for mechanical chest compression devices).
RESULTS: epidemiological analysis has shown persistent high mortality rate of CA. Italy, compared with the other European countries, has low rate of CPR before emergency medical service arrival. In Italian ambulances and Intensive Care Units the implementation of post CA care is low compared to the other European countries. Our analyses have shown the possibility to determine neurological outcome only after 24 hours from the index event. NSE values more than 45.1 µg/L or NSE values less than 45.1 µg/L in a patient older than 78 years old are index of unfavourable neurological outcome (respectively p<0.0001 and p=0.009). A good neurological outcome, was associated with NSE value at 24 hours less than 45.1 µg/L in a patient younger than 78 years old with S-100B value at 24 hours <0.31 µg/L (p=0.025). During therapeutic hypothermia at 32°C coronary blood flow velocity showed significant reduction, proportional to rate-pressure product reduction (p=0.0001) with a potential in reducing ischemia-reperfusion damage. Finally the use of mechanical chest compression devices is feasible during cardiac arrest, by allowing the transport of cardiac arrest patients with the possibility to perform emergent coronary angioplasty or ECMO implantation.
CONCLUSION: high quality CPR and early defibrillation are able to improve survival in out-of-hospital CA patients. For this reason it is crucial to spread the resuscitation culture from an institutional level. To increase the prognosis of these patients it is also important to integrate high quality CPR with early defibrillation and advance post CA care. Our data demonstrate the possibility to determine neurological outcome after 24 hours only with biochemical values and the beneficial effect of temperature reduction for myocardial ischemic-reperfusion damage
Reply to the letter to the editor: "ventricular fibrillation and takotsubo syndrome: which one was first?".
No full textAuthor Meets Reader: Not the Marrying Kind: A Feminist Critique of Same-Sex Marriage
No full textThis is an audio recording of an author meets reader session held at the SLSA Annual Conference, University of York, 27 March 2013. Nicola Barker's book, Not the Marrying Kind: A Feminist Critique of Same-Sex Marriage, was the winner of the 2013 Hart SLSA Book Prize. In the session she introduces the book and then engages in discussion about it with Daniel Monk
South Thompson Valley and Pinantan official settlement plan.
No full textThe recommended policies contained in this plan provide the Thompson-Nicola Regional District with the means to protect and enhance the agricultural economic base, regulate the supply and location of rural residential growth, guide commercial and industrial development and satisfy the historical, recreational, social and environmental concerns of the settlement plan area.Not peer reviewedPlanning documen
Rural Residential Study
No full textThe Thompson-Nicola Regional District has recently been grappling with some of the basic problems and conflicts of trying to provide for rural residential lot demand and, at the same tie, trying to protect the resources, aesthetics and social climate of existing rural area.Not peer reviewedstudydraf
A case report of cardiac tamponade after a road accident: think beyond trauma
No full textBackground Cardiac tamponade is a life-threatening compression of the heart caused by the accumulation of fluid in the pericardial sac. Although central venous catheters (CVCs) are essential in modern medicine, they carry a certain risk of complications including cardiac tamponade.Case summary A 12-year-old female was involved in a road accident reporting multiple severe traumatic injuries, including a left humerus fracture and subdural haemorrhage. After 2 days in the intensive care unit, she suddenly developed hypotension and cardiac tamponade was diagnosed. Analysis of the pericardial fluid showed high glucose levels comparable to the parenteral nutrition that she was receiving. Retraction of the CVC allowed resolution of the effusion.Discussion Cardiac tamponade is a rare but serious adverse event after CVC insertion, mostly among younger patients. Awareness of this risk allows physicians to promptly recognize and treat this dangerous complication
The Role of Coordination and Cooperation for Bt-maize cultivation in Brandenburg, Germany
No full textSince 2006, several varieties of transgenic Bt-maize are approved for commercial cultivation in Germany. The German regulatory framework for growing these crops comprises ex-ante regulations as well as ex-post liability rules to protect conventional and organic farming from possible negative side effects of transgenic plants and to ensure co-existence. Public regulation is also suspected to impose additional costs to those farmers who intend to plant Bt-maize. We address the question how Bt-maize growing farmers perceive the additional costs of regulation and whether coordination or cooperation takes place in order to diminish these costs. In 2006, we carried out a case study in the Oderbruch region (Brandenburg, Germany) comprising eight Bt-maize growing farmers and six adjacent neighbours. The predominantly large farms chose intrafarm coordination to manage the construction of buffer zones within their own fields and to avoid the planting of Bt-maize close to their neighbours. Inter-farm coordination or cooperation with adjacent farmers was not regarded necessary to achieve co-existence.Coordination, Cooperation, Bt-maize, Crop Production/Industries,
Standard and natural motion protocols for the kinetic measurements of the squat
No full textTwo motion protocols that describe the sequence of movements to be complied with by a subject to perform a controlled squat are presented. The protocols are intended to be used in gait analysis to obtain repeatable and reproducible results that can be compared among different studies. The first protocol (“standard”) is closer to other studies in the literature, in order to improve comparison with previous experimental results. The second protocol (“natural”) reproduces a squat movement more similar to natural conditions, also allowing a deeper knee flexion. The two motion protocols are tested by a volunteer on a gait lab. Results of experimental tests in terms of joint and foot-ground angles, ground reaction force and centre of pressure show the characteristics of the standard and natural squat, and the repeatability of the tests
- …
