130 research outputs found
Oncologia Medica
No full textIl capitolo in questione tratta sia i farmaci ormai consolidati della terapia oncologica, sia in modo particolare tutti i principali progressi farmacologici nella cura delle malattie tumorali
Trattamento della comorbidità nel paziente anziano: prospettive future
No full textIntroduzione: in tutto il mondo si verifica un aumento della popolazione anziana, legato all'allungamento della vita media ed al miglioramento della qualitˆ della vita. Materiali e metodi: per effettuare questo studiAno ci siamo avvalsi di una cartella cinica informatizzata creata per archiviare ed elaborare i dati clinici ambulatoriali. Analisi dei dati: abbiamo valutato 250 pazienti che afferivano al nostro ambulatorio. Il ricovero ? stato necessario durante il periodo preso in considerazione per 52 pazienti. Risultati: la gestione ambulatoriale polifunzionale informatizzata ha consentito di ottimizzare il lavoro permettendo una migliore gestione del paziente (maggiore disponibilitˆ e reperibilitˆ delle informazioni cliniche) ed un notevole risparmio in termini economici (riduzione dei ricoveri impropri) e di tempo
Effect of Low dose of Sacubitril/Valsartan in patients with Chronic Severe Heart Failure on Body composition, Bioimpedenziometry, Heart Rate Variability and T-peak-to T-end index.
No full textObjective: We evaluated the role of sacubitril/valsartan in heart rate variability, T-peak to T-end index, external cell mass, internal cell mass and total body water in elderly patients with heart failure with reduced ejection fraction (HFrEF).
Methods: Eleven elderly patients (9 males; mean age 77 years, range 70–87; 2 females, mean age 60 years, range 50–71) with HFrEF (<35%) were included in this analysis. Four patients presented moderate chronic kidney failure (creatinine clearance [CrCl] 30–59 mL/min) and four patients with diabetes (HbA1c >6.5%). All patients had hypertension and dyspnoea due to HF. Clinical outcomes of this investigation were kidney function, glucose, brain-natriuretic peptide, heart rate variability, T-peak to T-end index and markers of body water composition with bioelectrical impedance analysis (BIA).
Results: One-month therapy with sacubitril/valsartan 24/26 mg/bid was associated with an improved redistribution of body water (extracellular mass: 19.4 ± 3.0 at baseline vs 18.4 ± 2.6 Kg/m at 1 month; p = .001), body weight reduction (81 ± 8 vs 78 ± 8 Kg; p = .002) and improved clinical outcomes (i.e. reduction of dyspnoea, mean duration of symptoms and walking test).
Conclusions: Based on our preliminary results, sacubitril/valsartan could be a new effective approach in the treatment of elderly patients with chronic HFrEF. However, further studies are necessary to confirm these preliminary findings
Artificial intelligence for heart rate variability analyzing with arrhythmias
No full textIntroduction. Existing standards of Heart Rate Variability (HRV) technology limit its use to sinus rhythm. A small number of extrasystoles is allowed, if the device used has special procedures for the detection and replacement of ectopic complexes. However, it is important to expand the indicated limits of the applicability of the HRV technology. This specially regards the cases when the HRV technology looks promising in the diagnostics, as, for example, in atrial fibrillation and atrial flutter.
Materials and Methods. All ECG measurements were performed on XAI-MEDICA® equipment and software. Processing of the obtained RR Series was carried out using the software Kubios® HRV Standard. All recommended HRV characteristics for Time-Domain, Frequency-Domain and Nonlinear were calculated.
The purpose of the work. The article presents an artificial intelligence (AI) procedure for detecting episodes of arrhythmias
and reconstruction of core patient’s rhythm, and demonstrates the efficacy of its use for the HRV analysis in patients with varying degrees of arrhythmias.
The results of the study. It was shown efficiency of developed artificial intelligence procedure for HRV analyzing of patients with different level of arrhythmias. These were demonstrated for Time-Domain, Frequency-Domain and Nonlinear methods. The direct inclusion into review of Arrhythmia Episodes and the use of the initial RR Series leads to a significant distortion of the results of the HRV analysis for the whole set of methods and for all considered options for arrhythmia.
Conclusion. High efficacy of operation of the procedure AI core rhythm extraction from initial RR Series for patients with arrhythmia was reported in all cases
Intermittent flow parameters from void fraction analysis
No full textTwo-phase horizontal intermittent flow in straight pipes is experimentally investigated. A new procedure is proposed to characterize the flow through the statistical analysis of the instantaneous cross-sectional averaged void fraction obtained by means of ring impedance probes. The algorithm, based on the statistical analysis of the void fraction records, allows the main intermittent flow parameters, such as slug frequency and length, time average void fraction, minimum and average liquid film height to be evaluated. The procedure is validated through flow visualizations, as obtained from a fast digital video camera.
Experiments on air-water horizontal flows in 40 mm and 60 mm inner diameter pipes are performed. The operating conditions cover the 0.3-4.0 m/s and 0.6-3.0 m/s gas and liquid superficial velocity ranges, respectively.
An extensive comparison with literature data shows a general agreement with present measurement. The reliability of both the instrumentation and the signal analysis procedures allows new correlations for minimum and average liquid film height in stratified regions to be proposed. Finally proper dimensionless numbers were applied to correlate frequency data in a wide range of superficial velocity values
Effect of Ferric Sodium EDTA administration, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine, on cardiovascular risk evaluation: exploration of the HRV frequency domain
No full textdiseases. Using the Heart Rate Variability (HRV) analysis is possible to provide an evaluation of the safety and the
effectiveness of intervention.
Objective: To evaluate the efficacy and safety of Ferric Sodium EDTA in combination with vitamin C, folic acid, copper
gluconate, zinc gluconate and selenomethionine (Ferachel forte®) 2 tabs/day for 24 days in elderly patients with secondary
anaemia, by exploring the HRV frequency domain.
Methods: In 45 elderly patients with secondary anaemia and/or low-moderate kidney failure, laboratory values after
administration of Ferric Sodium EDTA, 2 tabs a day, in combination with vitamin C, folic acid, copper gluconate, zinc
gluconate and selenomethionine (Ferachel forte®) for 24 days (N=16 patients) or ferrous gluconate 63 mg/day added to
saline solution, administered using intravenous access during the hospitalization period of 15 ± 5 days (N=29 patients)
were evaluated. Also, ECG signals and bioelectrical impedance (BIA) were measured.
Results: Oral iron supplementation with Ferric Sodium EDTA, in combination with vitamin C, folic acid, copper gluconate,
zinc gluconate and selenomethionine (Ferachel forte®) confirmed to be effective and safe about the cardiovascular risk
in old patients. This study showed the real superiority of the oral administration about the cardiovascular risk in elderly
patients in comparison with intravenous administration of ferrous gluconate.
Conclusion: This study confirms that Ferric Sodium EDTA combination (Ferachel forte®) can be a valid alternative to ferrous
gluconate intravenous therapy (gold standard) in the treatment of secondary anaemia in elderly patients. In fact, during
the treatment, efficacy results have been maintained without statistically significant variations about cardiovascular risk,
evaluated by exploring the HRV frequency domain
A Bus Driver Scheduling Problem: a new mathematicalmodel and a GRASP approximate solution
No full textThis paper addresses the problem of determining the best scheduling for
Bus Drivers, a N P-hard problem consisting of finding the minimum number of
drivers to cover a set of Pieces-Of-Work (POWs) subject to a variety of rules and
regulations that must be enforced such as spreadover and working time. This problem
is known in literature as Crew Scheduling Problem and, in particular in public
transportation, it is designated as Bus Driver Scheduling Problem. We propose a new
mathematical formulation of a Bus Driver Scheduling Problem under special constraints
imposed by Italian transportation rules. Unfortunately, this model can only
be usefully applied to small or medium size problem instances. For large instances,
a Greedy Randomized Adaptive Search Procedure (GRASP) is proposed. Results
are reported for a set of real-word problems and comparison is made with an exact
method. Moreover, we report a comparison of the computational results obtained
with our GRASP procedure with the results obtained by Huisman et al. (Transp. Sci.
39(4):491–502, 2005)
Osteosarcoma parostale del femore in una donna di 49 anni: un tumore raro ad un'età inusuale.
No full textA case of ventricular Ffibrillation (VF) in patient affected by chronic obstructive pulmonary disease (COPD), obstructive sleep apnoea syndrome, electrolytes disorder and frailty
No full textChronic obstructive pulmonary disease (COPD) is associated with an increased cardiovascular risk, although the pathophysiological mechanisms responsible for this interdependence are not completely known. For instance, the increased sympathetic activity may be implied. The severity of COPD correlates with various arrhythmic manifestations such as atrial fibrillation, atrial flutter, and either sustained or nonsustained ventricular tachycardia. COPD and obstructive sleep apnea syndrome may increase the overall cardiovascular risk, especially in elderly patients. Additionally, electrolytic disorders
may precipitate cardiac rhythm disturbances and thus cause important arrhythmic consequences such as ventricular fibrillation, as reported in our clinical case. We discuss here the possible treatment of this association of pathological conditions on the basis of a single case we have successfully
treated, and provide a brief review of the available literature regarding cardiovascular comorbidities in COPD patients. © 2018 S. Karger AG, Base
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