101,998 research outputs found
Echocardiographic Evaluation of Neoplastic Infiltration of the Heart and Great Vessels: Preliminary Experience with Panoramic and Omniplane Probes
No full textEvaluation of the Electromagnetic Power Absorption in Humans Exposed to Plane Waves: The Effect of Breathing Activity
No full textThe safety aspects of the exposure of people to uniform plane waves in the frequency range from 900 MHz to 5 GHz are analyzed. Starting from a human body model available in the literature, representing a man in resting state, two new anatomical models are considered, representing different phases of the respiratory activity: tidal breath and deep breath. These models have been used to evaluate the whole body Specific Absorption Rate (SAR) and the 10-g averaged and 1-g averaged SAR. The analysis is performed using a parallel implementation of the finite difference time domain method. A uniform plane wave, with vertical polarization, is used as an incident field since this is the canonical exposure situation used in safety guidelines. Results show that if the incident electromagnetic field is compliant with the reference levels promulgated by the International Commission on Non-Ionizing Radiation Protection and by IEEE, the computed SAR values are lower than the corresponding basic restrictions, as expected. On the other side, when the Federal Communications Commission reference levels are considered, 1-g SAR values exceeding the basic restrictions for exposure at 4 GHz and above are obtained. Furthermore, results show that the whole body SAR values increase passing from the resting state model to the deep breath model, for all the considered frequencies
Data set from Dellafiore F, Arrigoni C, Ghizzardi G, Baroni I, Conte G, Turrini F, Castiello G, Magon A, Pittella F, Caruso R. Development and validation of the pressure ulcer management self-efficacy scale for nurses. J Clin Nurs. 2019 Sep;28(17-18):3177-3188. doi: 10.1111/jocn.14875. Epub 2019 Apr 21. PMID: 30938908.
No full textData set from Dellafiore F, Arrigoni C, Ghizzardi G, Baroni I, Conte G, Turrini F, Castiello G, Magon A, Pittella F, Caruso R. Development and validation of the pressure ulcer management self-efficacy scale for nurses. J Clin Nurs. 2019 Sep;28(17-18):3177-3188. doi: 10.1111/jocn.14875. Epub 2019 Apr 21. PMID: 30938908
This is the abstract:
Background: Pressure ulcers (PUs) represent a current issue for healthcare delivery. Nurse self-efficacy in managing PUs could predict patients' outcome, being a proxy assessment of their overall competency to managing PUs. However, a valid and reliable scale of this task-specific self-efficacy has not yet been developed.
Objectives: To develop a valid and reliable scale to assess nurses' self-efficacy in managing PUs, that is, the pressure ulcer management self-efficacy scale for nurses (PUM-SES).
Methods: This study had a multi-method and multi-phase design, where study reporting was supported by the STROBE checklist (File S1). Phase 1 referred to the scale development, consisting in the items' generation, mainly based on themes emerged from the literature and discussed within a panel of experts. Phase 2 focused on a three-step validation process: the first step aimed to assess face and content validity of the pool of items previously generated (initial version of the PUM-SES); the second aimed to assess psychometrics properties through exploratory factorial analysis; the third step assessed construct validity through confirmative factorial analysis, while concurrent validity was evaluated describing the relationships between PUM-SES and an established general self-efficacy measurement. Reliability was assessed through the evaluation of stability and internal consistency.
Results: PUM-SES showed evidence of face and content validity, adequate construct and concurrent validity, internal consistency and stability. Specifically, PUM-SES had four domains, labelled as follows: assessment, planning, supervision and decision-making. These domains were predicted by the same second-order factor, labelled as PU management self-efficacy.
Conclusion: PUM-SES is a 10-item scale to measure nurses' self-efficacy in PU management. A standardised 0-100 scoring is suggested for computing each domain and the overall scale. PUM-SES might be used in clinical and educational research.
Relevance to clinical practice: Optimising nurses' self-efficacy in PU management might enhance clinical assessment, determining better outcomes in patients with PUs
Mechanisms of coronary flow reserve impairment in human hypertension - An integrated approach by transthoracic and transesophageal echocardiography
No full textThe purpose of this study was to investigate the different mechanisms responsible for an impairment of coronary vasodilator capacity in hypertensive subjects by an integrated echocardiographic approach, including transesophageal Doppler echocardiography, which allows noninvasive monitoring of coronary flow velocity in the left anterior descending artery during pharmacological vasodilation. The study population consisted of 17 healthy control subjects and 33 hypertensive subjects: 10 without hypertrophy, 16 with mild to moderate hypertrophy, and 7 with severe left ventricular hypertrophy. Mean systolic and diastolic flow velocities were monitored basally (together with indexes of myocardial oxygen demand, such as heart rate, myocardial inotropism, and left Ventricular wall stress) and during infusion of low-dose (0.56 mg/kg per 4 minutes) and high-dose (0.84 mg/kg per 9 minutes) dipyridamole. Coronary reserve was assessed as the ratio of mean diastolic velocity after high-dose dipyridamole and basal diastolic velocity, and minimum coronary resistance as the ratio of diastolic blood pressure and diastolic velocity after high-dose dipyridamole. Compared with the control group, in all hypertensive groups, coronary reserve was similarly decreased (3.54+/-0.84 versus 2.59+/-0.42, 2.29+/-0.46, and 2.43+/-0.71; P<.01) and minimum resistance increased (0.56+/-0.15 versus 0.75+/-0.31, 0.75+/-0.19, and 0.78+/-0.21 mm Hg . s(-1). cm(-1); P=NS). These results confirm that coronary reserve in hypertensive individuals is reduced even before the occurrence of left ventricular hypertrophy. The reduction in coronary reserve depends on both an increase in resting coronary flow and an impairment in maximal vasodilator capacity. An increase in resting flow is dependent on higher heart rate and wall stress in hypertensive subjects without ventricular hypertrophy and on increased myocardial mass in hypertensive subjects with hypertrophy. Hypertensive subjects with ventricular hypertrophy also demonstrated a significantly blunted response to low-dose dipyridamole
Transesophageal echocardiography in myocardial ischemia: a review.
No full textThis article reviews established as well as emerging fields in the application of transesophageal echocardiography (TEE) in the investigation of myocardial ischemia. TEE already has a well defined and established role in stress echocardiography in patients with poor transthoracic acoustic window, and in the detection of intraoperative myocardial ischemia in cardiac and noncardiac surgery. The evaluation of right ventricular ischemia and infarction and the assessment of coronary flow reserve (CFR) are relatively new fields in the application of TEE and the potential of this technique has not yet been fully evaluated. The evidence collected and reviewed in this article is still preliminary but it presupposes a significant role of TEE in the diagnosis and pathophysiological assessment of myocardial ischemia
Il ruolo del laboratorio chimico-tossicologico nell’ambito del contratto terapeutico con il tossicodipendente
No full textHypertension and Left Ventricular Hypertrophy Further Impair Utilization of the Reduced Coronary Reserve in Patients with Coronary artery Stenosis
No full textLeft ventricular hypertrophy (LVH) predisposes to an increased infarct size after coronary occlusion in dog. Aim of the study was to investigate the impact of the coexistence of LVH secondary to hypertension and coronary stenosis on the coronary vasodilator capacity in man. Coronary flow velocity in left anterior descending artery (LAD) was monitored by Transesophageal-Doppler at baseline and during low- and high-dose of iv. Dipyridamole (0.56mg/Kg/4min followed after 2min by 0.28mg/Kg/2min) in 56 patients, divided as follows: 19 normal controls (N Group), 21 pts with hypertension, LVH and no CAD (LVH Group), and 16 pts with moderate LAD artery stenosis (≤ 75%) [10 without LVH (LAD Group) and 6 with LVH secondary to hypertension (LAD + LVH Group)]. All pts had Dipyridamole Echo test negative for left ventricular asynergy. Blood pressure and left ventricular mass were similar in N vs LAD pts, and in LVH vs LAD + LVH. Mean total coronary flow velocity was measured from Doppler recordings. Coronary reserve was computed as the ratio of high-dose Dipyridamole to Basal flow velocity. Minimum coronary resistance and the percent of coronary reserve recruited after low-dose Dipyridamole were also computed.ResultsBaseline coronary flow velocity was 29±6 cm/sec in N, and significantly higher in LVH and CAD (39±11 and 41±11, respectively, p<0.01). Coronary flow velocity after high-dose Dipyridamole was 92±18 in N, and significantly lower only in LAD + LVH (68±16, p<0.05). Coronary reserve was 3.3±0.7 in N, and significantly reduced in all pts subgroups (2.4±0.4, 2.2±0.6, 2.3±0.4 in LVH, LAD, LAD + LVH; P<0.01 vs N). Percent of coronary reserve recruited after low-dose Dipyridamole was 94±8% in N, 91±11% in LAD, and lower in LVH (79±11%, P<0.01 vs N) and in LAD + LVH (69±10%, P<0.05 vs LVH). Compared to N, minimum coronary resistance was significantly higher in LVH (p<0.05) and LAD + LVH (p<0.01) (0.94±0.2 vs 1.20±0.3 and 1.40±0.4 mmHg/ml/min, respectively); it was also higher in LAD + LVH than in LAD alone (1.07±0.2 mmHg/ml/min, p<0.05).ConclusionsCoronary reserve is similarly reduced in pts with LVH secondary to hypertension, LAD stenosis alone, or LVH + LAD stenosis. Coexistence of hypertensive LVH with LAD stenosis is associated. compared to LAD stenosis alone, with significantly higher minimum coronary resistance and a hindered utilization of the reduced coronary reserve
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