196,103 research outputs found
Equipment for noninvasive mechanical ventilation.
No full textNoninvasive ventilation consists of the application of a ventilator to the patient’s airways without recourse to orotracheal intubation or tracheostomy and therefore requires a range of devices that guarantee mechanical ventilatory support to the spontaneous pulmonary breathing. Two different types of systems are defined, namely closed and opened, depending on the type of circuit and mask used. Mechanical noninvasive ventilator delivers gas flow through pressured or volumed algorithms as well as in the intensive care unit but often are easier to manage. The importance of a good ventilation is often driven by specialized teamwork by clinicians, nursery, and trained personnel. Communicating and receiving feedback from the patient who needs to undergo a NIV session, if possible, increases compliance and improves the outcome of care significantly. Technical aspects of devices with detailed references to interfaces, management, and prevention of ventilation side effects are reported
Sleep-related hypoxaemia and excessive erythrocytosis in Andean high-altitude natives
Get PDFSleep-related hypoxaemia and excessive erythrocytosis in Andean
high-altitude natives.
L. Spicuzza * , N. Casiraghi # , A. Gamboa } , C. Keyl z , A. Schneider z , A. Mori § , F. Leon-Velarde } , G.U. Di Maria * , L. Bernardi #
*Dept of Internal Medicine and Medical Specialities, University of Catania, # Dept of Internal Medicine and § Pathology, IRCCS S. Matteo and University of Pavia, Italy. } University Cayetano Heredia, Lima, Peru. z Dept of Anaesthesiology, University of Regensburg, Germany.
To determine whether nocturnal hypoxaemia contributes to the excessive erythrocytosis (EE) in Andean natives, standard polysomnographies were performed in 10 patients with EE and in 10 controls (mean haematocrit 76.6 +/- 1.3% and 5.4 +/- 0.8%, respectively) living at an altitude of 4,380 m. In addition, the effect of O2 administration for 1 h prior to sleep, and the relationship between the hypoxic/hypercapnic ventilatory response and the apnoea/hypopnoea index (AHI) during sleep were studied. Awake arterial oxygen saturation (Sa,O2) was significantly lower in patients with EE than in controls (83.7 +/- 0.3% versus 85.6 +/- 0.4%). In both groups, the mean Sa,O2 significantly decreased during sleep (to 80.0 +/- 0.8% in EE and to 82.8 +/- 0.5% in controls). The mean Sa,O2 values remained significantly lower in patients with EE than in controls at all times of the night, and patients with EE spent significantly more time than the controls with an Sa,O2 of <80%. There were no differences between the two groups in the number and duration of the apnoeas/hypopnoeas. None of these variables were affected by O2 administration. In both groups the AHI positively correlated with the hypercapnic ventilatory response. Andean natives undergo minor respiratory disorders during sleep. The reduction in oxygen saturation found in subjects with excessive erythrocytosis was small, yet consistent and potentially important, as it remained below the threshold known for the increase in erythropoietin stimulation. This may be an important factor promoting erythropoiesis, but its relevance needs to be further explored
Arthroscopic shoulder instability surgery in patients under 25 years of age: the key role of soft tissue with both anterior and posterior axillary hammock tensioning
No full textBackground The arthroscopic treatment of shoulder instability is widely debated in the literature and includes very different surgical techniques. Imaging techniques do not allow an accurate assessment of soft tissue quality. The aim of the study is to demonstrate that correct patient selection and a surgical technique involving anterior and posterior capsular ligament repair with axillary retention may be the most crucial factors for successful arthroscopic treatment. Methods Patients with recurrent shoulder instability who underwent arthroscopic stabilization between 2014 and 2015 and aged between 15 and 25 years, were included. The minimum follow-up was 5 years. Specific exclusion criteria were critical bone loss and patients with genetic connective tissue disorders. Demographics, instability characteristics, surgical procedures, recurrences, both dislocations and subluxations, and surgical revisions were evaluated. The surgical procedure, always performed by the same surgeon, involved the use of a minimum of 3 double-suture fixation devices and repair/tensioning of the axillary hammock. Statistical analysis was based on the non-parametric Kendall statistical model and proportions test, with p < 0.05. Results The study population consisted of 44 patients. The first dislocation occurred in 61.4% of cases between the ages of 15 and 19. The number of dislocations prior to surgery was < 3 in 29.5%, between 3 and 9 episodes in 25%, and 10 or more episodes in 45.5%. Defined by patients who had no recurrent dislocations and those whose symptom of instability or subluxation did not require surgical revision, the surgical success rate was 90.9%. During the follow-up period, 4.5% of patients required surgical revision. Patients who required none or one reduction maneuver or had less than three dislocation episodes were statistically correlated with no recurrences after surgery. After the first dislocation, the 88.6% of patients had recurrency. Furthermore, if treated after only one episode, 75% of patients were affected by an isolated capsulolabral injury. Prompt stabilization surgery allows a simpler procedure, due to a reduced bone damage and associated injuries. Conclusions Even in a high-risk age group under 25 years, when the bone defect is subcritical, performing a standardised surgical technique including antero-posterior capsulolabral repair with axillary hammock retensioning demonstrates high success rates. Patients who correlate with the highest chance of success are those who have had less than three dislocation episodes and who have not undergone reduction manoeuvres, confirming the importance of soft tissue quality and thus of early treatment
Hepatitis B vaccine administered by intradermal route in patients with celiac disease unresponsive to the intramuscular vaccination schedule: A pilot study
No full textIgE values and T-lymphocyte subsets in children with atopic eczema/dermatitis syndrome
No full textHigh levels of IgE and IgE-mediated reactions represent a typical finding in patients with atopic eczema/dermatitis syndrome (AEDS). However, 10-30% of patients usually do not show any increase of total blood IgE levels and any detectable specific IgE sensitization. We performed this study to evaluate the difference of T-lymphocyte subsets in AEDS patients with high or normal IgE values. We enrolled 21 children with AEDS who were at least two years of age (8 boys and 13 girls, aged 2-13 years) and 20 children as control cases with the same age and sex. These patients were classified as IgE-associated AEDS or not IgE-associated AEDS syndrome according to their IgE levels. We used monoclonal antibodies against CD3 (T cells), CD4 (T-helper cells), CD8 (T-cytotoxic cells), CD 19 (B cells), CD56 and CD16 (natural killer cells), CD3/HLA-DR (activated T cells), CD45Ra in CD4 (naive lymphocytes), CD25 (interleukin-2 receptor), CD57 in CD3 (suppressor/cytotoxic), and CD5 in CD20 (Becton Dickinson, Mountain View, CA). The severity of atopic dermatitis (AD) was determined according to the Scoring Atopic Dermatitis (SCORAD) index. Moreover, we checked the levels of peripheral blood eosinophils and of total and specific IgE for a panel of inhalant and food allergens. We found that the CD8+ level was significantly lower and the CD4/CD8 ratio was significantly higher than in healthy cases. Moreover, patients with not IgE associated AEDS (aAD) showed CD4+ levels significantly higher than IgE aAD patients and healthy controls. We found no difference of the SCORAD index in the two groups but there was an inverse relationship between this index and CD4/CD8 ratio. We did not find any correlation between IgE levels and the SCORAD index between eosinophils and SCORAD index or between age and IgE values. A decrease of CD8+ circulating T cells and an increase of the CD4/CD8 ratio are peculiar findings in AEDS patients with either high or normal IgE values
Dr. Duane M. Jackson, Morehouse College, July 2011
No full textThis video is a conversation with Dr. Duane M. Jackson. Dr. Jackson talks about his paper, "Recall and the Serial Position Effect: The Role of Primacy and Recency on Accounting Students' Performance." Jackie Daniel, AUC Woodruff Library, is the interviewer
EXPLORING THE UNDERLYING MECHANISMS IN THE DEVELOPMENT OF AMBIVALENT SEXISM IN YOUNGER GENERATIONS A Research Contribution
No full textThe result of a research project at the University of Palermo, this book attempts a multidisciplinary response to the psychological, educational and cultural demands and needs of the student population regarding gender representations and stereotypes. It is structured in three parts: the first is devoted to the “Psychodynamic Perspective”, i.e., the detection and screening of representations of the self; the second is devoted to the “Pedagogical Perspective”, i.e., the detection and analysis of the educational needs of the students of the University of Palermo thanks to an analysis of male and female representation and the related educational needs of a group of University of Palermo students; and the third to “The narrative workshop”, aimed at analyzing the texts produced by the students and the proposed literary texts – by bell hooks, and Elena Ferrante – focused on the representation of the relations between the male and female universes. Finally, an appendix collects the texts produced by the students
A rare case of pediatric tuberculosis associated with diffuse bilateral bronchiectasis
No full textIn Italy 3.5% of all cases of tuberculosis occur in pediatric age, with a grater incidence
(about ten-fold) among children of immigrants. We describe the case of an Indonesian
child resident in Italy, whose anamnesis showed neither a family history of tuberculosis
nor an obvious exposure to this disease. The child was hospitalized in our Department for
persistent fever, and cervical lymphadenopathy, and was diagnosed as having active tuberculosis
only after a long diagnostic work-up. In addition to the common apical localization,
lung injury was characterised by bronchiectasis involving both lungs, probably
due to a process of traction.In Italy 3.5% of all cases of tuberculosis occur in pediatric age, with a grater incidence (about ten-fold) among children of immigrants. We describe the case of an Indonesian child resident in Italy, whose anamnesis showed neither a family history of tuberculosis nor an obvious exposure to this disease. The child was hospitalized in our Department for persistent fever, and cervical lymphadenopathy, and was diagnosed as having active tuberculosis only after a long diagnostic work-up. In addition to the common apical localization, lung injury was characterised by bronchiectasis involving both lungs, probably due to a process of traction
"Reflections on the subject of Emigration from Europe with a view to Settlement in the United States" By M. Carey.
No full text"Reflections on the subject of Emigration from Europe with a view to Settlement in the United States: containing bried sketches of the moral and political character of those states.
By M. Carey, member of the American philosophical, and of the American Antiquarian Society, and author of The Olive Branch, Cindiciae Hibernicae, essays on banking, on political economy, and on internal improvement.
To which are now added the English editor's comments on the subject; together with Important Advice to Emigrants, and Cautions Against Impositions Practiced in the Outports
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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