870 research outputs found
David Labate Interview for the Veterans\u27 Voices Project
No full textDavid V. Labate enlisted in the United States Air Force in February 1965. He was a member of Detachment 1, 903th Aeromedical Evacuation Squadron. He served during the Vietnam War and achieved the rank of E-4. He provided medical support for casualties and sick service members in aeromedical flights and casualty staging facilities attached to the Army, Navy, and Marine medical units. He received the Air Medal and the Marine Presidential Unit Citation. Labate left military service in February 1969.https://corescholar.libraries.wright.edu/veterans_voices/1107/thumbnail.jp
Pulmonary Hypertension in Heart Failure Patients : Pathophysiology and Prognostic Implication
No full textPulmonary hypertension (PH) due to left heart disease (LHD), i.e., group 2 PH, is the most common reason for increased pressures in the pulmonary circuit. Although recent guidelines incorporate congenital heart disease in this classification, left-sided heart diseases of diastolic and systolic origin including valvular etiology are the vast majority. In these patients, an increased left-sided filling pressure triggers a multistage hemodynamic evolution that ends into right ventricular failure through an initial passive increase in pulmonary artery pressure complicated over time by pulmonary vasoconstriction, endothelial dysfunction, and remodeling of the small-resistance pulmonary arteries. Regardless of the underlying left heart pathology, when present, PH-LHD is associated with more severe symptoms, worse exercise tolerance, and outcome, especially when right ventricular dysfunction and failure are part of the picture. Compared with group 1 and other forms of pulmonary arterial hypertension, PH-LHD is more often seen in elderly patients with a higher prevalence of cardiovascular comorbidities and most, if not all, of the features of metabolic syndrome, especially in case of HF preserved ejection fraction. In this review, we provide an update on current knowledge and some potential challenges about the pathophysiology and established prognostic implications of group 2 PH in patients with HF of either preserved or reduced ejection fraction
Group 2 PH : Medical Therapy
No full textPulmonary hypertension (PH) secondary to left heart disease, classified as Group 2, is a widely underestimated target of therapy. Prevention and treatment of initial subclinical stages are not valued as a priority in the management of this chronic disease population, whereas attention is high for PH consequences in patients with advanced heart failure (HF) requiring a left ventricular mechanical assist device or heart transplant candidates. Even so, there is a growing interest toward the evidence of a clinical and prognostic role of PH in the elderly populations and in HF with preserved ejection fraction (HFpEF). Certainly, along with a prevalence definition not yet defined, the search for effective pharmacological approaches that might favorably affect the aging process and the natural history of HFpEF from earlier stages is not an easy task. Pharmacological studies that have tested some traditional pulmonary arterial hypertension approved drugs (i.e., prostanoids and endothelin-1 receptor blockers) primarily in PH and HF with reduced ejection fraction have not been positive, especially because of concomitant side effects, i.e., systemic hypotension, fluid retention and hepatic toxicity. In recent years, interest has moved toward drugs overexpressing the nitric oxide (NO)-cyclic guanosine monophosphate pathway with recent availability of well-tolerated selective pulmonary vasodilators, such as phosphodiesterase type 5 inhibitors and guanylate cyclase stimulators. Single center studies performed with these drugs have shown good tolerability and safety profile providing alternating hemodynamic results mainly because of recruitment of patients at different stages of the pulmonary vascular disease. Nonetheless, the overexpression of NO pathway appears to remain the most solid background for targeting lung microvessel dysfunction and treating RV dysfunction since the earliest stages of the disease
Povertà e potere. Un corpo a corpo
No full textThe question that moves this essay is whether there is an opposite of power, which is not non-power as a simple negation, but its opposite. If it is possible to fight against power without submitting to its essence. Poverty could be interpreted in this sense, as a form of conscious dispossession of the will to dominate
Past, present, and future rehabilitation practice patterns for patients with heart failure : the European perspective
No full textThe recent European Society of Cardiology position paper strongly advises participation of patients with stable heart failure (HF) in structured exercise training (ET) programs, and in most recent years considerable efforts have been put into standardization of exercise prescription. Up to now, 3 ET modalities are proposed for HF populations with variable combinations and extent of effects: (1) endurance aerobic (continuous and interval); (2) strength/resistance; (3) respiratory. Irrespective of ET modalities, most of the studies have clearly demonstrated significant improvements in exercise physiology (ie, oxygen consumption, muscle function, and ventilation), quality of life, and left ventricular function
Neutrophil gelatinase-associated lipocalin immunoexpression in colorectal carcinoma: A stage-specific prognostic factor?
No full textTNM post-surgical staging is considered to be one of the most powerful prognosticators for colorectal carcinoma. Although patient survival mostly decreases concomitantly to stage increase, in a percentage of cases TNM stage appears only to express the anatomic extent of the neoplasia with no correlation with clinical outcome. Thais, the identification of additional prognostic markers for colorectal cancer is required. Neutrophil gelatinase-associated lipocalin (NGAL) is a 25-kDa protein that appears to play an important role in colorectal cancer progression. In order to evaluate whether NGAL expression may be considered as a predictor of colorectal cancer progression, we analyzed its correlation with clinicopathological characteristics, as well as with patient progression-free survival in a series of surgically resected colorectal carcinomas. A variable NGAL immunoexpression was found in 24 out of the 64 analyzed cases. When only the positive cases were considered, a significant association was found between a high NGAL expression and the presence of distant metastases or high tumor stage. In addition, the presence of NGAL was a significant negative prognostic marker correlated with a shorter progression-free survival in stage I colorectal carcinoma, but not in the remaining TNM stages. If our findings are confirmed in more extensive analyses on stage I colorectal carcinoma, NGAL assessment may be used in order to select those patients with a higher progression risk and to submit them to adjuvant therapies useful to prevent adverse outcome
A command governor approach to plasma shape control
No full textThe paper deals with the application of the socalled Command Governor (CG) approach to the shape control of plasmas in thermonuclear fusion reactors. A primal internal loop controlling the plasma-wall gaps is designed first and a CG device is then tuned to modify, whenever necessary, the reference to the primal loop, taking into account constraints due to voltages saturations on the converters, currents limitations in the active coils, force limits on the mechanical structures, minimum clearance between the plasma and the vacuum chamber wall, maximum induced forces on coils. The reference signal modification is accomplished through an online optimization procedure which embodies plasma model forecasts computed along a finite time virtual receding horizon as usual in model predictive paradigms. The ITER (International Thermonuclear Experimental Reactor) tokamak is assumed as a case study. Numerical simulations are carried out on a numerical nonlinear model taking into account almost a hundred of constraints. ©2009 IEEE
Constrained plasma shape control in ITER
No full textThis paper presents an application of a novel constrained control methodology known as Command Governor (CG) to the shape control of plasmas in thermonuclear fusion reactors. The CG strategy is based on predictive control ideas and consists in modifying, whenever necessary, the reference signal supplied to a primal internal loop controlling the plasma distance from the internal walls of the tokamak, taking into account constraints due to voltages saturations on the converters, currents limitations in the active coils for magnetic confinement, force limits on the mechanical structures, minimum clearance between the plasma and the vacuum chamber wall, maximum induced forces on coils. The reference signal modification is accomplished through an on-line optimization procedure which embodies plasma model forecasts computed along a finite time virtual receding horizon. A numerical example with about a hundred of constraints, is developed with reference to ITER
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