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Symptoms of temporal lobe epilepsy (TLE) are frequently associated with autonomic dysregulation, whose underlying biological processes are thought to strongly contribute to sudden unexpected death in epilepsy (SUDEP). While abnormal cardiovascular patterns commonly occur during ictal events, putative patterns of autonomic cardiac effects during pre-ictal (PRE) periods (i.e. periods preceding seizures) are still unknown. In this study, we investigated TLE-related heart rate variability (HRV) through instantaneous, nonlinear estimates of cardiovascular oscillations during inter-ictal (INT) and PRE periods...

Symptoms of temporal lobe epilepsy (TLE) are frequently associated with autonomic dysregulation, whose underlying biological processes are thought to strongly contribute to sudden unexpected death in epilepsy (SUDEP). While abnormal cardiovascular patterns commonly occur during ictal events, putative patterns of autonomic cardiac effects during pre-ictal (PRE) periods (i.e. periods preceding seizures) are still unknown. In this study, we investigated TLE-related heart rate variability (HRV) through instantaneous, nonlinear estimates of cardiovascular oscillations during inter-ictal (INT) and PRE periods...

647 Background: Administration of taxanes every 2 weeks (q2w), or "dose dense therapy", is one of the most promising chemotherapy regimens in node positive (N+) breast cancer. AERO-B03 is a randomized phase II trial designed to assess the feasibility of docetaxel dose dense regimens in this setting. METHODS: From December 2003 to September 2004, 100 patients (pts) with N+ breast cancer were randomized to receive 6 TEC (docetaxel 75 mg/m(2), epirubicin 75 mg/m(2) and cyclophosphamide 500 mg/m(2) q3w) (control), 4 EC (epirubicin 100 mg/m(2) and cyclophosphamide 600 mg/m(2) q2w) followed by 4 T (docetaxel 100 mg/m(2) q2w) (dose dense A) or 4 T followed by 4 EC (dose dense B)...

INTRODUCTION: Uncontrolled donors after circulatory determination of death (uDCDD) represent a yet unexplored pool of organs potentially available for transplantation. The aims of this study were to validate a protocol of cardiac death in the pig and to investigate lung function during the process. MATERIALS AND METHODS: Cardiac death was induced in preanesthetized animals with an injection of 600 mg propofol; once systolic blood pressure was <50 mm Hg (Agonal Phase), a 20 mEq bolus of KCl was given and, after asystolia was documented, cardiopulmonary resuscitation (CPR) started, followed by 5 minutes no touch (end-CPR)...

PURPOSE: The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. METHODS: We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria...

We developed a protocol to procure lungs from uncontrolled donors after circulatory determination of death (NCT02061462). Subjects with cardiovascular collapse, treated on scene by a resuscitation team and transferred to the emergency room, are considered potential donors once declared dead. Exclusion criteria include unwitnessed collapse, no-flow period of >15 min and low flow >60 min. After death, lung preservation with recruitment maneuvers, continuous positive airway pressure, and protective mechanical ventilation is applied to the donor...

OBJECTIVE: To identify the patient- and fracture-related determinants that influence performance-oriented mobility in hip fracture patients as measured by the Performance-Oriented Mobility Assessment (POMA) score. METHOD: A prospective study was conducted. Patients aged 65 or older (n = 186) were prospectively recruited. Patients were assessed for mobility (Tinetti POMA), level of independence (Modified Barthel Index), emotional distress (Goldberg General Health Questionnaire), comorbidities (Charlson Comorbidity Index), and Perceived Health (categorical scale)...

BACKGROUND: Aim of this study was to compare early graft function after transplantation of recipients transplanted with livers procured from donors after brain death who experienced transient or sustained cardio-circulatory collapse. METHODS: We retrospectively analysed patients who underwent liver transplantation (LTx) at our Institution from January 2010 to May 2012. Recipients were divided into 3 groups: those who received livers from brain death donors who experienced reversible cardio-circulatory arrest before organ procurement (RCA); those who experienced sustained cardio-circulatory collapse, treated with extra-corporeal membrane oxygenation support as rescue therapy of refractory cardiogenic shock (ECMO)...

Among patients with respiratory insufficiency awaiting lung transplantation, small adult patients have a lower opportunity of receiving size-matched pulmonary grafts, because of the shortage of donors, particularly those of small size. Reducing the size of an oversized graft is one of the methods to increase the donor pool; similarly, ex vivo lung perfusion is an emerging technique aimed toward the same purpose. We describe how we combined the 2 techniques (lobar transplantation plus contralateral nonanatomic graft reduction during ex vivo lung perfusion) to overcome graft shortage in a clinical case...

Informed consents are routinely used as an important source of information to help patients make appropriate clinical decisions. However, current standard consent forms may not accomplish their intended purpose due to the variety of patient literacy and experiences and, in the dental school setting, the developing competence of students. The purpose of this pilot study was to test the efficacy of a personalized informed consent generated through an electronic health record (EHR) at one dental school and its role in patient decision making...

The aim was to examine the effect of a single intramuscular (i.m.) injection of equine chorionic gonadotrophin (eCG) on Day 3 after oestrus on corpus luteum (CL) development, circulating progesterone and conceptus development in cross-bred beef heifers. In Experiment 1, heifers received: (1) saline, or a single i.m. injection of eCG on Day 3 at (2) 250IU (3) 500IU (4) 750IU or (5) 1000IU. Administration of eCG resulted in increased luteal tissue area and progesterone and oestradiol concentrations compared with controls...

Elevated intra-abdominal pressure (IAP) exerts effects not only on intra-abdominal organs, but also on organs distant to the abdominal compartment. Abdomino-thoracic interaction during intra-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS) interferes with pulmonary, cardiovascular and cerebral function. In accordance with recent guidelines, IAH is defined as IAP above 12 mmHg and ACS as IAP more than 20 mmHg with one or more new organ failures. In this review we will first discuss the effects of elevated IAP on pulmonary dynamics and the relevance for interpreting airway pressures and adjusting ventilator settings...

OBJECTIVE: To investigate the effects of a physiotherapy protocol on patients with pleural effusion. DESIGN: Randomized controlled trial. SETTING: University hospital. PARTICIPANTS: A total of 104 consecutive inpatients with a medical diagnosis of pleural effusion. INTERVENTION: Patients were randomly allocated to a control group receiving standard treatment (medical treatment and drainage) or an intervention group treated with physiotherapy added to standard treatment...

A key mission of a dental school is to train students to be competent dentists through the delivery of comprehensive care to patients. Comprehensive care is defined as a seamless and integrated dental treatment that addresses all patients' dental needs. Identification of a health care problem is the essential first step in quality improvement to medical education curriculum and its outcomes. It is critical for students to receive adequate clinical experience and for patients to receive needed treatment. This study assessed the degree to which comprehensive care was delivered from the patient and student perspective, and to determine why patients discontinue their course of treatment...

BACKGROUND: Obese patients are at risk of developing postoperative pulmonary complications. We hypothesized that preoperative changes in dynamic spirometry due to body posture would correlate with the drop of forced vital capacity (FVC) measured early after surgery. METHODS: Thirty consecutive morbidly obese patients undergoing gastric banding were investigated. All subjects were studied the day before surgery (T0) and on postoperative day one (T1). Forced Vital Capacity (FVC) was measured, together with heart rate, mean arterial pressure and respiratory rate...

PURPOSE: To compare the short-term effects of a neurodynamic sliding technique versus control condition on hamstring flexibility in healthy, asymptomatic male soccer players. SUBJECTS: Twenty-eight young male soccer players from Palencia, Spain (mean age 20.7 yrs ± 1.0, range 19-22) with decreased hamstring muscle flexibility. METHODS: Subjects were randomly assigned to one of two groups: neurodynamic sliding intervention or no intervention control...

OBJECTIVE: To compare the effectiveness of proprioceptive neuromuscular facilitation combined with exercise, classic stretching physiotherapy intervention, and educational intervention at improving patient function and pain in patients with patellofemoral pain syndrome. DESIGN: Randomized, controlled, blind trial over four months. SETTING: Urban population, Spain. PARTICIPANTS: Patients undergoing primary care for retropatellar pain...

INTRODUCTION: The feasibility and utility of a lung donor score that has been recently proposed was tested among a pool of lung donors referred to the Nord Italia Transplant program (NITp) organ procurement organization. MATERIAL AND METHODS: Each lung donor was assigned an Oto score including, age, smoking history, chest X-ray, secretions and ratio of arterial oxygen tension to inspired oxygen fraction (PaO(2)/FiO(2)). Based on clinical compromise, each variable received a score between 0 and 3, except for PaO(2)/FiO(2), which was scored between 0 and 6 given its overall relevance...

INTRODUCTION: Ex vivo lung perfusion (EVLP) has been validated as a valuable technique to increase the pool of organs available for lung transplantation. MATERIAL AND METHODS: After a preclinical experience, we obtained permission from the Ethics Committee of our institution to transplant lungs after EVLP reconditioning. ABO compatibility, size match, and donor arterial oxygen pressure (PaO(2))/fraction of inspired oxygen (FiO(2)) ≤ 300 mm Hg were considered to be inclusion criteria, whereas the presence of chest trauma and lung contusion, evidence of gastric content aspiration, pneumonia, sepsis, or systemic disease were exclusion criteria...

Lipomatous myopathy is a degenerative muscle pathology characterized by the substitution of muscle cells with adipose tissue, sporadically reported in cattle, pigs, and rarely in sheep, horses and dogs. This study investigated the pathology of this myopathy in 40 muscle samples collected from regularly slaughtered Piedmontese cattle living in Piedmont region (Italy). None of the animals showed clinical signs of muscular disease. Muscle specimens were submitted to histological and enzymatic investigations. Gross pathology revealed a different grade of infiltration of adipose tissue, involving multiple or single muscles...