Multiple retrospective analysis of survival and evaluation of 4 cardiac death predictors in a population of dogs affected by 5 degenerative mitral valve disease in ACVIM class C treated 6 with different therapeutic protocols

Clinical records of dogs with spontaneous degenerative mitral valve disease (DMVD) with clinical signs related to congestive heart failure (CHF) that had been recruited during routine clinical practice, between 2001 and 2018 at the Cardiology Unit of the Veterinary Teaching Hospital (University of Milan) were included in this retrospective cohort study. Baseline echocardiographic data were evaluated. Median survival times (MSTs) were calculated. Data on therapeutic treatment, ISACHC or ACVIM classes were reviewed based on the inclusion period and type of endpoint (i.e. cardiac death or death for other causes). The main goal of this data review was to retrospectively evaluate 259 clinical records of subjects belonging to ACVIM C class examined between 2001 to 2018 together with the 202 examined between 2010 to 2018. The MSTs of these subjects was 531 d (2001-2018) and 335.5 d (2010-2018), respectively. Univariate survival regression analysis for subjects included from 2010 to 2018 showed the following variables as being significantly related to cardiac death (CD): LA/Ao ratio (HR 2.754, p=0.000), E wave (HR 2.961, p=0.000), E/A ratio (HR 1.372, p=0.000), EDVI (HR 1.007, p=0.000), ESVI (HR 1.012, p=0.026), Allo(d) (HR 4.018, p=0.000) andAllo(s) (HR 2.674, p=0.049), age (HR 1.006, p=0.009) and PH severity (HR=1.309, p=0.012). Multivariate analysis, adjusted for age, showed that the only variable that determined a statistically significant difference in MST was PH severity (HR 1.334, p=0.033). The type of therapeutic treatment within this class was not significant for the MST of the subjects

Reduction of the QCD string to a time component vector potential

We demonstrate the equivalence of the relativistic flux tube model of mesons to a simple potential model in the regime of large radial excitation. We make no restriction on the quark masses; either quark may have a zero or finite mass. Our primary result shows that for fixed angular momentum and large radial excitation, the flux tube/QCD string meson with a short-range Coulomb interaction is described by a spinless Salpeter equation with a time component vector potential V(r) = ar - k/r.Comment: RevTeX4, 10 pages, 3 eps figure

Distonia flessoria dell’arto superiore post-stroke evoluta in distonia estensoria, dopo inoculo di tossina botulinica

Introduzione - Descrizione di un caso clinico riguardante la comparsa di un atteggiamento posturale distonico estensorio di mano e polso dell\u2019arto superiore in una paziente emiplegica trattata con tossina botulinica per il controllo dell\u2019ipertono spastico flessorio dell\u2019arto. Presentazione del caso - Una donna caucasica di 59 anni affetta da emiplegia spastica sinistra \ue8 stata ricoverata presso l\u2019U.O. di Riabilitazione Specialistica dell\u2019Ospedale San Carlo di Milano. Il disturbo motorio era insorto xxx giorni prima in seguito a una vasta emorragia cerebrale intraparenchimale fronto-parietale destra. La paziente era stata sottoposta a craniotomia decompressiva e successiva cranioplastica. All\u2019ingresso la paziente si presentava con ridotta vigilanza, neglect ed emiplegia spastica sinistra. Successivamente il quadro neuromotorio migliorava progressivamente con la comparsa di iniziale motilit\ue0 artuale sinistra e miglioramento del quadro cognitivo e del neglect. L\u2019arto superiore sinistro presentava un marcato ipertono spastico associato a dolore e impotenza funzionale (atteggiamento in schema flessorio con mano chiusa a pugno, gomito flesso e spalla addotta). Circa tre mesi dopo era effettuato un trattamento ecoguidato della spasticit\ue0 focale con tossina botulinica A (muscolo pronatore rotondo, flessore superficiale e profondo delle dita, flessori radiale e ulnare del carpo, bicipite brachiale), ottenendo un miglioramento clinico e funzionale. Rivalutata dopo cinque mesi, la paziente presentava un buon controllo dell\u2019ipertono flessorio con presenza di motilit\ue0 attiva antigravitaria ai vari fulcri dell\u2019arto superiore. Si evidenziava, per\uf2, la comparsa di una distonia focale a livello della muscolatura estensoria del polso e della mano sinistri che rimanevano atteggiati in supinazione ed estensione con conseguente compromissione delle attivit\ue0 funzionali potenzialmente possibili. Era pertanto effettuato un altro trattamento ecoguidato focale con tossina botulinica A (Dysport, fl 500 UI) nei muscoli estensore radiale lungo carpo (150 UI), estensore radiale breve del carpo (150 UI), estensore comune delle dita (100 UI) ed estensore ulnare del carpo (100 UI). Era poi effettuato un trattamento fisioterapico mirato con stretching muscolare e rieducazione neuromotoria e propriocettiva, associato a ciclo di terapia occupazionale per il recupero delle attivit\ue0 funzionali. La paziente era valutata clinicamente e con test funzionali, prima e dopo il trattamento. Conclusioni - Il caso descrive una paziente che, in seguito a un\u2019emorragia cerebrale, ha sviluppato un\u2019emiplegia con spasticit\ue0 flessoria dell\u2019arto superiore sinistro. Dopo il trattamento con tossina botulina dei muscoli flessori, si era evidenziata una riduzione della spasticit\ue0 flessoria, contestualmente associata alla comparsa di una spasticit\ue0 estensoria, in un contesto di lento e progressivo recupero della motilit\ue0 attiva. Il trattamento con tossina botulinica ha permesso il controllo degli aspetti posturali distonici e un recupero funzionale significativo dell\u2019arto superiore plegico nella paziente esaminata, dimostrandosi efficace nel migliorare la funzionalit\ue0 dell\u2019arto superiore in caso di distonia focale posturale post-emorragia cerebrale. Attualmente sono in corso controlli clinici seriati al fine di valutare la persistenza dell\u2019efficacia del trattamento. Bibliografia - 1. Muhammad Umar, Tahir Masood, Mazhar Badshah. Post-Stroke Focal Hand Dystonia; Botulinum Toxin And Task Specific Training. The Professional Medical Journal (www.theprofesional.com) - 2. Nakamura Y. Botulinum toxin for treatment of the focal dystonia. 2017 Jul 29;57(7):367-72. doi: 10.5692/clinicalneurol.cn-001018. Epub 2017 Jul 24

Prevalence, risk factors and outcomes of patients coming from the community with sepsis due to multidrug resistant bacteria

Background: Although previous studies showed an increasing prevalence of infections due to multi-drug resistant (MDR) bacteria in the community, specific data on sepsis are lacking. We aimed to assess prevalence, risk factors and outcomes of patients with sepsis due to MDR bacteria. Methods: An observational, retrospective study was conducted on consecutive adult patients coming from the community and admitted to the Policlinico Hospital, Milan, Italy, with a diagnosis of sepsis between January 2011 and December 2015. Primary study outcome was in-hospital mortality. Results: Among 518 patients, at least one MDR bacteria was isolated in 88 (17%). ESBL+ Enterobacteriaceae were the most prevalent MDR bacteria (9.7%) followed by MRSA (3.9%). Independent risk factors for sepsis due to MDR bacteria were septic shock (OR: 2.2; p = 0.002) and hospitalization in the previous 90 days (OR: 2.3; p = 0.003). Independent risk factors for sepsis due to ESBL+ bacteria were hospitalization in the previous 90 days (OR: 2.1; p = 0.02) and stroke (OR: 2.1; p = 0.04). A significantly higher mortality was detected among patients with vs. without MDR bacteria (40.2% vs. 23.1% respectively, p = 0.001). Independent risk factors for mortality among patients with sepsis were coagulation dysfunction (OR: 3.2; p = 0.03), septic shock (OR: 3.2; p = 0.003), and isolation of a MDR bacteria (OR: 4.6; p < 0.001). Conclusion: In light of the prevalence and impact of MDR bacteria causing sepsis in patients coming from the community, physicians should consider ESBL coverage when starting an empiric antibiotic therapy in patients with specific risk factors, especially in the presence of septic shock

Nonperturbative QCD Vacuum Effects in Nonlocal Quark Dynamics

A straightforward calculation reveals the essentially nonlocal character of the leading heavy $Q\bar{Q}$ interaction arising from nonperturbative gluon field correlations in the model of a fluctuating QCD vacuum. In light of this quarkonium spin splitting ratio predictions which have supported the scalar confinement ansatz are reconsidered as a specific example of possible consequences for spectroscopy.Comment: Latex, 9 page

Optical nanofibers and spectroscopy

We review our recent progress in the production and characterization of tapered optical fibers with a sub-wavelength diameter waist. Such fibers exhibit a pronounced evanescent field and are therefore a useful tool for highly sensitive evanescent wave spectroscopy of adsorbates on the fiber waist or of the medium surrounding. We use a carefully designed flame pulling process that allows us to realize preset fiber diameter profiles. In order to determine the waist diameter and to verify the fiber profile, we employ scanning electron microscope measurements and a novel accurate in situ optical method based on harmonic generation. We use our fibers for linear and non-linear absorption and fluorescence spectroscopy of surface-adsorbed organic molecules and investigate their agglomeration dynamics. Furthermore, we apply our spectroscopic method to quantum dots on the surface of the fiber waist and to caesium vapor surrounding the fiber. Finally, towards dispersive measurements, we present our first results on building and testing a single-fiber bi-modal interferometer.Comment: 13 pages, 18 figures. Accepted for publication in Applied Physics B. Changes according to referee suggestions: changed title, clarification of some points in the text, added references, replacement of Figure 13

Reliability of postural control measures in children and young adolescents

Although many studies have been carried out regarding postural stability during pediatric age, reliable information and a complete analysis of all age groups are still lacking. The purpose of this study was to verify the test-retest reliability of posturographic parameters in four sensory conditions and provide normative values for children and young adolescents. 289 subjects, aged 6-14 years, were assessed by means of the static posturography system SVeP. 173 elementary school pupils (114 males and 59 females, aged 6-10 years; mean age 8.80 \ub1 1.53) and 116 middle school students (60 males and 56 females, aged 11-14 years; mean age 12.6 \ub1 0.9) underwent static posturography in two consecutive trials with four testing conditions: eyes open and eyes closed with and without foam pads. The participants were divided into nine age groups. Thirty healthy young adults were also recruited for comparison. The analysis of test-retest reliability demonstrated an excellent reliability of velocity measurement and a moderate reliability of area measurement. Velocity and area decreased significantly with age in all sensory conditions, indicating an improvement in postural control from childhood to adolescence. Postural stability had not reached the adult level by the age of 13-14 years. Reliable information regarding postural stability can be obtained in children and young adolescents by means of stabilometric parameters. These data can be used as a reference for early detection of atypical postural development and for the assessment of dizziness and balance disorders in children

Lipid Reshaping and Lipophagy Are Induced in a Modeled Ischemia-Reperfusion Injury of Blood Brain Barrier

Ischemic-reperfusion (I/R) injury induced a remodeling of protein and lipid homeostasis, under oxidative stress and inflammatory status. Starvation occurring during I/R is a condition leading to autophagy activation, which allows abnormal material clearance or amino acid, or both, and fatty acid (FA) recycling essential for survival. This study investigated the lipid reshaping, peroxidation, and related-signaling pathways, in rat brain endothelial cells (RBE4) subjected to 3 h of oxygen and glucose deprivation (OGD) and restoration of standard condition (I/R in vitro model). Lipids and proteins were analyzed after 1 or 24 h of oxygen and nutrient restoration. Together with the oxidative stress and inflammatory status, I/R injury induced a reshaping of neutral lipids and biogenesis of lipid droplets (LD) with excessive lipid storage. The increase of LC3-II/LC3-I ratio, an autophagy marker, and LC3 co-localization with LD suggest the activation of lipophagy machinery to counteract the cell engulfment. Lipophagy leads to cholesterol ester (CE) hydrolysis, increasing free cholesterol (FC) secretion, which occurred by specific transporters or unconventional exocytosis pathways, or both. Here, we propose that an unconventional spreading of FC and other lipid metabolites may influence the neurovascular unit (NVU) cells, contributing to Blood brain barrier (BBB) alteration or adaptation, or both, to the cumulative effects of several transient ischemia

Preliminary Investigation of Cardiovascular–Renal Disorders in Dogs with Chronic Mitral Valve Disease

Background: Veterinary literature lacks data about cardiovascular\u2013renal disorders (CvRD) and cardiorenal-anemia syndrome (CRAS) in dogs. Hypothesis: A direct correlation exists between ACVIM class and IRIS stage; chronic kidney disease (CKD) complicates chronic mitral valve disease (CMVD) more often than does anemia in dogs. Animals: One hundred and fifty-eight client-owned dogs with CMVD. Methods: Signalment, physical examination findings, electrocardiography, thoracic radiographs, echocardiography, and blood analysis were retrospectively evaluated to assess the prevalence of CKD and anemia in dogs with CMVD and to investigate the relationships among ACVIM class, IRIS stage, and survival. Results: The prevalence of CKD and anemia in dogs with CMVD was significantly higher than in the general population of dogs. Dogs being treated for heart failure had a significantly higher prevalence of CKD than did dogs that had not received treatment. A statistically significant direct correlation was found between ACVIM class and IRIS stage. Severe heart disease, severe renal disease or both, furosemide administration, and advanced age at diagnosis of heart disease were associated with shorter survival time. Survival time of dogs affected by CvRD was statistically shorter than survival time of dogs affected by CMVD alone. Conclusion and Clinical Relevance: Chronic mitral valve disease is associated with increased prevalence of CKD and anemia in dogs. Treatment for medical management of heart failure may play a role in inducing CKD. Class of heart disease and IRIS stage were directly correlated. Cardiovascular\u2013renal disorders decrease survival time compared to the only presence of CMVD alone, whereas anemia does not play a central role in worsening heart function

Analysis of the vector and axialvector BcB_c mesons with QCD sum rules

In this article, we study the vector and axialvector $B_c$ mesons with the QCD sum rules, and make reasonable predictions for the masses and decay constants, then calculate the leptonic decay widths. The present predictions for the masses and decay constants can be confronted with the experimental data in the future. We can also take the masses and decay constants as basic input parameters and study other phenomenological quantities with the three-point vacuum correlation functions via the QCD sum rules.Comment: 14 pages, 16 figure