A Possible Case of Neurogenic Pulmonary Edema in a Sheep following Intracranial Surgery

A 3-year-old female crossbred sheep weighing 64 kg was anaesthetized for intracranial surgery as a part of a research project. Premedication and induction of anesthesia were uneventful as well as tracheal intubation. Anesthesia was maintained with isoflurane in a 50% mixture of oxygen and air, fentanyl (5-15 µg kg-1h-1) and lidocaine (1.8 mg kg-1h-1). During anesthesia, an increased alveolar-arterial oxygen gradient was calculated on the basis of arterial blood gas analysis: inspiratory fraction of oxygen was increased and a recruitment manoeuvre was performed. After 210 minutes of anesthesia, the sheep was let recover with oxygen supplementation under monitoring of pulse-oxymetry, capnography, inspired and expired oxygen, temperature and invasive blood pressure. At tracheal extubation no signs of regurgitation or aspiration were noticed. Twenty-five minutes later, the sheep showed deterioration of neurological status and clonic seizure responsive to diazepam. After transient tachycardia, blood pressure rose acutely and sinus bradycardia followed. Severe tachypnea started in few minutes accompanied by loud respiratory noises and harsh diffuse crackles on both sides of the thorax. Foamy blood nasal exudates discharged from the nostrils. Neurogenic pulmonary edema as a sequel of increased intracranial pressure was suspected and treated with intravenous mannitol (0.5 gkg-1) and furosemide (4 mgKg-1). Hypoxemia was successfully managed with oxygen supplementation. Motor and cognitive functions improved progressively and were deemed normal within 12 hours from the episode, when arterial partial pressure of oxygen was 11.7 kPa (88 mmHg) at room air

Processing and Communication Delays in EWS: On the Performance of the Earthcloud Prototype

A Seismic Alert System (SAS), also called Earthquake Warning System (EWS) or Earthquake Early Warning System (EEW or EEWS), represents one of the most important measures that can be taken to prevent and minimize earthquake damage. These systems are mainly used to detect P-waves and the faster seismic waves and to subsequently trigger an alarm about the incoming S-waves, the slower and most dangerous seismic waves. In some cases, distributed systems are also able to alert some locations before the impending P-waves strike them. This paper presents Earthcloud, a cloud-based SAS that aims to provide all the former capabilities while retaining financial accessibility. Earthcloud first results, generated from four months of data acquisition, are compared with those coming from other systems. In particular, the paper focuses on processing and communication delays, showing how the Earthcloud new detection strategy may minimize delays. Although a thorough test campaign with more sensor nodes is needed to assess performance reliably, especially for highly dense urban scenarios, initial results are promising, with total latencies for Earthcloud always kept under the 1-second mark, despite being at the expense of solid magnitude estimation

Usability of the SedLine® electroencephalographic monitor of depth of anaesthesia in pigs: a pilot study.

To investigate the usability of the SedLine® monitor in anaesthetized pigs. Five juvenile healthy pigs underwent balanced isoflurane-based general anaesthesia for surgical placement of a subcutaneous jugular venous port. The SedLine® was applied to continuously monitor electroencephalographic (EEG) activity and its modulation during anaesthesia. Computer tomography and magnetic resonance were performed to investigate the relationship between electrodes' positioning and anatomical structures. The pediatric SedLine® EEG-sensor could be easily applied and SedLine®-generated variables collected. An EEG Density Spectral Array (DS) was displayed over the whole procedure. During surgery, the EEG signal was dominated by elevated power in the delta range (0.5-4 Hz), with an underlying broadband signal (where power decreased with increasing frequency). The emergence period was marked by a decrease in delta power, and a more evenly distributed power over the 4-40 Hz frequency range. From incision to end of surgery, mean SedLine®-generated values (± standard deviation) were overall stable [23.0 (± 2.8) Patient State Index (PSI), 1.0% (± 3.8%) Suppression Ratio (SR), 8.8 Hz (± 2.5 Hz) Spectral Edge Frequency 95% (SEF) left, 7.7 Hz (± 2.4 Hz) SEF right], quickly changing during emergence [75.3 (± 11.1) PSI, 0.0 (± 0.0) SR, 12.5 (± 6.6) SEF left 10.4 (± 6.6) SEF right]. Based on the imaging performed, the sensor does not record EEG signals from the same brain areas as in humans. SedLine®-DSA and -generated variables seemed to reflect variations in depth of anaesthesia in pigs. Further studies are needed to investigate this correlation, as well as to define the species-specific brain structures monitored by the EEG-sensor

Molecular dynamic simulation of mGluR5 amino terminal domain : essential dynamics analysis captures the agonist or antagonist behaviour of ligands

We describe the application of molecular dynamics followed by principal component analysis to study the inter-domain movements of the ligand binding domain (LBD) of mGluR5 in response to the binding of selected agonists or antagonists. Our results suggest that the method is an attractive alternative to current approaches to predict the agonist-induced or antagonist-blocked LBD responses. The ratio between the eigenvalues of the first and second eigenvectors (R1,2) is also proposed as a numerical descriptor for discriminating the ligand behavior as a mGluR5 agonist or antagonist

The role of the multidisciplinary evaluation of interstitial lung diseases: Systematic literature review of the current evidence and future perspectives

The opportunity of a multidisciplinary evaluation for the diagnosis of interstitial pneumonias highlighted a major change in the diagnostic approach to diffuse lung disease. The new American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society guidelines for the diagnosis of idiopathic pulmonary fibrosis have reinforced this assumption and have underlined that the exclusion of connective tissue disease related lung involvement is mandatory, with obvious clinical and therapeutic impact. The multidisciplinary team discussion consists in amoment of interaction among the radiologist, pathologist and pulmonologist, also including the rheumatologist when considered necessary, to improve diagnostic agreement and optimize the definition of those cases in which pulmonary involvement may represent the first or prominent manifestation of an autoimmune systemic disease. Moreover, the proposal of classification criteria for interstitial lung disease with autoimmune features (IPAF) represents an effort to define lung involvement in clinically undefined autoimmune conditions. The complexity of autoimmune diseases, and in particular the lack of classification criteria defined for pathologies such as anti-synthetase syndrome, makes the involvement of the rheumatologist essential for the correct interpretation of the autoimmune element and for the application of classification criteria, that could replace clinical pictures initially interpreted as IPAF in defined autoimmune disease, minimizing the risk of misdiagnosis. The aim of this review was to evaluate the available evidence about the efficiency and efficacy of different multidisciplinary team approaches, in order to standardize the professional figures and the core set procedures that should be necessary for a correct approach in diagnosing patients with interstitial lung disease

The transbonchial lung biopsy for diagnosis of diffuse parenchymal lung disease; Pro

The diagnosis of diffuse parenchymal lung disease (DPLD) may require invasive procedures after all noninvasive tools have failed. The clinical context in which these diseases develop and the radiological patterns are crucial for defining the timing and the methods to be used. After the introduction in clinical practice of HRCT scan, the evaluation of imaging patterns, along with the immunological status of the patient and the clinical course of the disease (acute vs. chronic) seem to be crucial to choose the best diagnostic procedure

The natural areas of Rome Province detected by airborne remotely sensed data

Rome Province with its 4 million inhabitants is one of the Italians areas with the largest urban expansion, mainly concentrated around the capital city. The uncontrolled urbanization of the past has heavily marked the landscape, especially Rome countryside and coastline. However many zones have exceeded the anthropic pressurewithout serious consequence since the sensitivity towards environmental protection has grown in recent years. Rome Province Administration has devoted special attention to the improvement and protection of its naturalistic heritage by means of a series of administrative actions, cultural initiatives and projects for environmental education. In this perspective a three-year agreement was concluded with CNR LARA focused on the study of natural vegetation by means of MIVIS (Multispectral Infrared Visible Imaging Spectrometer) remotely sensed data. This study distinguished and mapped the most important natural forests, shrub and herbaceous formations, assessed the health conditions of the arboreal vegetation, identified the areas with little water supply, and measured some environmental parameters, like temperature and surface humidity. The results achieved highlight the large botanical and naturalistic assortment and the complexity of the study-area