29 research outputs found
Comparative effect of continuos combined hormone replacement therapy regimens on brachial artery blood flow
AIM (Artery in microgravity): Design and development of an ice cubes mission
The Artery In Microgravity (AIM) project is the first experiment to be selected for the “Orbit Your Thesis!” programme of ESA Academy. It is a 2U experiment cube designed for the ICE Cubes facility on board of the International Space Station. The experiment is expected to be launched on SpaceX-20 in early 2020. The project is being developed by an international group of students from ISAE-SUPAERO and Politecnico di Torino, under the supervision of the ISAE-SUPAERO and Politecnico di Torino staff. The experiment is a test-bench for investigating haemodynamics in microgravity focusing on coronary heart disease, the most common form of cardiovascular disease and the cause of approximately 9 million deaths every year. Coronary heart disease is caused by stenosis of the coronary artery due to the build-up of plaque. While the development of atherosclerosis is not fully understood, the primary event seems to be subtle and repeated injury to the artery walls through various mechanisms including physical stresses from flow disturbances as well as from systemic and biological risk factors. In the presence of severe stenosis, patients are treated with the implantation of one or more coronary stents, which are tubular scaffolds devoted to restore and maintain myocardial perfusion. The coronary stenting procedure is largely applied (e.g., 1.8 million stents per year implanted in USA) In view of the impact that coronary artery disease has on humans, as well as of the increasing number of people that will be involved in space flights in the future, the way astronauts in space coronary hemodynamics is affected by the absence of gravity in the presence of stenosis or of stenting needs to be investigated in depth. In addition, as most stents are metallic objects, the radiation exposure in space might interact with their surface, altering blood flow, inducing particles release and ultimately leading to stent failure. Therefore, the aim of AIM is to start studying the vascular haemodynamics in a stented and a stenosed coronary artery on Earth and in microgravity and the stent-radiation coupling. This will allow to learn about the effect gravity plays on coronary artery haemodynamics, the effects of microgravity and radiation on the performance of implantable devices and ultimately the risks of myocardial infarction to astronauts on long-distance spaceflight. The experimental setup consists of a closed hydraulic loop containing two models of a coronary artery in series. An electric pump and reservoir will control the flow of a blood-mimicking fluid through the system. One model of the coronary artery will contain a coronary stent. The pressure of the fluid will be studied along its path using a series of pressure sensors and a camera will visualise the flow. The same experiments will be repeated on the ground with the same conditions as the in-flight model for comparison. The paper will outline in detail the design and development of the AIM experiment cube and the results of testing. The full data and results will be available after the completion of the mission which is expected to be between March and June 2020
Relationship between B-type natriuretic peptide levels and echocardiographic indices of left ventricular filling pressures in post-cardiac surgery patients
<p>Abstract</p> <p>Background</p> <p>B-type natriuretic peptide (BNP) is increased in post-cardiac surgery patients, however the mechanisms underlying BNP release are still unclear. In the current study, we aimed to assess the relationship between postoperative BNP levels and left ventricular filling pressures in post-cardiac surgery patients.</p> <p>Methods</p> <p>We prospectively enrolled 134 consecutive patients referred to our Center 8 ± 5 days after cardiac surgery. BNP was sampled at hospital admission and related to the following echocardiographic parameters: left ventricular (LV) diastolic volume (DV), LV systolic volume (SV), LV ejection fraction (EF), LV mass, relative wall thickness (RWT), indexed left atrial volume (<sub>i</sub>LAV), mitral inflow E/A ratio, mitral E wave deceleration time (DT), ratio of the transmitral E wave to the Doppler tissue early mitral annulus velocity (E/E').</p> <p>Results</p> <p>A total of 124 patients had both BNP and echocardiographic data. The BNP values were significantly elevated (mean 353 ± 356 pg/ml), with normal value in only 17 patients (13.7%). Mean LVEF was 59 ± 10% (LVEF ≥50% in 108 pts). There was no relationship between BNP and LVEF (p = 0.11), LVDV (p = 0.88), LVSV (p = 0.50), E/A (p = 0.77), DT (p = 0.33) or RWT (p = 0.50). In contrast, BNP was directly related to E/E' (p < 0.001), LV mass (p = 0.006) and <sub>i</sub>LAV (p = 0.026). At multivariable regression analysis, age and E/E' were the only independent predictors of BNP levels.</p> <p>Conclusion</p> <p>In post-cardiac surgery patients with overall preserved LV systolic function, the significant increase in BNP levels is related to E/E', an echocardiographic parameter of elevated LV filling pressures which indicates left atrial pressure as a major determinant in BNP release in this clinical setting.</p
ICAROS (Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization): Temporary report of the first prospective, longitudinal registry of the cardiac rehabilitation network GICR/IACPR
Physicians and vaccination against influenza: the experience of a Roman hospital
Gli autori riportano i risultati di uno studio effettuato sul personale ospedaliero al fine di valutare le loro opinioni ed atteggiamenti nei riguardi della vaccinazione antinfluenzale del personale sanitario. Lo studio evidenzia che persistono numerose perplessitĂ e lacune formative da parte del personale
La formazione manageriale degli operatori sanitari: Un approccio multidisciplinare per valutarne qualitĂ ed efficacia
Objectives: to evaluate the effectiveness and the quality of a training course for health managers, using qualitative and quantitative instruments. Materials and methods: the achievements and the satisfaction of the participants have been evaluated by (a) an open-answers questionnaire, administered both as entrance and exit test, aimed at evaluating the changes in knowledge regarding six key-concepts of the management: quality, resources, needs, projects, communication, responsibility; (b) a questionnaire administered on the occasion of the end of each module, aimed at evaluating the satisfaction about the level of teachers and the contents of the course; (c) a form to be filled by each component atfter the presentation of the projects prepared by the different groups of participants as a core achievement of the course, aimed at obtaining individual judgements about each project