The Role of rescue therapies in the treatment of severe ARDS

ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven. Restrictive fluid management seems to be a favorable strategy with no significant reduction in 60-d mortality. Future studies are needed to clarify the efficacy of these therapies on outcomes in patients with severe ARDS, and institution of these therapies may be considered on a case-by-case basis

Dynamical fluctuations in an exactly solvable model of spin glasses

In this work we calculate the dynamical fluctuations at O(1/N) in the low temperature phase of the $p=2$ spherical spin glass model. We study the large-times asymptotic regimes and we find, in a short time-differences regime, a fluctuation dissipation relation for the four-point correlation functions. This relation can be extended to the out of equilibrium regimes introducing a function $X_{t}$ which, for large time $t$, we find scales as $t^{-1/2}$ as in the case of the two-point functions.Comment: Latex, 8 page

Extracorporeal CO2 removal in hypercapnic patients who fail noni nvasive ventialtion and refuse endotracheal intubation. a case series

Noninvasive ventilation (NIV) represents the standard of care for patients with exacerbation of chronic obstructive pulmonary disease. However, NIV fails in almost 40% of the most severe forms of acute hypercapnic respiratory failure and patients must undergo endotracheal intubation and invasive ventilation. Such transition from NIV to invasive ventilation is associated to increased mortality. Under these circumstances, patients may express a clear intention not to be intubated

WHO Takes Action to Promote the Health of Refugees and Migrants

Migration is a defining issue of our time, with 1 billion migrants globally, of whom 258 million have crossed borders. Climate change and political instability propel ever-greater displacement, with major detriments to health. Policies that fail to prevent human trafficking or guarantee essential services undermine Universal Health Coverage (UHC) and the global pledge to “leave no one behind.” The World Health Assembly should robustly implement WHO’s Global Action Plan (GAP) on the Health of Refugees and Migrants.ugees and Migrants

Antioxidative defence mechanisms in two grapevine (Vitis vinifera L.) cultivars grown under boron excess in the irrigation water

The aim of this study was to investigate the impact of B excess on the antioxidative defence system in two grapevine cultivars differently sensitive to B, in order to evaluate in which way the different sensitivity was correlated to the activation of defence mechanisms. Two-year-old Vitis vinifera L. plants (‘Merlot’ and ‘Sangiovese’), grafted on the same rootstock, were subjected to B treatment as potted vines, and biochemical determinations were employed to evaluate the antioxidative response. Compared to ‘Sangiovese’, ‘Merlot’ showed a much higher B accumulation and both leaf and peroxidative damages. In B-treated ‘Sangiovese’ the activity of superoxide dismutase did not change compared to control leaves, whereas in ‘Merlot’ a dramatic decrease in the enzyme activity was observed. B increased reduced ascorbate pools in both cultivars, but ascorbate peroxidase activity was enhanced only in ‘Merlot’. In this latter cv. an enhancement of total phenols was also observed. ‘Merlot’ showed a lower ability to contrast B accumulation in leaves than ‘Sangiovese’ evidencing a higher oxidative stress. Even if defence mechanisms were generally activated in ‘Merlot’, they did not counteract efficiently metabolic damages likely due to the dramatic decrease in superoxide dismutase, the first enzyme involved in the detoxification of oxygen radicals

Long term therapeutic efficacy of a soft monobloc mandibular advancement device in adults with obstructive sleep apnea

To evaluate the long term (48 months) therapeutic efficacy of a soft monobloc mandibular advancement device in adult patients with mild or moderate obstructive sleep apnea

Invasive intraneural interfaces: foreign body reaction issues

Intraneural interfaces are stimulation/registration devices designed to couple the peripheral nervous system (PNS) with the environment. Over the last years, their use has increased in a wide range of applications, such as the control of a new generation of neural-interfaced prostheses. At present, the success of this technology is limited by an electrical impedance increase, due to an inflammatory response called foreign body reaction (FBR), which leads to the formation of a fibrotic tissue around the interface, eventually causing an inefficient transduction of the electrical signal. Based on recent developments in biomaterials and inflammatory/fibrotic pathologies, we explore and select the biological solutions that might be adopted in the neural interfaces FBR context: modifications of the interface surface, such as organic and synthetic coatings; the use of specific drugs or molecular biology tools to target the microenvironment around the interface; the development of bio-engineered-scaffold to reduce immune response and promote interface-tissue integration. By linking what we believe are the major crucial steps of the FBR process with related solutions, we point out the main issues that future research has to focus on: biocompatibility without losing signal conduction properties, good reproducible in vitro/in vivo models, drugs exhaustion and undesired side effects. The underlined pros and cons of proposed solutions show clearly the importance of a better understanding of all the molecular and cellular pathways involved and the need of a multi-target action based on a bio-engineered combination approach

Volume changes of grafted autogenous bone in sinus augmentation procedure

to evaluate associations between the osseous remodelling add 3-dimensional features of both the grafted bone and the recipient site as well as the density of the grafted bone,and to assess the relation between the degree of bone resorption and the type of autogenous bone.grafting procedure or the source(block or particulate bone from iliac crest or block bone from chin