Is hospital admission valuable in managing syncope? Results from the STePS study

The proper way to test the usefulness of hospitalization in syncope patients would be to conduct a randomized controlled trial. However, this approach is characterized by major theoretical and ethical limitations which make this procedure unfeasible. Data from observational studies indirectly show that hospitalization might help reduce the short-term risk of death and adverse events by promptly identifying and treating life-threatening events or conditions. Future research should focus on identifying which patients will benefit from hospitalization. In this regard, we should be able both to correctly risk-stratify patients and to analyze syncope observation units and protocols, which may provide a safe alternative for the evaluation of intermediate-risk patients

autonomic cardiovascular control in hyperthyroid women during sleep

Hyperthyroidism is characterized by hyperadrenergic symptoms (i.e., tachycardia, anxiety, and increased metabolic state). Although hyperthyroid patients often complain about an impairment of sleep, no data are available on sleep characteristics and autonomic cardiovascular control during sleep in these patients. We aimed to assess sleep qualitative indices and autonomic cardiovascular regulation during sleep in hyperthyroidism (Hyperthyr) and after treatment. Six subjects with a first diagnosis of Graves' disease or hyperfunctioning nodule underwent a complete polysomnographic study (PSG) at the time of diagnosis and after the treatment, when they became euthyroid (Euthyr). ECG and respiratory signals were extracted and samples of consecutive 250–300 beats were analyzed using linear spectral and nonlinear entropy analysis of heart rate variability (HRV), during the different sleep stages. Heart rate was decreased and total power increased in Euthyr compared to Hyperthyr, both during wake and sleep; no changes of the sympathovagal balance were observed. Entropy analysis showed that regularity index was reduced in Euthyr compared to Hyperthyr, suggesting changes in the complexity of the cardiovascular control. Periodic leg movements (PLM) were reduced in Euthyr compared to Hyperthyr. In conclusion, hyperthyroidism seems to be associated with an increased sleep fragmentation, due to PLM and an altered cardiac autonomic control

Soluble interleukin-1 receptor type 2 plasma levels in Parkinson’s disease: relationship with cardiac autonomic profile before and after peripheral mechanical somatosensory stimulation

Introduction: Systemic inflammation promotes neurodegeneration in Parkinson’s disease (PD). Interleukin-1 receptor type 2 (sIL-1R2) plasma levels increase during inflammation. Data on sIL-1R2 in PD patients and its relationship with PD cardiac autonomic profile are limited, given the possible anti-inflammatory effect of vagal activation. Previously, automated mechanical peripheral somatosensory stimulation (AMPSS) enhanced cardiac vagal modulation. Objectives were to 1) evaluate sIL-1R2 plasma concentrations in PD patients and healthy controls and 2) investigate the correlations between sIL-1R2 and cardiac autonomic indices obtained by spectrum analysis of heart rate variability before and after AMPSS.Methods: sIL-1R2 plasma levels were assessed in 48 PD patients and 50 healthy controls. Electrocardiogram and beat-by-beat arterial pressure were recorded at baseline and after 5 AMPSS sessions in 16 PD patients.Results: PD patients had higher sIL-1R2 levels than controls. In the PD subgroup, an inverse correlation between sIL-1R2 and HFnu was found. There was a negative correlation between changes induced by AMPSS on HFnu and sIL-1R2.Discussion: Higher sIL-1R2 levels in PD patients reflect the inflammatory dysregulation associated with the disease. In PD patients, higher sIL-1R2 was associated with reduced cardiovagal tone. Increased cardiovagal modulation following AMPSS was associated with lower sIL-1R2 levels in Parkinson’s disease patients, suggesting inflammatory state improvement

Image texture analysis and colorimetry for the classification of uranium ore concentrate powders

In the context of nuclear security, uranium ore concentrates (UOCs) play an important role: they are traded in large quantities and this makes their use “out of regulatory control” a possible scenario. Once an incident of illicit trafficking o f n uclear m aterial is detected, an understanding of its origin and production process is required; this implies the necessity to use analytical techniques able to measure characteristic parameters (e.g. physical, chemical, isotopic characteristics of the nuclear materials) which are referred to, in the field o f t he n uclear f orensics, a s signatures. The present study investigates the potential of image texture analysis (i.e. the angle measure technique), combined with the spectrophotometric determination of colours for the evaluation of the origin of several UOCs. The use of different multivariate statistical techniques allows the categorization of about 80 different samples into a few groups of UOCs powders, which makes this approach a promising method complementing the already established methods in nuclear forensics

Impact of point of care ultrasound on the number of diagnostic examinations in elderly patients admitted to an internal medicine ward

Cost analysis of using point of care ultrasound devices in general medicine department of an hospital in Italy

Independent predictors of the severity of liver disease (presence of NASH and clinically significant fibrosis, i.e. stage >1) at multivariate logistic regression analysis in 159 patients with histological NAFLD.

<p>OR: odds ratio; c.i.: confidence interval; high risk of OSAS with sleepiness: positivity for both BQ and ESS vs. all other patients. BMI: body mass index; IFG: impaired fasting glucose; ALT: alanine aminotransferases.</p

Demographic and clinical features of 159 NAFLD patients according to the risk of OSAS with or without daytime sleepiness.

<p>Data are shown as Mean ± SD (% values) according to data distribution; P value: at ANOVA; *P<0.05 vs. BQ− (t-test or Chi-square according to data distribution); BMI: body mass index; HOMA-IR: homeostasis metabolic assessment insulin resistance index; IFG: impaired fasting glucose; ALT: alanine aminotransferases; GGT: gamma-glutamyl-transferase.</p

Prevalence of positivity for BQ alone (BQ+ESS−), ESS alone (BQ−ESS+), and both BQ and ESS (BQ+ESS+) in 159 non-morbidly obese patients with histological NAFLD and 80 matched controls without ultrasonographic evidence of hepatic steatosis.

<p>P = ns: not significant.</p

Association between high risk for OSAS with sleepiness (BQ+ESS+) vs. low risk (all other patients) with histological severity of liver disease (prevalence of NASH and of clinically significant fibrosis, i.e. stage >1) in 159 non-morbidly obese patients with histological NAFLD.

<p>Association between high risk for OSAS with sleepiness (BQ+ESS+) vs. low risk (all other patients) with histological severity of liver disease (prevalence of NASH and of clinically significant fibrosis, i.e. stage >1) in 159 non-morbidly obese patients with histological NAFLD.</p