724 research outputs found

    Chronic critical illness: the price of survival

    Get PDF
    BACKGROUND: The evolution of the techniques used in the intensive care setting over the past decades has led on one side to better survival rates in patients with acute conditions and severely impaired vital functions. On the other side, it has resulted in a growing number of patients who survive an acute event, but who then become dependent on one or more life support techniques. Such patients are called chronically critically ill patients. MATERIALS & METHODS: No absolute definition of the disease is currently available, although most patients are characterized by the need for prolonged mechanical ventilation. Mortality rates are still high even after dismissal from intensive care unit (ICU) and transfer to specialized rehabilitation care settings. RESULTS: In recent years, some studies have tried to clarify the pathophysiological characteristics underlying chronic critical illness (CCI), a disease that is also characterized by severe endocrine and inflammatory impairments, partly accounting for the almost constant set of symptoms. DISCUSSION: Currently, no specific treatment is available. However, a strategic early therapeutic approach on ICU admission might try to prevent the progress of the acute disease towards chronic critical illness

    Expanded Endoscopic Approach for Anterior Skull Base Tumors: Experience of a Multidisciplinary Skull Base Team

    Get PDF
    Abstract: The aim of this study is to describe the experience of a multidisciplinary skull base team with transnasal endoscopic surgery for anterior cranial base tumors. A retrospective chart review was conducted on patients who underwent an exclusive expanded transnasal approach to the anterior skull base in the period from December 2014 to November 2015. Data on patient demographics, tumor characteristics, surgical information, imaging, and postoperative complications were collected and analyzed. From a total of 120 patients with skull base diseases managed by the skull base team, 36 were admitted to this study. The overall complication rate in this series was 16.7%, gross total resection was achieved in 32 cases (88.9%) and postoperative CSF leakage occurred in 5 cases (13.9%). Our preliminary results confirm that an exclusive endoscopic transnasal approach to the anterior cranial base

    Subspace Energy Monitoring for Anomaly Detection @Sensor or @Edge

    Get PDF
    The amount of data generated by distributed monitoring systems that can be exploited for anomaly detection, along with real time, bandwidth, and scalability requirements leads to the abandonment of centralized approaches in favor of processing closer to where data are generated. This increases the interest in algorithms coping with the limited computational resources of gateways or sensor nodes. We here propose two dual and lightweight methods for anomaly detection based on generalized spectral analysis. We monitor the signal energy laying along with the principal and anti-principal signal subspaces, and call for an anomaly when such energy changes significantly with respect to normal conditions. A streaming approach for the online estimation of the needed subspaces is also proposed. The methods are tested by applying them to synthetic data and real-world sensor readings. The synthetic setting is used for design space exploration and highlights the tradeoff between accuracy and computational cost. The real-world example deals with structural health monitoring and shows how, despite the extremely low computations costs, our methods are able to detect permanent and transient anomalies that would classically be detected by full spectral analysis

    Frequency reallocation based on cochlear place frequencies in cochlear implants: a pilot study

    Get PDF
    Purpose: The aim of this study is to evaluate speech perception outcomes after a frequency reallocation performed through the creation of an anatomically based map obtained with Otoplan®, a tablet-based software that allows the cochlear duct length to be calculated starting from CT images. Methods: Ten postlingually deafened patients who underwent cochlear implantation with MED-EL company devices from 2015 to 2019 in the Tertiary referral center University Hospital of Verona have been included in a retrospective study. The postoperative CT scans were evaluated with Otoplan®; the position of the intracochlear electrodes was obtained, an anatomical mapping was carried out and then it was submitted to the patients. All patients underwent pure tonal and speech audiometry before and after the reallocation and the audiological results were processed considering the Speech Recognition Threshold (SRT), the Speech Awareness Threshold (SAT) and the Pure Tone Average (PTA). The differences in the PTA, SAT and SRT values before and after the reallocation were determined. The results were statistically processed using the software Stata with a significance value of α < 0.05. Results: The mean values of SRT (61.25 dB versus 51.25 dB) and SAT (49 dB versus 41 dB) were significantly lower (p: 0.02 and p: 0.04, respectively) after the reallocation. No significant difference was found between PTA values (41.5 dB versus 39.25 dB; p: 0.18). Conclusions: Our preliminary results demonstrate better speech discrimination and rapid adaptation in implanted postlingually deaf patients after anatomic mapping and subsequent frequency reallocation
    • …
    corecore