Obstructive Sleep Apnea and Patent Foramen Ovale

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Why cardiovascular rehabilitation services should include patients with intermittent claudication?

Chronic peripheral arterial disease represents a frequent and underestimated localization of atherosclerosis and its management often appears to be inadequate. The association with ischemic heart disease, the weighty prevalence of coronary disease risk factors, the high cardiovascular rate of morbidity and mortality, the sharp reduction in the tenor of life and the well-being supervised physical training efficacy constitute the main reasons that transform Cardiac Rehabilitation into an ideal setting for the treatment of patients suffering from intermittent claudication. Thanks to the cultural patrimony of cardiologists, together with other professionals, such as psychologists, dieticians, physiotherapists and nurses, it is possible to initiate an multi- comprehensive treatment program. Besides, this type of management may decrease both morbidity and mortality as well as reduce symptoms and improve the patients’ quality of life

Is obesity still a coronary risk factor?

a risk factor for developing coronary artery disease, once coronary artery disease has been established, the correlation of obesity with total mortality, cardiovascular mortality, myocardial infarction, and revascularization is unclear and still remains a matter of debate. The relationship between obesity and mortality in patients with coronary artery disease has so far only been investigated by posthoc analysis of cohort studies, which have produced contradictory results. When a higher percentage body fat has been found to be a strong independent predictor of event-free survival, the phenomenon has been described as an ‘obesity paradox’ or ‘reverse epidemiology’. A recent meta-analysis, appearing in the August 19 issue of Lancet on 250.152 patients with documented coronary artery disease, suggests that after grouping 40 cohort studies with adjusted risks, overweight patients were consistently associated with a better survival and lower cardiovascular events than patients with a low body mass index, whereas obesity was associated with a higher total mortality only in patients with history of coronary artery bypass graft, and severe obesity was associated with a significantly higher cardiovascular mortality but not with an increased risk for total mortality. Far from proving that obesity is harmless, these findings suggest that alternative methods might be required to better characterize individuals who truly have excess body fat and that additional studies with different methods are needed. Moreover, still unknown is the unique contribution of higher muscle-to-fat ratio, which may be merely a surrogate of increased physical fitness. Future research is needed to assess the link between high muscle mass, high body fat and clinical outcomes

Speed Finite Control Set Model Predictive Control of a PMSM fed by Matrix Converter

This paper presents a new speed Finite Control Set Model Predictive Control (FCS-MPC) algorithm which has been applied to a Permanent Magnet Synchronous Motor (PMSM) driven by a Matrix Converter (MC). This method replaces the classical cascaded control scheme with a single control law that controls the motor currents and speed. Additionally, unlike classical MC modulation methods, the method allows direct control of the MC input currents. The performance of the proposed work has been verified by simulation studies and experimental results

Sensorless finite-control set model predictive control for IPMSM drives

This paper investigates the feasibility of a sensorless field oriented control (FOC) combined with a finite control set model predictive current control (FCS-MPC) for an interior permanent magnet synchronous motor (IPMSM). The use of a FCS-MPC makes the implementation of most of the existing sensorless techniques difficult due to the lack of a modulator. The proposed sensorless algorithm exploits the saliency of the motor and the intrinsic higher current ripple of the FCS-MPC to extract position and speed information using a model-based approach. This method does not require the injection of additional voltage vectors or the periodic interruption of the control algorithm and consequently it has no impact on the performance of the current control. The proposed algorithm has been tested in simulation and validated on an experimental set-up, showing promising results

IGBT-SiC dual fed ground power unit

This paper presents the design and control of a three-phase ground power supply unit for aircraft servicing. A new mixed technology converter composed by a three-phase Silicon Carbide (SiC) full bridge unit and a three-phase full bridge IGBT unit connected across the same dc link is used instead of the conventional full bridge configuration. In order to satisfy the stringent requirements of the output voltage quality particular attention is given to the controller. The common dc link topology of the converter allows circulation of Zero Sequence Current (ZSC), therefore also a 0 axis regulator is necessary. The state space model of the system considering the LC output filter is presented and used in order to synthetize the controller parameters using the Optimal Control theory

Short and medium term functional capacity after single cycle of controlled physical training in subjects with claudication

BACKGROUND. Previous studies have shown the positive effect of exercise rehabilitation in patients with claudication, but uncertainties remain surrounding the optimal exercise program strategy and the persistence of the benefits over time. The purpose of the present study has been to prospectively assess the feasibility of short-course intensive supervised exercise training beyond pain threshold and to verify the maintenance of walking capacity during a medium term follow-up. METHODS. Ninety patients with intermittent claudication due to peripheral artery disease were enrolled in a supervised intensive exercise training. Seventy six of them (67 ± 7 years, 64 male and 12 female, 48 with bilateral claudication) performed a graded treadmill testing at baseline and after 3 months. Sixty patients completed also a specific questionnaire (Walking Impairement Questionnarie). After a mean follow-up of 2.6 years, fifty six patients repeated treadmill testing and 24 patients repeated the questionnaire. RESULTS. After training, the patients showed a 91% and 53% increase in the initial and absolute claudication distance time, respectively (p=0.0000). At follow-up there was no change in the initial claudication distance time, whereas absolute claudication distance time was reduced by only 13% (p=0.0001). All items of the questionnaire showed a statistically significant improvement after training (from 30 to 71%) and remained unchanged at follow-up. Sixty seven percent of the patients were considered responder, 15% partial responder and 18% no-responder to exercise training, whereas at follow- up these percentages were 55%, 13% and 32%, respectively. These results after training and at follow-up were independent from age, sex, smoke, hypertension, coronary artery disease and diabetes. CONCLUSIONS. Our findings confirm that a short supervised exercise therapy in the form of walking out over pain threshold is effective in maximizing the walking time of the majority of patients with intermittent claudication, independently of demographic data and their associated cardiac risk factors or comorbidities. After a mean follow-up of 2.6 years there was only a minor reduction of absolute claudication distance time and no modification of initial claudication distance time and questionnaire’s score, despite the fact that none of these patients were contacted by the rehabilitation centre after their physical training period

TA Treatment of Depression:A Hermeneutic Single-Case Efficacy Design Study - Giorgio

This study is the fourth of a series of seven and belongs to the second Italian systematic replication of findings from previous series that investigated the effectiveness of a manualized transactional analysis treatment for depression through Hermeneutic Single-Case Efficacy Design. The therapist was a white Italian man with 17 years of clinical experience and the patient, Giorgio, was a 23-year-old white Italian man who attended sixteen sessions of transactional analysis psychotherapy. Giorgio satisfied DSM-5 criteria for Major Depressive Disorder, Persistent Depressive Disorder,Panic Disorder, Agoraphobia and Dependent Personality Disorder. The treatment focused on both symptoms remission and conflicts at the core of dependent personality. The judges evaluated the case as a good outcome, mediated by the work on core conflicts of personality, that enhanced the treatment outcome and the remission of depressive symptoms. This case study suggests that the classical treatment for depression may be enhanced by considering the conflicts at the base of personality traits or disorders.Citation - APA format:Benelli, E., Procacci, M., Fornaro, A., Calvo, V., Mannarini, S., Palmieri, A. and Zanchetta, M. (2018). TA Treatment of Depression:A Hermeneutic Single-Case Efficacy Design Study - Giorgio. International Journal of Transactional Analysis Research & Practice, 9(2), 3-22 https://doi.org/10.29044/v9i2p

Fucino palaeo-lake: Towards the Palaeoenvironmental history of the last 430 Ka

© 2010 AIQUA - Associazione Italiana per lo Studio del Quaternario e EMMEVI - Servizio Congressi SPA. The sedimentary succession deposited in Fucino palaeo-lake potentially records the environmental history of the Central Mediterranean Region continuously since the early Pleistocene and up to recent historical times. Fucino palaeo-lake sediments are interbedded with numerous volcanic ash layers which allow the reconstruction a robust and independent chronological framework of past environment changes. This framework is a fundamental tool to synchronise different archives at a regional and extra-regional scale and to better understand the spatio-temporal climate variability in the Quaternary at the orbital and millennial-scales. Here we present new preliminary data for the last five glacial to interglacial cycles