Isolated right atrial appendage (RAA) rupture in blunt trauma – a case report and an anatomic study comparing RAA and right atrium (RA) wall thickness

BACKGROUND: Heart chambers rupture in blunt trauma is uncommon and is associated with a high mortality. The determinant factors, and the incidence of isolated heart chambers rupture remains undetermined. Isolated rupture of the right atrium appendage (RAA) is very rare, with 8 cases reported in the reviewed literature. The thin wall of the RAA has been presumed to render this chamber more prone to rupture in blunt trauma. OBJECTIVE: To report a case of isolated RAA rupture in blunt trauma, and to compare right atrium (RA) and RAA wall thickness in a necropsy study. METHODS: The thickness of RA and RAA wall of hearts from cadavers of fatal penetrating head trauma victims was measured. Our case of isolated RAA rupture is presented. The main findings of the 8 cases reported in the literature, and the findings of our case, were organized in a table. RESULT: The comparison of the data showed that wall thickness of the RAA (0.53 ± 0.33 mm) was significantly thinner than that of RA (1.11 ± 0.42 mm) (p < 0.05). COMMENTS: In all these 9 cases of isolated RAA rupture, cardiac tamponade occurred, RAA rupture was diagnosed intraoperatively and sutured, and the patients survived. Main mechanisms hypothesized for heart chamber rupture include mechanical compression coincident with phases of cardiac cycle, leading to high hydrostatic pressure inside the chamber. Published series include numerous cases of RA rupture, and only a few cases of RAA rupture. CONCLUSION: Thus, our data suggests that wall thickness is not a determinant factor for RA or RAA rupture in blunt trauma

A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases : The ADVICE pilot study

Objectives Intensive health services’ utilization is common in older individuals affected by chronic diseases. This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services’ use (readmissions and/or emergency service access) among older people affected by chronic conditions. Methods This is a non-randomized before-after pilot study. A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months. Standard home care was provided during the first four months’ period (months 1–4), followed by the educational intervention until the end of the study (months 5–8). The intervention, based on the teach-back method, consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment, potential complications, medication adherence, and health behaviours. Rates of health services’ use were collected immediately before (T0), and after the interventions (T1). Differences in utilization rates were examined by the McNemar’s test. Potential factors associated with the risk of health services’ use were explored with a Cox proportional hazard regression model. Results The sample (n = 78) was predominantly female (n = 50, 64.1%), and had a mean age of 76.2 (SD = 4.8) years. Diabetes mellitus was the most frequent disease (n = 27, 34.6%). McNemar’s test indicated a significant reduction in health services’ use at T1 (McNemar χ2 = 28.03, P < 0.001). Cox regressions indicated that time and patient education, as well as their interaction, were the only variables positively associated with the probability of health services’ use. Conclusion A teach-back intervention led by a family nurse practitioner has the potential to reduce health services’ use in older patients with chronic diseases

Multipurpose High Frequency Electron Spin Resonance Spectrometer for Condensed Matter Research

We describe a quasi-optical multifrequency ESR spectrometer operating in the 75-225 GHz range and optimized at 210 GHz for general use in condensed matter physics, chemistry and biology. The quasi-optical bridge detects the change of mm wave polarization at the ESR. A controllable reference arm maintains a mm wave bias at the detector. The attained sensitivity of 2x10^10 spin/G/(Hz)1/2, measured on a dilute Mn:MgO sample in a non-resonant probe head at 222.4 GHz and 300 K, is comparable to commercial high sensitive X band spectrometers. The spectrometer has a Fabry-Perot resonator based probe head to measure aqueous solutions, and a probe head to measure magnetic field angular dependence of single crystals. The spectrometer is robust and easy to use and may be operated by undergraduate students. Its performance is demonstrated by examples from various fields of condensed matter physics.Comment: submitted to Journal of Magnetic Resonanc

On the low temperature microwave absorption anomaly in single-wall carbon nanotubes

The low temperature microwave absorption anomaly reported by Corzilius et al. [Phys. Rev. B 75, 235416 (2007)] in single-wall carbon nanotubes (SWCNTs) is revisited. It was originally reported that the microwave absorption of CVD grown SWCNTs shows an unexpected increase below similar to 20?K (using flow cryostats) which depends on the microwave power. The original observation was made using the microwave cavity perturbation method while sweeping the microwave frequency. We reproduced this effect on arc-discharge based SWCNTs, using static cryogenic conditions with cooled microwave cavities, and employing a stable frequency source locked to the cavity resonance. Our observation shows that the microwave absorption anomaly is robust against the tube type and the experimental conditions

The Fulleride Polymer Mg5C60

We synthesized a series of MgxC60 samples with nominal composition of x between 1 and 6 via solid state reaction between C 60 and Mg powder. For x = 5 a two dimensional structure was found. The polymer phase is unusually stable up to high temperatures, it remains unchanged at 823 K for 20 minutes as confirmed by ESR. The mid-infrared absorption spectrum suggests that the polymer sheets contain single bonded fulleride ions. Both the spin susceptibility and microwave conductivity measurements show that Mg5C60 is metallic for T > 200 K. The transition from metallic to insulating states around 200 K may be attributed to Anderson localization. © 2007 WILEY-VCH Verlag GmbH & Co. KGaA

Influence of formulation variables and preliminary study on the in vivo absorption

The aim of this work was to produce by co-extrusion-spheronization pellets with two cohesive layers, one of them containing a self-emulsifying system for vinpocetine, a poorly water soluble model drug. Two layers were prepared: an inert layer of microcrystalline cellulose, lactose and water and a second one wetted with the self-emulsifying system. Different formulations of both layers were tested, evaluating the effects of formulation variables with an experimental design. The screening amongst formulations was performed preparing rod extrudates and using the extrusion profiles to assess their suitability for extrusion and to anticipate quality of the spheronized extrudates. Tubular extrudates and co-extrudates/spheronized pellets were then produced. Two types of bi-layered pellets were prepared: type I with the self-emulsifying system internally and the inert matrix externally, whereas type II vice versa. The pellets were characterized for sizing and shape, density, hardness, in vitro dissolution and disintegration and released droplets size and in vivo tests. Although both types of pellets demonstrated adequate morphological and technological characteristics, pellets type II revealed an improved drug solubility and in vivo bioavailability. These preliminary technological and pharmacokinetic data demonstrated that co-extrusion/spheronization is a viable technology to produce bi-layered cohesive self-emulsifying pellets of good quality and improved in vivo bioavailability. (C) 2007 Elsevier B.V. All rights reserved