Transpulmonary pressure to guide mechanical ventilation: Art or science?

open3noNo abstract availableSupported in part by Progetti di Ricerca di Interesse Nazionale (PRIN 2017, project J4BE7A) of the Italian Minister of Education, University, and Research.openRanieri V.M.; Tonetti T.; Nava S.Ranieri V.M.; Tonetti T.; Nava S

ACOUSTIC ANALYSIS OF SWALLOWING SOUNDS: A NEW TECHNIQUE FOR ASSESSING DYSPHAGIA

Objective: To perform acoustic analysis of swallowing sounds, using a microphone and a notebook computer system, in healthy subjects and patients with dysphagia affected by neurological diseases, testing the positive/negative predictive value of a pathological pattern of swallowing sounds for penetration/aspiration. Design: Diagnostic test study, prospective, not blinded, with the penetration/aspiration evaluated by fibreoptic endo scopy of swallowing as criterion standard. Subjects: Data from a previously recorded database of normal swallowing sounds for 60 healthy subjects according to gender, age, and bolus consistency was compared with those of 15 patients with dysphagia from a university hospital referral centre who were affected by various neurological diseases. Methods: Mean duration of the swallowing sounds and postswallowing apnoea were recorded. Penetration/aspiration was verified by fibreoptic endoscopy of swallowing in all patients with dysphagia. Results: The mean duration of swallowing sounds for a liquid bolus of 10 ml water was significantly different between patients with dysphagia and healthy patients. We also described patterns of swallowing sounds and tested the negative/positive predictive values of post-swallowing apnoea for penetration/aspiration verified by fibreoptic endoscopy of swallowing (sensitivity 0.67 (95% confidence interval 0.24–0.94); specificity 1.00 (95% confidence interval 0.56–1.00)). Conclusion: The proposed technique for recording and measuring swallowing sounds could be incorporated into the bedside evaluation, but it should not replace the use of more diagnostic and valuable measures

effectiveness of switching therapy from complexing protein containing botulinum toxin type a to a formulation with low immunogenicity in spasticity after stroke a case report

Objective: some patients receiving botulinum toxin type a therapy develop immunological resistance due to the production of neutralizing antibodies against the neurotoxin, thus partially or completely reducing the therapeutic effect. Case report: We report here neurophysiological and clinical findings for a 58-year-old man treated with botulinum toxin type A for spasticity after ischaemic stroke, who became a secondary non-responder patient. subsequent treatment with a different preparation of botulinum toxin type A had a great therapeutic effect on his spasticity. the muscles injected and the dosages were the same for each treatment, but evaluation with the Modified Ashworth Scale after treatment with the second preparation showed a reduction of approximately 2 points compared with the first examination. The clinical results were also supported by extensor digitorum brevis testing of the right muscle, which showed a reduction in compound muscle action potential, whereas it was unchanged in the non-injected muscle. No side-effects were reported, and after 1 year of treatment with this formulation clinical benefits were still evident. Conclusion: the neurophysiological and clinical results obtained in this patient suggest that switching therapy from a complexing protein-containing product to a product potentially free of complexing proteins, which has low immunogenicity, may be a viable therapeutic option in secondary non-responder patients

effect of intrathecal baclofen botulinum toxin type a and a rehabilitation programme on locomotor function after spinal cord injury a case report

Objective: a few studies have reported the use of botulinum toxin injections after spinal cord injury, as this is the gold standard to treat focal spasticity. We report such a case here. Case report: a 38-year-old woman who had become paraplegic and care-dependent secondary to cervico-thoracic intramedullary ependymoma, presented 8 months later with painful lower limb spasticity, which was being treated with oral anti-spastic and benzodiazepine drugs with no therapeutic effect. We treated the patient with intrathecal baclofen to reduce her spasticity and in order to avoid the major side-effects of high dosages of oral baclofen. after motor rehabilitation programmes, which included functional ele

Desmopressin Stimulates Nitric Oxide Production in Human Lung Microvascular Endothelial Cells

Desmopressin (dDAVP) is the best characterized analogue of vasopressin, the endocrine regulator of water balance endowed with potent vasoconstrictive effects. Despite the use of dDAVP in clinical practice, ranging from the treatment of nephrogenic diabetes insipidus to bleeding disorders, much remains to be understood about the impact of the drug on endothelial phenotype. The aim of this study was, thus, to evaluate the effects of desmopressin on the viability and function of human pulmonary microvascular endothelial cells (HLMVECs). The results obtained demonstrate that the vasopressor had no cytotoxic effect on the endothelium; similarly, no sign of endothelial activation was induced by dDAVP, indicated by the lack of effect on the expression of inflammatory cytokines and adhesion molecules. Conversely, the drug significantly stimulated the production of nitric oxide (NO) and the expression of the inducible isoform of nitric oxide synthase, NOS2/iNOS. Since the intracellular level of cAMP also increased, we can hypothesize that NO release is consequent to the activation of the vasopressin receptor 2 (V2R)/guanylate cyclase (Gs)/cAMP axis. Given the multifaceted role of NOS2-deriving NO for many physio-pathological conditions, the meanings of these findings in HLMVECs appears intriguing and deserves to be further addressed

Methyl orange photo‐degradation by tio2 in a pilot unit under different chemical, physical, and hydraulic conditions

The photo‐catalytic degradation of a textile azo‐dye as Methyl Orange was studied in an innovative unit constituted by a channel over which a layer of titanium dioxide (TiO2) catalyst in anatase form was deposited and activated by UVB irradiation. The degradation kinetics were followed after variation of the chemical, physical, and hydraulic/hydrodynamic parameters of the system. For this purpose, the influence of the TiO2 dosage (g/cm3), dye concentration (mg/L), pH of the solution, flow‐rate (L/s), hydraulic load (cm), and irradiation power (W) were evaluated on the degradation rates. It was observed that the maximum dosage of TiO2 was 0.79 g/cm3 while for higher dosage a reduction of homogeneity of the cement conglomerate occurred. The Langmuir– Hinshelwood (LH) kinetic model was followed up to a dye concentration around 1 mg/L. It was observed that with the increase of the flow rate, an increase of the degradation kinetics was obtained, while the further increase of the flow‐rate associated with the modification of the hydraulic load determined a decrease of the kinetic rates. The results also evidenced an increase of the kinetic rates with the increase of the UVB intensity. A final comparison with other dyes such as Methyl Red and Methylene Blue was carried out in consideration of the pH of the solution, which sensibly affected the removal efficiencies

COVID-19 Vaccination Status among Adults Admitted to Intensive Care Units in Veneto, Italy

: This cohort study examines admissions to intensive care units for COVID-19–associated acute respiratory distress syndrome by COVID-19 vaccination status among adults in the Veneto region of Italy from May to December 2021

Gelatin-based coating enriched with blueberry juice preserves the nutraceutical quality and reduces the microbial contamination of tomato fruit

To preserve quality and extend the shelf life of tomato, a bioactive edible coating was prepared using gelatin wastes from pharmaceutical industry and lyophilised blueberry juice (BJ). The effectiveness of gelatin-coating (G) and G enriched with blueberry juice (GB) was tested, monitoring carotenoids, polyphenols and flavonoids content, the antioxidant activity and the antimicrobial efficiency of coating against the native microflora. After 7 d of storage, coated fruit showed higher phenolic and flavonoids content and increased antioxidant activity, while carotenoids were unaffected by the treatments. The growth of mesophilic bacteria of GB, and the growth of coliform bacteria of G and GB were significantly reduced during the entire period. The results indicate that GB preserved the nutritional quality of tomatoes and that BJ was able to increase the antimicrobial activity of the coating. This paves the way for a possible use of this biodegradable waste polymer as an eco-friendly coating material

Status of the Cylindical-GEM project for the KLOE-2 Inner Tracker

The status of the R&D on the Cylindrical-GEM (CGEM) detector foreseen as Inner Tracker for KLOE-2, the upgrade of the KLOE experiment at the DAFNE phi-factory, will be presented. The R&D includes several activities: i) the construction and complete characterization of the full-size CGEM prototype, equipped with 650 microns pitch 1-D longitudinal strips; ii) the study of the 2-D readout with XV patterned strips and operation in magnetic field (up to 1.5T), performed with small planar prototypes in a dedicated test at the H4-SPS beam facility; iii) the characterization of the single-mask GEM technology for the realization of large-area GEM foils.Comment: 4 pages, 10 figures, Presented at Vienna Conference on Instrumentation (Feb 15-20, 2010, Vienna, Austria). Submitted to the Proceeding