The aim of this study was to use 3-dimensional (3D) speckle-tracking echocardiography to test the hypothesis that left ventricular (LV) dyssynchrony may negatively affect LV torsional mechanics in patients with idiopathic dilated cardiomyopathy (IDC) and that LV torsion may improve after cardiac resynchronization therapy. This study included 65 subjects; 20 ...

Rapid shallow breathing index (RSBI, respiratory frequency [f] divided by tidal volume [Vt]) has been used to prognosticate liberation from mechanical ventilation (LMV). We hypothesize that dynamic changes in RSBI predict failed LMV better than isolated RSBI measurements. We conducted a retrospective study of patients who were mechanically ventilated (MV) ...

This study determined patterns of sensory signs in complex regional pain syndrome (CRPS) type I and II and peripheral nerve injury (PNI). Patients with upper-limb CRPS-I (n=298), CRPS-II (n=46), and PNI (n=72) were examined with quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain. ...

We describe cardiovascular responses during the Valsalva maneuver and syncope in the youngest reported patient with stretch syncope, which was induced by neck stretching and back hyperextension. The pattern of cardiovascular responses during stretch syncope was similar to that during a pathologic Valsalva maneuver, indicating adrenergic dysfunction in this patient. ...

Background and aims Acute occlusions of the large intracranial arteries are relatively resistant to intravenous thrombolysis. Therefore, multimodal approaches combining intravenous thrombolysis with endovascular mechanical recanalization are increasingly being applied. In this setting, intravenous thrombolysis may facilitate subsequent mechanical thrombectomy. To test this hypothesis, we analyzed the influence of intravenous ...

Petit mal absence has been reported with 3-Hz generalized spike-and-wave discharges induced by secondary bilateral synchrony. Absence seizure may be present in patients with frontal lobe epilepsy. The thalamic rhythmogenic mechanisms responsible for spike-and-wave discharges have been investigated, providing a better understanding of the underlying anatomico-physiological mechanisms. We report the ...

Patients with Parkinson's disease (PD) commonly develop lower urinary tract symptoms (LUTS) as their disease severity progresses. It is a well-established fact that neurodegeneration of the nigrostriatal dopaminergic pathway occurs in PD. This neurochemical deficiency explains many of the motor disturbances encountered in patients with PD. However, the underlying cause ...

: Patients with spinal cord injury (SCI) are at particular risk for deep vein thrombosis (DVT) during their hospital course. In most researches on the prevention of thromboembolic events after SCI, the cause of SCI was usually limited to traumatic origin, and pharmaco-prophylaxis was usually started immediately after SCI irrespective ...

AIMS: To assess left ventricular (LV) twist mechanics in patients with Tako-tsubo cardiomyopathy (TTC). METHODS AND RESULTS: Two-dimensional strain and LV twist by speckle-tracking echocardiography was performed in 17 consecutive patients with typical TTC according to the Mayo clinic criteria [78 ± 8 years, 88% women, and mean left ventricular ...

Spontaneous junctional ectopic tachycardia (JET) in adults is rare, and the electrophysiologic mechanism has not been definitively established. Two patients who presented with JET, not associated with cardiac surgery, were evaluated and studied in the electrophysiology laboratory, and electrophysiologic and pharmacologic maneuvers were performed to assess the mechanisms of tachycardia. ...

Visual and oculomotor signs and symptoms are common and well defined in patients with multiple sclerosis. On the other hand, the phenomenon of "upside-down" reversal of vision is very rare and thus not well known. The physiopathology of this phenomenon also has not been well understood. Herein, we present a ...

Patients with unilateral neglect tend to ignore sensory information from their contralesional hemispace. Many symptoms of neglect can be reduced by exposing patients to rightward-shifting prism goggles. It was noted that the effects on neglect symptoms last for at least two hours. This seems surprising in light of the fact ...

To evaluate whether manual hyperinflation maneuvers can cause aspiration of oropharyngeal secretions in patients under mechanical ventilation. Adult patients under mechanical ventilation in whom a dye was injected in the oropharyngeal cavity and had their tracheal secretion aspirated after 30minutes (min) participated in this study. In the event of dye ...

BACKGROUND: Coronal malalignment occurs frequently in TKA and may affect implant durability and knee function. Designed to improve alignment accuracy and precision, the patient-specific positioning guide is predicated on restoration of the overall mechanical axis and is a multifaceted new tool in achieving traditional goals of TKA. QUESTIONS/PURPOSES: We compared ...

Quantitative characterization of ankle mechanical impedance is critical for understanding lower extremity function in persons with neurological disorders. In this paper, we examine the feasibility of employing an ankle robot and multivariable analysis to determine static ankle impedance in 4 patients: 1 with multiple sclerosis and 3 with stroke. We ...

A significant and increasing number of chronic kidney disease (CKD) patients are treated with online hemodiafiltration (OL-HDF), even in the absence of more conclusive survival data. OL-HDF affords several clinical benefits including control of anemia of CKD, a common affliction in dialysis patients. In efforts to understand the underlying mechanisms ...

We present a patient with a clinically isolated syndrome suggestive of multiple sclerosis, who developed a full-blown picture of paranoid psychosis with suicidal attempt. Four new lesions were observed on brain MRI, one in the left and one in the right temporal lobe, one subcortically in the cingulate gyrus and ...

BACKGROUND: The measurement of the maximal inspiratory pressure (PImax) is of great importance in choosing the time for the start of weaning. OBJECTIVE: To measure the inspiratory pressure in mechanically ventilated patients suitable for weaning to determine the point at which the PImax is achieved along sixty seconds of observation, ...

Background: Right ventricular outflow tract ventricular tachycardia (RVOT-VT), arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/ARVD), and Brugada syndrome (BrS) were characterized by arrhythmias originating in the right ventricle, and the pathophysiologic mechanism underlying these arrhythmias has not been fully understood. Methods: This study consisted of 40 subjects, including 20 patients with RVOT-VT, ...

INTRODUCTION: Preclinical and clinical studies suggest that mechanical ventilation contributes to the development of acute kidney injury (AKI), particularly in the setting of lung-injurious ventilator strategies. OBJECTIVE: To determine whether ventilator settings in critically ill patients without acute lung injury (ALI) at onset of mechanical ventilation affect the development of ...

PURPOSE OF REVIEW: The International League of Associations for Rheumatology criteria parse out juvenile idiopathic arthritis (JIA) into seven groups, with the aim of creating homogeneous subgroups suitable for clinical and research evaluation. However, prior studies have shown that psoriatic JIA (psJIA) may be a heterogeneous entity. RECENT FINDINGS: PsJIA ...

Summary Background and objectives The aim of our study was to assess the new diagnostic criteria of acute kidney injury (AKI) proposed by the Acute Kidney Injury Network (AKIN) in a large cohort of mechanically ventilated patients. Design, setting, participants, & measurements This is a prospective observational cohort study enrolling ...

We describe an adult patient with an unruptured choroidal-type arteriovenous malformation (AVM) associated with progressive hydrocephalus. There was no evidence of mechanical obstruction of the ventricular system by the AVM nidus itself or a draining vein. However significant reflux into periventricular and transmedullary veins was demonstrated. Following partial targeted embolization ...

Background: In patients with mechanical prostheses (MP), thromboembolism is one of the most serious complications. The study aim was to assess the incidence of sources of thromboembolism in patients with correctly functioning MP with and without a history of thromboembolism.Methods: Two hundred ninety-seven patients with correctly functioning MP were enrolled ...

The goal of this study is to propose a methodology for evaluating recovery mechanisms in subacute and chronic post-stroke patients after a robot-aided upper-limb therapy, using a set of biomechanical parameters. Fifty-six post-stroke subjects, thirteen subacute and forty-three chronic patients participated in the study. A 2 dof robotic system, implementing ...

Volume expansion is used in patients with hemodynamic insufficiency in an attempt to improve cardiac output. Finding criteria to predict fluid responsiveness would be helpful to guide resuscitation and to avoid excessive volume effects. Static and dynamic indicators have been described to predict fluid responsiveness under certain conditions. In this ...

AIM: The aim of this study was to investigate the effects of manual and mechanical lymph drainage on the bioelectrical composition of body tissues of patients with lymphoedema of the lower limbs. METHOD: Twenty-one patients with lymphoedema of one leg were evaluated using single frequency bioelectrical impedance with four electrodes ...

Purpose:  Endotoxins have been proved to be responsible for acute anterior uveitis (AAU) in animals in a well-established experimental model of endotoxin-induced uveitis (EIU). The purpose of our study was the detection of antibodies against endotoxins of selected enterobacteria in the serum of patients with idiopathic AAU and searching for ...

OBJECTIVES.: To assess safety and effectiveness of balloon aortic valvuloplasty (BAV) in patients with symptomatic severe aortic stenosis (AS) and significant aortic regurgitation. BACKGROUND.: BAV is a palliative procedure that has possibly been underused in patients with symptomatic AS not suitable for surgical aortic valve replacement or transcatheter aortic valve ...

In our previous studies, we showed that a significant proportion of patients with various cardiovascular diseases have active tissue factor (TF) and factor (F)XIa in their plasma. The objective of the present study was to evaluate these two proteins in plasma from patients with aortic stenosis and establish their relationship ...

AIMS: To report aortic root geometry by echocardiography in a large population of healthy, asymptomatic aortic stenosis (AS) patients in relation to current vendor-specified requirements for transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: Baseline data in 1481 patients with asymptomatic AS (mean age 67 years, 39% women) in the ...

OBJECTIVE: To assess whether endothelium-dependent and endothelium-independent flow-mediated dilation (FMD) are impaired in patients with systemic lupus erythematosus (SLE) with no history of vascular event; and to determine factors moderating impaired FMD in SLE. METHODS: Electronic databases were searched for case-control studies that compared endothelium-dependent and/or endothelium-independent FMD at the ...

This study was designed to evaluate the possible relationship between vascular inflammatory status [namely, high-sensitivity C-reactive protein (hs-CRP) and white blood cell (WBC)] and aortic elasticity parameters in patients with prehypertension. The study population consisted of 25 newly diagnosed prehypertensive individuals (18 men, mean age=34±6 years) and 25 healthy controls ...

BACKGROUND: Cardiovascular (CV) disease is a major cause of morbidity and mortality in patients with end-stage renal disease. In recent years, arterial stiffness has taken on great importance in the pathophysiology of CV diseases. The independent predictive value of arterial stiffness for CV events and for all-cause and CV mortality ...

Establishing a functional vascular access while minimizing the risk of dialysis access-associated ischemic steal syndrome (DASS) may present a challenging problem in patients with severe peripheral vascular disease where even a low-flow arteriovenous fistula (AVF) may lead to severe symptoms and physical findings of DASS. Proximalization of arterial inflow for ...

Impaired regulation of transforming growth factor-β (TGFβ) signaling pathway has been linked to thoracic aortic aneurysm (TAA). Previous work has indicated that differential splicing is a common phenomenon, potentially influencing the function of proteins. In the present study we have investigated the occurrence of differential splicing in the TGFβ pathway ...

BACKGROUND: Advances in esophageal manometry have facilitated identification of variants of achalasia, suggesting they are more common than previously thought. This study assesses the frequency and clinical characteristics of patients with motility abnormalities similar to, but not meeting criteria for, classic achalasia. STUDY DESIGN: Records of patients undergoing high-resolution esophageal ...

BACKGROUND: Coarctation of aorta (CoA) patients present cardiovascular complications late after repair the causes of which are not fully understood. Our study investigates the neurohormonal and immune activation and the elastic properties of the aorta and peripheral vessels in adult patients with coarctation of aorta (CoA), late after repair. METHODS: ...

Vascular calcification is associated with cardiovascular disease in hemodialysis (HD) patients. Some reports have previously shown that simple assessment of aortic calcification using plain radiography is associated with cardiovascular (CV) events; however, these studies simply assessed whether aortic calcification was present or absent only, without considering its extent. Here, we ...

AIMS: The prevalence of heart failure with preserved ejection fraction (HFpEF) has increased in the past two decades, and diabetes mellitus (DM) is frequently associated with HFpEF. Although it has been demonstrated that left ventricular (LV) diastolic and vascular functional abnormalities are generally observed in HFpEF, it remains to be ...

BACKGROUND: To determine whether C-reactive protein (CRP) in combination with a stroke risk stratification scheme can help in identifying transesophageal echocardiographic (TEE) markers of thromboembolism such as left atrial (LA)/left atrial appendage (LAA) thrombus, severe LA/LAA spontaneous echocardiographic contrast (SEC), and aortic plaque≥4mm. METHODS: Transthoracic echocardiography, TEE, and CRP measurement ...

BACKGROUND: Chronic progressive external ophthalmoplegia is a mitochondrial myopathy that causes muscular or multisystem symptoms and has dysphagia as one manifestation. AIM: To evaluate esophageal contractions in patients with chronic progressive external ophthalmoplegia. METHODS: We studied 14 patients with chronic progressive external ophthalmoplegia and 16 asymptomatic volunteers. The diagnosis of ...

PURPOSE:: To document the evolution and functional and structural significance of parafoveal rings of high-density fundus autofluorescence (AF) in patients with retinitis pigmentosa and preserved visual acuity. METHODS:: Fifty-two patients with nonsyndromic retinitis pigmentosa or Usher syndrome, who had a parafoveal ring of high-density AF and a visual acuity of ...

OBJECTIVES: Aortic valve replacement (AVR) is recommended in patients with symptomatic aortic stenosis (AS). However a large number of elderly patients remain untreated because of a high operative risk. The aim of this study was to assess the risk profile of a group of AS patients, evaluating the prevalence of ...

Hadjivassiliou M, Aeschlimann D, Grünewald RA, Sanders DS, Sharrack B, Woodroofe N. GAD antibody associated neurological illness and its relationship to gluten sensitivity. Acta Neurol Scand: 2011: 123: 175-180. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Background -  The high prevalence of gluten sensitivity in patients with stiff-person ...

Both occult hypoperfusion and volume overload are associated with increased morbidity and mortality in critically ill patients. Accurately predicting fluid responsiveness (FRes) allows for optimization of cardiac performance while avoiding fluid overload and prolonged mechanical ventilation. To simultaneously assess the ability to predict FRes using the stroke volume variation (SVV) ...

The absence of coronary artery calcification (CAC) has been used to as an indication to rule out significant coronary artery disease (CAD). However, diagnostic usefulness of 'zero calcium score criteria' as a decision-making strategy to rule out significant CAD as the etiology of acute chest pain has not been studied ...

Although the importance of orbito-frontal cortex (OFC) is established in the pathogenesis of obsessive compulsive disorder (OCD), no study have evaluated its relation to the traditional psychodynamic perspective. In the present study, we aimed to evaluate the relationship between the defense styles consisting of mature, immature and neurotic defenses and ...

Light transmission aggregation (LTA) is considered the reference method to identify residual platelet reactivity (RPR) in high-risk patients with coronary artery disease on clopidogrel treatment. An international standardization of this technique is still ongoing and different concentrations of adenosine diphosphate (ADP) as the agonist for LTA have been used to ...

BACKGROUND: To investigate elastic characteristics of the aorta in patients with epilepsy. METHODS: Seventy five patients with a diagnosis of epilepsy through clinical and EEG findings and age and sex matched, 50 healthy controls were included. Systolic and diastolic blood pressures plus systolic and diastolic diameter of the aortic root ...