Joint Analysis of Cardiovascular Control and Shear Wave Elastography to Determine Carotid Plaque Vulnerability.

: Carotid artery stenosis (CAS) is one of the main causes of stroke, and the vulnerability of plaque has been proved to be a determinant. A joint analysis of shear wave elastography, a radiofrequency echo-based wall tracking technique for arterial stiffness evaluation, and of autonomic and baroreflex function is proposed to noninvasively, preoperatively assess plaque vulnerability in asymptomatic CAS patients scheduled for carotid endarterectomy. : Elastographic markers of arterial stiffness were derived preoperatively in 78 CAS patients (age: 74.

Prolonged exposure for posttraumatic stress disorder following spinal cord injury: A randomized controlled trial.

Purpose/objective: Individuals with a spinal cord injury (SCI) may experience posttraumatic stress disorder (PTSD) at a higher rate, which is associated with worse psychiatric comorbidity, decreased quality of life, and greater disability. Yet, effective PTSD interventions remain understudied for individuals with SCI. We conducted the first randomized controlled trial (RCT) of an evidence-based psychotherapy (prolonged exposure [PE]) with survivors of SCI during acute rehabilitation.

Factors affecting perceived caregiver burden: caregivers of trauma patients discharged from the intensive care unit.

Background: Caregivers to intensive care unit survivors are vulnerable to caregiver burden, which has been demonstrated to have consequences to patients' and caregivers' mental and physical health. Potentially modifiable factors should be explored so that interventions may be developed.

Methods: Ninety-one anticipated caregivers were prospectively assessed both at a southwestern trauma intensive care unit during their patient's admission and at home via remote interview 3 months after intensive care unit admission.

3D patient-specific modeling and structural finite element analysis of atherosclerotic carotid artery based on computed tomography angiography.

The assessment of carotid plaque vulnerability is a relevant clinical information that can help prevent adverse cerebrovascular events. To this aim, in this study, we propose a patient-specific computational workflow to quantify the stress distribution in an atherosclerotic carotid artery, by means of geometric modeling and structural simulation of the plaque and vessel wall. Ten patients were involved in our study.

Role of Preoperative Ultrasound Shear-Wave Elastography and Radiofrequency-Based Arterial Wall Tracking in Assessing the Vulnerability of Carotid Plaques: Preliminary Results.

We aimed at evaluating the ability of point shear-wave elastography (pSWE) and of a radiofrequency (RF) echo-tracking-based method in preoperatively assessing the vulnerability of the carotid plaque in patients undergoing carotid endarterectomy (CEA) for significant asymptomatic stenosis. All patients who underwent CEA from 03/2021 to 03/2022 performed a preoperative pSWE and an RF echo-based wall evaluation of arterial stiffness using an Esaote MyLab ultrasound system (EsaoteTM, Genova, Italy) with dedicated software. The data derived from these evaluations (Young's modulus (YM), augmentation index (AIx), pulse-wave velocity (PWV)) were correlated with the outcome of the analysis of the plaque removed during the surgery.

Seasonal variation and group size affect movement patterns of two pelagic dolphin species (Lagenorhynchus obscurus and Delphinus delphis).

Movement is a key factor in the survival and reproduction of most organisms with important links to bioenergetics and population dynamics. Animals use movement strategies that minimize the costs of locating resources, maximizing energy gains. Effectiveness of these strategies depends on the spatial distribution, variability and predictability of resources.

The role of resilience and spirituality in recovery following cardiac surgery.

Higher levels of resilience and spirituality are independently linked to better physical and mental health outcomes, within both general and cardiac populations. We investigated the long-term associations of such psychological factors following cardiac surgery. A total of 402 patients undergoing routine cardiac surgery at two large urban hospitals in the Dallas, Texas, area were prospectively enrolled in this study, with completed follow-up data for 364 (90.

Quality of Life Is Improved 1 Year After Cardiac Surgery.

Background: Quality of life (QoL) is increasingly important in the era of patient-centered outcomes and value-based reimbursement. However most follow-up is limited to 30 days, and long-term data on QoL improvement associated with symptom relief are lacking. Therefore we sought to analyze QoL after cardiac surgery in a nonemergent, all-comers population.

Utility of Brief Psychological Measures for Prediction of Prolonged Symptom Clearance in Concussed Student Athletes.

Objective: Variability in recovery time following sport-related concussion (SRC) is poorly understood. We explored the utility of brief mood, anxiety, and sleep questionnaires as postinjury predictors of SRC symptom clearance in adolescents.

Method: At initial visit 0-2 weeks postinjury, concussed athletes aged 12-18 years self-reported injury/medical factors (prior concussion, loss of consciousness, amnesia, and concussion symptom severity) and were administered psychological symptom measures.

Reliability of Medical History Reporting in Older Adults With and Without Cognitive Impairment.

Background: Clinical diagnosis of cognitive disorders depends on accurate reporting of medical history, yet little is known about the reliability and the validity of such reports, particularly in older patients with and without cognitive impairment.

Methods: In 2 studies, we examined the reliability and the validity of reported histories of select medical events in adults with and without cognitive impairment from a large national cohort.

Results: Information from subjects (N = 3664), obtained from 2 time points, 6 to 12  months apart, was consistent across most medical events, regardless of the diagnostic group (range = 97.

Anxiety, depression, and healthcare utilization 1 year after cardiac surgery.

Background: While it is known that depression and anxiety influence cardiac surgery recovery, the mechanisms of such remain unclear. We examined the influence of anxiety and/or depression on health care utilization and quality of life (QOL) in the 12 months following cardiac surgery.

Methods: (N = 306) patients at two North Texas hospitals were assessed pre-operatively, at 30 days, and one year post-operatively using the Hospital Anxiety and Depression Scale and Kansas City Cardiomyopathy Quality of Life measures.

Injectable fillers: an American perspective.

Since 1981, there has been a significant repertoire of United States Food and Drug Administrtion (FDA) approved fillers for both cosmetic rejuvenation and facial lipoatrophy. Currently available dermal fillers include bovine, human and porcine collagens, hyaluronic acids of animal and biosynthetic origin, poly-L-lactic acid, calcium hydroxylapatite, and polymethylmethacrylate. Many of these fillers were first available in Europe and Canada before their arrival in the United States (USA) and many of the complications known about these products have come from studies conducted both in the USA and abroad.

Stress induced cardiomyopathy presenting as acute coronary syndrome: Tako-Tsubo in Mercogliano, Southern Italy.

Background: Tako-tsubo syndrome (TTS) in its typical (apical) and atypical (non-apical) forms is being increasingly recognized in the West owing to early systematic coronary angiography in acute coronary syndromes (ACS).

Aim Of The Study: To assess the incidence, the clinical characteristics and the outcome of TTS in a single high volume cath lab in Southern Italy over the last 6 years.

Methods: Among 1674 consecutive patients (pts) referred to our coronary care units in the last 6 years (2001-2006) for ACS we selected 6 (0.

[Complete congenital atrioventricular block: a case report and review of the literature].

The description of a clinical case of a newborn with congenital complete atrioventricular block, due to maternal connective-tissue disease, is the occasion for a review of the literature. The clinical elements allowing an early diagnosis and treatment of these patients, who often need a permanent pacemaker, are described.

[The electrophysiological bases of aberrant intraventricular conduction during atrial fibrillation].

Twenty-four hours electrocardiogram from 4 patients with chronic atrial fibrillation and intraventricular aberrant conduction were analyzed. Aim of the study was to evaluate the reliability of the Ashman's and Akthar's rules in electrocardiographic differential diagnosis between aberrancy and ectopy. We computed parameters related to 10 RR interval preceding the aberrant conduction (AB+ Group), normal complex QRS (AB-Group) and ectopic QRS (E Group): coupling interval (CI), preceding CI cycle (PCL1), preceding PCL1 cycle (PCL2), the difference between PCL1 an PCL2 (delta PCL1), the difference between CI an PCL1 (delta CI), the mean value (RR10) and the standard deviation (RR10SD) of the 10 QRS complexes preceding the end of the sequence.

[Surgical treatment of incessant atrial tachycardia: description of a case].

A 50 year old woman with no evidence of structural heart disease was referred for ectopic incessant repetitive atrial tachycardia uncontrolled by medical therapy. Intracavitary and transesophageal simultaneous recordings revealed the earliest atrial electrical activity to be located in the left atrium. Intraoperative electrophysiologic mapping demonstrated that the site of earliest atrial activation was in a small diverticulum of the left atrial appendage.

[Double ventricular response to a single atrial stimulation caused by simultaneous anterograde conduction through two atrioventricular nodal pathways].

In a patient with atrioventricular nodal reentrant tachycardia, during programmed stimulation, an atrial extrastimulus induced a double ventricular response due to a single atrial depolarization, with simultaneous and delayed anterograde conduction through fast and slow pathways, and induced the tachycardia. Pacing-induced type I block involving both pathways put these pathways out of phase, so that the distal conduction system and the ventricle responded to both the fast and slow pathways anterograde impulses.

[Linking in a phase-3 branch block: the electrocardiographic manifestations].

Two cases of phase 3 intraventricular block and linking phenomenon of type 1 and type 2 (or bigeminal rhythm linking) are presented. In the first case, complexes that follow the extrasystolic blocked beat are wide, although they are associated with relative long R-R cycle:type 1 linking. In the second case, bundle branch block and normal conduction alternate in bigeminal extrasystolic beats:type 2 linking.

[Slow and fast AV nodal pathways in tachycardia complicating Wolff-Parkinson-White syndrome: report of a case].

Electrophysiologic studies in a patient with intermittent ventricular pre-excitation revealed several types of paroxysmal narrow-QRS tachycardia (PSVT). One type of PSVT was characterized by normal retrograde atrial sequences with P waves occurring simultaneously with QRS. This type of PSVT reflected AV nodal reentry with anterograde slow pathway and retrograde fast pathway conduction.