A point-to-point simple telehealth application for cardiovascular prevention: the ESINO LARIO experience. Cardiovascular prevention at point of care.

Recent epidemiological evidence indicates that chronic degenerative diseases, notably cardiovascular, represent the major toll in terms of death and of impaired quality of life. Recent estimates indicate that a small increase in financial resources in a number of clinical cases may be sufficient to minimize the consequences of elevated cardiovascular risk per individual. The observation that lifestyle choices, and in particular increased physical exercise, might strongly impact cardiovascular risk, suggests a redesign of preventive strategies, based on the combination of pharmacological and behavioral interventions.

Confinement and sleep deprivation effects on propensity to take risks.

Introduction: The impact of confinement and sleep deprivation on risk-taking propensity is a key issue in crew management. We investigated both confinement and gender effects on risk propensity and performance during up to 36 h of extended wakefulness.

Method: We studied 4 groups of 3 men and 3 women [N = 24, mean age (+/- SD) = 32.

Spontaneous baroreflex sensitivity estimates during graded bicycle exercise: a comparative study.

In the literature, several methods have been proposed for the assessment of the baroreflex sensitivity from spontaneous variability of heart period and systolic arterial pressure. The present study compares the most utilized approaches for the evaluation of the spontaneous baroreflex sensitivity (i.e.

Caudate volumes in public transportation workers exposed to trauma in the Stockholm train system.

The caudate nucleus is a structure implicated in the neural circuitry of psychological responses to trauma. This study aimed to quantify the volume of the caudate in persons exposed to trauma. Thirty-six subjects under 65 were recruited from transport workers in Stockholm who reported having been unintentionally responsible for a person-under-the-train accident or among employees having experienced an assault in their work (1999-2001) between 3 months and 6 years before MRI scanning.

Preventing bacterial infections with pilus-based vaccines: the group B streptococcus paradigm.

We recently described the presence of 3 pilus variants in the human pathogen group B streptococcus (GBS; also known as Streptococcus agalactiae), each encoded by a distinct pathogenicity island, as well as the ability of pilus components to elicit protection in mice against homologous challenge. To determine whether a vaccine containing a combination of proteins from the 3 pilus types could provide broad protection, we analyzed pili distribution and conservation in 289 clinical isolates. We found that pilus sequences in each island are conserved, all strains carried at least 1 of the 3 islands, and a combination of the 3 pilus components conferred protection against all tested GBS challenge strains.

Hemodynamic, autonomic and baroreflex changes after one night sleep deprivation in healthy volunteers.

Background: Sleep disorders are associated to a number of cardiovascular disturbances that might increase cardiovascular risk. Sleep deprivation, in particular, might, by inducing autonomic dysregulation, raise arterial pressure and hypertensive risk. Available evidence however is contradictory.

Mitochondrial function is related to alterations at brain SPECT in depressed patients.

Introduction: 99mTc-d,l-hexamethylpropylene amine oxime (99mTc-HMPAO) retention in brain is proportional to cerebral blood flow and related to both the local hemodynamic state and to the cellular content of reduced glutathione. Alterations of the regional distribution of 99mTc-HMPAO retention, with discrepant results, have been reported at functional brain imaging of unipolar depression. Since mitochondrial involvement has been reported in depressed patients, the aim of the study was to explore whether the 99mTc-HMPAO retention at single-photon emission computed tomography in depressed patients may relate to different levels of mitochondrial function.

Thresholds for Cenozoic bipolar glaciation.

The long-standing view of Earth's Cenozoic glacial history calls for the first continental-scale glaciation of Antarctica in the earliest Oligocene epoch ( approximately 33.6 million years ago), followed by the onset of northern-hemispheric glacial cycles in the late Pliocene epoch, about 31 million years later. The pivotal early Oligocene event is characterized by a rapid shift of 1.

Evidence of autonomic dysregulation in otherwise healthy cancer caregivers: a possible link with health hazard.

Caregiving, an important component of cancer patient treatment, may set forth a cascade of stress responses such as sympatho-adrenal activation, immuno-humoral changes and an unhealthy lifestyle, which could be hazardous to caregivers' health. In this observational study, we addressed whether autonomic nervous system (ANS) regulation and perception of stress would be altered in a group of 58 health cancer caregivers as compared to 60 controls. We employed non invasive autoregressive spectral analysis of cardiovascular variabilities and ad hoc questionnaires.

Dynamic adaptation of cardiac baroreflex sensitivity to prolonged exposure to microgravity: data from a 16-day spaceflight.

This study explored the process of arterial baroreflex adaptation to microgravity, starting from the first day of flight, during the 16-day STS-107 Columbia Space Shuttle mission. Continuous blood pressure (BP), ECG, and respiratory frequency were collected in four astronauts on ground (baseline) and during flight at days 0-1, 6-7, and 12-13, both at rest and during moderate exercise (75 W) on a cycle ergometer. Sensitivity of the baroreflex heart rate control (BRS) was assessed by sequence and spectral alpha methods.

Calcium channels, neuromuscular synaptic transmission and neurological diseases.

Voltage-dependent calcium channels are essential in neuronal signaling and synaptic transmission, and their functional alterations underlie numerous human disorders whether monogenic (e.g., ataxia, migraine, etc.

A chromatin-wide transition to H4K20 monomethylation impairs genome integrity and programmed DNA rearrangements in the mouse.

H4K20 methylation is a broad chromatin modification that has been linked with diverse epigenetic functions. Several enzymes target H4K20 methylation, consistent with distinct mono-, di-, and trimethylation states controlling different biological outputs. To analyze the roles of H4K20 methylation states, we generated conditional null alleles for the two Suv4-20h histone methyltransferase (HMTase) genes in the mouse.

Volumetrics of the caudate nucleus: reliability and validity of a new manual tracing protocol.

Our aim was to develop a reliable and valid manual segmentation protocol for tracing the caudate nucleus in MRI for volumetric and, potentially, shape analysis of the caudate. Using the protocol, two inter- and intra-rater reliability studies were conducted using five different raters on two different image analysis platforms (ANALYZE, Mayo Biomedical Imaging Resource, Rochester MN, USA, and HERMES, Nuclear Diagnostics AB, Stockholm, Sweden). Reference images for the detailed protocol are described.

Principal component analysis of FDG PET in amnestic MCI.

Purpose: The purpose of the study is to evaluate the combined accuracy of episodic memory performance and (18)F-FDG PET in identifying patients with amnestic mild cognitive impairment (aMCI) converting to Alzheimer's disease (AD), aMCI non-converters, and controls.

Methods: Thirty-three patients with aMCI and 15 controls (CTR) were followed up for a mean of 21 months. Eleven patients developed AD (MCI/AD) and 22 remained with aMCI (MCI/MCI).

Development of an e-learning system for occupational medicine: usability issues.

The aim of the present paper is to describe the process of developing an e-learning system for continuous medical education in the field of occupational medicine, with special focus on usability. The following steps are described: the needs analysis of the potential users; the prototype of the system that has been set up; the usability evaluation of the prototype by a sample of ten users; the analysis of the potential improvements; the evaluation of the revised system. The results of the usability tests point out that investing in improving usability was useful, even when they have not been recommended as mandatory.

Macromolecular interactions and rheological properties of buckwheat-based dough obtained from differently processed grains.

The physicochemical properties of the protein and starch fractions of flour obtained from buckwheat grains that were previously dehulled or puffed after dehulling were investigated. Dehulling removed most of the nonprotein, nonstarch components of the grain, without affecting the chemical and structural features of the protein and starch components, as made evident by microstructural and spectroscopic measurements. Puffing resulted in extensive modifications of the interprotein network as well as in most of the properties of the buckwheat starch.

Analysis of heart period and arterial pressure variability in childhood hypertension: key role of baroreflex impairment.

In adults, initial stages of hypertension are associated with elevated sympathetic drive and significant alterations in indirect autonomic markers. There is growing evidence that children in the highest-pressure percentiles will be more likely to develop hypertension in adulthood, although mechanisms are not understood. We assessed whether computer analysis of RR interval and arterial blood pressure variability could detect early autonomic alterations in childhood hypertension, as assessed by noninvasive time and frequency domain measures of baroreflex regulation.

Primary pulmonary high grade non-Hodgkin's lymphoma in an elderly patient. A case report.

An 82-year-old non-smoker female was admitted with cough, fever and poor general health. Radiological examination revealed a right parahilar mass and a transbronchial biopsy confirmed the presence of a tumor. Immunohistochemical analysis established the diagnosis of high-grade primary pulmonary lymphoma.

Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: outcome is stable in 35-month follow-up.

Post-traumatic stress disorder (PTSD) is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR).

Priming-like effect and successful desensitization after anaphylactic shock by latex sublingual immunotherapy.

The present report deals with some unusual events observed restarting allergy vaccine in a case of anaphylactic shock which occurred giving the maximum scheduled dose (25 drops) of rush sublingual immunotherapy (SLIT) to latex. Restarting SLIT by usual (not rush) scheme we observed long-lasting fall of reactivity threshold. The maximum tolerable dose was reduced to 2 drops, a dose fivefold smaller than the one well tolerated during previous rush phase (10 drops).

Heart rate and vasomotor control during exercise.

Spontaneous baroreflex function and vascular changes were assessed in young adults during dynamical mild exercise. Windkessel time constant was assessed by two different methods: two-element windkessel model, and by an autoregressive (AR) model, while the baroreflex sensitivity (BRS, ms/mmHg) was assessed by the sequence method. Results showed a change in the baroreflex control of heart rate (HR) with the severity of exercise, as well as the resetting phenomenon.

Comparison of BRS estimates during mild dynamical exercise and recovery.

Ten estimates of baroreflex sensitivity (BRS) were compared during progressive graded exercise: they were computed from sequence method, spectral and cross-spectral analysis methods, and parametric model-based methods. Results showed baroreflex control of heart rate (HR) changes as a function of the intensity of exercise, as well as the resetting phenomenon. Sequence, spectral and cross-spectral methods generally provided higher estimates than parametric model-based ones.

Multivariate parametric model for the identification of diastolic pressure and pulse pressure components.

Arterial pressure variability is a relatively unexplored topic among the various and detailed studies of cardiovascular variability. A deeper analysis of components and contributions carried by diastolic and pulse pressure may provide a unique insight on the potential systemic effects due to vasomotor activity and response at the level of microcirculation, whose dynamics are either driven by neural and vascular modulations. The aim of the present work is to develop a multivariate parametric model for the identification of the main components of diastolic and pulse pressure in order to investigate all the potential correlations between systemic arterial pressure variability and peripheral sources of oscillations and to analyze their interactions with the most known mechanisms of cardiovascular regulation.