Stress echocardiography in heart failure.

Echocardiography has the ability to noninvasively explore hemodynamic variables during pharmacologic or exercise stress test in patients with heart failure. In this review, we detail some important potential applications of stress echocardiography in patients with heart failure. In patients with coronary artery disease and chronic LV dysfunction, dobutamine stress echocardiography is able to distinguish between viable and fibrotic tissue to make adequate clinical decisions.

Histological and microscopy FT-IR imaging study on the proliferative activity and angiogenesis in head and neck tumours.

Micro Fourier transform infrared spectroscopy enables one to study small samples because of the high quality spectra that can be obtained. Biochemical and morphological changes between control and pathological tissues of head and neck tumours have been monitored drawing three-dimensional chemical maps of the main vibrational modes in the regions of interest. Comparison between spectral and histological data shows a satisfactory degree of accordance.

Cognitive impairment in the intensive care unit.

Delirium is a frequent complication in older patients in the ICU and often persists beyond their ICU stay. Delirium in older persons in the ICU is a dynamic and complex process. There is a high prevalence of pre-existing cognitive impairment in patients who are admitted to the medical ICU.

Underrecognition of preexisting cognitive impairment by physicians in older ICU patients.

Objectives: Cognitive impairment increases with age, as do many serious illnesses requiring intensive care. Little is known, however, about physician recognition of preexisting cognitive impairment in the ICU and which patient factors may play a role in physician recognition.

Design: Cross-sectional comparative study.

Compressing inverse lyotropic systems: Structural behavior and energetics of dioleoyl phosphatidyl ethanolamine.

The pressure effects on the stability and energetics of lipid phases in the L-alpha-dioleoyl phosphatidyl ethanolamine (DOPE)-water system are presented. Using synchrotron diffraction experiments, performed at a wide range of concentrations, pressure-induced transitions from the inverse hexagonal (H(II)) to the lamellar L(alpha) phase and from the L(alpha) to the lamellar L(beta) phase are demonstrated. Moreover, in the most dehydrated samples an intermediate phase is found between the H(II) and the L(alpha) phases, confirming that the lamellar-to-nonlamellar phase transition occurs through key intermediate structures.

Is the N170 for faces cognitively penetrable? Evidence from repetition priming of Mooney faces of familiar and unfamiliar persons.

Impoverished images of faces, two-tone Mooney faces, severely impair the ability to recognize to whom the face pertains. However, previously seeing the corresponding face in a clear format helps fame-judgments to Mooney faces. In the present experiment, we sought to demonstrate that enhancement in the perceptual encoding of Mooney faces results from top-down effects, due to previous activation of familiar face representation.

Screening for preexisting cognitive impairment in older intensive care unit patients: use of proxy assessment.

Objectives: To determine the prevalence of preexisting cognitive impairment (CI) in patients admitted to the medical intensive care unit (ICU) and compare two different proxy measures of preexisting CI in ICU patients.

Design: Cross-sectional comparative study.

Setting: Urban university teaching hospital.

Delirium in the intensive care unit: occurrence and clinical course in older patients.

Objectives: To describe the occurrence of delirium in a cohort of older medical intensive care unit (ICU) patients and its short-term duration in the hospital and to determine the association between preexisting dementia and the occurrence of delirium.

Design: Prospective cohort study.

Setting: Fourteen-bed medical ICU of an 800-bed university teaching hospital.

[Pleuro-pancreatic fistula diagnosed by ultrasonography].

A pleural effusion resulting from pancreatitic-pleural fistula is a rare clinical entity which has, however, been more frequently recognised in the last ten years. The cause is a fistula tract between the pancreas and the pleura. Elevated amylase levels in the pleural fluid are the key to suspecting this diagnosis, which needs to be confirmed using imaging techniques such as CT, MRI and ultrasound or ERCP, which are necessary for defining the therapeutic strategy.

[Ultrasonography of normal vermiform appendix].

The aim of this study was the detection and visualisation of the normal vermiform appendix and its characteristics by ultrasonography in adults with no clinical suggestion of acute or chronic abdominal disease. A prospective study was performed in 200 subjects. The graded-compression ultrasonography technique was used to explore the lower right quadrant of the abdomen and the pelvis.

A sample scanning system with nanometric accuracy for quantitative SPM measurements.

A sample scanning device operating in a working volume of 30 x 30 x 18 microm with interferometer and capacitance-based controls of displacements, is described. The xy-stage uses plane mirror linear interferometers and fast phase-meters for control of displacements of precise ball-bearing stages driven by piezo flexure actuators. The stage operates with a full range bandwidth of 200 Hz, and an estimated accuracy (k = 2) of 3 nm + 1 x 10(-3) L, where L is the lateral displacement.

[Mottled hyperpigmentation of the fundus oculi associated with angioid streaks in pseudoxanthoma elasticum].

The Authors report mottled fundus in association with pseudoxanthoma elasticum in 8 of 9 patients. The mottled hyperpigmentation is an early uncommonly described finding, consisting of a speckled, yellowish mottling of the posterior pole temporal to the macula at ophthalmoscopic examination; this appearance, called "peau d'orange", is believed to be caused by changes in the retinal pigmented epithelium overlying a calcified and degenerating Bruch's membrane. This finding is virtually pathognomonic of pseudoxanthoma elasticum and may be present even in the first decade of the disease, prior to the appearance of the angioid streaks.

[A case of idiopathic hypereosinophilic syndrome].

Idiopathic hypereosinophilic syndrome (IHS) is reported in a 59-year-old farmer. Skin manifestations were represented by pruritic erythemato-squamous and papulonodular lesions, the heart was affected by endomyocardic fibrosis, and periodic intestinal colics denoted a possible gut involvement. A mild and transient beneficial effect was achieved by treatment with antihistamines, sodium-chromoglycate, steroids.

[Porokeratosis palmaris et plantaris disseminata with squamous cell carcinoma].

A 53-year-old man presented porokeratosis palmaris, plantaris et disseminata with some features (exacerbation of lesions, in the sun light, zosteriform fashion of them on the trunk and extremities) distinctive of other variants of porokeratosis. Lately, four squamous cell carcinomas had arisen on the areas involved by disease. Histologic study of porokeratosis lesions showed epidermal changes typical of the disease ("cornoid lamella"), but also a mild disorder of malpighian stratification.

[Proteiform syndrome (Proteus syndrome). Skin manifestations in a recently observed case].

The case of a 4-year-old female affected by partial gigantism of the feet, syndactyly and polydactyly, partial right hemihypertrophy of buttock and lower limb, warty hyperpigmented nevus and vulvar lipoma is described. The Authors discuss about the Proteus syndrome, pointing out its rarity, the polymorphism and the problems of differential diagnosis with the Klippel-Trenaunay-Weber syndrome and with other congenital hamartomatous disorders.

The unsteady form of the Bernoulli equation for estimating pressure drop in the airways.

Previous investigators have used the steady Bernoulli equation to correct the underestimation of alveolar pressure by airway pressure observed during unsteady flow conditions. Using a simple idealized geometry, we demonstrate a method of including the unsteady term of the Bernoulli equation. Our approach was to determine the axial velocity distribution from the wave equation and employ this solution with the unsteady Bernoulli equation.

Kaposi's sarcoma as clinical manifestation of the acquired immunodeficiency syndrome in a hemophilic patient.

The authors report the natural history of HIV infection in a patient with severe hemophilia A who became HIV-seropositive in 1983 and, four years later, developed full-blown AIDS associated with a disseminated Kaposi's sarcoma. Neutralizing antibody titers against HIV were shown to be inversely disease-associated, while the progression of clinical symptoms was directly related to the decline of T4 cells and the increase of urinary neopterin levels. It is suggested that the presence of an HLA DR 5 phenotype and repeated CMV infection could have been crucial for the development of KS.

In vitro acantholysis by captopril and thiopronine.

The possible acantholytic property of captopril and thiopronine has been investigated using in vitro tissue cultures. Normal human breast skin explants have been cultured in Hanks' balanced salt solution containing 40% normal inactivated human serum with the addition of L-cysteine, or reduced glutathione (GSH), or captopril, or thiopronine, at four different concentrations (1, 5, 10, 15 mM). Patterns of diffuse, mainly suprabasal acantholysis, with formation of bullae, were observed in the skin explants cultured with captopril or thiopronine at a 15-mM concentration after 5 days of culture; intraepidermal splits were present also at a 10-mM concentration.