bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Titanium Carbide Chlorination by Statistical Design
Authors: Ahmadi Eltefat , Sereiratana E.M. , Rezan S.A. , Yeoh F.Y. , Ahmad Fauzi M.N. , Zhang G.
Published: July 2016

In present study, the effects of the process parameters on chlorination of Titanium Carbide (TiC) was studied. Besides that, process parameters were investigated by using experimental design of experiment (DOE) and statistical analysis. The chlorination of the samples was carried out at temperatures between 400 to 500°C. Effects of three parameters, namely temperature, soaking time, and molar ratio of potassium permanganate (KMnO4) to hydrochloric acid (HCl) were investigated. The interaction, on the rate of chlorination of TiC were statistically evaluated by using DOE. The weight loss (wt. %) was the main response taken into account in this paper. The results of the experimental design indicated that the main significant factor for chlorination of TiC was higher temperature, soaking time and higher molar ratio of KMnO4 to HCl. DOE results have demonstrated that the highest extent of chlorination obtained at the highest weight loss (wt. %) was about 54.59 wt. % at 500°C with a soaking time of 180 minutes and KMnO4 to HCl molar ratio of 0.17 respectively. The amounted to a titanium extraction of about 96.39 %. On the other hand, the lowest wt. lost was 30.76 wt. % and this was obtained at 500°C for 120 minutes with KMnO4 to HCl molar ratio of 0.09 respectively. The results obtained from this work will be employed as a guide for the future studies on chlorination of nitrided/carburized Malaysian ilmenite or titanium oxycarbonitride. The final aim was to produce TiCl4 at low temperatures (≤500°C) using the latter samples. The experimental values are in good agreement with calculations from the statistical model.
Behavior of Rectangular Concrete Column Confined with Sisal Fiber Reinforced Polymers (Sisal FRP)
Authors: Suwattanakorn Atipphat , Hussain Qudeer , Rattanapitikon Winyu , Pimanmas Amorn
Published: July 2016

This research work presents the results of experiment study on the axial behavior of low-high strength concrete rectangular columns confined by Sisal Fiber Reinforced Polymers (Sisal FRP). The objective of this study is investigate the performance of Sisal FRP composites to increase strength and ductility of rectangular columns through external confinement. The research parameter were confinement thickness and strength of concrete core. A total of 16 rectangular columns were tested under Universal Testing Machine (UTM) up to failure point. Test result shown that the external confinement by Sisal FRP are very effective to increase strength and ductility.
Shear Strengthening of Reinforced Concrete Beams with HFRP Composite
Authors: Siriluk Sanyawit , Hussain Qudeer , Rattanapitikon Winyu , Pimanmas Amorn
Published: July 2016

This paper presents an experimental study on the strengthening of scaled reinforced concrete (RC) deep beam using hemp fiber reinforced polymer (HFRP) composite. HFRP is the composite material which compose of hemp fiber bonding with epoxy resin. The major benefit of using hemp fiber is that their low price, high toughness, and hemp is natural fiber product which that can be found locally. In this study 2 different fiber orientation has been apply to scaled deep beam and also different in thickness (fiber layer). Three scaled deep beam were strengthened using HFRP composite, remaining one beam was tested as control (unstrengthen) beam. The test result show that HFRP composite are effective to enhance ultimate load capacity for RC beam. The HFRP composite applied in U-Shape was result into higher ultimate load compare with the sample that applied with both side strengthen method
The Effect of Mixing Ratios on Pore Properties of Fe Foam Fabricated Using Slurry Coating Process
Authors: Yun Jung Yeul , Park Da Hee , Wang Jei Pil
Published: July 2016

Metal foams have a cellular structure consisting of a solid metal containing a large volume fraction of pores. In particular, open, penetrable pores are necessary for industrial applications such as in high temperature filters and as support for catalysts. In this study, Fe foam with greater than 90% porosity, 2-mm pore size was successfully fabricated using a slurry coating process and the pore properties were characterized. The Fe and Fe2O3 powder mixing ratios were controlled to produce Fe foam samples with different pore sizes and porosity. First, the slurry was prepared through the uniform mixing of powders, distilled water, and polyvinyl alcohol (PVA). The amount of slurry coated on the PU foam increased with theFe2O3 mixing powder ratio, but the shrinkage and porosity of the Fe foams decreased, respectively, with increasing Fe2O3 mixing powder ratio.
Synthesis and Characterization of Nanomagnetic Graphene via Co-Precipitation Technique with Aid of Ultrasound
Authors: Abo-Zahhad E.M. , El-Shazly Ahmed Hassan , El Kady Marwa F.
Published: July 2016

Graphene nanoplates (GNPs) was immobilized with nanomagnetite using co-precipitation technique with the aid of ultrasound for the production of magnetic graphene nanoplate composite Fe3O4/G (MGNC) production. The physico-chemical properties of graphene were compared with the fabricated magnetic graphene composite using different characterization techniques. The crystalline and chemical structures of nanographene before and after magnetic immobilization were identified using X-Ray diffraction. The morphological structure of magnetic composite was identified by using Transmission Electron Microscope (TEM).it was carried out to investigate the precipitation of nanomagnetite onto the nanographene sheets. Atomic Force Microscope (AFM) analysis of magnetic graphene composites confirms the presence of magnetic nanoparticles attached to nanographene. The Vibrating sample magnetometer (VSM) confirmed the superparamagnetic properties of the prepared composite that represented with its hysteresis curve, and the saturation moment per unit mass, Ms for the MGNCs is 22.7548 emu·g−1
Tunable Properties of Three-Dimensional Graphene-Loaded Plasmonic Absorber Using Plasmonic Nanoparticles
Authors: Li Jia Ye , Zhu Jin Feng , Liu Qing H.
Published: July 2016

We demonstrate a three-dimensional nanostructure design by combining graphene and conventional plasmonic nanostructures, to achieve the high absorbance in the visible region. Furthermore, the peak position and bandwidth of graphene absorption spectra are tunable in a wide wavelength range through a specific structural configuration. Comparing the results of two structures which is based on different materials, Gold and Silver. The structure made of Silver present a better performance. These results imply that graphene in combination with plasmonic perfect absorbers have a promising potential for developing advanced nanophotonic devices.
Fabrication of TiO2 Nanoparticles on Large-Area Graphene Oxide Sheets as Promising Photocatalytic Material
Authors: Tan Tong Ling , Abd Hamid Sharifah Bee , Lee Kian Mun , Lai Chin Wei
Published: July 2016

Nowadays, the discharge of synthetic dyes effluents into water system has created serious water contamination problems which could gravely impact the quality of human life. Photocatalytic oxidation (PCO) by TiO2 has shown superior performance on towards the remediation of various organic pollutants. In this study, two dimensional (2D) graphene oxide (GO) sheets supported titanium dioxide (TiO2) nanoparticles were successfully synthesized by a simple and efficient sol-gel method using titanium isopropoxide (TTIP) and GO as the precursor. The graphite powder was first oxidized into hydrophilic GO using modified Hummer’s method followed by the addition of titanium solution. The resulting nanocomposites were then applied in the PCO of methyl orange under UV irradiation. The TiO2 nanoparticles were spherical in shape, with a particle size of 20-30 nm were well-deposited on the GO sheets. The presence of anatase phase in GO/TiO2 was confirmed by the XRD studies. The nanocomposites exhibited enhanced photocatalytic activity than TiO2, probably due to the addition of graphene oxide which retard the electron-hole recombination in the hybrid material.
Relation between Friction Stir Spot Welding Parameters and Mechanical Properties of High Density Polyethylene/Glass Spheres Polymer Composites
Authors: Taşdemir Münir , Bilici Mustafa Kemal , Kurt Mehmet
Published: July 2016

In the present study, we attempt to use powder of glass spheres filler and reinforce material in HDPE to produce composite structure and then evaluate its mechanical properties to study the effect of welding parameters and filler content on mechanical properties of HDPE. The effect of welding parameters (tool rotational speed, the plunge depth and the dwell time) on friction stir spot welding properties of high density polyethylene/glass spheres (hollow) polymer composites sheets was studied.
The Effect of Preparation Temperature of Electrolytes on Undoped and Ag-Doped TiO2 Nanotube Structures
Authors: Photharin Somkuan , Samran Buagun , Vongwatthaporn Rinnatha , Kodtharin Narongsak , Chaiyarat Ramida , Tipparach Udom
Published: July 2016

In this work, we present the effect of preparation temperature of electrolytes for fabricating undoped and silver (Ag) doped titanium dioxide (TiO2) nanotubes by the electrochemical anodic oxidation of pure titanium sheets in electrolytes, mixtures of ethylene glycol (EG), ammonium fluoride (NH4F) and deionized water, that contain with different of silver ions. Heat treatment of electrolytes was carried out at 100 °C during preparation process. The morphology and structure of prepared nanotubes were characterized by X-ray diffraction (XRD) and scanning electron microscope (SEM). The structures of TiO2 nanotubes obtained from heat treatment and non-heat treatment of electrolyte solutions and adding silver ions in electrolyte solution are similar. The nanotubes appear in arrays and the diameters of nanotubes were about 92 nm for non-heat treatment electrolyte solution and undoped TiO2 and about 102 nm for heat treatment electrolyte solution and all Ag-doped TiO2 nanotube arrays. When the concentration of silver nitrate (AgNO3) increases, the TiO2 nanotube arrays cracked and are not well arranged.
Experimental Study of Laser Welding Process and Properties of 2205 Duplex Stainless Sheet Steels
Authors: Hu Shan Shan , Yang Bi Tao , Zeng Bo Dong , Zheng Dong Rui , Yang Zi Li
Published: July 2016

2205 duplex (austenitic-ferritic) stainless steel has a good weldability and an excellent corrosion resistance. The good weldability is achieved when in close to 50-50 ferrite-austenite ratio. In this study, the welding process and properties were investigated by pulsed Nd:YAG laser welding. Tensile test, surface microhardness test, surface topography and microstructures of 2205 duplex stainless steel welds were performed under different welding speeds, input currents, pulse widths, frequencies and defocus distance. The relationship among them was revealed and the optimal welding parameters were obtained. The results showed in the condition of I = 160 A, T = 5 ms, f = 25 Hz, V = 500 mm/min and Z =-1 mm, the amount of ferrite and austenite in welds was roughly same, overlap rate of solder joints was above 78% and the weldability was good.
The Research of Contour Surface Recover Technology Based on 3D Printing Parts
Authors: Zhang Hong You , Wu Ming Yu
Published: July 2016

This paper presents a reverse modeling method of complex cavity body parts, and the 3D printing technology was combined and was applied to the surface of the complex cavity parts recover. Through 3D scanner efficient accurate scanning product information, and extract the need for processing of 3D solid surface, and finally adopts macromolecule ABS materials, application in Fused Deposition (FDM, Fused Deposition Modeling) for the principle of the 3D printer, respectively in different ways to print the extraction of surface, and a comparative study was carried out.
Comparison of Thrust Force in Ultrasonic Assisted Drilling and Conventional Drilling of Aluminum Alloy
Authors: Li Xiao Feng , Dong Zhi Gang , Kang Ren Ke , Wang Yi Dan , Liu Jin Ting , Zhang Yuan
Published: July 2016

The origin of drilling force in drilling with twist drill is quite complicated owning to the complex shape of the drill bit cutting edges. In this paper, the drilling experiments both with and without the ultrasonic were designed and conducted on aluminum alloy with pre-drilled hole. The drilling force was tested and the different effects between the cutting edges of the twist drill on the drilling force were analyzed under various drilling parameters including the spindle speed, feed rate and vibration amplitude. The drilling force of conventional drilling (CD) and ultrasonic assisted drilling (UAD) was characterized and the roles of the ultrasonic vibration in drilling were discussed.
Cutting Temperature Experiment and Simulation Analysis of the Complex Groove Turning Insert
Authors: Shi Li Min , Yang Cheng
Published: July 2016

In order to study the complex groove inserts in the cutting process caused by temperature variation of cutting,Using multi factor cutting method and combined with finite element simulation technology, from cutting parameters and chip-breaking groove two aspects influence on cutting temperature and cutting force cutting tests were carried out and experimental study on the complex groove turning insert edge chamfering, rounded cutting edge radius on cutting temperature effects. Also tested the effects of temperature on the chip shape cutting and breaking, and analyzed the temperature on the Influence law of cutting tool wear, thus providing a theoretical basis for tool wear.
Performance of a Holed-Insert in Finish-Turning of Inconel 718 under Jet Coolant
Authors: Fang Zheng Long , Obikawa Toshiyuki
Published: July 2016

Nickel-based alloy has been widely used in the aerospace industry due to its excellent mechanical properties. As originally designed to retain mechanical strength under the high temperature environment, the tool wear problems normally represent in the severe flank/crater wear and corrosion during the machining process. In this study, two types of holed-insert (OHT and THT) were proposed to excite the coolant convection so as to increase the heat transfer from the insert to the coolant under the jet coolant (JC) method. As a result, JC method showed the ability of increasing the flank wear resistance, and the THT type of holed-insert extended the tool life by approximately 59% compared with the ordinary insert.
Is’it time to renew and potentiate the regional GICR agency?
Authors: Carlon Roberto
Published: July 2016

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Bi-level home ventilators for non invasive positive pressure ventilation
Authors: Scala R.
Published: July 2016

With the widespread use of non-invasive positive pressure mechanical ventilation, great efforts have been made to produce machines, the bi-level home ventilators, which are less sophisticated, cheaper and able to better compensate air leaks with respect to the domiciliary volume- target machines and the traditional ventilators used in intensive care unit. As consequence of quick technologic evolution, bi-level home ventilators may be nowadays successfully applied for both the non-invasive ventilatory domiciliary treatment of chronic respiratory failure and the management of acute respiratory failure especially outside the intensive care setting. In this paper, the author describes the technical aspects, the individual characteristics and the clinical applications of the most common used bi-level ventilators.
Endobronchial low-grade MALT lymphoma causing unilateral hypertranslucency
Authors: Erbaycu A.E. , Karasu I. , Özdemirkıran F.G. , Yücel N. , Özsöz A. , Bilgir O.
Published: July 2016

Mucosa-associated lymphoid tissue-derived lymphoma (MALT lymphoma) arises not only from the stomach but also from various non-gastrointestinal sites. A thirty two year old woman, suffering from breathlessness for one year, had been treated for bronchial asthma. A chest radiograph showed a mediastinum and heart transposition to the right side and emphysema of the left lung. In the thorax spiral tomography, a mass narrowing left main bronchi, five centimeters in length from the carina, was seen. A fiberoptic bronchoscopy revealed millimetric polypoid lesions those nearly totally obstructed the left main bronchi. The bronchoscopic biopsy showed a diagnosis of MALT lymphoma. She was seen for check-ups following chemotherapy but no further treatment has been carried out.
Silicotuberculosis in the elderly: report of two cases
Authors: Scafa F. , Minelli C.M. , Fonte R. , Rosso G.L. , Cappelli M.I. , Candura S.M.
Published: July 2016

Silicotuberculosis is observed rarely in the current clinical practice. We present two patients (a 72-year-old man and a 84-year-old woman) who developed silicosis after having worked for several decades in the ceramics industry. In both, pulmonary tuberculosis complicated the clinical picture several years after retirement. The first subject presented a multicavitary lesion in the apex of the right lung, which subsequently evolved with fibrosis. The other developed bilateral tubercular bronchopneumonia and right tubercular pleurisy, that improved after prolonged antimycobacterial polychemotherapy. The two cases confirm that patients with silicosis are at an increased risk of developing tuberculosis, and show that, nowadays, silicotuberculosis may represent a geriatric problem. In the elderly, recognition of tuberculosis associated with silicosis is often difficult. Occupational history, radiology (conventional chest radiography and computed tomography) and microbiology (identification of Mycobacterium tuberculosis in sputum and pleural exudate) are helpful for the correct diagnosis, which, in turn, is important for prognosis and treatment, as well as in relation to medico-legal issues and occupational-related compensation claims.
Pulmonary haemodynamics in patients with OSAS or an overlap syndrome
Authors: Hawrylkiewicz I. , Sliwinski P. , Górecka D. , Plywaczewski R. , Zielinski J.
Published: July 2016

Background. Alveolar hypoxia is the most important mechanism leading to pulmonary arterial vasoconstriction, remodelling and pulmonary hypertension. Patients with Obstructive Sleep Apnoea Syndrome (OSAS) experience multiple short periods of alveolar hypoxia during apnoeic episodes. However, the question as to whether these hypoxic episodes are responsible for the development of permanent pulmonary hypertension is still debatable. We aimed to investigate the relationship between the episodes of nocturnal desaturation and pulmonary haemodynamics in two distinct group patients: with pure OSAS or an overlap syndrome. Methods: We studied 67 patients with severe OSAS (means: age 45±8 years, AHI 62±22, FEV1 3.6±0.8 L = 97±16% of predicted PaO2 72±10 mmHg, PaCO2 40±4 mmHg) and 17 patients with an overlap syndrome (OS), means: age 51±5 years, AHI 64±19, FEV1 1.5±0.7 = 43±16% of predicted PaO2 57±9 mmHg). All subjects underwent pulmonary artery catheterisation with pressure and flow recordings and an overnight full sleep study. Results. On average patients with OSAS had nocturnal desaturation (mean overnight SaO2 = 87±5%) and normal PPA (15.8±4.6 mmHg). Only 11 out of 67 subjects (16%) presented with pulmonary hypertension. Patients with OS had nocturnal desaturation (mean overnight SaO2 = 80.2±8.5%) and mild pulmonary hypertension (PPA 24.2±7.4 mmHg). Only three out of 17 patients had normal pulmonary arterial pressure. Conclusions. In patients with severe OSAS, pulmonary hypertension is rare (16%) and is related best to the severity of the disease and to obesity. In OS patients diurnal pulmonary hypertension is frequent but does not correlate with the severity of nocturnal desaturation.
Effects of fixed compared to automatic CPAP on sleep in Obstructive Sleep Apnoea Syndrome
Authors: Resta O. , Carratù P. , Depalo A. , Giliberti T. , Ardito M. , Marrone O. , Insalaco G.
Published: July 2016

Background: Automatic CPAP has been developed to improve CPAP efficiency and compliance. Continually matching the effective pressure may be associated to more frequent arousals that could disturb sleep. The aim of the present study was to compare sleep architecture after one month’s home therapy with CPAP or with an AutoCPAP device. Methods: Twenty OSAS patients (18 M / 2 F) after polysomnographic study with CPAP titration received either an automatic (AutoSet T, ResMed, Sydney, Australia) or a fixed level CPAP machine in a random, single blind fashion for one month. At the end of the home treatment period polysomnography was repeated while CPAP was administered by the same machine used at home. Results: There was no significant difference between groups in terms of age (50.0 vs 45.5, NS), sex, BMI (38.3 vs 35.1, NS), RDI (45.4 vs 48.0, NS), and CPAP effective level (9.8 vs 10.8, NS). After one month of therapy the correction of sleep respiratory disturbances and of sleep structure was satisfactory in both groups. No difference in any polysomnographic variable or in subjective sleepiness was found at re-evaluation. Conclusions: The results of this study demonstrate that on average CPAP administered by a fixed CPAP machine and by the AutoSet T autoCPAP device has similar effects in improving respiratory function during sleep, nocturnal sleep architecture, and subjective daytime sleepiness after a one-month therapy. As autoCPAP devices are more expensive than fixed CPAP machines, their prescription should be considered only after a clear demonstration of an increase in compliance to treatment by these devices.
Respiratory bronchiolitis associated with interstitial lung disease
Authors: Canessa P.A. , Pratticò L. , Bancalari L. , Fedeli F. , Bacigalupo B. , Silvano S.
Published: July 2016

lung disease (RB-ILD), first described by Niewoehner et al in an autopsy study of cigarette smokers who died from non pulmonary causes in 1974, is a rare entity that should be distinguished from the other interstitial lung diseases and in particular from desquamative interstitial pneumonia, although the two conditions share a similar histopathological pattern. RB-ILD is clearly connected with tobacco smoking and has been inserted in the “smoking related interstitial lung diseases” together with DIP and Cell histiocytosis of Langerhans; it may also be associated with occupational exposure to machine fumes . The following is a case report of a patient with both smoking and occupational exposure.
Arteriovenous malformations of the lung: diagnosis by thin-section HRCT and Cine-MRI
Authors: Yilmaz E. , Akkoclu A. , Gulsen A. , Osma E.
Published: July 2016

We report a case in which a solitary large and multiple group of small pulmonary arteriovenous malformations were demonstrated by computed tomography and magnetic resonance images that could aid diagnosis and therapeutic planning without the need for catheter angiography.
Indoor particulate matter measurement as a tool in the process of the implementation of Smoke-free Hospitals
Authors: Nardini S. , Cagnin R. , Invernizzi G. , Ruprecht A. , Boffi R. , Formentini S.
Published: July 2016

Aim of the study: There are International and National standards that requires hospitals and health premises to be smoke-free. According to recent data from Italy and other European Countries, smoking is a widespread habit in hospitals. To get smoke-free hospitals in an Italian region, we have adopted the European Code for smoke-free hospitals, which sets standards and provides instruments for its implementation. According to the Code, whenever possible, each step towards a smoke-free hospital, should be shared by all staff. As a mean for achieving this goal, in our region the certification of single units as smoke-free units has been chosen. For getting the certification, besides implementing the Code, we planned to use ETS (Environmental Tobacco Smoke) monitoring, as ETS should not be present in hospitals. As a marker of ETS we have chosen Particulate Matter (PM), as it can easily be measured in real-time with a portable instrument and, when other - even outdoor - sources of combustion can be ruled out, it is an accurate detector of cigarette smoke. Here the first experience of measuring PM in hospitals for monitoring ETS and certificating smoke-free health premises, is described. Materials and methods: PM measurements were carried out without any previous notification in different areas of two Network hospitals of the Veneto Region, during a single working day. A real time laser-operated aerosol mass analyser was used. Several classes of PM (PM1, PM2.5, PM7, PM10, TSP Total Suspended Particles) were measured. Results: Outdoor PM levels were found to be repeatedly lower than the annual official limits of 65 mcg/m3 and around the 24 hour official limits of 15 mcg/m3 [15 to 20 mcg/m3, with an overall mean (±SD) of 17.8 (1.9)] throughout the whole day. Very good indoor air quality was found in the operating theaters and isolation department, where PM2.5 concentrations were much lower than outdoor levels [1.6 (0.9) and 5.9 (0.6) mcg/m3, respectively]. No increase in PM pollution was found in the surveyed medical offices, halls and waiting rooms where smoking was positively forbidden [PM2.5 concentrations of 14.8 (2.2) and 12.9 (1.1) mcg/m3] except in a medical office and in two coffee rooms for staff only where high PM levels were recorded [PM2.5 58.7 (29.1), 27.0 (10.6) and 107.1 (47.8) mcg/m3] and an offence of smoking restrictions could be proved. Conclusions: The measurement of PM in hospital for monitoring ETS proved to be both feasible and sensible. PM measurements with a portable instrument can be used both for controlling the compliance with rules or chosen standards and for educating staff about smoking related hazards, thus gaining consensus for the implementation of the tobacco control policy. In our experience, PM measurement can be used as an aid inside all actions designed by the European Code for smoke-free hospitals.
Non-invasive positive pressure ventilation in acute hypercapnic respiratory failure: clinical experience of a respiratory ward
Authors: Scala R. , Naldi M. , Archinucci I. , Coniglio G.
Published: July 2016

Background: Although a controlled trial demonstrated that non-invasive positive pressure ventilation (NIV) can be successfully applied to a respiratory ward (RW) for selected cases of acute hypercapnic respiratory failure (AHRF), clinical practice data about NIV use in this setting are limited. The aim of this observational study is to assess the feasibility and efficacy of NIV applied to AHRF in a RW in everyday practice. Methods: Twenty-two percent (216/984) of patients consecutively admitted for AHRF to our RW in Arezzo (years: 1996-2003) received NIV in addition to standard therapy, according to pre-defined routinely used criteria. Tolerance, effects upon arterial blood gases (ABG), success rate (avoidance a priori criteria for intubation) and predictors of failure of NIV were analysed. Results: Nine patients (4.2%) were found to be intolerant to NIV, while the remaining 207 (M: 157, F: 50; mean (SD) age: 73.2 (8.9) yrs; COPD: 71.5%) were ventilated for >1 hour. ABG significantly improved after two hours of NIV (pH: 7.32 (0.06) versus median (Interquartiles) 7.28 (7.24-7.31), p<0.0001; PaCO2: 71.9 (13.5) mmHg versus 80.0 (15.2) mmHg, p<0.0001; PaO2/FiO2: 212 (66) versus 184 (150-221), p<0.0001). NIV succeeded in avoiding intubation in 169/207 patients (81.6%) with hospital mortality of 15.5%. NIV failure was independently predicted by Activity of Daily Living score, pneumonia as cause of AHRF and Acute Physiology and Chronic Health Evaluation III score. Conclusions: In clinical practice NIV is feasible, effective in improving ABG and useful in avoiding intubation in most AHRF episodes that do not respond to the standard therapy managed in an RW adequately trained in NIV.
An unusual presentation of tuberculosis
Authors: Karkoulias K. , Tsiamita M. , Prodromaki E. , Spiropoulos K.
Published: July 2016

We describe a case of a male with no symptoms and normal chest X ray, diagnosed with TB. The chest computed tomography revealed a cavity formation on the upper left lobe.
The Left Ventricular Dysfunction Questionnaire: Italian translation and validation
Authors: Miani Daniela , Gregori Dario , Ghidina Marco , Rozbowsky Patrizia , Pilotto Laura , Albanese Maria Cecilia , Fresco Claudio , Fioretti Paolo Maria
Published: July 2016

Patients affected by heart failure have a compromised quality of life (QOL) and in the last few years “health related quality of life” has become an important outcome indicator for the evaluation of heart failure treatment. Methods: Translation into Italian of the Left Ventricular Dysfunction Questionnaire (LVD-36), a new, 36-item, disease-specific health status instrument for patients with congestive heart failure, and its subsequent validation by administration to 50 consecutive patients in our heart failure outpatient clinic. The Italian LVD-36 was compared to the “The Minnesota Living with Heart Failure Questionnaire” (MLHF). Results: The Italian version of the LVD-36 correlates well with MLHF for ejection fraction (EF), NYHA class I and II, etiology and therapy. Since, however, the LVD-36 has only one domain, it may be able to offer more synthetic information than MLHF about patients’ status. Conclusions: The Italian version of the LVD-36 appears to be a reliable instrument for assessing patients’ QOL and the degree of limitations imposed on them by the disease. It is short, clear and easy to complete. In patients with heart failure the LVD-36 correlates well with the MLHF and may be considered a new disease- specific instrument to estimate changes in health status, and an useful support in optimizing therapeutic options.
Endoscopic vein harvesting Impact of learning curve on results and rehabilitation
Authors: Piccardo Alessandro , Martinelli Luigi , Passerone Giancarlo
Published: July 2016

Background: The tendency of modern surgery is towards the reduction of invasiveness. The aim of this study is to evaluate the impact of the learning curve, the reliability, the short term results and the advantages in terms of rapid rehabilitation of endoscopic vein harvesting (EVH) in a consecutive series of 20 patients operated on of aorto-coronary bypass surgery. Methods: Between February and June 2005, 20 patients between 61 e 82 years of age underwent EVH with the use of Vasoview® 5 (Guidant Corporation, Indianapolis, USA). To evaluate the impact of learning curve on the total operative time, patients were divided in 4 chronologically consecutive groups (G1, G2, G3, G4). Intraoperative characteristics and short term results were evaluated. Results: The mean velocity and the mean time of harvesting in G4 were 0,68 cm/min and 45 min. respectively, similar to the time required for a scheletonized left internal mammary artery harvesting. In the first 5 patients 2 conversions were required, one of them related to the EVH technique. No bleeding, functional impairment or infective complications are reported. Active mobilization was possible in every case in the first post-operative day. Conclusions: EVH is a reliable technique and the learning curve can be limited to the first 5 cases. The foreseeble reduction of infectious complications, the absence of pain and the immediate mobilization of the leg allow a rapid and effective rehabilitation.
Role of smokers in the household and of cardiac rehabilitation in smoking behaviour after acute myocardial infarction
Authors: Giallauria Francesco , Paragliola Teresa , Pilerci Francesco , Del Forno Domenico , De Lorenzo Anna , Manakos Athanasio , Lucci Rosa , Psaroudaki Marianna , D’Agostino Mariantonietta , Vigorito Carlo
Published: July 2016

Objects: This study aims to evaluate the influence of household smokers and of a prolonged, comprehensive home-based Cardiac Rehabilitation Program (CRP) on patient’s long term smoking behaviour after AMI. Methods: 164 male post-AMI patients, all smokers until the day of AMI, were subdivided into three groups: Group A (n=54): patients with recent AMI, discharged from hospital without enrolment in CRP; Group B (n=55): similar to Group A but enrolled in an 8 weeks hospital-based CRP and then discharged home with routine care; Group C (n=55) enrolled in an 8 weeks hospital-based CRP followed by a further 10 months of formal home-based CRP, with scheduled hospital follow-up visits. Results: Smoking resumption at 12 months was influenced by the presence of household smokers (HS): 38% of patients with HS resumed smoking compared to 27% of patients without HS (p <0.01). Adherence to a CRP was inversely correlated to smoking resumption: there were fewer smoking patients at 12 months from AMI in Group C than in Groups A or B (11% in C vs. 29% and 55% in B and A, respectively, p <0.001). Conclusions: Long term maintenance of CRP seems to be the best way to achieve a reduction of long term smoking habit and maintain adherence to prescription in patients after AMI. Counselling and behavioural intervention should also be extended to family members in order to maximize the benefit of secondary prevention.
Obesity and cardiovascular disease: expected and unexpected relationship
Authors: Pedone Chiara , Urbinati Stefano , Pallotti Maria Giovanna , Pinelli Giuseppe
Published: July 2016

In all forms of cardiovascular disease, prevalence, incidence, morbidity and mortality are strikingly increased in obese persons, i.e. with elevated Body Mass Index or visceral adiposity. The relative excess risk for coronary events, congestive heart failure and sudden death is 1.5, 2, and 2.8 higher, respectively. Nevertheless, a paradoxical protective effect of obesity has been observed in patients with chronic heart failure, who present a better cardiovascular prognosis, i.e. lower risk of mortality, myocardial infarction, cerebrovascular events and post-PTCA bleedings. Even in patients submitted to cardiac surgery, moderate obesity is not correlated to perioperative morbidity and mortality, although sternal infections, supraventricular arrhythmias, and bleedings are more frequent. In conclusion, obese patients should undergo routine cardiac evaluation to identify those at high risk of cardiovascular events, or those with unknown coronary artery disease or asymptomatic left ventricular dysfunction. Special care should be devoted to the treatment and cardiovascular follow-up of obese patients.
Current management of spontaneous pneumothorax
Authors: Van Schil P.E. , Hendriks J.M. , De Maeseneer M.G. , Lauwers P.R.
Published: July 2016

Spontaneous pneumothorax is divided into primary, when there is no underlying lung disease, and secondary, mainly caused by chronic obstructive pulmonary disease. A variety of different non-invasive and invasive treatment options exist. Due to the lack of large randomised controlled trials no level A evidence is present. A first episode of a primary spontaneous pneumothorax is treated by observation if it is 20%, but recurrences are frequent. For recurrent or persisting pneumothorax a more invasive approach is indicated whereby video-assisted thoracic surgery provides a treatment of lung (resection of blebs or bullae) and pleura (pleurectomy or abrasion). In patients with a secondary spontaneous pneumothorax related to chronic obstructive pulmonary disease, there is an associated increased mortality and a more aggressive approach is warranted consisting of initial thoracic drainage followed by recurrence prevention by thoracoscopy or thoracotomy in patients with a low or moderate operative risk. Talc instillation by the thoracic drain is preferred for patients with a high operative risk.
Alpha-1 antitrypsin deficiency in Italy: regional differences of the PIS and PIZ deficiency alleles
Authors: De Serres F.J. , Luisetti M. , Ferrarotti I. , Blanco I. , Fernández-Bustillo E.
Published: July 2016

Background. Critical to the effective diagnosis and management of disease is information on its prevalence in a particular geographic area such as Italy. Alpha-1- antitrypsin deficiency (AAT Deficiency) is one of the most common serious hereditary diseases in the world, but its prevalence varies markedly from one country to another. AAT Deficiency affects at least 120.5 million carriers and deficient subjects worldwide for the two most prevalent deficiency alleles PIS and PIZ. This genetic disease is known to exist in Italy and is related to a high risk for development of jaundice in infants, liver disease in children and adults, and pulmonary emphysema in adults. Methods. Studies on the genetic epidemiology of AAT Deficiency has resulted in the development of a unique database that permits a unique analysis of the geographic distribution in 14 different regions located at random from Piemonte to Sicilia. Results. The use of Hardy-Weinberg statistical analysis to evaluate the distribution of these two deficiency alleles has demonstrated striking differences in the frequencies of these two deficiency alleles in these 14 different regions with 23/84 pair wise combinations significantly different (P=0.05) for PIS, and 5/84 combinations for PIZ. Conclusions. These findings demonstrate differences that impact the standards of care and diagnosis of AAT Deficiency in Italy since the prevalence of these deficiency alleles is not uniform throughout the country.
Changing prevalence of asthma in Turin school children between 1994 and 1999
Authors: Migliore E. , Piccioni P. , Garrone G. , Ciccone G. , Borraccino A. , Bugiani M.
Published: July 2016

Beckground: Asthma is a widespread chronic disorder in children and its prevalence has been on the increase in Europe. Only few studies have described the prevalence variation in respiratory symptoms in Italian regions. The aim of this study, conducted in Turin during the 1998/1999 school year, is to investigate the distribution of respiratory symptoms in a sample of Turin school children and to compare the obtained results with the findings of the SIDRIA study performed in 1994-95. Methods: the sample in study is composed of all the children attending to three elementary schools in Turin. All of the selected schools had already participated in the 94-95 ISAAC-SIDRIA study. A total of 448 pupils aged 6- 10 years received a standardised questionnaire to be filled by parents. Results: response rate is higher than 97% in all the studies. In 1999 we found that the prevalence of wheezing in the past 12 months was 7.3%. The 13.3% of children had asthma at least once in life and the 5.3% reported an attack in the last year. The comparison of our study results with the ISAACSIDRIA (1994-95) shows that the prevalence of asthma and asthma-like symptoms is rather stable among children, while the prevalence of bronchitis reveals a reduction of about 5.5%, but not statistically significant (p=0.094; 95%CI:-11.9;0.9). A considerable reduction in exposure to parents’ passive smoke is shown: ΔP%=-4.7 (95%CI: -9.4;-0.1) for maternal smoking in pregnancy, ΔP%=-8.2 and -15.2, respectively for maternal and paternal smoking in the first two years of life. Conclusions: The results indicate a stable prevalence rate in asthma symptoms in children. A possible explanation of slight variation in asthma prevalence may be due to a reduced exposure to outdoor and indoor risk factors as reported in the questionnaires.
Bronchial hyperreactivity and spirometric impairment in patients with allergic rhinitis
Authors: Cirillo I. , Vizzaccaro A. , Tosca M.A. , Negrini S. , Negrini A.C. , Marseglia G. , Ciprandi G.
Published: July 2016

Background: The Link between allergic rhinitis and asthma is well known. Bronchial hyperreactivity (BHR) may be present in rhinitics. The present study is aimed at evaluating a large group of subjects suffering from allergic rhinitis alone to investigate the presence of spirometric impairment and BHR both during and outside the pollen season. Methods: 360 rhinitics (subdivided in 3 groups: seasonal, SAR, perennial, PAR, and polysensitized, PolysR) were investigated by spirometry and methacholine challenge. Results: There was a significant seasonal difference concerning the number of rhinitics with impaired FEV1 (p<0.01 for SAR, p<0.02 for PAR, and p<0.03 for PolysR) and FEF25-75 (p<0.05 for SAR, p<0.03 for PAR, and p<0.05 for PolysR) as well as with BHR (p<0.05 for SAR and p<0.03 for PAR). Conclusions: This study evidences that an impairment of spirometric parameters and BHR may be observed in patients with allergic rhinitis alone. Thus, careful evaluation of lower airways should be performed in patients with allergic rhinitis alone.
Respiratory Medicine in general practice: what is the role of the pulmonary specialist?
Authors: Lusuardi M.
Published: July 2016

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CT in differential diagnosis of benign and malignant pleural disease
Authors: Yilmaz U. , Polat G. , Sahin N. , Soy Ö. , Gülay U.
Published: July 2016

Background. CT plays a valuable role in assessment of patients with a wide variety of diseases of the pleura, and pulmonologists should be aware of the significance of different CT findings for the differential diagnosis of benign and malignant pleural diseases. Methods. 155 patients with pleural disease who had undergone CT scans of the lungs and thorax before treatment were enrolled. We retrospectively reviewed CT findings in 146 patients with proven pleural disease. Results. Fifty-nine of the cases were malignant, 87 of them had benign pleural diseases. CT findings that were helpful in distinguishing malignant from benign pleural disease were: 1) pleural nodularity; 2) rind; 3) mediastinal pleural involvement; and 4) pleural thickening greater than 1 cm. The sensitivities and specificities were 37%/97%, 22%/97%, 31%/85%, 35%/87%, respectively. CT findings differentiating malignant pleural mesothelioma from metastatic pleural disease were identified. Findings for malignant mesothelioma were as follows: 1) involvement of interlobar fissure (sensitivity 30%, specificity 92%), 2) pleural thickening greater than 1 cm (sensitivity 60%, specificity 77%). Whereas, findings for metastatic pleural disease were mediastinal/hilar lymph node enlargement and lung parenchymal involvement (P<.05). Conclusion. CT is helpful in the differential diagnosis of pleural diseases, particularly in differentiating malignant from benign conditions and metastatic pleural disease from malignant mesothelioma.
A simple and easy home-based pulmonary rehabilitation programme for patients with Chronic Lung Diseases
Authors: Ock Na Joo , Soon Kim Dong , Ho Yoon Seong , Jin Jegal Yang , Sung Kim Woo , Suk Kim Eung , Wha Kim Myung
Published: July 2016

Background and Aim. To develop a simple and easy home-based pulmonary rehabilitation programme and investigate its effectiveness. Methods. Patients with stable chronic lung disease were divided into a rehabilitation group (n = 25) and a control group (n = 18). Rehabilitation consisted of education and 12 weeks of enforced aerobic and musclestrengthening exercises. Aerobic exercise training was performed mostly by walking based on the functional capacity of the patients assessed by the maximal incremental exercise test. Patients visited hospital every two weeks for evaluation and a new exercise regimen. Results. Five patients dropped out of the rehabilitation group but three were due to development of unrelated diseases, five controls did not co-operate in the second evaluation. After 12 weeks of rehabilitation, exercise capacity (maximum work load and VO2max), exercise endurance, 6-minute walking distance, and quality of life measured by the St. George Respiratory Questionnaire had significantly improved in the rehabilitation group but not in the controls. At a follow-up evaluation one year after the rehabilitation, some exercise parameters were still significantly higher than baseline in the rehabilitation group. Conclusions. We developed a simple home-based pulmonary rehabilitation programme, which seems to be clinically feasible and effective.
Pulmonary Alveolar Microlithiasis: CT and pathologic findings in 10 patients
Authors: Sumikawa H. , Johkoh T. , Tomiyama N. , Hamada S. , Koyama M. , Tsubamoto M. , Murai S. , Inoue A. , Nakamura H. , Tachibana T. , Müller N.L.
Published: July 2016

Background and Aim. To evaluate CT findings of pulmonary alveolar microlithiasis and correlate the CT with the pathologic findings. Methods. The study included 10 patients with pathologically proven microlithiasis. Two independent observers evaluated the presence, extent and distribution of the CT findings. CT findings were compared with those at autopsy in two patients and with transbronchial biopsy in eight patients. Results. All patients had a myriad of calcified nodules measuring approximately 1 mm in diameter. Close apposition of the nodules resulted in areas of ground-glass attenuation and consolidation, which were the predominant abnormality on CT in all 10 patients, involving 41% ± 16.3 (mean ± SD) and 30% ± 4.8 of the lung parenchyma, respectively. Calcifications were also seen along interlobular septa, bronchovascular bundles and pleura. Other findings included interlobular septal thickening, thickening of bronchovascular bundles, nodules, and subpleural cysts. There was a solid agreement between the observers for the presence (kappa value; 0.77) and extent (Spearman rank correlation; r= 0.81 to 1.0 p<0.01) of abnormalities. Autopsy specimens demonstrated microliths in alveolar airspaces and along interlobular septa, bronchovascular bundles and pleura. Subpleural small cysts were shown to represent dilated alveolar ducts. Conclusion. Pulmonary microlithiasis is characterised by the presence of numerous small, calcified nodules, calcifications along interlobular septa, bronchovascular bundles and pleura, ground-glass opacities, consolidation, and subpleural cysts. The cysts represent dilated alveolar ducts.
Commento editoriale alle linee guida britanniche sullâ€™ipertensione arteriosa 2006: â€œHypertension: management of hypertension in adults in primary care. Partial updateâ€
Authors: Riccio Carmine , Malvezzi Caracciolo Marco , Abrignani Maurizio G.
Published: July 2016

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Why cardiovascular rehabilitation services should include patients with intermittent claudication?
Authors: Carlon Roberto , Zanchetta Mario
Published: July 2016

Chronic peripheral arterial disease represents a frequent and underestimated localization of atherosclerosis and its management often appears to be inadequate. The association with ischemic heart disease, the weighty prevalence of coronary disease risk factors, the high cardiovascular rate of morbidity and mortality, the sharp reduction in the tenor of life and the well-being supervised physical training efficacy constitute the main reasons that transform Cardiac Rehabilitation into an ideal setting for the treatment of patients suffering from intermittent claudication. Thanks to the cultural patrimony of cardiologists, together with other professionals, such as psychologists, dieticians, physiotherapists and nurses, it is possible to initiate an multi- comprehensive treatment program. Besides, this type of management may decrease both morbidity and mortality as well as reduce symptoms and improve the patientsâ€™ quality of life.