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Abstract: Cross-wire anemometry was used to identify and characterize coherent flow pulsations in isothermal air flow near the gap regions of a five-rod bundle with a design pitch-to-diameter ratio of 1.149 and contained in a quasi-trapezoidal duct. It was confirmed that such pulsations are quasi-periodic and contribute significantly to the velocity fluctuations across the gap. The frequency of pulsations was found to decrease with diminishing rod–wall gap size in the range between 0.015D and 0.250D, where D is the rod diameter. The pulsations in a rod–wall gap and an adjacent rod–rod gap were strongly coupled and occurred at the same frequency as one rod was displaced towards the duct wall. [Copyright &y& Elsevier]

The aim of this study was to evaluate the rCBF (133Xe clearance method) in migrainous patients free from attack. Fifty patients suffering from migraine without aura (group M) and 20 suffering from migraine with aura (group MA) (age range 20-50 years) were submitted to 32 channel rCBF mapping during the interictal period. The rCBF data of patients were compared with those obtained from 60 healthy control subjects (group C) and 21 patients suffering from tension-type headache (group TH). The mean (average of all channels) rCBF values were: group M = 70.5 +/- 13.7 ml/100g/min; group MA = 56.6 +/- 11.4 ml/100g/min; group C = 62.3 +/- 8.3 ml/100g/min; group TH = 62.1 +/- 8.4 ml/100g/min (F = 11.93; p < 0.001). As expected, patients belonging to group TH had a normal rCBF. The mean rCBF of group M was significantly higher than that of groups C and TH, while in group MA it was significantly lower than in groups C and TH. Group M showed a diffuse hyperemia, while group MA showed rCBF values significantly lower than normal in posterior regions, according to aura. Our results suggest that: (a) the rCBF pattern in migrainous patients is different from that in both controls and TH patients, even during the interictal period; (b) patients suffering from migraine with and without aura are two distinct subpopulations with opposite rCBF deviations. [ABSTRACT FROM AUTHOR]

Background Major surgery such as oesophagectomy requires a postoperative stay in intensive care. Painful stimuli lead to sleep disturbance and impairment in quality of life. The aim of this study was to evaluate the effect of psychological counselling and sleep adjuvant measures on postoperative quality of sleep and quality of life. Methods This RCT was performed between January 2013 and October 2015. Patients undergoing oesophagectomy for cancer were randomized into one of four groups receiving: psychological counselling plus sleep adjuvant measures during the ICU stay; psychological counselling alone; sleep adjuvant measures alone during the ICU stay; or standard care. The primary endpoint was impairment in quality of life measured using the European Organisation for Research and Treatment of Cancer C30-QL2 questionnaire between admission for surgery and discharge from hospital. The secondary endpoint was impairment in quality of sleep assessed by means of the Pittsburgh Sleep Quality Index between admission for surgery and hospital discharge. Results The local ethics committee approved the early termination of the study because of relevant changes in the ICU setting. Some 87 patients were randomized and 74 patients were evaluated in the analysis. Psychological counselling reduced the impairment in quality of life (odds ratio 0·23, 95 per cent c.i. 0·09 to 0·61) and in quality of sleep (odds ratio 0·27, 0·10 to 0·73). Conclusion Perioperative psychological support reduces impairment in quality of life and quality of sleep after oesophagectomy. Registration number: NCT01738620 (). [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to confirm the effectiveness of auditory brain-stem responses (ABRs) and somatosensory evoked potentials (SEPs) in the diagnosis of brain death (BD).Methods: ABRs and SEPs were recorded at the same session in 130 BD patients (age range 8–77 years, 81 male and 49 female). Twenty-four cases were submitted to serial recordings from preterminal conditions through BD.Results: ABRs were absent in 92 cases (70.8%), only waves I or I–II were present in 32 cases (24.6%), while in the remaining 6 patients (4.6%) waves V and/or III were still present, excluding the death of the brain-stem. In 4 cases (3.1%) SEPs showed the absence of all components following the cervical N9, preventing the diagnosis of BD. Among 126 cases (96.9%) with preserved cervical N9–N13 SEPs confirmed the absence of brain-stem activity in 122 cases (93.7%), in whom no waves following P11 or P13 were recordable. SEPs excluded the diagnosis of BD in the remaining 4 cases (3.2%) showing preserved P14 and/or N18. In all pre terminal patients the far-field P14–N18 were present, and their disappearance was closely related to the onset of BD.Conclusions: The combined us of ABRs and SEPs was able to confirm BD in almost all patients, providing an objective confirmation of the diagnosis, and to exclude it in 7 cases, thus improving the reliability of diagnosis. [ABSTRACT FROM AUTHOR]