Watt-level single-frequency optical parametric oscillator around 2 µm.

A single-frequency optical parametric oscillator (OPO) operating in the wavelength range around 2 µm is reported. The OPO comprises a periodically poled LiNbO3 (PPLN) crystal for quasi-phase matching and a four-mirror ring-cavity resonant to the signal. The OPO signal and idler are tuned from 1.89 to 2.05 µm and from 2.21 to 2.42 µm, respectively, by changing the crystal temperature. Output powers in excess of 2 W are demonstrated at a pump power of 9 W for both the signal and idler over all of the respective tuning ranges. A detailed characterization of the intensity and frequency noise is presented. The OPO exhibits an integrated intensity noise below 0.1% and a linewidth of ∼58 kHz for an observation time of 1 ms. The reported performance makes this source an ideal candidate for the generation of squeezed light around 2 µm via cascaded second-harmonic generation (SHG) and parametric downconversion (PDC).

Feasibility and efficacy of a multidisciplinary palliative approach in patients with advanced interstitial lung disease. A pilot randomised controlled trial.

INTRODUCTION AND OBJECTIVES: Interstitial lung diseases (ILDs) encompass a heterogeneous group of parenchymal lung disorders which have a significant burden on quality of life and exercise. The primary purpose of this randomised pilot trial performed in advanced ILD was to determine the feasibility and efficacy of a multidisciplinary palliative care approach (including physiotherapist, psychologist, pulmonologists, and palliative care doctors) to relieve patients' symptoms of dyspnoea, depression measured with the Center for Epidemiological Studies-Depression (CES-D) scale and quality-of-life (QoL) at 6 and 12 months. MATHERIALS AND METHODS: Fifty patients with confirmed interstitial lung disease at computed tomography (CT) scan and advanced disease were enrolled at our clinic. Patients were randomised to usual care group vs intervention group; in the intervention group, patients were scheduled to meet a physiotherapist, a psychologist, a palliative care doctor, and a pulmonologist specialized in ILD care. Data on dyspnoea, cough, quality of life and depression were recorded; patients in the intervention group were also tested to assess lower body flexibility and strength. RESULTS: Both groups showed a worsening in dyspnoea during the time course of the trial, but the Borg scale was less in the intervention group at 6 and 12 months. A similar trend was observed also for the CES-D scale. No differences were observed for the other scales. CONCLUSIONS: A multi-disciplinary palliative care intervention in patients with advanced fibrosing interstitial lung disease is feasible and effective. TRIAL REGISTRATION: NCT02929966 on ClinGovTrial.

Musculoskeletal syndrome treated with global postural re-education in double-redo lung transplantation: a case report with an 8-month follow-up.

Postoperative pain and persisting fatigue represent critical concerns for patients receiving lung transplantation. The purpose of this study was to illustrate the trajectory of symptoms in a patient who presented with a posttransplant musculoskeletal syndrome after double redo-lung transplantation and attended therapeutic sessions of global postural re-education during the symptomatic phase. A 32-year-old woman with interstitial lung disease underwent double lung transplantation. At 23 months, functional parameters deteriorated, and the patient was placed on the active list for a second double-lung transplantation. Twenty months after re-transplantation, the patient reported continuous thoracic-lumbar musculoskeletal pain exacerbated by moving or performing the standard motor activities. Lower body flexibility improved during the observation period changed from -10 cm to 0 cm at the Chair Sitand- Reach Test. Leg strength improved as well, and the patient was able to perform more repetitions at the Squat Test, improving from 14 to 39. Pain intensity changed from 7 to 4 on a numerical rating scale. We observed that outcomes strictly related to treatment, with lower body flexibility, pain intensity, and physical function improving over time. As a result global postural re-education proved to be effective in this patient.

Assisted mobilisation in critical patients with COVID-19.

The therapeutic value of early physiotherapeutic treatment in critical respiratory settings has already been clearly outlined in the last fifteen years by several authors. However, there is still a controversial perception of mobilisation by healthcare professions. In-bed cycling has attracted increasing attention having been demonstrated as a feasible and safe intervention in critical settings. Patients with respiratory diseases are typically prone to fatigue and exertional dyspnoea, as we observe in COVID-19 pandemic; in fact, these patients manifest respiratory and motor damage that can even be associated with cognitive and mental limitations. COVID-19 is at risk of becoming a chronic disease if the clinical sequelae such as pulmonary fibrosis are confirmed as permanent outcomes by further analysis, particularly in those cases with overlapping pre-existent pulmonary alterations. In the present article, we propose a practical analysis of the effects of in-bed cycling, and further discuss its potential advantages if used in critical patients with COVID-19 in intensive care settings.

Octogenarian with an untreated femoral neck fracture: upright position during the postoperative course after aortic valve replacement.

We describe a patient with a femoral neck fracture undergoing an aortic valve replacement. The study design was a case report. An 82-year-old female with an untreated right femoral neck fracture, and a severe aortic valve stenosis was admitted to a cardiac surgery department for surgical treatment of the valve disease. She underwent aortic valve replacement with a sutureless biological valve prosthesis through a partial sternotomy. At an early stage, the patient was instructed to make postural changes in the standing position. As a result, she was able to perform body movements associated with either a sitting or standing position. This case shows that appropriate early mobilization of a patient with a femoral neck fracture is feasible after aortic valve replacement, even though this does not necessarily mean that the patient needs to walk.

Herniated lumbar disc treated with Global Postural Reeducation. A middle-term evaluation.

BACKGROUND: Herniated lumbar intervertebral disc (HLID) is a pathological condition frequently seen in rehabilitation medicine that is characterized by the compression of one or more nerve roots. AIM: The aim of this study was to describe the effects of Global Postural Reeducation on function and pain in patients with herniated disc at levels L4-L5 and/or L5-S1. MATERIALS AND METHODS: Twenty-four consecutive subjects were treated with Global Postural Reeducation. Before treatment, patients reported median average pain duration of 180 days. At the beginning of treatment and on days 15, 45, 120, and 180, all completed the Quebec Back Pain Disability Scale and the Numeric Pain Rating Scale. RESULTS: The median value of the Quebec Back Pain Disability Scale score decreased from 49 points at baseline to 22 points at 45 days. Moreover, the median Numeric Pain Rating Scale score decreased from 6 points at baseline to 2 points at 45 days. CONCLUSIONS: The present study indicates that Global Postural Reeducation is suitable for the conservative management of HLID. Moreover, patients gained a therapeutic benefit from being active participants in their recovery.