Wearing an eye mask during overnight sleep improves episodic learning and alertness.

Ambient light can influence sleep structure and timing. We explored how wearing an eye mask to block light during overnight sleep impacts memory and alertness, changes that could benefit everyday tasks like studying or driving. In Experiment 1, ninety-four 18-35-year-olds wore an eye mask while they slept every night for a week and underwent a control condition in which light was not blocked for another week. Five habituation nights were followed by a cognitive battery on the sixth and seventh days. This revealed superior episodic encoding and an improvement on alertness when using the mask. In Experiment 2, thirty-five 18-35-year-olds used a wearable device to monitor sleep with and without the mask. This replicated the encoding benefit and showed that it was predicted by time spent in slow-wave sleep. Our findings suggest that wearing an eye mask during overnight sleep can improve episodic encoding and alertness the next day.

Pancake polycystic kidney: case report.

Pancake kidney is a very rare fusion abnormality, characterised by the presence of a renal parenchymal mass located in pelvic site, generally with two pelvies and two ureters and without an intervening fibrous septum. The case here reported describes a condition of "pancake kidney", eventually associated with polycystic disease and abnormous vascular supply. Hypertension and microscopic hematuria were the only clinical signs.

[Cardioprotective effect of vitamin D in nondialyzed patients with stage 3-5 CKD]. / Effetti cardioprotettivi della vitamina D nei pazienti con malattia renale cronica allo stadio 3-5 non in dialisi.

Epidemiological and observational data indicate that there is a close relationship between progressive renal dysfunction in chronic kidney disease (CKD), cardiovascular disease, and mortality. In addition, deficits in vitamin D (25-hydroxyvitamin D) and vitamin D receptor (VDR) activation play a crucial role in adversely affecting cardiovascular health in CKD patients. Even in patients with mild CKD, renal dysfunction is associated with cardiovascular events. Modulation of vitamin D levels results in correlative regulatory effects on mineral homeostasis, hypertension, and vascular calcification. The use of VDR activators such as paricalcitol to treat these and other parameters outside of cardiovascular and renal disease not only results in enhanced patient health but significantly reduces the mortality risk in CKD patients.

[What underlies NYHA class in elderly patients with heart failure? Role of diastolic dysfunction, functional mitral regurgitation and abnormal ventilation during exercise]. / Determinanti della classe NYHA nel paziente anziano con scompenso cardiaco: ruolo della disfunzione diastolica, dell'insufficienza mitralica funzionale e dell'alterata ventilazione durante esercizio.

BACKGROUND: Color-Doppler ecocardiography and cardiopulmonary stress test are pivotal in the evaluation of patients with heart failure. Besides determining systolic function through left ventricular ejection fraction (EF), color-Doppler ecocardiography evaluates the presence and degree of functional mitral regurgitation and the severity of diastolic dysfunction. Moreover, in addition to the aerobic capacity indicated by peak O2 consumption, other parameters of cardiopulmonary stress have proven useful for diagnostic purposes, such as the peak VE/VCO2 ratio or ventilatory efficiency. Since in elderly patients with heart failure the functional impairment often is a combination of the effects of aging with those of disease, the relationship between symptoms, i.e. the NYHA class, ventricular pump function and aerobic performance is sometimes difficult to estabilish. MATERIALS AND METHODS: In 60 elderly with systolic heart failure (75 +/- 3 years, EF 30 +/- 6%), we correlated symptoms (i.e. NYHA class) with [1] degree of functional mitral regurgitation (FMR) determined by color-Doppler echocardiography; [2] degree of left ventricular diastolic dysfunction, measured by Doppler analysis of transmitralic and pulmonary veins flow; [3] VO2 and VE/VCO2 at peak exercise at cardiopulmonary test. RESULTS: In all patients, NYHA class was only weakly related with EF and peak VO2, with wide overlap of individual values among patients with different NYHA class. Instead, we observed a tight relationship between NYHA class, FMR degree, and severity of diastolic dysfunction and VE/VCO2 ratio at peak exercise (p<0.001), with a more evident partition among patients in different NYHA classes. CONCLUSIONS: In elderly heart failure patients, the reduced effort tolerance expressed by the NYHA classification is only weakly associated with reduced aerobic capacity and pump function, but rather is related with the presence of mitral regurgitation, left ventricular diastolic dysfunction, and a poor ventilatory efficiency during exercise.

Improvement in left ventricular diastolic stiffness induced by physical training in patients with dilated cardiomyopathy.

BACKGROUND: Diastolic dysfunction in long-term heart failure is accompanied by abnormal neurohormonal control and ventricular stiffness. The diastolic phase is determined by a balance between pressure gradients and intrinsic ventricular wall properties: according to a mathematical model, the latter (ie, left ventricular [LV] elastance, K(LV)) may be calculated by the formula: K(LV) = (70/[DT-20])(2) mm Hg/mL, where DT is the transmitral Doppler deceleration time. METHODS AND RESULTS: In 54 patients with chronic systolic heart failure (39 men, 15 women; age 65 +/- 10 years; New York Heart Association [NYHA], 2.3 +/- 0.9; ejection fraction [EF], 32% +/- 5%), we analyzed the relationship between K(LV) and an index of neurohormonal derangement (levels of brain natriuretic peptide [BNP]), and investigated whether 3 months of physical training could modulate diastolic operating stiffness. Patients were randomized to physical training (n = 27) or to a control group (n = 27). Before and after training, patients underwent Doppler echocardiogram and cardiopulmonary stress test. At baseline, ventricular stiffness was related to BNP levels (P < .01). Training improved NYHA class, exercise performance, and estimated pulmonary pressure. BNP was reduced. Ventricular volumes, mean blood pressure, and EF remained unchanged. A 27% reduction of elastance was observed (K(LV), 0.111 +/- 0.044 from 0.195 +/- 0.089 mm Hg/mL; P < .01), whose magnitude was related to changes in BNP (P < .05) and to K(LV) at baseline (P < .01). No changes in K(LV) were observed in controls after 3 months (0.192 +/- 0.115 from 0.195 +/- 0.121 mm Hg/mL). CONCLUSIONS: In heart failure, left ventricular diastolic stiffness is related to neurohormonal derangement and is modified by physical training. This improvement in LV compliance could result from a combination of hemodynamic improvement and regression of the fibrotic process.