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Background In dilative cardiomyopathy several factors influence dyspnoea. Patients with chronic heart failure may demonstrate impairment of breathing pattern, ventilatory drive and respiratory muscle strength, as well as reduction of ventilatory efficiency. The purpose of this study was to evaluate whether dilative cardiomyopathy is accompanied by changes in breathing pattern, respiratory muscle weakness and ventilatory neural drive. Methods We investigated 47 patients (36 men, mean age=47·8±11·2 years) with chronic heart failure due to dilative cardiomyopathy, and 30 healthy subjects (10 men, mean age=35·4±11·7 years) served as controls. Patients and controls underwent evaluation of left ventricular ejection fraction by 2D echocardiography, spirometry, body plethysmography, mouth occlusion pressure and respiratory muscle strength, as well as by submaximal treadmill exercise testing with gas exchange measurements. The patients' results were compared to controls and predicted standard normal values, and evaluated for differences according to the degree of severity of functional impairment. Results Patients with dilative cardiomyopathy demonstrated a slight reduction in lung volumes (15% of the patients with obstructive and 15% with restrictive lung function pattern) and diffusion capacity (20·4±6·8 vs 15·4±6·7 ml. min−1 . kPa−1; P<0·01). In neural drive, as assessed by mouth occlusion pressure, there was no significant difference between patients and controls. There was a slight but significant reduction in respiratory muscle strength, as assessed by measuring maximal inspiratory pressure in patients with dilative cardiomyopathy (6·7±2·4kPa vs 8·6±3·5kPa; P<0·01). The observed changes were more pronounced in the severe chronic heart failure patients (with a reduction in ventilatory efficiency) whereas no relationship among indices of cardiac or respiratory function was found. Conclusion Patients with chronic heart failure due to dilative cardiomyopathy develop respiratory muscle weakness without changes in neural ventilatory drive, and slight changes in breathing pattern related to the severity of the disease. [ABSTRACT FROM PUBLISHER]

J. Cosmet. Sci., 60, 143–151 (March/April 2009) Synopsis A system to determine the efficacy of hair treatments in terms of anti-breakage and split end prevention was developed which involves the repeated combing of hair strands. The device allows ten hair strands to be combed simultaneously. First, the influences of chemical hair treatments like bleaching on hair breakage were examined. In a next step, the protective effects of benchmark products from the market were studied. Since nearly all commercial products with anti-breakage claims contain silicones combined with cationic polymers, alternative actives were searched. In a test series with different waxes in shampoo formulations with a variable number of parameters, the particle size was found to be the factor with the strongest influence on the amount of wax deposited on the shampooed hair. Therefore, a targeted development was started, resulting in a combination of several ethers dispersed in sodium laureth sulfate. Excellent conditioning, anti-breakage and split ends protection properties of the compound were found, showing also a dosage dependency. The latter could be explained by analyzing the amounts of waxes applied on treated hair. In these experiments, a dependency on the concentration in the shampoo was found. [ABSTRACT FROM AUTHOR]

BACKGROUND Myocardial infarction is a frequent cause of out-of-hospital cardiac arrest. However, the benefits of early coronary angiography and revascularization in resuscitated patients without electrocardiographic evidence of ST-segment elevation are unclear. METHODS In this multicenter trial, we randomly assigned 554 patients with successfully resuscitated out-of-hospital cardiac arrest of possible coronary origin to undergo either immediate coronary angiography (immediate-angiography group) or initial intensive care assessment with delayed or selective angiography (delayed-angiography group). All the patients had no evidence of ST-segment elevation on postresuscitation electrocardiography. The primary end point was death from any cause at 30 days. Secondary end points included a composite of death from any cause or severe neurologic deficit at 30 days. RESULTS A total of 530 of 554 patients (95.7%) were included in the primary analysis. At 30 days, 143 of 265 patients (54.0%) in the immediate-angiography group and 122 of 265 patients (46.0%) in the delayed-angiography group had died (hazard ratio, 1.28; 95% confidence interval [CI], 1.00 to 1.63; P=0.06). The composite of death or severe neurologic deficit occurred more frequently in the immediate-angiography group (in 164 of 255 patients [64.3%]) than in the delayed-angiography group (in 138 of 248 patients [55.6%]), for a relative risk of 1.16 (95% CI, 1.00 to 1.34). Values for peak troponin release and for the incidence of moderate or severe bleeding, stroke, and renal-replacement therapy were similar in the two groups. CONCLUSIONS Among patients with resuscitated out-of-hospital cardiac arrest without ST-segment elevation, a strategy of performing immediate angiography provided no benefit over a delayed or selective strategy with respect to the 30-day risk of death from any cause. (Funded by the German Center for Cardiovascular Research; TOMAHAWK ClinicalTrials.gov number, NCT02750462. [ABSTRACT FROM AUTHOR]