This is the first study that shows a significant increase of both PEP peaks, and therefore, it provides a preferred setup for assessing the function of mechanical nociceptive pathways in the context of central sensitization.This is the first study that shows a significant increase of both PEP peaks, and therefore, it provides a preferred setup for assessing the function of mechanical nociceptive pathways in the context of central sensitization. Optimal nutritional therapy, including the individually adapted provision of energy, is associated with better clinical outcomes. Indirect calorimetry is the best tool to measure and monitor energy expenditure and hence optimize the energy prescription. Similarly to other medical techniques, indications and contra-indications must be acknowledged to optimise the use of indirect calorimetry in clinical routine. Measurements should be repeated to enable adaptation to the clinical evolution, as energy expenditure may change substantially. This review aims at providing clinicians with the knowledge to routinely use indirect calorimetry and interpret the results. We performed a bibliographic research of publications referenced in PubMed using the following terms "indirect calorimetry", "energy expenditure", "resting energy expenditure", "VCO ", "VO ", "nutritional therapy". We included mainly studies published in the last ten years, related to indirect calorimetry principles, innovations, patient's benefits, clinical use in practice and medico-economic aspects. We have gathered the knowledge required for routine use of indirect calorimetry in clinical practice and interpretation of the results. A few clinical cases illustrate the decision-making process around its application for prescription, and individual optimisation of nutritional therapy. We also describe the latest technical innovations and the results of tailoring nutrition therapy according to the measured energy expenditure in medico-economic benefits. The routine use of indirect calorimetry should be encouraged as a strategy to optimize nutrition care.The routine use of indirect calorimetry should be encouraged as a strategy to optimize nutrition care. Amino acid availability is a regulatory factor of protein anabolism and is partly dependent on enteral amino acid uptake. selleck inhibitor During continuous enteral feeding, enteral amino acid uptake may vary considerably, but this has not been documented systematically. In this pragmatic study, we investigated patients in the intensive care unit (n=10) and healthy adults (n=10). The time course of essential amino acid concentrations in arterial plasma and the uptake of dietary phenylalanine were recorded during 12hours of continuous enteral feeding, using a C-labeled phenylalanine tracer. Plasma essential amino acid concentrations and C-phenylalanine enrichment reached a tentative steady state after no more than 4.5h from start of tracer infusion. There was a large intra- and inter-individual variability in both cohorts. No periodicity could be detected in the temporal variation. During continuous enteral feeding, uptake of amino acids shows large intra- and inter-individual variation. A tentative steady state of C-phenylalanine uptake is eventually reached. Registered at Australian New Zealand Clinical Trials Registry, trial ID ACTRN12616000593437.Registered at Australian New Zealand Clinical Trials Registry, trial ID ACTRN12616000593437.Utilization of dual-energy X-ray absorptiometry is increasing in clinical settings and the fitness industry as a viable tool to assess total and regional body composition, including visceral adiposity. Previous research using small samples ( less then 50) has described several pitfalls in patient positioning, scan acquisition, and/or analysis that alter regional body composition values. Our aim was to quantify the largest probable error in measures of total, android, gynoid, and visceral fat caused by incorrect placement of the head cut-line, in a large sample of adults. Total body images (N = 436) from 196 women and 67 men (20-85 years) scanned on a GE Lunar Prodigy densitometer were analyzed using enCORE software in 2 ways (1) placing the head cut-line just beneath the bony protuberance of the chin according to manufacturer recommendation (correct method); (2) placing the head cut-line at the lowest point below the chin and just above the soft tissue at the shoulders (incorrect method). All other cut-lines ise measures of regional body fat.Modafinil, methyphenidate (MPH) and d-amphetamine (d-amph) are putative cognitive enhancers. However, efficacy of cognitive enhancement has yet to be fully established. We examined cognitive performance in healthy non-sleep-deprived adults following modafinil, MPH, or d-amph vs placebo in 3 meta-analyses, using subgroup analysis by cognitive domain; executive functions (updating, switching, inhibitory control, access to semantic/long term memory), spatial working memory, recall, selective attention, and sustained attention. We adhered to PRISMA. We identified k = 47 studies for analysis; k = 14 studies (64 effect sizes) for modafinil, k = 24 studies (47 effect sizes) for Methylphenidate, and k = 10 (27 effect sizes) for d-amph. There was an overall effect of modafinil (SMD=0.12, p=.01). Modafinil improved memory updating (SMD=0.28, p=.03). There was an overall effect of MPH (SMD=0.21, p=.0004) driven by improvements in recall (SMD=0.43, p=.0002), sustained attention (SMD=0.42, p=.0004), and inhibitory control (SMD=0.27, p=.03). There were no effects for d-amph. MPH and modafinil show enhancing effects in specific sub-domains of cognition. However, data with these stimulants is far from positive if we consider that effects are small, in experiments that do not accurately reflect their actual use in the wider population. There is a user perception that these drugs are effective cognitive enhancers, but this is not supported by the evidence so far. To assess the association between admission serum uric acid (SUA) levels and in-hospital outcomes in a real-world patients population with acute coronary syndrome (ACS) and to investigate the potential incremental prognostic value of SUA added to GRACE score (GRACE-SUA score). The data of consecutive ACS patients admitted to Coronary Care Unit of San Paolo and Niguarda hospitals in Milan (Italy) were retrospectively analyzed. 1088 patients (24% female) were enrolled. Mean age was 68 years (IQR 60-78). STEMI and NSTE-ACS patients were 504 (46%) and 584 (54%) respectively. SUA (OR 1.72 95%CI 1.33-2.22, p<0.0001) and GRACE score (OR 1.04 95%CI 1.02-1.06, p<0.0001) were significantly associated with an increased risk of in-hospital death at the multivariate analysis. Admission values of SUA were stratified in four quartiles. Rates of acute kidney injury, implantation of intra-aortic balloon pump and non-invasive ventilation use were significantly higher in the last quartile compared to Q1, Q2 and Q3 (p <0.

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