1
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Chau A, Markley JC. Re-attempting the procedure after an accidental dural puncture during an epidural blood patch: is there a hole in the plan? Int J Obstet Anesth 2024; 57:103953. [PMID: 37989614 DOI: 10.1016/j.ijoa.2023.103953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/21/2023] [Indexed: 11/23/2023]
Affiliation(s)
- A Chau
- University of British Columbia, Vancouver, BC, Canada.
| | - J C Markley
- University of California San Francisco, San Francisco, CA, USA
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2
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Yamaguchi E, Ffrench O'Carroll R, Chau A, Preston R. Successful antepartum de-labelling of local anaesthetic allergy in a parturient with a self-reported allergy to amide and ester local anaesthetics. Int J Obstet Anesth 2024:103978. [PMID: 38508964 DOI: 10.1016/j.ijoa.2024.103978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/22/2023] [Accepted: 01/06/2024] [Indexed: 03/22/2024]
Affiliation(s)
- E Yamaguchi
- Room 1Q72-4500 Oak Street, Vancouver BC, Canada V6H 3N1.
| | | | - A Chau
- BC Women's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - R Preston
- BC Women's Hospital, University of British Columbia, Vancouver, BC, Canada
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3
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Chau A, Smiley R. Intrathecal morphine and delayed micturition after cesarean delivery: the rose and the thorn. Anaesth Crit Care Pain Med 2023; 42:101272. [PMID: 37419322 DOI: 10.1016/j.accpm.2023.101272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Affiliation(s)
- A Chau
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
| | - R Smiley
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, USA. https://twitter.com/RichSmileyMD
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4
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Chau A, Hofmeyr R. Hypothesis-generating procedures and unmasking novel associations in large observational studies: are we doing harm while doing good? Anaesthesia 2023; 78:9-13. [PMID: 36178605 DOI: 10.1111/anae.15877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 12/13/2022]
Affiliation(s)
- A Chau
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
| | - R Hofmeyr
- Department of Anaesthesia and Peri-operative Medicine, Groote Schuur Hospital, Cape Town, South Africa.,Department of Anaesthesia and Peri-operative Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
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5
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Prior CH, Burlinson CEG, Chau A. Emergencies in obstetric anaesthesia: a narrative review. Anaesthesia 2022; 77:1416-1429. [PMID: 36089883 DOI: 10.1111/anae.15839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
Abstract
We conducted a narrative review in six areas of obstetric emergencies: category-1 caesarean section; difficult and failed airway; massive obstetric haemorrhage; hypertensive crisis; emergencies related to neuraxial anaesthesia; and maternal cardiac arrest. These areas represent significant research published within the last five years, with emphasis on large multicentre randomised trials, national or international practice guidelines and recommendations from major professional societies. Key topics discussed: prevention and management of failed neuraxial technique; role of high-flow nasal oxygenation and choice of neuromuscular drug in obstetric patients; prevention of accidental awareness during general anaesthesia; management of the difficult and failed obstetric airway; current perspectives on the use of tranexamic acid, fibrinogen concentrate and cell salvage; guidance on neuraxial placement in a thrombocytopenic obstetric patient; management of neuraxial drug errors, local anaesthetic systemic toxicity and unusually prolonged neuraxial block regression; and extracorporeal membrane oxygenation use in maternal cardiac arrest.
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Affiliation(s)
- C H Prior
- Department of Anaesthesia, West Middlesex University Hospital, London, UK
| | - C E G Burlinson
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
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6
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Chau A, El-Boghdadly K. Analysis of paralysis: understanding the role of vocal cords in facemask ventilation. Anaesthesia 2022; 77:949-952. [PMID: 35727639 DOI: 10.1111/anae.15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Affiliation(s)
- A Chau
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
| | - K El-Boghdadly
- Department of Anaesthesia and Peri-Operative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
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7
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Mercadante A, Lee S, Uh K, Chau A, Truong U, Jeong A, Hata M, Law A. Impact of adherence goal awareness intervention on PDC in various settings: Does awareness help modify medication-taking behavior? Exploratory Research in Clinical and Social Pharmacy 2021; 4:100072. [PMID: 35479847 PMCID: PMC9031037 DOI: 10.1016/j.rcsop.2021.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/18/2021] [Accepted: 09/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background Interventions to improve medication adherence in chronic conditions have shown limited success or sustainability. Previous data revealed that phone calls to patients regarding adherence goal awareness resulted in significant improvement in proportion of days covered (PDC). Objectives The objective of this study was to explore specific pharmacist adherence interventions via phone in various practice settings. Methods A prospective, randomized controlled study was conducted with patients who belonged to university-associated health care settings [ambulatory care, chain store, small health plan, and federally qualified health center (FQHC)]. At each site, patients with at least one chronic medication and a calculated PDC < 0.80 were randomized into control (n=115) and intervention (n=126) groups. Control groups (C) received usual pharmacy communication while intervention groups (X) were specifically called by a pharmacist to be informed of PDC goals and their commitment to adherence. PDC values were calculated 3 to 12 months for both groups the time of intervention, then compared with each patient's respective baseline/pre-PDC. Results Data from a total of 241 patients were pooled to examine change in PDC. There was no significant difference between groups in baseline criteria or PDC. Comparing within groups, there were significant correlations between Pre- and Post-PDCs for the intervention group (X = 0.32 p < 0.05) alone. There were significant improvements from initial PDC to those calculated at the time of Post-intervention PDC within both groups, (C = 0.18 ± 0.28 p < 0.05) and (X = 0.16 ± 0.24, p < 0.05). Approximately 44% of all sampled patients reached their adherence goals (PDC ≥ 0.80) after 3–9 months. Conclusions Results suggested that patient adherence behavior may improve after any call made by pharmacy staff. This communication and attention from the pharmacy may be enough for patients to consider their medication-taking habits without the need for discussing specific goals and importance of adherence.
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Brohan J, Taylor J, West A, Albert A, Chau A. Developing an institutional focused cardiac ultrasound course for obstetric anesthesiologists. Int J Obstet Anesth 2021; 49:103233. [PMID: 34810055 DOI: 10.1016/j.ijoa.2021.103233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/11/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022]
Affiliation(s)
- J Brohan
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - J Taylor
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - A West
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - A Albert
- Women's Health Research Institute, BC Women's Hospital, Vancouver, B.C., Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, B.C., Canada.
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9
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Sim N, Lee S, Yap HY, Tan QY, Tan J, Wong D, Chau A, Mak M, Chong TT, Tay HT. A review of the Turned-down Onto Pericapsular-tissue Hemisectioned Amputated Toe (TOPHAT) flap for wound coverage during ray amputations of the toes. Foot (Edinb) 2021; 47:101803. [PMID: 33964533 DOI: 10.1016/j.foot.2021.101803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/07/2021] [Accepted: 04/11/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Exposure of the adjacent Metatarsal-Phalangeal Joint (MTPJ) commonly occurs after application of Topical Negative Pressure Wound Therapy (TNPWT) for a ray amputation wound. This is due to mechanical soft tissue erosion or trauma to the adjacent digital artery from direct pressure effect. This results in toe gangrene requiring a ray amputation and ultimately a larger wound bed. We describe the use of the Turned-down Onto Pericapsular-tissue Hemisectioned Amputated Toe (TOPHAT) flap - a filleted toe flap to protect the adjacent MTPJ capsule combined with a novel Negative Pressure Wound Therapy with instillation and dwell-time (NPWTi-d) dressing technique. The flap protects the adjacent joint capsule and reduces the wound burden whilst allowing the wound to benefit from TNPWT, thereby accelerating wound healing. MATERIAL AND METHODS A retrospective review was conducted of patients with toe gangrene requiring ray amputation that underwent the TOPHAT flap on in our institution from 2019 and 2020. Complications such as wound dehiscence, hematoma, flap necrosis and secondary infection were recorded. Other outcomes recorded were time taken to final skin grafting and time taken for complete wound epithelialization. RESULTS 9 patients underwent treatment with the TOPHAT flap. 2 patients had flap necrosis. 7 patients progressed to definitive skin coverage with skin grafting. One patient subsequently had progressive arterial disease despite successful skin grafting and required above knee amputation. The mean time to final skin grafting and complete wound epithelialization was 49.5 days and 107.5 days respectively. All patients were satisfied with the outcomes and were able to return to their pre-morbid function. CONCLUSIONS The TOPHAT flap has a consistent vascular supply that provides durable soft tissue coverage. It is a robust and easily reproducible technique to accelerate wound healing after ray amputations even in patients with peripheral vascular disease.
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Affiliation(s)
- N Sim
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - S Lee
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - H Y Yap
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - Q Y Tan
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - J Tan
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - D Wong
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - A Chau
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - M Mak
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - T T Chong
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - H T Tay
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
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Taylor J, Chau A, Massey S. In reply. Int J Obstet Anesth 2021; 46:102966. [PMID: 33714669 DOI: 10.1016/j.ijoa.2021.102966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Affiliation(s)
- J Taylor
- Faculty of Medicine, University of British Columbia, Vancouver, B.C., Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, B.C., Canada
| | - S Massey
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, B.C., Canada.
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Taylor J, Chau A, Gunka V, Polishchuk E, Albert A, Chen J, Massey S. The incidence of dry chlorhexidine gluconate transfer from skin to surgical gloves: a simulation and in vitro study. Int J Obstet Anesth 2020; 45:111-114. [PMID: 33334665 DOI: 10.1016/j.ijoa.2020.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/24/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND To prevent alcohol-based chlorhexidine from reaching the cerebrospinal fluid, it is recommended that the antiseptic solution be allowed to dry before skin palpation or puncture. However, no guidelines specify a drying time interval. Manufacturers recommend 3 min of air drying, based upon the isopropyl alcohol component. Therefore, to fill this knowledge gap, we designed a simulation study to investigate the incidence of primary chlorhexidine transfer from skin to gloves following three drying time intervals. We also investigated the incidence of secondary chlorhexidine transfer from gloves to another surface following one drying time interval. METHODS An alcohol-based chlorhexidine antiseptic solution with dye, ChloraPrep®, was applied to the skin of the lumbar region of 20 volunteers. Cotton-tipped applicators wrapped in material from gloves were taken from the application area at 3, 4, 5, and 10 min following application. Transfer of chlorhexidine from skin to gloves, and gloves to another medium, was assessed through a chemical assay that produced a color change when chlorhexidine was present on the sample. RESULTS The incidence of primary chlorhexidine transfer from skin to gloves at 3, 4 and 10 min following application was 99.5%, 99.4%, and 99.6%, respectively. The incidence of secondary chlorhexidine transfer from gloves to another surface was 68.9%. CONCLUSION Gloves are routinely contaminated with chlorhexidine during central neuraxial blockade. The high incidence of secondary transfer in our simulation suggests a pathway by which chlorhexidine may gain access to the neuraxial space.
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Affiliation(s)
- J Taylor
- Faculty of Medicine, University of British Columbia, Vancouver, B.C., Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - V Gunka
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - E Polishchuk
- Department of Chemistry, University of British Columbia, Vancouver, B.C., Canada
| | - A Albert
- Women's Health Research Institute, Vancouver, B.C., Canada
| | - J Chen
- Department of Chemistry, University of British Columbia, Vancouver, B.C., Canada
| | - S Massey
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada.
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Manceau G, Sabbagh C, Mege D, Lakkis Z, Bege T, Tuech JJ, Benoist S, Lefèvre JH, Karoui M, Bridoux V, Venara A, Beyer‐Berjot L, Codjia T, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Rullier E, Tresallet C, Tetard O, Rivier P, Fayssal E, Collard M, Moszkowicz D, Lupinacci R, Peschaud F, Etienne JC, Loge L, Bege T, Corte H, D’Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, Villeon B, Pautrat K, Eveno C, Abdalla S, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Panis Y, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K, Voron T, Parc Y. Colon sparing resection versus extended colectomy for left-sided obstructing colon cancer with caecal ischaemia or perforation: a nationwide study from the French Surgical Association. Colorectal Dis 2020; 22:1304-1313. [PMID: 32368856 DOI: 10.1111/codi.15111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 02/08/2023]
Abstract
AIM It is not known whether patients with obstructive left colon cancer (OLCC) with caecal ischaemia or diastatic perforation (defined as a blowout of the caecal wall related to colonic overdistension) should undergo a (sub)total colectomy (STC) or an ileo-caecal resection with double-barrelled ileo-colostomy. We aimed to compare the results of these two strategies. METHOD From 2000 to 2015, 1220 patients with OLCC underwent surgery by clinicians who were members of the French Surgical Association. Of these cases, 201 (16%) were found to have caecal ischaemia or diastatic perforation intra-operatively: 174 patients (87%) underwent a STC (extended colectomy group) and 27 (13%) an ileo-caecal resection with double-end stoma (colon-sparing group). Outcomes were compared retrospectively. RESULTS In the extended colectomy group, 95 patients (55%) had primary anastomosis and 79 (45%) had a STC with an end ileostomy. In the colon-sparing group, 10 patients (37%) had simultaneous resection of their primary tumour with segmental colectomy and an anastomosis which was protected by a double-barrelled ileo-colostomy. The demographic data for the two groups were comparable. Median operative time was longer in the STC group (P = 0.0044). There was a decrease in postoperative mortality (7% vs 12%, P = 0.75) and overall morbidity (56% vs 67%, P = 0.37) including surgical (30% vs 40%, P = 0.29) and severe complications (17% vs 27%, P = 0.29) in the colon-sparing group, although these differences did not reach statistical significance. Cumulative morbidity included all surgical stages and the rate of permanent stoma was 66% and 37%, respectively, with no significant difference between the two groups. Overall survival and disease-free survival were similar between the two groups. CONCLUSION The colon-sparing strategy may represent a valid and safe alternative to STC in OLCC patients with caecal ischaemia or diastatic perforation.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - C Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - D Mege
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - T Bege
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - J J Tuech
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - S Benoist
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - J H Lefèvre
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Sorbonne Université, Paris, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Prior C, Sims K, Seligman K, Jackson S, Chau A. Peripartum management of a parturient with type 1C (clearance) von Willebrand disease. Int J Obstet Anesth 2020; 44:112-115. [PMID: 32942216 DOI: 10.1016/j.ijoa.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/30/2020] [Accepted: 08/17/2020] [Indexed: 11/25/2022]
Abstract
Peripartum replacement of factor VIII and von Willebrand factor is not usually required in type 1 von Willebrand disease, as the levels of endogenous factors tend to increase to within the normal range as a physiological change of pregnancy. However, there is wide heterogeneity of genotypes and phenotypes associated with type 1 von Willebrand disease. Here, we describe the anesthetic management of a parturient with type 1C von Willebrand disease, a subtype characterized by decreased plasma von Willebrand factor survival.
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Affiliation(s)
- C Prior
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada.
| | - K Sims
- Adult Bleeding Disorders Program of British Columbia, St Paul's Hospital, Vancouver, BC, Canada
| | - K Seligman
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - S Jackson
- Adult Bleeding Disorders Program of British Columbia, St Paul's Hospital, Vancouver, BC, Canada; Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Chau
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
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Au K, Shippam W, Chau A. Gastric insufflation and high-flow nasal oxygenation in obstetric patients: a reply. Anaesthesia 2020; 75:1262-1263. [PMID: 32584422 DOI: 10.1111/anae.15059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Au
- British Columbia Women's Hospital, Vancouver, BC, Canada
| | - W Shippam
- British Columbia Women's Hospital, Vancouver, BC, Canada
| | - A Chau
- British Columbia Women's Hospital, Vancouver, BC, Canada
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Chau A, Farber M. Do quantitative blood loss measurements and postpartum hemorrhage protocols actually make a difference? Yes, no, and maybe. Int J Obstet Anesth 2020; 42:1-3. [DOI: 10.1016/j.ijoa.2020.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/17/2020] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
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Au K, Shippam W, Taylor J, Albert A, Chau A. Determining the effective pre‐oxygenation interval in obstetric patients using high‐flow nasal oxygen and standard flow rate facemask: a biased‐coin up–down sequential allocation trial. Anaesthesia 2020; 75:609-616. [DOI: 10.1111/anae.14995] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2019] [Indexed: 12/14/2022]
Affiliation(s)
- K. Au
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
| | - W. Shippam
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
| | - J. Taylor
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
| | - A. Albert
- Women's Health Research Institute Vancouver BC Canada
| | - A. Chau
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
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Shippam W, Preston R, Douglas J, Chau A. Redefining endpoints with apnoeic oxygenation in pregnancy – better the devil you know than the devil you don't? Anaesthesia 2019; 74:1621-1622. [DOI: 10.1111/anae.14882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- W. Shippam
- British Columbia Women's Hospital Vancouver Canada
| | - R. Preston
- British Columbia Women's Hospital Vancouver Canada
| | - J. Douglas
- British Columbia Women's Hospital Vancouver Canada
| | - A. Chau
- British Columbia Women's Hospital Vancouver Canada
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Chau A, Petroni D. M104 INTERFERENCE OF INTERFERON BETA-1A WITH VENOM IMMUNOTHERAPY IN A PATIENT WITH MULTIPLE SCLEROSIS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bottomley D, Scarsbrook A, Teoh E, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook G, Chau A, Miller M, Gleeson F. Impact of Positron Emission Tomography (PET) with 18F-Fluciclovine on Management of Patients with Recurrence of Prostate Cancer: Results from the Falcon Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Manceau G, Mege D, Bridoux V, Lakkis Z, Venara A, Voron T, De Angelis N, Ouaissi M, Sielezneff I, Karoui M, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Tresallet C, Tetard O, Regimbeau JM, Sabbagh C, Rivier P, Fayssal E, Collard M, Moszkowicz D, Peschaud F, Etienne JC, loge L, Beyer L, Bege T, Corte H, D'Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Lefevre JH, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, De la Villeon B, Pautrat K, Eveno C, Brouquet A, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K. Thirty-day mortality after emergency surgery for obstructing colon cancer: survey and dedicated score from the French Surgical Association. Colorectal Dis 2019; 21:782-790. [PMID: 30884089 DOI: 10.1111/codi.14614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/27/2019] [Indexed: 02/08/2023]
Abstract
AIM The aim was to define risk factors for postoperative mortality in patients undergoing emergency surgery for obstructing colon cancer (OCC) and to propose a dedicated score. METHOD From 2000 to 2015, 2325 patients were treated for OCC in French surgical centres by members of the French National Surgical Association. A multivariate analysis was performed for variables with P value ≤ 0.20 in the univariate analysis for 30-day mortality. Predictive performance was assessed by the area under the receiver operating characteristic curve. RESULTS A total of 1983 patients were included. Thirty-day postoperative mortality was 7%. Multivariate analysis found five significant independent risk factors: age ≥ 75 (P = 0.013), American Society of Anesthesiologists (ASA) score ≥ III (P = 0.027), pulmonary comorbidity (P = 0.0002), right-sided cancer (P = 0.047) and haemodynamic failure (P < 0.0001). The odds ratio for risk of postoperative death was 3.42 with one factor, 5.80 with two factors, 15.73 with three factors, 29.23 with four factors and 77.25 with five factors. The discriminating capacity in predicting 30-day postoperative mortality was 0.80. CONCLUSION Thirty-day postoperative mortality after emergency surgery for OCC is correlated with age, ASA score, pulmonary comorbidity, site of tumour and haemodynamic failure, with a specific score ranging from 0 to 5.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - D Mege
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - V Bridoux
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - A Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - T Voron
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Saint Antoine Hospital, Sorbonne Université, Paris, France
| | - N De Angelis
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Henri Mondor Hospital, Université Paris-Est (UEP), Créteil, France
| | - M Ouaissi
- Department of Digestive Surgery, Tours University Hospital, Tours, France
| | - I Sielezneff
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
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Shippam W, Preston R, Douglas J, Taylor J, Albert A, Chau A. High-flow nasal oxygen vs. standard flow-rate facemask pre-oxygenation in pregnant patients: a randomised physiological study. Anaesthesia 2019; 74:450-456. [DOI: 10.1111/anae.14567] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 12/18/2022]
Affiliation(s)
- W. Shippam
- British Columbia Women's Hospital; Vancouver BC Canada
| | - R. Preston
- British Columbia Women's Hospital; Vancouver BC Canada
| | - J. Douglas
- University of British Columbia; Vancouver BC Canada
| | - J. Taylor
- British Columbia Women's Hospital; Vancouver BC Canada
| | - A. Albert
- Women's Health Research Institute; Vancouver BC Canada
| | - A. Chau
- British Columbia Women's Hospital; Vancouver BC Canada
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Abstract
Sepsis remains a leading cause of maternal morbidity and mortality. Recognition and treatment of maternal sepsis are often delayed due to the physiological adaptations of pregnancy and vague or absent signs and symptoms during its initial presentation. Over the past decade, our understanding of sepsis has evolved and maternal early warning systems have been developed in an effort to help providers promptly identify and stratify parturients who are at risk. In addition, new consensus definitions and care bundles have recently been published by the World Health Organization and the Surviving Sepsis Campaign to facilitate earlier recognition and timely management of sepsis. In this narrative review, we summarize the available evidence about sepsis and provide an overview of the research efforts focused on maternal sepsis to date. Controversies and challenges surrounding the anesthetic management of parturients with sepsis or at risk of developing sepsis during pregnancy or the puerperium will be highlighted.
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Affiliation(s)
- C E G Burlinson
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - D Sirounis
- Division of Critical Care Medicine, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - K R Walley
- Division of Critical Care Medicine, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - A Chau
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
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Cleveland H, Hernandez J, Ashton D, Chau A, Nagaraj A, Pimpalwar S. 3:36 PM Abstract No. 115 Portal vein recanalizations in pediatric liver transplant patients: single-center experience. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Teoh EJ, Bottomley D, Scarsbrook A, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook GJ, Warbey VS, Chau A, Ward P, Miller MP, Stevens DJ, Wilson L, Gleeson FV, Scheidhauer K, Seidl C, Autenrieth M, Bruchertseifer F, Apostolidis C, Kurtz F, Horn T, Pfob C, Schwaiger M, Gschwend J, D'Alessandria C, Morgenstern A, Uprimny C, Kroiss A, Decristoforo C, von Guggenberg E, Nilica B, Horninger W, Virgolini I, Rasul S, Poetsch N, Woehrer A, Preusser M, Mitterhauser M, Wadsak W, Widhalm G, Mischkulnig M, Hacker M, Traub-Weidinger T, Wright CL, Binzel K, Wuthrick EJ, Miller ED, Maniawski P, Zhang J, Knopp MV, Rep S, Hocevar M, Vaupotic J, Zdesar U, Zaletel K, Lezaic L, Mairinger S, Filip T, Sauberer M, Flunkert S, Wanek T, Stanek J, Okamura N, Langer O, Kuntner C, Fornito MC, Balzano R, Di Martino V, Cacciaguerra S, Russo G, Seifert D, Kleinova M, Cepa A, Ralis J, Hanc P, Lebeda O, Mosa M, Vandenberghe S, Mikhaylova E, Borys D, Viswanath V, Stockhoff M, Efthimiou N, Caribe P, Van Holen R, Karp JS, Binzel K, Zhang J, Wright CL, Maniawski P, Knopp MV, Haller PM, Farhan C, Piackova E, Jäger B, Knoll P, Kiss A, Podesser BK, Wojta J, Huber K, Mirzaei S, Traxl A, Komposch K, Glitzner E, Wanek T, Mairinger S, Sibilia M, Langer O, Fornito MC, Russello M, Russo G, Balzano R, Sorko S, Gallowitsch HJ, Kohlfuerst S, Matschnig S, Rieser M, Sorschag M, Lind P, Ležaič L, Rep S, Žibert J, Frelih N, Šuštar S, Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Baum RP, Langbein T, Singh A, Shahinfar M, Schuchardt C, Volk GF, Kulkarni HR, Fornito MC, Cacciaguerra S, Balzano R, Di Martino GV, Russo G, Thomson WH, Kudlacek M, Karik M, Farhan C, Rieger H, Pokieser W, Glaser K, Mirzaei S, Petz V, Tugendsam C, Buchinger W, Schmoll-Hauer B, Schenk IP, Rudolph K, Krebs M, Zettinig G, Zoufal V, Wanek T, Krohn M, Mairinger S, Stanek J, Sauberer M, Filip T, Pahnke J, Langer O, Weitzer F, Pernthaler B, Salamon S, Aigner R, Koranda P, Henzlová L, Kamínek M, Váchalová M, Bachleda P, Summer D, Garousi J, Oroujeni M, Mitran B, Andersson KG, Vorobyeva A, Löfblom JN, Orlova A, Tolmachev V, Decristoforo C, Kaeopookum P, Summer D, Orasch T, Lechner B, Petrik M, Novy Z, Rangger C, Haas H, Decristoforo C. Abstracts of the 33rd International Austrian Winter Symposium : Zell am See, Austria. 24-27 January 2018. EJNMMI Res 2018; 8:5. [PMID: 29362999 PMCID: PMC5780335 DOI: 10.1186/s13550-017-0354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E J Teoh
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - D Bottomley
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Scarsbrook
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Payne
- University College London, London, UK
| | - A Afaq
- University College London, London, UK
| | - J Bomanji
- University College London, London, UK
| | - N van As
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S Chua
- The Royal Marsden NHS Foundation Trust, London, UK
| | - P Hoskin
- Mount Vernon Cancer Centre, London, UK
| | | | - G J Cook
- King's College London, London, UK
| | | | - A Chau
- Blue Earth Diagnostics, Oxford, UK
| | - P Ward
- Blue Earth Diagnostics, Oxford, UK
| | | | | | - L Wilson
- Blue Earth Diagnostics, Oxford, UK
| | - F V Gleeson
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K Scheidhauer
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - C Seidl
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Autenrieth
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | | | | | - F Kurtz
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - T Horn
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C Pfob
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Schwaiger
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - J Gschwend
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C D'Alessandria
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | | | - C Uprimny
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - A Kroiss
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - E von Guggenberg
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - B Nilica
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - W Horninger
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - I Virgolini
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - S Rasul
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - N Poetsch
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - A Woehrer
- Clinical Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Preusser
- Clinical University of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
- CBmed GmbH, Center for Biomarker Research in Medicine, Graz, Austria
| | - G Widhalm
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Mischkulnig
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - T Traub-Weidinger
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - C L Wright
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - K Binzel
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - E J Wuthrick
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E D Miller
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - P Maniawski
- Clinical Science, Philips Healthcare, Cleveland, OH, USA
| | - J Zhang
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - Sebastijan Rep
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Hocevar
- Department of Oncological Surgery, Oncology Institute Ljubljana, Ljubljana, Slovenia
| | | | - Urban Zdesar
- Institute of Occupational Safety Ljubljana, Ljubljana, Slovenia
| | - Katja Zaletel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Luka Lezaic
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Mairinger
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Thomas Filip
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sauberer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Flunkert
- Neuropharmacology, QPS Austria GmbH, Grambach, Austria
| | - T Wanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - N Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - O Langer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - C Kuntner
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - V Di Martino
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - S Cacciaguerra
- Pediatric Surgery Department Arnas Garibaldi Catania, Catania, Italy
| | - G Russo
- H. Pharmacy Department Arnas Garibaldi Catania, Catania, Italy
| | - D Seifert
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Kleinova
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - A Cepa
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - J Ralis
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - P Hanc
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - O Lebeda
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Mosa
- Charles university Faculty of Science Prague, Prague, Czech Republic
| | - S Vandenberghe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | | | - D Borys
- Silesian University of Technology Gliwice, Gliwice, Poland
| | - V Viswanath
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - M Stockhoff
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - N Efthimiou
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - P Caribe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - R Van Holen
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - J S Karp
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - P M Haller
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - C Farhan
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - E Piackova
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - B Jäger
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - P Knoll
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Kiss
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - B K Podesser
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - J Wojta
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - K Huber
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - S Mirzaei
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Traxl
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - K Komposch
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Glitzner
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - T Wanek
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Mairinger
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sibilia
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - O Langer
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - M Russello
- Liver Unit ARNAS Garibaldi, Catania, Italy
| | - G Russo
- H.Pharmacy Department ARNAS Garibaldi, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - S Sorko
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - H J Gallowitsch
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Kohlfuerst
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Matschnig
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Rieser
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Sorschag
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - P Lind
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - L Ležaič
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Rep
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - J Žibert
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - N Frelih
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Šuštar
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - R P Baum
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - T Langbein
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - A Singh
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M Shahinfar
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - C Schuchardt
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - G F Volk
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - H R Kulkarni
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M C Fornito
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | | | - R Balzano
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | - G V Di Martino
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - G Russo
- Pharmacy H. Department Arnas Garibaldi, Catania, Italy
| | - W H Thomson
- Physics and Nuclear Medicine, City Hospital, Birmingham, UK
| | - M Kudlacek
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - M Karik
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - C Farhan
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - H Rieger
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - W Pokieser
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - K Glaser
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - S Mirzaei
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - V Petz
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - C Tugendsam
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - W Buchinger
- Schilddrueseninstitut Gleisdorf, Gleisdorf, Austria
| | - B Schmoll-Hauer
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Krankenanstalt Rudolfstiftung, Vienna, Austria
| | - I P Schenk
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Sozialmedizinisches Zentrum Hietzing, Vienna, Austria
| | - K Rudolph
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - M Krebs
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Clinical Division of Endocrinology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - G Zettinig
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - V Zoufal
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Wanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Krohn
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - S Mairinger
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M Sauberer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Filip
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Pahnke
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - O Langer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - F Weitzer
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - B Pernthaler
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - S Salamon
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - R Aigner
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - P Koranda
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - L Henzlová
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - M Kamínek
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - Mo Váchalová
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - P Bachleda
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - J Garousi
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - M Oroujeni
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - B Mitran
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - K G Andersson
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Vorobyeva
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - J N Löfblom
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Orlova
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - V Tolmachev
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - P Kaeopookum
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
- Research and Development Division, Thailand Institute of Nuclear Technology, Nakhonnayok, Thailand
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - T Orasch
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - B Lechner
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - M Petrik
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - Z Novy
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - C Rangger
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - H Haas
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
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Chau A, Jongco A. P266 Allogenic hematopoietic stem cell transplant in a patient with mast cell activation syndrome. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chau A, Fang Y, Wong A, Yu R, Woo J. SOCIAL CONNECTIONS MEDIATE THE ASSOCIATION BETWEEN FRAILTY AND MEANING IN LIFE FOR OLDER PEOPLE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A. Chau
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Y. Fang
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - A. Wong
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - R. Yu
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - J. Woo
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Teutsch P, Opel R, Chau A, Cayton J, Akins D, Lim M. 0279 SLEEP AND BEHAVIORAL PHENOTYPE OF A COMBINED MOUSE MODEL OF TBI AND PTSD. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chau A, Kukreja K, Hernandez J, Pimpalwar S, Ashton D. Myth busting the stigma of portable primary placement tunneled femoral vein central lines in children. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bach-Gansmo T, Nanni C, Nieh P, Zanoni L, Bogsrud T, Sletten H, Korsan K, Kieboom J, Chau A, Ward P, Willoch F, Goodman M, Fanti S, Schuster D. Staging of Biochemically Relapsing Prostate Cancer Using the Positron Emission Tomography Tracer Fluciclovine F18. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chau A, Frasson M, Debove C, Maggiori L, Panis Y. Colonic prolapse after intersphincteric resection for very low rectal cancer: a report of 12 cases. Tech Coloproctol 2016; 20:701-5. [PMID: 27631305 DOI: 10.1007/s10151-016-1522-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/12/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND There are no published data concerning management of patients with exteriorized colonic prolapse (CP) after intersphincteric rectal resection (ISR) and side-to-end coloanal manual anastomosis (CAA) for very low rectal cancer. The aim of the present study was to report our experience in 12 consecutive cases of CP following ISR with CAA. METHODS From 2006 to 2014, all patients with very low rectal cancer who developed CP after ISR and CAA were reviewed. Demographic and surgical data, prolapse symptoms and treatment were recorded. Postoperative morbidity, functional outcomes and results after prolapse surgery were recorded. RESULTS Twelve out of 143 patients (8 %) who underwent ISR with side-to-end CAA for low rectal cancer presented CP: 7/107 ISR (7 %) with partial resection of the internal anal sphincter (IAS) and 5/36 ISR (14 %) with subtotal or total resection of the IAS (NS). CP was diagnosed after a median of 6 months (range 2-72 months) after ISR. All patients with CP suffered from pain and fecal incontinence. Median Wexner fecal incontinence score before surgery was 16.5 (range 12-20). Three patients refused reoperation. Nine patients underwent transanal surgery with prolapse resection (including colonic stump and side-to-end anastomosis) and new end-to-end CAA (with posterior myorraphy in 4 cases). After a median follow-up of 30 months (range 8-87 months), 3/9 patients (33 %) had CP recurrence: One with very poor function was treated by abdominoperineal resection and definitive stoma. The 2 others were successfully reoperated on transanally. Median Wexner fecal incontinence score after CP surgery was 9 (range 0-20). No CP recurrence was noted for the 6 other patients, and function improved in all cases. Thus, at the end of follow-up, 8/9 patients (89 %) had no recurrence after surgery. CONCLUSIONS We believe surgery must be attempted in these patients who develop CP after ISR with CAA for very low rectal cancer in order to improve function and symptoms. A transanal approach with CP resection and new end-to-end anastomosis appeared to be safe and effective. Larger studies are needed to confirm our results.
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Affiliation(s)
- A Chau
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France
| | - M Frasson
- Coloproctology Unit, University Hospital La Fe, Valencia, Spain
| | - C Debove
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France
| | - L Maggiori
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France
| | - Y Panis
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France.
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Chau A, Markley J, Juang J, Tsen L. Cytokines in the perinatal period – Part I. Int J Obstet Anesth 2016; 26:39-47. [DOI: 10.1016/j.ijoa.2015.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/28/2015] [Accepted: 12/22/2015] [Indexed: 01/18/2023]
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Chau A, Markley J, Juang J, Tsen L. Cytokines in the perinatal period – Part II. Int J Obstet Anesth 2016; 26:48-58. [DOI: 10.1016/j.ijoa.2015.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/28/2015] [Accepted: 12/22/2015] [Indexed: 11/29/2022]
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Hogeveen J, Bird G, Chau A, Krueger F, Grafman J. Acquired alexithymia following damage to the anterior insula. Neuropsychologia 2016; 82:142-148. [PMID: 26801227 PMCID: PMC4752907 DOI: 10.1016/j.neuropsychologia.2016.01.021] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/06/2016] [Accepted: 01/17/2016] [Indexed: 12/31/2022]
Abstract
Alexithymia is a subclinical condition characterized by impaired awareness of one's emotional states, which has profound effects on mental health and social interaction. Despite the clinical significance of this condition, the neurocognitive impairment(s) that lead to alexithymia remain unclear. Recent theoretical models suggest that impaired anterior insula (AI) functioning might be involved in alexithymia, but conclusive evidence for this hypothesis is lacking. We measured alexithymia levels in a large sample of brain-injured patients (N=129) and non-brain-injured control participants (N=33), to determine whether alexithymia can be acquired after pronounced damage to the AI. Alexithymia levels were first analysed as a function of group, with patients separated into four groups based on AI damage: patients with >15% damage to AI, patients with <15% damage to AI, patients with no damage to AI, and healthy controls. An ANOVA revealed that alexithymia levels varied across groups (p=0.009), with >15% AI damage causing higher alexithymia relative to all other groups (all p<0.01). Next, a multiple linear regression model was fit with the degree of damage to AI, the degree of damage to a related region (the anterior cingulate cortex, ACC), and the degree of damage to the whole brain as predictor variables, and alexithymia as the dependent variable. Critically, increased AI damage predicted increased alexithymia after controlling for the other two regressors (ACC damage; total lesion volume). Collectively, our results suggest that pronounced AI damage causes increased levels of alexithymia, providing critical evidence that this region supports emotional awareness.
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Affiliation(s)
- J Hogeveen
- Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - G Bird
- MRC Social, Genetic, and Developmental Psychology Centre, King's College London, London, United Kingdom; Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - A Chau
- Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - F Krueger
- Molecular Neuroscience Department, George Mason University, Fairfax, VA, USA; Department of Psychology, George Mason University, Fairfax, VA, USA
| | - J Grafman
- Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Neurology, Feinberg School of Medicine, Northwestern University, USA.
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Debove C, Maggiori L, Chau A, Kanso F, Ferron M, Panis Y. What happens after R1 resection in patients undergoing laparoscopic total mesorectal excision for rectal cancer? A study in 333 consecutive patients. Colorectal Dis 2015; 17:197-204. [PMID: 25421215 DOI: 10.1111/codi.12849] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/20/2014] [Indexed: 01/03/2023]
Abstract
AIM There are no studies on the respective influence of microscopic involvement at the circumferential (R1c) and the distal margin (R1d) of the surgical specimen on oncological results after laparoscopic mesorectal excision. METHOD We studied 333 consecutive patients undergoing laparoscopic mesorectal excision for cancer. An R1 resection was defined a by a circumferential and/or distal margin of 1 mm or less. RESULTS Forty (12%) patients had an R1 resection including R1c [n = 28 (70%)], R1d [n = 7 (18%)] or both [n = 5 (12%)]. After a mean of 28 (0-97) months, comparisons of R1 with R0 resection were as follows: mortality 10% and 4% (NS), overall recurrence 48% and 19% (P < 0.001), 2-year disease-free survival rate 51% and 76% (P < 0.001) and overall survival (OS) rate 91% and 96% (NS). For R1c patients mortality was 14% (4% for R0; P = 0.026), overall recurrence 46% (19% for R0; P = 0.028) and 2-year OS 88% (96% for R0; P = 0.025). No significant differences were found between R1d and R0. The metastatic recurrence rate was greater in R1c then R0 (29% vs 12%; P = 0.036) but not for R1d (14% vs 12%; NS). Locoregional recurrence rates of R1c (7%) and R1d (0%) were similar to R0 (4%). CONCLUSION This study shows that the poorer prognosis observed after R1 resection for rectal cancer is due to circumferential rather than distal involvement. This is mainly related to a higher rate of metastatic recurrence.
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Affiliation(s)
- C Debove
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France
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Ellens NPK, Kobelevskiy I, Chau A, Waspe AC, Staruch RM, Chopra R, Hynynen K. The targeting accuracy of a preclinical MRI-guided focused ultrasound system. Med Phys 2014; 42:430-9. [DOI: 10.1118/1.4903950] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Piessen G, Chau A, Mariette C, Bouillot J, Veyrie N. Evaluation of training of residents and chief-residents in visceral and digestive surgery in France: Results of a national survey. J Visc Surg 2013; 150:297-305. [DOI: 10.1016/j.jviscsurg.2013.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Versieren K, Heindryckx B, Qian C, Gerris J, De Sutter P, Exposito Navarro A, Ametzazurra A, Nagore D, Crisol L, Aspichueta F, Mendoza R, Matorras R, Garcia MM, Valley JK, Swinton PS, Boscardin WJ, Lue TF, P. Rinaudo, Wu MC, Bern O, Strassburger D, Komarovsky D, Kasterstein E, Komsky A, Maslansky B, Raziel A, Friedler S, Gidoni Y, Ron-El R, Tang J, Fang C, Zhang MF, Li T, Zhuang GL, Suh DS, Joo JK, Choi JR, Kim SC, JO MS, Kim KH, Lee KS, Katz-Jaffe MG, Stevens J, McCormick S, Smith R, Schoolcraft WB, Ben-Ami I, Komsky A, Strassburger D, Bern O, Komarovsky D, Kasterstein E, Maslansky B, Raziel A, Friedler S, Gidoni Y, Ron-El R, Koch J, Costello M, Kilani S, Namm A, Arend A, Aunapuu M, Joo JK, Lee KS, Choi YM, Cho JD, Sipe C, Pelts EJ, Matthews JM, Sanchez SR, Brohammer RLB, Wagner Y, Liebermann J, Uhler M, Beltsos A, Chen MJ, Guu HF, Chen YF, Yih YJ, Ho JYP, Lin TY, Ho ESC, Lopes FB, Figueira RCS, Braga DPAF, Ferreira RC, Aoki T, Iaconelli A, Borges E, Van de Velde H, Cauffman G, Verloes A, De Paepe C, Sterckx J, Van Ranst H, Devroey P, Tournaye H, Liebaers I, Santos MA, Teklenburg G, Macklon NS, Van Opstal D, Schuring-Blom GH, Krijtenburg PJ, de Vreeden-Elbertse J, Fauser BC, Baart EB, Cawood S, Doshi A, Gotts S, Serhal P, Milachich T, Petkova L, Barov D, Shterev A, Esteves TC, Balbach ST, Arauzo-Bravo MJ, Pfeiffer MJ, Boiani M, Le Gac S, van Rossem F, Esteves T, Bioani M, van den Berg A, Valeri C, Pappalardo S, De Felici M, Manna C, Ryu H, Park CY, Min SH, Choi SK, Park C, Lee SH, Kim KR, Jeong H, Chi HJ, Wittemer C, Celebi C, Viville S, Luceno Maestre F, Castilla Alcala JA, Gomez-Palomares JL, Cabello Y, Hernandez J, Marqueta J, Herrero J, Vidal E, Fernandez-Shaw S, Coroleu B, McRae C, Baskind E, Sharma V, Fisher J, Boldi Cotti P, Colasante C, Perego L, De Lauretis L, Montag M, Koster M, Nikolov A, van der Ven H, Lee SG, Lee YC, Kang SM, Kang YJ, Shin YK, Jung JH, Lim JH, Dorfmann A, Carroll K, Sisson M, Geltinger M, Yap S, Iwaszko M, Hara T, Naruse K, Matsuura K, Kodama T, Sato K, Tateaki Y, Tanaka J, Minasi MG, Scarselli F, Rubino P, Casciani V, Colasante A, Lobascio M, Alviggi E, Ferrero S, Litwicka K, Iammarrone E, Cucinelli F, Giannini PG, Tocci A, Nagy ZP, Greco E, Borini A, Tarozzi N, Fiorentin D, Bonu MA, Nadalini M, Johnson J, De Santis L, Bianchi V, Casciani V, Rubino P, Minasi MG, Colasante A, Scarselli F, Lobascio AM, Arizzi L, Iammarrone E, Litwicka K, Ferrero S, Tocci A, Piscitelli C, Cucinelli F, Nagy ZP, Greco E, Mesut N, Ciray HN, Mesut A, Aksoy T, Bahceci M, Lee YM, Chen HW, Wu P, Tzeng CR, Antonova I, Milachich T, Petkova L, Yunakova M, Chaveeva P, A. Shterev, Hlinka D, Dudas M, Rutarova J, Rezacova J, Lazarovska S, Aoi Y, Takahashi H, Saitou H, Takiue C, Kawakami N, Tone M, Hirata R, Terada S, Yoshioka N, Habara T, Hayashi N, Montagut J, Bonald F, Guillen N, Guitard V, Balu-Genvrin E, Crae E, Nogueira D, Silva J, Cunha M, Viana P, Teixeira da Silva JM, Oliveira C, Goncalves A, Barros N, Sousa M, Barros A, van de Werken C, Jahr H, Laven JSE, Baart EB, Gamiz Izquierdo P, De los Santos JM, Tejera A, Pellicer A, Romero JL, Galan A, Albert C, Santos MJDL, Adriaenssens T, Wathlet S, Segers I, Verheyen G, Van De Velde H, Coucke W, Devroey P, Smitz J, Paternot G, D'Hooghe TM, Debrock S, Spiessens C, Hwang HK, Kim HM, Lee JH, Jung YJ, Kang A, Kook MJ, Jung JY, An SJ, Kwon HC, Lee SJ, Somova O, Feskov A, Feskova I, Chumakova N, Zozulina O, Zhilkova YE, Binda M, Campo R, Van Kerkhoven G, Frederickx V, Serneels A, Roziers P, Vranken I, Lopes AS, Van Nuland A, Gordts S, Puttemans P, Valkenburg M, Gordts S, Rodriguez-Arnedo A, Ten J, Guerrero J, Lledo B, Carracedo MA, Ortiz JA, Llacer J, Bernabeu R, Usui K, Nakajo Y, Ota M, Hattori H, Kyoya T, Takisawa T, Kyono K, Ferrieres A, Poulain M, Loup V, Anahory T, Dechaud H, Hamamah S, Eckert J, Premkumar G, Lock F, Brooks S, Haque S, Cameron IT, Cheong Y, Fleming TP, Prados N, Ruiz M, Garcia-Ortega J, Vime P, Hernaez MJ, Crespo M, Fernandez-Sanchez M, Pellicer A, Hashimoto S, Kato N, Saeki K, Morimoto Y, Leung CON, Pang RTK, Liu WM, Lee KF, Yeung WSB, Wada T, Elliott T, Kahn J, Lowderman J, Wright G, Chang C, Bernal D, Kort H, Nagy Z, de los Santos JM, Escrich L, Grau N, Pellicer A, Romero JL, Escriba MJ, Escriba M, Grau N, Escrich L, de los Santos JM, Pellicer A, Romero JL, Tasker F, Hamoda H, Wilner H, Grace J, Khalaf Y, Miyaji S, Mizuno S, Horiuchi L, Haruki A, Fukuda A, Morimoto Y, Utsunomiya T, Kumasako Y, Ito H, Goto K, Koike M, Abe H, Sakamoto T, Kojima F, Koshika T, Muzii L, Magli MC, Gioia L, Scaravelli G, Ferraretti AP, Gianaroli L, Capoti A, Magli MC, Lappi M, Maggi E, Ferraretti AP, Gianaroli L, Scott L, Finn A, Kloos B, Davies D, Yamada M, Hamatani T, Akutsu H, Chikazawa N, Ogawa S, Okumura N, Mochimaru Y, Kuji N, Aoki D, Yoshimura Y, Umezawa A, Aprysko VP, Yakovenko SA, Seregina EA, Yutkin EV, Yelke H, Milik S, Candan ZN, Altin G, Unal S, Atayurt Z, Y. Kumtepe, Chung JT, Son WY, Zhang X, Tan SL, Ao A, Seli E, Botros L, Henson M, Roos P, Judge K, Sakkas D, group MSGMS, Feliciano M, Monahan D, Ermolovich E, Rosenwaks Z, Palermo GD, Mantikou E, van Echten-Arends J, Sikkema-Raddatz B, van der Veen F, Repping S, Mastenbroek S, Botros L, Seli E, Henson M, Roos P, Judge K, Sakkas D, Group MBS, Wells V, Thum MY, Abdalla HI, Machiya R, Akimoto S, Nobuyoshi T, Yoshii N, Hosaka T, Odawara Y, Heindryckx B, Vanden Meerschaut F, Lierman S, Qian C, O'Leary T, Gerris J, De Sutter P, Assou S, Haouzi D, Pellestor F, Monzo C, Dechaud H, De Vos J, Hamamah S, Conaghan J, Fischer E, Popwell J, Ryan I, Chenette P, Givens C, Schriock E, Herbert C, Ermolovich E, Monahan D, Neri QV, Rosenwaks Z, Palermo GD, Verheyen G, Camus M, Van de Velde H, Haentjens P, Devroey P, Mugica A, Esbert M, Molina JM, Garrido N, Pellicer A, Ballesteros A, Calderon G, Rossi ALS, Rocha AM, Alegretti JR, Hassun PA, Gomes LP, Criscuollo T, Serafini P, Motta ELA, Munoz M, Meseguer M, Cruz M, Perez-Cano I, Pellicer A, Gadea B, Martinez M, Fortuno S, Gundersen J, Garrido N, Cruz M, Garrido N, Perez-Cano I, Munoz M, Pellicer A, Martinez M, Gadea B, Selles E, Betersen J, Meseguer M, Le Meaux E, Assou S, Haouzi D, Loup V, Dechaud H, De Vos J, Hamamah S, Ouandaogo G, Assou S, Haouzi D, Ferrieres A, Anahory T, De Vos J, Hamamah S, Monzo C, Assou S, Haouzi D, Pellestor F, Dechaud H, De Vos J, S. Hamamah, Gismano E, Borini A, Cino I, Calzi F, Rabellotti E, Papaleo E, Bianchi V, De Santis L, Sunkara SK, Siozos A, Bolton V, Khalaf Y, Braude P, El-Toukhy T, Cho YS, Ambruosi B, Totaro P, Dell'Aquila ME, Gioacchini G, Bizzaro D, Giorgini E, Ferraris P, Sabbatini S, Carnevali O, Knaggs P, Chau A, Khalil S, Trew G, Lavery S, Jovanovic VP, Gomez R, Sauer CM, Shawber CJ, Outtz HH, Wang X, Sauer MV, Kitajewski J, Zimmermann RC, Mahrous E, Clarke H, Virant-Klun I, Bacer-Kermavner L, Mivsek J, Tomazevic T, Pozlep B, Zorn B, Vrtacnik-Bokal E, Dundure I, Bazarova J, Fodina V, Brikune J, Lakutins J, Jee B, Jo J, Lee J, Suh C, Kim S, Moon S, Shufaro Y, Lebovich M, Aizenman E, Simon A, Laufer N, A. Saada Reisch, Ribeiro MA, Pinto A, Gomes F, Silva Carvalho JL, Almeida H, Massaro FC, Petersen CG, Mauri AL, Silva LFI, Nicoletti APM, Cavagna M, Pontes A, Baruffi RLR, Oliveira JBA, Franco JG, Valcarcel A, Viglierchio MI, Tiveron M, Guidobono M, Inza R, Vilela M, Vilela M, Valcarcel A, Viglierchio MI, Kenny A, Lombardi C, Marconi G. Posters * Embryology (Embryo Selection). Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chan R, Chau A, Karl W, Nadkarni S, Khalil A, Iftimia N, Shishkov M, Tearney G, Kaazempur-Mofrad M, Bouma B. OCT-based arterial elastography: robust estimation exploiting tissue biomechanics. Opt Express 2004; 12:4558-72. [PMID: 19484007 DOI: 10.1364/opex.12.004558] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
We present a novel multi-resolution variational framework for vascular optical coherence elastography (OCE). This method exploits prior information about arterial wall biomechanics to produce robust estimates of tissue velocity and strain, reducing the sensitivity of conventional tracking methods to both noise- and strain-induced signal decorrelation. The velocity and strain estimation performance of this new estimator is demonstrated in simulated OCT image sequences and in benchtop OCT scanning of a vascular tissue sample.
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Koos BJ, Chau A, Matsuura M, Punla O, Kruger L. Thalamic lesions dissociate breathing inhibition by hypoxia and adenosine in fetal sheep. Am J Physiol Regul Integr Comp Physiol 2000; 278:R831-7. [PMID: 10749769 DOI: 10.1152/ajpregu.2000.278.4.r831] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effects of diencephalic lesions on respiratory responses to intra-arterially infused adenosine (ADO) were determined in chronically catheterized fetal sheep (>0.8 term). These studies were designed to test the hypothesis that the inhibitory effects of ADO on fetal breathing, like those of hypoxia, are mediated by the parafascicular nuclear complex (Pf) of the posteromedial thalamus. ADO inhibited breathing [control (C): 26 +/- 2.6, ADO: 4 +/- 1 min/h] in normal fetuses and in a fetus with a lesion that virtually destroyed the thalamus but left intact most of Pf. Neuronal lesions in the diencephalon, produced by injecting ibotenic acid, abolished the inhibitory effects of ADO on breathing (C: 31 +/- 5.1, ADO: 30 +/- 4.5 min/h) when the lesions encompassed Pf or the sector immediately rostral to Pf that retained the capacity to regulate hypoxic inhibition. Smaller lesions created by the insertion of needles also eliminated the depressant effects of ADO when disruptions were within Pf or a rostral component of the thalamic cortical activating system. It is concluded that 1) a medial thalamic sector is critically involved in ADO-induced apnea and 2) ADO-dependent and ADO-independent mechanisms mediate hypoxic inhibition.
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Affiliation(s)
- B J Koos
- Nicholas S. Assali Perinatal Research Laboratory, Departments of Obstetrics and Gynecology and Neurobiology, Brain Research Institute, University of California Los Angeles School of Medicine, Los Angeles, California 90095-1740, USA.
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Abstract
8-Phenyltheophylline (PT), a potent and specific inhibitor of adenosine receptors, was infused intra-arterially into unanesthetized fetal sheep to determine the role of adenosine in hypoxic inhibition of fetal breathing. PT in normoxic fetuses increased heart rate and the incidence of low-voltage electrocortical activity, rapid eye movements (REM), and breathing. Mean breath amplitude increased by 44%. Hypoxia (preductal arterial PO2 = 14 Torr) induced a metabolic acidemia, a transient bradycardia, and hypertension while virtually eliminating REM and breathing. PT administration during hypoxia enhanced the metabolic acidemia, blocked the bradycardia and hypertension, increased the incidence of REM and breathing, and elevated mean breath amplitude. The results indicate that 1) adenosine is involved in fetal glycolytic and cardiovascular responses to hypoxia, 2) activation of central adenosine receptors mediates about one-half the inhibitory effects of hypoxia on REM and breathing, and 3) the depression of breathing may critically depend on a hypoxia-induced reduction in phasic REM sleep.
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Affiliation(s)
- A Chau
- Department of Obstetrics and Gynecology, Nicholas S. Assali Perinatal Research Laboratory, School of Medicine, The Brain Research Institute, University of California, Los Angeles, California 90095-1740, USA
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Abstract
OBJECTIVE This study was designed to determine the role of adenosine in the hypoxic release of corticotropin in fetal sheep. STUDY DESIGN The adenosine receptor antagonist 8-phenyltheophylline or the vehicle was infused intra-arterially to chronically catheterized fetal sheep (>0.8 term) during an hour of fetal hypoxemia (Pa O 2 congruent with 14 mm Hg). Control studies were also performed in which 8-phenyltheophylline or the vehicle was administered to normoxic fetuses. RESULTS 8-Phenyltheophylline abolished hypoxia-induced bradycardia and hypertension and produced a nearly 5-fold greater rise in fetal plasma concentrations of corticotropin and approximately a 3-fold greater increase in plasma cortisol levels. During normoxia 8-phenyltheophylline increased plasma cortisol concentrations by 2-fold without altering corticotropin levels, mean arterial blood pressure, or heart rate. CONCLUSION Adenosine blunts fetal corticotropin release during hypoxia, which in turn reduces cortisol secretion. At lower corticotropin concentrations, adenosine also appears to dampen the cortisol response through direct effects on the adrenals.
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Affiliation(s)
- A Chau
- Nicholas S. Assali Perinatal Research Laboratory, Department of Obstetrics and Gynecology, University of California, Los Angeles School of Medicine, USA
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Abstract
The effects of lesions rostral to the brain stem on breathing responses to hypoxia were determined in chronically catheterized fetal sheep (>0.8 term). These studies were designed to test the hypothesis that the diencephalon is involved in hypoxic inhibition of fetal breathing. As in normal fetuses, hypoxia inhibited breathing with transection rostral to the thalamus or transection resulting in virtual destruction of the thalamus but sparing most of the parafascicular nuclear complex. Neuronal lesions were produced in the fetal diencephalon by injecting ibotenic acid through cannulas implanted in the brain. Hypoxic inhibition of breathing was abolished when the lesions encompassed the parafascicular nuclear complex but was retained when the lesions spared the parafascicular nuclear region or when the vehicle alone was injected. A new locus has been identified immediately rostral to the midbrain, which is crucial to hypoxic inhibition of fetal breathing. This thalamic sector involves the parafascicular nuclear complex and may link central O2-sensing cells to motoneurons that inhibit breathing.
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Affiliation(s)
- B J Koos
- Department of Obstetrics, Nicholas S. Assali Perinatal Research Laboratory, Brain Research Institute, UCLA School of Medicine, Los Angeles, California 90095-1740, USA
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Abstract
Motor impairment (tilt-plane test) test was used to assess the phenomenon of rapid tolerance and crosstolerance to benzodiazepines, barbiturates, and ethanol. The motor impairment responses to benzodiazepines (chlordiazepoxide and diazepam) and to various barbiturates (pentobarbital, phenobarbital, and barbital) were significantly reduced on day 2 in rats that had been treated on day 1 with benzodiazepines and barbiturates, respectively, compared to the control group treated with saline on day 1. Benzodiazepine treatment on day 1 resulted in rapid crosstolerance to the motor impairment effects of ethanol on day 2. Benzodiazepine treatment, however, did not result in rapid crosstolerance to the three barbiturates (pentobarbital, barbital, and phenobarbital) tested. In contrast to the lack of rapid crosstolerance to barbiturates after treatment with benzodiazepines, barbiturate treatment clearly conferred rapid crosstolerance to benzodiazepines and to ethanol. This asymmetry of rapid crosstolerance raises the possibility that benzodiazepines and barbiturates invoke tolerance by mechanisms that are not wholly identical. Therefore, tolerance to the broad range of actions of barbiturates would include crosstolerance to the effects of benzodiazepines, whereas tolerance to benzodiazepines would include only a weak or partial crosstolerance to some of the effects of barbiturates.
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Affiliation(s)
- J M Khanna
- Department of Pharmacology, University of Toronto, Ontario, Canada
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Abstract
CGS-21680 (CGS), a highly selective adenosine A2a receptor agonist, may excite the fetal carotid bodies. This study was designed to determine 1) whether CGS stimulates fetal breathing and 2) whether sinoaortic denervation abolishes CGS-induced tachycardia. In eight intact fetuses (> 0.8 term), intra-arterial CGS infusion (6 micrograms.min-1.kg estimated fetal wt-1) increased mean arterial PCO2 by 3-7 Torr, reduced fetal arterial PO2 by 2-5 Torr, and produced a mild metabolic acidemia. Heart rate increased from 154 +/- 7 (control) to 249 +/- 12 beats/min, but mean arterial pressure was not significantly affected. CGS initially increased the frequency, amplitude, and incidence of fetal breathing, but this hyperpnea was followed by prolonged respiratory depression that was not reversed with blockade of adenosine A1 receptors. Denervation of both carotid bodies together with interruption of the vagi abolished the hyperpnea without altering the respiratory depression or the maximum rise in heart rate. We conclude that CGS induces 1) tachycardia by a mechanism independent of the peripheral arterial chemoreceptors, 2) hyperpnea by stimulating peripheral adenosine A2a receptors, and 3) respiratory depression by activating central A2a receptors.
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Affiliation(s)
- B J Koos
- Nicholas S. Assali Perinatal Research Laboratory, Department of Obstetrics and Gynecology, University of California Los Angeles School of Medicine 90095-1740, USA
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Abstract
We recently reported that the noncompetitive antagonists, (+)-MK-801 and ketamine, block the development of rapid tolerance to ethanol. We now show that pretreatment with these NMDA antagonists also blocks rapid tolerance to the various barbiturates (pentobarbital, barbital, and phenobarbital) examined. Tolerance to pentobarbital occurred under three difference conditions: (a) in groups of rats that were tested at repeated times on day 1 (intoxicated practice or testing group), (b) in groups of rats that were not tested on the apparatus but handled at the same times on day 1 (dummy testing or associative learning group), and (c) in groups of rats that were not subjected to testing at all on day 1 (nontesting). However, NMDA antagonists blocked intoxicated practice and associative tolerance, but not tolerance produced in the nontesting group. In the last experiment NMDA antagonist failed to block tolerance (unlearned) when animals were treated in the animal quarters and tested in a different room (i.e., in the laboratory). These findings suggest that NMDA antagonists affect barbiturate tolerance in a manner similar to their effect on ethanol tolerance.
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Affiliation(s)
- J M Khanna
- Department of Pharmacology, University of Toronto, Ontario, Canada
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Abstract
We have recently reported that pretreatment with NMDA receptor antagonists [(+)MK-801 and ketamine] inhibited the development of rapid tolerance to ethanol hypothermia and motor-impairment on day 2 in animals receiving ethanol on day 1, compared to the control group pretreated with saline. In these studies rats were tested at 30, 60, 90 and 120 min after ethanol on both day 1 and 2. In the present report we compared the development of rapid tolerance under 2 different conditions: (1) in groups of rats that were tested on the tilt-plane at all test times (Testing or Intoxicated Practice group), (2) in groups of rats that were not tested on the tilt-plane but were handled at all test times on day 1 (dummy testing). Rats were pretreated with ethanol or saline on day 1 and tested with ethanol on day 2 in all the above studies. Both testing (intoxicated practice) and dummy testing of animals on day 1 after pretreatment with ethanol produced rapid tolerance to ethanol on day 2. However, (+)MK-801 or ketamine pretreatment, which blocked rapid tolerance in the intoxicated practice testing paradigm, failed to block rapid tolerance in the dummy testing paradigm. Similar results were obtained for rapid tolerance and for the effect of ketamine in the hypothermia experiment. These findings suggest that NMDA antagonists block rapid tolerance in the intoxicated testing paradigm but not in the dummy testing paradigm. However, whether the two types of rapid tolerance tested in the present experiments are indeed different or interrelated remains to be further investigated.
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Affiliation(s)
- J M Khanna
- Department of Pharmacology, University of Toronto, Canada
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Khanna JM, Lê AD, Kalant H, Chau A, Shah G. Effect of lipid solubility on the development of chronic cross-tolerance between ethanol and different alcohols and barbiturates. Pharmacol Biochem Behav 1997; 57:101-10. [PMID: 9164559 DOI: 10.1016/s0091-3057(96)00163-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Tolerance to ethanol and cross-tolerance to other alcohols (n-propanol, n-butanol, t-butanol, isobutanol, t-amyl alcohol, n-amyl alcohol, and benzyl alcohol) and barbiturates (pentobarbital, secobarbital, amobarbital, thiopental, barbital and phenobarbital) that differ in lipid:water partition coefficient was examined in rats after chronic pretreatment with ethanol. Tolerance and cross-tolerance were studied with three different measures (hypothermia, tilt-plane, and rotarod). Tolerance to ethanol resulted in significant cross-tolerance to alcohols with low lipid solubility (n-propanol and t-butanol), whereas no cross-tolerance was seen with alcohols of high lipid solubility (isobutanol, n-amyl alcohol, t-amyl alcohol and benzyl alcohol). Cross-tolerance to n-butanol (which has intermediate lipid solubility) appeared to be metabolic rather than functional. Tolerance to ethanol also resulted in significant cross-tolerance to barbital and phenobarbital, but not to pentobarbital, secobarbital, amobarbital or thiopental. These studies suggest that lipid solubility is an important factor in relation to specificity of cross-tolerance to alcohols and barbiturates.
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Affiliation(s)
- J M Khanna
- Department of Pharmacology, University of Toronto, Canada
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de la Vega H, Specht CA, Chau A, Semino CE, Robbins PW, Eichinger D, Caplivski D, Ghosh S, Samuelson J. Cyst-specific exochitinases of Entamoebae contain unique hydrophilic repeats at their amino termini. Arch Med Res 1997; 28 Spec No:143-6. [PMID: 9033047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- H de la Vega
- Center for Cancer Research, Massachusetts Institute of Technology, Cambridge 02139, USA
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Abstract
We have reexamined the effect of NMDA antagonists [(+)MK-801 and ketamine] on rapid tolerance to chlordiazepoxide. (+)MK-801 and ketamine blocked the development of rapid tolerance to chlordiazepoxide, but this effect was dependent on the dose ratio of the NMDA antagonist to that of the benzodiazepine used to produce rapid tolerance. Furthermore, NMDA antagonists blocked both learned and unlearned tolerance to chlordiazepoxide. It appears that in addition to impairment of memory and learning, NMDA antagonists may also influence some other mechanism involved in the production of drug-tolerance.
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Affiliation(s)
- J M Khanna
- Department of Pharmacology, University of Toronto, Canada
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