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Hiesmayr M, Fischer A, Veraar C, Mora B, Tarantino S, Weimann A, Volkert D. [Nutrition practices in intensive care units: nutritionDay from 2007-2021]. Med Klin Intensivmed Notfmed 2023; 118:89-98. [PMID: 36853418 PMCID: PMC9992071 DOI: 10.1007/s00063-023-00996-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 03/01/2023]
Abstract
In intensive care units (ICU), patients who are not able to eat or are considered at nutritional risk typically receive medical nutrition therapy based on partially contradictory guidelines as well as the strategies used in large randomized trials. The aim of this study is to analyze patient data from the nutritionDay project in intensive care to describe current clinical approaches to nutrition support worldwide, in Europe and in the group of German-speaking countries, the DACH (i.e., Germany, Austria, Switzerland) region. From 2007-2021, data of 18,918 adult patients in 1595 ICUs from 63 different countries were included in this cross-sectional study. The aim was to recruit all patients present in ICUs. Median stay in the ICU was 4 days on nutritionDay. Little difference in patient characteristics were observed between worldwide, Europe, and the DACH region. Patient were 64 years old, 40% female, 50% ventilated, 29% sedated, and 10% needed renal replacement therapy. A quarter of the patients died in hospital within 60 days and about half of the patients had been discharged home. Enteral nutrition was given twice as frequently as parenteral nutrition (48% versus 24%). Many patients received oral nutrition (39%) and a substantial number received no nutrition support (10%). Parenteral nutrition was used more frequently in Europe than in other world regions, the lowest use being observed in North America. The amount of nutrition given is very similar in all regions regardless of the nutrition route with about 1500 kcal and 60 g of protein per day. A clear association with body weight was not observed and the variation around the median was very large with half of patients receiving amounts 25% below or above the median. Upon completion of data entry, the nutritionDay project allows each ICU to download a unit report summarizing data that allows comparison with worldwide data in numeric and graphical form to permit easy benchmarking of medical nutrition therapy.
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Affiliation(s)
- Michael Hiesmayr
- Zentrum für Medical Data Science, Medizinische Universität Wien, Wien, Österreich.
- Klinische Abteilung Herz-Thorax-Gefäßchirurgische Anästhesie und Intensivmedizin, Medizinische Universität Wien, Spitalgasse 23, 1090, Wien, Österreich.
| | - Arabella Fischer
- Klinische Abteilung Herz-Thorax-Gefäßchirurgische Anästhesie und Intensivmedizin, Medizinische Universität Wien, Spitalgasse 23, 1090, Wien, Österreich
| | - Cecilia Veraar
- Klinische Abteilung Herz-Thorax-Gefäßchirurgische Anästhesie und Intensivmedizin, Medizinische Universität Wien, Spitalgasse 23, 1090, Wien, Österreich
| | - Bruno Mora
- Klinische Abteilung Herz-Thorax-Gefäßchirurgische Anästhesie und Intensivmedizin, Medizinische Universität Wien, Spitalgasse 23, 1090, Wien, Österreich
| | - Silvia Tarantino
- Zentrum für Medical Data Science, Medizinische Universität Wien, Wien, Österreich
| | - Arved Weimann
- Abteilung für Allgemein‑, Viszeral- und Onkologische Chirurgie, Klinikum St. Georg, Leipzig, Deutschland
| | - Dorothee Volkert
- Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Nürnberg, Deutschland
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Bortolotti A, Fullagar S, Mora B, Shuilleabhain NN, Ugolotti NDM, Bueno AX, Donato A, Galak E, Tonelli L. More-than-human Perspectives on Physical Activity, Health and Education. Saúde Redes 2022. [DOI: 10.18310/2446-4813.2022v8n3p513-527] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The Culture/Nature dualism has supplied post-Enlightenment philosophers, scientists and social scientists with a neat way to set limits on the respective concerns of the social and natural sciences (see Barad, 2007; Braidotti, 2013; Fullagar et al., 2019), and has enabled the creation of distinctions between “modern” (read “civilised”) and “traditional” (read “primitive”) bodies and ways of being-in-the-world (Denowski and Viveiros de Castro, 2014). Yet, when critically exploring issues of embodiment, the influence of the built environment on well-being, climate transitions and/or the ongoing Covid-19 pandemic such distinctions start to become problematic, as eloquently argued in the last three decades by feminist, post-human, new-materialist and political ecological –among others– debates and propositions. Giving continuity to an ongoing dialogue started in 2018 between scholars and activists from Latin America and Europe (see Donato, Tonelli, Galak, 2019) this seminar explored how the interrelated domains of health, physical activity, and education can look like from perspectives that de-stabilise established ontological boundaries between nature, culture, the body, and their relationship. It did so through a dialogue between Alessandro Bortolotti, Simone Fullagar, Bruno Mora, Niamh Ni Shuilleabhain, four scholars from Australia, Italy, United Kingdom and Uruguay. The online event took place as the first of a two-parts online seminar series on Re-assembling the nature-culture-body nexus: practices and epistemologies.
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Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19), an acute respiratory disease caused by a novel coronavirus (SARS-CoV-2), is emerging as a worldwide public health emergency. Several scientific contributions reported the potential relevance of human leukocyte antigen (HLA) polymorphism and susceptibility to viruses, such as SARS-CoV. In our study, we examined a population of coeliac subjects presenting the HLA haplotype DQ2 and/or DQ8. Our aim was to evaluate whether HLA DQ2 and/or DQ8 haplotype play a role in SARS-CoV-2-infection. The aim was also to evaluate the difficulty in following the gluten-free diet due to all the adversities produced by the pandemic, such as the food supply disruption, and the difficulties in managing the clinical follow-up. METHODS 191 consecutive coeliac patients completed a questionnaire on their current clinical status, psychological effects, and management of the gluten-free diet experienced during the COVID-19 pandemic and questions regarding possible SARS-CoV-2 infection. RESULTS Out of the 191 patients who participated in the study, 42 were full-blown coeliac and 149 were in remission. From the answers provided, 84.8% of patients declared that they no longer consider themselves vulnerable to COVID-19 as they suffer from coeliac disease; 94.2% of patients did not encounter any difficulties in managing the gluten-free diet or in acquiring specific foods and 64.9% of patients in our study underwent diagnostic testing for SARS-CoV-2. Out of this number, 31.5% did so due to contacts with subjects affected by COVID-19, 26.6% for work related reasons, 11.3% due to flu-like symptoms and 30.6% for other reasons. Only 5.8% of the enrolled patients received a diagnosis of COVID-19. Out of all the patients in our population who were diagnosed with COVID-19, 94.8% developed no symptoms and none of them needed hospitalization or intensive care. CONCLUSION The hypothesis that the HLADQ2 and/or DQ8 haplotype plays a protective role against SARS-CoV-2 infection, as against other viral infections, is intriguingly suggestive.KEY MESSAGESCOVID-19 as a public health emergency;SARS-CoV-2 and possible complications in coeliac disease;Role of HLA DQ2 and/or DQ8 in SARS-CoV-2 infection.
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Affiliation(s)
- N Greco
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - A Meacci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - B Mora
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Rome, Italy
| | - A Picarelli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19), an acute respiratory disease caused by a novel coronavirus (SARS-CoV-2), is emerging as a worldwide public health emergency. Several scientific contributions reported the potential relevance of human leukocyte antigen (HLA) polymorphism and susceptibility to viruses, such as SARS-CoV. In our study, we examined a population of coeliac subjects presenting the HLA haplotype DQ2 and/or DQ8. Our aim was to evaluate whether HLA DQ2 and/or DQ8 haplotype play a role in SARS-CoV-2-infection. The aim was also to evaluate the difficulty in following the gluten-free diet due to all the adversities produced by the pandemic, such as the food supply disruption, and the difficulties in managing the clinical follow-up. METHODS 191 consecutive coeliac patients completed a questionnaire on their current clinical status, psychological effects, and management of the gluten-free diet experienced during the COVID-19 pandemic and questions regarding possible SARS-CoV-2 infection. RESULTS Out of the 191 patients who participated in the study, 42 were full-blown coeliac and 149 were in remission. From the answers provided, 84.8% of patients declared that they no longer consider themselves vulnerable to COVID-19 as they suffer from coeliac disease; 94.2% of patients did not encounter any difficulties in managing the gluten-free diet or in acquiring specific foods and 64.9% of patients in our study underwent diagnostic testing for SARS-CoV-2. Out of this number, 31.5% did so due to contacts with subjects affected by COVID-19, 26.6% for work related reasons, 11.3% due to flu-like symptoms and 30.6% for other reasons. Only 5.8% of the enrolled patients received a diagnosis of COVID-19. Out of all the patients in our population who were diagnosed with COVID-19, 94.8% developed no symptoms and none of them needed hospitalization or intensive care. CONCLUSION The hypothesis that the HLADQ2 and/or DQ8 haplotype plays a protective role against SARS-CoV-2 infection, as against other viral infections, is intriguingly suggestive.KEY MESSAGESCOVID-19 as a public health emergency;SARS-CoV-2 and possible complications in coeliac disease;Role of HLA DQ2 and/or DQ8 in SARS-CoV-2 infection.
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Affiliation(s)
- N Greco
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - A Meacci
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - B Mora
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Rome, Italy
| | - A Picarelli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Mora B, Guglielmelli P, Kuykendall A, Maffioli M, Rotunno G, Komrokji RS, Palandri F, Kiladjian JJ, Iurlo A, Auteri G, Cattaneo D, De Stefano V, Salmoiraghi S, Devos T, Cervantes F, Merli M, Campagna A, Benevolo G, Brociner M, Albano F, Gotlib J, Caramella M, Ruggeri M, Ross DM, Orsini F, Pessina C, Colugnat I, Pallotti F, Barbui T, Bertù L, Della Porta MG, Vannucchi AM, Passamonti F. P995: MYELOID NEOPLASMS-ASSOCIATED GENE VARIANTS IN 639 PATIENTS WITH POST-POLYCYTHEMIA VERA AND POST-ESSENTIAL THROMBOCYTHEMIA MYELOFIBROSIS: AN ANALYSIS OF THE MYSEC COHORT. Hemasphere 2022. [PMCID: PMC9430043 DOI: 10.1097/01.hs9.0000846848.27311.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Veraar C, Geilen J, Fischer A, Sulz I, Tarantino S, Mouhieddine M, Mora B, Schuh C, Singer P, Hiesmayr MJ. Timing of parenteral nutrition in ICU patients: A transatlantic controversy. Clin Nutr ESPEN 2021; 46:532-538. [PMID: 34857246 DOI: 10.1016/j.clnesp.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/27/2021] [Accepted: 08/07/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS European and North American guidelines on Parenteral Nutrition (PN) and large Randomized Controlled Trials give divergent advices on nutritional therapeutic strategies for critically ill patients. We therefore investigated differences in therapeutic strategies of clinicians between European and Non-European Intensive Care Units (ICU) regarding start day of PN, preferred route of administration and prescription of total energy targets over the years. METHODS In this study 16,032 patients from 1389 different ICUs were included. Data collection was performed in 28 different European and Non-European ICUs from 2007 to 2018 via nutritionDay, a worldwide-standardized one-day multinational cross-sectional audit. RESULTS In this analysis an abrupt delay in PN start days was observed in 2011 (7.64 days (4.31; 19.97); p = 0.001) and 2012 (6.41 days (3.1; 9.72); p = 0.001), which was significantly reversed within the following years until 2018. In European, compared to Non-European countries PN prescription was increased (27% versus 13%). Patients from North-America received significantly less kcal per day compared to Europe (-4.3 kcal kg-1 (-6.9; -1.6); p = 0.001). CONCLUSIONS Our study provides further evidence on transatlantic discrepancies in nutritional therapy of ICU patients. Regular audits, such as nutritionDay are substantial for self-reflection of clinical daily practice of intensivists. It is time for worldwide consensus in nutritional therapy by developing worldwide guidelines and supporting standardization in nutrition care of critically ill patients.
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Affiliation(s)
- Cecilia Veraar
- Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Johannes Geilen
- Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Arabella Fischer
- Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Isabella Sulz
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Silvia Tarantino
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Mohamed Mouhieddine
- Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Bruno Mora
- Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Christian Schuh
- Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | - Pierre Singer
- Department of General Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Michael J Hiesmayr
- Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria.
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Koschutnik M, Dannenberg V, Dona C, Nitsche C, Kammerlander AA, Mora B, Bartunek A, Wiedemann D, Zimpfer D, Huelsmann M, Schneider M, Bartko PE, Goliasch G, Hengstenberg C, Mascherbauer J. Transcatheter versus surgical valve repair in patients with severe mitral regurgitation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Transcatheter edge-to-edge mitral valve repair (TMVR) is increasingly performed, however, its efficacy in comparison with surgical MV treatment (SMV) is unknown.
Methods
Consecutive patients with severe mitral regurgitation (MR) undergoing TMVR (68% functional, 32% degenerative) or SMV (9% functional, 91% degenerative; 23% MV replacement) were enrolled. To account for differences in baseline characteristics, propensity score-matching including age, EuroSCORE-II, left ventricular ejection fraction, and NT-proBNP was performed. A composite of heart failure (HF) hospitalization/death was defined as primary endpoint. Kaplan-Meier curves and Cox-regression analyses were used to investigate associations between baseline, imaging, and procedural parameters and outcome.
Results
Between July 2017 and April 2020, 245 patients were enrolled, of which 102 patients could be adequately matched (73y/o, 61% females, EuroSCORE-II: 5.7%, p>0.05 for all). Despite matching, TMVR patients were sicker at baseline (higher rates of prior myocardial infarction, coronary revascularization, pacemakers/defibrillators, and diabetes mellitus, p<0.009 for all).
Patients were followed for 28.3±27.2 months, during which 27 events (17 deaths, 10 HF hospitalizations) occurred.Postprocedural MR reduction (MR grade <2: TMVR vs. SMV: 88% vs. 94%, p=0.487) and freedom from HF hospitalization/death (log-rank: p=0.221) were similar at two years. By multivariable Cox analyses, EuroSCORE-II (adj.HR 1.07 [95% CI: 1.00–1.13], p=0.027) and postprocedural MR severity (adj.HR 1.85 [95% CI: 1.17–2.92], p=0.009) emerged as independent predictors of outcome.
Conclusions
In this propensity matched, all-comers cohort, 2-year outcomes after TMVR versus SMV were similar. Given the reported favorable long-term durability of TMVR, the interventional approach emerges as valuable alternative for a substantial number of patients with functional and degenerative MR at high/prohibitive surgical risk.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Koschutnik
- Medical University of Vienna AKH, Vienna, Austria
| | - V Dannenberg
- Medical University of Vienna AKH, Vienna, Austria
| | - C Dona
- Medical University of Vienna AKH, Vienna, Austria
| | - C Nitsche
- Medical University of Vienna AKH, Vienna, Austria
| | | | - B Mora
- Medical University of Vienna AKH, Vienna, Austria
| | - A Bartunek
- Medical University of Vienna AKH, Vienna, Austria
| | - D Wiedemann
- Medical University of Vienna AKH, Vienna, Austria
| | - D Zimpfer
- Medical University of Vienna AKH, Vienna, Austria
| | - M Huelsmann
- Medical University of Vienna AKH, Vienna, Austria
| | - M Schneider
- Medical University of Vienna AKH, Vienna, Austria
| | - P E Bartko
- Medical University of Vienna AKH, Vienna, Austria
| | - G Goliasch
- Medical University of Vienna AKH, Vienna, Austria
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Mora B, Roth D, Bernardi MH, Base E, Weber U. Estimation of pulmonary artery pressure with transesophageal echocardiography: An observer-blinded test accuracy study. Medicine (Baltimore) 2021; 100:e26988. [PMID: 34414978 PMCID: PMC8376331 DOI: 10.1097/md.0000000000026988] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 07/26/2021] [Indexed: 01/04/2023] Open
Abstract
With the declining use of the pulmonary artery catheter (PAC), transesophageal echocardiography (TEE) has become an appealing alternative to obtain pulmonary artery pressure non-invasively using the simplified Bernoulli equation. The validation of this method in the perioperative setting has been scarce with no clear recommendations about which view is the most accurate to estimate right ventricular systolic pressure (RVSP).Therefore, we performed a prospective, observer-blinded, diagnostic test accuracy study to assess the difference in systolic pulmonary artery pressure (sysPAP) measuring both, invasively sysPAP and estimated RVSP with TEE in 3 different views: the mid-esophageal (ME) 4Chamber, the ME right ventricular (RV) inflow-outflow and the ME modified bicaval view.To show a clinically significant difference of at least 10% in RVSP, we included 40 cardiac surgical patients divided into 3 subgroups: Patients with mild to moderate tricuspid regurgitation (TR) and mean PAP <25 mm Hg, patients with mild to moderate TR and mean PAP≥ 25 mm Hg, and patients with severe TR.For the whole cohort, bias of estimated RVSP compared to measured sysPAP was 5.27 mm Hg, precision was 7.96 mm Hg, limits of agreement were -10.66 to 21.19 mm Hg. The best agreement between the 2 methods was found in patients with severe TR and in the ME RV inflow-outflow and the modified bicaval view. Good Doppler signals were available in 35% and 46% in these views, and in 20% in the ME 4 chamber view.The estimation of the sysPAP by TEE cannot be considered reliable in the clinical perioperative setting. Only measurements that provide a full Doppler envelope show sufficient precision to provide accurate estimations.
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Affiliation(s)
- Bruno Mora
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Martin H. Bernardi
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Eva Base
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Ulrike Weber
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria
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Best J, Kuchakulla M, Khodamoradi K, Lima T, Frech F, Achua J, Rosete O, Mora B, Arora H, Ibrahim E, Ramasamy R. P–070 Evaluation of SARS-CoV–2 in human semen and effect on total sperm number: A prospective observational study. Hum Reprod 2021. [PMCID: PMC8385871 DOI: 10.1093/humrep/deab130.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Study question Is the SARS-CoV–2 virus present in human semen and what is the impact on semen parameters following an infection? Summary answer SARS-CoV–2 infection, though not detected in semen of recovered men, can affect TSN in ejaculate in the acute setting. What is known already Early epidemiological data has suggested that the primary mode of transmission is through respiratory droplets, but the presence of SARS-CoV–2 has been identified in other bodily fluids such as feces, urine, and semen. Study design, size, duration We prospectively recruited thirty men diagnosed with acute SARS-CoV–2 infection using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) of pharyngeal swab specimens. Thirty semen samples from recovered men were obtained 11–64 days after testing positive for SAR-CoV–2 infection. The median duration between positive SAR-CoV–2 test and semen collection was 37 days (IQR=23). Participants/materials, setting, methods Semen samples were collected from each individual using mailed kits. Follow-up semen samples were done with mailed kits or in-person in office setting. Semen analysis and PCR was performed after samples were received. Main results and the role of chance The median total sperm number (TSN) in ejaculate was 12.5 million (IQR=53.1). When compared with age-matched SARS-CoV–2(-) men, TSN was lower among SARS-CoV–2(+) men (p = 0.0024). Five men completed a follow-up sperm analysis (median 3 months) and had a median TSN of 18 million (IQR=21.6). No RNA was detected by means of RT-PCR in the semen in 16 samples tested. Limitations, reasons for caution First, most of the semen samples came from non-severe men of whom were in the recovery stage and lacked symptoms. Additionally, our sample size was relatively small and overnight mail-in semen analysis kits were used during the acute phase of infection to minimize contact with positive subjects. Wider implications of the findings: Our findings suggest extremely low risk of viral transmission during sexual contact and assisted reproductive techniques, although further data need to be obtained. The impact on TSC in recovered men from SARS-CoV–2 infection is concerning, nevertheless long-term follow-up of these men is critical to determine the nadir of TSC. Trial registration number 20200401
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Affiliation(s)
- J Best
- University of MIami, Urology, MIAMI, USA
| | | | | | - T Lima
- University of MIami, Urology, MIAMI, USA
| | - F Frech
- University of MIami, Urology, MIAMI, USA
| | - J Achua
- University of MIami, Urology, MIAMI, USA
| | - O Rosete
- University of MIami, Urology, MIAMI, USA
| | - B Mora
- University of MIami, Urology, MIAMI, USA
| | - H Arora
- University of MIami, Urology, MIAMI, USA
| | - E Ibrahim
- University of MIami, Urology, MIAMI, USA
| | - R Ramasamy
- University of MIami, Urology, MIAMI, USA
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Dubin J, Balaji N, Rainer Q, Wyant W, Efimenko I, Mora B, Guevara A, Paz L, Winter A, Ramasamy R. 131 Sexual Health Influences in Women: A Cross-Sectional Survey. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.150] [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: 10/21/2022]
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Dubin J, Balaji N, Rainer Q, Efimenko I, Wyant W, Mora B, Paz L, Winter A, Ramasamy R. 132 Female Perceptions of Erectile Dysfunction and the Role of Male Blame on Female Sexual Health: A Cross-Sectional Survey. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.151] [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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Koschutnik M, Goliasch G, Nitsche C, Kammerlander A, Dona C, Dannenberg V, Schneider M, Bartko P, Mora B, Bartunek A, Andreas M, Hengstenberg C, Mascherbauer J. Acute hemodynamic effects of iatrogenic inter-atrial shunts after percutaneous edge-to-edge mitral valve repair. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Implantable interatrial shunt devices improve pulmonary vascular function in patients with heart failure by transferring richly oxygenated blood to the right heart. Whether iatrogenic atrial septum defects (iASDs) after percutaneous edge-to-edge mitral valve repair (pMVR) are also associated with beneficial hemodynamic effects has not been investigated.
Methods
We consecutively enrolled patients with relevant functional (FMR) and degenerative mitral regurgitation (DMR) scheduled for pMVR. Invasive hemodynamic assessments were performed prior to and immediately after the procedure.
Results
97 consecutive patients (75.4±9.1 years; 58% female) were prospectively included, 65 (66%) presented with relevant FMR. At baseline when compared to the DMR group, FMR was associated with worse left ventricular (LV) function (LV ejection fraction: 39 vs. 49%; p=0.001), higher NT-proBNP levels (7404 vs. 5214 pg/mL; p=0.023), worse renal function (serum creatinine: 1.7 vs. 1.3 mg/dL; p=0.019), and higher usage of spironolactone (68 vs. 42%; p=0.018) and sacubitril/valsartan (33 vs. 0%; p<0.001).
Following pMVR, cardiac output (CO) and systemic blood flow (Qs) increased significantly (CO: 4.6 to 5.5 L/min; p<0.001; Qs: 4.9 to 5.8 L/min; p=0.002), with more pronounced changes in the FMR subgroup (ΔCO: 1.0 vs. 0.6 L/min; Figure 1A; ΔQs: 1.2 vs. 0.1 L/min), when compared to DMR. Pulmonary blood flow (Qp) increased by 26% (4.3 to 5.4 L/min; p=0.008), accompanied by a raise in pulmonary artery (PA) oxygen (O2) saturation from 73 to 77% (p<0.001). Arterial O2 saturation levels remained unchanged (98.3 to 98.7%; p=0.165), confirming no significant changes in systemic oxygenation. These changes were associated with a slight decline in pulmonary vascular resistance (PVR: 250 to 225 dynes*sec/cm5; p=0.369, Figure 1B), and a tendency towards improvement of pulmonary compliance (PAC: 3.6 to 4.0 mL/mmHg; p=0.414).
Conclusions
Invasively measured CO, Qs, Qp, and mixed-venous PA O2 saturation increased immediately after pMVR, alongside with potentially beneficial effects on pulmonary vasculature with marked improvements in PVR and PAC. These changes were more pronounced in the FMR subgroup. Further studies are required to assess long-term hemodynamic effects and underlying mechanisms of persistent iASDs on pulmonary vascular function.
Figure 1. Invasive hemodynamics
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Koschutnik
- Medical University of Vienna AKH, Vienna, Austria
| | - G Goliasch
- Medical University of Vienna AKH, Vienna, Austria
| | - C Nitsche
- Medical University of Vienna AKH, Vienna, Austria
| | | | - C Dona
- Medical University of Vienna AKH, Vienna, Austria
| | - V Dannenberg
- Medical University of Vienna AKH, Vienna, Austria
| | - M Schneider
- Medical University of Vienna AKH, Vienna, Austria
| | - P Bartko
- Medical University of Vienna AKH, Vienna, Austria
| | - B Mora
- Medical University of Vienna AKH, Vienna, Austria
| | - A Bartunek
- Medical University of Vienna AKH, Vienna, Austria
| | - M Andreas
- Medical University of Vienna AKH, Vienna, Austria
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Stelzmueller ME, Zilberszac R, Heinrich N, Mora B, Laufer G, Wisser W. Concomitant Transapical Transcatheter Aortic Valve Implantation and Transapical Mitral Valve Repair With NeoChord Implantation. Innovations (Phila) 2019; 14:564-568. [PMID: 31524023 DOI: 10.1177/1556984519871905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
One-third of the patients with severe symptomatic aortic valve stenosis (sAS) present with hemodynamic relevant mitral valve insufficiency (rMI). In patients who undergo conventional surgery, the rMI never would be left untreated; however, in cases of transcatheter aortic valve implantation (TAVI), the impact of rMI is often overlooked and left untreated. The combination of transapical TAVI (TA-TAVI) and NeoChord implantation represents a novel, promising therapeutic option for high-risk-surgery patients with sAS and rMI due to a prolapsed or flailed leaflet. This case report describes 2 patients (1 male, 1 female; mean age 82 years) who underwent TA-TAVI and concomitant NeoChord implantation at our institute. Both presented with sAS and rMI due to a prolapse of the P2 segment of the mitral valve. At first, the TA-TAVI was implanted under angio-guidance, followed by three-dimensional echo-guided implantation of the NeoChords, through the same approach, which was slightly posterior and lateral to the apex. TA-TAVI using an Edwards Sapien 3 (26 mm, n = 1 and 29 mm, n = 1) and NeoChord implantation (2 in the first and 3 in the second patient) was successful in both cases. Post-intervention discharge echo indicated no paravalvular or central insufficiency after the procedure and only a trace of mitral valve insufficiency. TA-TAVI and concomitant NeoChord implantation is a feasible and promising treatment option for high-risk patients with rMI. Despite its technical demands, in experienced hands, it is a safe procedure for those not well suited for surgical intervention.
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Affiliation(s)
| | - Robert Zilberszac
- Department of Cardiology, Medical University Vienna, Vienna, Austria
| | - Nikolaus Heinrich
- Department of Cardiothoracic Anesthesia and Intensive Care, Medical University Vienna, Vienna, Austria
| | - Bruno Mora
- Department of Cardiothoracic Anesthesia and Intensive Care, Medical University Vienna, Vienna, Austria
| | - Guenther Laufer
- Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria
| | - Wilfried Wisser
- Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria
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14
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Weber U, Zapletal B, Base E, Hambrusch M, Ristl R, Mora B. Resident performance in basic perioperative transesophageal echocardiography: Comparing 3 teaching methods in a randomized controlled trial. Medicine (Baltimore) 2019; 98:e17072. [PMID: 31490407 PMCID: PMC6738965 DOI: 10.1097/md.0000000000017072] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Training in transesophageal echocardiography (TEE) is based on hands-on training in the operating room, which is time consuming and therefore limits its experience among anesthesiologists. Medical simulations have been successfully used for training of invasive procedures in many areas.This paper compares the difference in effectiveness of teaching the 11 basic TEE views using either e-learning, simulation based training or hands-on training in the operating room in 3 groups of residents. METHODS We included 51 anesthesia and intensive care residents of all training levels but no prior training in echocardiography in this prospective randomized single-center study.Residents received a tutorial about theoretical knowledge followed by 2 practical study sessions either by e-learning using an online simulator (www.pie.med.utoronto.ca/TEE), with the simulation mannequin (CAE Vimedix Simulator) or in the operating room. Both, a theoretical multiple choice test (0-50 points) and a practical exam test (0-110 points) on the simulation mannequin had to be completed.The primary endpoint was the post-training scores in the practical and theoretical exams after all training sessions. RESULTS Residents received significantly higher test scores in both practical and theoretical examinations after training with the simulation mannequin (108.41 ± 2.09, 40.6 ± 5.23, n = 17) compared with e-learning (106.88 ± 4.53, 36 ± 4.76, n = 17) or hands-on training (106.82 ± 2.01, 34.94 ± 4.72, n = 17). CONCLUSIONS Simulation based TEE training provides more effective training than other teaching methods. It is therefore especially suitable for the initial stages of TEE training to acquire psychomotor skills and knowledge of echo-anatomy.
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Affiliation(s)
- Ulrike Weber
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anaesthesiology, General Intensive Care and Pain Medicine
| | - Bernhard Zapletal
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anaesthesiology, General Intensive Care and Pain Medicine
| | - Eva Base
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anaesthesiology, General Intensive Care and Pain Medicine
| | - Michael Hambrusch
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anaesthesiology, General Intensive Care and Pain Medicine
| | - Robin Ristl
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Bruno Mora
- Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Department of Anaesthesiology, General Intensive Care and Pain Medicine
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15
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Weber U, Roth D, Base E, Mora B. Intraoperative estimation of pulmonary artery pressure with transoesophageal echocardiography. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Brebi P, Cartas I, Mora B, Buchegger K, Viscarra T, Zanella L, Riquelme I, Ili C. PO-492 Establishment of new drug-resistant gastric cancer cell lines. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.509] [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: 11/03/2022] Open
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17
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Wiedemann D, Rupprechter V, Mascherbauer J, Kammerlander A, Mora B, Dimitrov K, Weber B, Andreas M, Laufer G, Kocher A. Tricuspid valve replacement: results of an orphan procedure - which is the best prosthesis? J Cardiovasc Surg (Torino) 2018; 59:626-632. [PMID: 29430890 DOI: 10.23736/s0021-9509.18.10392-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Replacement of the tricuspid valve is uncommon. Prostheses specifically designed for this position are not available. Bovine, porcine as well as mechanical valve prostheses are currently used, however, the most suitable prosthesis type has not been defined. METHODS We retrospectively analyzed all consecutive patients who underwent tricuspid valve replacement (TVR) at the Medical University of Vienna from 1996 to 2014. Baseline patient characteristics, prosthesis type, and postoperative outcome data were collected. RESULTS A total of 58 patients underwent TVR. Forty-one patients (71%) received biological (18 bovine, 23 porcine), and 17 patients (29%) mechanical prostheses. One-year survival (70.2% vs. 76.5%, P=0.18), and freedom from reoperation at one year (86.3% vs. 94.1%, P=0.35) was not significantly different bioprostheses and mechanical valves. Freedom from reoperation rates for bovine versus porcine prostheses (one-year: 88.2% vs. 84.4%, P=0.145) were also not significantly different. However, three bovine prosthesis had to be reoperated due to high-grade central regurgitation without any signs of endocarditis or structural valve degeneration. CONCLUSIONS There is a lack of clinical trials on tricuspid valve replacement and no specific guidelines for the choice of prosthesis. In the current study we have not identified significant differences in mortality between mechanical and biological valves. However, bovine prostheses seem less suitable for the tricuspid position due to the high closing volume with consecutive severe postoperative regurgitation.
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Affiliation(s)
- Dominik Wiedemann
- Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria -
| | - Veronika Rupprechter
- Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Julia Mascherbauer
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Andreas Kammerlander
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Bruno Mora
- Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Kamen Dimitrov
- Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Benedikt Weber
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Martin Andreas
- Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Günther Laufer
- Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Alfred Kocher
- Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
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18
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Ruberti S, Bianchi E, Guglielmelli P, Rontauroli S, Barbieri G, Tavernari L, Fanelli T, Norfo R, Pennucci V, Fattori GC, Mannarelli C, Bartalucci N, Mora B, Elli L, Avanzini MA, Rossi C, Salmoiraghi S, Zini R, Salati S, Prudente Z, Rosti V, Passamonti F, Rambaldi A, Ferrari S, Tagliafico E, Vannucchi AM, Manfredini R. Involvement of MAF/SPP1 axis in the development of bone marrow fibrosis in PMF patients. Leukemia 2017; 32:438-449. [PMID: 28745329 PMCID: PMC5808097 DOI: 10.1038/leu.2017.220] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 06/16/2017] [Accepted: 06/26/2017] [Indexed: 01/13/2023]
Abstract
Primary myelofibrosis (PMF) is a myeloproliferative neoplasm characterized by hyperplastic megakaryopoiesis and myelofibrosis. We recently described the upregulation of MAF (v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog) in PMF CD34+ hematopoietic progenitor cells (HPCs) compared to healthy donor. Here we demonstrated that MAF is also upregulated in PMF compared with the essential thrombocytemia (ET) and polycytemia vera (PV) HPCs. MAF overexpression and knockdown experiments shed some light into the role of MAF in PMF pathogenesis, by demonstrating that MAF favors the megakaryocyte and monocyte/macrophage commitment of HPCs and leads to the increased expression of proinflammatory and profibrotic mediators. Among them, we focused our further studies on SPP1 and LGALS3. We assessed SPP1 and LGALS3 protein levels in 115 PMF, 47 ET and 24 PV patients plasma samples and we found that SPP1 plasma levels are significantly higher in PMF compared with ET and PV patients. Furthermore, in vitro assays demonstrated that SPP1 promotes fibroblasts and mesenchymal stromal cells proliferation and collagen production. Strikingly, clinical correlation analyses uncovered that higher SPP1 plasma levels in PMF patients correlate with a more severe fibrosis degree and a shorter overall survival. Collectively our data unveil that MAF overexpression contributes to PMF pathogenesis by driving the deranged production of the profibrotic mediator SPP1.
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Affiliation(s)
- S Ruberti
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - E Bianchi
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - P Guglielmelli
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - S Rontauroli
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - G Barbieri
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - L Tavernari
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - T Fanelli
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - R Norfo
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy.,Haematopoietic Stem Cell Biology Laboratory, MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - V Pennucci
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - G Corbizi Fattori
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy.,GenOMec, University of Siena, Siena, Italy
| | - C Mannarelli
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy.,GenOMec, University of Siena, Siena, Italy
| | - N Bartalucci
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - B Mora
- Division of Hematology, Ospedale ASST Sette Laghi, Universita degli Studi dell'Insubria, Varese, Italy
| | - L Elli
- Division of Hematology, Ospedale ASST Sette Laghi, Universita degli Studi dell'Insubria, Varese, Italy
| | - M A Avanzini
- Department of Pediatric Onco-Hematology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - C Rossi
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - S Salmoiraghi
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - R Zini
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - S Salati
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - Z Prudente
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - V Rosti
- Center for the Study of Myelofibrosis, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Passamonti
- Division of Hematology, Ospedale ASST Sette Laghi, Universita degli Studi dell'Insubria, Varese, Italy
| | - A Rambaldi
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - S Ferrari
- Department of Life Sciences, Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy
| | - E Tagliafico
- Department of Life Sciences, Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy
| | - A M Vannucchi
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - R Manfredini
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
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Weber U, Zapletal B, Base E, Hambrusch M, Mora B. Evaluation of simulator training on transoesophageal echocardiography performance in anaesthesia residents. J Cardiothorac Vasc Anesth 2017. [DOI: 10.1053/j.jvca.2017.02.162] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Passamonti F, Mora B, Giorgino T, Guglielmelli P, Cazzola M, Maffioli M, Rambaldi A, Caramella M, Komrokji R, Gotlib J, Kiladjian JJ, Cervantes F, Devos T, Palandri F, De Stefano V, Ruggeri M, Silver R, Benevolo G, Albano F, Caramazza D, Rumi E, Merli M, Pietra D, Casalone R, Barbui T, Pieri L, Vannucchi AM. Driver mutations’ effect in secondary myelofibrosis: an international multicenter study based on 781 patients. Leukemia 2016; 31:970-973. [DOI: 10.1038/leu.2016.351] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Bendavid I, Singer P, Theilla M, Themessl-Huber M, Sulz I, Mouhieddine M, Schuh C, Mora B, Hiesmayr M. NutritionDay ICU: A 7 year worldwide prevalence study of nutrition practice in intensive care. Clin Nutr 2016; 36:1122-1129. [PMID: 27637833 DOI: 10.1016/j.clnu.2016.07.012] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/16/2016] [Accepted: 07/20/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION To determine the nutrition practice in intensive care units and the associated outcome across the world, a yearly 1 day cross sectional audit was performed from 2007 to 2013. The data of this initiative called "nutritionDay ICU" were analyzed. MATERIAL AND METHODS A questionnaire translated in 17 languages was used to determine the unit's characteristics, patient's condition, nutrition condition and therapy as well as outcome. All the patients present in the morning of the 1 day prevalence study were included from 2007 to 2013. RESULTS 9777 patients from 46 countries and 880 units were included. Their SAPS 2 was median 38 (IQR 27-51), predicted mortality was 30.7% ± 26.9, and their SOFA score 4.5 ± 3.4 with median 4 (IQR 2-7). Administration of calories did not appear to be related to actual or ideal body weight within all BMI groups. Patients with a BMI <18.5 or >40 received slightly less calories than all other BMI groups. Two third of the patients were either ventilated or were in the ICU for longer than 24 h at nutritionDay. Routes of feeding used were the oral, enteral and parenteral routes. More than 40% of the patients were not fed during the first day. The mean energy administered using enteral route was 1286 ± 663 kcal/day and using parenteral nutrition 1440 ± 652 kcal/day. 60 days mortality was 26.0%. DISCUSSION This very large collaborative cohort study shows that most of the patients are underfed during according to actual recommendations their ICU stay. Prescribed calories appear to be ordered regardless to the ideal weight of the patient. Nutritional support is slow to start and never reaches the recommended targets. Parenteral nutrition prescription is increasing during the ICU stay but reaching only 20% of the population studied if ICU stay is one week or longer. The nutritional support worldwide does not seem to be guided by weight or disease but more to be standardized and limited to a certain level of calories. These observations are showing the poor observance to guidelines.
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Affiliation(s)
- Itai Bendavid
- Department of Critical Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital and Sackler School of Medicine, Tel Aviv University, 49100, Israel
| | - Pierre Singer
- Department of Critical Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital and Sackler School of Medicine, Tel Aviv University, 49100, Israel.
| | - Miriam Theilla
- Department of Critical Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital and Sackler School of Medicine, Tel Aviv University, 49100, Israel
| | - Michael Themessl-Huber
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, 1090 Vienna, Austria
| | - Isabella Sulz
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, 1090 Vienna, Austria
| | - Mohamed Mouhieddine
- Division of Cardiac Thoracic Vascular Anaesthesia & Intensive Care Medicine, Medical University Vienna, 1090 Vienna, Austria
| | - Christian Schuh
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, 1090 Vienna, Austria
| | - Bruno Mora
- Division of Cardiac Thoracic Vascular Anaesthesia & Intensive Care Medicine, Medical University Vienna, 1090 Vienna, Austria
| | - Michael Hiesmayr
- Division of Cardiac Thoracic Vascular Anaesthesia & Intensive Care Medicine, Medical University Vienna, 1090 Vienna, Austria
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Menger J, Mora B, Skhirtladze K, Fischer A, Jan Ankersmit H, Dworschak M. Accuracy of Continuous Cardiac Output Measurement With the LiDCOplus System During Intra-Aortic Counterpulsation After Cardiac Surgery. J Cardiothorac Vasc Anesth 2015; 30:592-8. [PMID: 26718662 DOI: 10.1053/j.jvca.2015.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 07/10/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the effect of intra-aortic counterpulsation on precision, accuracy, and concordance of continuous pulse contour cardiac output determined using LiDCOplus (LiDCO Group, London). DESIGN Prospective trial. SETTING University hospital critical care unit. PARTICIPANTS Patients with intra-aortic balloon pump support in the 1:1 mode after elective or urgent cardiac surgery. INTERVENTIONS Lithium dilution calibrated pulse contour cardiac output was compared with pulmonary artery bolus thermodilution cardiac output during hemodynamically stable conditions in the course of standardized postoperative management. MEASUREMENTS AND MAIN RESULTS Fifty-one paired measurements demonstrated good correlation between the 2 methods (r = 0.88, p<0.001). Mean bias was -0.14±0.81 L/min, limits of agreement 1.48 to -1.77 L/min, and percentage error 28%. Concordance between the 2 techniques regarding directional changes>±10% cardiac output was 100% (p = 0.008). Trending ability was moderate when paired cardiac output changes were assessed using linear regression, 4-quadrant table, and polar plots. When changes <±10% of the reference cardiac output were excluded, 90% of the data pairs still lay within the 30° radial limits. Optimal timing of the balloon pump was indispensable for proper determination of pulse contour cardiac output. CONCLUSIONS Because of the LiDCOplus-specific algorithm in determining stroke volume from the arterial pulse waveform, which differs from other devices, accuracy and precision of continuous pulse contour cardiac output only are affected insignificantly by intra-aortic counterpulsation. The authors nevertheless caution that the device should be recalibrated after major hemodynamic alterations or otherwise inexplicable changes of the pulse contour cardiac output to improve trending.
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Affiliation(s)
- Johannes Menger
- Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine
| | - Bruno Mora
- Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine
| | - Keso Skhirtladze
- Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine
| | - Arabella Fischer
- Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine
| | - Hendrik Jan Ankersmit
- Department of Surgery, and Christian Doppler Laboratory for Cardiac and Thoracic Diseases, General Hospital Vienna, Medical University of Vienna, Vienna, Austria
| | - Martin Dworschak
- Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine.
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23
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Weber U, Base E, Ristl R, Mora B. Effect of Preload Alterations on Left Ventricular Systolic Parameters Including Speckle-Tracking Echocardiography Radial Strain During General Anesthesia. J Cardiothorac Vasc Anesth 2015; 29:852-9. [PMID: 25910985 DOI: 10.1053/j.jvca.2014.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 08/26/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Frequently used parameters for evaluation of left ventricular systolic function are load-sensitive. However, the impact of preload alterations on speckle-tracking echocardiographic parameters during anesthesia has not been validated. Therefore, two-dimensional (2D) speckle-tracking echocardiography radial strain (RS) was assessed during general anesthesia, simulating 3 different preload conditions. DESIGN Single-center prospective observational study. SETTING University hospital. PARTICIPANTS Thirty-three patients with normal left ventricular systolic function undergoing major surgery. INTERVENTIONS Transgastric views of the midpapillary level of the left ventricle were acquired at 3 different positions. MEASUREMENTS AND MAIN RESULTS Fractional shortening (FS), fractional area change (FAC), and 2D speckle-tracking echocardiography RS were analyzed in the transgastric midpapillary view. Considerable correlation above 0.5 was found for FAC and FS in the zero and Trendelenburg positions (r = 0.629, r = 0.587), and for RS and FAC in the anti-Trendelenburg position (r = 0.518). In the repeated-measures analysis, significant differences among the values measured at the 3 positions were found for FAC and FS. For FAC, there were differences up to 2.8 percentage points between the anti-Trendelenburg position and the other 2 positions. For FS, only the difference between position zero and anti-Trendelenburg was significant, with an observed change of 1.66. Two-dimensional RS was not significantly different at all positions, with observed changes below 1 percentage point. CONCLUSIONS Alterations in preload did not result in clinically relevant changes of RS, FS, or FAC. Observed changes for RS were smallest; however, the variation of RS was larger than that of FS or FAC.
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Affiliation(s)
- Ulrike Weber
- Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria.
| | - Eva Base
- Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria
| | - Robin Ristl
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Bruno Mora
- Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria
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Morales R, Basaran AC, Villegas JE, Navas D, Soriano N, Mora B, Redondo C, Batlle X, Schuller IK. Exchange-bias phenomenon: the role of the ferromagnetic spin structure. Phys Rev Lett 2015; 114:097202. [PMID: 25793846 DOI: 10.1103/physrevlett.114.097202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Indexed: 06/04/2023]
Abstract
The exchange bias of antiferromagnetic-ferromagnetic (AFM-FM) bilayers is found to be strongly dependent on the ferromagnetic spin configuration. The widely accepted inverse proportionality of the exchange bias field with the ferromagnetic thickness is broken in FM layers thinner than the FM correlation length. Moreover, an anomalous thermal dependence of both exchange bias field and coercivity is also found. A model based on springlike domain walls parallel to the AFM-FM interface quantitatively accounts for the experimental results and, in particular, for the deviation from the inverse proportionality law. These results reveal the active role the ferromagnetic spin structure plays in AFM-FM hybrids which leads to a new paradigm of the exchange bias phenomenon.
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Affiliation(s)
- R Morales
- Department of Chemical-Physics & BCMaterials, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
- IKERBASQUE, Basque Foundation for Science, 48011 Bilbao, Spain
| | - Ali C Basaran
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, USA
| | - J E Villegas
- Unité Mixte de Physique CNRS/Thales, 91767 Palaiseau, France and Université Paris Sud, 91405 Orsay, France
| | - D Navas
- IFIMUP-IN and Departamento Física e Astronomia, Universidade do Porto, 4169-007 Porto, Portugal
| | - N Soriano
- Department of Chemical-Physics, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - B Mora
- Department of Chemical-Physics, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - C Redondo
- Department of Chemical-Physics, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - X Batlle
- Departament de Física Fonamental and Institut de Nanociència i Nanotecnologia IN2UB, Universitat de Barcelona, 08028 Barcelona, Catalonia, Spain
| | - Ivan K Schuller
- Department of Physics and Center for Advanced Nanoscience, University of California San Diego, La Jolla, California 92093, USA
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Maffioli M, Genoni A, Caramazza D, Mora B, Bussini A, Merli M, Giorgino T, Casalone R, Passamonti F. Looking for CALR mutations in familial myeloproliferative neoplasms. Leukemia 2014; 28:1357-60. [PMID: 24441291 DOI: 10.1038/leu.2014.33] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M Maffioli
- Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - A Genoni
- Genetic Unit, Medical Genetic and Cytogenetics Laboratory, SSD, SMEL, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - D Caramazza
- Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - B Mora
- Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - A Bussini
- Genetic Unit, Medical Genetic and Cytogenetics Laboratory, SSD, SMEL, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - M Merli
- Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - T Giorgino
- Institute of Biomedical Engineering, National Research Council of Italy (ISIB-CNR), Padua, Italy
| | - R Casalone
- Genetic Unit, Medical Genetic and Cytogenetics Laboratory, SSD, SMEL, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - F Passamonti
- Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy
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Habertheuer A, Ehrlich M, Wiedemann D, Mora B, Rath C, Kocher A. A rare case of primary cardiac B cell lymphoma. J Cardiothorac Surg 2014; 9:14. [PMID: 24422789 PMCID: PMC4021862 DOI: 10.1186/1749-8090-9-14] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 12/30/2013] [Indexed: 12/02/2022] Open
Abstract
Primary cardiac lymphomas represent an extremely rare entity of extranodal lymphomas and should be distinguished from secondary cardiac involvement of disseminated lymphomas belonging to the non-Hodgkin’s classification of blood cancers. Only 90 cases have been reported in literature. Presentation of cardiac lymphomas on imaging studies may not be unambiguous since they potentially mimic other cardiac neoplasms including myxomas, angiosarcoma or rhadomyomas and therefore require multimodality cardiac imaging, endomyocardial biopsy, excisional intraoperative biopsy and pericardial fluid cytological evaluation to establish final diagnosis. Herein we report the case of a 70 y/o immunocompetent Caucasian female with a rapidly progressing superior vena cava syndrome secondary to a large primary cardiac diffuse large B cell lymphoma (NHL lymphoma) almost completely obstructing the right atrium, right ventricle and affecting both mitral and tricuspid valve. The patient had no clinical evidence of disseminated disease and was successfully treated with extensive debulking during open-heart surgery on cardiopulmonary bypass and 6 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy (R-CHOP).
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Affiliation(s)
- Andreas Habertheuer
- Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna A-1090, Austria.
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Stelzmüller ME, Sandner S, Mirschinka K, Mora B, Laufer G, Wisser W. Predicting mortality in high-risk TAVI patient: Is the EuroSCORE II superior to logistic EuroSCORE? Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332713] [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: 10/27/2022]
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Stelzmüller ME, Mirschinka K, Mora B, Sandner S, Laufer G, Wisser W. Trace to mild Paravalvular Regurgitation after Transcatheter Aortic Valve Implantation (TAVI): A multivariante analysis. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332527] [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: 10/27/2022]
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Barker R, Lang T, Steinlechner B, Mora B, Heigel P, Gauss N, Zimpfer M, Kober A. Transcutaneous electrical nerve stimulation as prehospital emergency interventional care: treating acute pelvic pain in young women. Neuromodulation 2012; 9:136-42. [PMID: 22151638 DOI: 10.1111/j.1525-1403.2006.00053.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives. In Europe, patients with acute pelvic pain are transported to the hospital in an ambulance without an emergency physician. We hypothesized that transcutaneous electrical nerve stimulation (TENS) would be an effective noninvasive procedure for pain treatment. Methods. We conducted a prospective, randomized, blinded study where 100 women were randomly assigned into a real- or a sham-TENS group. TENS began before the transport to the ambulance and was left in place until the arrival at the hospital. Each patient rated her pain on paper using a visual analog scale. Results. Compared to sham TENS, patients with active TENS felt that their pain was reduced by half after treatment (p < 0.01), anxiety scores significantly decreased (p < 0.01), heart rate and arteriolar vasoconstriction decreased significantly (p < 0.01), and nausea (p < 0.01) was lessened. Overall satisfaction with the received care was significantly higher (p < 0.01). Conclusion. TENS is a safe, rapid, and effective analgesic treatment for acute pelvic pain.
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Affiliation(s)
- Renate Barker
- Department of Anesthesia and Intensive Care, University of Vienna, Vienna, Austria; Department of Anesthesia and Intensive Care, University of Naples, Italy Department of Anesthesia and Intensive Care, University of Pecs, Pecs, Hungary
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Fakin R, Zimpfer D, Sodeck GH, Rajek A, Mora B, Dumfarth J, Grimm M, Czerny M. Influence of temperature management on neurocognitive function in biological aortic valve replacement. A prospective randomized trial. J Cardiovasc Surg (Torino) 2012; 53:107-112. [PMID: 22231536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM Aim of this study was to elucidate if postoperative neurocognitive function after biological aortic valve replacement (AVR) can be influenced by temperature management during cardiopulmonary bypass (CPB). METHODS In this prospective randomized study, we measured the effect of mild hypothermic (32 °C, N.=30) vs. normothermic (37 °C, N.=30) CPB on neurocognitive function. All patients underwent elective isolated biological AVR (mean age 67 ± 8 years, mean additional EuroSCORE 5.6 ± 2.4). Neurocognitive function was objectively measured by means of objective P300 auditory-evoked potentials before surgery, one week and four months after surgery. Clinical data and outcome were monitored. RESULTS P300 evoked potentials were comparable between patients operated with mild hypothermic (370 ± 30 ms) and normothermic CPB (373 ± 32 ms) before surgery (P=0.85). P300 peak latencies were prolonged (=impaired) in patients operated with normothermic (402 ± 29, P<0.0001) as well as with mild hypothermic CPB (405 ± 30 ms, P<0.0001) one week after surgery. Even four months after surgery, still impairment of P300 peak latencies could be documented in either patients operated with normothermic (394 ± 28 ms) and mild hypothermic CPB (400 ± 33 ms,) in repeated measures analysis of variance (P=0.042). Group comparison revealed no difference between patients operated with normothermic and mild hypothermic CPB at one week (P=0.54) and four months (P=0.67) after surgery. Clinical data as well as postoperative adverse events were comparable between the two groups. CONCLUSION Normothermic temperature management during CPB is non-inferior to hypothermic in means of neuroprotection. Since patients after biological aortic valve replacement show a subclinical but measurable cognitive deficit up to four months after surgery, other factors have to be addressed to add further benefit to the extremely good results of open biological AVR.
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Affiliation(s)
- R Fakin
- Division of General Thoracic Surgery, University Hospital Bern, University of Bern, Bern, Switzerland
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Megiorni F, Pizzuti A, Mora B, Rizzuti A, Garelli V, Maxia C, Carlesimo M, Fotruna M, Delle Chiaie R, Cavaggioni G, Rossi A. Genetic association of
HLA‐DQB1
and
HLA‐DRB1
polymorphisms with alopecia areata in the Italian population. Br J Dermatol 2011; 165:823-7. [DOI: 10.1111/j.1365-2133.2011.10466.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
| | | | - B. Mora
- Departments of Experimental Medicine,
| | | | - V. Garelli
- Internal Medicine and Medical Specialities,
| | - C. Maxia
- Internal Medicine and Medical Specialities,
| | | | | | | | - G. Cavaggioni
- U.O.D. Psychotherapy – Department of Neurology and Psychiatry NPD03, ‘Sapienza’ University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - A. Rossi
- Internal Medicine and Medical Specialities,
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Mora B, Base E, Andreas M, Schmid W, Weber U, Junreitmaier M, Foerster F, Hiesmayr M, Tschernich H. O-34 Frequency of gastrointestinal lesions with transoesophageal echocardiography in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth 2011. [DOI: 10.1053/j.jvca.2011.03.047] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mora B, Ince I, Birkenberg B, Skhirtladze K, Pernicka E, Ankersmit HJ, Dworschak M. Validation of cardiac output measurement with the LiDCOTM pulse contour system in patients with impaired left ventricular function after cardiac surgery*. Anaesthesia 2011; 66:675-81. [DOI: 10.1111/j.1365-2044.2011.06754.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mora B, Curti E, Vittadini E, Barbanti D. Effect of different air/steam convection cooking methods on turkey breast meat: physical characterization, water status and sensory properties. Meat Sci 2011; 88:489-97. [PMID: 21356579 DOI: 10.1016/j.meatsci.2011.01.033] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 01/24/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022]
Abstract
Turkey breast samples were cooked using a forced convection oven at three relative humidity levels (RH=8, 35 and 88%) at 100°C. Cooking parameters (temperature, cook value, and yield), textural and sensory properties as well as water status of the samples were evaluated. The application of different RH levels resulted in different cooking performances and cooked meat quality. Low steam cooking conditions (RH=35%) significantly increased cooking yield (7% higher than the high steam cooking), moisture content and water-holding capacity and had a positive effect on perceived tenderness, as shown by sensory analysis, where steam cooked samples were perceived as the most tender. The more mobile protons of (1)H T(2) (relaxing at times longer than 1s) in low steam samples were related to the higher perceived tenderness. Low steam cooking allowed for less water consumption, making this process an attractive cooking method as compared to high steam, as it also resulted in higher quality cooked turkey meat.
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Affiliation(s)
- B Mora
- Dipartimento di Ingegneria Industriale, Università degli Studi di Parma, Viale G.P. Usberti 181/A, 43124 Parma, Italy.
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Pabari PA, Kyriacou A, Moraldo M, Unsworth B, Baruah R, Sutaria N, Hughes A, Mayet J, Francis DP, Uejima T, Loboz K, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evangelista A, Leftheriotis G, Fraser AG, Kiotsekoglou A, Govindan M, Govind SC, Saha SK, Camm AJ, Azcarate PM, Castano S, Rodriguez-Manero M, Arraiza M, Levy B, Barba J, Rabago G, Bastarrika G, Nemes A, Takacs R, Varkonyi T, Gavaller H, Baczko I, Forster T, Wittmann T, Papp JG, Lengyel C, Varro A, Tumasyan LR, Adamyan KG, Savu O, Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Versiero M, Galderisi M, Esposito R, Rapacciuolo A, Esposito G, Raia R, Morgillo T, Piscione F, De Simone G, Oraby MA, Maklady FA, Mohamed EM, Eraki AZ, Zaliaduonyte-Peksiene D, Tamuleviciute E, Janenaite J, Marcinkeviciene J, Mizariene V, Bucyte S, Vaskelyte J, Trifunovic D, Nedeljkovic I, Popovic D, Ostojic M, Vujisic-Tesic B, Petrovic M, Stankovic S, Sobic-Saranovic D, Banovic M, Dikic-Djordjevic A, Savino K, Lilli A, Grikstaite E, Giglio V, Bordoni E, Maragoni G, Cavallini C, Ambrosio G, Nedeljkovic I, Ostojic M, Vujisic-Tesic B, Jakovljevic B, Petrovic M, Trifunovic D, Beleslin B, Nedeljkovic M, Banovic M, Petrovic O, Moral S, Rodriguez-Palomares J, Descalzo M, Marti G, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Evangelista A, Garcia-Dorado D, Schnell F, Donal E, Thebault C, Bernard A, Corbineau H, Le Breton H, Kochanowski J, Scislo P, Piatkowski R, Roik M, Marchel M, Kosior D, Opolski G, Lesniak-Sobelga AM, Wicher-Muniak E, Kostkiewicz M, Olszowska M, Suchon E, Klimeczek P, Banys P, Pasowicz M, Tracz W, Podolec P, Moral S, Rodriguez-Palomares J, Descalzo M, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Laynez A, Evangelista A, Garcia-Dorado D, Hoefsten DE, Loegstrup BB, Norager B, Moller JE, Flyvbjerg A, Egstrup K, Streb W, Szulik M, Nowak J, Markowicz-Pawlus E, Duszanska A, Sedkowska A, Kalarus Z, Kukulski T, Spinelli L, Morisco C, Assante Di Panzillo E, Buono F, Crispo S, Trimarco B, Oraby MA, Hawary AA, Nasr GM, Fawzy MM, Faber L, Scholtz W, Boergermann J, Wiemer M, Kleikamp G, Bogunovic N, Dimitriadis Z, Gummert J, Hering D, Horstkotte D, Luca' F, Gelsomino S, Lorusso R, Caciolli S, Carella R, Bille' G, De Cicco G, Pazzagli V, Gensini GF, Borowiec A, Dabrowski R, Janas J, Kraska A, Firek B, Kowalik I, Szwed H, Marcus KA, De Korte CL, Feuth T, Thijssen JM, Kapusta L, Dahl J, Videbaek L, Poulsen MK, Pellikka PA, Veien K, Andersen LI, Haghfelt T, Moller JE, Haberka M, Mizia - Stec K, Adamczyk T, Mizia M, Chmiel A, Pysz P, Sosnowski M, Gasior Z, Trusz - Gluza M, Tendera M, Niklewski T, Wilczek K, Chodor P, Podolecki T, Frycz-Kurek A, Kukulski T, Kalarus Z, Zembala M, Yurdakul S, Yildirimturk O, Tayyareci Y, Memic K, Demiroglu ICC, Aytekin S, Garcia Alonso CJ, Ferrer Sistach E, Delgado L, Lopez Ayerbe J, Vallejo Camazon N, Gual Capllonch F, Espriu Simon M, Ruyra X, Caballero Parrilla A, Bayes Genis A, Lecuyer L, Berrebi A, Florens E, Noghin M, Huerre C, Achouh P, Zegdi R, Fabiani JN, De Chiara B, Moreo A, Musca F, De Marco F, Lobiati E, Belli O, Mauri F, Klugmann S, Caballero A, Vallejo N, Gonzalez Guardia A, Nunez Aragon R, Bosch C, Lopez Ayerbe J, Ferrer E, Pedro Botet ML, Gual F, Bayes Genis A, Cusma-Piccione M, Zito C, Oreto G, Giuffre R, Todaro MC, Barbaro CM, Lanteri S, Longordo C, Salvia J, Carerj S, Bensaid A, Gallet R, Fougeres E, Lim P, Nahum J, Deux JF, Gueret P, Teiger E, Dubois-Rande JL, Monin JL, Yurdakul S, Tayyareci Y, Yildirimturk O, Behramoglu F, Colakoglu Z, Aytekin V, Demiroglu C, Aytekin S, Gargani L, Poggianti E, Bucalo R, Rizzo M, Agrusta F, Landi P, Sicari R, Picano E, Sutandar A, Siswanto BB, Irmalita I, Harimurti G, Hayashi SY, Nascimento MM, Lindholm B, Lind B, Seeberger A, Nowak J, Pachaly MA, Riella MC, Bjallmark A, Brodin LA, Poanta L, Porojan M, Dumitrascu DL, Ikonomidis I, Tzortzis S, Lekakis J, Kremastinos DT, Paraskevaidis I, Andreadou I, Nikolaou M, Katsibri P, Anastasiou-Nana M, Maceira Gonzalez AM, Ripoll C, Cosin-Sales J, Igual B, Salazar J, Belloch V, Cosin-Aguilar J, Pennell DJ, Masaki M, Pulido JN, Yuasa T, Gillespie S, Afessa B, Brown DR, Mankad SV, Oh JK, Gurghean AL, Mihailescu AM, Tudor I, Homentcovschi C, Muraru M, Bruckner IV, Correia CE, Rodrigues B, Moreira D, Santos LF, Gama P, Dionisio O, Cabral C, Santos O, Bombardini T, Gherardi S, Arpesella G, Valente S, Calamai I, Pasanisi E, Sansoni S, Picano E, Szymanski P, Dobrowolski P, Lipczynska M, Klisiewicz A, Hoffman P, Stepowski D, Kurtz B, Grezis-Soulie G, Savoure A, Anselme F, Bauer F, Castillo J, Herszkowicz N, Ferreira C, Goscinska A, Mizia-Stec K, Gasior Z, Mizia M, Haberka M, Chmiel A, Poborski W, Azevedo O, Quelhas I, Guardado J, Fernandes M, Miranda CS, Gaspar P, Lourenco A, Medeiros R, Almeida J, L Bennani S, Algalarrondo V, Dinanian S, Guiader J, Juin C, Adams D, Slama MS, Onaindia JJ, Quintana O, Velasco S, Astigarraga E, Cacicedo A, Gonzalez J, Rodriguez I, Sadaba M, Eneriz M, Laraudogoitia Zaldumbide E, Nunez-Gil I, Luaces M, Zamorano J, Garcia Rubira JC, Vivas D, Ibanez B, Marcos Alberca P, Fernandez Golfin C, Alonso J, Macaya C, Silva Marques J, Almeida AG, Carvalho V, Jorge C, Silva D, Gato Varela M, Martins S, Brito D, Lopes MG, Tripodi E, Miserrafiti B, Montemurro V, Scali R, Tripodi P, Marchel M, Kochanowski J, Piatkowski R, Scislo P, Winkler A, Madej A, Hausmanowa-Petrusewicz I, Opolski G, Fijalkowski M, Koprowski A, Jaguszewski M, Galaska R, Taszner M, Rynkiewicz A, Citro R, Rigo F, Provenza G, Ciampi Q, Patella MM, D'andrea A, Antonini-Canterin F, Vriz O, Astarita C, Bossone E, Heggemann F, Walter TH, Kaelsch TH, Sueselbeck T, Papavassiliu TH, Borggrefe M, Haghi D, Monk-Hansen T, Have Dall C, Bisgaard Christensen S, Snoer M, Gustafsson F, Rasmusen H, Prescott E, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Di Lenarda A, Bussani R, Sinagra G, Butz T, Faber L, Lang CN, Meissner A, Plehn G, Yeni H, Langer C, Horstkotte D, Trappe HJ, Gu X, Gu XY, He YH, Li ZA, Han JC, Chen J, Gaudron P, Niemann M, Herrmann S, Hu K, Bijnens B, Hillenbrand H, Beer M, Ertl G, Weidemann F, Mazzone A, Mariani M, Foffa I, Vianello A, Del Ry S, Bevilacqua S, Andreassi MG, Glauber M, Berti S, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Roik M, Postula M, Marchel M, Kosior D, Opolski G, Dragulescu A, Van Arsdell G, Al-Radi O, Caldarone C, Mertens L, Lee KJ, Unsworth B, Casula RP, Yadav H, Baruah R, Cherian A, Sutaria N, Hughes AD, Mayet J, Francis DP, Vitarelli A, D'orazio S, Nguyen BL, Iorio G, Battaglia D, Caranci F, Padella V, Capotosto L, Alessandroni L, Barilla F, Cardin C, Hascoet S, Saudron M, Caudron G, Arnaudis B, Acar P, Sun MM, Shu XH, Pan CZ, Fang XY, Kong DH, Fang F, Zhang Q, Chan YS, Xie JM, Yip WK, Lam YY, Sanderson JE, Yu CM, Rosca M, O' Connor K, Romano G, Magne J, Calin A, Popescu BA, Muraru D, Pierard L, Ginghina C, Lancellotti P, Roushdy A, Elfiky I, El Shahid G, Elfiky A, El Sayed M, Wierzbowska-Drabik K, Chrzanowski L, Kapusta A, Plonska-Goscinak E, Krzeminska-Pakula M, Kurpesa M, Rechcinski T, Trzos E, Kasprzak JD, Ersboll MK, Valeur N, Mogensen UM, Andersen M, Moller JE, Hassager C, Sogaard P, Kober LV, Kloeckner M, Hayat D, Nahum J, Dussault C, Lellouche N, Elbaz N, Dubois-Rande JL, Gueret P, Lim P, Demopoulos A, Hatzigeorgiou G, Leontiades E, Motsi A, Karatasakis G, Athanassopoulos G, Zycinski P, Chrzanowski L, Wierzbowska-Drabik K, Kasprzak J, Vazquez Alvarez MC, Medrano Lopez C, Camino Lopez M, Granja S, Zunzunegui Martinez JL, Maroto Alvaro E, Tsai WC, Chen JY, Liu YW, Lin CC, Tsai LM, Silva Marques J, Gomes DC, Robalo Martins S, Gois MR, Ribeiro S, Nunes Diogo A, Almeida AG, Lopes MG, Zito C, Sengupta P, Di Bella G, Cusma-Piccione M, Oreto G, Caracciolo G, Longordo C, Lentini S, Carerj S, Kinova E, Zlatareva N, Goudev A, Papagiannis N, Mpouki M, Papagianni A, Vorria M, Mpenetos G, Lytra D, Papadopoulou E, Sgourakis P, Malakos J, Kyriazis J, Saha SK, Kodali V, Toole R, Govind SC, Kiotsekoglou A, Gopal AS, Celutkiene J, Rudys A, Grabauskiene V, Glaveckaite S, Sadauskiene E, Lileikiene Z, Bickauskaite N, Ciburiene E, Skorniakov V, Laucevicius A, Attenhofer Jost CH, Pfyffer M, Lindquist R, Santos JLF, Coelho ORC, Mady CM, Picard MHP, Salemi VMC, Funk L, Butz T, Lang CN, Prull MW, Plehn G, Yeni H, Meissner A, Trappe HJ, Tsai WC, Liu YW, Shih JY, Lin CC, Huang YY, Tsai LM, Lancellotti P, Donal E, Magne J, O'connor K, Moonen M, Pierard LA, Cozma DC, Mornos C, Ionac A, Petrescu L, Dragulescu D, Dan R, Popescu I, Dragulescu SI, Von Lueder TG, Hodt A, Gjerdalen GF, Andersen TE, Solberg EE, Steine K, Savu O, Van Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Rostek M, Pikto-Pietkiewicz W, Dluzniewski M, Antoniewicz A, Poletajew S, Borowka A, Pasierski T, Malyutina SK, Ryabikov M, Ragino J, Ryabikov A, Sitia S, Tomasoni L, Atzeni F, Gianturco L, Sarzi-Puttini P, De Gennaro Colonna V, Turiel M, Uejima T, Loboz K, Vriz O, Polombo C, Carerj S, Hughes A, Vinereanu D, Gutierrez FR, Lefhtheriotis G, Fraser AG, Hurst RT, Nelson MR, Mookadam F, Thota V, Emani U, Al Harthi M, Stepanek J, Cha S, Lester SJ, Ho EMM, Hemeryck L, Hall M, Scott K, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Santos L, Cortez-Dias N, Silva D, Silva Marques J, Ribeiro S, Goncalves S, Almeida Ribeiro M, Robalo Martins S, Bordalo E Sa A, Lopes MG, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Magnino C, Marcos-Alberca P, Milan A, Nunez-Gil I, Almeria C, Caniadas V, Rodrigo JL, Perez De Isla L, Macaya C, Zamorano JL, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, Brodin L, Waldenstrom A, Roosens B, Hernot S, Droogmans S, Van Camp G, Lahoutte T, Lancellotti P, Cosyns B, Ho EMM, Scott K, Hemeryck L, Hall M, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Rao CM, Aguglia D, Casciola G, Imbesi C, Marvelli A, Sgro M, Benedetto D, Tripepi R, Zoccali C, Benedetto FA, Muraru D, Badano LP, Cardillo M, Del Mestre L, Gianfagna P, Proclemer A, Tschernich HD, Mora B, Base E, Weber U, Dumfarth J, Mukherjee C, Skaltsiotis HS, Kaladaridis AK, Bramos DB, Kottis GK, Antoniou AA, Agrios IA, Takos DT, Vasiladiotis NV, Pamboucas KP, Toumanidis STT, Shim A, Kasprzak JD, Lipec P, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Cameli M, Lisi M, Padeletti M, Bigio E, Bernazzali S, Tsoulpas C, Maccherini M, Henein M, Mondillo S, Garcia Lunar I, Mingo Santos S, Monivas Palomero V, Mitroi C, Beltran Correas P, Ruiz Bautista L, Muniz Lozano A, Gonzalez Gonzalez M, Pabari PA, Stegemann B, Willson K, Kyriacou A, Moraldo M, Mayet J, Hughes A, Francis DP, Zeppellini R, Iavernaro A, Zadro M, Carasi M, De Domenico R, Rigo T, Artuso E, Erente G, Ramondo A, Le TT, Huang FQ, Gu Y, Tan RS. Poster session II * Thursday 9 December 2010, 14:00-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Mora B, Base E, Schmid W, Andreas M, Weber U, Junreitmaier M, Foerster F, Hiesmayr M, Tschernich HD, Guldbrand D, Goetzsche O, Eika B, Fumagalli S, Francini S, Gabbai D, Pedri S, Casalone Rinaldi M, Makhanian Y, Sollami R, Tarantini F, Marchionni N, Azcarate PM, Castano S, Rodriguez-Manero M, Arraiza M, Levy B, Barba J, Rabago G, Bastarrika G, Rus H, Radoi M, Ciurea C, Boda D, Erdei T, Denes M, Mihalcz A, Kardos A, Foldesi CS, Temesvari A, Lengyel M, Cameli M, Lisi M, Righini F, Ballo P, Henein M, Mondillo S, Nistri S, Galderisi M, Ballo PC, Pagliani L, Olivotto I, Santoro A, Papesso B, Innelli P, Cecchi F, Mondillo S, Hristova K, Katova TZ, Kostova V, Simova Y, Nesheva N, Ivanovic B, Tadic MT, Simic DS, Rao CM, Aguglia D, Casciola G, Imbesi C, Marvelli A, Sgro M, Benedetto D, Tripepi G, Zoccali C, Benedetto FA, Mantziari L, Kamperidis V, Damvopoulou E, Ventoulis I, Giannakoulas G, Paraskevaidis S, Vassilikos V, Karvounis H, Styliadis IH, Sonder TK, Loegstrup BB, Lambrechtsen J, Van Bortel LM, Segers P, Egstrup K, Tho A, Moceri P, Bertora D, Gibelin P, Cho EJ, Choi KY, Kim BJ, Kim DB, Jang SW, Park CS, Jung HO, Jeon HK, Youn HJ, Kim JH, Donal E, Coquerel N, Bodi S, Thebault C, Kervio G, Carre F, Daly MJ, Fairley SL, Doherty R, Ashfield K, Kirkpatrick R, Smith B, Buchanan J, Hill L, Dixon LJ, Rosca M, O' Connor K, Magne J, Romano G, Calin A, Popescu BA, Beladan CC, Pierard L, Ginghina C, Lancellotti P, Bochenek T, Wita K, Tabor Z, Grabka M, Elzbieciak M, Trusz-Gluza M, Moreau O, Thebault C, Kervio G, Leclercq C, Donal E, Sahlen A, Shahgaldi K, Aminoff A, Aagaard P, Manouras A, Winter R, Ehrenborg E, Braunschweig F, Bedetti G, Gargani L, Pizzi C, Sicari R, Picano E, Ballo P, Nistri S, Innelli P, Galderisi M, Mondillo S, Zhang J, Zhang HB, Duan YY, Chen LL, Li J, Liu LW, Zhu T, Li HL, Su HL, Zhou XD, Ruiz Ortiz M, Mesa Rubio D, Delgado Ortega M, Romo Penas E, Toledano Degado F, Leon Del Pino C, Lopez Aguilera J, Villanueva Fernandez E, Cejudo Diaz Del Campo L, Suarez De Lezo J, Abergel E, Simon M, Dehant P, Bogino E, Jimenez M, Verdier JC, Chauvel C, Albertsen AE, Nielsen JC, Mortensen PT, Egeblad H, Nasr GM, Tawfik S, Omar A, Olofsson M, Boman K, Sonder TK, Loegstrup BB, Lambrechtsen J, Segers P, Van Bortel LM, Egstrup K, Rezzoug N, Vaes B, Degryse J, Vanoverschelde JL, Pasquet AA, Poggio D, Bonadies M, Pacher V, Mazzetti S, Grillo M, D'elia E, Khouri T, Specchia G, Mornos C, Rusinaru D, Cozma D, Ionac A, Petrescu L, Rotzak R, Rosenman Y, Patterson RD, Ratnatheepan S, Bogle RG, Goebel B, Gjesdal O, Kottke D, Otto S, Jung C, Edvardsen T, Figulla HR, Poerner TC, Otsuka T, Suzuki M, Yoshikawa H, Hashimoto G, Itou N, Ono T, Yamamoto M, Osaki T, Tsuchida T, Sugi K, Wolber T, Haegeli L, Huerlimann D, Brunckhorst C, Duru F, Wu ZM, Shu XH, Dong LL, Fan B, Ge JB, Greutmann M, Tobler D, Biaggi P, Mah M, Crean A, Oechslin EN, Silversides CK, Ivanovic B, Tadic MT, Simic DS, Giusca S, Jurcut R, Ghiorghiu I, Coman IM, Popescu BA, Amzulescu M, Ionescu R, Delcroix M, Voigt JU, Ginghina C, Piatkowski R, Kochanowski J, Scislo P, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Maceira Gonzalez AM, Cosin-Sales J, Dalli E, Igual B, Monmeneu JV, Lopez-Lereu P, Estornell J, Ruvira J, Sotillo J, Stevanovic A, Toncev A, Dimkovic S, Dekleva M, Paunovic N, Toncev D, Sekularac N, Yildirimturk O, Helvacioglu FF, Tayyareci Y, Yurdakul S, Demiroglu ICC, Aytekin S, Pinedo Gago M, Amat Santos I, Revilla Orodea A, Lopez Diaz J, Arnold R, De La Fuente Galan L, Recio Platero A, Gomez Salvador I, Puerto Sanz A, San Roman Calvar JA, Yotti R, Bermejo J, Mombiela T, Benito Y, Sanchez PL, Solis J, Prieto R, Fernandez-Aviles F, Zilberszac R, Gabriel H, Graf S, Mundigler G, Maurer G, Rosenhek R, Zito C, Salvia J, Longordo C, Donato D, Alati E, Miceli M, Pardeo A, Arcidiaco S, Oreto G, Carerj S, Kamperidis V, Hadjimiltiades S, Sianos G, Anastasiadis K, Grosomanidis V, Efthimiadis G, Karvounis H, Parcharidis G, Styliadis IH, Yousry M, Rickenlund A, Petrini J, Gustafsson T, Liska J, Hamsten A, Eriksson P, Franco-Cereceda A, Eriksson MJ, Caidahl K, Mizia-Stec K, Pysz P, Jasinski M, Drzewiecka-Gerber A, Krejca M, Bochenek A, Wos S, Gasior Z, Trusz-Gluza M, Tendera M, Yildirimturk O, Helvacioglu FF, Tayyareci Y, Yurdakul S, Demiroglu ICC, Aytekin S, Niki K, Sugawara M, Takamisawa I, Watanabe H, Sumiyoshi T, Hosoda S, Ida T, Takanashi S, Olsen NT, Sogaard P, Jons C, Mogelvang R, Larsson HBW, Goetze JP, Nielsen OW, Fritz-Hansen T, Sayar N, Orhan AL, Erer HB, Eren M, Atmaca H, Yilmaz HY, Cakmak N, Altay S, Terzi S, Yesilcimen K, Garcia Orta R, Moreno E, Lopez M, Uribe I, Vidal M, Ruiz-Lopez MF, Gonzalez-Molina M, Oyonarte JM, Lopez S, Azpitarte J, Szymanski C, Levine RA, Zheng H, Handschumacher MD, Tawakol A, Hung J, Le Ven F, Etienne Y, Jobic Y, Frachon I, Castellant P, Fatemi M, Blanc JJ, Rusinaru D, Tribouilloy C, Grigioni F, Avierinos JF, Barbieri A, Buiciuc O, Enriquez-Sarano M, Said K, Farag AK, El-Ramly M, Rizk H, Iorio A, Pinamonti B, Bobbo M, Merlo M, Massa L, Faganello G, Di Lenarda A, Sinagra G, Margato R, Ribeiro H, Ferreira C, Matias A, Fontes P, Moreira JI, Milan A, Puglisi E, Magnino C, Fabbri A, Leone D, Vairo A, Crudo V, Iannaccone A, Milazzo V, Veglio F, Maroz-Vadalazhskaya N, Ostrovskiy I, Zito C, Imbalzano E, Saitta A, Oreto G, Cusma-Piccione M, Di Bella G, Nava R, Ferro M, Falanga G, Carerj S, Frigy A, Buzogany J, Szabados CS, Dan L, Carasca E, Ikonomidis I, Lekakis J, Tzortzis S, Kremastinos DT, Papadopoulos C, Paraskevaidis I, Triantafyllidi H, Trivilou P, Venetsanou K, Anastasiou-Nana M, Wierzbowska-Drabik K, Kurpesa M, Trzos E, Rechcinski T, Mozdzan M, Kasprzak JD, Kosmala W, Kotwica T, Przewlocka-Kosmala M, Mysiak A, Skultetyova D, Filipova S, Chnupa P, Mantziari L, Pechlivanidis G, Giannakoulas G, Dimitroula H, Karvounis H, Styliadis IH, Milan A, Puglisi E, Magnino C, Fabbri A, Leone D, Vairo A, Iannaccone A, Crudo V, Milazzo V, Veglio F, Tsai WC, Liu YW, Lin CC, Huang YY, Tsai LM, Park SM, Kim YH, Shin SM, Shim WJ, Gonzalez Mansilla A, Torres Macho J, Sanchez Sanchez V, Diez P, Delgado J, Borruel S, Saenz De La Calzada C, Pyxaras S, Valentincic M, Barbati G, Lo Giudice F, Perkan A, Magnani S, Merlo M, Pinamonti B, Sinagra G, Palecek T, Ambroz D, Jansa P, Lindner J, Vitovec M, Polacek P, Jiratova K, Linhart A, Baskurt M, Dogan GM, Abaci O, Kaya A, Kucukoglu S, Duszanska A, Kukulski T, Skoczylas I, Majsnerowska A, Nowowiejska-Wiewiora A, Streb W, Szulik M, Polonski L, Kalarus Z, Yerly PO, Prella M, Joly A, Nicod L, Aubert JD, Aebischer N, Dores H, Leal S, Rosario I, Correia MJ, Monge J, Grilo AM, Arroja I, Fonseca C, Aleixo A, Silva A, Perez-David E, Sanchez-Alegre M, Yotti R, Gomez Anta I, De La Torre J, Alarcon J, Garcia Robles JA, Lafuente J, Bermejo J, Fernandez-Aviles F, Garcia Alonso CJ, Vallejo Camazon N, Gonzalez Guardia A, Nunez R, Bosch Carabante C, Mateu L, Gual Capllonch F, Ferrer Sistach E, Lopez Ayerbe J, Bayes Genis A, Tomaszewski A, Kutarski A, Tomaszewski M, Bramos D, Kalantaridou A, Takos D, Skaltsiotis E, Trika C, Tsirikos N, Pamboukas C, Kottis G, Toumanidis S, Aggeli C, Felekos I, Roussakis G, Kazazaki C, Lampropoulos K, Lagoudakou S, Stergiou C, Pitsavos C, Stefanadis C, Kihara C, Murata K, Wada Y, Tanaka T, Uchida K, Okuda S, Susa T, Matsuzaki M, Shahgaldi K, Manouras A, Abrahamsson A, Gudmundsson P, Brodin L, Winter R, Knebel F, Schattke S, Sanad W, Schimke I, Schroeckh S, Brechtel L, Lock J, Makauskiene R, Baumann G, Borges AC, Moelmen-Hansen HE, Wisloff U, Aamot IL, Stoylen A, Ingul CB, Estensen ME, Beitnes JO, Grindheim G, Henriksen T, Aaberge L, Smiseth OA, Gullestad L, Aakhus S, Gargani L, Agoston G, Moggi Pignone A, Capati E, Badano L, Moreo A, Bombardieri S, Varga A, Sicari R, Picano E, Carrideo M, Faricelli S, Corazzini A, Ippedico R, Ruggieri B, Di Blasio A, D'angelo E, Di Baldassarre A, Ripari P, Gallina S, Kentrschynskyj A, Rickenlund A, Caidahl K, Hylander B, Jacobson S, Pagels A, Eriksson MJ, Dumitrescu SI, Tintoiu I, Greere V, Cristian G, Chiriac L, Pinte F, Droc I, Neagoe G, Stanciu S, Voicu VA, Kuch-Wocial A, Pruszczyk P, Szmigielski CA, Szulc M, Styczynski G, Sinski M, Kaczynska A, Ryabikov A, Malyutina S, Halcox J, Bobak M, Nikitin YU, Marmot M, Barbosa D, Kiss G, Orderud F, Amundsen B, Jasaityte R, Loeckx D, Claus P, Torp H, D'hooge J, Kuhl JT, Lonborg J, Fuchs A, Andersen M, Vejlstrup N, Engstrom T, Moller JE, Kofoed KF, Smith LA, Bhan A, Paul M, Monaghan MJ, Zaborska B, Stec S, Sikora-Frac M, Krynski T, Kulakowski P, Pushparajah K, Dashwood D, Barlow A, Nugent K, Miller O, Simpson J, Valeur N, Ersboll MK, Kjaergaard J, Greibe R, Risum N, Hassager C, Sogaard P, Kober L, Sahlen A, Manouras A, Shahgaldi K, Winter R, Brodin L, Popovic D, Nedeljkovic I, Petrovic M, Vujisic-Tesic B, Arandjelovic A, Stojiljkovic S, Stojiljkovic S, Jakovljevic B, Damjanovic S, Ostojic M, Agrios IA, Bramos DB, Skaltsiotis HS, Takos DT, Kaladaridis A, Vasiladiotis NV, Kottis GK, Antoniou AA, Pamboucas CP, Toumanidis STT, Locorotondo G, Porto I, Paraggio L, Fedele E, Barchetta S, De Caterina AR, Rebuzzi AG, Crea F, Galiuto L, Lipiec P, Szymczyk E, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Shim A, Kasprzak JD, Vainer J, Habets J, Lousberg A, Pont De C, Waltenberger J, Farouk H, Heshmat H, Adel A, El Chilali K, Baghdady Y, Sorour K, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, A'roch R, Haney M, Waldenstrom A, Mladenovic Z, Tavciovski D, Mijailovic Z, Djordjevic - Dikic A, Obradovic S, Matunovic R, Jovic Z, Djuric P, Torp H, Aase S, Dalen H, Sarkola T, Redington AN, Keeley F, Bradley T, Jaeggi E, Sahlen H, Winter R, Brodin L, Sahlen A, Olsen NT, Risum N, Jons C, Mogelvang R, Valeur N, Fritz-Hansen T, Sogaard P. Poster session IV * Friday 10 December 2010, 14:00-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Skhirtladze K, Mora B, Moritz A, Birkenberg B, Ankersmit HJ, Dworschak M. Impaired recovery of cardiac output and mean arterial pressure after successful defibrillation in patients with low left ventricular ejection fraction. Resuscitation 2010; 81:1123-7. [DOI: 10.1016/j.resuscitation.2010.06.004] [Citation(s) in RCA: 14] [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] [Received: 03/08/2010] [Revised: 05/25/2010] [Accepted: 06/03/2010] [Indexed: 11/30/2022]
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González R, Castro P, García F, Plana M, Bayas JM, Lafuente S, Serrano B, Mora B, Argelich R, Gatell JM, Vilella A. Effects of highly active antiretroviral therapy on vaccine-induced humoral immunity in HIV-infected adults. HIV Med 2010; 11:535-9. [PMID: 20408890 DOI: 10.1111/j.1468-1293.2010.00830.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The acquisition of adequate vaccine-induced humoral immunity is especially important in HIV-infected individuals, who are at increased risk of infections. The aim of the study was to assess the safety of administering a complete vaccination programme to successfully treated HIV-infected adults and to evaluate specific humoral responses and the effect of highly active antiretroviral therapy (HAART) interruption on these responses. METHODS A placebo-controlled, double-blind clinical trial was designed and 26 HIV-infected adults enrolled. Study participants were randomized to receive either a complete immunization schedule with commercial vaccines or placebo for 12 months. HAART was then discontinued for 6 months. Specific humoral responses were evaluated at baseline, at month 12 and after HAART interruption and compared between groups. RESULTS There were neither local nor systemic secondary effects related to vaccination. Specific humoral responses to vaccines were adequate, but a loss of immunoglobulin G titres was observed after HAART interruption in 12 study participants. CONCLUSIONS HAART interruption may cause impairment of previously acquired vaccine-induced immunity in HIV-infected adults.
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Affiliation(s)
- R González
- Preventive Medicine and Epidemiology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
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Iannuzzi E, Iannuzzi M, Mora B, Sidro L, Berrino L, Chiefari M, Tufano R. Relationship between A-line Autoregressive Index, Spectral Entropy and steady state predicted site-effect effective concentrations at 05-50-95 of propofol at different clinical endpoints. Minerva Anestesiol 2009; 75:692-697. [PMID: 19940821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM Target controlled infusion intravenous anesthesia is a growing phenomenon. Nowadays, many anesthesiologists feel the need to monitor depth of anesthesia during total intravenous anesthesia, even though it is not a standard technique worldwide. Spectral Entropy (SE) is a relatively new depth of anesthesia index. The aim of this study was to investigate whether predicted site-effect propofol concentrations, A-line Autoregressive Index (AAI) and SE values are useful for predicting loss of verbal contact (LVC) and loss of consciousness (LOC) during steady-state conditions. METHODS Forty-four patients scheduled for elective major abdominal surgery were recruited. All patients were unpremedicated. A target controlled infusion of propofol was administered using Schnider's pharmacokinetic model. The initial propofol infusion provided a site-effect concentration of 1.0 mcg mL-1, and was increased stepwise by 1.0 mcg mL-1 every 4 minutes until the concentration reached 6.0 mcg mL-1. A 4 minute interval was chosen to assure that steady state site-effect concentrations were obtained. AAI, SE and propofol site-effect concentrations were recorded when LVC occurred and also when LOC occurred. Population values for predicted site-effect concentrations at the clinical endpoints were estimated and correlated with AAI and SE values. RESULTS In our study for LOC the effect-site concentration to include 90% of patients was 5.85 ?mcg mL-1 (5.70-5.90) and 3.4 mcg mL-1 (3.24-3.60) for LVC. In this study, 90% of patients lost verbal contact at an AAI value of 68 (64.6-71.4) and an SE value of 68.2 (66.2-70.2). LOC occurred in 90% of patients at an AAI value of 39.2 (37.2-41.1) and an SE value of 40.2 (38.1-41.3). CONCLUSIONS LOC and LVC occur within a defined range of predicted site-effect concentrations. More emphasis should be given to site-effect concentrations. SE and AAI have similar values at different endpoints and similar correlation with Ceprop. AAI and SE are both useful tools in predicting both LVC and LOC.
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Affiliation(s)
- E Iannuzzi
- Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy.
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Weber U, Reitinger A, Szusz R, Hellmich C, Steinlechner B, Hager H, Mora B, Selzer M, Hiesmayr M, Kober A. Emergency ambulance transport induces stress in patients with acute coronary syndrome. Emerg Med J 2009; 26:524-8. [DOI: 10.1136/emj.2008.059212] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mora B, Skhirtladze K, Dworschak M. Severe cerebral desaturation during anterior transapical beating heart aortic valve implantation. Br J Anaesth 2009; 102:891-2. [DOI: 10.1093/bja/aep122] [Citation(s) in RCA: 3] [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: 11/12/2022] Open
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Leon A, Martinez E, Milinkovic A, Mora B, Mallolas J, Blanco JL, Larrousse M, Laguno M, Gallart T, Plana M, Gatell JM, Garcia F. Influence of repeated cycles of structured therapy interruption on the rate of recovery of CD4+ T cells after highly active antiretroviral therapy resumption. J Antimicrob Chemother 2008; 63:184-8. [DOI: 10.1093/jac/dkn461] [Citation(s) in RCA: 5] [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: 11/13/2022] Open
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Mora B, Iannuzzi M, Lang T, Steinlechner B, Barker R, Dobrovits M, Wimmer C, Kober A. Auricular acupressure as a treatment for anxiety before extracorporeal shock wave lithotripsy in the elderly. J Urol 2007; 178:160-4; discussion 164. [PMID: 17499304 DOI: 10.1016/j.juro.2007.03.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE Auricular acupuncture at the relaxation point has been shown to be effective treatment for anxiety. We hypothesized that auricular acupressure may decrease anxiety in elderly individuals who are transported by ambulance before receiving ESWL. MATERIALS AND METHODS We enrolled 100 patients with renal calculi who were transported to the local hospital by special ambulance, accompanied by 2 paramedics. Paramedic 1 performed data collection, while paramedic 2 performed auricular acupressure in patients randomly assigned to a relaxation group and a sham treated group. Anxiety was measured using a visual analog scale score on a scale of 0 to 100 mm. RESULTS Each group consisted of 50 patients with similar demographic characteristics. The relaxation group had significantly decreased anxiety scores upon arrival at the hospital and lower anticipation of pain scores (mean+/-SD 57.6+/-21.8 to 15.4+/-9.8 and 35.7+/-29.7 to 9.5+/-4.1 mm VAS) than the sham treated group (55.5+/-25.9 to 49.8+/-28.9 and 37.7+/-24.1 to 33.8+/-25.2 mm VAS, respectively, 2-way repeated measure ANOVA each p=0.001). Estimated waiting times for treatment did not differ significantly between the 2 groups (5.0+/-2.5 and 5.5+/-2.95, respectively, repeated measures ANOVA p=0.83). The Post-Intervention Anxiety visual analog scale demonstrated the significant superiority of the true treatment group (19.5+/-5.9 and 66.8+/-27.9 mm VAS, respectively, p=0.001). CONCLUSIONS Elderly patients who received auricular acupressure at specific relaxation points while being transported to the hospital were less anxious, anticipated less pain and were more optimistic about the outcome of treatment that they will receive than the sham treated group. These data prove that this is an effective treatment for anxiety that improves the patient overall perception of ESWL.
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Affiliation(s)
- Bruno Mora
- Department of Anesthesia and Intensive Care, Medical University of Vienna, Vienna, Austria
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Steinlechner B, Dworschak M, Birkenberg B, Lang T, Schiferer A, Moritz A, Mora B, Rajek A. Low-dose remifentanil to suppress haemodynamic responses to noxious stimuli in cardiac surgery: a dose-finding study. Br J Anaesth 2007; 98:598-603. [PMID: 17426069 DOI: 10.1093/bja/aem069] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High-dose remifentanil (1-5 microg kg-1 min-1), commonly used for cardiac surgery, has been associated with muscle rigidity, hypotension, bradycardia, and reduced cardiac output. The aim of this study was to determine an optimal lower remifentanil dose, which should be accompanied by fewer adverse events, that still effectively suppresses haemodynamic responses to typical stressful stimuli (i.e. intubation, skin incision, and sternotomy). METHODS Total i.v. anaesthesia consisted of a target-controlled propofol (2 microg ml-1) and a remifentanil infusion. Forty patients were allocated to receive either a constant infusion of remifentanil at 0.1 microg kg-1 min-1 or up-titrations to 0.2, 0.3, or 0.4 microg kg-1 min-1, respectively, 5 min before each stimulus. Subsequently, changes in heart rate and mean arterial blood pressure were recorded for 8 min. Increases exceeding 20% of baseline were considered to be of clinical relevance. Patients who exhibited these alterations were termed responders. RESULTS The number of responders was less with the two higher remifentanil dosages (P<0.05) while propofol target doses could either be kept at the same level or even be reduced without affecting the plane of anaesthesia. Although single phenylephrine bolus had to be applied more frequently in these two groups (P<0.05), no severe haemodynamic depression was observed. CONCLUSIONS Remifentanil at 0.3 and 0.4 microg kg-1 min-1 in combination with a target-controlled propofol infusion in the pre-bypass period is well tolerated. It appears to mitigate potentially hazardous haemodynamic responses from stressful stimuli equally well as higher doses when compared with data from the literature.
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Affiliation(s)
- B Steinlechner
- Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care, University Hospital Vienna, Vienna, Austria.
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Weigl M, Moritz A, Steinlechner B, Schmatzer I, Mora B, Fakin R, Zimpfer D, Ankersmit HJ, Khazen C, Dworschak M. Neuronal Injury After Repeated Brief Cardiac Arrests During Internal Cardioverter Defibrillator Implantation Is Associated With Deterioration of Cognitive Function. Anesth Analg 2006; 103:403-9, table of contents. [PMID: 16861424 DOI: 10.1213/01.ane.0000226088.59744.3e] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To determine the degree of neurocognitive dysfunction after placement of internal cardioverter defibrillators (ICD) and its relationship to the extent of neuronal injury, we studied 42 patients undergoing ICD (n = 21) or pacemaker (PM) insertion (control patients, n = 21). The Mini Mental State Examination, the Trailmaking A test and the forward and backward Digit Span tests were used and P300 latencies were determined preoperatively and postoperatively. Serum neuron-specific enolase (NSE) was determined before and at the end of, as well as 2, 6, and 24 h after surgery. Preoperatively, PM patients scored worse in the Digit Span backward and the Trailmaking tests and showed prolonged P300 latencies. Postoperatively, the Digit Span backward scores declined and NSE levels increased only in the ICD group (P < or = 0.05). The difference between preoperative and postoperative Digit Span backward scores correlated with the increase in serum NSE levels (r2 = 0.3, P < or = 0.05). Moreover, P300 latencies increased in 13 of 17 ICD patients, but decreased in 7 of 10 PM patients (P < or = 0.05). PM patients even improved in the Trailmaking test (P < or = 0.05). Neuronal injury from even brief periods of global brain ischemia seems to be associated with deteriorating neurocognitive function.
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Affiliation(s)
- Manuela Weigl
- Department of Anesthesiology and General Intensive Care, Division of Cardiothoracic and Vascular Anesthesia and Intensive Care, University Hospital Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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Mora B, Giorni E, Dobrovits M, Barker R, Lang T, Gore C, Kober A. Transcutaneous electrical nerve stimulation: an effective treatment for pain caused by renal colic in emergency care. J Urol 2006; 175:1737-41; discussion 1741. [PMID: 16600745 DOI: 10.1016/s0022-5347(05)00980-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE Acute renal colic is one of the most anguishing forms of pain in humans. We hypothesized that TENS is an effective pain treatment in patients with acute renal colic. MATERIALS AND METHODS A total of 100 patients with acute flank pain and suspected renal colic consented to participate in our study. Paramedic 1 recorded baseline parameters at the emergency site and at the end of transportation. Paramedic 2 performed TENS in patients randomly assigned to G1 with actual TENS or to G2 with sham TENS. Pain and anxiety were measured using paper based visual analog scales on a scale of 0 to 100 mm. RESULTS Of 100 screened patients 73 had renal colic, including 39 in G1 and 34 in G2. There was no significant difference with regard to potentially influencing factors, such as patient age, sex, weight, height, blood pressure and heart rate, pain, nausea and anxiety between the groups before treatment. G1 showed a significant mean pain decrease +/- SD of more than 50% (85.7 +/- 10.5 to 33.3 +/- 16.0 mm, p <0.01). G2 showed no variation in mean pain scores (85.8 +/- 18.0 to 82.6 +/- 14.3 mm). G1 showed changes in the mean anxiety score (69.0 +/- 8.4 to 37.7 +/- 15.1 mm, p <0.01), nausea score (90.7 +/- 9.2 to 44.9 +/- 22.0 mm) and heart rate (92 +/- 10 to 64 +/- 8 bpm), while G2 showed nonsignificant changes. CONCLUSIONS This trial shows that local TENS is a rapid and effective treatment for renal colic pain. We found TENS to be a good nondrug therapy under the difficult circumstances of out of hospital rescue.
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Affiliation(s)
- Bruno Mora
- Department of Anesthesia and Intensive Care, University of Vienna, Vienna, Austria
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Taccari E, Spadaro A, Sorgi ML, Riccieri V, Mora B. [Role for familial and genetic features in the therapeutic response of psoriatic arthritis]. Reumatismo 2004; 56:162-8. [PMID: 15470522 DOI: 10.4081/reumatismo.2004.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AIM OF THE STUDY To analyze PsA patients with and without a familiar distribution for Ps and PsA, in order to better evaluate the genetic data, to verify the existence of different expression of the disease and finally to define the susceptibility to treatment in these patients. MATERIALS AND METHODS 230 PsA patients were selected for familiar or sporadic distribution of the disease and were evaluated for the main clinical, demographic, radiological and laboratory features, as well as for the ongoing treatments. In each patient HLA class I (A,B,C) and II (DRB1, DQB1) antigens were typed with PCR-SSP method while MICA-A exon 5 microsatellite typing was performed by heteroduplex analysis in 122 subjects. RESULTS A familiar distribution for Ps and PsA was found in 68 patients (29.6%) although only two patients had familiarity for PsA. In the familiar PsA group the male prevalence was significantly higher respect to the sporadic one (p<0.001) and the more frequently involved relative was the father (28%). Mean age (p<0.006) and age at onset of Ps (p<0.004) and PsA (p<0.014) were significantly lower in familiar respect to sporadic PsA. Between the two groups no difference was found concerning the articular involvement, the radiological findings, the disease activity (including number of painful/swollen joints), the inflammatory laboratory parameters (including ESR and CRP) and genetic aspects, including the frequencies of MICA-A alleles that were analysed in 30 patients with the familiar form and in 92 with the sporadic one. In the follow-up the therapeutic response to any evaluated treatment adopted for PsA did not show any significant difference in the two groups. All these results were confirmed even when the patients in the two groups were matchable for sex, age and disease duration. CONCLUSION Our results confirm that familiar PsA is characterized by an early onset of the disease and by a male and fatherly predominance respect to the sporadic form, although the clinical-radiologic findings, the genetic typing and the therapeutic response do not permit us to identify any particular subset.
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Affiliation(s)
- E Taccari
- Dipartimento di Clinica e Terapia Medica Applicata, Unità di Reumatologia, Università di Roma, Rome.
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Imperatore F, Diurno F, Passannanti T, Mora B, Romano L, Occhiochiuso L. Bronchoscopic transillumination guidance for open standard surgical tracheostomy. MedGenMed 2003; 5:31. [PMID: 12827092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The standard tracheostomy technique, described in 1909 by Jackson, has been increasingly used in intensive care units. Since 1957, several different types of percutaneous tracheostomy techniques have been described and performed with the support of bronchoscopic transillumination. The authors present the case of a respiratory failure due to obstruction of the upper airway by an exceptionally large goiter, which was successfully resolved by a standard open surgical tracheostomy. In this case, surgical tracheostomy was preceded by bronchoscopic transillumination, which facilitated identification of the appropriate tracheostomy site.
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Affiliation(s)
- Francesco Imperatore
- Unit of Anesthesia and Intensive Care, Department of Emergency, A. Cardarelli Hospital, Naples, Italy
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