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Pujol-Fontrodona G, Domínguez-Roldán JM, Valero R. Organic law regulating euthanasia: knowledge and involvement of doctors in Spain one year after its implementation. Rev Clin Esp 2023; 223:596-603. [PMID: 37898356 DOI: 10.1016/j.rceng.2023.10.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/27/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND AND AIMS The Organic Law Regulating Euthanasia (LORE, for its initials in Spanish) came into force in June 2021. This study aims to examine knowledge of the LORE among physicians licensed in Spain as well as their involvement with and the impact of the law. METHODS This work is a descriptive, cross-sectional study conducted by means of a survey. Information was gathered through a self-administered questionnaire. RESULTS The survey was answered by 1446 physicians licensed in Spain. The samples' demographic characteristics were as follows: 54.7% were women, the mean age was 52 ± 14 years, and 66.0% worked in a hospital. Catalonia was the autonomous community with the most participants (44.6%). Regarding specialties, anesthesiology and resuscitation had the highest number of participants (21.9%), followed by family and community medicine (18.5%). The LORE was known in detail by 24.3% of physicians, 58.0% had a positive opinion of it, and 31.1% had direct experience with the euthanasia procedure. Practitioners working in the hospital setting perceived the law more favorably compared to those in the primary care setting (62.3% vs. 47.3%, p < 0.01). CONCLUSIONS Most doctors did not have in-depth knowledge of the LORE, although a majority supported its existence, particularly those in hospital medicine. Most physicians who viewed the LORE negatively were male, older, and worked in primary care. A minority of physicians considered registering as conscientious objectors.
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Affiliation(s)
- G Pujol-Fontrodona
- Servicio de Anestesiología y Reanimación, Hospital Clínic Barcelona, Barcelona, España
| | - J M Domínguez-Roldán
- Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, España; Departamento de Medicina, Universidad de Sevilla, Sevilla, España
| | - R Valero
- Servicio de Anestesiología y Reanimación, Hospital Clínic Barcelona, Barcelona, España; Departamento de Cirugía y Especialidades Médico quirúrgicas, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM), Madrid, España.
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2
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Valencia JA, Fabregas N, Tercero J, Valero R. Assessment of cerebral blood flow velocities, brain midline shift and optic nerve sheath diameter by ultrasound in patients undergoing elective craniotomy: A prospective observational feasibility study. Rev Esp Anestesiol Reanim (Engl Ed) 2023; 70:269-275. [PMID: 37150439 DOI: 10.1016/j.redare.2022.02.008] [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] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/16/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Brain ultrasound allows measuring the cerebral flow velocity, brain midline shift and optic nerve sheath diameter. Literature is scarce in determining the feasibility to perioperatively perform these measurements altogether and the cerebrovascular behavior in patients scheduled for elective craniotomy. METHODS We assessed bilateral cerebral flow velocities, composite index, brain midline shift and optic nerve sheath diameter by cerebral ultrasound in patients scheduled for elective craniotomy before anesthetic induction, at extubation, and at 6 and 24 h after. The aim was to assess the feasibility of brain ultrasound in patients for elective craniotomy and to describe the changes in cerebral flow velocities, brain midline shift and optic nerve sheath diameter from baseline values at different times in the postoperative period. RESULTS Sixteen patients were included, of these two were excluded from analysis due to an inadequate sonographic window. There were no changes throughout the study regarding cerebral flow velocity, brain midline shift nor optic nerve sheath diameter assessments. All parameters were maintained in the physiological range without significant variations during the procedure. No perioperative complications were detected. CONCLUSIONS The results of our study show the feasibility to perform a perioperative assessment of cerebral flow velocity, brain midline shift or optic nerve sheath diameter jointly and successfully to obtain additional information of baseline cerebral hemodynamics in patients scheduled for elective craniotomy and their postoperative changes during the first 24 h. Future studies with lager samples are needed to address the efficacy of cerebral ultrasound as a monitoring tool.
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Affiliation(s)
- J A Valencia
- Sección Neuroanestesia, Department of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.
| | - N Fabregas
- Sección Neuroanestesia, Department of Anesthesiology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - J Tercero
- Sección Neuroanestesia, Department of Anesthesiology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - R Valero
- Sección Neuroanestesia, Department of Anesthesiology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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Mourre F, Giorgi R, Beliard S, Valero R. Maternal inheritance of a genetic mutation for familial hypercholesterolemia predispose to coronary atherosclerosis in adulthood. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.011] [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: 11/25/2022]
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4
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Gómez Tarradas JM, Calvo A, Belda I, Topczewski T, Tercero FJ, Valero R. Anaesthetic management in neurosurgery in a patient with Eisenmenger syndrome and Down syndrome. A case report. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:109-113. [PMID: 35168917 DOI: 10.1016/j.redare.2020.10.014] [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] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 10/09/2020] [Indexed: 06/14/2023]
Abstract
Adults patients with congenital heart disease increasingly present for non cardiac surgery. The anesthetic management this type of patients in neurosurgery requires a meticulous surgical anesthetic planning. The need for urgent intervention, with the presence of a congenital heart disease evolved to Eisenmenger syndrome, associated to a difficult airway, is a challenge for the anesthesiologist. The use of dexmedetomidine may be a valid alternative. We present the case of a patient with Down syndrome, and Eisenmenger syndrome who underwent drainage of brain abscess from the emergency department and was subsequently scheduled for reintervention. We compare the different anesthetic techniques used in both procedures, analyzing the implications they had on the main physiopathological alterations presented by the patient.
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Affiliation(s)
- J M Gómez Tarradas
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - A Calvo
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain
| | - I Belda
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain
| | - T Topczewski
- Servicio de Neurocirugía, Hospital Clínic de Barcelona, Barcelona, Spain
| | - F J Tercero
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Valero
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain
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Gómez Tarradas JM, Calvo A, Belda I, Topczewski T, Tercero FJ, Valero R. Anaesthetic management in neurosurgery in a patient with Eisenmenger syndrome and Down syndrome. A case report. Rev Esp Anestesiol Reanim (Engl Ed) 2021; 69:S0034-9356(20)30294-2. [PMID: 34565573 DOI: 10.1016/j.redar.2020.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 07/23/2020] [Accepted: 10/09/2020] [Indexed: 10/20/2022]
Abstract
Adults patients with congenital heart disease increasingly present for non cardiac surgery. The anesthetic management this type of patients in neurosurgery requires a meticulous surgical anesthetic planning. The need for urgent intervention, with the presence of a congenital heart disease evolved to Eisenmenger Syndrome, associated to a difficult airway, is a challenge for the anesthesiologist. The use of dexmedetomidine may be a valid alternative. We present the case of a patient with Down syndrome, and Eisenmenger syndrome who underwent drainage of brain abscess from the emergency department and was subsequently scheduled for reintervention. We compare the different anesthetic techniques used in both procedures, analyzing the implications they had on the main physiopathological alterations presented by the patient.
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Affiliation(s)
- J M Gómez Tarradas
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, España.
| | - A Calvo
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, España
| | - I Belda
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, España
| | - T Topczewski
- Servicio de Neurocirugía, Hospital Clínic de Barcelona, Barcelona, España
| | - F J Tercero
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, España
| | - R Valero
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, España
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Tandogdu Z, Collins J, Shaw G, Rohn J, Koves B, Sachdeva A, Ghazi A, Haese A, Mottrie A, Kumar A, Sivaraman A, Tewari A, Challacombe B, Rocco B, Giedelman C, Wagner C, Rogers CG, Murphy DG, Pushkar D, Ogaya-Pinies G, Porter J, Seetharam KR, Graefen M, Orvieto MA, Moschovas MC, Schatloff O, Wiklund P, Coelho R, Valero R, de Reijke TM, Ahlering T, Rogers T, van der Poel HG, Patel V, Artibani W, Wagenlehner F, Maes K, Rha KH, Nathan S, Bjerklund Johansen TE, Hawkey P, Kelly J. Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID-19) pandemic: an international accelerated consensus statement. BJU Int 2021; 127:729-741. [PMID: 33185026 DOI: 10.1111/bju.15299] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment. A second aim was to identify the infection prevention and control (IPC) measures to achieve a low likelihood of coronavirus disease 2019 (COVID-19) hazard if radical prostatectomy (RP) was to be carried out during the outbreak and whilst the disease is endemic. METHODS We conducted an accelerated consensus process and systematic review of the evidence on COVID-19 and reviewed international guidance on prostate cancer. These were presented to an international prostate cancer expert panel (n = 34) through an online meeting. The consensus process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. The Consensus opinion was defined as ≥80% agreement and this was used to reconfigure the prostate cancer pathways. RESULTS Evidence on the delayed management of patients with prostate cancer is scarce. There was 100% agreement that prostate cancer pathways should be reconfigured and measures developed to prevent nosocomial COVID-19 for patients treated surgically. Consensus was reached on prioritisation criteria of patients for surgery and management pathways for those who have delayed treatment. IPC measures to achieve a low likelihood of nosocomial COVID-19 were coined as 'COVID-19 cold' sites. CONCLUSION Reconfiguring management pathways for patients with prostate cancer is recommended if significant delay (>3-6 months) in surgical management is unavoidable. The mapped pathways provide guidance for such patients. The IPC processes proposed provide a framework for providing RP within an environment with low COVID-19 risk during the outbreak or when the disease remains endemic. The broader concepts could be adapted to other indications beyond prostate cancer surgery.
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Affiliation(s)
- Zafer Tandogdu
- Department of Urology, University College London Hospital, London, UK.,Medical School, University College London, London, UK
| | - Justin Collins
- Department of Urology, University College London Hospital, London, UK
| | - Greg Shaw
- Department of Urology, University College London Hospital, London, UK
| | - Jennifer Rohn
- Medical School, University College London, London, UK
| | - Bela Koves
- Department of Urology, Budapest Hospital, Budapest, Hungary
| | - Ashwin Sachdeva
- Department of Urology, NHS Foundation Trust, Freeman Hospital, Newcastle Upon-Tyne, UK
| | - Ahmed Ghazi
- Department of Urology, University of Rochester, Rochester, NY, USA
| | - Alexander Haese
- Leitender Arzt für Roboterassistierte Urologie, Martini-Klinik am UKE GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Alex Mottrie
- Department of Urology, OLV Hospital, Aalst, Belgium
| | - Anup Kumar
- Department Urology, Robotics and Renal Transplant, Safdarjang Hospital and VMMC, New Delhi, India
| | | | - Ashutosh Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Bernardo Rocco
- Department of Urology AOU di Mldena, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Christian Wagner
- Head of Robotic Urology, St. Antonius - Hospital Gronau, Gronau, Germany
| | - Craig G Rogers
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia
| | | | | | | | | | - Markus Graefen
- Martini-Klinik, University-Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rafael Coelho
- University of São Paulo School of Medicine, São Paulo, Brazil
| | - Rair Valero
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Theo M de Reijke
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Travis Rogers
- Adventhealth Global Robotics Institute, Celebration, FL, USA
| | - Henk G van der Poel
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Vipul Patel
- Adventhealth Global Robotics Institute, Celebration, FL, USA
| | | | - Florian Wagenlehner
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, Giessen, Germany
| | | | - Koon H Rha
- Department of Urology, Institute of Urological Science, Yonsei University, Seoul, Korea
| | - Senthil Nathan
- Department of Urology, University College London Hospital, London, UK
| | | | - Peter Hawkey
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK.,Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - John Kelly
- Department of Urology, University College London Hospital, London, UK.,Medical School, University College London, London, UK
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7
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Mourre F, Beliard S, Valero R, Giorgi R. Cardiovascular Events According To Maternal Or Paternal Heritability Of Genetic Mutation In Familial Hypercholesterolemia. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Valero R, Sawczyn G, Garisto J, Yau R, Kaouk J. Combined robotic radical prostatectomy and left partial nephrectomy by a single port ap-proach. Int Braz J Urol 2020; 46:869. [PMID: 32648436 DOI: 10.1590/s1677-5538.ibju.2019.0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/24/2019] [Indexed: 06/11/2023] Open
Affiliation(s)
- Rair Valero
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Guilherme Sawczyn
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Juan Garisto
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Roger Yau
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jihad Kaouk
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Hurtado P, Herrero S, Valero R, Valencia L, Fàbregas N, Ingelmo I, Badenes R, Iturri F, Carrero E. Postoperative circuits in patients undergoing elective craniotomy. A narrative review. ACTA ACUST UNITED AC 2020; 67:404-415. [PMID: 32561114 DOI: 10.1016/j.redar.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/17/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
Abstract
In 2017, the Neurosciences section of the Spanish Society of Anaesthesiology, Critical Care and Pain Therapy published a national survey on postoperative care and treatment circuits in neurosurgery. The survey showed that practices vary widely, depending on the centre, the anaesthesiologist and the pathology of the patient. There is currently no standard postoperative circuit for cranial neurosurgical procedures in Spanish hospitals, and there is sufficient evidence to show that not all patients undergoing elective craniotomy should be routinely admitted to a postsurgical critical care unit. The aim of this study is to perform a narrative review of postoperative circuits in elective craniotomy in order to standardise clinical practice in the light of published studies. For this purpose, we searched MEDLINE (PubMed) to retrieve studies published in the last ten years, up to November 2019, using the keywords neurosurgery and postoperative care, craniotomyand postoperative care.
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Affiliation(s)
- P Hurtado
- Servicio de Anestesiología, Hospital Clínic, Universitat de Barcelona, España
| | - S Herrero
- Área Quirúrgica, Dirección de Enfermería, Hospital Clínic, Universitat de Barcelona, España
| | - R Valero
- Servicio de Anestesiología, Hospital Clínic, Universitat de Barcelona, España
| | - L Valencia
- Servicio de Anestesiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Gran Canaria, España
| | - N Fàbregas
- Servicio de Anestesiología, Hospital Clínic, Universitat de Barcelona, España
| | - I Ingelmo
- Servicio de Anestesiología, Hospital Ramón y Cajal, Madrid, España
| | - R Badenes
- Servicio de Anestesiología, Hospital General de Valencia, España
| | - F Iturri
- Servicio de Anestesiología, Hospital de Cruces, Baracaldo, Bilbao, España
| | - E Carrero
- Servicio de Anestesiología, Hospital Clínic, Universitat de Barcelona, España.
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López AM, Belda I, Bermejo S, Parra L, Áñez C, Borràs R, Sabaté S, Carbonell N, Marco G, Pérez J, Massó E, Soto JM, Boza E, Gil JM, Serra M, Tejedor V, Tejedor A, Roza J, Plaza A, Tena B, Valero R. Recommendations for the evaluation and management of the anticipated and non-anticipated difficult airway of the Societat Catalana d'Anestesiologia, Reanimació i Terapèutica del Dolor, based on the adaptation of clinical practice guidelines and expert consensus. ACTA ACUST UNITED AC 2020; 67:325-342. [PMID: 32471791 DOI: 10.1016/j.redar.2019.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/06/2019] [Indexed: 11/27/2022]
Abstract
The Airway Division of the Catalan Society of Anaesthesiology, Intensive Care and Pain Management (SCARTD) presents its latest guidelines for the evaluation and management of the difficult airway. This update includes the technical advances and changes observed in clinical practice since publication of the first edition of the guidelines in 2008. The recommendations were defined by a consensus of experts from the 19 participating hospitals, and were adapted from 5 recently published international guidelines following an in-depth analysis and systematic comparison of their recommendations. The final document was sent to the members of SCARTD for evaluation, and was reviewed by 11 independent experts. The recommendations, therefore, are supported by the latest scientific evidence and endorsed by professionals in the field. This edition develops the definition of the difficult airway, including all airway management techniques, and places emphasis on evaluating and classifying the airway into 3 categories according to the anticipated degree of difficulty and additional safety considerations in order to plan the management strategy. Pre-management planning, in terms of preparing patients and resources and optimising communication and interaction between all professionals involved, plays a pivotal role in all the scenarios addressed. The guidelines reflect the increased presence of video laryngoscopes and second-generation devices in our setting, and promotes their routine use in intubation and their prompt use in cases of unanticipated difficult airway. They also address the increased use of ultrasound imaging as an aid to evaluation and decision-making. New scenarios have also been included, such as the risk of bronchoaspiration and difficult extubation Finally, the document outlines the training and continuing professional development programmes required to guarantee effective and safe implementation of the guidelines.
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Affiliation(s)
- A M López
- Hospital Clínic de Barcelona, Barcelona, España
| | - I Belda
- Hospital Clínic de Barcelona, Barcelona, España
| | - S Bermejo
- Consorci Mar Parc de Salut de Barcelona, Barcelona, España
| | - L Parra
- Consorci Sanitari Integral, L'Hospitalet de Llobregat, España
| | - C Áñez
- Hospital Universitari de Tarragona Joan XXIII, Tarragona, España
| | - R Borràs
- Hospital Universitari Dexeus, Barcelona, España
| | - S Sabaté
- Fundació Puigvert (IUNA), Barcelona, España
| | - N Carbonell
- Hospital Universitari Dexeus, Barcelona, España
| | - G Marco
- Hospital Universitari Santa Maria de Lleida, Lleida, España
| | - J Pérez
- Hospital Universitari Parc Taulí, Sabadell, España
| | - E Massó
- Hospital Universitari Germans Trias i Pujol, Badalona, España
| | - J Mª Soto
- Hospital d' Igualada, SEM, Igualada, España
| | - E Boza
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, España
| | - J M Gil
- Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - M Serra
- Consorci Sanitari Integral, L'Hospitalet de Llobregat, España
| | - V Tejedor
- Consorci Sanitari Integral, L'Hospitalet de Llobregat, España
| | - A Tejedor
- Consorci Sanitari Integral, L'Hospitalet de Llobregat, España
| | - J Roza
- Hospital Universitari de Vic, Vic, España
| | - A Plaza
- Hospital Clínic de Barcelona, Barcelona, España
| | - B Tena
- Hospital Clínic de Barcelona, Barcelona, España
| | - R Valero
- Hospital Clínic de Barcelona, Barcelona, España.
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Sawczyn G, Aminsharifi A, Garisto J, Valero R, Kaouk J. Single-port transvesical robotic simple prostatectomy using the novel SPⓇ surgical system: Technical aspects. Urology Video Journal 2020. [DOI: 10.1016/j.urolvj.2019.100022] [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: 10/25/2022] Open
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Valero R, Sawczyn G, Garisto J, Yau R, Kaouk J. Multiquadrant Combined Robotic Radical Prostatectomy And Left Partial Nephrectomy: A Combined procedure by A Single Approach. Actas Urol Esp 2020; 44:119-124. [PMID: 31864774 DOI: 10.1016/j.acuro.2019.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/23/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION To present the first case of a concomitant robotic radical prostatectomy and a left robotic partial nephrectomy performed by a single-port approach using the SP® da Vinci surgical system (Intuitive Surgical, Sunnyvale CA, EE.UU.). PATIENT AND METHODS A 66-year-old male diagnosed with localized prostate cancer and a left kidney renal mass incidentally found on computed tomography (CT) scan during prostate cancer evaluation. Procedures were performed using a single supra-umbilical 3cm incision, plus one additional laparoscopic port, utilizing a standard Gelpoint® (Applied Medical, Rancho Santa Margarita, CA, EE.UU.) and replicating the technique previously described for single-port transperitoneal radical prostatectomy and partial nephrectomy with the use of the SP® robotic platform. RESULTS Total operative time was 256minutes (min) with a console time of 108min for radical prostatectomy, and 101min for the partial nephrectomy respectively, including a warm ischemia time of 26min. Estimated blood loss was 250cc. Blood transfusion was not needed. Final pathology for prostate was adenocarcinoma Gleason 7 (4+3) and for the kidney lesion was renal cell carcinoma. After two months of follow-up, PSA was undetectable and no complications or recurrence were detected. CONCLUSIONS The single-port approach has advantages as easier surgical planning and transition for combined and multi-quadrants surgeries: faster recovery, minimal postoperative pain and need for opioids, and excellent cosmetic outcome. We suggest that combined procedures should be performed only in high volume institutions by surgeons with vast experience in robotic surgery in selected patients.
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García-Orellana M, Valero R, Fàbregas N, de Riva N. Is "normal" arterial blood pressure "optimal" in all patients? Rev Esp Anestesiol Reanim (Engl Ed) 2020; 67:53-54. [PMID: 31952812 DOI: 10.1016/j.redar.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/12/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Affiliation(s)
| | - R Valero
- Consultor Senior. Servicio de Anestesiología. Hospital Clínic de Barcelona
| | - N Fàbregas
- Consultor Senior. Servicio de Anestesiología. Hospital Clínic de Barcelona
| | - N de Riva
- Consultor 1. Servicio de Anestesiología. Hospital Clínic de Barcelona.
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Iturri F, Valencia L, Honorato C, Martínez A, Valero R, Fàbregas N. Narrative review of acute post-craniotomy pain. Concept and strategies for prevention and treatment of pain. ACTA ACUST UNITED AC 2019; 67:90-98. [PMID: 31761317 DOI: 10.1016/j.redar.2019.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 06/17/2019] [Revised: 08/05/2019] [Accepted: 09/02/2019] [Indexed: 01/03/2023]
Abstract
The aim of this narrative review is to confirm that acute pain after craniotomy is frequent and presents with moderate to severe intensity. We also highlight the importance of not only treating post-craniotomy pain, but also of preventing it in order to reduce the incidence of chronic pain. Physicians should be aware that conventional postoperative analgesics (non-steroidal anti-inflammatory, paracetamol, cyclooxygenase inhibitors 2, opioids) are not the only options available. Performing a scalp block prior to surgical incision or after surgery, the use of intraoperative dexmedetomidine, and the perioperative administration of pregabalin are just some alternatives that are gaining ground. The management of post-craniotomy pain should be based on perioperative multimodal analgesia in the framework of an "enhaced recovery after surgery" (ERAS) approach.
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Affiliation(s)
- F Iturri
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Cruces, Barakaldo, España
| | - L Valencia
- Servicio de Anestesiología y Reanimación, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, España.
| | - C Honorato
- Servicio de Anestesiología y Reanimación, Clínica Universitaria de Navarra, Pamplona, España
| | - A Martínez
- Servicio de Anestesiología y Reanimación, Clínica Universitaria de Navarra, Pamplona, España
| | - R Valero
- Servicio de Anestesiología y Reanimación, Hospital Clinic, Barcelona, España
| | - N Fàbregas
- Servicio de Anestesiología y Reanimación, Hospital Clinic, Barcelona, España
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Alegret N, Serra P, Pessas JP, Curià X, Vidal J, Valero R. Anesthetic management of the diaphragmatic pacemaker placement surgery. Our experience in the Institut Guttmann. ACTA ACUST UNITED AC 2019; 66:497-505. [PMID: 31759615 DOI: 10.1016/j.redar.2019.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/06/2019] [Accepted: 10/02/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The diaphragm pacemaker (DP) has proven its utility in replacing mechanical ventilation in patients with chronic spinal cord injury (SCI) and amyotrophic lateral sclerosis (ALS). The DP improves patient quality of life and reduces morbidity and mortality and their associated health care costs. The anesthetic management of these patients and the particularities of the surgical procedure are challenging. The aim of our study is to analyze anesthetic management and intraoperative complications in patients undergoing DP placement in our hospital. METHODS We performed a chart review of patients treated between December 2007 and July 2017, recording the patients' preoperative status, anesthetic management and intraoperative complications. RESULTS The study included 16 patients (5 pediatric) undergoing DP implantation for chronic SCI (63%), ALS (25%) and other neurologic conditions (12%). Abdominal laparoscopy was performed under general anesthesia, with intravenous (87%) or inhalational (13%) induction and maintenance using total intravenous (50%) or balanced (50%) anesthesia. Rocuronium was administered in one case to permit airway management. Complications included: hypotension (50%), difficulties in mechanical ventilation during laparoscopy (31%), pneumothorax (12.5%) and autonomic dysreflexia (6%). CONCLUSIONS DP placement under general anesthesia is a safe intervention in both adult and pediatric patients. Complications derived from both the underlying disease and the surgical technique may appear, and must be rapidly identified and treated to obtain a satisfactory surgical outcome.
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Affiliation(s)
- N Alegret
- Servicio de Anestesiología y Reanimación, Institut Guttmann, Badalona, Barcelona, España.
| | - P Serra
- Servicio de Anestesiología y Reanimación, Institut Guttmann, Badalona, Barcelona, España
| | - J P Pessas
- Servicio de Anestesiología y Reanimación, Institut Guttmann, Badalona, Barcelona, España
| | - X Curià
- Medicina Interna, Institut Guttmann, Badalona, Barcelona, España
| | - J Vidal
- Unidad Lesionados Medulares, Institut Guttmann, Badalona, Barcelona, España
| | - R Valero
- Servicio de Anestesiología y Reanimación, Hospital Clínic, Barcelona, España
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Kaouk J, Valero R, Sawczyn G, Garisto J. Extraperitoneal single‐port robot‐assisted radical prostatectomy: initial experience and description of technique. BJU Int 2019; 125:182-189. [DOI: 10.1111/bju.14885] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jihad Kaouk
- Glickman Urological and Kidney Institute Cleveland Clinic Cleveland OH USA
| | - Rair Valero
- Glickman Urological and Kidney Institute Cleveland Clinic Cleveland OH USA
| | - Guilherme Sawczyn
- Glickman Urological and Kidney Institute Cleveland Clinic Cleveland OH USA
| | - Juan Garisto
- Glickman Urological and Kidney Institute Cleveland Clinic Cleveland OH USA
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Belhassen M, Van Ganse E, Ginoux M, Nolin M, Bada H, Bruckert E, Krempf M, Rebours V, Valero R, Moulin P. Identification Of Medical Complications And Real-Life Care Of Familial And Multifactorial Chylomicronaemia Syndromes: The Esthym Study. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Belhassen M, Van Ganse E, Nolin M, Bruckert E, Krempf M, Rebours V, Valero R, Moulin P. Complications et prise en charge en soins courants des sujets présentant une hypertriglycéridémie majeure : appariement d’un observatoire avec la base du SNDS (étude ESTHYM). Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.013] [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: 10/26/2022] Open
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19
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Werner M, López-Rueda A, Zarco F, Blasco J, San Román L, Amaro S, Carrero E, Valero R, Oleaga L, Macho J, Bargalló N. Value of Posterior circulation ASPECTS and Pons-Midbrain Index on non-contrast CT and CT Angiography Source Images in patients with basilar artery occlusion recanalized after mechanical thrombectomy. Radiología (English Edition) 2019. [DOI: 10.1016/j.rxeng.2018.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Arlaban M, Barreda P, Ballesteros M, Rodrigo E, Suberviola B, Valero R, Miñambres E, Ruiz-San Millán J. Static Cold Storage vs Ex Vivo Machine Perfusion: Results From a Comparative Study on Renal Transplant Outcome in a Controlled Donation After Circulatory Death Program. Transplant Proc 2019; 51:311-313. [DOI: 10.1016/j.transproceed.2018.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/29/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
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Valero R, Sanchez-Fructuoso A, Rodrigo E, Belmar L, Cos MA, Perez-Flores I, Delgado J, San Millan JCR. Variability of the Mammalian Target of Rapamycin Inhibitors Is Correlated With Long-Term Renal Graft Survival. Transplant Proc 2018; 51:341-343. [PMID: 30879537 DOI: 10.1016/j.transproceed.2018.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Many studies demonstrate the relationship between the high intrapatient variability of calcineurin inhibitor (CNI) levels and poor long-term renal graft outcome. Our objective is to analyze the intrapatient variability observed in the mammalian target of rapamycin inhibitors (mTOR-i) blood levels, to compare the variability of sirolimus (SRL) with that of everolimus (EVL) in kidney transplant patients converted to an mTOR-i, and to analyze whether the coefficient of variation (CV) was correlated with long-term graft survival. METHODS We analyzed 279 adult renal transplant patients converted to an mTOR-i. CV was calculated using at least 3 blood trough levels between 3 and 18 months postconversion. RESULTS The mean and median CV of the entire group was 25.54% and 23.7%, respectively. SRL and EVL mean CV was 23.8% and 27.1% (P = .03), respectively. The group of patients into the last tertile with CV> 28.52% presented a lower death-censored graft survival (75.26% vs. 93.01%, P < .0001) with a mean follow-up of 66.5 months. CONCLUSION The CV of mTOR-i is correlated with long-term renal graft survival, so it should be considered a prognostic factor. SRL has a lower CV than EVL in renal transplant patients converted to mTOR-i in the stable posttransplant phase.
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Affiliation(s)
- R Valero
- Nephrology Department, Valdecilla University Hospital, Santander, Spain.
| | - A Sanchez-Fructuoso
- Nephrology Department, Clinico San Carlos University Hospital, Madrid, Spain
| | - E Rodrigo
- Nephrology Department, Valdecilla University Hospital, Santander, Spain
| | - L Belmar
- Nephrology Department, Valdecilla University Hospital, Santander, Spain
| | - M A Cos
- Pharmacology Department, Valdecilla University Hospital, Santander, Spain
| | - I Perez-Flores
- Nephrology Department, Clinico San Carlos University Hospital, Madrid, Spain
| | - J Delgado
- Nephrology Department, Clinico San Carlos University Hospital, Madrid, Spain
| | - J C R San Millan
- Nephrology Department, Valdecilla University Hospital, Santander, Spain
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Lobo LM, Masson W, Molinero G, Siniawski D, Huerin M, Nogueira JP, Valero R. 52Therapy with cholesteryl ester transfer protein (CETP) inhibitors and diabetes risk. A Meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L M Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - W Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - D Siniawski
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - M Huerin
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | | | - R Valero
- Aix-Marseille University, Department of Nutrition, Metabolic, Marseille, France
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Calabrese A, Nicolay A, Wolff E, Dupont J, Valero R, Beliard S, Maraninchi M. Growth hormone (GH) and triglyceride-rich lipoprotein (TRL) metabolism: Effect of one month of discontinued growth hormone treatment in growth hormone deficient patients. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.474] [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: 10/28/2022]
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Secin FP, Coelho R, Monzó Gardiner JI, Salcedo JGC, Puente R, Martínez L, Finkelstein D, Valero R, León A, Angeloni D, Rozanec J, Berger M, Cavazzola LT, Faria EF, Machado RD, Lott F, Campos F, Morales Montor JG, Moreno CS, Barrios HD. Robotic surgery in public hospitals of Latin-America: a castle of sand? World J Urol 2018; 36:595-601. [PMID: 29459996 DOI: 10.1007/s00345-018-2227-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 02/05/2018] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION There is no information about the evolution of robotic programs in public hospitals of Latin-America. OBJECTIVE To describe the current status and functioning of robotic programs in Latin-American public hospitals since their beginning to date. METHODS We conducted a survey among leading urologists working at public hospitals of Latin-America who had acquired the Da Vinci laparoscopic-assisted robotic system. Questions included: date the program started, its utilization by other services, number and kind of surgeries, surgery paying system, surgery related deaths, occurrence and reasons of robotic program interruptions and its use for training purposes. Medians and 25-75 centiles (IQR) were estimated. RESULTS Since 2009, there are ten public hospitals of four Latin-American countries that acquired the Da Vinci robotic system. The median number of months robotic programs has been functioning without considering transitory interruption: 43 (IQR 35, 55). Median number of urologic and total surgeries performed: 140 (IQR 94, 168) and 336 (IQR 292, 621), respectively. The corresponding median number of urologic and total surgeries performed per month: 3 (IQR 2, 5) and 8 (IQR 5, 11). Median number of total surgeries performed per year per institution was 94 (IQR 68,123). The median proportion of urologic cases was 40% (IQR 31, 48), ranging from 24 to 66%. Five of ten institutions had their urology programs transitory or definitively closed due to the high burden costs. CONCLUSION Adoption and development of robotic surgery in some public hospitals of Latin-America have been hindered by high costs.
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Affiliation(s)
| | | | | | | | | | - Levin Martínez
- Hospital de Clínicas, Facultad de Medicina - Universidad de la República, Montevideo, Uruguay
| | - Diana Finkelstein
- Hospital de Trauma Federico Abete, Malvinas Argentinas, Buenos Aires, Argentina
| | - Rair Valero
- Hospital Universitario de Caracas, Caracas, Venezuela
| | - Antonio León
- Hospital Universitario de Caracas, Caracas, Venezuela
| | - Daniel Angeloni
- Hospital Escuela de Agudos Dr. Ramón Madariaga, Misiones, Argentina
| | - José Rozanec
- Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Milton Berger
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | | | - Felipe Lott
- Brazilian National Cancer Institute, INCA, Rio do Janeiro, Brazil
| | - Franz Campos
- Brazilian National Cancer Institute, INCA, Rio do Janeiro, Brazil
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Romero Kräuchi O, Valencia L, Iturri F, Mariscal Ortega A, López Gómez A, Valero R. National survey on perioperative anaesthetic management in the endovascular treatment of acute ischaemic stroke. Rev Esp Anestesiol Reanim (Engl Ed) 2018; 65:13-23. [PMID: 28923240 DOI: 10.1016/j.redar.2017.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the anaesthetic management of treatment for endovascular acute ischaemic stroke (AIS) in Spain. MATERIALS AND METHOD A survey was designed by the SEDAR Neuroscience Section and sent to the Spanish anaesthesiology departments with a primary stroke centre between July and November 2016. RESULTS Of the 47 hospitals where endovascular treatment of AIS is performed, 37 anaesthesiology departments participated. Thirty responses were obtained; three of which were eliminated due to duplication (response rate of 72.9%). Health coverage for AIS endovascular treatment was available 24hours a day in 63% of the hospitals. The anaesthesiologist in charge of the procedure was physically present in the hospital in 55.3%. There was large inter-hospital variability in non-standard monitoring and type of anaesthesia. The most important criterion for selecting type of anaesthesia was multidisciplinary choice made by the anaesthesiologist, neurologist and neuroradiologist (59.3%). The duration of time from arrival to arterial puncture was 10-15minutes in 59.2%. In 44.4%, systolic blood pressure was maintained between 140-180mmHg, and diastolic blood pressure<105mmHg. Glycaemic levels were taken in 81.5% of hospitals. Intravenous heparinisation was performed during the procedure in 66.7% with different patterns of action. In cases of moderate neurological deterioration with no added complications, 85.2% of the included hospitals awakened and extubated the patients. CONCLUSIONS The wide variability observed in the anaesthetic management and the organization of the endovascular treatment of AIS demonstrates the need to create common guidelines for anaesthesiologists in Spain.
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Affiliation(s)
- O Romero Kräuchi
- Servicio de Anestesiología, Hospital Universitario de Son Espases, Palma de Mallorca, España.
| | - L Valencia
- Servicio de Anestesiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, España
| | - F Iturri
- Servicio de Anestesiología, Hospital Universitario Cruces, Bilbao, Vizcaya, España
| | - A Mariscal Ortega
- Servicio de Anestesiología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - A López Gómez
- Servicio de Anestesiología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - R Valero
- Servicio de Anestesiología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
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Valero R, Carrero E, Fàbregas N, Iturri F, Saiz-Sapena N, Valencia L. National survey on postoperative care and treatment circuits in neurosurgery. Rev Esp Anestesiol Reanim 2017; 64:441-452. [PMID: 28318531 DOI: 10.1016/j.redar.2017.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 01/18/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The analysis of surgical processes should be a standard of health systems. We describe the circuit of care and postoperative treatment for neurosurgical interventions in the centres of our country. MATERIAL AND METHODS From June to October 2014, a survey dealing with perioperative treatments and postoperative circuits after neurosurgical procedures was sent to the chiefs of Anaesthesiology of 73 Spanish hospitals with neurosurgery and members of the Neuroscience Section of SEDAR. RESULTS We obtained 45 responses from 30 centres (41.09%). Sixty percent of anaesthesiologists perform preventive locoregional analgesic treatment. Pain intensity is systematically assessed by 78%. Paracetamol, non-steroidal anti-inflammatory and morphine combinations are the most commonly used. A percentage of 51.1 are aware of the incidence of postoperative nausea after craniotomy and 86.7% consider multimodal prophylaxis to be necessary. Dexamethasone is given as antiemetic (88.9%) and/or anti-oedema treatment (68.9%). A percentage of 44.4 of anaesthesiologists routinely administer anticonvulsive prophylaxis in patients with supratentorial tumours (levetiracetam, 88.9%), and 73.3% of anaesthesiologists have postoperative surveillance protocols. The anaesthesiologist (73.3%) decides the patient's destination, which is usually ICU (83.3%) or PACU (50%). Postoperative neurological monitoring varied according to the type of intervention, although strength and sensitivity were explored in between 70-80%. CONCLUSIONS There is great variability in the responses, probably attributable to the absence of guidelines, different structures and hospital equipment, type of surgery and qualified personnel. We need consensual protocols to standardize the treatment and the degree of monitoring needed during the postoperative period.
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Affiliation(s)
- R Valero
- Servicio de Anestesiología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España.
| | - E Carrero
- Servicio de Anestesiología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - N Fàbregas
- Servicio de Anestesiología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - F Iturri
- Servicio de Anestesiología, Hospital Universitario Cruces, Bilbao, Vizcaya, España
| | - N Saiz-Sapena
- Servicio de Anestesiología, Hospital 9 de Octubre, Valencia, España
| | - L Valencia
- Servicio de Anestesiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España
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Portolés J, Perez-Saez MJ, Sanchez-Sobrino B, Hernandez D, Rodriguez-Ferrero ML, Moreso F, Lafuente O, Valero R, Mazuecos MA, Juega J, Alonso A, Jimenez C, Ramos A, Melilli E, Pascual J. SP776EXPANDED CRITERIA DONORS AFTER CARDIAC DEATH: AN INCREASING AND USEFUL SOURCE FOR KIDNEY TRANSPLANTATION. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx158.sp776] [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: 11/15/2022] Open
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Cabedo N, Valero R, Alcón A, Gomar C. Prevalence and characterization of postoperative pain in the Postanaesthesia Care Unit. ACTA ACUST UNITED AC 2017; 64:375-383. [PMID: 28363327 DOI: 10.1016/j.redar.2016.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 09/20/2016] [Revised: 11/23/2016] [Accepted: 11/24/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Immediate postoperative pain occurs initially after surgery, while the patient is in the Post-Anaesthesia Recovery Unit. Very few studies assess this pain in this most immediate phase. OBJECTIVE Cross-sectional study of the prevalence and characteristics of immediate postoperative pain in patients after surgery. MATERIAL AND METHODS Between August 2014 and February 2015, a sample of 503 patients from the Post-Anaesthesia Recovery Unit was followed. Immediate postoperative pain was assessed (by the patient and the researcher) using the visual analogue scale (VAS; range 0-10) on 5 occasions after surgery. The impact of numerous factors (age, gender, type of surgery, type of anaesthesia and analgesic) on the pain, as well as variation in vital signs and the presence of side effects, were analysed. RESULTS Assessment of the pain showed overall VAS values of 2.2±2.8 on all occasions. Pain was reported to be of greatest intensity 20min after the patients' arrival in the Post-Anaesthesia Recovery Unit (P<.001). The VAS values reported by the researcher (1.4±2.0) were lower than those reported by the patients. Although there was a very strong correlation (R2=0.82; P<.001) and they followed a parallel distribution, there was moderate concordance (kappa=0.4). Plastic surgery and neurosurgery were the specialties with the highest percentages of VAS values in the strong intensity range (8-10). Patients with regional block techniques (with or without general anaesthesia) had lower VAS values than other general anaesthesia groups. Male patients and older patients displayed less pain than female and young patients, respectively (P<.001). CONCLUSIONS Studying the characteristics of postoperative pain at such an early stage allows for improved management. It helps to predict, according to the type of surgery and the anaesthesia used, those patients in which higher VAS values may be seen and to better adapt analgesic therapy.
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Affiliation(s)
- N Cabedo
- Departament de Cirurgia i Especialitats Quirúrgiques, Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - R Valero
- Departament de Cirurgia i Especialitats Quirúrgiques, Facultat de Medicina, Universitat de Barcelona, Barcelona, España; Departamento de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, España.
| | - A Alcón
- Departamento de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, España
| | - C Gomar
- Departament de Cirurgia i Especialitats Quirúrgiques, Facultat de Medicina, Universitat de Barcelona, Barcelona, España; Departamento de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, España
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Targher G, Dauriz M, Laroche C, Temporelli PL, Hassanein M, Seferovic PM, Drozdz J, Ferrari R, Anker S, Coats A, Filippatos G, Crespo‐Leiro MG, Mebazaa A, Piepoli MF, Maggioni AP, Tavazzi L, Crespo‐Leiro M, Anker S, Coats A, Ferrari R, Filippatos G, Maggioni A, Mebazaa A, Piepoli M, Amir O, Chioncel O, Dahlström U, Jimenez JD, Drozdz J, Erglis A, Fazlibegovic E, Fonseca C, Fruhwald F, Gatzov P, Goncalvesova E, Hassanein M, Hradec J, Kavoliuniene A, Lainscak M, Logeart D, Merkely B, Metra M, Otljanska M, Seferovic P, Kostovska ES, Temizhan A, Tousoulis D, Andarala M, Ferreira T, Fiorucci E, Gracia G, Laroche C, Pommier C, Taylor C, Cuculici A, Gaulhofer C, Casado EP, Szymczyk E, Ramani F, Mulak G, Schou IL, Semenka J, Stojkovic J, Mehanna R, Mizarienne V, Auer J, Ablasser K, Fruhwald F, Dolze T, Brandner K, Gstrein S, Poelzl G, Moertl D, Reiter S, Podczeck‐Schweighofer A, Muslibegovic A, Vasilj M, Fazlibegovic E, Cesko M, Zelenika D, Palic B, Pravdic D, Cuk D, Vitlianova K, Katova T, Velikov T, Kurteva T, Gatzov P, Kamenova D, Antova M, Sirakova V, Krejci J, Mikolaskova M, Spinar J, Krupicka J, Malek F, Hegarova M, Lazarova M, Monhart Z, Hassanein M, Sobhy M, El Messiry F, El Shazly A, Elrakshy Y, Youssef A, Moneim A, Noamany M, Reda A, Dayem TA, Farag N, Halawa SI, Hamid MA, Said K, Saleh A, Ebeid H, Hanna R, Aziz R, Louis O, Enen M, Ibrahim B, Nasr G, Elbahry A, Sobhy H, Ashmawy M, Gouda M, Aboleineen W, Bernard Y, Luporsi P, Meneveau N, Pillot M, Morel M, Seronde M, Schiele F, Briand F, Delahaye F, Damy T, Eicher J, Groote P, Fertin M, Lamblin N, Isnard R, Lefol C, Thevenin S, Hagege A, Jondeau G, Logeart D, Le Marcis V, Ly J, Coisne D, Lequeux B, Le Moal V, Mascle S, Lotton P, Behar N, Donal E, Thebault C, Ridard C, Reynaud A, Basquin A, Bauer F, Codjia R, Galinier M, Tourikis P, Stavroula M, Tousoulis D, Stefanadis C, Chrysohoou C, Kotrogiannis I, Matzaraki V, Dimitroula T, Karavidas A, Tsitsinakis G, Kapelios C, Nanas J, Kampouri H, Nana E, Kaldara E, Eugenidou A, Vardas P, Saloustros I, Patrianakos A, Tsaknakis T, Evangelou S, Nikoloulis N, Tziourganou H, Tsaroucha A, Papadopoulou A, Douras A, Polgar L, Merkely B, Kosztin A, Nyolczas N, Nagy AC, Halmosi R, Elber J, Alony I, Shotan A, Fuhrmann AV, Amir O, Romano S, Marcon S, Penco M, Di Mauro M, Lemme E, Carubelli V, Rovetta R, Metra M, Bulgari M, Quinzani F, Lombardi C, Bosi S, Schiavina G, Squeri A, Barbieri A, Di Tano G, Pirelli S, Ferrari R, Fucili A, Passero T, Musio S, Di Biase M, Correale M, Salvemini G, Brognoli S, Zanelli E, Giordano A, Agostoni P, Italiano G, Salvioni E, Copelli S, Modena M, Reggianini L, Valenti C, Olaru A, Bandino S, Deidda M, Mercuro G, Dessalvi CC, Marino P, Di Ruocco M, Sartori C, Piccinino C, Parrinello G, Licata G, Torres D, Giambanco S, Busalacchi S, Arrotti S, Novo S, Inciardi R, Pieri P, Chirco P, Galifi MA, Teresi G, Buccheri D, Minacapelli A, Veniani M, Frisinghelli A, Priori S, Cattaneo S, Opasich C, Gualco A, Pagliaro M, Mancone M, Fedele F, Cinque A, Vellini M, Scarfo I, Romeo F, Ferraiuolo F, Sergi D, Anselmi M, Melandri F, Leci E, Iori E, Bovolo V, Pidello S, Frea S, Bergerone S, Botta M, Canavosio F, Gaita F, Merlo M, Cinquetti M, Sinagra G, Ramani F, Fabris E, Stolfo D, Artico J, Miani D, Fresco C, Daneluzzi C, Proclemer A, Cicoira M, Zanolla L, Marchese G, Torelli F, Vassanelli C, Voronina N, Erglis A, Tamakauskas V, Smalinskas V, Karaliute R, Petraskiene I, Kazakauskaite E, Rumbinaite E, Kavoliuniene A, Vysniauskas V, Brazyte‐Ramanauskiene R, Petraskiene D, Stankala S, Switala P, Juszczyk Z, Sinkiewicz W, Gilewski W, Pietrzak J, Orzel T, Kasztelowicz P, Kardaszewicz P, Lazorko‐Piega M, Gabryel J, Mosakowska K, Bellwon J, Rynkiewicz A, Raczak G, Lewicka E, Dabrowska‐Kugacka A, Bartkowiak R, Sosnowska‐Pasiarska B, Wozakowska‐Kaplon B, Krzeminski A, Zabojszcz M, Mirek‐Bryniarska E, Grzegorzko A, Bury K, Nessler J, Zalewski J, Furman A, Broncel M, Poliwczak A, Bala A, Zycinski P, Rudzinska M, Jankowski L, Kasprzak J, Michalak L, Soska KW, Drozdz J, Huziuk I, Retwinski A, Flis P, Weglarz J, Bodys A, Grajek S, Kaluzna‐Oleksy M, Straburzynska‐Migaj E, Dankowski R, Szymanowska K, Grabia J, Szyszka A, Nowicka A, Samcik M, Wolniewicz L, Baczynska K, Komorowska K, Poprawa I, Komorowska E, Sajnaga D, Zolbach A, Dudzik‐Plocica A, Abdulkarim A, Lauko‐Rachocka A, Kaminski L, Kostka A, Cichy A, Ruszkowski P, Splawski M, Fitas G, Szymczyk A, Serwicka A, Fiega A, Zysko D, Krysiak W, Szabowski S, Skorek E, Pruszczyk P, Bienias P, Ciurzynski M, Welnicki M, Mamcarz A, Folga A, Zielinski T, Rywik T, Leszek P, Sobieszczanska‐Malek M, Piotrowska M, Kozar‐Kaminska K, Komuda K, Wisniewska J, Tarnowska A, Balsam P, Marchel M, Opolski G, Kaplon‐Cieslicka A, Gil R, Mozenska O, Byczkowska K, Gil K, Pawlak A, Michalek A, Krzesinski P, Piotrowicz K, Uzieblo‐Zyczkowska B, Stanczyk A, Skrobowski A, Ponikowski P, Jankowska E, Rozentryt P, Polonski L, Gadula‐Gacek E, Nowalany‐Kozielska E, Kuczaj A, Kalarus Z, Szulik M, Przybylska K, Klys J, Prokop‐Lewicka G, Kleinrok A, Aguiar CT, Ventosa A, Pereira S, Faria R, Chin J, De Jesus I, Santos R, Silva P, Moreno N, Queirós C, Lourenço C, Pereira A, Castro A, Andrade A, Guimaraes TO, Martins S, Placido R, Lima G, Brito D, Francisco A, Cardiga R, Proenca M, Araujo I, Marques F, Fonseca C, Moura B, Leite S, Campelo M, Silva‐Cardoso J, Rodrigues J, Rangel I, Martins E, Correia AS, Peres M, Marta L, Silva GF, Severino D, Durao D, Leao S, Magalhaes P, Moreira I, Cordeiro AF, Ferreira C, Araujo C, Ferreira A, Baptista A, Radoi M, Bicescu G, Vinereanu D, Sinescu C, Macarie C, Popescu R, Daha I, Dan G, Stanescu C, Dan A, Craiu E, Nechita E, Aursulesei V, Christodorescu R, Otasevic P, Seferovic P, Simeunovic D, Ristic A, Celic V, Pavlovic‐Kleut M, Lazic JS, Stojcevski B, Pencic B, Stevanovic A, Andric A, Iric‐Cupic V, Jovic M, Davidovic G, Milanov S, Mitic V, Atanaskovic V, Antic S, Pavlovic M, Stanojevic D, Stoickov V, Ilic S, Ilic MD, Petrovic D, Stojsic S, Kecojevic S, Dodic S, Adic NC, Cankovic M, Stojiljkovic J, Mihajlovic B, Radin A, Radovanovic S, Krotin M, Klabnik A, Goncalvesova E, Pernicky M, Murin J, Kovar F, Kmec J, Semjanova H, Strasek M, Iskra MS, Ravnikar T, Suligoj NC, Komel J, Fras Z, Jug B, Glavic T, Losic R, Bombek M, Krajnc I, Krunic B, Horvat S, Kovac D, Rajtman D, Cencic V, Letonja M, Winkler R, Valentincic M, Melihen‐Bartolic C, Bartolic A, Vrckovnik MP, Kladnik M, Pusnik CS, Marolt A, Klen J, Drnovsek B, Leskovar B, Anguita MF, Page JG, Martinez FS, Andres J, Genis A, Mirabet S, Mendez A, Garcia‐Cosio L, Roig E, Leon V, Gonzalez‐Costello J, Muntane G, Garay A, Alcade‐Martinez V, Fernandez SL, Rivera‐Lopez R, Puga‐Martinez M, Fernandez‐Alvarez M, Serrano‐Martinez J, Crespo‐Leiro M, Grille‐Cancela Z, Marzoa‐Rivas R, Blanco‐Canosa P, Paniagua‐Martin M, Barge‐Caballero E, Cerdena IL, Baldomero IFH, Padron AL, Rosillo SO, Gonzalez‐Gallarza RD, Montanes OS, Manjavacas AI, Conde AC, Araujo A, Soria T, Garcia‐Pavia P, Gomez‐Bueno M, Cobo‐Marcos M, Alonso‐Pulpon L, Cubero JS, Sayago I, Gonzalez‐Segovia A, Briceno A, Subias PE, Hernandez MV, Cano MR, Sanchez MG, Jimenez JD, Garrido‐Lestache EB, Pinilla JG, Villa BG, Sahuquillo A, Marques RB, Calvo FT, Perez‐Martinez M, Gracia‐Rodenas M, Garrido‐Bravo IP, Pastor‐Perez F, Pascual‐Figal D, Molina BD, Orus J, Gonzalo FE, Bertomeu V, Valero R, Martinez‐Abellan R, Quiles J, Rodrigez‐Ortega J, Mateo I, ElAmrani A, Fernandez‐Vivancos C, Valero DB, Almenar‐Bonet L, Sanchez‐Lazaro I, Marques‐Sule E, Facila‐Rubio L, Perez‐Silvestre J, Garcia‐Gonzalez P, Ridocci‐Soriano F, Garcia‐Escriva D, Pellicer‐Cabo A, Fuente Galan L, Diaz JL, Platero AR, Arias J, Blasco‐Peiro T, Julve MS, Sanchez‐Insa E, Aured‐Guallar C, Portoles‐Ocampo A, Melin M, Hägglund E, Stenberg A, Lindahl I, Asserlund B, Olsson L, Dahlström U, Afzelius M, Karlström P, Tengvall L, Wiklund P, Olsson B, Kalayci S, Temizhan A, Cavusoglu Y, Gencer E, Yilmaz M, Gunes H. In‐hospital and 1‐year mortality associated with diabetes in patients with acute heart failure: results from the
ESC‐HFA
Heart Failure Long‐Term Registry. Eur J Heart Fail 2016; 19:54-65. [DOI: 10.1002/ejhf.679] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/24/2016] [Accepted: 09/20/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- Giovanni Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Marco Dauriz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Cécile Laroche
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
| | | | | | | | | | - Roberto Ferrari
- Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care & Research E.S: Health Science Foundation Cotignola Italy
| | - Stephan Anker
- Innovative Clinical Trials, Department of Cardiology & Pneumology University Medical Center Göttingen (UMG) Göttingen Germany
| | - Andrew Coats
- Monash University Australia and University of Warwick Coventry UK
| | | | - Maria G. Crespo‐Leiro
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Complexo Hospitalario Universitario A Coruna CHUAC La Coruna Spain
| | - Alexandre Mebazaa
- Inserm 942, Hôpital Lariboisière Université Paris Diderot Paris France
| | - Massimo F. Piepoli
- Department of Cardiology Polichirurgico Hospital G. da Saliceto Piacenza Italy
| | - Aldo Pietro Maggioni
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
- ANMCO Research Center Florence Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care & Research E.S. Health Science Foundation Cotignola Italy
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Togo AH, Valero R, Delerce J, Raoult D, Million M. "Anaerotruncus massiliensis," a new species identified from human stool from an obese patient after bariatric surgery. New Microbes New Infect 2016; 14:56-57. [PMID: 27699051 PMCID: PMC5035336 DOI: 10.1016/j.nmni.2016.07.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 07/27/2016] [Indexed: 11/30/2022] Open
Abstract
We report the main characteristics of a new bacterial species strain AT3T (CSUR = P2007, DSM = 100567) that was isolated from the stool sample collected from a 47-year-old obese French man after he underwent bariatric surgery.
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Affiliation(s)
- A H Togo
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, France
| | - R Valero
- Aix Marseille Université, NORT "Nutrition, Obesity and Risk of Thrombosis," Inserm 1062, INRA1260, France; APHM, CHU Hôpital de la Conception, Service Nutrition, Maladies Métaboliques et Endocrinologie, Marseille, France
| | - J Delerce
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, France
| | - D Raoult
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, France; Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M Million
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, France
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Vázquez-Alonso E, Iturri Clavero F, Valencia Sola L, Fábregas N, Ingelmo Ingelmo I, Valero R, Cassinello C, Rama-Maceiras P, Jorques A. Clinical practice guideline on thromboprophylaxis and management of anticoagulant and antiplatelet drugs in neurosurgical and neurocritical patients. Rev Esp Anestesiol Reanim 2016; 63:406-418. [PMID: 26965554 DOI: 10.1016/j.redar.2016.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/18/2016] [Indexed: 06/05/2023]
Affiliation(s)
- E Vázquez-Alonso
- Servicio de Anestesiología, Complejo Hospitalario Universitario Granada, Granada, España.
| | - F Iturri Clavero
- Servicio de Anestesiología, Hospital Universitario Cruces, , Bilbao, Vizcaya, España
| | - L Valencia Sola
- Servicio de Anestesiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, España
| | - N Fábregas
- Servicio de Anestesiología, Hospital Clinic, Universitat de Barcelona, Barcelona, España
| | - I Ingelmo Ingelmo
- Servicio de Anestesiología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - R Valero
- Servicio de Anestesiología, Hospital Clinic, Universitat de Barcelona, Barcelona, España
| | - C Cassinello
- Servicio de Anestesiología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - P Rama-Maceiras
- Servicio de Anestesiología, Complejo Hospitalario Universitario Juan Canalejo, A Coruña, España
| | - A Jorques
- Servicio de Neurocirugía, Complejo Hospitalario Universitario Granada, Granada, España
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Togo AH, Khelaifia S, Valero R, Cadoret F, Raoult D, Million M. 'Negativicoccus massiliensis', a new species identified from human stool from an obese patient after bariatric surgery. New Microbes New Infect 2016; 13:43-4. [PMID: 27408741 PMCID: PMC4930332 DOI: 10.1016/j.nmni.2016.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 05/24/2016] [Accepted: 05/30/2016] [Indexed: 12/01/2022] Open
Abstract
We report here the main characteristics of ‘Negativicoccus massiliensis’ strain AT7 (CSURP = P2082, DSM = 100853) isolated from a stool sample collected from a 47-year-old obese French man before bariatric surgery.
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Affiliation(s)
- A H Togo
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, Marseille, France
| | - S Khelaifia
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, Marseille, France
| | - R Valero
- Aix Marseille Université, NORT 'Nutrition, Obesity and Risk of Thrombosis', INSERM1062, INRA1260, Marseille, France; APHM, CHU Hôpital de la Conception, Service Nutrition, Maladies Métaboliques et Endocrinologie, Marseille, France
| | - F Cadoret
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, Marseille, France
| | - D Raoult
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, Marseille, France; Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M Million
- Aix-Marseille Université, URMITE, UM63, CNRS7278, IRD198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Faculté de médecine, Marseille, France
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López AM, Muñoz-Rojas G, Fontanals M, de San José I, Hermoso A, Valero R. Clinical evaluation of the Baska Mask laryngeal mask in adult patients in ambulatory surgery. ACTA ACUST UNITED AC 2015; 62:551-6. [PMID: 25698608 DOI: 10.1016/j.redar.2015.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 07/20/2014] [Revised: 01/02/2015] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the clinical performance of the Baska Mask, a new second-generation supraglottic airway device with a self-inflating cuff and two side suction channels for continuous aspiration. MATERIAL AND METHODS Eighty adult patients without difficult airways were prospectively included. Ease of insertion and number of attempts needed, quality of ventilation, airway seal pressure, fibreoptic view, ease of gastric access, and complications were assessed. Sizes 3, 4, 5 were analyzed and compared. RESULTS First attempt insertion success rate was 88% and the overall rate was 100%, although additional maneuvers were necessary in 44% of the cases. The ventilation was adequate in 96%, with 39% of them requiring adjusting maneuvers. Size 3 needed significantly less adjustments, and achieved a higher seal pressure than sizes 4 and 5 combined. The airway seal pressure was 33 ± 7 cm H2O. Complete or partial vocal cords were visible in 90% of the 66 cases assessed. Partial obstruction, caused by distortion of the cuff-free border, was seen in 5%, and no glottic structures were identified in 5%. Gastric access was easy in all cases. Complications were mild and transient. CONCLUSIONS The Baska Mask achieves a high seal pressure, effective ventilation, and a quick access to drain gastric contents. However, additional adjustment maneuvers are frequently required to insert the mask and to optimize ventilation.
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Affiliation(s)
- A M López
- Servicio de Anestesiología, Hospital Clínico, Barcelona, España.
| | - G Muñoz-Rojas
- Servicio de Anestesiología, Hospital Clínico, Barcelona, España
| | - M Fontanals
- Servicio de Anestesiología, Hospital Clínico, Barcelona, España
| | - I de San José
- DUE, Unidad de Cirugía Mayor Ambulatoria, Hospital Clínico, Barcelona, España
| | - A Hermoso
- DUE, Unidad de Cirugía Mayor Ambulatoria, Hospital Clínico, Barcelona, España
| | - R Valero
- Servicio de Anestesiología, Hospital Clínico, Barcelona, España
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Gárate J, Sánchez-Salas R, Valero R, Matheus R, León A, Dávila H. Pentafecta outcomes after robot-assisted laparoscopic radical prostatectomy: first 100 cases in Latinoamerican Hospital. Actas Urol Esp 2015; 39:20-5. [PMID: 24974068 DOI: 10.1016/j.acuro.2013.12.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 11/10/2013] [Accepted: 12/01/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Radical prostatectomy (RP) is the standard treatment for cancer control in the long term. The rise of minimally invasive surgery and new technologies have yielded better results and enabled us to pursue more ambitious objectives. The main works still use the trifecta as classic presentation, but this does not cover all aspects of surgery. Pentafecta is a new and more comprehensive methodology to report outcomes after RP, including complications and surgical margin status with the three major outcomes classically reported. The purpose of this study is to report our experience with robot-assisted laparoscopic radical prostatectomy (RALRP) by applying the concept of pentafecta. MATERIAL AND METHOD Describe the experience in this institution from March 2009 to December 2012 of RALRP by pentafecta. RESULTS We performed 101 interventions and obtained the following results: Average age 60.89 ± 7.32 years (40-77), total PSA 8.5 ± 5.57 ng/dl (0.2-29); D'Amico classification: Low 29 (28.71%), Medium 65 (64.36%), High 7 (6.93%); Operative time 253.44 ± 51.51 min (90-540), Complications 12.9% (Clavien I-II 10.89% and Clavien IIIa 1.98%); Positive surgical margins 20.83%; Biochemistry recurrence 12.5% follow-up (6-44 months); and Continence 87.5% per year and Potency 59.52%. CONCLUSIONS RALRP is a safe and reproducible procedure with excellent results in terms of pentafecta, inclusive during the initial experience at a low volumen center for prostate cancer. A longer follow-up study and experience with higher volume of patients are required to obtain better results and data to be compared with excellence centers.
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Affiliation(s)
- J Gárate
- Unidad de Cirugía Robótica, Servicio de Urología, Hospital Universitario de Caracas, Caracas, Venezuela.
| | - R Sánchez-Salas
- Unidad de Cirugía Robótica, Servicio de Urología, Hospital Universitario de Caracas, Caracas, Venezuela
| | - R Valero
- Unidad de Cirugía Robótica, Servicio de Urología, Hospital Universitario de Caracas, Caracas, Venezuela
| | - R Matheus
- Unidad de Cirugía Robótica, Servicio de Urología, Hospital Universitario de Caracas, Caracas, Venezuela
| | - A León
- Unidad de Cirugía Robótica, Servicio de Urología, Hospital Universitario de Caracas, Caracas, Venezuela
| | - H Dávila
- Unidad de Cirugía Robótica, Servicio de Urología, Hospital Universitario de Caracas, Caracas, Venezuela
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Pardoi Camps F, García Carrión C, Beneit Montesinos J, Lázaro Martínez. J, Gomez F, Valero R, Chana P. Efficacy of a platelet-rich plasma treatment in subjects with plantar fasciosis. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.711] [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: 10/25/2022]
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Valero R, Atín M, Ballestero R, Martin P, Gomez F, Gómez S, Chana P. Effectiveness of exercise to reduce falls and injuries in elderly people. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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López AM, Valero R, López S, Zaballos M, García ML. LMA Supreme: new design or a pig in a poke? Rev Esp Anestesiol Reanim 2013; 60:597-598. [PMID: 24199913 DOI: 10.1016/j.redar.2013.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 06/26/2013] [Indexed: 06/02/2023]
Affiliation(s)
- A M López
- Servicio de Anestesiología, Hospital Clínic Barcelona, Spain.
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Valero R, Varela E, Küçükdeveci AA, Oral A, Ilieva E, Berteanu M, Christodoulou N. Spinal pain management. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:715-725. [PMID: 24145230] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the PRM interventions. The aim of this paper is to describe the role of PRM physicians in the management of spinal pain focusing particularly on low back pain and neck pain. These disorders are associated with significant disability that results in activity limitations and participation restrictions. A wide variety of PRM interventions including patient education, behavioural therapies, exercise, a number of physical modalities, manual techniques, and multidisciplinary rehabilitation may help patients with low back pain and cervical pain in improving their functioning. PRM physicians may address many of the problems encountered by these patients in many life areas taking the International Classification of Functioning, Disability and Health as a reference guide and may have an important role in improving the quality of their lives.
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Affiliation(s)
- R Valero
- Member, Board Committee, UEMS Board of PRM, Departamento de Medicina Física y Rehabilitacion, Facultad de Medicina UCM Ciudad Universitaria, Madrid, Spain -
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Varela E, Oral A, Ilieva E, Küçükdeveci AA, Valero R, Berteanu M, Christodoulou N. Musculoskeletal perioperative problems. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:753-759. [PMID: 24145233] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the physical and rehabilitation medicine interventions. According to the UEMS-PRM section, the role of PRM physician in musculoskeletal perioperative settings has to be situated inside general pain management. Musculoskeletal surgery (MSS) represents a frequent medical situation among patients suffering from musculoskeletal disorders (MSDs), in which PRM physicians need to be involved. A wide number of MSDs have to be operated in order to diminish disability and relieve symptoms, thus improving the patient´s functioning and social participation: Joint replacements, spine decompressions, vertebroplasties, internal fixation of unstable fractures, arthroscopies for tendon and joint repairs, and others. This paper describes the role of the PRM physician during the perioperative period. A well-coordinated rehabilitation programme followed by a good home rehabilitation programme results in pain reduction, faster recovery with better patient participation and increased cost effectiveness. PRM physicians have to identify patients at risk of continuing activity limitation and participation restriction who will benefit from an early rehabilitation process and formulate a PRM programme of care taking into account each patient's environmental factors.
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Affiliation(s)
- E Varela
- Member, Professional Practice Committee, UEMS Section of PRM, Departamento de Medicina Física y Rehabilitación, Facultad de Medicina UCM, Ciudad Universitaria, Madrid, Spain -
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Oral A, Ilieva EM, Küçükdeveci AA, Varela E, Valero R, Berteanu M, Christodoulou N. Local soft tissue musculoskeletal disorders and injuries. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:727-742. [PMID: 24145231] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of PRM interventions. Soft tissue musculoskeletal disorders (MSDs) and injuries are associated with significant pain and loss of function that may lead to significant disability. The aim of this paper is to define the role of PRM physician in the management of local soft tissue MSDs and injuries with their specific focus on assessing and improving function as well as participation in the community. The training of PRM specialists make them well equipped to successfully treat MSDs including soft tissue MSDs and injuries. PRM specialists may well meet the needs of patients with soft tissue MSDs and injuries using PRM approaches including 1) assessment based on the comprehensive model of functioning, the International Classification of Functioning, Disability and Health (ICF), that enable them to identify the areas of impaired functioning in order to apply necessary measures; 2) accurate diagnosis using instrumental diagnostic procedures in addition to clinical examination; 3) outcome measurements available to them; 4) evidence-based pharmacological and nonpharmacological treatments; and finally 5) maintenance of social involvement including "return to work" based on restoration of function, all of which will eventually result in improved quality of life for patients with soft tissue MSDs and injuries.
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Affiliation(s)
- A Oral
- Member, Board Committee, UEMS Board of PRM, Department of Physical Medicine and RehabilitationIstanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey -
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Varela E, Valero R, Küçükdeveci AA, Oral A, Ilieva E, Berteanu M, Christodoulou N. Shoulder pain management. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:743-751. [PMID: 24145232] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the physical and rehabilitation medicine interventions. According to the PCC of the UEMS-PRM Section, the role of PRM physician in the management of shoulder pain (SP) has to be situated inside the general pain management field. SP is a common condition that can place limitations on the activity and restriction in social life participation of sufferers. A variety of shoulder problems, commonly including subacromial impingement, calcifying tendinitis, frozen shoulder, acromio-clavicular disturbances, gleno-humeral instability and gleno-humeral arthritis, can cause pain, and patients should be assessed and treated in order to relieve symptoms and reduce disability. This position paper describes the role of the PRM specialist in the management of such patients. Many assessment methods and treatment interventions are usually used in the management of patients with SP. Depending on the process, disability and patient characteristics, some intervention modalities have reported evidence in pain relief, movement and daily life activity (DLA) restoration, thus permiting a patient early recovery and social participation. Oral medications, local injections, physical therapy modalities and exercises are normally used for the management of SP. The PRM specialist should, always use this best medical evidence to decide how to efficiently and effectively reduce SP-related disability. An adequate therapeutic algorithm is also proposed in order to channelize the above mentioned evidence and reach the best results.
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Affiliation(s)
- E Varela
- Member, Professional Practice Committee, UEMS Section of PRM, Departamento de Medicina Física y Rehabilitación, Facultad de Medicina UCM, Ciudad Universitaria, Madrid, Spain -
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Oral A, Ilieva EM, Küçükdeveci AA, Varela E, Valero R, Berteanu M, Christodoulou N. Generalised and regional soft tissue pain syndromes. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:535-549. [PMID: 24084413] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of PRM interventions. Generalised and regional soft tissue pain syndromes constitute a major problem leading to loss of function and disability, resulting in enormous societal burden. The aim of this paper is to describe the unique role of PRM physicians in the management of these disabling conditions that require not only pharmacological interventions but also a holistic approach including the consideration of body functions, activities and participation as well as contextual factors as described in the ICF. Evidence-based effective PRM interventions include exercise and multicomponent treatment including a psychotherapeutic intervention such as cognitive behavioural therapy (CBT) in addition to exercise, the latter based on strong evidence for reducing pain and improving quality of life in fibromyalgia syndrome (FMS). Balneotherapy, meditative movement therapies, and acupuncture have also been shown as efficacious in improving symptoms in FMS. Emerging evidence suggests the use of transcranial magnetic or direct current stimulation (rTMS or tDCS) in FMS patients with intractable pain not alleviated by other interventions. Graded exercise therapy and CBT are evidence-based options for chronic fatigue syndrome. The use of some physical modalities and manipulation for myofascial pain syndrome is also supported by evidence. As for complex regional pain syndrome (CRPS), strong evidence exists for rTMS and graded motor imagery as well as moderate evidence for mirror therapy. Interventional techniques such as blocks and spinal cord stimulation may also be considered for CRPS based on varying levels of evidence. PRM physicians' functioning oriented approaches on the assessment and management, adopting the ICF as a reference, may well meet the needs of patients with soft tissue pain syndromes, the common problems for whom are loss of function and impaired quality of life. Available evidence for the effectiveness of PRM interventions serves as the basis for the explicit role of PRM specialists in the management of these health conditions.
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Affiliation(s)
- A Oral
- Member, Board Committee, UEMS Board of PRM, Department of Physical Medicine and RehabilitationIstanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey -
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Küçükdeveci AA, Oral A, Ilıeva EM, Varela E, Valero R, Berteanu M, Chrıstodoulou N. Inflammatory arthritis. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:551-564. [PMID: 24084414] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the physical and rehabilitation medicine interventions. Inflammatory arthritis is a major cause of disability with an important economic burden in society. The goals in the management of inflammatory arthritis are to control pain and disease activity, prevent joint damage, protect and enhance function and improve quality of life. This paper aims to define the role of PRM physicians in people with inflammatory arthritis. PRM interventions imply non-pharmacological treatments which include patient education for joint protection, energy conservation and self-management techniques, exercise therapy, physical modalities, orthoses/assistive devices and balneotherapy. Therapeutic patient education and exercises are the cornerstones of therapy with strong evidence of their effectiveness to improve function. Physical modalities are primarily used to decrease pain and stiffness whereas orthoses/assistive devices are usually prescribed to enhance activities and participation. PRM physicians have distinct roles in the management of people with inflammatory arthritis such that they effectively organise and supervise the PRM program in the context of interdisciplinary team work. Their role starts with a comprehensive assessment of patient's functioning based on the International Classification of Functioning Disability and Health (ICF) as the framework. In the light of this assessment, appropriate PRM interventions individualised for the patient are administered. Future research and actions regarding the role of PRM in inflammatory arthritis should target access to care, updates on the use and effectiveness of physical modalities, orthoses/assistive devices, and standardization of therapeutic patient education programs.
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Affiliation(s)
- A A Küçükdeveci
- Member of Professional Practice Committee, UEMS Section of PRM, Department of Physical Medicine and Rehabilitation Faculty of Medicine, Ankara University, Ankara, Turkey -
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Ilieva EM, Oral A, Küçükdeveci AA, Varela E, Valero R, Berteanu M, Christodoulou N. Osteoarthritis. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:579-593. [PMID: 24084416] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the PRM interventions. Osteoarthritis (OA) is the most common joint disorder and the major cause of musculoskeletal pain and limited mobility in the elderly in the world. Therefore, proper management of persons with OA is of substantial importance. The goal of OA management is to reduce the impact of OA on the individual by reducing pain and improving function, activities and participation. The aim of this paper is to descibe the explicit role of PRM physicians in providing management for persons with OA. The optimal management of OA requires the combination of both non-pharmacological and pharmacological approaches, an issue most of the main guidelines on the evidence-based management of OA share in common. There is good level of evidence about the effectiveness of PRM interventions in the management of OA: high level of evidence about the effect of education, weight reduction and exercise and growing evidence about the effectiveness of physical agent modalities. PRM specialists are involved not only in diagnosis and medical and physical treatments of OA, but, as a rehabilitation strategy, they also deal with the problems of the person focusing on the improvement of all components of human functioning as defined in the ICF including personal and environmental factors with a holistic approach. ICF core sets for OA serve as excellent models for directing proper assessments as well as targeting interventions. PRM specialists well meet the needs of people with OA from the early stages of the disease to the stage of disability that could cause activity limitations and participation restrictions. In conclusion, PRM specialists can make substantial contributions to providing management of OA in order to improve the functioning of individuals with OA from both personal and societal perspective.
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Affiliation(s)
- E M Ilieva
- Member, Professional Practice Committee, UEMS Section of PRM, Board Committee, Department of Physical and Rehabilitation Medicine, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria -
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Oral A, Küçükdeveci AA, Varela E, Ilieva EM, Valero R, Berteanu M, Christodoulou N. Osteoporosis. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:565-577. [PMID: 24084415] [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: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of PRM interventions. A wide range of health conditions treated by PRM specialists carries the risk of osteoporosis (OP). The consequences of OP may be associated with significant disability. The aim of this paper is: to define the role of PRM physicians in the prevention and management of OP, to describe the needs of people with OP in relation to rehabilitation strategy, and to highlight why and how PRM physicians should be involved in the diagnosis and management of OP. PRM physicians may intervene in the prevention of and risk factor assessment for OP, falls and fractures along with other assessments of functioning and of quality of life. In addition, they are involved in diagnosis and in both pharmacological and nonpharmacological treatment of OP. From a specific PRM perspective based on the International Classification of Functioning, Disability and Health (ICF), there is an important role in optimizing functioning and promoting "activities and participation", including interventions associated with environmental factors for people with OP or osteoporotic fractures. Evidence suggests that a large number of interventions within the scope of PRM that range from preventive strategies (including education and self management and most importantly exercise) to pain management strategies and spinal orthoses or hip protectors may be effective in the prevention and/or management of OP and its sequelae. Competencies and aptitudes of PRM specialists, focusing especially on functioning while providing care over the whole course of a health condition from the hospital to the community, may well place them in the management of OP. Evidence-based effective PRM interventions further warrant the role of PRM physicians in the management of OP.
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Affiliation(s)
- A Oral
- Member, Board Committee, UEMS Board of PRM, Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey -
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Million M, Angelakis E, Maraninchi M, Henry M, Giorgi R, Valero R, Vialettes B, Raoult D. Correlation between body mass index and gut concentrations of Lactobacillus reuteri, Bifidobacterium animalis, Methanobrevibacter smithii and Escherichia coli. Int J Obes (Lond) 2013. [PMID: 23459324 DOI: 10.1038/ijo.2013.20ijo201320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Genus and species level analysis is the best way to characterize alterations in the human gut microbiota that are associated with obesity, because the clustering of obese and lean microbiotas increases with the taxonomic depth of the analysis. Bifidobacterium genus members have been associated with a lean status, whereas different Lactobacillus species are associated both with a lean and an obese status. OBJECTIVES AND METHODS We analyzed the fecal concentrations of Bacteroidetes, Firmicutes, Methanobrevibacter smithii, the genus Lactobacillus, five other Lactobacillus species previously linked with lean or obese populations, Escherichia coli and Bifidobacterium animalis in 263 individuals, including 134 obese, 38 overweight, 76 lean and 15 anorexic subjects to test for the correlation between bacterial concentration and body mass index (BMI). Of these subjects, 137 were used in our previous study. FINDINGS Firmicutes were found in >98.5%, Bacteroidetes in 67%, M. smithii in 64%, E. coli in 51%, Lactobacillus species between 17 and 25% and B. animalis in 11% of individuals. The fecal concentration of Lactobacillus reuteri was positively correlated with BMI (coefficient=0.85; 95% confidence interval (CI) 0.12-0.58; P=0.02) in agreement with what was reported for Lactobacillus sakei. As reported, B. animalis (coefficient=-0.84; 95% CI -1.61 to -0.07; P=0.03) and M. smithii (coefficient=-0.43, 95% CI -0.90 to 0.05; P=0.08) were negatively associated with the BMI. Unexpectedly, E. coli was found here for the first time to negatively correlate with the BMI (coefficient=-1.05; 95% CI -1.60 to -0.50; P<0.001). CONCLUSION Our findings confirm the specificity of the obese microbiota and emphasize the correlation between the concentration of certain Lactobacillus species and obesity.
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Affiliation(s)
- M Million
- 1] URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France [2] APHM, CHU Timone, Pôle Infectieux, Marseille, France
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Sánchez Fructuoso A, Maestro M, Calvo N, De La Orden V, Pérez Flores I, Vidaurreta M, Valero R, Fernández-Pérez C, Barrientos A. Role of Fibroblast Growth Factor 23 (FGF23) in the Metabolism of Phosphorus and Calcium Immediately After Kidney Transplantation. Transplant Proc 2012; 44:2551-4. [DOI: 10.1016/j.transproceed.2012.09.070] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Rivas E, Ubré M, Martínez-Pallí G, Valero R, Beltran J, López A, Balust J. [Fibreoptic clinical training in anaesthesia. Course design and results based on a self-assessment survey]. Rev Esp Anestesiol Reanim 2012; 59:483-488. [PMID: 22921112 DOI: 10.1016/j.redar.2012.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 06/06/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Fibreoptic intubation is the technique of choice for resolving complications related to a difficult airway. Our aim was to determine whether a clinical-practice-based, individualized course provides sufficient training and confidence to allow anaesthetists to routinely practice fibreoptic intubation. METHODS Our hospital developed a clinical-practice-based, individualized course on fibreoptic intubation in general anaesthesia that provided practice in sedated spontaneously breathing patients and insertion through supraglottic devices. From 2005 to 2009, we e-mailed participants for response to an anonymous online self-assessment survey. We asked participants about the training outcomes and their overall degree of satisfaction. RESULTS Seventy-seven participants were sent the questionnaire six months after the course and 61% responded. All respondents considered themselves skilled in handling the bronchoscope at the end of the course and 97% used it in their routine practice in patients with difficult airways. CONCLUSIONS These results suggest a high success rate can be expected from individually tailored fibreoptic intubation courses that supplement theory and mannequin experience with clinical practice.
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Affiliation(s)
- E Rivas
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Clínic de Barcelona, Universitat de Barcelona, España.
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Vendrell M, Valero R, Mercadal J, Enseñat J, Fábregas N. [Cerebrovascular accident with haemorrhagic transformation in a patient on antiplatelet treatment subjected to surgery of a hypophyseal macroadenoma]. Rev Esp Anestesiol Reanim 2012; 59:448-451. [PMID: 22809577 DOI: 10.1016/j.redar.2012.06.003] [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] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 05/23/2012] [Indexed: 06/01/2023]
Abstract
The case is presented of a 51 year-old woman, proposed for endoscopic endonasal transsphenoidal resection of a hypophyseal macroadenoma diagnosed in the context of a stroke suffered 10 weeks before the date of the surgery. During this time, she had been treated with antiplatelet drugs, which were withdrawn 5 days before the surgery. The surgical procedure was performed without any incidents. On the second day after the surgery, the patient had an ischaemic infarction of the left cerebellar hemisphere, with signs of hydrocephaly and a posterior haemorrhagic transformation, with brain death 5 days after the operation. There are no definitive guidelines on the use of antiplatelet drugs in the perioperative period of neurosurgery. Also, there is no agreement as regards the waiting time between a cerebrovascular event and surgery, it appears that between 4 and 12 weeks would be the most advisable. The importance of an individual assessment of each patient before surgery is emphasised, as well as a review of the antiplatelet management of the patient with a risk of thrombosis in the context of neurosurgery, and their possible postoperative complications.
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Affiliation(s)
- M Vendrell
- Universidad de Barcelona, Barcelona, España.
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Borràs R, Periñan R, Fernández C, Plaza A, Andreu E, Schmucker E, Añez C, Valero R. [Airway management algorithm in the obstetrics patient]. Rev Esp Anestesiol Reanim 2012; 59:436-443. [PMID: 22947195 DOI: 10.1016/j.redar.2012.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 05/05/2012] [Indexed: 06/01/2023]
Affiliation(s)
- R Borràs
- Departamento de Anestesiología y Reanimación, Institut Universitari Dexeus, Barcelona, España.
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