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Baminiwatta A, Fernando R, Solangaarachchi I, Abayabandara-Herath T, Wickremasinghe AR, Hapangama A. Improving psychological well-being among healthcare workers during the COVID-19 pandemic with an online mindfulness intervention: A randomised waitlist-controlled trial. Int J Psychol 2024; 59:410-418. [PMID: 38355927 DOI: 10.1002/ijop.13118] [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: 02/20/2023] [Accepted: 01/06/2024] [Indexed: 02/16/2024]
Abstract
The high prevalence of psychological problems observed among healthcare workers (HCWs) during the COVID-19 pandemic called for interventions to safeguard their mental health. We assessed the effectiveness of a 6-week online mindfulness-based intervention in improving well-being and reducing stress among HCWs in Sri Lanka. Eighty HCWs were recruited and randomised into two groups: waitlist-control (WLC) and intervention groups. In the intervention, 1-hour online sessions were conducted at weekly intervals and participants were encouraged to do daily home practice. Stress and well-being were measured pre- and post-intervention using the Perceived Stress Scale and WHO-5 Well-being Index, respectively. One-way analysis of covariance was used to evaluate the effectiveness, in both intention-to-treat (ITT) and complete-case (CC) analyses. A significantly greater improvement in well-being occurred in the intervention arm compared to WLC on both ITT (p = .002) and CC analyses (p < .001), with medium-to-large effect sizes (partial η2 = .117-.278). However, the reduction in stress following the intervention was not significant compared to the WLC group on both ITT (p = .636) and CC analyses (p = .262). In the intervention arm, the median number of sessions attended by participants was 3. Low adherence to the intervention may have contributed to the apparent non-significant effect on stress.
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Affiliation(s)
- Anuradha Baminiwatta
- Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Roshan Fernando
- Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | | | | | | | - Aruni Hapangama
- Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Baminiwatta A, Fernando R, Gadambanathan T, Jiyatha F, Sasala R, Kuruppuarachchi L, Wickremasinghe R, Hapangama A. Measuring Resilience Among Sri Lankan Healthcare Workers: Validation of the Brief Resilience Scale in Sinhalese and Tamil Languages. Indian J Psychol Med 2023; 45:542-543. [PMID: 37772141 PMCID: PMC10523521 DOI: 10.1177/02537176231174185] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Affiliation(s)
- Anuradha Baminiwatta
- Dept. of Psychiatry, Faculty of Medicine,
University of Kelaniya, Ragama, Sri Lanka
| | - Roshan Fernando
- Dept. of Psychiatry, Faculty of Medicine,
University of Kelaniya, Ragama, Sri Lanka
| | | | - Fathima Jiyatha
- Dept. of Clinical Science, Faculty of Health
Sciences, Eastern University, Chenkaladi, Sri Lanka
| | - Rashmi Sasala
- Dept. of Psychiatry, Faculty of Medicine,
University of Kelaniya, Ragama, Sri Lanka
| | | | | | - Aruni Hapangama
- Dept. of Psychiatry, Faculty of Medicine,
University of Kelaniya, Ragama, Sri Lanka
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Wagstaff DT, Bulamba F, Fernando R. Obstetric anaesthesia over the next 10 years: Africa and Middle East. Int J Obstet Anesth 2023; 55:103877. [PMID: 37076357 DOI: 10.1016/j.ijoa.2023.103877] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 04/21/2023]
Abstract
Maternal and neonatal health outcomes vary within Africa and the Middle East. Despite substantial improvements over the past 20 years, there are persisting inequities in access to, and the quality of, obstetric anaesthetic care. These are most noticeable in Sub-Saharan Africa which has only 3% of the world's healthcare workforce but approximately two-thirds of global maternal deaths. Improvements are being made by: improving access; increasing numbers of trained staff; delivering accessible training; gathering data; conducting research and quality improvement activities; using innovative technologies; and forming productive collaborations. Further improvements will be needed to cope with increasing demand, the impacts of climate change and potential future pandemics.
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Baminiwatta A, Fernando R, Williams S. Improving medical students' understanding of dementia using a movie ( The Father). Educ Prim Care 2023; 34:109. [PMID: 36799504 DOI: 10.1080/14739879.2023.2178333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
| | - Roshan Fernando
- Department of Psychiatry, University of Kelaniya, Ragama, Sri Lanka
| | - Shehan Williams
- Department of Psychiatry, University of Kelaniya, Ragama, Sri Lanka
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Alhammad MF, Mathias R, Nahid S, Fernando R, Shallik N. No: 7535 Urinary guidewire and Tritube solved the mystery of severe tracheal stenosis management: a case report. Trends in Anaesthesia and Critical Care 2023. [DOI: 10.1016/s2210-8440(23)00087-4] [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: 03/08/2023]
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Korenblik R, van Zon JFJA, Olij B, Heil J, Dewulf MJL, Neumann UP, Olde Damink SWM, Binkert CA, Schadde E, van der Leij C, van Dam RM, van Baardewijk LJ, Barbier L, Binkert CA, Billingsley K, Björnsson B, Andorrà EC, Arslan B, Baclija I, Bemelmans MHA, Bent C, de Boer MT, Bokkers RPH, de Boo DW, Breen D, Breitenstein S, Bruners P, Cappelli A, Carling U, Robert MCI, Chan B, De Cobelli F, Choi J, Crawford M, Croagh D, van Dam RM, Deprez F, Detry O, Dewulf MJL, Díaz-Nieto R, Dili A, Erdmann JI, Font JC, Davis R, Delle M, Fernando R, Fisher O, Fouraschen SMG, Fretland ÅA, Fundora Y, Gelabert A, Gerard L, Gobardhan P, Gómez F, Guiliante F, Grünberger T, Grochola LF, Grünhagen DJ, Guitart J, Hagendoorn J, Heil J, Heise D, Herrero E, Hess G, Hilal MA, Hoffmann M, Iezzi R, Imani F, Inmutto N, James S, Borobia FJG, Jovine E, Kalil J, Kingham P, Kollmar O, Kleeff J, van der Leij C, Lopez-Ben S, Macdonald A, Meijerink M, Korenblik R, Lapisatepun W, Leclercq WKG, Lindsay R, Lucidi V, Madoff DC, Martel G, Mehrzad H, Menon K, Metrakos P, Modi S, Moelker A, Montanari N, Moragues JS, Navinés-López J, Neumann UP, Nguyen J, Peddu P, Primrose JN, Olde Damink SWM, Qu X, Raptis DA, Ratti F, Ryan S, Ridouani F, Rinkes IHMB, Rogan C, Ronellenfitsch U, Serenari M, Salik A, Sallemi C, Sandström P, Martin ES, Sarría L, Schadde E, Serrablo A, Settmacher U, Smits J, Smits MLJ, Snitzbauer A, Soonawalla Z, Sparrelid E, Spuentrup E, Stavrou GA, Sutcliffe R, Tancredi I, Tasse JC, Teichgräber U, Udupa V, Valenti DA, Vass D, Vogl TJ, Wang X, White S, De Wispelaere JF, Wohlgemuth WA, Yu D, Zijlstra IJAJ. Resectability of bilobar liver tumours after simultaneous portal and hepatic vein embolization versus portal vein embolization alone: meta-analysis. BJS Open 2022; 6:6844022. [PMID: 36437731 PMCID: PMC9702575 DOI: 10.1093/bjsopen/zrac141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/09/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Many patients with bi-lobar liver tumours are not eligible for liver resection due to an insufficient future liver remnant (FLR). To reduce the risk of posthepatectomy liver failure and the primary cause of death, regenerative procedures intent to increase the FLR before surgery. The aim of this systematic review is to provide an overview of the available literature and outcomes on the effectiveness of simultaneous portal and hepatic vein embolization (PVE/HVE) versus portal vein embolization (PVE) alone. METHODS A systematic literature search was conducted in PubMed, Web of Science, and Embase up to September 2022. The primary outcome was resectability and the secondary outcome was the FLR volume increase. RESULTS Eight studies comparing PVE/HVE with PVE and six retrospective PVE/HVE case series were included. Pooled resectability within the comparative studies was 75 per cent in the PVE group (n = 252) versus 87 per cent in the PVE/HVE group (n = 166, OR 1.92 (95% c.i., 1.13-3.25)) favouring PVE/HVE (P = 0.015). After PVE, FLR hypertrophy between 12 per cent and 48 per cent (after a median of 21-30 days) was observed, whereas growth between 36 per cent and 67 per cent was reported after PVE/HVE (after a median of 17-31 days). In the comparative studies, 90-day primary cause of death was similar between groups (2.5 per cent after PVE versus 2.2 per cent after PVE/HVE), but a higher 90-day primary cause of death was reported in single-arm PVE/HVE cohort studies (6.9 per cent, 12 of 175 patients). CONCLUSION Based on moderate/weak evidence, PVE/HVE seems to increase resectability of bi-lobar liver tumours with a comparable safety profile. Additionally, PVE/HVE resulted in faster and more pronounced hypertrophy compared with PVE alone.
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Affiliation(s)
- Remon Korenblik
- Correspondence to: R. K., Universiteigssingel 50 (room 5.452) 6229 ER Maastricht, The Netherlands (e-mail: ); R. M. v. D., Maastricht UMC+, Dept. of Surgery, Level 4, PO Box 5800, 6202 AZ Maastricht, The Netherlands (e-mail: )
| | - Jasper F J A van Zon
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bram Olij
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,GROW—Department of Surgery, School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Jan Heil
- Department of General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Maxime J L Dewulf
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ulf P Neumann
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Steven W M Olde Damink
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany,NUTRIM—Department of Surgery, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Christoph A Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Erik Schadde
- Department of General, Visceral and Transplant Surgery, Klinik Hirslanden, Zurich, Switzerland,Department of General, Visceral and Transplant Surgery, Hirslanden Klink St. Anna Luzern, Luzern, Switzerland
| | | | - Ronald M van Dam
- Correspondence to: R. K., Universiteigssingel 50 (room 5.452) 6229 ER Maastricht, The Netherlands (e-mail: ); R. M. v. D., Maastricht UMC+, Dept. of Surgery, Level 4, PO Box 5800, 6202 AZ Maastricht, The Netherlands (e-mail: )
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Fernando R, Gan L, Xiao J, Yun Y. Hyperprolactinemia induced by brexpiprazole in patients with schizophrenia: A case report. Psychiatry Res 2021; 305:114215. [PMID: 34563975 DOI: 10.1016/j.psychres.2021.114215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/31/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Roshan Fernando
- Northern Area Mental Health Services, Royal Melbourne Hospital, Epping, Victoria, Australia
| | - Lucy Gan
- Department of Psychiatry, Northern Health, Epping, Victoria, Australia
| | - Junhua Xiao
- School of Health Sciences, Swinburne University of Technology, Victoria, Australia; School of Allied Health, La Trobe University, Victoria, Australia
| | - Yang Yun
- Northern Area Mental Health Services, Royal Melbourne Hospital, Epping, Victoria, Australia.
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Peacock S, Briggs D, Barnardo M, Battle R, Brookes P, Callaghan C, Clark B, Collins C, Day S, Diaz Burlinson N, Dunn P, Fernando R, Fuggle S, Harmer A, Kallon D, Keegan D, Key T, Lawson E, Lloyd S, Martin J, McCaughan J, Middleton D, Partheniou F, Poles A, Rees T, Sage D, Santos-Nunez E, Shaw O, Willicombe M, Worthington J. BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation. Int J Immunogenet 2021; 49:22-29. [PMID: 34555264 PMCID: PMC9292213 DOI: 10.1111/iji.12558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
All UK H&I laboratories and transplant units operate under a single national kidney offering policy, but there have been variations in approach regarding when to undertake the pre‐transplant crossmatch test. In order to minimize cold ischaemia times for deceased donor kidney transplantation we sought to find ways to be able to report a crossmatch result as early as possible in the donation process. A panel of experts in transplant surgery, nephrology, specialist nursing in organ donation and H&I (all relevant UK laboratories represented) assessed evidence and opinion concerning five factors that relate to the effectiveness of the crossmatch process, as follows: when the result should be ready for reporting; what level of donor HLA typing is needed; crossmatch sample type and availability; fairness and equity; risks and patient safety. Guidelines aimed at improving practice based on these issues are presented, and we expect that following these will allow H&I laboratories to contribute to reducing CIT in deceased donor kidney transplantation.
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Affiliation(s)
- S Peacock
- Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - D Briggs
- H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK
| | - M Barnardo
- Clinical Transplant Immunology, Churchill Hospital, Oxford, UK
| | - R Battle
- H&I Laboratory, SNBTS, Edinburgh, UK
| | - P Brookes
- H&I Laboratory, Harefield Hospital, Harefield, UK
| | - C Callaghan
- Department of Nephrology and Transplantation, Guy's Hospital, London, UK
| | - B Clark
- H&I Laboratory, Leeds Teaching Hospitals NHS Trust, UK
| | - C Collins
- H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK
| | - S Day
- H&I Laboratory, Southmead Hospital, Bristol, UK
| | - N Diaz Burlinson
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
| | - P Dunn
- Transplant Laboratory, Leicester General Hospital, Leicester, UK
| | - R Fernando
- H&I Laboratory, The Anthony Nolan Laboratories, Royal Free Hospital, UK
| | - S Fuggle
- Organ Donation & Transplantation, NHSBT, Stoke Gifford, Bristol, UK
| | - A Harmer
- H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK
| | - D Kallon
- H & I Laboratory, Royal London Hospital, London, UK
| | - D Keegan
- Department of H&I, Beaumont Hospital, Dublin, UK
| | - T Key
- H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK
| | - E Lawson
- Organ Donation and Transplantation, NHSBT, Birmingham, UK
| | - S Lloyd
- Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK
| | - J Martin
- H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - J McCaughan
- H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - D Middleton
- H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK
| | - F Partheniou
- H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK
| | - A Poles
- H&I Laboratory, University Hospitals Plymouth, Plymouth, UK.,H&I Laboratory, NHSBT Filton, Bristol, UK
| | - T Rees
- Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK
| | - D Sage
- H&I Laboratory, NHSBT Tooting Centre, London, UK
| | - E Santos-Nunez
- H&I Laboratory, Imperial College Healthcare NHS Trust, London, UK
| | - O Shaw
- H&I Laboratory, Viapath, Guys & St Thomas, London, UK
| | - M Willicombe
- Department of Immunology and Inflammation, Imperial College London, UK
| | - J Worthington
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
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Ahmed I, Majeed A, Fernando R, Hyare H, Columb M, Setty T. Magnetic resonance imaging of cerebrospinal fluid spread in the epidural space and postdural puncture headache in obstetrics: A proof-of-concept study. Eur J Anaesthesiol 2021; 38:777-784. [PMID: 33470687 DOI: 10.1097/eja.0000000000001445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Currently, performing an epidural blood patch (EBP) for postdural puncture headache (PDPH) remains a subjective clinical decision. An evidence-based protocol may be of value in identifying women at high risk of developing a severe PDPH. OBJECTIVE To investigate a potential correlation between the extent of CSF spread in the epidural space, as noted on Magnetic Resonance Imaging (MRI), and the likelihood of development of severe PDPH in obstetric patients. DESIGN A prospective double-blind quasi-observational study. SETTING Eight tertiary obstetric units, from NHS hospitals. PATIENTS Parturients with accidental dural puncture (ADP) underwent T1 and T2-weighted MRI scans of the brain and lumbar spine within 48 h after delivery. All women were followed up, daily, for 1 week. MAIN OUTCOME MEASURES For each woman, a PDPH severity score was calculated using a four-point Verbal Reporting Scale (none = 0, mild = 1, moderate = 2, severe = 3), with additional points awarded for visual, auditory and emetic symptoms. MRIs were reported by a neuroradiologist, blind to the patient details, using a predefined MRI score. RESULTS Twenty-two parturients were recruited; 86% (n=19) developed PDPH and 10 of these (53%) required an EBP. The median (range) time for the onset of PDPH was 24 (4 to 126) hours. The median (range) cumulative PDPH severity score was 10 (0 to 21), whereas, the median (range) MRI score was 2.5 (0 to 12). Spearman (rs) analysis identified a significant positive correlation (rs = 0.46; P = 0.024) between cumulative PDPH severity and MRI scores. Of all the radiological features identified in an MRI (lumbar dural shift, caudal brain displacement, epidural or intrathecal blood), the presence of intrathecal blood was most strongly correlated with PDPH severity (P = 0.043). CONCLUSION Following an ADP, the extent of CSF spread in the epidural space correlates with the severity of subsequent PDPH. CLINICAL TRIAL NUMBER AND REGISTRY URL ISRCTN14959004, https://www.isrctn.com/.
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Affiliation(s)
- Iftikhar Ahmed
- From the Department of Anaesthesia, King Faisal Specialist Hospital & Research Centre, Kingdom of Saudi Arabia (IA, AM), Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar (RF), Department of Anaesthesia, University College Hospital, London (HH, TS) and Department of Anaesthesia, University Hospital of South Manchester, Wythenshawe, UK (MC)
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Samanta BR, Fernando R, Rösch D, Reisler H, Osborn DL. Primary photodissociation mechanisms of pyruvic acid on S1: observation of methylhydroxycarbene and its chemical reaction in the gas phase. Phys Chem Chem Phys 2021; 23:4107-4119. [DOI: 10.1039/d0cp06424f] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Following S1 ← S0 excitation at 351 nm, pyruvic acid dissociates mainly into methylhydroxycarbene (MHC) and CO2. Some MHC molecules isomerize to more stable acetaldehyde and vinyl alcohol; the remaining MHC is stabilized and reacts bimolecularly.
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Affiliation(s)
- B. R. Samanta
- Department of Chemistry
- University of Southern California
- Los Angeles
- USA
| | - R. Fernando
- Department of Chemistry
- University of Southern California
- Los Angeles
- USA
| | - D. Rösch
- Combustion Research Facility
- Sandia National Laboratories
- Livermore
- USA
| | - H. Reisler
- Department of Chemistry
- University of Southern California
- Los Angeles
- USA
| | - D. L. Osborn
- Combustion Research Facility
- Sandia National Laboratories
- Livermore
- USA
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Gupta A, von Heymann C, Magnuson A, Alahuhta S, Fernando R, Van de Velde M, Mercier FJ, Schyns-van den Berg AMJV, Bryon B, Soetens F, Dewandre PY, Lambert G, Christiaen J, Schepers R, Van Houwe P, Kalmar A, Vanoverschelde H, Bauters M, Roofthooft E, Devroe S, Van de Velde M, Jadrijevic A, Jokic A, Marin D, Sklebar I, Mihaljević S, Kosinova M, Stourac P, Adamus M, Kufa C, Volfová I, Zaoralová B, Froeslev-Friis C, Mygil B, Krebs Albrechtsen C, Kavasmaa T, Alahuhta S, Mäyrä A, Mennander S, Rautaneva K, Hiekkanen T, Kontinen V, Linden K, Toivakka S, Boselli E, Greil PÉ, Mascle O, Courbon A, Lutz J, Simonet T, Barbier M, Hlioua T, Meniolle d’Hauthville F, Quintin C, Bouattour K, Lecinq A, Soued M, Bonnet MP, Carbonniere M, Fischer C, Picard PC, Bonnin M, Storme B, Bouthors AS, Detente T, Nguyen Troung M, Keita H, Nebout S, Osse L, Delmas A, Vial F, Kaufner L, Hoefing C, Mueller S, Becke K, Blobner M, Lewald H, Schaller SJ, Muggleton E, Bette B, Neumann C, Weber S, Grünewald M, Ohnesorge H, Helf A, Jelting Y, Kranke P, von Heymann C, Welfle S, Staikou C, Stavrianopoulou A, Tsaroucha A, Kalopita K, Loukeri A, Valsamidis D, Matsota P, Thorsteinsson A, Tome R, Eidelman LA, Davis A, Orbach-Zinger S, Ioscovich A, Ramona I, De Simone L, Pesetti B, Brazzi L, Zito A, Camorcia M, Della Rocca G, Aversano M, Frigo MG, Todde C, Morina Q, Macas A, Keraitiene G, Rimaitis K, Borg F, Tua C, Kuijpers-Visser AG, Schyns-van den Berg A, Hollmann MW, Van den Berg T, Koolen E, Dons I, van der Knijff A, van der Marel C, Ruysschaert N, Pelka M, Pluymakers C, Koopman S, Teunissen AJ, Cornelisse D, van Dasselaar N, Verdouw B, Beenakkers I, Dahl V, Hagen R, Vivaldi F, Eriksen JR, Wiszt R, Aslam Tayyaba N, Ringvold EM, Chutkowski R, Skirecki T, Wódarski B, Faria MA, Ferreira A, Sampaio AC, Ferreira I, Matias B, Teixeira J, Araujo R, Cabido H, Fortuna R, Lemos P, Cardoso C, Moura F, Pereira C, Pereira S, Tavares F, Vasconcelos P, Abecasis M, Lança F, Muchacho P, Ormonde L, Guedes-Araujo I, Pinho-Oliveira V, Paredes P, Bentes C, Gouveia F, Milheiro A, Castanheira C, Neves M, Pacheco V, Cortez M, Tranquada R, Tareco G, Furtado I, Pereira E, Marinho L, Seabra M, Bulasevic A, Kendrisic M, Jovanovic L, Pujić B, Kutlesic M, Grochova M, Simonova J, Pavlovic G, Rozman A, Blajic I, Graovac D, Stopar Pintraic T, Chiquito T, Monedero P, Carlos-Errea DJ, Guillén-Casbas R, Veiga-Gil L, Basso M, Garcia Bartolo C, Hernandez C, Ricol L, De Santos MP, Gràcia Solsona JA, López-Baamonde M, Magaldi Mendaña M, Plaza Moral AM, Vendrell M, Trillo L, Perez Garcia AR, Alamillo Salas C, Moret E, Ramió L, Aguilar Sanchez JL, Soler Pedrola M, Valldeperas Hernandez MI, Aldalur G, Bárcena E, Herrera J, Iturri F, Martínez A, Martínez L, Serna R, Gilsanz F, Guasch Arevalo E, Iannuccelli F, Latorre J, Rodriguez Roca C, Pérez Pardo OC, Sierra Biddle N, Suárez Cendaña C, Hernández González L, Remacha González C, Sánchez Nuez R, Anta D, Beleña JM, García-Cuadrado C, Garcia I, Manrique S, Suarez E, Hein A, Arbman E, Hansson H, Tillenius M, Al-Taie R, Ledin-Eriksson S, Lindén-Söndersö A, Rosén O, Austruma E, Gillberg L, Darvish B, Gupta A, Nordstöm JL, Persson J, Rosenberg J, Brühne L, Forshammar J, Ugarph Edfeldt M, Rolfsson H, Hellblom A, Levin K, Rabow S, Thorlacius K, Bansch P, Robertson (Baeriswyl) M, Stamer U, Mathivon S, Savoldelli G, Auf der Maur P, Filipovic M, Dullenkopf A, Brunner M, Girard T, Vonlanthen C, Ozbilgin S, Gunaydin D B, Corman Dincer P, Tas Tuna A. Management practices for postdural puncture headache in obstetrics: a prospective, international, cohort study. Br J Anaesth 2020; 125:1045-1055. [PMID: 33039123 DOI: 10.1016/j.bja.2020.07.061] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 04/01/2020] [Revised: 07/05/2020] [Accepted: 07/30/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. METHODS Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. RESULTS A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19-1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. CONCLUSIONS Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP.
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Affiliation(s)
- Anil Gupta
- Department of Perioperative Medicine and Intensive Care and Institution of Physiology and Pharmacology, Karolinska Hospital and Karolinska Institutet, Stockholm, Sweden.
| | - Christian von Heymann
- Department of Anaesthesia, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Anders Magnuson
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Seppo Alahuhta
- Department of Anaesthesiology, Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Roshan Fernando
- Department of Anesthesiology and Intensive Care Medicine, The Womens Wellness and Research Centre, Doha, Qatar
| | | | - Frédéric J Mercier
- Département d'Anesthésie, Hôpital Antoine Béclère, AP-HP, Université Paris-Saclay, France
| | - Alexandra M J V Schyns-van den Berg
- Department of Anesthesiology, Albert Schweitzer Ziekenhuis, Dordrecht and Department of Anesthesiology, Leiden University Medical Centre, Leiden, The Netherlands
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Al-Sulttan S, Bampoe S, Howle R, Setty T, Columb M, Patel A, Fernando R, Husain T, Sultan P. A prospective, up-down sequential allocation study investigating the effectiveness of vital capacity breaths using high-flow nasal oxygenation versus a tight-fitting face mask to pre-oxygenate term pregnant women. Int J Obstet Anesth 2020; 45:28-33. [PMID: 33129656 DOI: 10.1016/j.ijoa.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/03/2020] [Accepted: 08/16/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The role of high flow nasal oxygenation (HFNO) for pre-oxygenation before obstetric general anaesthesia remains unclear. This study aimed to determine the number of vital capacity breaths using HFNO required to pre-oxygenate 90% of parturients to an end-tidal oxygen concentration fraction (FETO2) of ≥0.90 (termed EN90). METHODS Using up-down, sequential allocation trial design, volunteer term parturients undergoing caesarean delivery were investigated with HFNO with their mouth closed, followed by mouth open, and if FETO2 ≥0.90 was not achieved after a maximum of 20 vital capacity breaths, pre-oxygenation was attempted with a face mask. The primary outcome was the number of vital capacity breaths required using HFNO (mouth open and closed) to achieve EN90. Secondary outcomes included assessment of EN90 using mouth open versus mouth closed and face mask pre-oxygenation, maternal satisfaction and evaluation of fetal cardiotocography. RESULTS Twenty women at term were recruited. Successful pre-oxygenation occurred in 4 (20%), 3 (15%) and 14 (70%) women with HFNO mouth closed, HFNO mouth open, and via face mask respectively. At up to 20 vital capacity breaths, face mask pre-oxygenation was more successful at achieving EN90 compared with both HFNO with a closed (P=0.006) or open (P=0.001) mouth. Closed mouth HFNO did not outperform open mouth pre-oxygenation. CONCLUSION Face mask pre-oxygenation is more effective at achieving EN90 compared with to HFNO within a clinically acceptable number of vital capacity breaths. Further studies are needed to determine the role of HFNO in optimising the time before desaturation and for apnoeic oxygenation in term parturients.
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Affiliation(s)
- S Al-Sulttan
- Department of Anaesthesia, University College London NHS Trust, London, UK
| | - S Bampoe
- Department of Anaesthesia, University College London NHS Trust, London, UK; University College London, UK.
| | - R Howle
- Department of Anaesthesia, University College London NHS Trust, London, UK
| | - T Setty
- Anaesthesia, Queens Medical Centre, Nottingham, UK
| | - M Columb
- Anaesthesia & Intensive Care Medicine, University of Manchester Hospitals NHS Foundation Trust, Wythenshawe Hospital, UK
| | - A Patel
- University College London, UK
| | - R Fernando
- The Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - T Husain
- Anaesthesia, Ashford & St Peters NHS Foundation Trust, UK
| | - P Sultan
- Stanford University School of Medicine, CA, USA
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Samanta BR, Fernando R, Rösch D, Reisler H, Osborn DL. Looking at the bigger picture: Identifying the photoproducts of pyruvic acid at 193 nm. J Chem Phys 2020; 153:074307. [DOI: 10.1063/5.0018582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B. R. Samanta
- Department of Chemistry, University of Southern California, Los Angeles, California 90089-0482, USA
| | - R. Fernando
- Department of Chemistry, University of Southern California, Los Angeles, California 90089-0482, USA
| | - D. Rösch
- Combustion Research Facility, Sandia National Laboratories, Livermore, California 94551-0969, USA
| | - H. Reisler
- Department of Chemistry, University of Southern California, Los Angeles, California 90089-0482, USA
| | - D. L. Osborn
- Combustion Research Facility, Sandia National Laboratories, Livermore, California 94551-0969, USA
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Swanger AM, Fesmire JE, Fernando R. Oxygen storage module with physisorption technology for closed-circuit respirators. IOP Conf Ser Mater Sci Eng 2020; 755:10.1088/1757-899x/755/1/012106. [PMID: 37206896 PMCID: PMC10193508 DOI: 10.1088/1757-899x/755/1/012106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The new Cryogenic Flux Capacitor (CFC) technology employs nano-porous aerogel composites to store large quantities of fluid molecules in a physisorbed solid-state condition at moderate pressures and cryogenic temperatures. By its design architecture, a CFC device can be "charged" and "discharged" quickly and on demand according to standby/usage requirements. One of three main application areas is the CFC-Life for breathing air or oxygen supply to meet new demands in life support systems. Through the Liquid Oxygen Storage Module (LOXSM) Project, the National Institute for Occupational Safety and Health, and Cryogenics Test Laboratory have partnered to test the feasibility of applying the CFC technology to Closed-Circuit Escape Respirators (CCER), or respirators operating on the closed-circuit principle in general. The envisioned Cryogenic Oxygen Storage Module (COSM) is an innovative concept to store oxygen in solid-state form, according to physisorption processes at any cryogenic temperature, and deliver it as a gas using the CFC as the core storage element. Gaseous oxygen would be admitted into the breathing loop of the CCER by introducing heat into the storage module. Potentially replacing the gaseous or chemical based oxygen supply used in today's closed-circuit respirators, the COSM is a high capacity, conformal, small-size solution for future life support equipment of all kinds. In particular, are the CCER devices that must to be carried on the person, ready to be quickly deployed and used for escape in an emergency. Initial test data for physisorption of oxygen in aerogel materials and CFC core modules are presented. The basic operational parameters for charging and discharging are summarized through prototype testing of the cryogenic oxygen storage module.
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Affiliation(s)
- A M Swanger
- NASA Kennedy Space Center, Cryogenics Test Laboratory, Kennedy Space Center, FL 32899 USA
| | - J E Fesmire
- NASA Kennedy Space Center, Cryogenics Test Laboratory, Kennedy Space Center, FL 32899 USA
| | - R Fernando
- National Institute for Occupational Safety and Health, Pittsburgh, PA 15236 USA
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Ramage S, Armstrong S, Fernando R. Update on Vasopressors for Cesarean Delivery. Curr Anesthesiol Rep 2019. [DOI: 10.1007/s40140-019-00315-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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del Arroyo A, Sanchez J, Patel S, Phillips S, Reyes A, Cubillos C, Fernando R, David A, Sultan P, Ackland G, Reeve A, Sodha S, Ciechanowicz S, Olearo E, Dick J, Stewart A. Role of leucocyte caspase-1 activity in epidural-related maternal fever: a single-centre, observational, mechanistic cohort study. Br J Anaesth 2019; 122:92-102. [DOI: 10.1016/j.bja.2018.09.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 09/03/2018] [Accepted: 09/24/2018] [Indexed: 01/19/2023] Open
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Leffert L, Butwick A, Carvalho B, Arendt K, Bates SM, Friedman A, Horlocker T, Houle T, Landau R, Dubois H, Fernando R, Houle T, Kopp S, Montgomery D, Pellegrini J, Smiley R, Toledo P. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesth Analg 2018; 126:928-944. [DOI: 10.1213/ane.0000000000002530] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Fernando R. TECHNOLOGIES FOR THE NEXT GENERATION CLOSED-CIRCUIT ESCAPE RESPIRATORS. Trans Soc Min Metall Explor Inc 2018; 2018:469-471. [PMID: 37020536 PMCID: PMC10071403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
The National Institute for Occupational Safety and Health (NIOSH) National Personal Protective Technology Laboratory (NPPTL) is leading an effort to develop the next generation of self-escape breathing apparatus for egress from confined spaces in emergency scenarios. A backpack style closed-circuit mine escape respirator design was one configuration explored as part of the research imperative directed by the 2006 MINER Act. Stakeholder feedback from MSHA and at the NIOSH Breathing Air Supply Partnership Meeting indicated a smaller belt worn unit that does not sacrifice performance is desirable. This paper outlines some further technology advancements that may be investigated toward developing such a small-sized respirator. Technologies being considered are novel chemicals for improved carbon dioxide (CO2) absorption and oxygen (O2) production, eliminating a dedicated CO2 scrubber by incorporating its function in the spaces of the respirator's breathing loop and storing O2 in a liquid form with long standby capabilities. When these technologies are applied to a future design, there is the possibility of having an escape respirator that can be belt worn and capable of being certified to 42 Code of Federal Regulations (CFR) Part 84 standards, including sub-part O for escape purposes including mine escape.
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Kinsella SM, Carvalho B, Dyer RA, Fernando R, McDonnell N, Mercier FJ, Palanisamy A, Sia ATH, Van de Velde M, Vercueil A. International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia. Anaesthesia 2017; 73:71-92. [DOI: 10.1111/anae.14080] [Citation(s) in RCA: 233] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S. M. Kinsella
- Department of Anaesthesia; St Michael's Hospital; Bristol UK
| | - B. Carvalho
- Department of Anesthesiology; Stanford University School of Medicine; Stanford CA USA
| | - R. A. Dyer
- Department of Anaesthesia and Perioperative Medicine; University of Cape Town; South Africa
| | - R. Fernando
- Department of Anaesthesia; Hamad Women's Hospital; Doha Qatar
| | - N. McDonnell
- Department of Anaesthesia and Pain Medicine; King Edward Memorial Hospital for Women; Subiaco Australia
| | - F. J. Mercier
- Département d'Anesthésie-Réanimation; Hôpital Antoine Béclère; Clamart France
| | - A. Palanisamy
- Department of Anesthesiology; Washington University School of Medicine; St. Louis MO USA
| | - A. T. H. Sia
- Department of Women's Anaesthesia; KK Women's and Children's Hospital; Singapore
| | - M. Van de Velde
- Department of Anesthesiology; UZ Leuven; Leuven Belgium
- Department of Cardiovascular Sciences; KU Leuven; Leuven Belgium
| | - A. Vercueil
- Department of Anaesthesia and Intensive Care Medicine; King's College Hospital NHS Foundation Trust; London UK
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Abstract
Numerous techniques are in use to provide analgesia for labor, of which central neuraxial block is widely considered superior to non-neuraxial options. Central neuraxial techniques have evolved over many years to provide greater efficacy, safety and maternal satisfaction. This narrative review focuses on the literature relating to central neuraxial labor analgesia from the past 5 years, from November 2010 to October 2015. We discuss the evidence related to the various central neuraxial techniques used, the increasingly widespread use of ultrasound guidance and the evidence surrounding other novel methods of central neuraxial block insertion. The timing of institution of central neuraxial analgesia in labor is considered, as are the advances in maintenance regimens for labor analgesia.
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Affiliation(s)
- Serena Sodha
- Obstetric Anaesthesia Research Fellow, Department of Anesthesia, University College Hospital, London, UK
| | - Alexandra Reeve
- Consultant, Department of Anesthesia, University College Hospital, London, UK
| | - Roshan Fernando
- Consultant, Department of Anesthesia, University College Hospital, London, UK
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Fernando R, Munasinghe D, Gunasena A, Abeynayake P. Determination of nitrofuran metabolites in shrimp muscle by liquid chromatography-photo diode array detection. Food Control 2017. [DOI: 10.1016/j.foodcont.2015.08.044] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Loubert C, Gagnon PO, Fernando R. Minimum effective fluid volume of colloid to prevent hypotension during caesarean section under spinal anesthesia using a prophylactic phenylephrine infusion: An up-down sequential allocation study. J Clin Anesth 2017; 36:194-200. [DOI: 10.1016/j.jclinane.2016.10.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 09/26/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
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Mon W, Stewart A, Fernando R, Ashpole K, El-Wahab N, MacDonald S, Tamilselvan P, Columb M, Liu YM. Cardiac output changes with phenylephrine and ephedrine infusions during spinal anesthesia for cesarean section: A randomized, double-blind trial. J Clin Anesth 2016; 37:43-48. [PMID: 28235526 DOI: 10.1016/j.jclinane.2016.11.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 04/26/2016] [Revised: 10/14/2016] [Accepted: 11/03/2016] [Indexed: 12/13/2022]
Abstract
Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 μg/min or ephedrine 5 mg/min infusions. Baseline hemodynamics (cardiac output, heart rate, systolic blood pressure) were recorded in the left lateral tilt position before fluid preload, and recorded every minute after spinal anesthesia until delivery. Umbilical cord blood gases were analyzed within 5 minutes of delivery. Good systolic blood pressure control was attained in both groups with minimal periods of hypotension (SBP <80% of bSBP) or hypertension (SBP >120% of bSBP). Cardiac output and heart rate increased over time with ephedrine, but decreased with phenylephrine. The maximum increase in CO from the baseline was 12%, in the ephedrine group, and this occurred 20 minutes after spinal injection. Cardiac output fell by more than 17% in the phenylephrine group, maximal at 10 minutes following spinal injection. Despite good systolic blood pressure control and increased cardiac output with ephedrine, administration of ephedrine was associated with significantly more fetal acidosis [Median (Interquartile range, IQR) UApH - phenylephrine = 7.33 (7.31-7.34) and ephedrine = 7.22 (7.16-7.27), P < .05].
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Affiliation(s)
- W Mon
- University College London Hospitals NHS Foundation Trust, London, UK
| | - A Stewart
- University College London Hospitals NHS Foundation Trust, London, UK
| | - R Fernando
- University College London Hospitals NHS Foundation Trust, London, UK
| | - K Ashpole
- St.Richard's Hospital, Chichester, UK
| | - N El-Wahab
- University College London Hospitals NHS Foundation Trust, London, UK
| | - S MacDonald
- Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, UK
| | | | - M Columb
- University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, UK
| | - Y M Liu
- University College London Hospitals NHS Foundation Trust, London, UK
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Rosado C, Antunes F, Barbosa R, Fernando R, Estudante M, Silva HN, Rodrigues LM. About the in vivo quantitation of skin anisotropy. Skin Res Technol 2016; 23:429-436. [PMID: 27882608 DOI: 10.1111/srt.12353] [Citation(s) in RCA: 16] [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] [Accepted: 10/18/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND/PURPOSE Human skin anisotropy is difficult to quantify. The Cutiscan® , is allegedly, the first biometrical system to provide information on the elastic and viscoelastic properties, as well as on anisotropy and directionality of the human skin in vivo. Thus, this study aims to contribute to characterize this new device and its applicability, and to compare its behavior with two other well-known devices-the Cutometer® and the Reviscometer® . METHODS Measurements were conducted with each device in three different anatomical sites (forehead, forearm and leg) of 20 female volunteers engaged after informed consent. The participants in the study were aged 19-73 years (mean age 37 ± 18.7 years old), and were divided in two groups (n = 10), based on their age - Group I, mean age 22 ± 1.3 years; Group II, mean age 52 ± 13.7 years. RESULTS All devices were useful tools to explore the anatomical and the age dependant changes in biomechanical terms, showing different discriminative capacities. Interesting correlations were established between the variables provided by the equipment. CONCLUSION The Cutiscan® descriptors delivered excellent relationships with those from Cutometer® and Reviscometer® , while providing more detailed information about skin anisotropy through a full 360° analysis.
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Affiliation(s)
- C Rosado
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
| | - F Antunes
- Pharmacological Sciences Department, School of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
| | - R Barbosa
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
| | - R Fernando
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
| | - M Estudante
- iMed.ULisboa - Research Institute for Medicines, School of Pharmacy, Lisbon, Portugal
| | - H N Silva
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal.,Pharmacological Sciences Department, School of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
| | - L M Rodrigues
- CBIOS - Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal.,Pharmacological Sciences Department, School of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
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27
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Patel S, Fernando R. Opioids should be given before cord clamping for caesarean delivery under general anaesthesia. Int J Obstet Anesth 2016; 28:76-80. [PMID: 27720615 DOI: 10.1016/j.ijoa.2016.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/20/2016] [Accepted: 08/27/2016] [Indexed: 11/26/2022]
Affiliation(s)
- S Patel
- Department of Anaesthetics, University College London Hospitals NHS Foundation Trust, London, UK.
| | - R Fernando
- Department of Anaesthetics, University College London Hospitals NHS Foundation Trust, London, UK
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28
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Abstract
Intrapartum fever is associated with excessive maternal interventions as well as higher neonatal morbidity. Epidural-related maternal fever (ERMF) contributes to the development of intrapartum fever. The mechanism(s) for ERMF has remained elusive. Here, we consider how inflammatory mechanisms may be modulated by local anesthetic agents and their relevance to ERMF. We also critically reappraise the clinical data with regard to emerging concepts that explain how anesthetic drug-induced metabolic dysfunction, with or without activation of the inflammasome, might trigger the release of nonpathogenic, inflammatory molecules (danger-associated molecular patterns) likely to underlie ERMF.
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Affiliation(s)
- Pervez Sultan
- From the *Department of Anaesthesia, University College London Hospital, London, United Kingdom; †Department of Obstetrics and Maternal Fetal Medicine, University College London Hospital, London, United Kingdom; and ‡William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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29
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Blanchart A, Fernando R, Häring M, Assaife-Lopes N, Romanov RA, Andäng M, Harkany T, Ernfors P. Endogenous GAB AA receptor activity suppresses glioma growth. Oncogene 2016; 36:777-786. [PMID: 27375015 DOI: 10.1038/onc.2016.245] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/11/2016] [Accepted: 06/06/2016] [Indexed: 12/23/2022]
Abstract
Although genome alterations driving glioma by fueling cell malignancy have largely been resolved, less is known of the impact of tumor environment on disease progression. Here, we demonstrate functional GABAA receptor-activated currents in human glioblastoma cells and show the existence of a continuous GABA signaling within the tumor cell mass that significantly affects tumor growth and survival expectancy in mouse models. Endogenous GABA released by tumor cells, attenuates proliferation of the glioma cells with enriched expression of stem/progenitor markers and with competence to seed growth of new tumors. Our results suggest that GABA levels rapidly increase in tumors impeding further growth. Thus, shunting chloride ions by a maintained local GABAA receptor activity within glioma cells has a significant impact on tumor development by attenuating proliferation, reducing tumor growth and prolonging survival, a mechanism that may have important impact on therapy resistance and recurrence following tumor resection.
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Affiliation(s)
- A Blanchart
- Department of Medical Biochemistry and Biophysics, Division of Molecular Neurobiology, Karolinska Institutet, Stockholm, Sweden
| | - R Fernando
- Department of Medical Biochemistry and Biophysics, Division of Molecular Neurobiology, Karolinska Institutet, Stockholm, Sweden
| | - M Häring
- Department of Medical Biochemistry and Biophysics, Division of Molecular Neurobiology, Karolinska Institutet, Stockholm, Sweden
| | - N Assaife-Lopes
- Department of Medical Biochemistry and Biophysics, Division of Molecular Neurobiology, Karolinska Institutet, Stockholm, Sweden
| | - R A Romanov
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - M Andäng
- Department of Physiology and Pharmacology, Biophysics of Stem Cell and Tissue Growth, Karolinska Institutet, Stockholm, Sweden
| | - T Harkany
- Department of Medical Biochemistry and Biophysics, Division of Molecular Neurobiology, Karolinska Institutet, Stockholm, Sweden.,Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - P Ernfors
- Department of Medical Biochemistry and Biophysics, Division of Molecular Neurobiology, Karolinska Institutet, Stockholm, Sweden
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30
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Jeewandara K, Gomez L, Paranavitane S, Jayarathne M, Tantirimudalige M, Fernando S, Fernando R, Prathapan S, Ogg G, Malavige G. Obesity and the presence of asthma are associated with hospitalization due to dengue infection. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.933] [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: 10/22/2022] Open
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31
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Loubert C, Fernando R. Falling after epidural analgesia: lessons from obstetric anesthesia. Can J Anaesth 2016; 63:519-23. [PMID: 26830644 DOI: 10.1007/s12630-016-0603-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/10/2016] [Accepted: 01/26/2016] [Indexed: 11/27/2022] Open
Affiliation(s)
- Christian Loubert
- Department of Anesthesiology, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada
| | - Roshan Fernando
- University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK.
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32
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Sauvé G, Fernando R. Beyond Fullerenes: Designing Alternative Molecular Electron Acceptors for Solution-Processable Bulk Heterojunction Organic Photovoltaics. J Phys Chem Lett 2015; 6:3770-80. [PMID: 26722869 DOI: 10.1021/acs.jpclett.5b01471] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Organic photovoltaics (OPVs) are promising candidates for providing a low cost, widespread energy source by converting sunlight into electricity. Solution-processable active layers have predominantly consisted of a conjugated polymer donor blended with a fullerene derivative as the acceptor. Although fullerene derivatives have been the acceptor of choice, they have drawbacks such as weak visible light absorption and poor energy tuning that limit overall efficiencies. This has recently fueled new research to explore alternative acceptors that would overcome those limitations. During this exploration, one question arises: what are the important design principles for developing nonfullerene acceptors? It is generally accepted that acceptors should have high electron affinity, electron mobility, and absorption coefficient in the visible and near-IR region of the spectra. In this Perspective, we argue that alternative molecular acceptors, when blended with a conjugated polymer donor, should also have large nonplanar structures to promote nanoscale phase separation, charge separation and charge transport in blend films. Additionally, new material design should address the low dielectric constant of organic semiconductors that have so far limited their widespread application.
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Affiliation(s)
- Geneviève Sauvé
- Department of Chemistry, Case Western Reserve University , Cleveland, Ohio 44106, United States
| | - Roshan Fernando
- Department of Chemistry, Case Western Reserve University , Cleveland, Ohio 44106, United States
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33
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Aawar N, Alikhan R, Bruynseels D, Cannings-John R, Collis R, Dick J, Elton C, Fernando R, Hall J, Hood K, Lack N, Mallaiah S, Maybury H, Nuttall J, Paranjothy S, Rayment R, Rees A, Sanders J, Townson J, Weeks A, Collins P. Fibrinogen concentrate versus placebo for treatment of postpartum haemorrhage: study protocol for a randomised controlled trial. Trials 2015; 16:169. [PMID: 25906770 PMCID: PMC4408576 DOI: 10.1186/s13063-015-0670-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 03/24/2015] [Indexed: 11/28/2022] Open
Abstract
Background Postpartum haemorrhage (PPH) is a major cause of maternal morbidity. Bleeding is caused by a combination of physical causes, such as failure of the uterus to contract or operations, and is made worse by impairment of the blood clotting system. A number of studies have shown that low levels of the blood clotting factor fibrinogen are associated with progression of bleeding, the need for invasive interventions and transfusions of red blood cells and fresh frozen plasma (FFP). This trial will investigate whether early infusion of fibrinogen concentrate during a major PPH, with the aim of correcting a low fibrinogen to a level that is normal for delivery, based on the Fibtem test, reduces the total number of allogeneic blood products (red blood cells, FFP, cryoprecipitate and platelets) transfused after study medication until discharge, compared to placebo. Methods/design This is a prospective, randomised, double-blind placebo controlled trial. Women will enter an observational phase and if their Fibtem levels fall they will be randomised in the interventional phase. A total of 60 women will be randomised and women are eligible for the trial if they meet all of the following inclusion criteria: age 18 years or over, gestation ≥24 + 0 weeks, haemorrhage of about 1500 ml and on-going bleeding without another complication or haemorrhage of about 1000 ml and caesarean section/uterine atony/placental abruption/placenta praevia/cardiovascular instability or microvascular oozing. Participants with a Fibtem A5 < 16 mm will be randomly allocated to receive either a bolus infusion of fibrinogen concentrate or placebo (isotonic saline). The dose of fibrinogen concentrate or placebo will be calculated based on the woman’s ideal body weight for height and the measured Fibtem A5 with the aim of increasing the Fibtem A5 to 23 mm. Discussion The trial aims to provide evidence on the efficacy and safety of fibrinogen concentrate during acute bleeding in an obstetric setting. Trial registration ISRCTN ref: ISRCTN46295339 (01.07.2013); EudraCT: 2012-005511-11 (28.11.2012), UKCRN ref: 13940.
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Affiliation(s)
- Nadine Aawar
- Innovation, Methodology and Engagement, South East Wales Trials Unit, Institute of Translation, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
| | - Raza Alikhan
- Department of Haematology, Cardiff and Vale University Health Board, Cardiff, UK.
| | - Daniel Bruynseels
- Department of Anaesthetics and Pain Control, Cardiff and Vale University Health Board, Cardiff, UK.
| | - Rebecca Cannings-John
- Innovation, Methodology and Engagement, South East Wales Trials Unit, Institute of Translation, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
| | - Rachel Collis
- Department of Anaesthetics and Pain Control, Cardiff and Vale University Health Board, Cardiff, UK.
| | - John Dick
- Department of Anaesthetics, University College Hospital, London, UK.
| | - Christopher Elton
- Department of Anaesthetics, Leicester Royal Infirmary, Leicester, UK.
| | - Roshan Fernando
- Department of Anaesthetics, University College Hospital, London, UK.
| | - Judith Hall
- Department of Anaesthetics and Pain Control, Cardiff and Vale University Health Board, Cardiff, UK. .,Institute of Infection and Immunity, Critical Illness Research Group, Cardiff University School of Medicine, Cardiff, UK.
| | - Kerry Hood
- Innovation, Methodology and Engagement, South East Wales Trials Unit, Institute of Translation, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
| | - Nicki Lack
- Department of Obstetrics, University College Hospital, London, UK.
| | - Shuba Mallaiah
- Department of Anaesthetics, Liverpool's Women's Hospital, Liverpool, UK.
| | - Helena Maybury
- Department of Obstetrics, Leicester Royal Infirmary, Leicester, UK.
| | - Jacqueline Nuttall
- Innovation, Methodology and Engagement, South East Wales Trials Unit, Institute of Translation, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
| | - Shantini Paranjothy
- Institute of Primary Care and Public Health, Cardiff University School of Medicine, Cardiff, UK.
| | - Rachel Rayment
- Department of Obstetrics, Cardiff and Vale University Health Board, Cardiff, UK.
| | - Alexandra Rees
- Department of Obstetrics, Cardiff and Vale University Health Board, Cardiff, UK.
| | - Julia Sanders
- Innovation, Methodology and Engagement, South East Wales Trials Unit, Institute of Translation, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK. .,Department of Obstetrics, Cardiff and Vale University Health Board, Cardiff, UK.
| | - Julia Townson
- Innovation, Methodology and Engagement, South East Wales Trials Unit, Institute of Translation, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
| | - Andrew Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK.
| | - Peter Collins
- Department of Haematology, Cardiff and Vale University Health Board, Cardiff, UK. .,Institute of Infection and Immunity, Critical Illness Research Group, Cardiff University School of Medicine, Cardiff, UK.
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34
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Heesen M, Stewart A, Fernando R. Vasopressors for the treatment of maternal hypotension following spinal anaesthesia for elective caesarean section: past, present and future. Anaesthesia 2015; 70:252-7. [DOI: 10.1111/anae.13007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - A. Stewart
- Department of Anaesthesia; University College London Hospitals NHS Foundation Trust; London UK
| | - R. Fernando
- Department of Anaesthesia; University College London Hospitals NHS Foundation Trust; London UK
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35
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Etheridge FS, Fernando R, Golen JA, Rheingold AL, Sauve G. Tuning the optoelectronic properties of core-substituted naphthalene diimides by the selective conversion of imides to monothioimides. RSC Adv 2015. [DOI: 10.1039/c5ra05920h] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Molecules with a low optical gap and high electron affinity were obtained via selective thionation of the distal carbonyls of 2,6-dialkylamino core-substituted naphthalene diimide.
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Affiliation(s)
- F. S. Etheridge
- Department of Chemistry
- Case Western Reserve University
- Cleveland
- USA
| | - R. Fernando
- Department of Chemistry
- Case Western Reserve University
- Cleveland
- USA
| | - J. A. Golen
- Department of Chemistry and Biochemistry
- UMass Dartmouth
- Dartmouth
- USA
| | - A. L. Rheingold
- Department of Chemistry and Biochemistry
- University of California at San Diego
- La Jolla
- USA
| | - G. Sauve
- Department of Chemistry
- Case Western Reserve University
- Cleveland
- USA
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36
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Fernando R, Etheridge F, Muller E, Sauvé G. Tuning the optical and electrochemical properties of core-substituted naphthalenediimides with styryl imide substituent. NEW J CHEM 2015. [DOI: 10.1039/c4nj01645a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Unusually broad thin-film visible absorption (500–800 nm) for naphthalenediimide molecules was obtained by using the combination of alkylamino core substituents and styryl imide substituents.
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Affiliation(s)
- Roshan Fernando
- Department of Chemistry
- Case Western Reserve University
- Cleveland
- USA
| | | | - Evan Muller
- Department of Chemistry
- Case Western Reserve University
- Cleveland
- USA
| | - Geneviève Sauvé
- Department of Chemistry
- Case Western Reserve University
- Cleveland
- USA
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37
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Armstrong S, Fernando R, Tamilselvan P, Stewart A, Columb M. The effect of serial in vitro haemodilution with maternal cerebrospinal fluid and crystalloid on thromboelastographic (TEG®) blood coagulation parameters, and the implications for epidural blood patching. Anaesthesia 2014; 70:135-41. [DOI: 10.1111/anae.12911] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2014] [Indexed: 11/27/2022]
Affiliation(s)
- S. Armstrong
- Department of Anaesthesia; Frimley Health NHS Foundation Trust; Frimley UK
| | - R. Fernando
- Department of Anaesthesia; University College London Hospitals NHS Trust; London UK
| | - P. Tamilselvan
- Department of Anaesthesia; The Princess Alexandra Hospital; Harlow UK
| | - A. Stewart
- Department of Anaesthesia; University College London Hospitals NHS Trust; London UK
| | - M. Columb
- Department of Anaesthesia; South Manchester University Hospitals NHS Trust; Wythenshawe UK
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38
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El-Wahab N, Fernando R, Columb MO. A reply. Anaesthesia 2014; 69:1291-2. [PMID: 25302972 DOI: 10.1111/anae.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N El-Wahab
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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39
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Patel NP, El-Wahab N, Fernando R, Wilson S, Robson SC, Columb MO, Lyons GR. Fetal effects of combined spinal-epidural vs epidural labour analgesia: a prospective, randomised double-blind study. Anaesthesia 2014; 69:458-67. [PMID: 24738803 DOI: 10.1111/anae.12602] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2014] [Indexed: 02/02/2023]
Abstract
We have compared fetal heart rate patterns, Apgar scores and umbilical cord gas values following initiation of labour analgesia using either combined spinal-epidural or epidural. One hundred and fifteen healthy women requesting neuraxial analgesia in the first stage of labour were randomly assigned to receive either combined spinal-epidural (n = 62) or epidural analgesia (n = 53). Fetal heart rate traces, recorded for 30 min before and 60 min after neuraxial block, were categorised as normal, suspicious or pathological according to national guidelines. Sixty-one fetal heart rate tracings were analysed in the combined spinal-epidural group and 52 in the epidural group. No significant differences were found in fetal heart rate patterns, Apgar scores or umbilical artery and vein acid-base status between groups. However, in both combined spinal-epidural and epidural groups, there was a significant increase in the incidence of abnormal fetal heart rate patterns following neuraxial analgesia (p < 0.0001); two before compared with eight after analgesia in the combined spinal-epidural group and zero before compared with 11 after in the epidural group. These changes comprised increased decelerations (p = 0.0045) (combined spinal-epidural group nine before and 14 after analgesia, epidural group four before and 16 after), increased late decelerations (p < 0.0001) (combined spinal-epidural group zero before and seven after analgesia, epidural group zero before and eight after), and a reduction in acceleration rate (p = 0.034) (combined spinal-epidural group mean (SD) 12.2 (6.7) h(-1) before and 9.9 (6.1) h(-1) after analgesia, epidural group 11.0 (7.3) h(-1) before and 8.4 (5.9) h(-1) after). These fetal heart rate changes did not affect neonatal outcome in this healthy population.
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Affiliation(s)
- N P Patel
- Department of Anaesthesia, University College London Hospitals NHS Trust, London, UK
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40
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Polf J, Jackson I, Ranjan A, Zheng Y, Fernando R. SU-E-T-211: Induced Release of Nanocarrier Encapsulated Chemotherapeutic Drugs Using Proton Radiotherapy Beams. Med Phys 2014. [DOI: 10.1118/1.4888541] [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: 11/07/2022] Open
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41
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Fernando R, Maples D, Senavirathna LK, Zheng Y, Polf JC, Benton ER, Bartels KE, Piao D, Ranjan A. Hyperthermia Sensitization and Proton Beam Triggered Liposomal Drug Release for Targeted Tumor Therapy. Pharm Res 2014; 31:3120-6. [DOI: 10.1007/s11095-014-1404-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/28/2014] [Indexed: 12/25/2022]
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42
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Husain T, Liu Y, Fernando R, Nagaratnam V, Sodhi M, Tamilselvan P, Venkatesh S, England A, Columb M. How UK obstetric anaesthetists assess neuraxial anaesthesia for caesarean delivery: National surveys of practice conducted in 2004 and 2010. Int J Obstet Anesth 2013; 22:298-302. [DOI: 10.1016/j.ijoa.2013.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/26/2013] [Accepted: 07/07/2013] [Indexed: 10/26/2022]
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43
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Wolc A, Arango J, Settar P, Fulton JE, O'Sullivan NP, Preisinger R, Fernando R, Garrick DJ, Dekkers JCM. Analysis of egg production in layer chickens using a random regression model with genomic relationships. Poult Sci 2013; 92:1486-91. [PMID: 23687143 DOI: 10.3382/ps.2012-02882] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Random regression models allow for analysis of longitudinal data, which together with the use of genomic information are expected to increase accuracy of selection, when compared with analyzing average or total production with pedigree information. The objective of this study was to estimate variance components for egg production over time in a commercial brown egg layer population using genomic relationship information. A random regression reduced animal model with a marker-based relationship matrix was used to estimate genomic breeding values of 3,908 genotyped animals from 6 generations. The first 5 generations were used for training, and predictions were validated in generation 6. Daily egg production up to 46 wk in lay was accumulated into 85,462 biweekly (every 2 wk) records for training, of which 17,570 were recorded on genotyped hens and the remaining on their nongenotyped progeny. The effect of adding additional egg production data of 2,167 nongenotyped sibs of selection candidates [16,037 biweekly (every 2 wk) records] to the training data was also investigated. The model included a 5th order Legendre polynomial nested within hatch-week as fixed effects and random terms for coefficients of quadratic polynomials for genetic and permanent environmental components. Residual variance was assumed heterogeneous among 2-wk periods. Models using pedigree and genomic relationships were compared. Estimates of residual variance were very similar under both models, but the model with genomic relationships resulted in a larger estimate of genetic variance. Heritability estimates increased with age up to mid production and decreased afterward, resulting in an average heritability of 0.20 and 0.33 for pedigree and genomic models. Prediction of total egg number was more accurate with the genomic than with the pedigree-based random regression model (correlation in validation 0.26 vs. 0.16). The genomic model outperformed the pedigree model in most of the 2-wk periods. Thus, results of this study show that random regression reduced animal models can be used in breeding programs using genomic information and can result in substantial improvements in the accuracy of selection for trajectory traits.
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Affiliation(s)
- A Wolc
- Department of Genetics and Animal Breeding, Poznan University of Life Sciences, Poland.
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44
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Alempijevic D, Beriashvili R, Beynon J, Duque M, Duterte P, Fernando R, Fincanci S, Hansen S, Hardi L, Hougen H, Iacopino V, Mendonça M, Modvig J, Mendez M, Özkalipci Ö, Payne-James J, Peel M, Rasmussen O, Reyes H, Rogde S, Sajantila A, Treue F, Vanezis P, Vieira D. Statement on access to relevant medical and other health records and relevant legal records for forensic medical evaluations of alleged torture and other cruel, inhuman or degrading treatment or punishment. J Forensic Leg Med 2013; 20:158-63. [PMID: 23472795 DOI: 10.1016/j.jflm.2012.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In some jurisdictions attempts have been made to limit or deny access to medical records for victims of torture seeking remedy or reparations or for individuals who have been accused of crimes based on confessions allegedly extracted under torture. The following article describes the importance of full disclosure of all medical and other health records, as well as legal documents, in any case in which an individual alleges that they have been subjected to torture or other forms of cruel, inhuman or degrading treatment of punishment. A broad definition of what must be included in the terms medical and health records is put forward, and an overview of why their full disclosure is an integral part of international standards for the investigation and documentation of torture (the Istanbul Protocol). The fact that medical records may reveal the complicity or direct participation of healthcare professionals in acts of torture and other ill-treatment is discussed. A summary of international law and medical ethics surrounding the right of access to personal information, especially health information in connection with allegations of torture is also given.
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45
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Vijaya G, Cartwright R, Derpapas A, Gallo P, Fernando R, Khullar V. Changes in nerve growth factor level and symptom severity following antibiotic treatment for refractory overactive bladder. Int Urogynecol J 2013; 24:1523-8. [PMID: 23376905 DOI: 10.1007/s00192-012-2038-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 12/29/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Overactive bladder (OAB) has a multifactorial aetiology, and for some women symptoms may be associated with chronic urothelial inflammation secondary to bacterial colonisation. One marker of such inflammation may be urinary nerve growth factor (NGF). We hypothesised that for women with OAB and urothelial inflammation, urinary NGF would be reduced following antibiotic therapy. METHODS Women with overactive bladder and urodynamic diagnosis of detrusor overactivity who were refractory to anticholinergics, and had histological evidence of urothelial inflammation were treated with a 6-week course of rotating antibiotics. Urinary NGF was measured by ELISA before and after treatment. Three-day bladder diaries, the Patients' Perception of Intensity of Urgency Scale, the King's Health Questionnaire and the Patients' Perception of Bladder Condition questionnaire were used to assess subjective and objective outcomes of therapy. RESULTS Thirty-nine women with refractory DO were recruited. The NGF levels decreased significantly after antibiotic therapy (Wilcoxon signed rank test; p = 0.015). There were significant improvements in daytime frequency, nocturia and urgency (p < 0.05), and 74 % of women reported improvement in perception of their bladder condition. CONCLUSIONS Urinary NGF is responsive to antibiotic therapy. Women with refractory overactive bladder and elevated NGF may benefit from antibiotic treatment.
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Affiliation(s)
- G Vijaya
- St. Mary's Hospital, Imperial College Healthcare NHS Trust, Paddington, London, UK.
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Spurlock DM, Dekkers JCM, Fernando R, Koltes DA, Wolc A. Genetic parameters for energy balance, feed efficiency, and related traits in Holstein cattle. J Dairy Sci 2013; 95:5393-5402. [PMID: 22916946 DOI: 10.3168/jds.2012-5407] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 05/27/2012] [Indexed: 01/21/2023]
Abstract
Objectives of the current study were to estimate genetic parameters in Holstein cows for energy balance (EB) and related traits including dry matter intake (DMI), body weight (BW), body condition score (BCS), energy-corrected milk (ECM) production, and gross feed efficiency (GFE), defined as the ratio of total ECM yield to total DMI over the first 150 d of lactation. Data were recorded for the first half of lactation on 227 and 175 cows in their first or later lactation, respectively. Random regression models were fitted to longitudinal data. Also, each trait was averaged over monthly intervals and analyzed by single and multivariate animal models. Heritability estimates ranged from 0.27 to 0.63, 0.12 to 0.62, 0.12 to 0.49, 0.63 to 0.72, and 0.49 to 0.53 for DMI, ECM yield, EB, BW, and BCS, respectively, averaged over monthly intervals. Daily heritability estimates ranged from 0.18 to 0.30, 0.10 to 0.26, 0.07 to 0.22, 0.43 to 0.67, and 0.25 to 0.38 for DMI, ECM yield, EB, BW, and BCS, respectively. Estimated heritability for GFE was 0.32. The genetic correlation of EB at 10d in milk (DIM) with EB at 150 DIM was -0.19, suggesting the genetic regulation of this trait differs by stage of lactation. Positive genetic correlations were found among DMI, ECM yield, and BW averaged over monthly intervals, whereas correlations of these traits with BCS depended upon stage of lactation. Total ECM yield for the lactation was positively correlated with DMI, but a negative genetic correlation between total ECM yield and EB was found. However, the genetic correlation between total ECM yield and EB in the first month of lactation was -0.02, indicating that total production is not genetically correlated with EB during the first month of lactation, when negative EB is most closely associated with diminished fitness. The genetic correlation between GFE and EB ranged from -0.73 to -0.99, indicating that selection for more efficient cows would favor a lower energy status. However, the genetic correlation between EB in the first month of lactation and GFE calculated from 75 to 150 DIM was not significant, indicating that the unfavorable correlation between GFE and EB in early lactation may be minimized with alternative definitions of efficiency. Thus, EB, GFE and related traits will likely respond to genetic selection in Holstein cows. However, the impact of selection for improved feed efficiency on EB must be carefully considered to avoid potential negative consequences of further reductions in EB at the onset of lactation.
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Affiliation(s)
- D M Spurlock
- Department of Animal Science, Iowa State University, Ames 50011.
| | - J C M Dekkers
- Department of Animal Science, Iowa State University, Ames 50011
| | - R Fernando
- Department of Animal Science, Iowa State University, Ames 50011
| | - D A Koltes
- Department of Animal Science, Iowa State University, Ames 50011
| | - A Wolc
- Department of Animal Science, Iowa State University, Ames 50011; Department of Genetics and Animal Breeding, Poznan University of Life Sciences, Poland
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Mao Z, Vakhshouri K, Jaye C, Fischer DA, Fernando R, DeLongchamp DM, Gomez ED, Sauvé G. Synthesis of Perfluoroalkyl End-Functionalized Poly(3-hexylthiophene) and the Effect of Fluorinated End Groups on Solar Cell Performance. Macromolecules 2012. [DOI: 10.1021/ma301397p] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zhenghao Mao
- Department of Chemistry, Case Western Reserve University, Cleveland, Ohio 44106,
United States
| | - Kiarash Vakhshouri
- Department
of Chemical Engineering
and Materials Research Institute, The Pennsylvania State University, University Park, Pennsylvania 16802, United
States
| | - Cherno Jaye
- National Institute of Standards and Technology, Gaithersburg, Maryland
20899, United States
| | - Daniel A. Fischer
- National Institute of Standards and Technology, Gaithersburg, Maryland
20899, United States
| | - Roshan Fernando
- Department of Chemistry, Case Western Reserve University, Cleveland, Ohio 44106,
United States
| | - Dean M. DeLongchamp
- National Institute of Standards and Technology, Gaithersburg, Maryland
20899, United States
| | - Enrique D. Gomez
- Department
of Chemical Engineering
and Materials Research Institute, The Pennsylvania State University, University Park, Pennsylvania 16802, United
States
| | - Geneviève Sauvé
- Department of Chemistry, Case Western Reserve University, Cleveland, Ohio 44106,
United States
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Fernando R. I112 CURRENT MANAGEMENT OF PERINEAL TRAUMA AFTER VAGINAL DELIVERY. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60142-8] [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: 11/30/2022]
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Armstrong S, Fernando R, Columb M. A reply. Anaesthesia 2012. [DOI: 10.1111/j.1365-2044.2012.07284.x] [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: 12/01/2022]
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