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1.
Rolf Svedjeholm Gabriele Ferrari Farkas Vanky Örjan Friberg Jonas Holm 《Acta anaesthesiologica Scandinavica》2023,67(10):1373-1382
Background
Glutamate plays a key role for post-ischaemic recovery of myocardial metabolism. According to post hoc analyses of the two GLUTAMICS trials, patients without diabetes benefit from glutamate with less myocardial dysfunction after coronary artery bypass surgery (CABG). Copeptin reflects activation of the Arginine Vasopressin system and is a reliable marker of heart failure but available studies in cardiac surgery are limited. We investigated whether glutamate infusion is associated with reduced postoperative rises of plasma Copeptin (p-Copeptin) after CABG.Methods
A prespecified randomised double-blind substudy of GLUTAMICS II. Patients had left ventricular ejection fraction ≤0.30 or EuroSCORE II ≥3.0 and underwent CABG ± valve procedure. Intravenous infusion of 0.125 M L-glutamic acid or saline at 1.65 mL/kg/h was commenced 10–20 min before the release of the aortic cross-clamp and then continued for another 150 min P-Copeptin was measured preoperatively and postoperatively on day one (POD1) and day three. The primary endpoint was an increase in p-Copeptin from the preoperative level to POD1. Postoperative stroke ≤24 h and mortality ≤30 days were safety outcomes.Results
We included 181 patients of whom 48% had diabetes. The incidence of postoperative mortality ≤30 days (0% vs. 2.1%; p = .50) and stroke ≤24 h (0% vs. 3.2%; p = .25) did not differ between the glutamate group and controls. P-Copeptin increased postoperatively with the highest values recorded on POD1 without significant inter-group differences. Among patients without diabetes, p-Copeptin did not differ preoperatively but postoperative rise from preoperative level to POD1 was significantly reduced in the glutamate group (73 ± 66 vs. 115 ± 102 pmol/L; p = .02). P-Copeptin was significantly lower in the Glutamate group on POD1 (p = .02) and POD 3 (p = .02).Conclusions
Glutamate did not reduce rises of p-Copeptin significantly after moderate to high-risk CABG. However, glutamate was associated with reduced rises of p-Copeptin among patients without diabetes. These results agree with previous observations suggesting that glutamate mitigates myocardial dysfunction after CABG in patients without diabetes. Given the exploratory nature of these findings, they need to be confirmed in future studies. 相似文献2.
Alessandro Mandurino-Mirizzi Vilma Kajana Stefano Cornara Alberto Somaschini Andrea Demarchi Marco Galazzi Gabriele Crimi Marco Ferlini Rita Camporotondo Massimiliano Gnecchi Maurizio Ferrario Luigi Oltrona-Visconti Gaetano M. De Ferrari 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2021,31(7):2140-2143
BackgroundContrast associated-acute kidney injury (CA-AKI) has been associated with adverse outcomes after ST-segment elevation myocardial infarction (STEMI). However, early markers of CA-AKI are still needed to improve risk stratification. We investigated the association between elevated serum uric acid (eSUA) and CA-AKI in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).Methods and resultsSerum creatinine (Scr) was measured at admission and 24, 48 and 72 h after pPCI. CA-AKI was defined as an increase of 25% (CA-AKI 25%) or 0.5 mg/dl (CA-AKI 0.5) of Scr level above the baseline after 48 h following contrast administration. Multivariable analyses to investigate CA-AKI predictors were performed by binary logistic regression and multivariable backward logistic regression model.In the 3023 patients considered, CA-AKI was more frequent among patients with eSUA as compared with patients with normal SUA levels, considering both CA-AKI definitions (CA-AKI25%: 20.8% vs 16.2%, p < 0.012; CA-AKI 0.5: 10.1% vs 5.8%, p < 0.001). The association between eSUA and CA-AKI was confirmed at multivariable analyses (CA-AKI 25%: odd ratio 1.32, 95% CI 1.03–1.69, p = 0.027; CA-AKI 0.5: odd ratio 1.76, 95% CI 1.11–2.79, p = 0.016).ConclusionElevated serum uric acid is associated with CA-AKI after reperfusion in patients with STEMI treated with pPCI. 相似文献
3.
Background:Work-related stress (WRS) in the healthcare sector is a major issue for both workers and organizations. To date, no consensus exists regarding differences in gender susceptibility to WRS in healthcare workers (HCWs).Objectives:The purpose of this study was to analyze how male and female HCWs employed in emergency departments experienced WRS.Methods:A cross-sectional study was conducted regarding the perception of WRS in registered nurses employed in emergency departments. The Italian version of the Job Content Questionnaire and the Rapid Stress Assessment scale were administrated to 710 registered nurses.Results:The WRS assessment showed that significantly more females than males were in a situation of isostrain (18.5% vs 9.8% p<0,05). In females, low social support was associated with high levels of job strain (18,5% vs 4,4% p<0,05).Conclusion:This study reflects the need for a gender-specific approach in the evaluation of WRS in the healthcare sector, and is consistent with literature that evidenced gender differences in the perception of WRS. Lack of social support proved to be a determinant of WRS in female HCWs. Organizational interventions aimed at providing a more suitable workgroup design are required in order to minimize WRS in female HCWs.Key words: Stress, risk assessment, nurses, emergency department, social support 相似文献
4.
Deissler Heidrun L. Lang Gerhard K. Lang Gabriele E. 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2019,257(1):83-94
Graefe's Archive for Clinical and Experimental Ophthalmology - Intravitreal injection of the VEGF-binding protein aflibercept is widely used to treat various ocular diseases. In vitro,... 相似文献
5.
Ester Orlandi MD Stefano Cavalieri MD Roberta Granata MD Piero Nicolai MD Paolo Castelnuovo MD Cesare Piazza MD Alberto Schreiber MD Mario Turri-Zanoni MD Pasquale Quattrone MD Rosalba Miceli MD Gabriele Infante PhD Fausto Sessa MD Carla Facco MD Giuseppina Calareso MD Nicola Alessandro Iacovelli MD Davide Mattavelli MD Alberto Paderno MD Carlo Resteghini MD Laura Deborah Locati MD Lisa Licitra MD Paolo Bossi MD 《The Laryngoscope》2020,130(4):857-865
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Lukas Wisgrill Anja Weinhandl Lukas Unterasinger Gabriele Amann Rudolf Oehler Martin L. Metzelder Angelika Berger Thomas M. Benkoe 《Journal of pediatric surgery》2019,54(3):449-454
Background
Symptoms at suspicion of necrotizing enterocolitis (NEC) are often nonspecific and several biomarkers have been evaluated for their discriminative power to both diagnose and predict the course from NEC suspicion to complicated disease requiring surgical intervention. Thus, we aimed to assess the utility of interleukin-6 (IL-6) to predict surgical intervention in infants suffering from NEC and, furthermore, to discriminate infants with starting NEC or late-onset sepsis (LOS).Methods
IL-6 serum levels at disease onset were retrospectively analyzed in 24 infants suffering from NEC as well as 16 neonates with LOS.Results
IL-6 serum levels at disease onset were significantly higher in infants suffering from NEC necessitating surgical intervention in the disease course compared to infants with medical NEC (5000 [785–5000] vs. 370 [78–4716] pg/ml, p?=?0.0008) as well as gram-positive LOS (5000 [785–5000] vs. 84 [12–269] pg/ml, p?=?0.0001). Infants suffering from gram-negative LOS exhibited elevated IL-6 serum levels at disease onset comparable to infants with surgical NEC (5000 [1919–5000] vs. 5000 [785–5000] pg/ml, p?=?1.00).Conclusion
The proinflammatory cytokine IL-6 appears to be a promising marker to distinguish surgical NEC from medical NEC at the onset of disease but cannot discriminate between surgical NEC and gram-negative LOS.Level of evidence
II 相似文献10.
Gianluca Gambarini Lucila Piasecki Gabriele Miccoli Gianfranco Gaimari Roberto Di Giorgio Dario Di Nardo Adham A Azim Luca Testarelli 《Australian endodontic journal : the journal of the Australian Society of Endodontology Inc》2019,45(2):154-162
This study evaluated the effect of new motions of the motor TriAuto ZX2 on the cyclic fatigue of endodontic instruments. Vortex Blue 35.06 instruments were divided into four groups (n = 10) and tested for fatigue in a curved artificial canal (90° and 2 mm radius) using the following motions: continuous rotation (CR), Optimum Torque Reverse (OTR) set at 180° and the Optimum Glide Path (OGP), which was tested at 90° and 240°. The time to fracture (TTF) and the lengths of the fractured fragments were recorded. The mean TTF was significantly different among the groups (anova , P < 0.05): OGP 90° (213.39 ± 27.45), OTR 180° (121.24 ± 17.03), OGP 240° (45.24 ± 5.61) and CR (8.43 ± 1.27). Weibull analysis confirmed the shortest life expectancy for CR and the longest survival for OGP at 90°. The resistance to fatigue was affected by motions and pre‐set angles. The proprietary movements that are currently available for endodontic instruments were classified according to their kinematics. 相似文献