Swiss School of Archaeology in Greece
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Enhanced Recovery After Surgery (ERAS) Protocols in Cardiac Surgery: Impact on Opioid Consumption.
No full textBackground: Enhanced Recovery After Surgery (ERAS) protocols have been implemented in various surgical specialties to improve patient outcomes and reduce opioid consumption. In cardiac surgery, the traditionally high-dose opioid use is associated with prolonged ventilation, intensive care unit (ICU) stays, and opioid-related adverse drug events (ORADEs). This study evaluates the impact of an ERAS ® Society-certified program on opioid consumption in patients undergoing elective cardiac surgery at Lausanne University Hospital. Methods: A retrospective, monocentric observational study was conducted comparing two patient cohorts: one treated with ERAS protocols (2023-2024) and a retrospective control group from 2019. Data were collected from the hospital's electronic medical records and the ERAS program database. The primary outcome was total opioid consumption, measured intraoperatively and postoperatively (postoperative day (POD) 0-3). Secondary outcomes included pain control, length of stay, complications, and recovery parameters. Statistical analyses included multivariate logistic regression to identify factors associated with reduced opioid consumption. Results: Patients in the ERAS group demonstrated significantly lower total opioid consumption, whether intraoperatively (median sufentanil: 40 mcg vs. 51 mcg, p < 0.0001) or postoperatively (POD 0-3: p < 0.001). The ERAS group had faster extubation times, earlier mobilization and pain control with non-opioid analgesics, fewer complications, and shorter hospital stays (9 vs. 12 days, p < 0.001). Logistic regression identified fast-track extubation and absence of complications as strong predictors of reduced opioid use. Conclusions: The implementation of an ERAS protocol in cardiac surgery significantly reduces opioid consumption while enhancing recovery
[Involving Patient Partners: Platforms and Strategies in French-Speaking Switzerland]
No full textThe identification of potential patient partners (PP) remains a major challenge for researchers seeking to integrate patient and public involvement and engagement (PPIE) into their research projects. In the French-speaking part of Switzerland, PPIE groups or platforms have developed various approaches to engage PPs. However, the information required to gain a better understanding of these PPs can be organized into six common dimensions: sociodemographic data, experience with and knowledge of research and PPIE, experiential and technical knowledge of the disease, transversal knowledge and abilities, expectations for partnership, and constraints and availabilities. These dimensions help align the needs of research projects in terms of PPIE with the motivations, knowledge, and skills of the patients
Detection of thyroid hormones in urine by liquid chromatography coupled to tandem mass spectrometry
No full textRecently, the trend of thyroid hormones (TH) consumption in the sports community has been published. It is known the capacity of the exogenously administered TH to enhance metabolism, being an attractive feature for athletes, who search for weight control and increased caloric expenditure. This paper aimed the validation of a method to measure TH and related compounds in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The method was applied to urine samples collected before and after the administration of a diiodothyronine (3,5-T2) supplement. A method to detect nine TH included an enzymatic hydrolysis, liquid-liquid extraction, and solid-phase extraction. The extracts were analyzed by LC-MS/MS. Validated parameters showed good results for accuracy (85%-104%), precision (3%-16%), LOD (10-40 pg/mL, except for thyronacetic acids that was 200 pg/mL), and the combined uncertainty (2.2%-22%). Maximum concentration of 3,5-T2 in pre-administration samples was 0.71 ng/mL, and after 30 h of the last administration, concentrations returned to pre-administration values. Maximum values of ratios between the analyte and thyronine, T3, and T4 were 0.09, 0.19, and 0.12, respectively, and after 30 h of the last administration, the ratios reached back the basal values. Acidic or basic metabolites were not found in urine at least at the method LOD. A proposed method to assess TH in urine was validated, and as a proof of concept, its efficacy was demonstrated with an excretion study of 3,5-diiodothyronine. The consumption of 3,5-T2 was detected in urine measuring the analyte concentration and ratios between the analyte and thyronine, T3, and T4
Complement activation in secondary thrombotic microangiopathies
No full textSecondary thrombotic microangiopathies (TMAs) represent a heterogeneous group of diseases associated with a high risk of kidney failure and death despite available therapeutic strategies. Strong evidence implicates complement activation in the pathogenesis of secondary TMA, and emerging data increasingly suggest that pharmacological blockade of the complement improves the outcomes in patients with secondary TMA. Certain forms of secondary TMA, including postpartum TMA, TMA with coexisting hypertensive emergency and de novo TMA after kidney transplantation exhibit a high prevalence of pathogenic variants in complement genes, similar to those observed in primary atypical haemolytic uraemic syndrome. These conditions should be considered as complement-mediated TMA triggered by pregnancy or transplantation or in which severe hypertension represents a symptom rather than the aetiology of TMA. Their optimal management relies on early initiation of complement inhibition. Other aetiologies of secondary TMA (i.e. autoimmune diseases, haematopoietic stem cell transplantation, drugs, infections) are typically not linked with complement gene variants and their management primarily focuses on removal of the culprit trigger or treatment of the underlying condition. While well-designed trials are still awaited, a growing body of evidence suggests that complement activation is also involved in the pathophysiology of these diseases. Complement inhibitors, which have been associated with better outcomes, should be considered in patients with severe (life- or organ-threatening TMA) or refractory secondary TMA despite adequate management of the underlying condition. This review summarizes the current understanding and future directions in the management of secondary TMA, emphasizing the potential of complement inhibition as a therapeutic strategy.
© The Author(s) 2025. Published by Oxford University Press on behalf of the ERA
Gendering the history of biomedical technologies in the Arab world: The medicalisation of women’s sexual and reproductive health in Jordan and Tunisia
No full textExploring the influence of parental obesity on myocardial infarction outcomes in offspring
No full text
Cortical activity upon awakening from sleep reveals consistent spatio-temporal gradients across sleep stages in human EEG
No full textHow does the brain awaken from sleep? Several studies have suggested that the awakening process occurs asynchronously across brain regions, but the precise nature of these changes and how they are reflected in human electroencephalography (EEG) remains unknown. Here, we recorded 1,073 awakenings and arousals with high-density EEG and mapped brain activity at a second-to-second timescale around movement onset using source modeling. We found that cortical activity upon awakening progressed along highly consistent spatial and frequency gradients. In awakenings and arousals from non-rapid eye movement (NREM) sleep, transient increases in low-frequency power preceded increases in high-frequency power by a few seconds, whereas awakenings from REM sleep were mainly characterized by increases in high-frequency power. Regardless of sleep stage, high-frequency changes were first seen in frontal and last in occipital and inferior-temporal cortical areas, whereas low-frequency changes in NREM sleep started in a centro-parietal "hotspot," progressed frontally, and reached occipital and inferior-temporal regions last. Finally, the presence of these spatio-temporal arousal patterns during sleep, before participants were awakened by sounds, was followed by lower sleepiness ratings upon awakening. These results indicate a consistent spatio-temporal EEG signature of the awakening process that likely reflects the structural organization of arousal systems. Importantly, a transient increase in slow EEG frequencies, which are normally associated with sleep, is inherent to the arousal process and functionally correlates with feeling more awake when awakening from NREM sleep. These findings have important implications for the interpretation of arousal signals and the detection of incomplete awakenings in sleep disorders.
Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved
Perspectives on Orthology During the Quest for Orthologs
No full textThis special issue from the Quest for Orthologs community highlights ongoing challenges in detecting and characterizing orthologous genes in the annotation of protein functions. Eleven articles are presented describing ongoing research in this area.
© 2025. The Author(s)