1,721,436 research outputs found
Non-invasive ventilation and survival rates: the more, the better. A plea against its underuse
No full textCOVID-19 and islet transplantation: different twins
No full textFor those who work in the field of islet transplantation, the micro vascular COVID-19 lung vessels obstructive thrombo-inflammatory syndrome (recently referred to as MicroCLOTS) is familiar, as one cannot fail to recognize the presence of similarities with the instant blood mediated inflammatory reaction (IBMIR) occurring in the liver hours and days after islet infusion. Evidences in both MicroCLOTS and IBMIR suggest the involvement of the coagulation cascade and complement system activation, and proinflammatory chemokines/cytokines release. Identification and targeting of pathway(s) playing a role as “master regulator(s)” in the post-islet transplant detrimental inflammatory events could be potentially useful to suggest innovative COVID-19 treatments and vice versa. All the scientific organizations across the world are fighting the COVID-19 pandemic. Islet transplantation, and more generally the transplantation scientific community, could contribute suggesting strategies for innovative approaches. At the same time, in the near future, clinical trials in COVID-19 patients will produce an enormous quantity of clinical and translational data on the control of inflammation, and complement/microthrombosis activation. These data will represent a legacy to be transformed into innovation in the transplant field. It will be our contribution to change a dramatic event into advancement for the transplant field, and ultimately for our patients
A novel non-invasive ventilation mask to prevent and manage respiratory failure during fiberoptic bronchoscopy, gastroscopy and transesophageal echocardiography
No full textFiberoptic bronchoscopy (for difficult intubation, bronchoalveolar lavage or biopsies), gastric endoscopies and transesophageal echocardiography (for transfemoral aortic valve replacement, MitraClip or left atrial appendage closure), are widespread diagnostic and therapeutic procedures. Non-invasive ventilation during upper endoscopies can be used to prevent or treat acute respiratory failure especially in high risk or sedated patients. We describe a novel full face mask specifically developed not only for "elective" non-invasive ventilation during upper endoscopies but also for emergent application without probe removal. The mask is formed by two halves fixed only at the upper extremity allowing opening and closure while the probe is in place. Position of the port and shape of the mask allow easy insertion (through the nose or the mouth) and handling of different sized probes. The mask, commercialized as "Janus", preserves arterial oxygenation during procedures in spontaneously breathing patients with or at risk of hypoxemia (mainly fiberoptic bronchoscopy for guided tracheal intubation or for bronchoalveolar lavage). In patients requiring a true ventilatory support (like patients with neuromuscular disease or those deeply sedated), Janus also allows effective manual or mechanical ventilation. Its use can improve safety, patient's comfort (as sedation can be titrated to the desired effect without fearing respiratory depression) and efficiency, avoiding time wasting and allowing procedure completion. Prospective trials are required to confirm its effectiveness
History and Pioneers of Cardiac Anesthesia in Italy
No full textThe first use of extracorporeal circulation in Italy occurred in 1951 in Turin. In the 1960s only 12 heart surgery centers were using extracorporeal circulation to treat patients, and health professionals had to complete their training abroad. During the last 50 years, Italian cardiac anesthesia has become a branch of major importance, and it has experienced a constantly growing number of active centers and professionals. Today, about 50,000 cardiac surgeries are performed every year in approximately 100 centers. Many results have been achieved during this period, thanks to the contribution of several pioneers. In this article, the history of Italian cardiac anesthesia and the role of Italian anesthesiologists in the development of this subspecialty in Italy and Europe are reviewed
Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial
No full textObservational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications
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