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1. Solid Tumor Opioid Receptor Expression and Oncologic Outcomes: Analysis of the Cancer Genome Atlas and Genotype Tissue Expression Project

Author: Belltall A, Zúñiga-Trejos S, Garrido-Cano I, Eroles P, Argente-Navarro MP, Buggy DJ, Díaz-Cambronero O, and Mazzinari G
Subjects: surgery, tumor, immunohistochemistry, cancer, perioperative opioid, opioid receptors, neoplasm
Abstract: Background: Opioid receptors are expressed not only by neural cells in the central nervous system, but also by many solid tumor cancer cells. Whether perioperative opioids given for analgesia after tumor resection surgery might inadvertently activate tumor cells, promoting recurrence or metastasis, remains controversial. We analysed large public gene repositories of solid tumors to investigate differences in opioid receptor expression between normal and tumor tissues and their association with long-term oncologic outcomes.; Methods: We investigated the normalized gene expression of , kappa, delta opioid receptors (MOR, KOR, DOR), Opioid Growth Factor (OGFR), and Toll-Like 4 (TLR4) receptors in normal and tumor samples from twelve solid tumor types. We carried out mixed multivariable logistic and Cox regression analysis on whether there was an association between these receptors' gene expression and the tissue where found, i.e., tumor or normal tissue. We also evaluated the association between tumor opioid receptor gene expression and patient disease-free interval (DFI) and overall survival (OS).; Results: We retrieved 8,780 tissue samples, 5,852 from tumor and 2,928 from normal tissue, of which 2,252 were from the Genotype Tissue Expression Project (GTEx) and 672 from the Cancer Genome Atlas (TCGA) repository. The Odds Ratio (OR) [95%CI] for gene expression of the specific opioid receptors in the examined tumors varied: MOR: 0.74 [0.63-0.87], KOR: 1.27 [1.17-1.37], DOR: 1.66 [1.48-1.87], TLR4: 0.29 [0.26-0.32], OGFR: 2.39 [2.05-2.78]. After controlling all confounding variables, including age and cancer stage, there was no association between tumor opioid receptor expression and long-term oncologic outcomes.; Conclusion: Opioid receptor gene expression varies between different solid tumor types. There was no association between tumor opioid receptor expression and recurrence. Understanding the significance of opioid receptor expression on tumor cells remains elusive. Copyright © 2022 Belltall, Zuniga-Trejos, Garrido-Cano, Eroles, Argente-Navarro, Buggy, Diaz-Cambronero and Mazzinari.
Published: 2022

2. A worldwide perspective of sepsis epidemiology and survival according to age: Observational data from the ICON audit

Author: Kotfis, K., Wittebole, X., Jaschinski, U., Sole-Violan, J., Kashyap, R., Leone, M., Nanchal, R., Fontes, Le, Sakr, Y., Vincent, Jl, Tomas, E., Bibonge, Ea, Charra, B., Faroudy, M., Doedens, L., Farina, Z., Adler, D., Balkema, C., Kok, A., Alaya, S., Gharsallah, H., Muzha, D., Temelkov, A., Georgiev, G., Simeonov, G., Tsaryanski, G., Georgiev, S., Seliman, A., Vrankovic, S., Vucicevic, Z., Gornik, I., Barsic, B., Husedzinovic, I., Pavlik, P., Manak, J., Kieslichova, E., Turek, R., Fischer, M., Valkova, R., Dadak, L., Dostal, P., Malaska, J., Hajek, R., Zidkova, A., Lavicka, P., Starkopf, J., Kheladze, Z., Chkhaidze, M., Kaloiani, V., Medve, L., Sarkany, A., Kremer, I., Marjanek, Z., Tamasi, P., Krupnova, I., Vanags, I., Liguts, V., Pilvinis, V., Vosylius, S., Kekstas, G., Balciunas, M., Kolbusz, A., Kubler, A., Mielczarek, B., Mikaszewska-Sokolewicz, M., Tamowicz, B., Sulkowski, W., Smuszkiewicz, P., Pihowicz, A., Trejnowska, E., Hagau, N., Filipescu, D., Droc, G., Lupu, M., Nica, A., Stoica, R., Tomescu, D., Constantinescu, D., Zbaganu, Gv, Slavcovici, A., Bagin, V., Belsky, D., Palyutin, S., Shlyapnikov, S., Bikkulova, D., Gritsan, A., Natalia, G., Makarenko, E., Kokhno, V., Tolkach, A., Kokarev, E., Belotserkovskiy, B., Zolotukhin, K., Kulabukhov, V., Soskic, L., Palibrk, I., Jankovic, R., Jovanovic, B., Pandurovic, M., Bumbasirevic, V., Uljarevic, B., Surbatovic, M., Ladjevic, N., Slobodianiuk, G., Sobona, V., Cikova, A., Gebhardtova, A., Jun, C., Yunbo, S., Dong, U., Feng, S., Duan, M., Xu, Y., Xue, X., Gao, T., Xing, X., Zhao, X., Li, C., Gengxihua, G., Tan, H., Xu, J., Jiang, L., Tiehe, Q., Bingyu, Q., Shi, Q., Lv, Z., Zhang, L., Jingtao, L., Zhen, Z., Wang, Z., Wang, T., Yuhong, L., Zhai, Q., Chen, Y., Wang, C., Jiang, W., Ruilan, W., Xiaobo, H., Ge, H., Yan, T., Yuhui, C., Zhang, J., Jian-Hong, F., Zhu, H., Huo, F., Wang, Y., Zhuang, M., Ma, Z., Sun, J., Liuqingyue, L., Yang, M., Meng, J., Ma, S., Kang, Y., Yu, L., Peng, Q., Wei, Y., Zhang, W., Sun, R., Yeung, A., Wan, W., Sin, K., Lee, K., Wijanti, M., Widodo, U., Samsirun, H., Sugiman, T., Wisudarti, C., Maskoen, T., Hata, N., Kobe, Y., Nishida, O., Miyazaki, D., Nunomiya, S., Uchino, S., Kitamura, N., Yamashita, K., Hashimoto, S., Fukushima, H., Adib, Nn, Tai, L., Tony, B., Bigornia, R., Palo, J., Chatterjee, S., Tan, B., Kong, A., Goh, S., Lee, C., Pothirat, C., Khwannimit, B., Theerawit, P., Pornsuriyasak, P., Piriyapatsom, A., Mukhtar, A., Dsicu, Hamdy, An, Hosny, H., Ashraf, A., Mokhtari, M., Nowruzinia, S., Lotfi, A., Zand, F., Nikandish, R., Moghaddam, Om, Cohen, J., Sold, O., Sfeir, T., Hasan, A., Abugaber, D., Ahmad, H., Tantawy, T., Baharoom, S., Algethamy, H., Amr, A., Almekhlafi, G., Coskun, R., Sungur, M., Cosar, A., Gucyetmez, B., Demirkiran, O., Senturk, E., Ulusoy, H., Atalan, H., Serin, S., Kati, I., Alnassrawi, Z., Almemari, A., Krishnareddy, K., Kashef, S., Alsabbah, A., Poirier, G., Marshall, J., Herridge, M., Fernandez-Medero, R., Fulda, G., Banschbach, S., Quintero, J., Schroeder, E., Sicoutris, C., Gueret, R., Bauer, P., Wunderink, R., Jimenez, E., Ryan, A., Prince, D., Edington, J., Haren, F., Bersten, A., Hawkins, Dj, Kilminster, M., Sturgess, D., Ziegenfuss, M., O Connor, S., Lipman, J., Campbell, L., Mcallister, R., Roberts, B., Williams, P., Parke, R., Seigne, P., Freebairn, R., Nistor, D., Oxley, C., Young, P., Valentini, R., Wainsztein, N., Comignani, P., Casaretto, M., Sutton, G., Villegas, P., Galletti, C., Neira, J., Rovira, D., Hidalgo, J., Sandi, F., Caser, E., Thompson, M., Dias, Md, Fontes, L., Lunardi, M., Youssef, N., Lobo, S., Silva, R., Sales, J., Melo, Lmc, Oliveira, M., Fonte, M., Grion, C., Feijo, C., Rezende, V., Assuncao, M., Neves, A., Gusman, P., Dalcomune, D., Teixeira, C., Kaefer, K., Maia, I., Dantas, Vs, Filho, Rc, Amorim, F., Assef, M., Schiavetto, P., Houly, J., Bianchi, F., Dias, F., Avila, C., Gomez, J., Rego, L., Castro, P., Passos, J., Mendes, C., Mecatti, Gc, Ferrreira, M., Irineu, V., Guerreiro, M., Ugarte, S., Tomicic, V., Godoy, C., Samaniego, W., Escamilla, I., Castro, Lc, Duque, Gl, Diaz-Guio, D., Benitez, F., Urrego, Ag, Buitrago, R., Ortiz, G., Gaviria, Mv, Salas, D., Ramirez-Arce, J., Salgado, E., Morocho, D., Vergara, J., Sang, Mc, Carlos E. Orellana-Jimenez, Garrido, L., Diaz, O., Resiere, D., Osorio, C., La Vega, A., Carrillo, R., Sanchez, V., Villagomez, A., Zubieta, Rm, Sandia, M., Zalatiel, M., Poblano, M., Gonzalez, Dr, Arrazola, F., Francisco, Lj, Liamendys-Silva, Sa, Hernandez, M., Cadena, Dr, Islas, Il, Zarzavilla, Cb, Matos, A., Oyanguren, I., Cerna, J., Sierra, Rq, Jimenez, R., Castillo, L., Ocal, R., Sencan, A., Gianoni, Sm, Deicas, A., Hurtado, J., Burghi, G., Martinelli, A., Osten, I., Du Maine, C., Bhattacharyya, M., Bandyopadhyay, S., Yanamala, S., Gopal, P., Sahu, S., Ibrahim, M., Rathod, D., Mukundan, N., Dewan, A., Amin, P., Samavedam, S., Shah, B., Gurupal, D., Lahkar, B., Mandal, A., Sircar, M., Ghosh, S., Balasubramani, V., Kapadia, F., Vadi, S., Nair, K., Tripathy, S., Nandakumar, S., Sharma, J., Kar, A., Jha, S., Gurav, Kz, Patel, M., Bhaysar, A., Samaddar, D., Kulkarni, A., Hashmi, M., Ali, W., Nadeem, S., Indraratna, K., Margarit, A., Urbanek, P., Schlieber, J., Reisinger, J., Auer, U., Hartjes, A., Lerche, A., Janous, T., Kink, E., Krahulec, W., Smolle, K., Schueren, M., Thibo, P., Vanhoof, M., Ahmet, I., Gadisseux, P., Dufaye, P., Jacobs, O., Fraipont, V., Biston, P., Dive, A., Bouckaert, Y., Gilbert, E., Gressens, B., Pinck, E., Collin, V., Waele, J., Rimachi, R., Gusu, D., Decker, K., Mandianga, K., Heytens, L., Spapen, H., Olivier, V., Vandenheede, W., Rogiers, P., Kolodzeike, P., Kruse, M., Andersen, T., Harjola, V., Saarinen, K., Durocher, A., Moulront, S., Lepape, A., Losser, M., Cabaret, P., Kalaitzis, E., Zogheib, E., Charve, P., Francois, B., Lefrant, Jy, Beilouny, B., Forceville, X., Misset, B., Jacobs, F., Floccard, B., Payen, D., Wynckel, A., Castelain, V., Faure, A., Lavagne, P., Thierry, I., Moussa, M., Vieillard-Baron, A., Durand, M., Gainnier, M., Ichai, C., Arens, S., Hoffmann, C., Kaffarnik, M., Scharnofske, C., Voigt, I., Peckelsen, C., Weber, M., Gille, J., Lange, A., Schoser, G., Sablotzki, A., Bluethgen, A., Vogel, F., Tscheu, A., Fuchs, T., Wattenberg, M., Helmes, T., Scieszka, S., Heintz, M., Sakka, S., Kohler, J., Fiedler, F., Danz, M., Riessen, R., Kerz, T., Kersten, A., Tacke, F., Marx, G., Volkert, T., Schmutz, A., Nierhaus, A., Kluge, S., Abel, P., Janosi, R., Utzolino, S., Bracht, H., Toussaint, S., Peftoulidou, Mg, Myrianthefs, P., Armaganidis, A., Routsi, C., Xini, A., Mouloudi, E., Kokoris, I., Kyriazopoulos, G., Vlachos, S., Lavrentieva, A., Partala, P., Nakos, G., Moller, A., Stefansson, S., Barry, J., O Leary, R., Motherway, C., Faheem, M., Dunne, E., Donnelly, M., Konrad, T., Bonora, E., Achilli, C., Rossi, S., Castiglione, G., Penis, A., Albanese, D., Stocchetti, N., Citerio, G., Mozzoni, L., Sisillo, E., Negri, P., Savioli, M., Vecchiarelli, P., Puflea, F., Stankovic, V., Minoja, G., Montibeller, S., Calligaro, P., Sorrentino, R., Feri, M., Zambon, M., Colombaroli, E., Giarratano, A., Pellis, T., Capra, C., Antonelli, M., Gullo, A., Chelazzi, C., Capraris, A., Patroniti, N., Girardis, M., Franchi, F., Berlot, G., Buttigieg, M., Ponssen, H., Cate, Jt, Bormans, L., Husada, S., Buise, M., Hoven, B., Reidinga, A., Kuiper, M., Pickkers, P., Kluge, G., Den Boer, S., Kesecioglu, J., Leeuwen, H., Flaatten, H., Mo, S., Branco, V., Rua, F., Lafuente, E., Sousa, M., Catorze, N., Barros, M., Pereira, L., Oliveira, Av, Gomes, J., Gaspar, I., Pereira, M., Cymbron, M., Dias, A., Almeida, E., Beirao, S., Serra, I., Ribeiro, R., Povoa, P., Faria, F., Costa-E-Silva, Z., Nobrega, A., Fernandes, F., Gabriel, J., Voga, G., Rupnik, E., Kosec, L., Povsic, Mk, Osojnik, I., Tomic, V., Sinkovic, A., Gonzalez, J., Zavala, E., Valenzuela, Ap, Marina, L., Vidal-Cortes, P., Posada, I., Martin-Loeches, Ai, Guillen, Nm, Palomar, M., Sole-Violan, U., Torres, A., Gallego, Mg, Aguilar, G., Allue, Rm, Argueso, M., Parejo, M., Navarro, Mp, Jose, A., Nin, N., Lerma, Fa, Martinez, O., Lozano, Et, Lopez, Sa, Granda, Mp, Moreno, S., Llubia, C., Martos, Cd, Gonzalez-Arenas, P., Fernandez, Nl, Rueda, Bg, Pons, Ie, Cruza, N., Maroto, F., Estella, A., Ferrer, A., Fraile, Li, Quindos, B., Quintano, A., Tebar, M., Cardinal, I., Reyes, A., Rodriguez, A., Abella, A., Del Valle, Sg, Yus, S., Maseda, E., Berezo, U., Pedregosa, At, Laplaza, C., Ferrer, R., Rico-Feijoo, U., Rodriguez, M., Monedero, P., Eriksson, K., Lind, D., Chabanel, D., Zender, H., Heer, K., Frankenberger, B., Jakob, S., Mathew, S., Downes, R., Groba, Cb, Johnston, A., Meacher, R., Keays, R., Haji-Michael, P., Tyler, C., Ferguson, A., Jones, S., Tyl, D., Ball, A., Vogel, U., Booth, M., Downie, P., Watters, M., Brett, S., Garfield, M., Everett, L., Heenen, S., Dhir, S., Beardow, Z., Mostert, M., Brosnan, S., Pinto, N., Harris, S., Summors, A., Andrew, N., Rose, A., Appelboam, R., Davies, O., Vickers, E., Agarwal, B., Szakmany, T., Wimbush, S., Welters, I., Pearse, R., Hollands, R., Kirk-Bayley, U., Fletcher, N., Bray, B., Brealey, D., Intensive Care, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, UCL - (MGD) Services des soins intensifs, Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], and University of Wisconsin School of Medicine and Public Health
Subjects: Adult, Male, medicine.medical_specialty, Critical Illness, Medizin, Audit, Critical Care and Intensive Care Medicine, Sepsis, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Epidemiology, medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, In patient, Hospital Mortality, Prospective Studies, Mortality, ComputingMilieux_MISCELLANEOUS, Outcome, Aged, computer.programming_language, Aged, 80 and over, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, business.industry, Critically ill, ICU, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Hospitalization, Intensive Care Units, Increased risk, 030228 respiratory system, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, Observational study, Icon, business, computer
Abstract: Purpose: To investigate age-related differences in outcomes of critically ill patients with sepsis around the world., Methods: We performed a secondary analysis of data from the prospective ICON audit, in which all adult ( >16 years ) patients admitted to participating ICUs between May 8 and 18, 2012, were included, except admissions for routine postoperative observation. For this sub-analysis, the 10,012 patients with completed age data were included. They were divided into five age groups - 80 years. Sepsis was defined as infection plus at least one organ failure., Results: A total of 2963 patients had sepsis, with similar proportions across the age groups (80 = 30.9%). Hospital mortality increased with age and in patients >80 years was almost twice that of patients 70 years was independently associated with increased risk of dying., Conclusions: The odds for death in ICU patients with sepsis increased with age with the maximal rate of increase occurring between the ages of 71 and 77 years. (C) 2019 Elsevier Inc. All rights reserved., C1 [Kotfis, Katarzyna] Pomeranian Med Univ, Dept Anaesthesiol Intens Therapy & Acute Intoxica, Szczecin, Poland., [Wittebole, Xavier] UCL, Clin Univ St Luc, Dept Crit Care, Brussels, Belgium., [Jaschinski, Ulrich] Klinikum Augsburg, Klin Anasthesiol & Operat Intens Med, Augsburg, Germany., [Sole-Violan, Jordi] Hosp Univ Gran Canaria Dr Negrin, Dept Intens Care, Las Palmas Gran Canaria, Spain., [Kashyap, Rahul] Mayo Clin, Dept Anesthesia Ei Perioperat Med, Rochester, MN USA., [Leone, Marc] Aix Marseille Univ, Hop Nord, AP HM, Serv Anesthesie & Reanimat, Marseille, France., [Nanchal, Rahul] Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA., [Fontes, Luis E.] Hosp Alcides Carneiro, Petropolis Med Sch, Dept Intens Care & Evidence Based Med, Petropolis, Brazil., [Sakr, Yasser] Uniklinikum Jena, Dept Anesthesiol & Intens Care, Jena, Germany., [Vincent, Jean-Louis] Univ Libre Bruxelles, Erasme Univ Hosp, Dept Intens Care, Route Lenn 808, B-1070 Brussels, Belgium., [Tomas, E.] Clin Sagrada Esperanca, Luanda, Angola., [Bibonge, E. Amisi] Clin Univ Kinshasa, Kinshasa, DEM REP CONGO., [Charra, B.] Chu Ibn Rochd Casablanca, Casablanca, Morocco., [Faroudy, M.] Ibn Sina Hosp, Rabat, Morocco., [Doedens, L.] Chris Hani Baragwanath Acad Hosp, Soweto, South Africa., [Farina, Z.] Grays Hosp, Pietermaritzburg, South Africa., [Adler, D.] Sandton Medi Clin, Sandton, South Africa., [Balkema, C.] Tygerberg Hosp, Cape Town, South Africa., [Kok, A.] Union Hosp Alberton, Alberton, South Africa., [Alaya, S.] Bizerte Hosp, Bizerte, Tunisia., [Gharsallah, H.] Mil Hosp Tunis, Tunis, Tunisia., [Muzha, D.] Natl Trauma Ctr & Mil Hosp, Tirana, Albania., [Temelkov, A.] Alexandrovska Univ Hosp, Sofia, Bulgaria., [Georgiev, G.] Emergency Univ Hosp Pirogov, Sofia, Bulgaria., [Simeonov, G.] Tokuda Hosp Sofia, Sofia, Bulgaria., [Tsaryanski, G.] Uh St Ekaterina Sofia, Sofia, Bulgaria., [Georgiev, S.] Univ Hosp Obstet & Gynaecol, Sofia, Bulgaria., [Seliman, A.] Univ Hosp Sveta Marina Varna, Varna, Bulgaria., [Vrankovic, S.] Gen Hosp Siben, Shibenik, Croatia., [Vucicevic, Z.] Univ Hosp Ctr Sestre Milosrdnice, Zagreb, Croatia., [Gornik, I] Univ Hosp Ctr Zagreb, Zagreb, Croatia., [Barsic, B.] Univ Hosp Infect Dis, Zagreb, Croatia., [Husedzinovic, I] Univ Hosp Dubrava, Zagreb, Croatia., [Pavlik, P.] Ctr Cardiovasc & Transplant Surg, Prague, Czech Republic., [Manak, J.] Charles Univ Hosp, Prague, Czech Republic., [Kieslichova, E.] IKEM, Prague, Czech Republic., [Turek, R.] KNTB Zlin AS, Prague, Czech Republic., [Fischer, M.] Krajska Nemocnice Liberec, Prague, Czech Republic., [Valkova, R.] Masarykova Nemocnice V Usti Labem, Labem, Czech Republic., [Dadak, L.] St Annes Univ Hosp Brno, Brno, Czech Republic., [Dostal, P.] Univ Hosp Haradec Kralove, Haradec Kralove, Czech Republic., [Malaska, J.] Univ Hosp Brno, Brno, Czech Republic., [Hajek, R.] Univ Hosp Olomouc, Olomouc, Czech Republic., [Zidkova, A.] Univ Hosp Plzen, Plzen, Czech Republic., [Lavicka, P.] Charles Univ Hosp Plzen, Plzen, Czech Republic., [Starkopf, J.] Tartu Univ Hosp, Tartu, Estonia., [Kheladze, Z.] Crit Care Med Inst, Gainesville, Georgia., [Chkhaidze, M.] Jo Ann Med Ctr, Tbilisi, Georgia., [Kaloiani, V] Kipshidze Cent Univ Hosp, Tbilisi, Georgia., [Medve, L.] Dr Kenessey Albert Hosp, Balassagyarmat, Hungary., [Sarkany, A.] Fejer Cty St George Teaching Hosp, Szekesfehervar, Hungary., [Kremer, I] Flor Ferenc Cty Hosp, Budapest, Hungary., [Marjanek, Z.] Javorszky Odon Hosp, Vac, Hungary., [Tamasi, P.] Peterfy Hosp Budapest, Budapest, Hungary., [Krupnova, I] Infectol Ctr Latvia, Riga, Latvia., [Vanags, I] Paul Stradins Clin Univ Hosp, Riga, Latvia., [Liguts, V] Riga East Clin Univ Hosp, Riga, Latvia., [Pilvinis, V] Hosp Lithuanian Univ Hlth Sci Kauno Klinikos, Kaunas, Lithuania., [Vosylius, S.] Vilnius Univ Hosp, Vilnius, Lithuania., [Kekstas, G.] HSICU, Vilnius Univ Hosp Santariskiu Clin, Vilnius, Lithuania., [Balciunas, M.] CICU, Vilnius Univ Hosp Santariskiu Clin, Vilnius, Lithuania., [Kolbusz, A.] Csk Mswia, Warsaw, Poland., [Kubler, A.] Med Univ, Wroclaw, Poland., [Mielczarek, B.] Med Univ Wroclaw, Wroclaw, Poland., [Mikaszewska-Sokolewicz, M.] Med Univ Warsaw, Warsaw, Poland., [Kotfis, K.] Pomeranian Med Univ, Szczecin, Poland., [Tamowicz, B.] Reg Hosp Poznan, Poznan, Poland., [Sulkowski, W.] Szpital Powiatowy W Ostrowi Mazowieckiej, Ostrow Mazowiecka, Poland., [Smuszkiewicz, P.] Univ Hosp, Poznan, Poland., [Pihowicz, A.] Wojewodzki Szpital Zakazny, Torun, Poland., [Trejnowska, E.] Wojewodzkie Ctr Med, Warsaw, Poland., [Hagau, N.] Emergency Cty Hosp Cluj, Cluj Napoca, Romania., [Filipescu, D.] Emergency Inst Cardiovasc Dis, Bucharest, Romania., [Droc, G.] Fundeni Clin Inst, Bucharest, Romania., [Lupu, M.] Galati Hosp, Bucharest, Romania., [Nica, A.] Lnbi Prof Dr Matei Bals, Bucharest, Romania., [Stoica, R.] Inst Pulmonol Marius Nasta, Bucharest, Romania., [Tomescu, D.] Inst Clin Fundeni, Bucharest, Romania., [Constantinescu, D.] Sfantul Pantelimon Hosp, Bucharest, Romania., [Zbaganu, G. Valcoreanu] Spitalul Cf 2 Bucuresti, Bucharest, Romania., [Slavcovici, A.] Iuliu Hatieganu Univ Med & Pharm, Teaching Hosp Infect Dis, Cluj Napoca, Romania., [Bagin, V] City Clin Hosp 40, St Petersburg, Russia., [Belsky, D.] City Hosp 40, St Petersburg, Russia., [Palyutin, S.] Clin Hosp NVNV Solovyev, Yaroslavl, Russia., [Shlyapnikov, S.] Emergency Res Inst NA Djanelidze, St Petersburg, Russia., [Bikkulova, D.] Fed Res Ctr Paediat Haematol Oncol & Immunol, Moscow, Russia., [Gritsan, A.] Krasnoyarsk State Med Univ, Krasnoyarsk Reg Hosp, Krasnoyarsk, Russia., [Natalia, G.] Med Assoc Novaya Bolnitsa, Ekaterinburg, Russia., [Makarenko, E.] Mil Med Acad, Ekaterinburg, Russia., [Kokhno, V] Novosibirsk Med Univ, Novosibirsk, Russia., [Tolkach, A.] Omsk Reg Clin Hosp, Omsk, Russia., [Kokarev, E.] Railway Hosp Khabarovsk, Khabarovsk, Russia., [Belotserkovskiy, B.] St Alexy Hosp, St Louis, France., [Zolotukhin, K.] State Dist Hosp, Moscow, Russia., [Kulabukhov, V] Vishnevsky Inst Surg, Moscow, Russia., [Soskic, L.] Clin Ctr Serbia, Clin Cardiac Surg, Belgrade, Serbia., [Palibrk, I] Clin Ctr Serbia, Clin Digest Surg, Belgrade, Serbia., [Jankovic, R.; Jovanovic, B.] Clin Ctr Nis, Clin Vasc Surg, Nish, Serbia., [Pandurovic, M.] Clin Ctr Serbia, Emergency Ctr, Belgrade, Serbia., [Bumbasirevic, V] Clin Ctr Belgrade, Emergency Ctr, Belgrade, Serbia., [Uljarevic, B.] Gen Univ Hosp, Belgrade, Serbia., [Surbatovic, M.] Mil Med Acad, Belgrade, Serbia., [Ladjevic, N.] Urol Hosp, Belgrade, Serbia., [Slobodianiuk, G.] Dist Hosp, Bratislava, Slovakia., [Sobona, V] Fac Hosp, Bratislava, Slovakia., [Cikova, A.] Univ Hosp Bratislava, Hosp Ruzinov ICU, Bratislava, Slovakia., [Gebhardtova, A.] Univ Hosp Ruzinov Bratislava, Bratislava, Slovakia., [Jun, C.] Qingdao Univ, Tertiary Hosp, Qingdao, Shandong, Peoples R China., [Yunbo, S.] Qingdao Univ, Affiliated Hosp, Med Coll, Qingdao, Shandong, Peoples R China., [Dong, U.] Beijing Canc Hosp, Beijing Inst Canc Res, Beijing, Peoples R China., [Feng, S.] Beijing Chaoyang Hosp, Beijing, Peoples R China., [Duan, M.] Beijing Friendship Hosp, Beijing, Peoples R China., [Xu, Y.] Capital Med Univ, Beijing Tongren Hosp, Beijing, Peoples R China., [Xue, X.] Beijing Univ Peoples Hosp, Beijing, Peoples R China., [Gao, T.] Beijing Luhe Hosp, Beijing, Peoples R China., [Xing, X.] Chinese Acad Med Sci, Canc Hosp, Beijing, Peoples R China., [Zhao, X.] China Acad Chinese Med Sci, Guang An Men Hosp, Beijing, Peoples R China., [Li, C.] Peoples Hosp, Chuxiong, Yunnan, Peoples R China., [Gengxihua, G.] Donge Cty Peoples Hosp Shandong Prov, Liaocheng, Shandong, Peoples R China., [Tan, H.] Chinese Acad Med Sci, Fu Wai Hosp, Beijing, Peoples R China., [Xu, J.] Fujian Prov Hosp, Fuzhou, Fujian, Peoples R China., [Jiang, L.] Capital Med Univ, Fuxing Hosp, Beijing, Peoples R China., [Tiehe, Q.] Guangdong Gen Hosp, Guangzhou, Guangdong, Peoples R China., [Bingyu, Q.] Henan Prov Peoples Hosp, Zhengzhou, Henan, Peoples R China., [Shi, Q.] Xi An Jiao Tong Univ, Coll Med, Xian, Shaanxi, Peoples R China., [Lv, Z.] Kunming Third Peoples Hosp, Kunming, Yunnan, Peoples R China., [Zhang, L.] Lanzhou Univ, Hosp 2, Lanzhou, Gansu, Peoples R China., [Jingtao, L.] 309th Hosp, Beijing, Peoples R China., [Zhen, Z.] China Med Univ, Hosp 1, Beijing, Peoples R China., [Wang, Z.] Peking Univ, Shougang Hosp, Beijing, Peoples R China., [Wang, T.] Peking Univ, Hosp 3, Beijing, Peoples R China., [Yuhong, L.] Pla Navy Gen Hosp, Beijing, Peoples R China., [Zhai, Q.] Shandong Univ, Qilu Hosp, Jinan, Shandong, Peoples R China., [Chen, Y.] Jiaotong Univ, Affiliated Med Sch, Ruijin Hosp, Shanghai, Peoples R China., [Wang, C.] Shandong Prov Hosp, Jinan, Shandong, Peoples R China., [Jiang, W.] Shanghai 10th Peoples Hosp, Shanghai, Peoples R China., [Ruilan, W.] Shanghai First Peoples Hosp, Shanghai, Peoples R China., [Chen, Y.; Xiaobo, H.] Sichuan Prov Peoples Hosp, Chengdu, Sichuan, Peoples R China., [Ge, H.] Sir Run Run Shaw Hosp, Hangzhou, Zhejiang, Peoples R China., [Yan, T.] Affiliated Guiyang Med Coll, Guiyang, Guizhou, Peoples R China., [Yuhui, C.] Fudan Univ, Peoples Hosp Shanghai 5, Shanghai, Peoples R China., [Zhang, J.] Dalian Med Univ, Affiliated Hosp 1, Dalian, Peoples R China., [Jian-Hong, F.] Suzhou Univ, Affiliated Hosp 1, Suzhou, Peoples R China., [Zhu, H.] Xinjiang Med Univ, Affiliated Hosp 1, Urumqi, Peoples R China., [Huo, F.; Wang, Y.] Jilin Univ, Hosp 1, Changchun, Jilin, Peoples R China., [Li, C.] First Peoples Hosp Kunming, Kunming, Yunnan, Peoples R China., [Zhuang, M.] Gen Hosp Shenyang Mil Reg, Shenyang, Liaoning, Peoples R China., [Ma, Z.] Peoples Hosp Cangzhou, Cangzhou, Peoples R China., [Sun, J.] Jilin Univ, Hosp 2, Changchun, Jilin, Peoples R China., [Liuqingyue, L.] Second Peoples Hosp Liaocheng City Shandong Prov, Liaocheng, Shandong, Peoples R China., [Yang, M.] Third Xiangya Hosp, Changsha, Hunan, Peoples R China., [Meng, J.] Tongde Hosp Zhejiang Prov, Hangzhou, Zhejiang, Peoples R China., [Ma, S.] Tongji Univ, Shanghai East Hosp, Shanghai, Peoples R China., [Kang, Y.] West China Hosp, Scu, Peoples R China., [Yu, L.] Wuhan Ctr Hosp, Wuhan, Hubei, Peoples R China., [Peng, Q.] Xiangya Hosp, Changsha, Hunan, Peoples R China., [Wei, Y.] Yantai Yuhuangding Hosp, Yantai, Peoples R China., [Zhang, W.] Yantaishan Hosp, Yantai, Shandong, Peoples R China., [Sun, R.] Zhejiang Prov Peoples Hosp, Hangzhou, Zhejiang, Peoples R China., [Yeung, A.] Pamela Youde Nethersole Eastern Hosp, Hong Kong, Peoples R China., [Wan, W.] Princess Margaret Hosp, Hong Kong, Peoples R China., [Sin, K.] Queen Elizabeth Hosp, Hong Kong, Peoples R China., [Lee, K.] United Christian Hosp Hong Kong SAR, Hong Kong, Peoples R China., [Wijanti, M.] Anestesi, Yogyakarta, Indonesia., [Widodo, U.] Pku Muhammadiyah Bantu, Yogyakarta, Indonesia., [Samsirun, H.] Rd Mattaher Hosp Jambi, Jambi City, Indonesia., [Sugiman, T.] Rumah Sakit Pantai Lndah Kapuk, North Jakarta, Indonesia., [Wisudarti, C.] Sardjito Hosp, Yogyakarta, Indonesia., [Maskoen, T.] Sch Med Unpad, Hasan Sadikin Hosp, Bandung, Indonesia., [Hata, N.] Nippon Med Sch, Chiba Hokusoh Hosp, Inzai, Japan., [Kobe, Y.] Chiba Univ Hosp, Chiba, Japan., [Nishida, O.] Fujita Hlth Univ, Sch Med, Toyoake, Aichi, Japan., [Miyazaki, D.] Japanese Red Cross Maebashi Hosp, Maebashi, Gumma, Japan., [Nunomiya, S.] Jichi Med Univ Hosp, Shimotsuke, Japan., [Uchino, S.] Jikei Univ, Sch Med, Tokyo, Japan., [Kitamura, N.] Kimitsu Chuo Hosp, Kisarazu, Japan., [Yamashita, K.] Kochi Med Sch, Nankoku, Kochi, Japan., [Hashimoto, S.] Kyoto Prefectural Univ Med, Kyoto, Japan., [Fukushima, H.] Nara Med Univ Hosp, Kashihara, Nara, Japan., [Adib, N. Nik] Hosp Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia., [Tai, L.] Kuala Lumpur Hosp, Kuala Lumpur, Malaysia., [Tony, B.] Queen Elizabeth Hosp 2, Kota Kinabalu, Malaysia., [Bigornia, R.] Cebu Velez Gen Hosp, Cebu, Philippines., [Bigornia, R.] Perpetual Succour Hosp, Cebu, Philippines., [Palo, J.] Med City, Pasig, Philippines., [Chatterjee, S.] Alexandra Hosp, Singapore, Singapore., [Tan, B.] Natl Univ Hlth Syst, Singapore, Singapore., [Kong, A.] Singapore Gen Hosp, Singapore, Singapore., [Goh, S.] Tan Tock Seng Hosp, Singapore, Singapore., [Lee, C.] Natl Taiwan Univ Hosp, Taipei, Taiwan., [Pothirat, C.] Chiaingmai Univ, Maharaj Nakorn Chiangmai Hosp, Chiang Mai, Thailand., [Khwannimit, B.] Prince Songkla Univ, Hat Yai, Thailand., [Theerawit, P.] Ramathibodi Hosp, Bangkok, Thailand., [Pornsuriyasak, P.] Ramathibodi Hosp, Somdech Phra Debaratana Med Ctr, Bangkok, Thailand., [Piriyapatsom, A.] Mahidol Univ, Siriraj Hosp, Bangkok, Thailand., [Mukhtar, A.] Cairo Univ, Giza, Egypt., [Dsicu] Demerdash Surg Intens Care Unit, Cairo, Egypt., [Hamdy, A. Nabil] Ain Shams Fac Med, Cairo, Egypt., [Hosny, H.] Zaitoun Specialized Hosp, Cairo, Egypt., [Ashraf, A.] Gums, Tehran, Iran., [Mokhtari, M.] Sbums, Imam Hossein Hosp, Tehran, Iran., [Nowruzinia, S.] Imamreza Hosp, Mashhad, Razavi Khorasan, Iran., [Lotfi, A.] Laleh Hosp, Tehran, Iran., [Zand, F.] Shiraz Anesthesiol & Crit Care Res Ctr, Shiraz, Iran., [Nikandish, R.] Shiraz Univ Med Sci, Shiraz, Iran., [Moghaddam, O. Moradi] Tehran Med Sci Univ, Tehran, Iran., [Cohen, J.] Rabin Med Ctr, Petah Tiqwa, Israel., [Sold, O.] Sourasky Tel Aviv Med Ctr, Tel Aviv, Israel., [Sfeir, T.] Ctr Hosp Nord, Ettelbruck, Luxembourg., [Hasan, A.] Sohar Hosp, Sohar, Oman., [Abugaber, D.] Specialized Arab Hosp, Nablus, Palestine., [Ahmad, H.] Almana Gen Hosp, Khobar, Saudi Arabia., [Tantawy, T.] KFSHRC, Riyadh, Saudi Arabia., [Baharoom, S.] King Abdulaziz Med City Riyadh, Riyadh, Saudi Arabia., [Algethamy, H.] King Abdulaziz Univ, Jeddah, Saudi Arabia., [Amr, A.] King Saud Med City, Riyadh, Saudi Arabia., [Almekhlafi, G.] Riyadh Mil Hosp, Riyadh, Saudi Arabia., [Coskun, R.] Erciyes Univ, Med Fac, Kayseri, Turkey., [Sungur, M.] Erciyes Univ, Med Sch, Kayseri, Turkey., [Cosar, A.] Gulhane Mil Med Acad, Ankara, Turkey., [Gucyetmez, B.] Int Hosp, Istanbul, Turkey., [Demirkiran, O.] Istanbul Univ, Cerrahpasa Med Sch Hosp, Istanbul, Turkey., [Senturk, E.] Istanbul Univ, Istanbul Med Fac, Istanbul, Turkey., [Ulusoy, H.] Karadeniz Tech Univ, Med Fac, Trabzon, Turkey., [Atalan, H.] Mem Atasehir Hosp, Istanbul, Turkey., [Serin, S.] Pamukkale Univ, Denizli, Turkey., [Kati, I] Yuzuncu Yil Univ, Med Fac, Van, Turkey., [Alnassrawi, Z.] Dubai Hosp, Dubai, U Arab Emirates., [Almemari, A.] Mafraq Hosp, Abu Dhabi, U Arab Emirates., [Krishnareddy, K.] Sheikh Khalifa Med City, Abu Dhabi, U Arab Emirates., [Kashef, S.] Tawam Hosp, Al Ain, U Arab Emirates., [Alsabbah, A.] City Hosp, Dubai, U Arab Emirates., [Poirier, G.] Hop Charles Lemoyne, Longueuil, PQ, Canada., [Marshall, J.] St Michaels Hosp, Toronto, ON, Canada., [Herridge, M.] Toronto Gen Hosp, Toronto, ON, Canada., [Herridge, M.] Toronto Western Hosp, Toronto, ON, Canada., [Fernandez-Medero, R.] San Juan Hosp, San Juan, PR USA., [Fulda, G.] Christiana Care Hlth Syst, Newark, DE USA., [Banschbach, S.] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA., [Quintero, J.] El Camino Hosp, Mountain View, CA USA., [Schroeder, E.] George Washington Hosp, Washington, DC USA., [Sicoutris, C.] Hosp Univ Penn, Philadelphia, PA 19104 USA., [Gueret, R.] John H Stroger Hosp Cook Cty, Chicago, IL USA., [Kashyap, R.] Mayo Clin, CCM, Rochester, MN USA., [Bauer, P.] Mayo Clin, PCC, Rochester, MN USA., [Nanchal, R.] Med Coll Wisconsin, Milwaukee, WI 53226 USA., [Wunderink, R.] Northwestern Mem Hosp, Chicago, IL 60611 USA., [Jimenez, E.] Orlando Reg Med Ctr Inc, Orlando, FL USA., [Ryan, A.] Washington Hosp Ctr, Washington, DC 20010 USA., [Ryan, A.] Washington Hosp Ctr, 2H, Washington, DC USA., [Ryan, A.] Washington Hosp Ctr, 2G, Washington, DC USA., [Ryan, A.] Washington Hosp Ctr, 3H, Washington, DC USA., [Ryan, A.] Washington Hosp Ctr, 3G, Washington, DC USA., [Ryan, A.] Washington Hosp Ctr, 4H, Washington, DC USA., [Ryan, A.] Washington Hosp Ctr, CVRR, Washington, DC USA., [Prince, D.] Armadale Hlth Serv, Mount Nasura, WA, Australia., [Edington, J.] Bendigo Hosp, Bendigo, Vic, Australia., [Van Haren, F.] Canberra Hosp, Canberra, ACT, Australia., [Bersten, A.] Flinders Med Ctr, Bedford Pk, SA, Australia., [Hawkins, D. J.] Joondalup Hlth Campus, Joondalup, WA, Australia., [Kilminster, M.] Lismore Base Hosp, Lismore, NSW, Australia., [Sturgess, D.] Mater Adult Hosp, South Brisbane, Qld, Australia., [Ziegenfuss, M.] Prince Charles Hosp, Brisbane, Qld, Australia., [O'Connor, S.] Royal Adelaide Hosp, Adelaide, SA, Australia., [Lipman, J.] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia., [Campbell, L.] Royal Darwin Hosp, Tiwi, NT, Australia., [Mcallister, R.] Royal Hobart Hosp, Hobart, Tas, Australia., [Roberts, B.] Sir Charles Gairdner Hosp, Nedlands, WA, Australia., [Williams, P.] Queen Elizabeth Hosp, Woodville, SA, Australia., [Parke, R.] Auckland Dist Hlth Board, Auckland, New Zealand., [Seigne, P.] Christchurch Hosp, Christchurch, New Zealand., [Freebairn, R.] Hawkes Bay Hosp, Hastings, New Zealand., [Nistor, D.] Palmerston North Hosp, Midcent Hlth, Palmerston North, New Zealand., [Oxley, C.] Middlemore Hosp, Auckland, New Zealand., [Young, P.] Wellington Hosp, Wellington, New Zealand., [Valentini, R.] Cemic, Buenos Aires, DF, Argentina., [Wainsztein, N.] Fleni, Buenos Aires, DF, Argentina., [Comignani, P.] Hosp Aleman, Buenos Aires, DF, Argentina., [Casaretto, M.] Hosp Cent San Isidro, Buenos Aires, DF, Argentina., [Sutton, G.] Hosp Fernandez, Buenos Aires, DF, Argentina., [Villegas, P.] Hosp Francisco Lopez Lima Area Programa Gen Roca, Gen Roca, Argentina., [Galletti, C.] Sanatorio Allende, Cordoba, Argentina., [Neira, J.] Sanatorio Trinidad Palermo, Buenos Aires, DF, Argentina., [Rovira, D.] Sanatorio Julio Corzo Rosario, Rosario, Santa Fe, Argentina., [Hidalgo, J.] Karl Heusner Mem Hosp, Belize City, Belize., [Hidalgo, J.] Belize Healthcare Partner, Belize City, Belize., [Sandi, F.] Hosp Obrero 1, La Paz, Bolivia., [Caser, E.] Cias Unimed Vitoria, Vitoria, ES, Brazil., [Thompson, M.] Evangelical Hosp Cachoeiro De Itapemirim, Cachoeiro De Itapemirim, Brazil., [D'agostino Dias, M.] Hosp 9 Julho, Sao Paulo, Brazil., [Fontes, L.] Hosp Alcides Carneiro, Petropolis, Brazil., [Lunardi, M.] Hosp Clin Luzia De Pinho Melo, Mogi Das Cruzes, Brazil., [Youssef, N.] Hosp Nacoes Curitiba, Curitiba, Parana, Brazil., [Lobo, S.] Hosp Base Famerp, Sao Jose Do Rio Preto, Brazil., [Silva, R.] Hosp Clin Niteroi, Niteroi, RJ, Brazil., [Sales Jr, J.] Hosp Clin Padre Miguel, Rio De Janeiro, Brazil., [Madeira Campos Melo, L.] Hosp Terapia Intens, Sao Paulo, Brazil., [Oliveira, M.] Hosp Trabalhador, Curitiba, Parana, Brazil., [Fonte, M.] Hosp Esperanza, Olinda, PE, Brazil., [Grion, C.] Hosp Evangel Londrina, Londrina, Brazil., [Feijo, C.] Hosp Geral Fortaleza, Fortaleza, Ceara, Brazil., [Rezende, V] Hosp Geral Roraima, Boa Vista, Brazil., [Assuncao, M.] Hosp Israelita Albert Einstein, Sao Paulo, Brazil., [Neves, A.] Hosp Mater Dei, Belo Horizonte, MG, Brazil., [Gusman, P.; Dalcomune, D.] Hosp Meridional, Cariacica, ES, Brazil., [Teixeira, C.] Hosp Moinhos Vento, Porto Alegre, RS, Brazil., [Kaefer, K.] Hosp Municipal Ruth Cardoso, Balneario, Brazil., [Maia, I] Hosp Nereu Ramos, Florianopolis, SC, Brazil., [Souza Dantas, V] Hosp Pasteur, Rio De Janeiro, Brazil., [Costa Filho, R.] Hosp Pro Cardiaco, Rio De Janeiro, Brazil., [Amorim, F.] Hosp Reg Samambaia, Brasilia, DF, Brazil., [Assef, M.] Hosp Reg Hans Dieter Schmidt, Joinville, Brazil., [Schiavetto, P.] Hosp Santa Casa Campo Mourao, Campo Mourao, PR, Brazil., [Houly, J.] Hosp Santa Paula, Sao Paulo, SP, Brazil., [Houly, J.] Hosp Santapaula, Sao Paulo, Brazil., [Bianchi, F.] Hosp Sao Jose Avai, Itaperuna, RJ, Brazil., [Dias, F.] Hosp Sao Lucas Pucrs, Porto Alegre, RS, Brazil., [Avila, C.] Hosp Sao Vicente Paula, Rio De Janeiro, RJ, Brazil., [Gomez, J.] Hosp Sao Vicente Paulo, Rio De Janeiro, Brazil., [Rego, L.] Hosp Saude Mulher, Belem, Para, Brazil., [Castro, P.] Hosp Tacchini, Bento Goncalves, RS, Brazil., [Passos, J.] Hosp Unimed Costa Do Sol Macae Rj, Macae, RJ, Brazil., [Mendes, C.] Hosp Univ Ufpb Joao Pessoa, Joao Pessoa, Paraiba, Brazil., [Grion, C.] Hosp Univ Londrina, Londrina, Brazil., [Colozza Mecatti, G.] Hosp Univ Sao Francisco, Braganca Paulista, SP, Brazil., [Ferrreira, M.] Santa Casa Caridade Diamantina, Diamantina, MG, Brazil., [Irineu, V] Santa Casa Misericordia Tatui, Tatui, Brazil., [Guerreiro, M.] Sao Francisco de Paula Hosp, Sao Francisco De Paula, RS, Brazil., [Ugarte, S.] Clin Indisa, Providencia, Chile., [Tomicic, V] Clin Las Lilas, Providencia, Chile., [Godoy, C.] Hosp Carlos Van Buren, Valparaiso, Chile., [Samaniego, W.] Hosp Trabajador Santiago, Santiago, Chile., [Escamilla, I] Hosp El Pino, San Bernardo, Chile., [Escamilla, I] Hosp Mutual De Seguridad, Santiago, Chile., [Castro Castro, L.] Ctr Med Imbanaco, Valle Del Cauca, Colombia., [Libreros Duque, G.] Clin Colombia Cali, Cali, Colombia., [Diaz-Guio, D.] Clin Del Cafe, Armenia, Colombia., [Benitez, F.] Clin La Estancia SA, Popayan, Colombia., [Guerra Urrego, A.] Clin Medellin, Medellin, Colombia., [Buitrago, R.] Fdn Clin Shaio, Bogota, Colombia., [Ortiz, G.] Hosp Santa Clara, Bogota, Colombia., [Villalba Gaviria, M.] Hosp Univ Fdn Santa Fe De Bogota, Bogota, Colombia., [Salas, D.] Calderon Guardia Hosp, San Jose, Costa Rica., [Ramirez-Arce, J.] Hosp Dr Rafael Angel Varlderon Guardia Ccss, San Jose, Costa Rica., [Salgado, E.] Clin La Merced, Quito, Ecuador., [Morocho, D.] Hosp Eugenio Espejo, Quito, Ecuador., [Vergara, J.] Hosp Luis Vernaza, Quito, Ecuador., [Chung Sang, M.] Shdug Sistema Hosp Docente De La Univ Guayaquil, Quito, Ecuador., [Orellana-Jimenez, C.] Gen Hosp, San Salvador, El Salvador., [Garrido, L.] Hosp Ctr Med, Guatemala City, Guatemala., [Diaz, O.] Inst Hondureno Seguro Social, La Ceiba, Honduras., [Resiere, D.] Ctr Hosp Univ Ft De France, Fort De France, Martinique, France., [Osorio, C.] Ctr Estatal Cuidados Crit, Salamanca, Mexico., [De La Vega, A.] Ctr Med Nacl 20 Noviembre Issste, Mexico City, DF, Mexico., [Carrillo, R.] Fdn Clin Med Sur, Mexico City, DF, Mexico., [Sanchez, V] Hosp San Jose TEC Monterrey, Monterrey, Mexico., [Villagomez, A.] Hosp 1 Octubre, Issste, Mexico., [Martinez Zubieta, R.] Hosp Espanol Mexico, Mexico City, DF, Mexico., [Sandia, M.] Hosp Gen Ajusco Medio, Mexico City, DF, Mexico., [Zalatiel, M.] Hosp Gen Guadalupe Victoria, Texcoco, Mexico., [Poblano, M.] Hosp Juarez Mexico, Mexico City, DF, Mexico., [Rodriguez Gonzalez, D.] Hosp Civil Guadalajara, Hspitaljuan I Menchaca, Guadalajara, Jalisco, Mexico., [Arrazola, F.; Juan Francisco, L.] Inst Mexicano Seguro Social, Mexico City, DF, Mexico., [Liamendys-Silva, S. A.] Inst Nacl Cancerol, Mexico City, DF, Mexico., [Hernandez, M.] ISSSTE Guerra Moya, Mexico City, DF, Mexico., [Hernandez, M.] Med Ctr ISSEMYM Toluca, Mexico City, DF, Mexico., [Rodriguez Cadena, D.] Mixta, Mexico City, DF, Mexico., [Lopez Islas, I.] Secretaria Salud Dist Fed, Mexico City, DF, Mexico., [Ballesteros Zarzavilla, C.] Hosp Santo Comas, Panama City, Panama., [Matos, A.] Social Secur Hosp, La Chorrera, Panama., [Oyanguren, I] Clin Anglo Amer, Lima, Peru., [Cerna, J.] Essalud, Lima, Peru., [Quispe Sierra, R.] Hosp Nacl Dos De Mayo, Lima, Peru., [Jimenez, R.] Hosp Rebagliati, Lince Dist, Peru., [Castillo, L.] Inst Nacl Enfermedades Neoplas, Surquillo, Peru., [Ocal, R.] Gulhane Med Fac, Istanbul, Turkey., [Sencan, A.] Izmir Ataturk Educ & Res Hosp, Izmir, Turkey., [Gianoni, S. 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Zirpe] Ruby Hall Pune, Pune, Maharashtra, India., [Patel, M.] Saifee Hosp, Mumbai, Maharashtra, India., [Bhaysar, A.] Spandan Multispecial Hosp, Vadodara, India., [Samaddar, D.] Tata Main Hosp, Jamshedpur, Jharkhand, India., [Kulkarni, A.] Tata Mem Hosp, Mumbai, Maharashtra, India., [Hashmi, M.] Aga Khan Univ, Karachi, Pakistan., [Ali, W.] Hearts Int Hosp, Rawalpindi, Pakistan., [Nadeem, S.] Liaquat Natl Hosp, Karachi, Pakistan., [Indraratna, K.] Sri Jayewardenepura Gen Hosp, Sri Jayawardenepura Kott, Sri Lanka., [Margarit, A.] Hosp Nostra Senyora Meritxell, Les Escaldes, Andorra., [Urbanek, P.] Akh Wien, Vienna, Austria., [Schlieber, J.] Allgemeines & Orthopad Landeskrankenhaus Stolzalp, Stolzalpe, Austria., [Reisinger, J.] Barmherzige Schwestern Linz, Linz, Austria., [Auer, U.] Gen Hosp Braunau, Braunau, Austria., [Hartjes, A.] Krankenhaus D Barmherzigen Schwestern Ried II, Ried Im Innkreis, Austria., [Lerche, A.] Krankenhaus Floridsdorf, Vienna, Austria., [Janous, T.] LK Gmund Waidhofen Thaya Zwettl, Standort Zwettl, Austria., [Kink, E.] LKH Horgas Enzenbach, Gratwein, Austria., [Krahulec, W.] LKH West, Graz, Austria., [Smolle, K.] Univ Hosp, Graz, Austria., [Van der Schueren, M.] AZ Groeninge Kortrijk, Kortrijk, Belgium., [Thibo, P.] AZ Jan Palfijn Gent, Ghent, Belgium., [Vanhoof, M.] AZ Turnhout, Turnhout, Belgium., [Ahmet, I] Bracops Anderlecht, Anderlecht, Belgium., [Gadisseux, P.] Ctr Hosp Mouscron, Mouscron, Belgium., [Dufaye, P.] CH Peltzer La Tourelle, Verviers, Belgium., [Jacobs, O.] Chirec Edith Cavell, Auderghem, Belgium., [Fraipont, V] CHR Citadelle, Liege, Belgium., [Biston, P.] CHU Charleroi, Charleroi, Belgium., [Dive, A.] CHU Mt Godinne, Yvoir, Belgium., [Bouckaert, Y.] CHU Tivoli, La Louviere, Belgium., [Gilbert, E.] CHwapi, Tournai, Belgium., [Gressens, B.] Clin St Pierre Ottignies, Ottignies, Belgium., [Pinck, E.] Clin Maternite St Elisabeth, Namur, Belgium., [Collin, V] Clin Europe St Michel, Etterbeek, Belgium., [Vincent, J. L.] Erasme Univ Hosp, Anderlecht, Belgium., [De Waele, J.] Ghent Univ Hosp, Ghent, Belgium., [Rimachi, R.] Moliere Hosp, Forest, Belgium., [Gusu, D.] Notre Dame, Brussels, Belgium., [De Decker, K.] Onze Lieve Vrouw Hosp, Aalst, Belgium., [Mandianga, K.] Ixelles Hosp, Ixelles, Belgium., [Heytens, L.] Sint Augustinus, Antwerp, Belgium., [Wittebole, X.] St Luc Univ Hosp UCL, Brussels, Belgium., [Spapen, H.] UZ Brussel, Brussels, Belgium., [Olivier, V] Vivalia Site Libramt, Libramont, Belgium., [Vandenheede, W.] VZW Gezondheidszorg Oostkust Knokke Heist, Knokke Heist, Belgium., [Rogiers, P.] ZNA Middelheim, Antwerp, Belgium., [Kolodzeike, P.] Herning Hosp, Herning, Denmark., [Kruse, M.] Hjoerring Hosp, Hjorring, Denmark., [Andersen, T.] Vejle Hosp, Vejle, Denmark., [Harjola, V] Helsinki Univ Cent Hosp, Helsinki, Finland., [Saarinen, K.] Seinajoki Cent Hosp, Seinajoki, Finland., [Leone, M.] Aix Marseille Univ, Hop Nord, Marseille, France., [Durocher, A.] Calmette Hosp, Lille, France., [Moulront, S.] Ctr Hosp Dunkerque, Dunkerque, France., [Lepape, A.] Ctr Hosp Lyon Sud, Lyon, France., [Losser, M.] CHU Nancy Brabois, Nancy, France., [Cabaret, P.] CH St Philibert, GHICL, Lille, France., [Kalaitzis, E.] CHR Dax, Dax, France., [Zogheib, E.] CHU Amiens, Amiens, France., [Charve, P.] CHU Dijon, Dijon, France., [Francois, B.] CHU Dupuytren, Limoges, France., [Lefrant, J. Y.] CHU Nimes, Nimes, France., [Beilouny, B.] Ctr Hosp Troyes, Troyes, France., [Forceville, X.] Ctr Hosp Meaux, Grp Hosp Est Francilien, Meaux, France., [Misset, B.] Grp Hosp Paris St Joseph, Paris, France., [Jacobs, F.] Hop Antoine Beclere, Clamart, France., [Floccard, B.] Hop Edouard Herriot, Lyon, France., [Payen, D.] Hop Lariboisere, AP HP, Paris, France., [Wynckel, A.] Hop Maison Blanche, Reims, France., [Castelain, V] Hop Univ Strasbourg, Strasbourg, France., [Faure, A.] Hosp Civils Lyon, Lyon, France., [Lavagne, P.] CHU Grenoble, Grenoble, France., [Thierry, I] CHU Nantes, Nantes, France., [Moussa, M.] CHRU Lille, Reanimat Chirurg Cardiovasc, Lille, France., [Vieillard-Baron, A.] Univ Hosp Ambroise Pare, Boulogne, France., [Durand, M.] Univ Hosp Grenoble, La Tronche, France., [Gainnier, M.] Univ Hosp Marseille, Marseille, France., [Ichai, C.] Univ Nice, Nice, France., [Arens, S.] Alexianer Krefeld Gmbh, Krefeld, Germany., [Hoffmann, C.] Charite Hochschulmed Berlin, Berlin, Germany., [Kaffarnik, M.] Charite, Berlin, Germany., [Scharnofske, C.] Diakoniekrankenhaus Henriettenstiftung Gmbh, Hannover, Germany., [Voigt, I] Elisabeth Krankenhaus Essen, Essen, Germany., [Peckelsen, C.] Munich Municipal Hosp Grp, Harlaching Hosp, Munich, Germany., [Weber, M.] Helios St Johannes Klin, Duisburg, Germany., [Gille, J.] Hosp St Georg Leipzig, Leipzig, Germany., [Lange, A.] Klin Hennigsdorf Oberhavel Kliniken Gmbh, Hennigsdorf, Germany., [Schoser, G.] Klin Tettnang, Tettnang, Germany., [Sablotzki, A.] Klinikum St Georg Leipzig, Leipzig, Germany., [Jaschinski, U.; Bluethgen, A.] Klinikum Augsburg, Augsburg, Germany., [Vogel, F.] Klinikum Bremen Mitte, Bremen, Germany., [Tscheu, A.] Klinikum Bremen Ost, Bremen, Germany., [Fuchs, T.] Klinikum Heidenheim, Heidenheim, Germany., [Wattenberg, M.] Klinikum Links Weser Gmbh, Bremen, Germany., [Helmes, T.] Klinikum Luedenscheid, Luedenscheid, Germany., [Scieszka, S.] Krankenhaus Neuwerk, Monchengladbach, Germany., [Heintz, M.] Marienkrankenhaus Schwerte, Schwerte, Germany., [Sakka, S.] Med Ctr Cologne Merheim, Cologne, Germany., [Kohler, J.] Schwarzwald Baar Klinikum Villingen Schwenningen, Villingen Schwenningen, Germany., [Fiedler, F.] St Elisabeth Krankenhaus Koln Hohenlind, Cologne, Germany., [Danz, M.] St Martinus Hosp Olpe, Olpe, Germany., [Sakr, Y.] Uniklinikum Jena, Jena, Germany., [Riessen, R.] Univ Klinikum Tubingen, Tubingen, Germany., [Kerz, T.] Univ Med Mainz, Mainz, Germany., [Kersten, A.] Univ Hosp Aachen, CPACC, Aachen, Germany., [Tacke, F.] Univ Hosp Aachen, DMIII, Aachen, Germany., [Marx, G.] Univ Hosp Aachen, OIC, Aachen, Germany., [Volkert, T.] Univ Hosp Muenster, Munster, Germany., [Schmutz, A.] Univ Med Ctr Freiburg, Fr
Published: 2019
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3. Intraabdominal Pressure Targeted Positive End-expiratory Pressure during Laparoscopic Surgery: An Open-label, Nonrandomized, Crossover, Clinical Trial

Author: Mazzinari G, Diaz-Cambronero O, Alonso-Iñigo JM, Garcia-Gregorio N, Ayas-Montero B, Ibañez JL, Serpa Neto A, Ball L, Gama de Abreu M, Pelosi P, Maupoey J, Argente Navarro MP, and Schultz MJ
Abstract: Transpulmonary driving pressure (ratio of tidal volume to respiratory system compliance) increases with increased intraabdominal pressure during laparoscopic surgery. High transpulmonary driving pressure during laparoscopic surgery is associated with increased risk of postoperative pulmonary complications.Intraoperative positive end-expiratory pressure prevents atelectasis, but may also cause overdistension.
Published: 2020

4. Effect of an individualized versus standard pneumoperitoneum pressure strategy on postoperative recovery: a randomized clinical trial in laparoscopic colorectal surgery

Author: Díaz-Cambronero O, Mazzinari G, Flor Lorente B, García Gregorio N, Robles-Hernandez D, Olmedilla Arnal LE, Martin de Pablos A, Schultz MJ, Errando CL, Argente Navarro MP, and on behalf of the IPPColLapSe II study investigators
Abstract: Background It remains uncertain whether individualization of pneumoperitoneum pressures during laparoscopic surgery improves postoperative recovery. This study compared an individualized pneumoperitoneum pressure (IPP) strategy with a standard pneumoperitoneum pressure (SPP) strategy with respect to postoperative recovery after laparoscopic colorectal surgery. Methods This was a multicentre RCT. The IPP strategy comprised modified patient positioning, deep neuromuscular blockade, and abdominal wall prestretching targeting the lowest intra-abdominal pressure (IAP) that maintained acceptable workspace. The SPP strategy comprised patient positioning according to the surgeon's preference, moderate neuromuscular blockade and a fixed IAP of 12 mmHg. The primary endpoint was physiological postoperative recovery, assessed by means of the Postoperative Quality of Recovery Scale. Secondary endpoints included recovery in other domains and overall recovery, the occurrence of intraoperative and postoperative complications, duration of hospital stay, and plasma markers of inflammation up to postoperative day 3. Results Of 166 patients, 85 received an IPP strategy and 81 an SPP strategy. The IPP strategy was associated with a higher probability of physiological recovery (odds ratio (OR) 2 center dot 77, 95 per cent c.i. 1 center dot 19 to 6 center dot 40, P = 0 center dot 017; risk ratio (RR) 1 center dot 82, 1 center dot 79 to 1 center dot 87, P = 0 center dot 049). The IPP strategy was also associated with a higher probability of emotional (P = 0 center dot 013) and overall (P = 0 center dot 011) recovery. Intraoperative adverse events were less frequent with the IPP strategy (P < 0 center dot 001) and the plasma neutrophil-lymphocyte ratio was lower (P = 0 center dot 029). Other endpoints were not affected. Conclusion In this cohort of patients undergoing laparoscopic colorectal surgery, an IPP strategy was associated with faster recovery, fewer intraoperative complications and less inflammation than an SPP strategy. Registration number: NCT02773173 ( ).
Published: 2020

5. A multifaceted individualized pneumoperitoneum strategy for laparoscopic colorectal surgery: a multicenter observational feasibility study

Author: Diaz-Cambronero O, Flor Lorente B, Mazzinari G, Vila Montañes M, García Gregorio N, Robles Hernandez D, Olmedilla Arnal LE, Argente Navarro MP, Schultz MJ, Errando CL, and IPPColLapSe study group
Subjects: Colorectal surgery, Colorectal surgery, Laparoscopy, Neuromuscular blockade, Laparoscopy, Neuromuscular blockade
Abstract: BackgroundWhile guidelines for laparoscopic abdominal surgery advise using the lowest possible intra-abdominal pressure, commonly a standard pressure is used. We evaluated the feasibility of a predefined multifaceted individualized pneumoperitoneum strategy aiming at the lowest possible intra-abdominal pressure during laparoscopic colorectal surgery.MethodsMulticenter prospective study in patients scheduled for laparoscopic colorectal surgery. The strategy consisted of ventilation with low tidal volume, a modified lithotomy position, deep neuromuscular blockade, pre-stretching of the abdominal wall, and individualized intra-abdominal pressure titration; the effect was blindly evaluated by the surgeon. The primary endpoint was the proportion of surgical procedures completed at each individualized intra-abdominal pressure level. Secondary endpoints were the respiratory system driving pressure, and the estimated volume of insufflated CO2 gas needed to perform the surgical procedure.ResultsNinety-two patients were enrolled in the study. Fourteen cases were converted to open surgery for reasons not related to the strategy. The intervention was feasible in all patients and well-accepted by all surgeons. In 61 out of 78 patients (78%), surgery was performed and completed at the lowest possible IAP, 8mmHg. In 17 patients, IAP was raised up to 12mmHg. The relationship between IAP and driving pressure was almost linear. The mean estimated intra-abdominal CO2 volume at which surgery was performed was 3.2L.ConclusionA multifaceted individualized pneumoperitoneum strategy during laparoscopic colorectal surgery was feasible and resulted in an adequate working space in most patients at lower intra-abdominal pressure and lower respiratory driving pressure.ClinicalTrials.gov (Trial Identifier: NCT03000465).
Published: 2019

6. age: Observational data from the ICON audit

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Slavcovici, A, Bagin, V, Belsky, D, Palyutin, S, Shlyapnikov, S, Bikkulova, D, Gritsan, A, Natalia, G, Makarenko, E, Kokhno, V, Tolkach, A, Kokarev, E, Belotserkovskiy, B, Zolotukhin, K, Kulabukhov, V, Soskic, L, Palibrk, I, Jankovic, R, Jovanovic, B, Pandurovic, M, Bumbasirevic, V, Uljarevic, B, Surbatovic, M, Ladjevic, N, Slobodianiuk, G, Sobona, V, Cikova, A, Gebhardtova, A, Jun, C, Yunbo, S, Dong, U, Feng, S, Duan, M, Xu, Y, Xue, X, Gao, T, Xing, X, Zhao, X, Li, C, Gengxihua, G, Tan, H, Xu, J, Jiang, L, Tiehe, Q, Bingyu, Q, Shi, Q, Lv, Z, Zhang, L, Jingtao, L, Zhen, Z, Wang, Z, Wang, T, Yuhong, L, Zhai, Q, Chen, Y, Wang, C, Jiang, W, Ruilan, W, Xiaobo, H, Ge, H, Yan, T, Yuhui, C, Zhang, J, Jian-Hong, F, Zhu, H, Huo, F, Wang, Y, Zhuang, M, Ma, Z, Sun, J, Liuqingyue, L, Yang, M, Meng, J, Ma, S, Kang, Y, Yu, L, Peng, Q, Wei, Y, Zhang, W, Sun, R, Yeung, A, Wan, W, Sin, K, Lee, K, Wijanti, M, Widodo, U, Samsirun, H, Sugiman, T, Wisudarti, C, Maskoen, T, Hata, N, Kobe, Y, Nishida, O, 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Abstract: Purpose: To investigate age-related differences in outcomes of critically ill patients with sepsis around the world. Methods: We performed a secondary analysis of data from the prospective ICON audit, in which all adult ( >16 years ) patients admitted to participating ICUs between May 8 and 18, 2012, were included, except admissions for routine postoperative observation. For this sub-analysis, the 10,012 patients with completed age data were included. They were divided into five age groups - 80 years. Sepsis was defined as infection plus at least one organ failure. Results: A total of 2963 patients had sepsis, with similar proportions across the age groups (80 = 30.9%). Hospital mortality increased with age and in patients >80 years was almost twice that of patients 70 years was independently associated with increased risk of dying. Conclusions: The odds for death in ICU patients with sepsis increased with age with the maximal rate of increase occurring between the ages of 71 and 77 years. (C) 2019 Elsevier Inc. All rights reserved. C1 [Kotfis, Katarzyna] Pomeranian Med Univ, Dept Anaesthesiol Intens Therapy & Acute Intoxica, Szczecin, Poland. [Wittebole, Xavier] UCL, Clin Univ St Luc, Dept Crit Care, Brussels, Belgium. [Jaschinski, Ulrich] Klinikum Augsburg, Klin Anasthesiol & Operat Intens Med, Augsburg, Germany. [Sole-Violan, Jordi] Hosp Univ Gran Canaria Dr Negrin, Dept Intens Care, Las Palmas Gran Canaria, Spain. [Kashyap, Rahul] Mayo Clin, Dept Anesthesia Ei Perioperat Med, Rochester, MN USA. [Leone, Marc] Aix Marseille Univ, Hop Nord, AP HM, Serv Anesthesie & Reanimat, Marseille, France. [Nanchal, Rahul] Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA. [Fontes, Luis E.] Hosp Alcides Carneiro, Petropolis Med Sch, Dept Intens Care & Evidence Based Med, Petropolis, Brazil. 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[Jimenez, E.] Orlando Reg Med Ctr Inc, Orlando, FL USA. [Ryan, A.] Washington Hosp Ctr, Washington, DC 20010 USA. [Ryan, A.] Washington Hosp Ctr, 2H, Washington, DC USA. [Ryan, A.] Washington Hosp Ctr, 2G, Washington, DC USA. [Ryan, A.] Washington Hosp Ctr, 3H, Washington, DC USA. [Ryan, A.] Washington Hosp Ctr, 3G, Washington, DC USA. [Ryan, A.] Washington Hosp Ctr, 4H, Washington, DC USA. [Ryan, A.] Washington Hosp Ctr, CVRR, Washington, DC USA. [Prince, D.] Armadale Hlth Serv, Mount Nasura, WA, Australia. [Edington, J.] Bendigo Hosp, Bendigo, Vic, Australia. [Van Haren, F.] Canberra Hosp, Canberra, ACT, Australia. [Bersten, A.] Flinders Med Ctr, Bedford Pk, SA, Australia. [Hawkins, D. J.] Joondalup Hlth Campus, Joondalup, WA, Australia. [Kilminster, M.] Lismore Base Hosp, Lismore, NSW, Australia. [Sturgess, D.] Mater Adult Hosp, South Brisbane, Qld, Australia. [Ziegenfuss, M.] Prince Charles Hosp, Brisbane, Qld, Australia. [O'Connor, S.] Royal Adelaide Hosp, Adelaide, SA, Australia. [Lipman, J.] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia. [Campbell, L.] Royal Darwin Hosp, Tiwi, NT, Australia. [Mcallister, R.] Royal Hobart Hosp, Hobart, Tas, Australia. [Roberts, B.] Sir Charles Gairdner Hosp, Nedlands, WA, Australia. [Williams, P.] Queen Elizabeth Hosp, Woodville, SA, Australia. [Parke, R.] Auckland Dist Hlth Board, Auckland, New Zealand. [Seigne, P.] Christchurch Hosp, Christchurch, New Zealand. [Freebairn, R.] Hawkes Bay Hosp, Hastings, New Zealand. [Nistor, D.] Palmerston North Hosp, Midcent Hlth, Palmerston North, New Zealand. [Oxley, C.] Middlemore Hosp, Auckland, New Zealand. [Young, P.] Wellington Hosp, Wellington, New Zealand. [Valentini, R.] Cemic, Buenos Aires, DF, Argentina. [Wainsztein, N.] Fleni, Buenos Aires, DF, Argentina. [Comignani, P.] Hosp Aleman, Buenos Aires, DF, Argentina. [Casaretto, M.] Hosp Cent San Isidro, Buenos Aires, DF, Argentina. [Sutton, G.] Hosp Fernandez, Buenos Aires, DF, Argentina. [Villegas, P.] Hosp Francisco Lopez Lima Area Programa Gen Roca, Gen Roca, Argentina. [Galletti, C.] Sanatorio Allende, Cordoba, Argentina. [Neira, J.] Sanatorio Trinidad Palermo, Buenos Aires, DF, Argentina. [Rovira, D.] Sanatorio Julio Corzo Rosario, Rosario, Santa Fe, Argentina. [Hidalgo, J.] Karl Heusner Mem Hosp, Belize City, Belize. [Hidalgo, J.] Belize Healthcare Partner, Belize City, Belize. [Sandi, F.] Hosp Obrero 1, La Paz, Bolivia. [Caser, E.] Cias Unimed Vitoria, Vitoria, ES, Brazil. [Thompson, M.] Evangelical Hosp Cachoeiro De Itapemirim, Cachoeiro De Itapemirim, Brazil. [D'agostino Dias, M.] Hosp 9 Julho, Sao Paulo, Brazil. [Fontes, L.] Hosp Alcides Carneiro, Petropolis, Brazil. [Lunardi, M.] Hosp Clin Luzia De Pinho Melo, Mogi Das Cruzes, Brazil. [Youssef, N.] Hosp Nacoes Curitiba, Curitiba, Parana, Brazil. [Lobo, S.] Hosp Base Famerp, Sao Jose Do Rio Preto, Brazil. [Silva, R.] Hosp Clin Niteroi, Niteroi, RJ, Brazil. [Sales Jr, J.] Hosp Clin Padre Miguel, Rio De Janeiro, Brazil. [Madeira Campos Melo, L.] Hosp Terapia Intens, Sao Paulo, Brazil. [Oliveira, M.] Hosp Trabalhador, Curitiba, Parana, Brazil. [Fonte, M.] Hosp Esperanza, Olinda, PE, Brazil. [Grion, C.] Hosp Evangel Londrina, Londrina, Brazil. [Feijo, C.] Hosp Geral Fortaleza, Fortaleza, Ceara, Brazil. [Rezende, V] Hosp Geral Roraima, Boa Vista, Brazil. [Assuncao, M.] Hosp Israelita Albert Einstein, Sao Paulo, Brazil. [Neves, A.] Hosp Mater Dei, Belo Horizonte, MG, Brazil. [Gusman, P.; Dalcomune, D.] Hosp Meridional, Cariacica, ES, Brazil. [Teixeira, C.] Hosp Moinhos Vento, Porto Alegre, RS, Brazil. [Kaefer, K.] Hosp Municipal Ruth Cardoso, Balneario, Brazil. [Maia, I] Hosp Nereu Ramos, Florianopolis, SC, Brazil. [Souza Dantas, V] Hosp Pasteur, Rio De Janeiro, Brazil. [Costa Filho, R.] Hosp Pro Cardiaco, Rio De Janeiro, Brazil. [Amorim, F.] Hosp Reg Samambaia, Brasilia, DF, Brazil. [Assef, M.] Hosp Reg Hans Dieter Schmidt, Joinville, Brazil. [Schiavetto, P.] Hosp Santa Casa Campo Mourao, Campo Mourao, PR, Brazil. [Houly, J.] Hosp Santa Paula, Sao Paulo, SP, Brazil. [Houly, J.] Hosp Santapaula, Sao Paulo, Brazil. [Bianchi, F.] Hosp Sao Jose Avai, Itaperuna, RJ, Brazil. [Dias, F.] Hosp Sao Lucas Pucrs, Porto Alegre, RS, Brazil. [Avila, C.] Hosp Sao Vicente Paula, Rio De Janeiro, RJ, Brazil. [Gomez, J.] Hosp Sao Vicente Paulo, Rio De Janeiro, Brazil. [Rego, L.] Hosp Saude Mulher, Belem, Para, Brazil. [Castro, P.] Hosp Tacchini, Bento Goncalves, RS, Brazil. [Passos, J.] Hosp Unimed Costa Do Sol Macae Rj, Macae, RJ, Brazil. [Mendes, C.] Hosp Univ Ufpb Joao Pessoa, Joao Pessoa, Paraiba, Brazil. [Grion, C.] Hosp Univ Londrina, Londrina, Brazil. [Colozza Mecatti, G.] Hosp Univ Sao Francisco, Braganca Paulista, SP, Brazil. [Ferrreira, M.] Santa Casa Caridade Diamantina, Diamantina, MG, Brazil. [Irineu, V] Santa Casa Misericordia Tatui, Tatui, Brazil. [Guerreiro, M.] Sao Francisco de Paula Hosp, Sao Francisco De Paula, RS, Brazil. [Ugarte, S.] Clin Indisa, Providencia, Chile. [Tomicic, V] Clin Las Lilas, Providencia, Chile. [Godoy, C.] Hosp Carlos Van Buren, Valparaiso, Chile. [Samaniego, W.] Hosp Trabajador Santiago, Santiago, Chile. [Escamilla, I] Hosp El Pino, San Bernardo, Chile. [Escamilla, I] Hosp Mutual De Seguridad, Santiago, Chile. [Castro Castro, L.] Ctr Med Imbanaco, Valle Del Cauca, Colombia. [Libreros Duque, G.] Clin Colombia Cali, Cali, Colombia. [Diaz-Guio, D.] Clin Del Cafe, Armenia, Colombia. [Benitez, F.] Clin La Estancia SA, Popayan, Colombia. [Guerra Urrego, A.] Clin Medellin, Medellin, Colombia. [Buitrago, R.] Fdn Clin Shaio, Bogota, Colombia. [Ortiz, G.] Hosp Santa Clara, Bogota, Colombia. [Villalba Gaviria, M.] Hosp Univ Fdn Santa Fe De Bogota, Bogota, Colombia. [Salas, D.] Calderon Guardia Hosp, San Jose, Costa Rica. [Ramirez-Arce, J.] Hosp Dr Rafael Angel Varlderon Guardia Ccss, San Jose, Costa Rica. [Salgado, E.] Clin La Merced, Quito, Ecuador. [Morocho, D.] Hosp Eugenio Espejo, Quito, Ecuador. [Vergara, J.] Hosp Luis Vernaza, Quito, Ecuador. [Chung Sang, M.] Shdug Sistema Hosp Docente De La Univ Guayaquil, Quito, Ecuador. [Orellana-Jimenez, C.] Gen Hosp, San Salvador, El Salvador. [Garrido, L.] Hosp Ctr Med, Guatemala City, Guatemala. [Diaz, O.] Inst Hondureno Seguro Social, La Ceiba, Honduras. [Resiere, D.] Ctr Hosp Univ Ft De France, Fort De France, Martinique, France. [Osorio, C.] Ctr Estatal Cuidados Crit, Salamanca, Mexico. [De La Vega, A.] Ctr Med Nacl 20 Noviembre Issste, Mexico City, DF, Mexico. [Carrillo, R.] Fdn Clin Med Sur, Mexico City, DF, Mexico. [Sanchez, V] Hosp San Jose TEC Monterrey, Monterrey, Mexico. [Villagomez, A.] Hosp 1 Octubre, Issste, Mexico. [Martinez Zubieta, R.] Hosp Espanol Mexico, Mexico City, DF, Mexico. [Sandia, M.] Hosp Gen Ajusco Medio, Mexico City, DF, Mexico. [Zalatiel, M.] Hosp Gen Guadalupe Victoria, Texcoco, Mexico. [Poblano, M.] Hosp Juarez Mexico, Mexico City, DF, Mexico. [Rodriguez Gonzalez, D.] Hosp Civil Guadalajara, Hspitaljuan I Menchaca, Guadalajara, Jalisco, Mexico. [Arrazola, F.; Juan Francisco, L.] Inst Mexicano Seguro Social, Mexico City, DF, Mexico. [Liamendys-Silva, S. A.] Inst Nacl Cancerol, Mexico City, DF, Mexico. [Hernandez, M.] ISSSTE Guerra Moya, Mexico City, DF, Mexico. [Hernandez, M.] Med Ctr ISSEMYM Toluca, Mexico City, DF, Mexico. [Rodriguez Cadena, D.] Mixta, Mexico City, DF, Mexico. [Lopez Islas, I.] Secretaria Salud Dist Fed, Mexico City, DF, Mexico. [Ballesteros Zarzavilla, C.] Hosp Santo Comas, Panama City, Panama. [Matos, A.] Social Secur Hosp, La Chorrera, Panama. [Oyanguren, I] Clin Anglo Amer, Lima, Peru. [Cerna, J.] Essalud, Lima, Peru. [Quispe Sierra, R.] Hosp Nacl Dos De Mayo, Lima, Peru. [Jimenez, R.] Hosp Rebagliati, Lince Dist, Peru. [Castillo, L.] Inst Nacl Enfermedades Neoplas, Surquillo, Peru. [Ocal, R.] Gulhane Med Fac, Istanbul, Turkey. [Sencan, A.] Izmir Ataturk Educ & Res Hosp, Izmir, Turkey. [Gianoni, S. Mareque] CAMS, Montevideo, Uruguay. [Deicas, A.] CASMU, Montevideo, Uruguay. [Hurtado, J.] Hosp Espanol Asse, Montevideo, Uruguay. [Burghi, G.] Hosp Maciel, Montevideo, Uruguay. [Martinelli, A.] Ctr Med Caracas, Caracas, Venezuela. [Von der Osten, I] Hosp Miguel Perez Carreno, Caracas, Venezuela. [Du Maine, C.] MSF Trauma Hosp Kunduz, Kunduz, Afghanistan. [Bhattacharyya, M.] Amri Hosp, Kolkata, India. [Bandyopadhyay, S.] Amri Hosp Salt Lake, Kolkata, W Bengal, India. [Yanamala, S.] Apollo Hosp, Hyderabad, India. [Gopal, P.] Apollo Hosp, Bangalore, Karnataka, India. [Sahu, S.] Apollo Hosp, Bhubaneswar, India. [Ibrahim, M.] Apollo Special Hosp, Chennai, Tamil Nadu, India. [Rathod, D.] Asian Heart Inst, Mumbai, Maharashtra, India. [Mukundan, N.] Baby Mem Hosp Ltd, Calicut, Kerala, India. [Dewan, A.] Batra Hosp & Mrc, New Delhi 110062, India. [Amin, P.] Bombay Hosp Inst Med Sci, Mumbai, Maharashtra, India. [Samavedam, S.] Care Hosp, Hyderabad, India. [Shah, B.] Cims Hosp, Ahmadabad, Gujarat, India. [Gurupal, D.] Columbiaasia Hosp, Mysore, Karnataka, India. [Lahkar, B.] Dispur Hosp, Gauhati, India. [Mandal, A.] Fortis Hosp, Bangalore, Karnataka, India. [Sircar, M.] Fortis Hosp, Noida, India. [Ghosh, S.] Fortis Escorts Hosp, Faridabad, India. [Balasubramani, V] Ganga Med Ctr & Hosp P Ltd, Coimbatore, Tamil Nadu, India. [Kapadia, F.] Hinduja Hosp, Mumbai, Maharashtra, India. [Vadi, S.] KDAH, Mumbai, Maharashtra, India. [Nair, K.] Kerala Inst Med Sci, RMCC, Thiruvananthapuram, Kerala, India. [Tripathy, S.] Kalinga Inst Med Sci, DTEM, Bhubaneswar, Odisha, India. [Nandakumar, S.] Kovai Med Ctr & Hosp, Coimbatore, Tamil Nadu, India. [Sharma, J.] Medanta Medic, Gurgaon, India. [Kar, A.] Med Superspecialty Hosp, Kolkata, W Bengal, India. [Jha, S.] Metro Heart Inst Multispecial, Faridabad, India. [Gurav, K. Zirpe] Ruby Hall Pune, Pune, Maharashtra, India. [Patel, M.] Saifee Hosp, Mumbai, Maharashtra, India. [Bhaysar, A.] Spandan Multispecial Hosp, Vadodara, India. [Samaddar, D.] Tata Main Hosp, Jamshedpur, Jharkhand, India. [Kulkarni, A.] Tata Mem Hosp, Mumbai, Maharashtra, India. [Hashmi, M.] Aga Khan Univ, Karachi, Pakistan. [Ali, W.] Hearts Int Hosp, Rawalpindi, Pakistan. [Nadeem, S.] Liaquat Natl Hosp, Karachi, Pakistan. [Indraratna, K.] Sri Jayewardenepura Gen Hosp, Sri Jayawardenepura Kott, Sri Lanka. [Margarit, A.] Hosp Nostra Senyora Meritxell, Les Escaldes, Andorra. [Urbanek, P.] Akh Wien, Vienna, Austria. [Schlieber, J.] Allgemeines & Orthopad Landeskrankenhaus Stolzalp, Stolzalpe, Austria. [Reisinger, J.] Barmherzige Schwestern Linz, Linz, Austria. [Auer, U.] Gen Hosp Braunau, Braunau, Austria. [Hartjes, A.] Krankenhaus D Barmherzigen Schwestern Ried II, Ried Im Innkreis, Austria. [Lerche, A.] Krankenhaus Floridsdorf, Vienna, Austria. [Janous, T.] LK Gmund Waidhofen Thaya Zwettl, Standort Zwettl, Austria. [Kink, E.] LKH Horgas Enzenbach, Gratwein, Austria. [Krahulec, W.] LKH West, Graz, Austria. [Smolle, K.] Univ Hosp, Graz, Austria. [Van der Schueren, M.] AZ Groeninge Kortrijk, Kortrijk, Belgium. [Thibo, P.] AZ Jan Palfijn Gent, Ghent, Belgium. [Vanhoof, M.] AZ Turnhout, Turnhout, Belgium. [Ahmet, I] Bracops Anderlecht, Anderlecht, Belgium. [Gadisseux, P.] Ctr Hosp Mouscron, Mouscron, Belgium. [Dufaye, P.] CH Peltzer La Tourelle, Verviers, Belgium. [Jacobs, O.] Chirec Edith Cavell, Auderghem, Belgium. [Fraipont, V] CHR Citadelle, Liege, Belgium. [Biston, P.] CHU Charleroi, Charleroi, Belgium. [Dive, A.] CHU Mt Godinne, Yvoir, Belgium. [Bouckaert, Y.] CHU Tivoli, La Louviere, Belgium. [Gilbert, E.] CHwapi, Tournai, Belgium. [Gressens, B.] Clin St Pierre Ottignies, Ottignies, Belgium. [Pinck, E.] Clin Maternite St Elisabeth, Namur, Belgium. [Collin, V] Clin Europe St Michel, Etterbeek, Belgium. [Vincent, J. L.] Erasme Univ Hosp, Anderlecht, Belgium. [De Waele, J.] Ghent Univ Hosp, Ghent, Belgium. [Rimachi, R.] Moliere Hosp, Forest, Belgium. [Gusu, D.] Notre Dame, Brussels, Belgium. [De Decker, K.] Onze Lieve Vrouw Hosp, Aalst, Belgium. [Mandianga, K.] Ixelles Hosp, Ixelles, Belgium. [Heytens, L.] Sint Augustinus, Antwerp, Belgium. [Wittebole, X.] St Luc Univ Hosp UCL, Brussels, Belgium. [Spapen, H.] UZ Brussel, Brussels, Belgium. [Olivier, V] Vivalia Site Libramt, Libramont, Belgium. [Vandenheede, W.] VZW Gezondheidszorg Oostkust Knokke Heist, Knokke Heist, Belgium. [Rogiers, P.] ZNA Middelheim, Antwerp, Belgium. [Kolodzeike, P.] Herning Hosp, Herning, Denmark. [Kruse, M.] Hjoerring Hosp, Hjorring, Denmark. [Andersen, T.] Vejle Hosp, Vejle, Denmark. [Harjola, V] Helsinki Univ Cent Hosp, Helsinki, Finland. [Saarinen, K.] Seinajoki Cent Hosp, Seinajoki, Finland. [Leone, M.] Aix Marseille Univ, Hop Nord, Marseille, France. [Durocher, A.] Calmette Hosp, Lille, France. [Moulront, S.] Ctr Hosp Dunkerque, Dunkerque, France. [Lepape, A.] Ctr Hosp Lyon Sud, Lyon, France. [Losser, M.] CHU Nancy Brabois, Nancy, France. [Cabaret, P.] CH St Philibert, GHICL, Lille, France. [Kalaitzis, E.] CHR Dax, Dax, France. [Zogheib, E.] CHU Amiens, Amiens, France. [Charve, P.] CHU Dijon, Dijon, France. [Francois, B.] CHU Dupuytren, Limoges, France. [Lefrant, J. Y.] CHU Nimes, Nimes, France. [Beilouny, B.] Ctr Hosp Troyes, Troyes, France. [Forceville, X.] Ctr Hosp Meaux, Grp Hosp Est Francilien, Meaux, France. [Misset, B.] Grp Hosp Paris St Joseph, Paris, France. [Jacobs, F.] Hop Antoine Beclere, Clamart, France. [Floccard, B.] Hop Edouard Herriot, Lyon, France. [Payen, D.] Hop Lariboisere, AP HP, Paris, France. [Wynckel, A.] Hop Maison Blanche, Reims, France. [Castelain, V] Hop Univ Strasbourg, Strasbourg, France. [Faure, A.] Hosp Civils Lyon, Lyon, France. [Lavagne, P.] CHU Grenoble, Grenoble, France. [Thierry, I] CHU Nantes, Nantes, France. [Moussa, M.] CHRU Lille, Reanimat Chirurg Cardiovasc, Lille, France. [Vieillard-Baron, A.] Univ Hosp Ambroise Pare, Boulogne, France. [Durand, M.] Univ Hosp Grenoble, La Tronche, France. [Gainnier, M.] Univ Hosp Marseille, Marseille, France. [Ichai, C.] Univ Nice, Nice, France. [Arens, S.] Alexianer Krefeld Gmbh, Krefeld, Germany. [Hoffmann, C.] Charite Hochschulmed Berlin, Berlin, Germany. [Kaffarnik, M.] Charite, Berlin, Germany. [Scharnofske, C.] Diakoniekrankenhaus Henriettenstiftung Gmbh, Hannover, Germany. [Voigt, I] Elisabeth Krankenhaus Essen, Essen, Germany. [Peckelsen, C.] Munich Municipal Hosp Grp, Harlaching Hosp, Munich, Germany. [Weber, M.] Helios St Johannes Klin, Duisburg, Germany. [Gille, J.] Hosp St Georg Leipzig, Leipzig, Germany. [Lange, A.] Klin Hennigsdorf Oberhavel Kliniken Gmbh, Hennigsdorf, Germany. [Schoser, G.] Klin Tettnang, Tettnang, Germany. [Sablotzki, A.] Klinikum St Georg Leipzig, Leipzig, Germany. [Jaschinski, U.; Bluethgen, A.] Klinikum Augsburg, Augsburg, Germany. [Vogel, F.] Klinikum Bremen Mitte, Bremen, Germany. [Tscheu, A.] Klinikum Bremen Ost, Bremen, Germany. [Fuchs, T.] Klinikum Heidenheim, Heidenheim, Germany. [Wattenberg, M.] Klinikum Links Weser Gmbh, Bremen, Germany. [Helmes, T.] Klinikum Luedenscheid, Luedenscheid, Germany. [Scieszka, S.] Krankenhaus Neuwerk, Monchengladbach, Germany. [Heintz, M.] Marienkrankenhaus Schwerte, Schwerte, Germany. [Sakka, S.] Med Ctr Cologne Merheim, Cologne, Germany. [Kohler, J.] Schwarzwald Baar Klinikum Villingen Schwenningen, Villingen Schwenningen, Germany. [Fiedler, F.] St Elisabeth Krankenhaus Koln Hohenlind, Cologne, Germany. [Danz, M.] St Martinus Hosp Olpe, Olpe, Germany. [Sakr, Y.] Uniklinikum Jena, Jena, Germany. [Riessen, R.] Univ Klinikum Tubingen, Tubingen, Germany. [Kerz, T.] Univ Med Mainz, Mainz, Germany. [Kersten, A.] Univ Hosp Aachen, CPACC, Aachen, Germany. [Tacke, F.] Univ Hosp Aachen, DMIII, Aachen, Germany. [Marx, G.] Univ Hosp Aachen, OIC, Aachen, Germany. [Volkert, T.] Univ Hosp Muenster, Munster, Germany. [Schmutz, A.] Univ Med Ctr Freiburg, Freiburg, Germany. [Nierhaus, A.; Kluge, S.] Univ Med Ctr Hamburg Eppendorf, Hamburg, Germany. [Abel, P.] Univ Med Greifswald, Greifswald, Germany. [Janosi, R.] Univ Duisburg Essen, Essen, Germany. [Utzolino, S.] Univ Freiburg, Freiburg, Germany. [Bracht, H.] Univ Clin Ulm, Ulm, Germany. [Toussaint, S.] Vivantes Klinikum Neukoelln, Berlin, Germany. [Peftoulidou, M. Giannakou] Ahepa Univ Hosp, Thessaloniki, Greece. [Myrianthefs, P.] Univ Athens, Athens, Greece. [Armaganidis, A.] Univ Athens, Med Sch, Athens, Greece. [Routsi, C.] Evangelismos Med Ctr, Athens, Greece. [Xini, A.] Gen Hosp Chania, Iraklion, Greece. [Mouloudi, E.] Hippokrateion Hosp, Thessaloniki, Greece. [Kokoris, I] Gen Hosp Velos, Volos, Greece. [Kyriazopoulos, G.] Lamia Gen Hosp, Lamia, Greece. [Vlachos, S.] Naval & Vet Hosp, Athens, Greece. [Lavrentieva, A.] Apanikolaou Gen Hosp, Thessaloniki, Greece. [Partala, P.] Univ Hosp Alexandroupolis, Alexandroupolis, Greece. [Nakos, G.] Univ Ioannina, Ioannina, Greece. [Moller, A.] Landspitali Univ Hosp, Reykjavik, Iceland. [Stefansson, S.] Landspitali Univ Hosp Fossvogur, Reykjavik, Iceland. [Barry, J.] Cork Univ Hosp, Cork, Ireland. [O'Leary, R.] Mercy Univ Hosp, Cork, Ireland. [Motherway, C.] Mid Western Reg Hosp Complex, Limerick, Ireland. [Faheem, M.] Midland Reg Hosp Mullingar, Mullingar, Co Westmeath, Ireland. [Dunne, E.] St Vincents Univ Hosp, Dublin, Ireland. [Donnelly, M.] Tallaght Hosp, Dublin, Ireland. [Konrad, T.] Univ Hosp Galway, Galway, Ireland. [Bonora, E.] Anesthesiol & Intens Care, Milan, Italy. [Achilli, C.] AO Osped Niguarda Ca Granda, Milan, Italy. [Rossi, S.] Azienda Osped Padova, Padua, Italy. [Castiglione, G.] Azienda Ospedaliero Univ Policlin Vittorio Emanue, Catania, Italy. [Penis, A.] Careggi Teaching Hosp, Florence, Italy. [Albanese, D.] Clinicized Hosp Ss Annunziata Chieti, Chieti, Italy. [Stocchetti, N.] Fdn Irccs Ca Granda Osped Maggiore Policlin, Milan, Italy. [Stocchetti, N.] Univ Milan, Milan, Italy. [Citerio, G.] H San Gerardo Monza, Monza, Italy. [Mozzoni, L.] Icu Ceccarini Hosp Ricc, Rimini, Italy. [Sisillo, E.] Irccs Ctr Cardiol Monzino, Milan, Italy. [De Negri, P.] Irccs Ctr Riferimento Oncol Basilicata, Basilicata, Italy. [Savioli, M.] Irccs Fdn Ca Granda, Osped Maggiore Policlin, Milan, Italy. [Vecchiarelli, P.] Osped Belcolle Viterbo, Viterbo, Italy. [Puflea, F.; Stankovic, V] Osped Civile Maggiore AOUI Verona, Verona, Italy. [Minoja, G.] Osped Circolo E Fdn Macchi, Varese, Italy. [Montibeller, S.] Osped Trento, Azienda Prov I Servizi Sanitari Prov Autonoma Tre, Trento, Italy. [Calligaro, P.] Osped Orlandi, Bussolengo, Italy. [Sorrentino, R.] Osped Regionale U Parini Aosta, Aosta, Italy. [Feri, M.] Osped San Donato Arezzo, Arezzo, Italy. [Zambon, M.] Osped San Raffaele, Segrate, Italy. [Colombaroli, E.] Policlin GB Rossi AOUI Verona, Verona, Italy. [Giarratano, A.] Policlin Univ Palermo, Palermo, Italy. [Pellis, T.] Santa Maria Angeli Hosp, Rome, Italy. [Capra, C.] Saronno Hosp, Saronno, Italy. [Antonelli, M.] Univ Cattolica Sacro Cuore, Milan, Italy. [Gullo, A.] Univ Catania, Catania, Italy. [Chelazzi, C.] Univ Florence, Florence, Italy. [De Capraris, A.] Univ Foggia, Foggia, Italy. [Patroniti, N.] Univ Milano Bicocca, San Gerardo Hosp, Milan, Italy. [Girardis, M.] Univ Modena, Modena, Italy. [Franchi, F.] Univ Siena, Siena, Italy. [Berlot, G.] Univ Trieste, Trieste, Italy. [Buttigieg, M.] Mater Hosp, Msida, Malta. [Ponssen, H.] Albert Schweitzer Hosp, Dordrecht, Netherlands. [Cate, J. Ten] Antoni Van Leeuwenhoek Ziekenhuis, Amsterdam, Netherlands. [Bormans, L.] Atrium Med Ctr Parkstad, Heerlen, Netherlands. [Husada, S.] Bovenij Hosp, Amsterdam, Netherlands. [Buise, M.] Catharina Hosp, Eindhoven, Netherlands. [Van Der Hoven, B.] Erasmus MC, Rotterdam, Netherlands. [Reidinga, A.] Martiniziekenhuis Groningen, Groningen, Netherlands. [Kuiper, M.] Med Ctr Leeuwarden, Leeuwarden, Netherlands. [Pickkers, P.] Radboud Univ Nijmegen, Med Ctr, Nijmegen, Netherlands. [Kluge, G.] Slotervaart Ziekenhuis Amsterdam, Amsterdam, Netherlands. [Den Boer, S.] Spaarne Ziekenhuis, Hoofddrop, Netherlands. [Kesecioglu, J.] Univ Med Ctr Utrecht, Utrecht, Netherlands. [Van Leeuwen, H.] Ziekenhuis Rijnstate, Arnhem, Netherlands. [Flaatten, H.] Haukeland Hosp, Bergen, Norway. [Mo, S.] Trondheim Reg & Univ Hosp, St Olays Hosp, Trondheim, Norway. [Branco, V] Ctr Hosp Cova Da Beira, Covilha, Portugal. [Rua, F.] Ctr Hosp Porto, Porto, Portugal. [Lafuente, E.] Ctr Hosp Tamega E Sousa, Guilhufe, Portugal. [Sousa, M.] Ctr Hosp Gaia Espinho, Epe, Espinho, Portugal. [Catorze, N.] Ctr Hosp Medio Tejo, Lisbon, Portugal. [Barros, M.] Ctr Hosp Tondela Viseu, Viseu, Portugal. [Pereira, L.] Faro Hosp, Faro, Portugal. [De Oliveira, A. Vintern] Hosp Curry Cabral, Lisbon, Portugal. [Gomes, J.] Hosp Luz, Lisbon, Portugal. [Gaspar, I] Hosp Egas Moniz Chlo, Lisbon, Portugal. [Pereira, M.] Ctr Hosp Porto, Hosp Santo Antonio, Proto, Portugal. [Cymbron, M.] Hosp Divino Espirito Santo, Epe, Ponta Delgada, Portugal. [Dias, A.] Hosp Espirito Santo Evora Epe, Evora, Portugal. [Almeida, E.] Hosp Garcia Orta, Almada, Portugal. [Beirao, S.] Hosp Geral Ctr Hosp E Univ Coimbra, Coimbra, Portugal. [Serra, I] Hosp Prof Doutor Fernando Fonseca Epe, Amadora, Portugal. [Ribeiro, R.] Hosp Sao Bernardo, Setubal, Portugal. [Povoa, P.] Hosp Sao Francisco Xavier, Chlo, Lisbon, Portugal. [Faria, F.] Inst Portugues Oncol Francisco Gentil, Porto, Portugal. [Costa-E-Silva, Z.] Santa Maria Hosp, Lisbon, Portugal. [Nobrega, A.] Serv Saude Regiao Autonoma Madeira, Funchal, Portugal. [Fernandes, F.] UCIP, Lisbon, Portugal. [Gabriel, J.] ULS Castelo Branco, Castelo Branco, Portugal. [Voga, G.] Gen Hosp Celje, Celje, Slovenia. [Rupnik, E.] Gen Hosp Izola, Izola, Slovenia. [Kosec, L.] Gen Hosp Novo Mesto, Novo Mesto, Slovenia. [Povsic, M. Kerin] Oncol Inst, Ljubljana, Slovenia. [Osojnik, I] Ukc Maribor, Maribor, Slovenia. [Tomic, V] Univ Clin Resp & Allerg Dis, Golnik, Slovenia. [Sinkovic, A.] Univ Clin Ctr Maribor, Maribor, Slovenia. [Gonzalez, J.] CH Salamanca, Salamanca, Spain. [Zavala, E.] Clin Hosp, Barcelona, Spain. [Perez Valenzuela, A.] Complejo Hosp Jaen, Jaen, Spain. [Marina, L.] Complejo Hosp Toledo, Toledo, Spain. [Vidal-Cortes, P.] Complexo Hosp Univ Ourense, Orense, Spain. [Posada, I] Complexo Hosp Univ Vigo, Galicia, Spain. [Ignacio Martin-Loeches, A.] Corp Sanitaria Parc Tauli, Barcelona, Spain. [Munoz Guillen, N.] Cruz Roja Hosp, Seville, Spain. [Palomar, M.] H Vall Hebron, Barcelona, Spain. [Sole-Violan, U.] HGGC Dr Negrin, Madrid, Spain. [Torres, A.] Hosp Clin Barcelona, Barcelona, Spain. [Gonzalez Gallego, M.] Hosp Clin San Carlos, Madrid, Spain. [Aguilar, G.] Hosp Clin Univ Valencia, Valencia, Spain. [Montoiro Allue, R.] Hosp Clin Univ Lozano Blesa, Zaragoza, Spain. [Argueso, M.] Hosp Clin Valencia, Valencia, Spain. [Parejo, M.] Hosp La Ribera, Valencia, Spain. [Palomo Navarro, M.] Hosp Sagunto, Port De Sagunt, Spain. [Jose, A.] Hosp San Juan Alicante, Alicante, Spain. [Nin, N.] Hosp Torrejon de Ardoz, Madrid, Spain. [Alvarez Lerma, F.] Hosp Mar, Barcelona, Spain. [Martinez, O.] Hosp Tajo, Madrid, Spain. [Tenza Lozano, E.] Hosp Gen Univ Elche, Elche, Spain. [Arenal Lopez, S.; Perez Granda, M.] Hosp Gen Univ Gregorio Maranon, Madrid, Spain. [Moreno, S.] Hosp Gen Univ Santa Lucia, Murcia, Spain. [Llubia, C.] Hosp Badalona Germans Trias & Pujol, Barcelona, Spain. [De la Fuente Martos, C.] Hosp Infanta Margarita, Cabra, Spain. [Gonzalez-Arenas, P.] Hosp Infanta Sofia, Madrid, Spain. [Llamas Fernandez, N.; Gil Rueda, B.] Hosp JM Morales Meseguer, Murcia, Spain. [Estruch Pons, I] Hosp Marina Salu Denia Alicante, Alicante, Spain. [Cruza, N.] Hosp Nuestra Senora Prado, Toledo, Spain. [Maroto, F.] Hosp San Juan De Dios Aljarafe, Bormujos, Spain. [Estella, A.] Hosp Sas Jerez, Andalucia, Spain. [Ferrer, A.] Hosp Son Llatzer, Palma De Mallorca, Spain. [Iglesias Fraile, L.; Quindos, B.] Hosp Univ Cent Asturias, Oviedo, Spain. [Quintano, A.] Hosp Univ Alava, Santiago, Spain. [Tebar, M.] Hosp Univ Basurto, Bilbao, Spain. [Cardinal, I] Hosp Univ Getafe, Getafe, Spain. [Reyes, A.] Hosp Univ La Princesa, Madrid, Spain. [Rodriguez, A.] Hosp Univ Tarragona Joan Xxiii, Tarragona, Spain. [Abella, A.] Hosp Univ Henares, Coslada, Spain. [Garcia Del Valle, S.] Hosp Univ Fdn Alcorcon, Alcorcon, Spain. [Yus, S.; Maseda, E.] Hosp Univ La Paz, Madrid, Spain. [Berezo, U.] Hosp Univ Rio Hortega, Valladolid, Spain. [Tejero Pedregosa, A.] Hosp Univ San Cecilio, Granada, Spain. [Laplaza, C.] Hosp Virgen Del Camino, Pamplona, Spain. [Ferrer, R.] Mutua Terrassa Univ Hosp, Terrassa, Spain. [Rico-Feijoo, U.] Rao Hortega Univ Hosp, Valladolid, Spain. [Rodriguez, M.] Serv Andaluz Salud, Andalucia, Spain. [Monedero, P.] Univ Okalingaf Navarra, Navarra, Spain. [Eriksson, K.] Karolinska Univ Hosp, Solna, Sweden. [Eriksson, K.] Karolinska Inst, Solna, Sweden. [Lind, D.] Sunderby Hosp, Lulea, Sweden. [Chabanel, D.] Hop Intercantonal La Broye, Payerne, Switzerland. [Zender, H.] Hop Neuchatelois La Chaux De Fonds, La Chaux De Fonds, Switzerland. [Heer, K.] Lindenhofspital, Bern, Switzerland. [Frankenberger, B.] Regionalspital Surselva Ilanz, Ilanz, Switzerland. [Jakob, S.] Univ Hosp Bern, Bern, Switzerland. [Mathew, S.] Alexandra Hosp Redditch, Redditch, England. [Downes, R.] Blackpool Teaching Hosp, Blackpool, England. [Groba, C. Barrera] Brighton & Sussex Univ Hosp, Brighton, E Sussex, England. [Johnston, A.] Cambridge Univ Hosp NHS Fdn Trust, Cambridge, England. [Meacher, R.] Charing Cross Hosp, London, England. [Keays, R.] Chelsea & Westminster Hosp, London, England. [Haji-Michael, P.] Christie Fdn Trust, Manchester, Lancs, England. [Tyler, C.] Cty Hosp, Lincoln, England. [Ferguson, A.] Craigavon Area Hosp, Craigavon, North Ireland. [Jones, S.] Cumberland Infirm, Carlisle, England. [Tyl, D.] Darent Valley Hosp, Dartford, England. [Ball, A.] Dorset Cty Hosp, Dorchester, England. [Vogel, U.] Ealing Hosp NHS Trust, Southall, Middx, England. [Booth, M.] Glasgow Royal Infirm, Glasgow, Lanark, Scotland. [Downie, P.] Gloucester Royal Hosp, Gloucester, England. [Watters, M.] Great Western Hosp, Swindon, Wilts, England. [Brett, S.] Imperial Coll Healthcare NHS Trust, London, England. [Garfield, M.] Ipswich Hosp Nhs Trust, Ipswich, Suffolk, England. [Everett, L.] James Paget Univ Hosp NHS Fdn Trust, Great Yarmouth, Norfolk, England. [Heenen, S.] Kings Coll Hosp London, London, England. [Dhir, S.] Kings Mill Hosp, Sutton In Ashfield, England. [Beardow, Z.] Leeds Teaching Hosp NHS Trust, Leeds, W Yorkshire, England. [Mostert, M.] Lewisham Healthcare NHS Trust, London, England. [Brosnan, S.] Luton & Dunstable Hosp NHS Trust, Luton, Beds, England. [Pinto, N.] Medway Maritime Hosp, Gillingham, England. [Harris, S.] Musgrove Pk Hosp, Taunton, Somerset, England. [Summors, A.] Nevill Hall Hosp, Abergavenny, Wales. [Andrew, N.] Pilgrim Hosp, Boston, England. [Rose, A.] Mid Yorkshire NHS Trust, Pinderfields Hosp, Wakefield, England. [Appelboam, R.] Plymouth Hosp Nhs Trust, Plymouth, Devon, England. [Davies, O.] Princess Royal Hosp Telford, Telford, Shrops, England. [Vickers, E.] Royal Bournemouth Hosp, Bournemouth, Dorset, England. [Agarwal, B.] Royal Free Hampstead NHS Fdn Trust, London, England. [Szakmany, T.] Royal Glamorgan Hosp, Llantrisant, Wales. [Wimbush, S.] Royal Hampshire Cty Hosp, Winchester, Hants, England. [Welters, I] Royal Liverpool Univ Hosp, Liverpool, Merseyside, England. [Pearse, R.] Barts Hlth NHS Trust, Royal London Hosp, London, England. [Hollands, R.] Royal Shrewsbury Hosp, Shrewsbury, Salop, England. [Kirk-Bayley, U.] Royal Surrey Cty Hosp, Guildford, Surrey, England. [Fletcher, N.] St Georges Healthcare, London, England. [Bray, B.] Surrey & Sussex Healthcare Trust, Redhill, Surrey, England. [Brealey, D.] Univ Coll Hosp, London, England.
Published: 2019

7. CRISPR-Cas systems: ushering in the new genome editing era

Author: Rojo, FP, Nyman, RKM, Johnson, AAT, Navarro, MP, Ryan, MH, Erskine, W, Kaur, P, Rojo, FP, Nyman, RKM, Johnson, AAT, Navarro, MP, Ryan, MH, Erskine, W, and Kaur, P
Abstract: In recent years there has been great progress with the implementation and utilization of Clustered Regularly Interspaced Palindromic Repeats (CRISPR) and CRISPR-associated protein (Cas) systems in the world of genetic engineering. Many forms of CRISPR-Cas9 have been developed as genome editing tools and techniques and, most recently, several non-genome editing CRISPR-Cas systems have emerged. Most of the CRISPR-Cas systems have been classified as either Class I or Class II and are further divided among several subtypes within each class. Research teams and companies are currently in dispute over patents for these CRISPR-Cas systems as numerous powerful applications are concurrently under development. This mini review summarizes the appearance of CRISPR-Cas systems with a focus on the predominant CRISPR-Cas9 system as well as the classifications and subtypes for CRISPR-Cas. Non-genome editing uses of CRISPR-Cas are also highlighted and a brief overview of the commercialization of CRISPR is provided.
Published: 2018

8. Iron metabolism in rats fed diets containing heated glucose-lysine

Author: Cristina Delgado-Andrade, Seiquer, I., Valverde, A., Navarro, Mp, and Comisión Interministerial de Ciencia y Tecnología, CICYT (España)
Abstract: Trabajo presentado al Conjoint congress SENC/NS, celebrado en Pamplona (España) del 8 al 11 de septiembre de 1999., Supported by CICYT.
Published: 1999

9. Biocontrol Activity of Bacillus altitudinis CH05 and Bacillus tropicus CH13 Isolated from Capsicum annuum L. Seeds against Fungal Strains.

Author: Espinosa Bernal MA, Mena Navarro MP, Arvizu Gómez JL, Saldaña C, Ramos López MÁ, Amaro Reyes A, Escamilla García M, Pacheco Aguilar JR, Moreno VP, Rodríguez Morales JA, Álvarez Hidalgo E, Nuñez Ramírez J, Hernández Flores JL, and Campos Guillén J
Abstract: In this study, seed-surface-associated bacteria from fresh fruits of Capsicum spp. were analyzed to explore potential isolates for biocontrol of phytopathogenic fungal strains. A total of 76 bacterial isolates were obtained from three different species of chili pepper ( C. annuum L., C. pubescens R. & P., and C. chinense Jacq.), and two isolates were selected via mycelial growth inhibition assays based on their production of volatile organic compounds (VOCs) against six fungal strains. Genomic analysis identified these isolates as Bacillus altitudinis CH05, with a chromosome size of 3,687,823 bp and with 41.25% G+C, and Bacillus tropicus CH13, with a chromosome size of 5,283,706 bp and with 35.24% G+C. Both bacterial strains showed high mycelial growth inhibition capacities against Sclerotium rolfsii , Sclerotinia sp., Rhizoctonia solani , and Alternaria alternata but lower inhibition capacities against Colletotrichum gloesporoides and Fusarium oxysporum . VOC identification was carried out after 24 h of fermentation with 64 VOCs for B. altitudinis CH05 and 53 VOCs for B. tropicus CH13. 2,5-Dimethyl pyrazine and acetoin had the highest relative abundance values in both bacterial strains. Our findings revealed that seed-surface-associated bacteria on Capsicum spp. have the metabolic ability to produce VOCs for biocontrol of fungal strains and have the potential to be used in sustainable agriculture.
Published: 2024
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10. Estimation of the difference between peritoneal microenvironment and core body temperature during laparoscopic surgery - a prospective observational study.

Author: Mazzinari G, Rovira L, Vila Montañes M, García Gregorio N, Ayas Montero B, Alberola Estellés MJ, Flor B, Argente Navarro MP, and Diaz-Cambronero O
Subjects: Humans, Female, Male, Prospective Studies, Middle Aged, Aged, Peritoneum surgery, Hypothermia prevention & control, Hypothermia etiology, Adult, Insufflation methods, Pneumoperitoneum, Artificial methods, Peritoneal Cavity surgery, Laparoscopy methods, Body Temperature, Carbon Dioxide
Abstract: Maintaining patients' temperature during surgery is beneficial since hypothermia has been linked with perioperative complications. Laparoscopic surgery involves the insufflation of carbon dioxide (CO 2 ) into the peritoneal cavity and has become the standard in many surgical indications since it is associated with better and faster recovery. However, the use of cold and dry CO 2 insufflation can lead to perioperative hypothermia. We aimed to assess the difference between intraperitoneal and core temperatures during laparoscopic surgery and evaluate the influence of duration and CO 2 insufflation volume by fitting a mixed generalized additive model. In this prospective observational single-center cohort trial, we included patients aged over 17 with American Society of Anesthesiology risk scores I to III undergoing laparoscopic surgery. Anesthesia, ventilation, and analgesia followed standard protocols, while patients received active warming using blankets and warmed fluids. Temperature data, CO 2 ventilation parameters, and intraabdominal pressure were collected. We recruited 51 patients. The core temperature was maintained above 36 °C and progressively raised toward 37 °C as pneumoperitoneum time passed. In contrast, the intraperitoneal temperature decreased, thus creating a widening difference from 0.4 [25th-75th percentile: 0.2-0.8] °C at the beginning to 2.3 [2.1-2.3] °C after 240 min. Pneumoperitoneum duration and CO 2 insufflation volume significantly increased this temperature difference (P < 0.001 for both parameters). Core vs. intraperitoneal temperature difference increased linearly by 0.01 T °C per minute of pneumoperitoneum time up to 120 min and then 0.05 T °C per minute. Each insufflated liter per unit of time, i.e. every 10 min, increased the temperature difference by approximately 0.009 T °C. Our findings highlight the impact of pneumoperitoneum duration and CO 2 insufflation volume on the difference between core and intraperitoneal temperatures. Implementing adequate external warming during laparoscopic surgery effectively maintains core temperature despite the use of dry and unwarmed CO 2 gases, but peritoneal hypothermia remains a concern, suggesting the importance of further research into regional effects.Trial registration: Clinicaltrials.gov: NCT04294758., (© 2024. The Author(s).)
Published: 2024
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11. Role of Volatile Organic Compounds Produced by Kosakonia cowanii Cp1 during Competitive Colonization Interaction against Pectobacterium aroidearum SM2.

Author: Mena Navarro MP, Espinosa Bernal MA, Martinez-Avila AE, Aponte Pineda LS, Montes Flores LA, Chan Ku CD, Hernández Gómez YF, González Espinosa J, Pacheco Aguilar JR, Ramos López MÁ, Arvizu Gómez JL, Saldaña Gutierrez C, Rodríguez Morales JA, Amaro Reyes A, Hernández Flores JL, and Campos Guillén J
Abstract: The competitive colonization of bacteria on similar ecological niches has a significant impact during their establishment. The synthesis speeds of different chemical classes of molecules during early competitive colonization can reduce the number of competitors through metabolic effects. In this work, we demonstrate for the first time that Kosakonia cowanii Cp1 previously isolated from the seeds of Capsicum pubescens R. P. produced volatile organic compounds (VOCs) during competitive colonization against Pectobacterium aroidearum SM2, affecting soft rot symptoms in serrano chili ( Capsicum annuum L.). The pathogen P. aroidearum SM2 was isolated from the fruits of C. annuum var. Serrano with soft rot symptoms. The genome of the SM2 strain carries a 5,037,920 bp chromosome with 51.46% G + C content and 4925 predicted protein-coding genes. It presents 12 genes encoding plant-cell-wall-degrading enzymes (PCDEWs), 139 genes involved in five types of secretion systems, and 16 genes related to invasion motility. Pathogenic essays showed soft rot symptoms in the fruits of C. annuum L., Solanum lycopersicum , and Physalis philadelphica and the tubers of Solanum tuberosum . During the growth phases of K. cowanii Cp1, a mix of VOCs was identified by means of HS-SPME-GC-MS. Of these compounds, 2,5-dimethyl-pyrazine showed bactericidal effects and synergy with acetoin during the competitive colonization of K. cowanii Cp1 to completely reduce soft rot symptoms. This work provides novel evidence grounding a better understanding of bacterial interactions during competitive colonization on plant tissue, where VOC synthesis is essential and has a high potential capacity to control pathogenic microorganisms in agricultural systems.
Published: 2024
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12. A Study of Resistome in Mexican Chili Powder as a Public Health Risk Factor.

Author: Mena Navarro MP, Espinosa Bernal MA, Alvarado Osuna C, Ramos López MÁ, Amaro Reyes A, Arvizu Gómez JL, Pacheco Aguilar JR, Saldaña Gutiérrez C, Pérez Moreno V, Rodríguez Morales JA, García Gutiérrez MC, Álvarez Hidalgo E, Nuñez Ramírez J, Hernández Flores JL, and Campos Guillén J
Abstract: Chili powder is an important condiment around the world. However, according to various reports, the presence of pathogenic microorganisms could present a public health risk factor during its consumption. Therefore, microbiological quality assessment is required to understand key microbial functional traits, such as antibiotic resistance genes (ARGs). In this study, metagenomic next-generation sequencing (mNGS) and bioinformatics analysis were used to characterize the comprehensive profiles of the bacterial community and antibiotic resistance genes (ARGs) in 15 chili powder samples from different regions of Mexico. The initial bacterial load showed aerobic mesophilic bacteria (AMB) ranging between 6 × 10 3 and 7 × 10 8 CFU/g, sporulated mesophilic bacteria (SMB) from 4.3 × 10 3 to 2 × 10 9 CFU/g, and enterobacteria (En) from <100 to 2.3 × 10 6 CFU/g. The most representative families in the samples were Bacillaceae and Enterobacteriaceae , in which 18 potential pathogen-associated species were detected. In total, the resistome profile in the chili powder contained 68 unique genes, which conferred antibiotic resistance distributed in 13 different classes. Among the main classes of antibiotic resistance genes with a high abundance in almost all the samples were those related to multidrug, tetracycline, beta-lactam, aminoglycoside, and phenicol resistance. Our findings reveal the utility of mNGS in elucidating microbiological quality in chili powder to reduce the public health risks and the spread of potential pathogens with antibiotic resistance mechanisms.
Published: 2024
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13. Quantum Molecular Resonance Radiofrequency Disc Decompression and Percutaneous Microdiscectomy for Lumbar Radiculopathy.

Author: Canós-Verdecho Á, Robledo R, Izquierdo RM, Bermejo A, Gallach E, Abejón D, Argente-Navarro MP, Peraita-Costa I, and Morales-Suárez-Varela M
Abstract: Within the practice of pain management, one of the most commonly encountered events is low back pain. Lumbar radiculopathy (LR) is a pain syndrome caused by the compression or irritation of the nerve roots in the lower back due to lumbar disc herniation, vertebra degeneration, or foramen narrowing. Symptoms of LR include low back pain that propagates toward the legs, numbness, weakness, and loss of reflexes. The aim of this study is to assess the long-term effectiveness of quantum molecular resonance disc decompression and its combination with a percutaneous microdiscectomy using Grasper© forceps (QMRG) in patients with persistent lumbar radiculopathy (LR) in relation to patient physical stress status. The main outcome measures of this prospective observational study were DN4, NRS, ODI, SF12, PGI, CGI, and MOS Sleep Scale. An improvement 12 months post-intervention was observed in patients without physical stress, presenting better overall results. The mean change was over the minimal clinically important difference in 64.3% of outcome measures studied for the whole sample. QMRG appears to be an effective treatment option for LR, but a reduction in physical stress is needed to ensure long-term effectiveness.
Published: 2023
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14. Preliminary data from a 4-year mirror-image and multicentre study of patients initiating paliperidone palmitate 6-monthly long-acting injectable antipsychotic: the Paliperidone 2 per Year study.

Author: García-Carmona JA, García-Pérez A, Isidro García G, Forcen-Muñoz LA, Ovejero García S, Sáez Povedano R, González-Galdámez AL, Mata Iturralde L, Hernández-Sánchez F, Ramirez Bonilla M, Fuentes-Pérez P, Ovejas-Catalán C, Suárez-Pinilla P, Valdivia-Muñoz F, Fernández Abascal B, Omaña Colmenares M, de Lourdes Martín-Pérez Á, Campos-Navarro MP, Baca-García E, Benavente-López S, Raya Platero A, Barberán Navalón M, Sánchez-Alonso S, Vázquez-Bourgon J, and Pappa S
Abstract: Background: Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions., Objectives: To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment., Methods: The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration)., Results: At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3-4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%., Conclusion: Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future data are needed to evaluate the full impact of PP6M in clinical practice., Competing Interests: JAGC received speaking honoraria from Janssen-Cilag Inc., advisor honoraria from Teva and research and speaking honoraria from Neuraxpharm, all of them outside the submitted work. Sofia Pappa reports grants and honoraria outside the submitted work. Other authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2023.)
Published: 2023
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15. An educational intervention to reduce the incidence of postoperative residual curarisation: a cluster randomised crossover trial in patients undergoing general anaesthesia.

Author: Díaz-Cambronero Ó, Mazzinari G, Errando CL, Garutti I, Gurumeta AA, Serrano AB, Esteve N, Montañes MV, Neto AS, Hollmann MW, Schultz MJ, and Argente Navarro MP
Subjects: Humans, Cross-Over Studies, Postoperative Complications epidemiology, Postoperative Complications prevention & control, Anesthesia, General, Neostigmine, Delayed Emergence from Anesthesia, Neuromuscular Blockade
Abstract: Background: The incidence of postoperative residual curarisation remains unacceptably high. We assessed whether an educational intervention on perioperative neuromuscular block management can reduce it., Methods: In this multicentre, cluster randomised crossover trial, centres were allocated to receive an educational intervention either in a first or a second period. The educational intervention consisted of a lecture about neuromuscular management key points, including quantitative neuromuscular monitoring and use of reversal agents. The lecture was streamed to allow repetition. Additionally, memory cards were distributed in each operating theatre. The primary outcome was postoperative residual curarisation in the PACU. Secondary outcomes were frequency of quantitative neuromuscular monitoring, use of reversal agents, and incidence of postoperative pulmonary complications during hospital stay. Measurements were performed before randomisation and after the first and the second period. The effect of the educational intervention was estimated using multivariable mixed effects logistic regression models., Results: We included 2314 subjects in 34 Spanish centres. Postoperative residual curarisation incidence was not affected by the educational intervention (odds ratio [OR] 0.90 [95% confidence interval {CI}: 0.51-1.58]; P=0.717 and 1.30 [0.73-2.30]; P=0.371] for first and second time-period interaction). The educational intervention increased the quantitative neuromuscular monitor usage (OR 2.04 [95% CI: 1.31-3.19]; P=0.002), the use of reversal agents was unchanged (OR 0.79 [95% CI: 0.50-1.26]; P=0.322), and the incidence of postoperative pulmonary complications decreased (OR 0.19 [95% CI: 0.10-0.35]; P<0.001)., Conclusions: An educational intervention on perioperative neuromuscular block management did not reduce the incidence of postoperative residual curarisation nor increase reversal, despite increased quantitative neuromuscular monitoring. Sugammadex reversal was associated with reduced postoperative residual curarisation. The educational intervention was associated with a decrease in postoperative pulmonary complications., Clinical Trial Registration: NCT03128151., (Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
Published: 2023
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16. Effects of high-intensity interval training with an eccentric hamstring exercise program in futsal players: A randomized controlled trial.

Author: Gómez EM, Atef H, Elsayed SH, Zakaria HM, Navarro MP, and Sulé EM
Subjects: Humans, Young Adult, Adult, Exercise, Exercise Therapy, High-Intensity Interval Training, Sports, Hamstring Muscles
Abstract: Background: Physiotherapy protocols based on high-intensity interval training (HIIT) or eccentric hamstring exercises like Nordic Curl (NC) have been scarcely studied in futsal players. The objective of this study was to compare the effectiveness of a HIIT combined with an NC exercise program versus a HIIT-only program in futsal players., Methods: Twenty-one futsal players were divided into (1) HIIT + NC group (n = 11, mean age = 21.55 [4.25]); and (2) HIIT group (n = 10, mean age = 20.90 [1.29]). The HIIT + NC group performed a HIIT circuit combined with 3 sets of 10 NC repetitions for 4 weeks, while the HIIT group performed the same protocol without NC exercise. Body mass index, intermittent work performance, vertical jump performance without and with arms, isometric strength of quadriceps and hamstrings, and the isometric hamstrings/quadriceps (H/Q) ratio, were assessed before and after the interventions., Results: The HIIT + NC group and the HIIT group showed a significant improvement in intermittent work performance after the intervention (P = .04 and P = .01, respectively). Also, both groups showed a trend of increasing quadriceps and hamstring isometric strength, although no significant changes were found (P > .05). In addition, neither the HIIT + NC protocol nor the HIIT protocol was sufficient to yield changes in body mass index nor to improve the vertical jump performance (P > .05)., Conclusion: Both an isolated HIIT protocol and HIIT in combination with NC exercise improved intermittent work performance in futsal players. The present study's findings may guide futsal players' physical preparation and injury prevention programs., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
Published: 2023
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17. Frequency of symptoms and the associated factors of eating disorders in a group of dental students in Medellín, Colombia.

Author: Sanjuán-Navarro PS, Agudelo-Suárez AA, Mora-Cárdenas AL, Angarita-Navarro MP, Valdés-Payares L, Martínez-Gómez ML, and Salazar-González CL
Subjects: Male, Adolescent, Humans, Female, Cross-Sectional Studies, Colombia epidemiology, Students, Dental, Pandemics, Feeding and Eating Disorders epidemiology
Abstract: Background: Eating disorders (EDs) are considered a public health problem. Scientific research has focused on teenagers due to their higher prevalence in this population. However, other groups, such as university students, may be exposed to suffering from EDs due to their academic, social and personal characteristics. Identifying the magnitude of EDs and the associated characteristics may impact the generation of prevention strategies., Objectives: The aim of the present study was to establish the prevalence of the risk of EDs (anorexia nervosa (AN) and bulimia nervosa (BN)) and the associated factors in dental students at the University of Antioquia, Medellín, Colombia.., Material and Methods: A cross-sectional study was conducted on 278 students (76 males, 202 females) with the use of a Google-Forms survey. The validated Spanish version of the Eating Attitudes Test-26 (EAT-26) and the Sick, Control, One Stone, Fat, Food (SCOFF) questionnaire were used. Other recorded variables included sociodemographic data, coronavirus disease 2019 (COVID-19)-related factors, health, and social support (the Duke-11 profile). The bivariate analysis of the risk of EDs was conducted according to different variables (95% confidence interval (CI)), followed by the logistic regression models adjusting for different variables (adjusted prevalence ratio (aPR) and 95% CI)., Results: According to EAT-26, the risk of EDs was 27.6% (18.8-38.6) for males and 28.7% (22.9-35.3) for females. However, differences between males and females were higher when the SCOFF questionnaire was applied (males: 6.6% (2.8-14.5); females: 22.3% (17.1-28.5); p < 0.01). According to the SCOFF instrument, after adjusting for sociodemographic and health variables, women were more likely to report the symptoms of EDs (aPR: 2.20; 95% CI: 1.06-4.57). Women receiving information from social networks were more likely to report the symptoms of EDs (aPR: 1.85; 95% CI: 1.19-2.88). Multivariate models showed that women reporting poor self-rated health and some symptoms during the mandatory confinement caused by the COVID-19 pandemic were more likely to report the symptoms of EDs., Conclusions: A higher risk of EDs was found in dental students. Healthcare, psychological and/or psychiatric interviews, and educational/early prevention strategies are required.
Published: 2023
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18. An Individualized Low-Pneumoperitoneum-Pressure Strategy May Prevent a Reduction in Liver Perfusion during Colorectal Laparoscopic Surgery.

Author: Olmedilla Arnal LE, Cambronero OD, Mazzinari G, Pérez Peña JM, Zorrilla Ortúzar J, Rodríguez Martín M, Vila Montañes M, Schultz MJ, Rovira L, Argente Navarro MP, and On Behalf Of The IPPColLapSe Ii Investigators
Abstract: High intra-abdominal pressure (IAP) during laparoscopic surgery is associated with reduced splanchnic blood flow. It is uncertain whether a low IAP prevents this reduction. We assessed the effect of an individualized low-pneumoperitoneum-pressure strategy on liver perfusion. This was a single-center substudy of the multicenter 'Individualized Pneumoperitoneum Pressure in Colorectal Laparoscopic Surgery versus Standard Therapy II study' (IPPCollapse-II), a randomized clinical trial in which patients received an individualized low-pneumoperitoneum strategy (IPP) or a standard pneumoperitoneum strategy (SPP). Liver perfusion was indirectly assessed by the indocyanine green plasma disappearance rate (ICG-PDR) and the secondary endpoint was ICG retention rate after 15 min (R 15 ) using pulse spectrophotometry. Multivariable beta regression was used to assess the association between group assignment and ICG-PDR and ICG-R 15 . All 29 patients from the participating center were included. Median IAP was 8 (25th-75th percentile: 8-10) versus 12 (12,12) mmHg, in IPP and SPP patients, respectively ( p < 0.001). ICG-PDR was higher (OR 1.42, 95%-CI 1.10-1.82; p = 0.006) and PDR-R 15 was lower in IPP patients compared with SPP patients (OR 0.46, 95%-CI 0.29-0.73; p = 0.001). During laparoscopic colorectal surgery, an individualized low pneumoperitoneum may prevent a reduction in liver perfusion.
Published: 2023
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19. Thermal and Rheological Characterization of Aqueous Nanofluids Based on Reduced Graphene Oxide (rGO) with Manganese Dioxide Nanocomposites (MnO 2 ).

Author: Lozano-Steinmetz F, Ramírez-Navarro MP, Vivas L, Vasco DA, Singh DP, and Zambra-Sazo C
Abstract: Nanofluids have become of interest in recent years thanks to their improved thermal properties, which make them especially interesting for microchannel heat sink applications. In this study, we prepared two aqueous nanofluids based on reduced graphene oxide (rGO) decorated with manganese dioxide (MnO2) at a concentration of 0.1 wt.%. The difference between the two nanofluids was in the preparation of the reduced graphene oxide decorated with MnO2. In the first case, the manganese salt was mixed with ascorbic acid before GO reduction with NaOH, and in the second case, the GO reduction with NaOH occurred under ascorbic acid. Ascorbic acid not only plays the role of a non-toxic and ecofriendly reducing agent but also acts as an important parameter to control the reaction kinetics. The structural, microstructural and spectral characterizations of the MnO2/rGO nanocomposite were conducted via X-ray diffractometry (XRD), Raman spectroscopy, FT-IR, TEM, SEM and EDS analyses. Moreover, the synthesized MnO2/rGO nanocomposites were utilized as nanofluids and their stability, thermal conductivity and rheological behaviors were studied. The thermal conductivity of the MnO2/rGO and MnO2AsA/rGO nanofluids was 17% and 14.8% higher than that of water for the average temperature range, respectively, but their viscosity remained statistically equal to that of water. Moreover, both nanofluids presented Newtonian behavior in the analyzed shear rate range. Therefore, both MnO2/rGO and MnO2AsA/rGO nanofluids are promising alternatives for use in applications with micro- and millichannel heat sinks.
Published: 2022
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20. Opioid Receptor Expression in Colorectal Cancer: A Nested Matched Case-Control Study.

Author: Belltall A, Mazzinari G, Garrido-Cano I, Giner F, Marí AM, Eroles P, Argente-Navarro MP, Cata JP, and Diaz-Cambronero O
Abstract: Background: There is growing interest in the possible effect of perioperative anesthetic management on the growth and spread of cancer. The impact of perioperative use of opioids on cancer recurrence remains controversial and an assessment cannot yet be established based on current publications. This study aimed to assess the differential expression of opioid receptors between healthy and tumor tissues in patients with stage II and III colorectal cancer undergoing elective surgery by immunohistochemistry (IHC)., Methods: Propensity-score matched case-control study nested in a retrospective cohort of patients with stage II or III colorectal. The primary endpoint was the difference in µ-opioid receptor (MOR) expression measured by IHC between tumor and healthy tissue in subject with or without recurrence. Secondary endpoints were to evaluate the differences in Opioid Growth Factor Receptor (OGFR), cyclic adenosine monophosphate (cAMP) production and protein kinase A (PKA) in the matched sample and from a from samples of colorectal cancer stored in the Cancer Genome Atlas (TCGA) and Genotype Tissue Expression Project (GTEx)., Results: There was a significant difference in MOR receptor (median 3 [intequartile range IQR: 1-3] and 0 [IQR: 0-2], P<0.001) and OGFR receptor (median 6 [IQR: 5-6] and 2 [IQR: 1-2], P<0.001) in tumor and control tissue respectively. However, there were no significant differences in cAMP nor PKA expression between both types of tissues and in expression in any of the analyzed variables by recurrence status. The MOR and OGFR expression data from TCGA database were similar to our sample size data with lower expression of MOR and higher expression of OGFR in tumoural samples with a skewed distribution for MOR expression in tumor tissue both in patients with and without recurrence., Conclusion: In patients with stage II and III colorectal cancer, overall expression of MOR and OGFR was significantly increased but was not different between previously matched patients with or without recurrence. No differences were found in the analyzed metabolic pathway of cAMP-PKA: These results were confirmed by an in silico analysis of samples from the TCGA-GTEx database., Competing Interests: OD-C: Received payment for educational talks and scientific conferences from MSD (Merck Sharp & Dohme, Inc.). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Belltall, Mazzinari, Garrido-Cano, Giner, Marí, Eroles, Argente-Navarro, Cata and Diaz-Cambronero.)
Published: 2022
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21. Modeling intra-abdominal volume and respiratory driving pressure during pneumoperitoneum insufflation-a patient-level data meta-analysis.

Author: Mazzinari G, Diaz-Cambronero O, Serpa Neto A, Martínez AC, Rovira L, Argente Navarro MP, Malbrain MLNG, Pelosi P, Gama de Abreu M, Hollmann MW, and Schultz MJ
Subjects: Abdomen, Adult, Bayes Theorem, Humans, Pneumoperitoneum, Artificial, Abdominal Cavity, Insufflation, Laparoscopy, Pneumoperitoneum
Abstract: During pneumoperitoneum, intra-abdominal pressure (IAP) is usually kept at 12-14 mmHg. There is no clinical benefit in IAP increments if they do not increase intra-abdominal volume IAV. We aimed to estimate IAV (ΔIAV) and respiratory driving pressure changes (Δ P RS ) in relation to changes in IAP (ΔIAP). We carried out a patient-level meta-analysis of 204 adult patients with available data on IAV and Δ P RS during pneumoperitoneum from three trials assessing the effect of IAP on postoperative recovery and airway pressure during laparoscopic surgery under general anesthesia. The primary endpoint was ΔIAV, and the secondary endpoint was Δ P RS . The endpoints' response to ΔIAP was modeled using mixed multivariable Bayesian regression to estimate which mathematical function best fitted it. IAP values on the pressure-volume (PV) curve where the endpoint rate of change according to IAP decreased were identified. Abdomino-thoracic transmission (ATT) rate, that is, the rate Δ P RS change to ΔIAP was also estimated. The best-fitting function was sigmoid logistic and linear for IAV and Δ P RS response, respectively. Increments in IAV reached a plateau at 6.0 [95%CI 5.9-6.2] L. ΔIAV for each ΔIAP decreased at IAP ranging from 9.8 [95%CI 9.7-9.9] to 12.2 [12.0-12.3] mmHg. ATT rate was 0.65 [95%CI 0.62-0.68]. One mmHg of IAP raised Δ P RS 0.88 cmH 2 O. During pneumoperitoneum, IAP has a nonlinear relationship with IAV and a linear one with Δ P RS . IAP should be set below the point where IAV gains diminish. NEW & NOTEWORTHY We found that intra-abdominal volume changes related to intra-abdominal pressure increase reached a plateau with diminishing gains in commonly used pneumoperitoneum pressure ranges. We also found a linear relationship between intra-abdominal pressure and respiratory driving pressure, a known marker of postoperative pulmonary complications.
Published: 2021
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22. Evaluation of Risk Factors Associated to Prescription of Benzodiazepines and its Patterns in a Cohort of Patients from Mental Health: A Real World Study in Spain.

Author: Simal-Aguado J, Campos-Navarro MP, Valdivia-Muñoz F, Galindo-Tovar A, and García-Carmona JA
Subjects: Drug Prescriptions, Female, Humans, Risk Factors, Spain, Benzodiazepines adverse effects, Mental Health
Abstract: Purpose: we aimed 1) to evaluate the risk factors associated to the benzodiazepines intake; 2) to assess the impact about the use of long acting injectables antipsychotics (LAIs); 3) to assess the risk in severe and affective disorders and 4) to identify the prescription patterns of use in mental health in a cohort of patients from Spain., Methods: 735 outpatients from Mental Health were included. Demographic and clinical data were collected. In order to compare the use of benzodiazepines we calculated the daily dose equivalents (mg/day) to diazepam as standard., Results: The most commonly prescribed benzodiazepine was clonazepam (33%) and the mean daily dose of diazepam equivalents was 24.9 mg. It was higher in affective disorders (40.35 ± 3.36) and lower in patients using LAIs antipsychotics (17.50 ± 1.39; p = 0.001). Multivariate analysis showed that to be women (OR = 1.559, 95% CI = 1.059-2.295, p = 0.024), the use of drugs (OR = 1.671, 95% CI = 1.127-2.477, p = 0.011) and suffering any affective disorder (OR = 1.542, 95% CI = 1.355-1.826, p = 0.040) increased the risk of benzodiazepine intake. In contrast, the use of LAIs antipsychotics significantly reduced it versus oral antipsychotics (OR = 5.226, 95% CI = 3.185-8.575, p = 0.001)., Conclusions: benzodiazepines are widely prescribed, mainly clonazepam followed by lorazepam and diazepam. Most of patients used at least one benzodiazepine and the mean daily intake was 25 mg diazepam equivalents. Therefore, benzodiazepines are extensively prescribed and used at higher doses than desirable. These, findings could be useful for clinicians and their practice., (Copyright © 1964–2019 by MedWorks Media Inc, Los Angeles, CA All rights reserved. Printed in the United States.)
Published: 2021

23. Pharmacokinetics of micafungin in patients treated with extracorporeal membrane oxygenation: an observational prospective study.

Author: López-Sánchez M, Moreno-Puigdollers I, Rubio-López MI, Zarragoikoetxea-Jauregui I, Vicente-Guillén R, and Argente-Navarro MP
Subjects: Adult, Aged, Antifungal Agents administration & dosage, Area Under Curve, Female, Half-Life, Humans, Male, Micafungin administration & dosage, Middle Aged, Prospective Studies, Tertiary Care Centers, Tissue Distribution, Antifungal Agents pharmacokinetics, Extracorporeal Membrane Oxygenation, Micafungin pharmacokinetics
Abstract: Objective: To determine micafungin plasma levels and pharmacokinetic behavior in patients treated with extracorporeal membrane oxygenation., Methods: The samples were taken through an access point before and after the membrane in two tertiary hospitals in Spain. The times for the calculation of pharmacokinetic curves were before the administration of the drug and 1, 3, 5, 8, 18 and 24 hours after the beginning of the infusion on days one and four. The area under the curve, drug clearance, volume of distribution and plasma half-life time with a noncompartmental pharmacokinetic data analysis were calculated., Results: The pharmacokinetics of the values analyzed on the first and fourth day of treatment did not show any concentration difference between the samples taken before the membrane (Cin) and those taken after the membrane (Cout), and the pharmacokinetic behavior was similar with different organ failures. The area under the curve (AUC) before the membrane on day 1 was 62.1 (95%CI 52.8 - 73.4) and the AUC after the membrane on this day was 63.4 (95%CI 52.4 - 76.7), p = 0.625. The AUC before the membrane on day 4 was 102.4 (95%CI 84.7 - 142.8) and the AUC was 100.9 (95%CI 78.2 - 138.8), p = 0.843., Conclusion: The pharmacokinetic parameters of micafungin were not significantly altered.
Published: 2020
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24. Mu Opioid Receptor 1 (MOR-1) Expression in Colorectal Cancer and Oncological Long-Term Outcomes: A Five-Year Retrospective Longitudinal Cohort Study.

Author: Díaz-Cambronero O, Mazzinari G, Giner F, Belltall A, Ruiz-Boluda L, Marqués-Marí A, Sánchez-Guillén L, Eroles P, Cata JP, and Argente-Navarro MP
Abstract: Preclinical evidence has shown increased expression of mu opioid receptor 1 (MOR-1) in colorectal cancer although its association with disease-free and overall survival (DFS and OS) has not been investigated. We hypothesized that MOR-1 was overexpressed in tumor samples compared to normal tissue and this was associated with decreased DFS and OS. We carried out a retrospective study assessing the association of MOR-1 tumor expression with long-term outcomes by immunohistochemistry in normal and tumor samples from 174 colorectal cancer patients. The primary endpoint was five years of DFS. Secondary endpoints were five years of OS, the difference in MOR-1 expression between normal and tumor tissue and the occurrence of postoperative complications. Multivariable Cox regression showed no significant association between MOR-1 expression and DFS (HR 0.791, 95% CI 0.603-1.039, p = 0.092). MOR-1 expression was higher in tumor tissue compared to non-tumor tissue. No associations were found between MOR-1 expression and OS or postoperative complications. These findings suggest that although MOR-1 is over-expressed in colorectal cancer samples there is no association to increased risk of recurrence or mortality. Future studies are warranted to elucidate the role of cancer stage, genetic polymorphism, and quantitative assessment of MOR-1 over-expression on long-term outcomes in colorectal cancer.
Published: 2020
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25. An individualised versus a conventional pneumoperitoneum pressure strategy during colorectal laparoscopic surgery: rationale and study protocol for a multicentre randomised clinical study.

Author: Diaz-Cambronero O, Mazzinari G, Errando CL, Schultz MJ, Flor Lorente B, García-Gregorio N, Vila Montañés M, Robles-Hernández D, Olmedilla Arnal LE, Martín-De-Pablos A, Marqués Marí A, and Argente Navarro MP
Subjects: Colon physiopathology, Digestive System Surgical Procedures adverse effects, Humans, Length of Stay, Multicenter Studies as Topic, Pneumoperitoneum, Artificial adverse effects, Postoperative Complications etiology, Pressure, Randomized Controlled Trials as Topic, Recovery of Function, Rectum physiopathology, Single-Blind Method, Spain, Time Factors, Treatment Outcome, Colon surgery, Digestive System Surgical Procedures methods, Laparoscopy adverse effects, Pneumoperitoneum, Artificial methods, Rectum surgery
Abstract: Background: A recent study shows that a multifaceted strategy using an individualised intra-abdominal pressure titration strategy during colorectal laparoscopic surgery results in an acceptable workspace at low intra-abdominal pressure in most patients. The multifaceted strategy, focused on lower to individualised intra-abdominal pressures, includes prestretching the abdominal wall during initial insufflation, deep neuromuscular blockade, low tidal volume ventilation settings and a modified lithotomy position. The study presented here tests the hypothesis that this strategy improves outcomes of patients scheduled for colorectal laparoscopic surgery., Methods: The Individualized Pneumoperitoneum Pressure in Colorectal Laparoscopic Surgery versus Standard Therapy (IPPCollapse-II) study is a multicentre, two-arm, parallel-group, single-blinded randomised 1:1 clinical study that runs in four academic hospitals in Spain. Patients scheduled for colorectal laparoscopic surgery with American Society of Anesthesiologists classification I to III who are aged > 18 years and are without cognitive deficits are randomised to an individualised pneumoperitoneum pressure strategy (the intervention group) or to a conventional pneumoperitoneum pressure strategy (the control group). The primary outcome is recovery assessed with the Post-operative Quality of Recovery Scale (PQRS) at postoperative day 1. Secondary outcomes include PQRS score in the post anaesthesia care unit and at postoperative day 3, postoperative complications until postoperative day 28, hospital length of stay and process-related outcomes., Discussion: The IPPCollapse-II study will be the first randomised clinical study that assesses the impact of an individualised pneumoperitoneum pressure strategy focused on working with the lowest intra-abdominal pressure during colorectal laparoscopic surgery on relevant patient-centred outcomes. The results of this large study, to be disseminated through conference presentations and publications in international peer-reviewed journals, are of ultimate importance for optimising the care and safety of laparoscopic abdominal surgery. Selection of patient-reported outcomes as the primary outcome of this study facilitates the translation into clinical practice. Access to source data will be made available through anonymised datasets upon request and after agreement of the Steering Committee of the IPPCollapse-II study., Trial Registration: ClinicalTrials.gov, NCT02773173 . Registered on 16 May 2016. EudraCT, 2016-001693-15. Registered on 8 August 2016.
Published: 2019
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26. Chronic Blockade of Brain Endothelin Receptor Type-A (ET A ) Reduces Blood Pressure and Prevents Catecholaminergic Overactivity in the Right Olfactory Bulb of DOCA-Salt Hypertensive Rats.

Author: Cassinotti LR, Guil MJ, Schöller MI, Navarro MP, Bianciotti LG, and Vatta MS
Subjects: Animals, Catecholamines pharmacology, Desoxycorticosterone Acetate adverse effects, Disease Models, Animal, Enzyme Activation drug effects, Gene Expression, Heart Rate drug effects, Hypertension physiopathology, Male, Phosphorylation, Rats, Tyrosine 3-Monooxygenase genetics, Tyrosine 3-Monooxygenase metabolism, Blood Pressure drug effects, Catecholamines metabolism, Endothelin A Receptor Antagonists pharmacology, Hypertension etiology, Hypertension metabolism, Olfactory Bulb drug effects, Olfactory Bulb metabolism, Receptor, Endothelin A metabolism
Abstract: Overactivity of the sympathetic nervous system and central endothelins (ETs) are involved in the development of hypertension. Besides the well-known brain structures involved in the regulation of blood pressure like the hypothalamus or locus coeruleus, evidence suggests that the olfactory bulb (OB) also modulates cardiovascular function. In the present study, we evaluated the interaction between the endothelinergic and catecholaminergic systems in the OB of deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Following brain ET receptor type A (ET A ) blockade by BQ610 (selective antagonist), transcriptional, traductional, and post-traductional changes in tyrosine hydroxylase (TH) were assessed in the OB of normotensive and DOCA-salt hypertensive rats. Time course variations in systolic blood pressure and heart rate were also registered. Results showed that ET A blockade dose dependently reduced blood pressure in hypertensive rats, but it did not change heart rate. It also prevented the increase in TH activity and expression (mRNA and protein) in the right OB of hypertensive animals. However, ET A blockade did not affect hemodynamics or TH in normotensive animals. Present results support that brain ET A are not involved in blood pressure regulation in normal rats, but they significantly contribute to chronic blood pressure elevation in hypertensive animals. Changes in TH activity and expression were observed in the right but not in the left OB, supporting functional asymmetry, in line with previous studies regarding cardiovascular regulation. Present findings provide further evidence on the role of ETs in the regulation of catecholaminergic activity and the contribution of the right OB to DOCA-salt hypertension., Competing Interests: The authors declare no conflict of interest.
Published: 2018
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27. CRISPR-Cas systems: ushering in the new genome editing era.

Author: Perez Rojo F, Nyman RKM, Johnson AAT, Navarro MP, Ryan MH, Erskine W, and Kaur P
Subjects: Animals, Animals, Genetically Modified, CRISPR-Associated Protein 9 metabolism, DNA genetics, DNA metabolism, DNA End-Joining Repair, Humans, Patents as Topic, Plants genetics, Plants, Genetically Modified, RNA, Guide, CRISPR-Cas Systems metabolism, Transcription Activator-Like Effector Nucleases genetics, Transcription Activator-Like Effector Nucleases metabolism, CRISPR-Associated Protein 9 genetics, CRISPR-Cas Systems, Clustered Regularly Interspaced Short Palindromic Repeats, Gene Editing methods, Genome, RNA, Guide, CRISPR-Cas Systems genetics
Abstract: In recent years there has been great progress with the implementation and utilization of Clustered Regularly Interspaced Palindromic Repeats (CRISPR) and CRISPR-associated protein (Cas) systems in the world of genetic engineering. Many forms of CRISPR-Cas9 have been developed as genome editing tools and techniques and, most recently, several non-genome editing CRISPR-Cas systems have emerged. Most of the CRISPR-Cas systems have been classified as either Class I or Class II and are further divided among several subtypes within each class. Research teams and companies are currently in dispute over patents for these CRISPR-Cas systems as numerous powerful applications are concurrently under development. This mini review summarizes the appearance of CRISPR-Cas systems with a focus on the predominant CRISPR-Cas9 system as well as the classifications and subtypes for CRISPR-Cas. Non-genome editing uses of CRISPR-Cas are also highlighted and a brief overview of the commercialization of CRISPR is provided.
Published: 2018
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28. Effects of dietary bread crust Maillard reaction products on calcium and bone metabolism in rats.

Author: Roncero-Ramos I, Delgado-Andrade C, Haro A, Ruiz-Roca B, Morales FJ, and Navarro MP
Subjects: Animals, Biological Availability, Body Weight, Calcium pharmacokinetics, Diet, Eating, Femur metabolism, Glycation End Products, Advanced metabolism, Molecular Weight, Rats, Rats, Wistar, Solubility, Tissue Distribution, Bone and Bones metabolism, Bread, Calcium metabolism, Calcium, Dietary pharmacokinetics, Maillard Reaction
Abstract: Maillard reaction products (MRP) consumption has been related with the development of bone degenerative disorders, probably linked to changes in calcium metabolism. We aimed to investigate the effects of MRP intake from bread crust on calcium balance and its distribution, and bone metabolism. During 88 days, rats were fed control diet or diets containing bread crust as source of MRP, or its soluble high molecular weight, soluble low molecular weight or insoluble fractions (bread crust, HMW, LMW and insoluble diets, respectively). In the final week, a calcium balance was performed, then animals were sacrified and some organs removed to analyse calcium levels. A second balance was carried out throughout the experimental period to calculate global calcium retention. Biochemical parameters and bone metabolism markers were measured in serum or urine. Global calcium bioavailability was unmodified by consumption of bread crust or its isolate fractions, corroborating the previously described low affinity of MRP to bind calcium. Despite this, a higher calcium concentration was found in femur due to smaller bones having a lower relative density. The isolate consumption of the fractions altered some bone markers, reflecting a situation of increased bone resorption or higher turnover; this did not take place in the animals fed the bread crust diet. Thus, the bread crust intake does not affect negatively calcium bioavailability and bone metabolism.
Published: 2013
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29. Is the Mediterranean diet adequate to satisfy zinc requirements during adolescence?

Author: Mesías M, Seiquer I, and Navarro MP
Subjects: Adolescent, Biological Availability, Child, Energy Intake, Feeding Behavior, Humans, Life Style, Male, Nutrition Surveys, Nutritional Status, Phytic Acid, Spain, Zinc deficiency, Diet, Mediterranean, Nutritional Requirements, Zinc administration & dosage, Zinc pharmacokinetics
Abstract: Objective: To evaluate Zn utilization and status among a sample of Spanish boys consuming a diet based on Mediterranean patterns., Design: Dietary Zn balance was assessed by means of Zn intake in food and Zn output in faeces and urine as measured by flame atomic absorption spectrophotometry. In addition, biomarkers of Zn status were analysed., Setting: Province of Granada, Spain., Subjects: Twenty healthy male adolescents aged 11-14 years, selected based on medical questionnaire, physical examination and nutritional survey of food habits and lifestyle., Results: Mean Zn intake was 11·36 (se 0·31) mg/d, 76% of the recommended value for Spanish adolescents. Zn absorption (2·53 (se 0·55) mg/d) was close to the value of 3·0 mg/d required for the growth spurt. Zn status biomarkers and growth parameters were within the normal values for this age group., Conclusions: Although a diet based on Mediterranean patterns is associated with factors which can affect Zn absorption, such as high consumption of phytate, its consumption in adequate amounts allows Zn status to be maintained during adolescence. Due to the importance of Zn in preventing growth and behavioural disorders among adolescents, long-term intervention trials to investigate the suitability of the Mediterranean diet with respect to Zn requirements at this time of life are needed.
Published: 2012
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30. Assessing the effects of severe heat treatment of milk on calcium bioavailability: in vitro and in vivo studies.

Author: Seiquer I, Delgado-Andrade C, Haro A, and Navarro MP
Subjects: Absorption, Animals, Biological Availability, Color, Lysine analogs & derivatives, Lysine analysis, Maillard Reaction, Models, Biological, Rats, Solubility, Calcium, Dietary metabolism, Digestion physiology, Food Handling methods, Hot Temperature, Milk chemistry
Abstract: Thermal processing of milk is a common practice. As milk is the main source of dietary calcium, this study aimed to assess the effects of overheating milk on calcium availability. Thus, thermally damaged milk (overheated, OH, milk; 3 cycles of sterilization at 116 °C, 16 min) was compared with UHT milk (150 °C, 6s) in 2 types of assays: in vitro and in vivo (rats). In addition, the greater Maillard reaction rate associated with thermal treatment in OH milk was confirmed by determining specific (furosine) and unspecific markers (CieLab color). A negative effect on calcium solubility was observed after in vitro digestion of OH milk compared with UHT milk. Feeding rats the diet containing OH milk as the protein source led to significantly lower values of apparent calcium absorption and retention than those found among animals fed the UHT milk diet. Whereas reducing the absorption appears to result mainly from the decreased food intake, the negative effect on retention seems to be due to factors derived from milk thermal damage, such as the formation of Maillard reaction products. It was concluded that milk-processing conditions warrant special attention to prevent impaired dietary calcium utilization. This may be especially important in situations where milk and dairy products are the main dietary components, such as in early infancy., (Copyright © 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)
Published: 2010
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31. Estimation of hydroxymethylfurfural availability in breakfast cereals. Studies in Caco-2 cells.

Author: Delgado-Andrade C, Seiquer I, Navarro MP, and Morales FJ
Subjects: Biological Transport, Active, Caco-2 Cells, Chromatography, High Pressure Liquid, Culture Media chemistry, Furaldehyde chemistry, Furaldehyde metabolism, Humans, Hydrolysis, Proteins chemistry, Trypsin, Edible Grain chemistry, Furaldehyde analogs & derivatives
Abstract: The transport and availability of hydroxymethylfurfural (HMF), an intermediary product of the Maillard reaction, was investigated in the Caco-2 cell line after in vitro gastrointestinal digestion. The study was carried out at two levels; (a) an HMF-spiked culture medium, and (b) digested commercial breakfast cereals (BC). In both assays, the higher the amount of HMF offered to the cells, the higher the absolute value of transported HMF. However, HMF availability and transport are not directly proportional to the initial HMF content since HMF is partly retained in the non-soluble fraction after digestion. In addition, HMF is degraded to some extent during the gastrointestinal digestion of both HMF-spiked cell medium and BC. Average HMF availability from three commercial breakfast cereals was 9.1% (4.98-12.99%). Variations in HMF availability may be related to the particular composition of each BC, where fibre could play an important role. On the other hand, possible metabolization into the cell should also be considered.
Published: 2008
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32. Diets rich in Maillard reaction products affect protein digestibility in adolescent males aged 11-14 y.

Author: Seiquer I, Díaz-Alguacil J, Delgado-Andrade C, López-Frías M, Muñoz Hoyos A, Galdó G, and Navarro MP
Subjects: Adolescent, Child, Cross-Over Studies, Feces chemistry, Feeding Behavior, Furaldehyde administration & dosage, Furaldehyde analogs & derivatives, Humans, Life Style, Male, Nitrogen analysis, Nitrogen metabolism, Nutrition Surveys, Spain, Diet, Dietary Proteins metabolism, Digestion, Maillard Reaction
Abstract: Background: Adolescents are nutritionally at risk because of their physiologic needs and dietary habits. Maillard reaction products (MRPs) are widely consumed by this population, mainly as a result of their high intake of fast food and snacks., Objective: We compared the effects of diets with different MRP contents on dietary protein utilization in adolescent males aged 11-14 y. The brown diet (BD) was rich and the white diet (WD) was poor in MRP content (hydroxymethylfurfural: 3.87 and 0.94 mg/kg; fluorescence intensity: 21.04% and 7.31%, respectively)., Design: In a 2-period crossover trial, 18 healthy adolescent males were randomly assigned to 2 groups. The first group consumed the WD for 2 wk, observed a 40-d washout period, and then consumed the BD for 2 wk. The second group received the diets in the opposite order. Subjects collected urine and feces on the last 3 d of each dietary period. Fasting blood samples were collected after both periods., Results: Compared with consumption of the WD, consumption of the BD resulted in 47% higher fecal nitrogen fecal excretion (P = 0.002), 12% lower apparent nitrogen absorption (P = 0.000), and a 6% lower nitrogen digestibility (P = 0.000). The apparent nitrogen retention and the utilization of ingested nitrogen did not differ significantly between the diets, although values after the BD tended to decrease. Serum biochemical variables related to nitrogen metabolism did not differ significantly., Conclusions: The consumption of a diet rich in MRPs negatively affects protein digestibility. The possible effects of an excessive intake of MRPs during adolescence warrant attention, and long-term effects should be considered.
Published: 2006
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33. [Effects of intake of heated mixtures of glucose-lysine and glucose-methionine on bone calcium].

Author: Delgado-Andrade C, Seiquer I, and Navarro MP
Subjects: Animals, Bone and Bones metabolism, Calcium analysis, Heating, Humans, Maillard Reaction, Rats, Rats, Wistar, Bone and Bones drug effects, Calcium metabolism, Glucose pharmacology, Lysine pharmacology, Methionine pharmacology
Abstract: During food thermal treatment Maillard's reaction may occur, which implicates mainly the carbonyl groups of reductory sugars and amino protein groups. Maillard's reaction products (MRP) may interfere with mineral bioavailability because of modifications of their physical-chemical moiety in the food or the lumen, disrupting the absorption process or its normal metabolism. In this study, we sought to investigate MRP influence on issues related to Ca bioavailability in vitro and in vivo. Equimolar mixtures of glucose-lysine (GL) and glucose-methionine (GM) (40% moisture) were heated at 150 degrees C for 90 minutes (samples GL90 and GM90, respectively). In vitro solubility was measured by additioning each samples to a 3.75 mM Ca solution at intestinal pH and ionic strength; after shaking and centrifugation, soluble and insoluble calcium was determined. Three percent of GL90 and GM90 were individually added to the AIN93-G diet to obtain D-GL90 and D-GM90 diets. Three Wistar rats groups were fed for 21 days with both diets and with AIN93-G as control, carrying out calcium balance during last week and extirpating various organs after sacrifice. GM90 did not affect calcium solubility; GL90 reduced it slightly, remaining in both cases more than 94% soluble. D-GL90 and D-GM90 did not modify calcium bioavailability, with as effective usage as with the control diet (57.6 +/- 1.3%, 57.8 +/- 2.3% and 63.9 +/- 2.6% in control diet, D-GL90 and D-GM90, respectively). MRP intake produced, however, metabolic changes that decreased bone calcium, accumulating compensatorily in other organs.
Published: 2005

34. Effects of different thermal treatments and storage on the proximate composition and protein quality in canned tuna.

Author: García-Arias MT, Navarro MP, and García-Linares MC
Subjects: Animals, Lipids analysis, Rats, Rats, Wistar, Amino Acids analysis, Dietary Proteins analysis, Food Preservation, Hot Temperature, Tuna
Abstract: The purpose of this project was to study the modifications in nutrient composition, amino acid content, and protein quality of white tuna preserves after each of the thermal treatments involved in the canning process. Also the influence that a three years storage period at room temperature has on the nutritional quality of canned tuna was studied. The biological assays used for the study of the protein utilization were carried out on Wistar rats, fed on semi-synthetic diets for 12 days varying only the protein source, casein or tuna provided as follows: raw, cooked in brine, steamed, sterilized tuna, and canned tuna stored for three years. The sterilization process and storage time led to a great increase in the lipid content of the canned tuna and to a porcentual decrease in protein, and moisture content. Amino acid composition of canned and cooked tuna did not show great modifications compared to raw tuna. Neither protein digestibility nor biological value of the cooked, canned, and stored tuna showed any deterioration. The protein quality of white tuna meat preserves has been compared with preserves made up of red and white tuna meat.
Published: 2004

35. Relationship between moderate food restriction during pregnancy and Fe, Zn and Cu contents in maternal tissues and foetuses.

Author: Vaquero MP and Navarro MP
Subjects: Animals, Bone and Bones metabolism, Copper blood, Female, Iron blood, Liver metabolism, Pregnancy, Rats, Rats, Wistar, Weight Gain, Zinc blood, Copper metabolism, Fetus metabolism, Food Deprivation, Iron metabolism, Zinc metabolism
Abstract: This study was undertaken to monitor Fe, Zn and Cu contents in several maternal tissues and the products of conception of rats submitted to moderate food restriction during pregnancy. Two groups of female rats, nonpregnant (NP) and pregnant (P1), were fed ad libitum. A second group of pregnant rats (restricted diet, P2) was fed for 14 days with the same intake as NP, then the intake was increased by 5% from day 14 to day 21. A significant decrease in liver Fe content was noted in P1 and P2 pregnant rats on day 21, being more marked in livers of P2. Increases in Cu and Zn contents in liver were induced during pregnancy, but the values were significantly lower in P2 than in P1. On day 21, no significant differences due to food restriction were noted in serum concentrations of these trace elements, placental weight and placental Fe. However, dam body weight gain, placental Zn and Cu contents were reduced in P2. Foetuses of undernourished dams exhibited at term lower weight and smaller amounts of Fe, Zn and Cu than those in P1. These results confirm that moderate food restriction during pregnancy produces intrauterine growth retardation and that newborns have low trace element contents (particularly in Cu), which make them dependent on correct postnatal supply.
Published: 1996
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36. Influence of moderate food restriction on calcium metabolism in pregnant rats.

Author: Vaquero MP and Navarro MP
Subjects: Absorption, Animals, Bone Density, Calcitriol blood, Calcium administration & dosage, Calcium blood, Female, Fetus anatomy & histology, Fetus metabolism, Pregnancy, Rats, Rats, Wistar, Calcium metabolism, Food Deprivation, Pregnancy, Animal metabolism
Abstract: Two groups of female rats, non-pregnant (NP) and pregnant (P1), were fed ad libitum. A second group of pregnant rats (restricted diet, P2) were restricted for 14 d to the same intake as NP, and their ration was then increased by 5% from d 14 to d 21. For the first 3 d P1 and P2 absorbed a higher percentage of calcium than NP. During the final wk of pregnancy serum calcium decreased and 1,25-dihydroxycholecalciferol increased regardless of the dietary regimen. In both P1 and P2, femur calcium was higher than in NP on d 7 and apparent bone density increased during the 2nd wk of pregnancy and decreased from then on, this decrease being more pronounced in P2. On d 21, P2 fetuses were smaller and contained a smaller amount of calcium than those in P1, although the calcium concentration in the body remained similar in both groups of fetuses.
Published: 1993
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37. Influence of dieldrin on the production and characteristics of the egg and utilization of calcium and phosphorus in the quail (Coturnix coturnix japonica) [proceedings].

Author: Varela G, Andujar M, and Navarro MP
Subjects: Animals, Egg Shell, Female, Male, Sex Factors, Calcium metabolism, Coturnix physiology, Dieldrin pharmacology, Oviposition drug effects, Phosphorus metabolism, Quail physiology
Published: 1976

38. Several aspects of mineral/protein nutrition in relation to consumption of an oil involved in the toxic syndrome.

Author: Navarro MP, Vaquero MP, Castrillon AM, and Varela G
Subjects: Animals, Body Weight, Bone and Bones analysis, Eating, Female, Nitrogen metabolism, Rats, Rats, Inbred Strains, Zinc metabolism, Dietary Proteins metabolism, Minerals metabolism, Plant Oils poisoning
Abstract: An oil involved in the 'toxic syndrome' and two similar mixtures of oils, one with and the other without added oleoanilides, were studied for their effects on the utilization of protein, calcium, magnesium, phosphorus, sodium, potassium and zinc. Forty-eight female Wistar rats initially weighing about 75 g were fed for 28 days on the same semi-synthetic diet containing: virgin olive oil, or a mixture of canbra oil (50%), refined olive-pomace oil (20%), grapeseed oil (20%) and animal fat (10%), or the same dietary mixture supplemented with either 700 ppm oleoanilides or the alleged toxic oil. Weight, food intake and nutritional balances were monitored. The food intake of the animals fed the toxic oil began to decrease at the end of the trial, producing a reduction in the amount of nutrients ingested, but no weight loss. This oil also negatively affected the digestion of protein, potassium, sodium and zinc, the mechanism of which, in the case of the first two, appears to be related to the source of the fat. It also decreased metabolic utilization while favouring protein catabolism and the elimination of phosphorus, magnesium and potassium. No substantial modifications were noted in the animals' bones.
Published: 1988
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39. Effects of consuming toxic oils and oleoanilides on fat digestibility and adipose tissue composition of rats.

Author: Higón E, Vaquero MP, Navarro MP, and Sánchez-Muniz FJ
Subjects: Adipose Tissue analysis, Animals, Body Weight drug effects, Eating drug effects, Female, Rats, Rats, Inbred Strains, Acetanilides toxicity, Adipose Tissue drug effects, Dietary Fats metabolism, Digestion drug effects, Oils toxicity
Abstract: An oil implicated in the Spanish "toxic syndrome" was studied for its effect on fat digestibility and adipose-tissue composition in rats. The effects produced by the mixture of oils and those induced by the presence of oleoanilides were assessed separately. For 4 wk, Wistar rats were fed diets containing either a mixture of oils similar to that constituting the toxic oil, the same mixture of oils supplemented with oleoanilides, or the toxic oil (which also contained oleoanilides) and were then compared with a group fed olive oil. Food consumption fluctuated sharply in the group fed the toxic oil, falling significantly in the last week of the study. The digestibility coefficient of the various fats was similar, although the rats fed the toxic oil did absorb less fat because of the lower intake. The nitrogen content of the periovarian adipose tissue was highest in the rats fed the toxic oil, and the adipose-tissue fatty acids most affected by this treatment were linoleic and linolenic acid. The delta-9 desaturase activity, measured in terms of the C16:1/C16:0 and C18:1/C18:0 ratios, was significantly less in the group fed the toxic oil, which suggests functional modifications of the adipocyte related to lipogenesis.
Published: 1988
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40. Dieldrin, Ca and P balance, and characteristics of the egg in the quail (Coturnix coturnix japonica).

Author: Andujar MM, Varela G, and Navarro MP
Subjects: Animals, Calcium blood, Female, Femur metabolism, Male, Oviposition, Calcium metabolism, Coturnix metabolism, Dieldrin metabolism, Eggs, Phosphorus metabolism, Quail metabolism
Abstract: A study was made of the Ca and P balance, Ca and P content in the femur, physical characteristics of the egg, mineral structure of the shell, and the number of eggs in quails treated with dieldrin (20 mg/kg of diet) for 48 days. The diet contained 3.24% Ca and 0.72% P. The Ca and P balance, the bone contents of Ca and P and the calcemia in the males were not changed by the pesticide. In the females, the pesticide decreased the amount of excreted Ca and Ca in the egg, for which reason the coefficient of nutritive utilization (CNU), the coefficient of corporal retention (CCR), and the Ca level in the femur were greater in treated laying quails. The calcemia remained stable, and the balance of P was not significantly modified by the dieldrin. The study of weight, size, and strength of the egg did not reveal any influence of the dieldrin, and egg production fluctuated throughout the test period.
Published: 1978
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41. Calcium balance in the quail (Coturnix coturnix japonica). 1, Influence of sex and diethylstilbestrol.

Author: Navarro MP and Murillo A
Subjects: Animals, Bone Development drug effects, Coturnix physiology, Egg Shell analysis, Eggs, Female, Femur metabolism, Male, Oviposition, Phosphorus metabolism, Sex Factors, Calcium, Dietary metabolism, Coturnix metabolism, Diethylstilbestrol pharmacology, Quail metabolism
Abstract: Young adult male and laying female quail, fed with a diet containing 2.64% Ca and 0.70% P, were used to study nutritive utilization, corporal calcium retention and endogenous excretion, calcemia, laying and properties of the egg (including the shell structure), mineralization of the femur bone, as well as the influence of diethylstilbestrol upon these parameters. The coefficient of nutritive utilization (C.N.U.) in the female was high and logically superior to that of the male, while the corporal retention was quite similar for both sexes. Most of the Ca absorbed (81.8%) and not excreted in urine, went to the egg and only 18.2% remained in the body. The diethylstilbestrol caused a big reduction of the C.N.U. in the female, but not in the male, parallel to an inhibition of laying, and an increase of corporal retention of used calcium. In both sexes the calcemia surprisingly increased, and the calcium level of the femur bone was higher, and even though the cortical osseous zone was slightly wider, the effect of treatment was noticeable, particularly in the medular tissue, which incremented in the female and appeared in the male. When quail were fed a calcium-restricted diet, the endogenous excretion of this mineral was small in the case of the female and significantly smaller in the male. This situation suppressed egg laying and resulted in a clearly decreased bone mineralization. The ingestion of diethylstilbestrol before feeding a diet poor in calcium provoked an increase of the endogenous excretion of calcium in both female and male quail.
Published: 1976
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42. [Efficacy of the protein of canned tuna (Thunnus alalunga) in animal growth].

Author: Navarro MP, Castrillón AM, Ortega RM, and Varela G
Subjects: Amino Acids, Essential metabolism, Animals, Diet, Female, Male, Nutritive Value, Rats, Body Weight drug effects, Dietary Proteins pharmacology, Fishes, Food Handling, Food Preservation, Tuna
Abstract: The effect of the manufacturing process on canned tuna (Thunnus alalunga) by the sterilization procedure at 115 degrees C for 60 and 90 minutes on its protein quality was studied. Protein quality was mainly evaluated according to its efficiency for animal growth. Protein from food obtained by the sterilization procedure at 115 degrees C for 60 minutes was similar for animal growth to that from a standard casein-methionine diet. No changes in digestibility and biological values were found between both proteins. Nevertheless, when the sterilization procedure was prolonged up to 90 minutes, the protein suffered modifications. Thus, protein digestibility decreased in spite of the fact that protein digestibility remained unmodified. On the other hand, introduction of the mixed protein into a diet based on flour plus tuna sterilized at 115 degrees C for 90 minutes, was not capable of maintaining the optimum patterns for weight evolution.
Published: 1986

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