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2. Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in europe. the ACVC-EAPCI EORP STEMI registry of the european society of cardiology

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Zeymer, U., Ludman, P., Danchin, N., Kala, P., Laroche, C., Sadeghi, M., Caporale, R., Shaheen, S. M., Legutko, J., Iakobsishvili, Z., Alhabib, K. F., Motovska, Z., Studencan, M., Mimoso, J., Becker, D., Alexopoulos, D., Kereseselidze, Z., Stojkovic, S., Zelveian, P., Goda, A., Mirrakhimov, E., Bajraktari, G., Al-Farhan, H., Serpytis, P., Raungaard, B., Marandi, T., Moore, A. M., Quinn, M., Karjalainen, P. P., Tatu-Chitolu, G., Gale, C. P., Maggioni, A. P., Weidinger, F., Sinnaeve, P., Ferrari, R., Karamfilov, K., Lidon, R. -M., Kereselidze, Z., Iakobishvili, Z., Erglis, A., Kedev, S., Dudek, D., Tatu-Chitoiu, G., Shlyakhto, E., Bunc, M., Mourali, M. S., Konte, M., Larras, F., Lefrancq, E. F., Mekhaldi, S., Shuka, N., Pavli, E., Tafaj, E., Gishto, T., Dibra, A., Duka, A., Gjana, A., Kristo, A., Knuti, G., Demiraj, A., Dado, E., Hasimi, E., Simoni, L., Siqeca, M., Sisakian, H., Hayrapetyan, H., Markosyan, S., Galustyan, L., Arustamyan, N., Kzhdryan, H., Pepoyan, S., Zirkik, A., Von Lewinski, D., Paetzold, S., Kienzl, I., Matyas, K., Neunteufl, T., Nikfardjam, M., Neuhold, U., Mihalcz, A., Glaser, F., Steinwender, C., Reiter, C., Grund, M., Hrncic, D., Hoppe, U., Hammerer, M., Hinterbuchner, L., Hengstenberg, C., Delle Karth, G., Lang, I., Winkler, W., Hasun, M., Kastner, J., Havel, C., Derntl, M., Oberegger, G., Hajos, J., Adlbrecht, C., Publig, T., Leitgeb, M. -C., Wilfing, R., Jirak, P., C. -Y., Ho, Puskas, L., Schrutka, L., Spinar, J., Parenica, J., Hlinomaz, O., Fendrychova, V., Semenka, J., Sikora, J., Sitar, J., Groch, L., Rezek, M., Novak, M., Kramarikova, P., Stasek, J., Dusek, J., Zdrahal, P., Polasek, R., Karasek, J., Seiner, J., Sukova, N., Varvarovsky, I., Lazarak, T., Novotny, V., Matejka, J., Rokyta, R., Volovar, S., Belohlavek, J., Siranec, M., Kamenik, M., Kralik, R., Ravkilde, J., Jensen, S. E., Villadsen, A., Villefrance, K., Schmidt Skov, C., Maeng, M., Moeller, K., Hasan-Ali, H., Ahmed, T. A., Hassan, M., Elguindy, A., Farouk Ismail, M., Ibrahim Abd El-Aal, A., El-Sayed Gaafar, A., Magdy Hassan, H., Ahmed Shafie, M., Nabil El-Khouly, M., Bendary, A., Darwish, M., Ahmed, Y., Amin, O. A., Abdelhakim, A., Abosaif, K., Kandil, H., Galal, M. A. G., El Hefny, E. E., El Sayed, M., Aly, K., Mokarrab, M., Osman, M., Abdelhamid, M., Mantawy, S., Ali, M. R., Kaky, S. D., Khalil, V. A., Saraya, M. E. A., Talaat, A., Nabil, M., Mounir, W. M., Mahmoud, K., Aransa, A., Kazamel, G., Anwar, S., Al-Habbaa, A., Abd El Monem, M., Ismael, A., Amin Abu-Sheaishaa, M., Abd Rabou, M. M., Hammouda, T. M. A., Moaaz, M., Elkhashab, K., Ragab, T., Rashwan, A., Rmdan, A., Abdelrazek, G., Ebeid, H., Soliman Ghareeb, H., Farag, N., Zaki, M., Seleem, M., Torki, A., Youssef, M., Allah Nasser, N. A., Rafaat, A., Selim, H., Makram, M. M., Khayyal, M., Malasi, K., Madkour, A., Kolib, M., Alkady, H., Nagah, H., Yossef, M., Wafa, A., Mahfouz, E., Faheem, G., Magdy Moris, M., Ragab, A., Ghazal, M., Mabrouk, A., El-Masry, M., Naseem, M., Samir, S., Reinmets, J., Allvee, M., Saar, A., Ainla, T., Vaide, A., Kisseljova, M., Pakosta, U., Eha, J., Lotamois, K., Sia, J., Myllymaki, J., Pinola, T., Paana, T., Mikkelsson, J., Ampio, M., Tsivilasvili, J., Zurab, P., Agladze, R., Melia, A., Gogoberidze, D., Khubua, N., Totladze, L., Metreveli, I., Chikovani, A., Eitel, I., Poss, J., Werner, M., Constantz, A., Ahrens, C., Tolksdorf, H., Klinger, S., Sack, S., Heer, T., Lekakis, J., Kanakakis, I., Xenogiannis, I., Ermidou, K., Makris, N., Ntalianis, A., Katsaros, F., Revi, E., Kafkala, K., Mihelakis, E., Diakakis, G., Grammatikopoulos, K., Voutsinos, D., Xanthopoulou, I., Mplani, V., Foussas, S., Papakonstantinou, N., Patsourakos, N., Dimopoulos, A., Derventzis, A., Athanasiou, K., Vassilikos, V. P., Papadopoulos, C., Tzikas, S., Vogiatzis, I., Datsios, A., Galitsianos, I., Koutsampasopoulos, K., Grigoriadis, S., Douras, A., Baka, N., Spathis, S., Kyrlidis, T., Hatzinikolaou, H., Kiss, R. G., Nowotta, F., Toth, K., Szabo, S., Lakatos, C., Jambrik, Z., Ruzsa, J., Ruzsa, Z., Rona, S., Toth, J., Vargane Kosik, A., Toth, K. S. B., Nagy, G. G., Ondrejko, Z., Koromi, Z., Botos, B., Pourmoghadas, M., Salehi, A., Massoumi, G., Soleimani, A., Sarrafzadegan, N., Roohafza, H., Azarm, M., Mirmohammadsadeghi, A., Rajabi, D., Rahmani, Y., Siabani, S., Najafi, F., Hamzeh, B., Karim, H., Siabani, H., Saleh, N., Charehjoo, H., Zamzam, L., Al-Temimi, G., Al-Yassin, A., Mohammad, A., Ridha, A., Al-Saedi, G., Atabi, N., Sabbar, O., Mahmood, S., Dakhil, Z., Yaseen, I. F., Almyahi, M., Alkenzawi, H., Alkinani, T., Alyacopy, A., Kearney, P., Twomey, K., Shlomo, N., Beigel, R., Caldarola, P., Rutigliano, D., Sublimi Saponetti, L., Locuratolo, N., Palumbo, V., Scherillo, M., Formigli, D., Canova, P., Musumeci, G., Roncali, F., Metra, M., Lombardi, C., Visco, E., Rossi, L., Meloni, L., Montisci, R., Pippia, V., Marchetti, M. F., Congia, M., Cacace, C., Luca, G., Boscarelli, G., Indolfi, C., Ambrosio, G., Mongiardo, A., Spaccarotella, C., De Rosa, S., Canino, G., Critelli, C., Chiappetta, D., Battista, F., Gabrielli, D., Marziali, A., Bernabo, P., Navazio, A., Guerri, E., Manca, F., Gobbi, M., Oreto, Giuseppe, Andò, Giuseppe, Carerj, Scipione, Saporito, Francesco, Cimmino, Michele, Rigo, F., Zuin, G., Tuccillo, B., Scotto DI Uccio, F., Irace, L., Lorenzoni, G., Meloni, I., Merella, P., Polizzi, G. 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A., Gaspar, A., Monteiro, S., Goncalves, F., Leite, L., Manuel Lopes Dos Santos, W., Amado, J., Pereira, D., Silva, B., Caires, G., Neto, M., Rodrigues, R., Correia, A., Freitas, D., Lourenco, A., Ferreira, F., Sousa, F., Portugues, J., Calvo, L., Almeida, F., Alves, M., Silva, A., Caria, R., Seixo, F., Militaru, C., Ionica, E., Istratoaie, O., Florescu, M., Lipnitckaia, E., Osipova, O., Konstantinov, S., Bukatov, V., Vinokur, T., Egorova, E., Nefedova, E., Levashov, S., Gorbunova, A., Redkina, M., Karaulovskaya, N., Bijieva, F., Babich, N., Smirnova, O., Filyanin, R., Eseva, S., Kutluev, A., Chlopenova, A., Shtanko, A., Kuppar, E., Shaekhmurzina, E., Ibragimova, M., Mullahmetova, M., Chepisova, M., Kuzminykh, M., Betkaraeva, M., Namitokov, A., Khasanov, N., Baleeva, L., Galeeva, Z., Magamedkerimova, F., Ivantsov, E., Tavlueva, E., Kochergina, A., Sedykh, D., Kosmachova, E., Skibitskiy, V., Porodenko, N., Litovka, K., Ulbasheva, E., Niculina, S., Petrova, M., Harkov, E., Tsybulskaya, N., Lobanova, A., Chernova, A., Kuskaeva, A., Kuskaev, A., Ruda, M., Zateyshchikov, D., Gilarov, M., Konstantinova, E., Koroleva, O., Averkova, A., Zhukova, N., Kalimullin, D., Borovkova, N., Tokareva, A., Buyanova, M., Khaisheva, L., Pirozhenko, A., Novikova, T., Yakovlev, A., Tyurina, T., Lapshin, K., Moroshkina, N., Kiseleva, M., Fedorova, S., Krylova, L., Duplyakov, D., Semenova, Y., Rusina, A., Ryabov, V., Syrkina, A., Demianov, S., Reitblat, O., Artemchuk, A., Efremova, E., Makeeva, E., Menzorov, M., Shutov, A., Klimova, N., Shevchenko, I., Elistratova, O., Kostyuckova, O., Islamov, R., Budyak, V., Ponomareva, E., Ullah Jan, U., Alshehri, A. M., Sedky, E., Alsihati, Z., Mimish, L., Selem, A., Malik, A., Majeed, O., Altnji, I., Alshehri, M., Aref, A., Alhabib, K., Aldosary, M., Tayel, S., Abd Alrahman, M., Asfina, K. N., Abdin Hussein, G., Butt, M., Markovic Nikolic, N., Obradovic, S., Djenic, N., Brajovic, M., Davidovic, A., Romanovic, R., Novakovic, V., Dekleva, M., Spasic, M., Dzudovic, B., Jovic, Z., Cvijanovic, D., Veljkovic, S., Ivanov, I., Cankovic, M., Jarakovic, M., Kovacevic, M., Trajkovic, M., Mitov, V., Jovic, A., Hudec, M., Gombasky, M., Sumbal, J., Bohm, A., Baranova, E., Kovar, F., Samos, M., Podoba, J., Kurray, P., Obona, T., Remenarikova, A., Kollarik, B., Verebova, D., Kardosova, G., Alusik, D., Macakova, J., Kozlej, M., Bayes-Genis, A., Sionis, A., Garcia Garcia, C., Duran Cambra, A., Labata Salvador, C., Rueda Sobella, F., Sans Rosello, J., Vila Perales, M., Oliveras Vila, T., Ferrer Massot, M., Baneras, J., Lekuona, I., Zugazabeitia, G., Fernandez-Ortiz, A., Viana Tejedor, A., Ferrera, C., Alvarez, V., DIaz-Castro, O., Agra-Bermejo, R. M., Gonzalez-Cambeiro, C., Gonzalez-Babarro, E., Domingo-Del Valle, J., Royuela, N., Burgos, V., Canteli, A., Castrillo, C., Cobo, M., Ruiz, M., Abu-Assi, E., Garcia Acuna, J., Zeymer, U., Ludman, P., Danchin, N., Kala, P., Laroche, C., Sadeghi, M., Caporale, R., Shaheen, S. M., Legutko, J., Iakobsishvili, Z., Alhabib, K. F., Motovska, Z., Studencan, M., Mimoso, J., Becker, D., Alexopoulos, D., Kereseselidze, Z., Stojkovic, S., Zelveian, P., Goda, A., Mirrakhimov, E., Bajraktari, G., Al-Farhan, H., Serpytis, P., Raungaard, B., Marandi, T., Moore, A. M., Quinn, M., Karjalainen, P. P., Tatu-Chitolu, G., Gale, C. P., Maggioni, A. P., Weidinger, F., Sinnaeve, P., Ferrari, R., Karamfilov, K., Lidon, R. -M., Kereselidze, Z., Iakobishvili, Z., Erglis, A., Kedev, S., Dudek, D., Tatu-Chitoiu, G., Shlyakhto, E., Bunc, M., Mourali, M. S., Konte, M., Larras, F., Lefrancq, E. F., Mekhaldi, S., Shuka, N., Pavli, E., Tafaj, E., Gishto, T., Dibra, A., Duka, A., Gjana, A., Kristo, A., Knuti, G., Demiraj, A., Dado, E., Hasimi, E., Simoni, L., Siqeca, M., Sisakian, H., Hayrapetyan, H., Markosyan, S., Galustyan, L., Arustamyan, N., Kzhdryan, H., Pepoyan, S., Zirkik, A., Von Lewinski, D., Paetzold, S., Kienzl, I., Matyas, K., Neunteufl, T., Nikfardjam, M., Neuhold, U., Mihalcz, A., Glaser, F., Steinwender, C., Reiter, C., Grund, M., Hrncic, D., Hoppe, U., Hammerer, M., Hinterbuchner, L., Hengstenberg, C., Delle Karth, G., Lang, I., Winkler, W., Hasun, M., Kastner, J., Havel, C., Derntl, M., Oberegger, G., Hajos, J., Adlbrecht, C., Publig, T., Leitgeb, M. -C., Wilfing, R., Jirak, P., Ho, C. -Y., Puskas, L., Schrutka, L., Spinar, J., Parenica, J., Hlinomaz, O., Fendrychova, V., Semenka, J., Sikora, J., Sitar, J., Groch, L., Rezek, M., Novak, M., Kramarikova, P., Stasek, J., Dusek, J., Zdrahal, P., Polasek, R., Karasek, J., Seiner, J., Sukova, N., Varvarovsky, I., Lazarak, T., Novotny, V., Matejka, J., Rokyta, R., Volovar, S., Belohlavek, J., Siranec, M., Kamenik, M., Kralik, R., Ravkilde, J., Jensen, S. E., Villadsen, A., Villefrance, K., Schmidt Skov, C., Maeng, M., Moeller, K., Hasan-Ali, H., Ahmed, T. A., Hassan, M., Elguindy, A., Farouk Ismail, M., Ibrahim Abd El-Aal, A., El-Sayed Gaafar, A., Magdy Hassan, H., Ahmed Shafie, M., Nabil El-Khouly, M., Bendary, A., Darwish, M., Ahmed, Y., Amin, O. A., Abdelhakim, A., Abosaif, K., Kandil, H., Galal, M. A. G., El Hefny, E. E., El Sayed, M., Aly, K., Mokarrab, M., Osman, M., Abdelhamid, M., Mantawy, S., Ali, M. R., Kaky, S. D., Khalil, V. A., Saraya, M. E. A., Talaat, A., Nabil, M., Mounir, W. M., Mahmoud, K., Aransa, A., Kazamel, G., Anwar, S., Al-Habbaa, A., Abd El Monem, M., Ismael, A., Amin Abu-Sheaishaa, M., Abd Rabou, M. M., Hammouda, T. M. A., Moaaz, M., Elkhashab, K., Ragab, T., Rashwan, A., Rmdan, A., Abdelrazek, G., Ebeid, H., Soliman Ghareeb, H., Farag, N., Zaki, M., Seleem, M., Torki, A., Youssef, M., Allah Nasser, N. A., Rafaat, A., Selim, H., Makram, M. M., Khayyal, M., Malasi, K., Madkour, A., Kolib, M., Alkady, H., Nagah, H., Yossef, M., Wafa, A., Mahfouz, E., Faheem, G., Magdy Moris, M., Ragab, A., Ghazal, M., Mabrouk, A., El-Masry, M., Naseem, M., Samir, S., Reinmets, J., Allvee, M., Saar, A., Ainla, T., Vaide, A., Kisseljova, M., Pakosta, U., Eha, J., Lotamois, K., Sia, J., Myllymaki, J., Pinola, T., Paana, T., Mikkelsson, J., Ampio, M., Tsivilasvili, J., Zurab, P., Agladze, R., Melia, A., Gogoberidze, D., Khubua, N., Totladze, L., Metreveli, I., Chikovani, A., Eitel, I., Poss, J., Werner, M., Constantz, A., Ahrens, C., Tolksdorf, H., Klinger, S., Sack, S., Heer, T., Lekakis, J., Kanakakis, I., Xenogiannis, I., Ermidou, K., Makris, N., Ntalianis, A., Katsaros, F., Revi, E., Kafkala, K., Mihelakis, E., Diakakis, G., Grammatikopoulos, K., Voutsinos, D., Xanthopoulou, I., Mplani, V., Foussas, S., Papakonstantinou, N., Patsourakos, N., Dimopoulos, A., Derventzis, A., Athanasiou, K., Vassilikos, V. P., Papadopoulos, C., Tzikas, S., Vogiatzis, I., Datsios, A., Galitsianos, I., Koutsampasopoulos, K., Grigoriadis, S., Douras, A., Baka, N., Spathis, S., Kyrlidis, T., Hatzinikolaou, H., Kiss, R. G., Nowotta, F., Toth, K., Szabo, S., Lakatos, C., Jambrik, Z., Ruzsa, J., Ruzsa, Z., Rona, S., Toth, J., Vargane Kosik, A., Toth, K. S. B., Nagy, G. G., Ondrejko, Z., Koromi, Z., Botos, B., Pourmoghadas, M., Salehi, A., Massoumi, G., Soleimani, A., Sarrafzadegan, N., Roohafza, H., Azarm, M., Mirmohammadsadeghi, A., Rajabi, D., Rahmani, Y., Siabani, S., Najafi, F., Hamzeh, B., Karim, H., Siabani, H., Saleh, N., Charehjoo, H., Zamzam, L., Al-Temimi, G., Al-Yassin, A., Mohammad, A., Ridha, A., Al-Saedi, G., Atabi, N., Sabbar, O., Mahmood, S., Dakhil, Z., Yaseen, I. F., Almyahi, M., Alkenzawi, H., Alkinani, T., Alyacopy, A., Kearney, P., Twomey, K., Shlomo, N., Beigel, R., Caldarola, P., Rutigliano, D., Sublimi Saponetti, L., Locuratolo, N., Palumbo, V., Scherillo, M., Formigli, D., Canova, P., Musumeci, G., Roncali, F., Metra, M., Lombardi, C., Visco, E., Rossi, L., Meloni, L., Montisci, R., Pippia, V., Marchetti, M. F., Congia, M., Cacace, C., Luca, G., Boscarelli, G., Indolfi, C., Ambrosio, G., Mongiardo, A., Spaccarotella, C., De Rosa, S., Canino, G., Critelli, C., Chiappetta, D., Battista, F., Gabrielli, D., Marziali, A., Bernabo, P., Navazio, A., Guerri, E., Manca, F., Gobbi, M., Oreto, G., Ando, G., Carerj, S., Saporito, F., Cimmino, M., Rigo, F., Zuin, G., Tuccillo, B., Scotto DI Uccio, F., Irace, L., Lorenzoni, G., Meloni, I., Merella, P., Polizzi, G. M., Pino, R., Marzilli, M., Morrone, D., Caravelli, P., Orsini, E., Mosa, S., Piovaccari, G., Santarelli, A., Cavazza, C., Romeo, F., Fedele, F., Mancone, M., Straito, M., Salvi, N., Scarparo, P., Severino, P., Razzini, C., Massaro, G., Cinque, A., Gaudio, C., Barilla, F., Torromeo, C., Porco, L., Mei, M., Iorio, R., Nassiacos, D., Barco, B., Sinagra, G., Falco, L., Priolo, L., Perkan, A., Strana, M., Percuku, L., Berisha, G., Mziu, B., Beishenkulov, M., Abdurashidova, T., Toktosunova, A., Kaliev, K., Serpytis, R., Butkute, E., Lizaitis, M., Broslavskyte, M., Xuereb, R. G., Mercieca Balbi, M., Paris, E., Buttigieg, L., Musial, W., Dobrzycki, S., Dubicki, A., Kazimierczyk, E., Tycinska, A., Wojakowski, W., Kalanska-Lukasik, B., Ochala, A., Wanha, W., Dworowy, S., Sielski, J., Janion, M., Janion-Sadowska, A., Wojtasik-Bakalarz, J., Bryniarski, L., Peruga, J. Z., Jonczyk, M., Jankowski, L., Klecha, A., Michalowska, J., Brzezinski, M., Kozmik, T., Kowalczyk, T., Adamczuk, J., Maliszewski, M., Kuziemka, P., Plaza, P., Jaros, A., Pawelec, A., Sledz, J., Bartus, S., Zmuda, W., Bogusz, M., Wisnicki, M., Szastak, G., Adamczyk, M., Suska, M., Czunko, P., Opolski, G., Kochman, J., Tomaniak, M., Miernik, S., Paczwa, K., Witkowski, A., Opolski, M. P., Staruch, A. D., Kalarus, Z., Honisz, G., Mencel, G., Swierad, M., Podolecki, T., Marques, J., Azevedo, P., Pereira, M. A., Gaspar, A., Monteiro, S., Goncalves, F., Leite, L., Manuel Lopes Dos Santos, W., Amado, J., Pereira, D., Silva, B., Caires, G., Neto, M., Rodrigues, R., Correia, A., Freitas, D., Lourenco, A., Ferreira, F., Sousa, F., Portugues, J., Calvo, L., Almeida, F., Alves, M., Silva, A., Caria, R., Seixo, F., Militaru, C., Ionica, E., Istratoaie, O., Florescu, M., Lipnitckaia, E., Osipova, O., Konstantinov, S., Bukatov, V., Vinokur, T., Egorova, E., Nefedova, E., Levashov, S., Gorbunova, A., Redkina, M., Karaulovskaya, N., Bijieva, F., Babich, N., Smirnova, O., Filyanin, R., Eseva, S., Kutluev, A., Chlopenova, A., Shtanko, A., Kuppar, E., Shaekhmurzina, E., Ibragimova, M., Mullahmetova, M., Chepisova, M., Kuzminykh, M., Betkaraeva, M., Namitokov, A., Khasanov, N., Baleeva, L., Galeeva, Z., Magamedkerimova, F., Ivantsov, E., Tavlueva, E., Kochergina, A., Sedykh, D., Kosmachova, E., Skibitskiy, V., Porodenko, N., Litovka, K., Ulbasheva, E., Niculina, S., Petrova, M., Harkov, E., Tsybulskaya, N., Lobanova, A., Chernova, A., Kuskaeva, A., Kuskaev, A., Ruda, M., Zateyshchikov, D., Gilarov, M., Konstantinova, E., Koroleva, O., Averkova, A., Zhukova, N., Kalimullin, D., Borovkova, N., Tokareva, A., Buyanova, M., Khaisheva, L., Pirozhenko, A., Novikova, T., Yakovlev, A., Tyurina, T., Lapshin, K., Moroshkina, N., Kiseleva, M., Fedorova, S., Krylova, L., Duplyakov, D., Semenova, Y., Rusina, A., Ryabov, V., Syrkina, A., Demianov, S., Reitblat, O., Artemchuk, A., Efremova, E., Makeeva, E., Menzorov, M., Shutov, A., Klimova, N., Shevchenko, I., Elistratova, O., Kostyuckova, O., Islamov, R., Budyak, V., Ponomareva, E., Ullah Jan, U., Alshehri, A. M., Sedky, E., Alsihati, Z., Mimish, L., Selem, A., Malik, A., Majeed, O., Altnji, I., Alshehri, M., Aref, A., Alhabib, K., Aldosary, M., Tayel, S., Abd Alrahman, M., Asfina, K. N., Abdin Hussein, G., Butt, M., Markovic Nikolic, N., Obradovic, S., Djenic, N., Brajovic, M., Davidovic, A., Romanovic, R., Novakovic, V., Dekleva, M., Spasic, M., Dzudovic, B., Jovic, Z., Cvijanovic, D., Veljkovic, S., Ivanov, I., Cankovic, M., Jarakovic, M., Kovacevic, M., Trajkovic, M., Mitov, V., Jovic, A., Hudec, M., Gombasky, M., Sumbal, J., Bohm, A., Baranova, E., Kovar, F., Samos, M., Podoba, J., Kurray, P., Obona, T., Remenarikova, A., Kollarik, B., Verebova, D., Kardosova, G., Alusik, D., Macakova, J., Kozlej, M., Bayes-Genis, A., Sionis, A., Garcia Garcia, C., Duran Cambra, A., Labata Salvador, C., Rueda Sobella, F., Sans Rosello, J., Vila Perales, M., Oliveras Vila, T., Ferrer Massot, M., Baneras, J., Lekuona, I., Zugazabeitia, G., Fernandez-Ortiz, A., Viana Tejedor, A., Ferrera, C., Alvarez, V., DIaz-Castro, O., Agra-Bermejo, R. M., Gonzalez-Cambeiro, C., Gonzalez-Babarro, E., Domingo-Del Valle, J., Royuela, N., Burgos, V., Canteli, A., Castrillo, C., Cobo, M., Ruiz, M., Abu-Assi, E., and Garcia Acuna, J.

Subjects
Registrie, medicine.medical_specialty, medicine.medical_treatment, Cardiology, Myocardial Reperfusion, 030204 cardiovascular system & hematology, 03 medical and health sciences, Hospital, 0302 clinical medicine, Reperfusion therapy, Percutaneous Coronary Intervention, Internal medicine, Fibrinolysis, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Registries, Prospective Studies, Prospective cohort study, Observational studies, observational studies, reperfusion therapy, business.industry, Mortality rate, Primary percutaneous coronary intervention, ST-elevation myocardial infarction, Europe, Hospitals, Treatment Outcome, ST Elevation Myocardial Infarction, Percutaneous coronary intervention, medicine.disease, primary percutaneous coronary intervention, Observational studie, 3. Good health, Prospective Studie, Cohort, Conventional PCI, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Aims The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset Conclusions The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.

Published
2021
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4. The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Author

Zeymer, U., Ludman, P., Danchin, N., Kala, P., Maggioni, A. P., Weidinger, F, P Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, P Maggioni, A, K Nagy, V, Nedoshivin, A, A-S, Petronio, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Franz, Weidinger, Uwe, Zeymer, Nicolas, Danchin, Peter, Ludman, Peter, Sinnaeve, Petr, Kala, Roberto, Ferrari, Maggioni, Aldo P., Artan, Goda, Parounak, Zelveian, Kiril, Karamfilov, Zuzana, Motovska, Bent, Raungaard, Toomas, Marandi, Sameh Mohamed Shaheen, Rosa-Maria, Lidon, Pasi Paavo Karjalainen, Zviad, Kereselidze, Dimitrios, Alexopoulos, David, Becker, Martin, Quinn, Zaza, Iakobishvili, Hasan, Al-Farhan, Masoumeh, Sadeghi, Roberto, Caporale, Francesco, Romeo, Erkin, Mirrakhimov, Pranas, Serpytis, Andrejs, Erglis, Sasko, Kedev, Matthew Mercieca Balbi, Alice May Moore, Dariusz, Dudek, Jacek, Legutko, Jorge, Mimoso, Gabriel, Tatu-Chitoiu, Sinisa, Stojkovic, Evgeny, Shlyakhto, Khalid, F AlHabib, Matjaz, Bunc, Martin, Studencan, Mohamed Sami Mourali, Gani, Bajraktari, Marème, Konte, Florian, Larras, Elin Folkesson Lefrancq, Souad, Mekhaldi, Cécile, Laroche, Goda, A, Shuka, N, Pavli, E, Tafaj, E, Gishto, T, Dibra, A, Duka, A, Gjana, A, Kristo, A, Knuti, G, Demiraj, A, Dado, E, Hasimi, E, Simoni, L, Siqeca, M, Sisakian, H, Hayrapetyan, H, Markosyan, S, Galustyan, L, Arustamyan, N, Kzhdryan, H, Pepoyan, S, Zirkik, A, D Von Lewinski, Paetzold, S, Kienzl, I, Matyas, K, Neunteufl, T, Nikfardjam, M, Neuhold, U, Mihalcz, A, Glaser, F, Steinwender, C, Reiter, C, Grund, M, Hrncic, D, Hoppe, U, Hammerer, M, Hinterbuchner, L, Hengstenberg, C, G Delle Karth, Lang, I, Winkler, W, Hasun, M, Kastner, J, Havel, C, Derntl, M, Oberegger, G, Hajos, J, Adlbrecht, C, Publig, T, M-C, Leitgeb, Wilfing, R, Jirak, P, C-Y, Ho, Puskas, L, Schrutka, L, Spinar, J, Parenica, J, Hlinomaz, O, Fendrychova, V, Semenka, J, Sikora, J, Sitar, J, Groch, L, Rezek, M, Novak, M, Kramarikova, P, Stasek, J, Dusek, J, Zdrahal, P, Polasek, R, Karasek, J, Seiner, J, Sukova, N, Varvarovsky, I, Lazarák, T, Novotny, V, Matejka, J, Rokyta, R, Volovar, S, Belohlavek, J, Motovska, Z, Siranec, M, Kamenik, M, Kralik, R, Raungaard, B, Ravkilde, J, E Jensen, S, Villadsen, A, Villefrance, K, C Schmidt Skov, Maeng, M, Moeller, K, Hasan-Ali, H, A Ahmed, T, Hassan, M, Elguind, A, M Farouk Ismail, A Ibrahim Abd El-Aal, A El-sayed Gaafar, H Magdy Hassan, M Ahmed Shafie, M Nabil El-khouly, Bendary, A, Darwish, M, Ahmed, Y, Amin, O, Abdelhakim, A, Abosaif, K, Kandil, H, M A, G Galal, E El Hefny, E, M El Sayed, Aly, K, Mokarrab, M, Osman, M, Abdelhamid, M, Mantawy, S, R Ali, M, D Kaky, S, A Khalil, V, M E, A Saraya, Talaat, A, Nabil, M, M Mounir, W, Aransa, K. Mahmoud A., Kazamel, G, Anwar, S, Al-Habbaa, A, M Abd el Monem, Ismael, A, Amin Abu-Sheaishaa, M., M Abd Rabou, M, T M, A Hammouda, Moaaz, M, Elkhashab, K, Ragab, T, Rashwan, A, Rmdan, A, Abdelrazek, G, Ebeid, H, H Soliman Ghareeb, Farag, N, Zaki, M, Seleem, M, Torki, A, Youssef, M, A AlLah Nasser, N, Rafaat, A, Selim, H, M Makram, M, Khayyal, M, Malasi, K, Madkou, A, Kolib, M, Alkady, H, Nagah, A, Yossef, M, Wafa, A, Mahfouz, E, Faheem, G, M Magdy Moris, Ragab, A, Ghazal, M, Mabrouk, A, El-Masry, M, Naseem, M, Samir, S, Marandi, T, Reinmets, J, Allvee, M, Saar, A, Ainla, T, Vaide, A, Kisseljova, M, Pakosta, U, Eha, J, Lotamois, K, Sia, J, Myllymaki, J, Pinola, T, P Karjalainen, P, Paana, P, Mikkelsson, J, Ampio, M, Tsivilasvili, J, Zurab, P, Kereselidze, Z, Agladze, R, Melia, A, Gogoberidze, D, Khubua, N, Totladze, L, Metreveli, I, Chikovani, A, Eitel, I, Pöss, J, Werner, M, Constantz, A, Ahrens, C, Tolksdorf, H, Klinger, S, Sack, S, Heer, T, Lekakis, J, Kanakakis, I, Xenogiannis, I, Ermidou, K, Makris, N, Ntalianis, A, Katsaros, F, Revi, E, Kafkala, K, Mihelakis, E, Diakakis, G, Grammatikopoulos, K, Voutsinos, D, Alexopoulos, D, Xanthopoulou, I, Mplani, V, Foussas, S, Papakonstantinou, N, Patsourakos, N, Dimopoulos, A, Derventzis, A, Athanasiou, K, P Vassilikos, V, Papadopoulos, C, Tzikas, S, Vogiatzis, I, Datsios, A, Galitsianos, I, Koutsampasopoulos, K, Grigoriadis, S, Douras, A, Baka, N, Spathis, S, Kyrlidis, T, Hatzinikolaou, H, G Kiss, R, Becker, D, Nowotta, F, Tóth, K, Szabó, S, Lakatos, C, Jambrik, Z, Ruzsa, J, Ruzsa, Z, Róna, S, Toth, J, A Vargane Kosik, K S, B Toth, G Nagy, G, Ondrejkó, Z, Körömi, Z, Botos, B, Pourmoghadas, M, Salehi, A, Massoumi, G, Sadeghi, M, Soleimani, A, Sarrafzadegan, N, Roohafza, H, Azarm, M, Mirmohammadsadeghi, A, Rajabi, D, Rahmani, Y, Siabani, S, Najafi, F, Hamzeh, B, Karim, H, Siabani, H, Saleh, N, Charehjoo, H, Zamzam, L, Al-Temimi, T, Al-Farhan, H, Al-Yassin, A, Mohammad, A, Ridha, A, Al-Saedi, G, Atabi, N, Sabbar, O, Mahmood, S, Dakhil, Z, F Yaseen, I, Almyahi, M, Alkenzawi, H, Alkinani, T, Alyacopy, A, Kearney, P, Twomey, K, Iakobishvili, Z, Shlomo, N, Beigel, R, Caldarola, P, Rutigliano, D, L Sublimi Saponetti, Locuratolo, N, Palumbo, V, Scherillo, M, Formigli, D, Canova, P, Musumeci, G, Roncali, F, Metra, M, Lombardi, C, Visco, E, Rossi, L, Meloni, L, Montisci, R, Pippia, V, F Marchetti, M, Congia, M, Cacace, C, Luca, G, Boscarelli, G, Indolfi, C, Ambrosio, G, Mongiardo, A, Spaccarotella, C, S De Rosa, Canino, G, Critelli, C, Caporale, R, Chiappetta, D, Battista, F, Gabrielli, D, Marziali, A, Bernabò, P, Navazio, A, Guerri, E, Manca, F, Gobbi, M, Oreto, G, Andò, G, Carerj, S, Saporito, F, Cimmino, M, Rigo, F, Zuin, G, Tuccillo, B, F Scotto di Uccio, L Scotto di Uccio, Lorenzoni, G, Meloni, I, Merella, P, M Polizzi, G, Pino, R, Marzilli, M, Morrone, D, Caravelliorsini, P, Orsini, E, Mosa, S, Piovaccari, G, Santarelli, A, Cavazza, C, Romeo, F, Fedele, F, Mancone, M, Straito, M, Salvi, N, Scarparo, P, Severino, P, Razzini, C, Massaro, G, Cinque, A, Gaudio, C, Barillà, F, Torromeo, C, Porco, L, Mei, M, Lorio, R, Nassiacos, D, Barco, B, Sinagra, G, Falco, L, Priolo, L, Perkan, A, Strana, M, Bajraktari, G, Percuku, L, Berisha, G, Mziu, B, Beishenkulov, M, Abdurashidova, T, Toktosunova, A, Kaliev, K, Serpytis, P, Serpytis, R, Butkute, E, Lizaitis, M, Broslavskyte, M, G Xuereb, R, M Moore, A, M Mercieca Balbi, Paris, E, Buttigieg, L, Musial, W, Dobrzycki, S, Dubicki, A, Kazimierczyk, E, Tycinska, A, Wojakowski, W, Kalanska-Lukasik, B, Ochala, A, Wanha, W, Dworowy, S, Sielski, J, Janion, M, Janion-Sadowska, A, Dudek, D, Wojtasik-Bakalarz, J, Bryniarski, L, Z Peruga, J, Jonczyk, M, Jankowski, L, Klecha, A, Legutko, J, Michalowska, J, Brzezinski, M, Kozmik, T, Kowalczyk, T, Adamczuk, J, Maliszewski, M, Kuziemka, P, Plaza, P, Jaros, A, Pawelec, A, Sledz, J, Bartus, S, Zmuda, W, Bogusz, M, Wisnicki, M, Szastak, G, Adamczyk, M, Suska, M, Czunko, P, Opolski, G, Kochman, J, Tomaniak, M, Miernik, S, Paczwa, K, Witkowski, A, P Opolski, M, D Staruch, A, Kalarus, Z, Honisz, G, Mencel, G, Swierad, M, Podolecki, T, Marques, J, Azevedo, P, A Pereira, M, Gaspar, A, Monteiro, S, Goncalves, F, Leite, L, Mimoso, J, Manuel Lopes dos Santos, W., Amado, J, Pereira, D, Silva, B, Caires, G, Neto, M, Rodrigues, R, Correia, A, Freitas, D, Lourenco, A, Ferreira, F, Sousa, F, Portugues, J, Calvo, J, Almeida, F, Alves, M, Silva, A, Caria, R, Seixo, F, Militaru, C, Ionica, E, Tatu-Chitoiu, G, Istratoaie, O, Florescu, M, Lipnitckaia, E, Osipova, O, Konstantinov, S, Bukatov, V, Vinokur, T, Egorova, E, Nefedova, E, Levashov, S, Gorbunova, A, Redkina, M, Karaulovskaya, N, Bijieva, F, Babich, N, Smirnova, O, Filyanin, R, Eseva, S, Kutluev, A, Chlopenova, A, Shtanko, A, Kuppar, E, Shaekhmurzina, E, Ibragimova, M, Mullahmetova, M, Chepisova, M, Kuzminykh, M, Betkaraeva, M, Namitokov, A, Khasanov, N, Baleeva, L, Galeeva, Z, Magamedkerimova, F, Ivantsov, E, Tavlueva, E, Kochergina, A, Sedykh, D, Kosmachova, E, Skibitskiy, V, Porodenko, N, Litovka, K, Ulbasheva, E, Niculina, S, Petrova, M, Harkov, E, Tsybulskaya, N, Lobanova, A, Chernova, A, Kuskaeva, A, Kuskaev, A, Ruda, M, Zateyshchikov, D, Gilarov, M, Konstantinova, E, Koroleva, O, Averkova, A, Zhukova, N, Kalimullin, D, Borovkova, N, Tokareva, A, Buyanova, M, Khaisheva, L, Pirozhenko, T, Novikova, T, Yakovlev, A, Tyurina, T, Lapshin, K, Moroshkina, N, Kiseleva, M, Fedorova, S, Krylova, L, Duplyakov, D, Semenova, Y, Rusina, A, Ryabov, V, Syrkina, A, Demianov, S, Reitblat, O, Artemchuk, A, Efremova, E, Makeeva, E, Menzorov, M, Shutov, A, Klimova, N, Shevchenko, I, Elistratova, O, Kostyuckova, O, Islamov, R, Budyak, V, Ponomareva, E, U Ullah Jan, M Alshehri, A, Sedky, E, Alsihati, Z, Mimish, L, Selem, A, Malik, A, Majeed, O, Altnji, I, Alshehri, M, Aref, A, Alhabib, K, Aldosary, M, Tayel, S, M Abd AlRahman, N Asfina, K, G Abdin Hussein, Butt, M, N Markovic Nikolic, Obradovic, S, Djenic, N, Brajovic, M, Davidovic, A, Romanovic, R, Novakovic, V, Dekleva, M, Spasic, M, Dzudovic, B, Jovic, Z, Cvijanovic, D, Cvijanovic, S, Ivanov, I, Cankovic, M, Jarakovic, M, Kovacevic, M, Trajkovic, M, Mitov, V, Jovic, A, Hudec, M, Gombasky, M, Sumbal, J, Bohm, A, Baranova, E, Kovar, F, Samos, M, Podoba, J, Kurray, P, Obona, T, Remenarikova, A, Kollarik, B, Verebova, D, Kardosova, G, Studencan, M, Alusik, D, Macakova, J, Kozlej, M, Bayes-Genis, A, Sionis, A, C Garcia Garcia, R-M, Lidon, A Duran Cambra, C Labata Salvador, F Rueda Sobella, J Sans Rosello, M Vila Perales, T Oliveras Vila, M Ferrer Massot, Bañeras, J, Lekuona, I, Zugazabeitia, G, Fernandez-Ortiz, A, A Viana Tejedor, Ferrera, C, Alvarez, V, Diaz-Castro, O, M Agra-Bermejo, R, Gonzalez-Cambeiro, C, Gonzalez-Babarro, E, J Domingo-Del Valle, Royuela, N, Burgos, V, Canteli, A, Castrillo, C, Cobo, M, Ruiz, M, Abu-Assi, E, M Garcia Acuna, J, U., Zeymer, P., Ludman, N., Danchin, P., Kala, A. P., Maggioni, F., Weidinger, STEMI Investigators, Ac, and Spaccarotella, C.

Subjects
Registrie, medicine.medical_specialty, Acute coronary syndrome, Registry, medicine.medical_treatment, Cardiology, Reperfusion therapy, Retrospective Studie, Medical, medicine, Humans, cardiovascular diseases, Myocardial infarction, Registries, Disease management (health), Acute Coronary Syndrome, Societies, Medical, Quality of Health Care, Retrospective Studies, Acca, biology, business.industry, Health Policy, Primary percutaneous coronary intervention, Percutaneous coronary intervention, Disease Management, Retrospective cohort study, medicine.disease, biology.organism_classification, primary percutaneous coronary intervention, registry, reperfusion therapy, ST-elevation myocardial infarction, Cardiac surgery, Europe, surgical procedures, operative, Emergency medicine, ST Elevation Myocardial Infarction, Societies, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Aims The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI. Methods and results Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission. Conclusion The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Published
2019

7. Correlations between ovarian follicular blood flow and superovulatory responses in ewes

Author

OLIVEIRA, M. E. F., FELICIANO, M. A. R., D'AMATO, C. C., OLIVEIRA, L. G., BICUDO, S. D., FONSECA, J. F. da, VICENTE, W. R. R., VISCO, E., BARTLEWSKID, P. M., Maria E. F. Oliveira, São Paulo State University (USP) - Jaboticabal, SP, Brazil, Marcus A. R. Feliciano, USP - Jaboticabal, SP, Brazil, Carla C. D'Amato, USP - Jaboticabal, SP, Brazil, Luís G. Oliveira, USP - Jaboticabal, SP, Brazil, Sony D. Bicudo, Paulo State University (USP) - Botucatu, SP, Brazil, Jeferson Ferreira da Fonseca, CNPC, Wilter R. R. Vicente, USP - Jaboticabal, SP, Brazil, Elise Visco, University of Guelph, Guelph, Canada, and Pawel M. Bartlewskid, University of Guelph, Guelph, Canada.

Subjects
Sheep, Ovino, Ovelha, Reproduction, Superovulação, Color Doppler sonography, Antral follicles, Superovulation, Ewes, Ovário, Blood circulation, Reprodução animal
Abstract

The primary goal of this study was to employ ultrasonography to examine the ovaries of ewes undergoing superovulatory treatment for correlations between antral follicular blood flow and ovarian responses/embryo yields. Five Santa Inês ewes were subjected to a short- (Days 0?6, Group 1) and five to a long-term progesterone-based protocol (Days 0?12, Group 2) to synchronize estrus and ovulations after the superovulatory treatment. Porcine FSH (pFSH, 200 mg) was administered in 8 decreasing doses over 4 days, starting on Days 4 and 10 in Groups 1 and 2, respectively. After CIDR removal, all ewes were bred by a ram and embryos were recovered surgically 7 days later. Transrectal ovarian ultrasonography was performed the day before and on all 4 days of the superovulatory treatment. Both an arbitrary-scale [(0) non-detectable; (1) small; (2) moderate; (3) intense blood flow] and quantitative analysis of the blood flow area were used to assess the follicular blood flow in color Doppler images. There were no significant correlations between the arbitrary blood flow scores and superovulatory responses in the ewes of the present study. However, there was a positive correlation between the quantitative estimates of follicular blood flow on the final day of the superovulatory treatment, and the number (DA: r = 0.68, P < 0.05; DA/TA × 100%: r = 0.85, P < 0.05) and percentage (DA: r = 0.65, P < 0.05; DA/TA × 100%: r = 0.91, P < 0.001) of unfertilized eggs (DA: Doppler area, TA: total area of the largest ovarian cross section). This experiment presents a commercially practical tool for predicting superovulatory outcomes in ewes and evidence for the existence of follicular blood flow threshold that may impinge negatively on oocyte quality when surpassed during hormonal ovarian superstimulation.

Published
2014

8. Endovascular treatment of carotid artery stenosis: evidences from randomized controlled trials and actual indications

Author

Ilardi, F., Magliulo, F., Gargiulo, G., Schiattarella, G.G., Carotenuto, G., Serino, F., Ferrone, M., Visco, E., Scudiero, F., Carbone, A., Perrino, C., Trimarco, B., and Esposito, G.

Subjects
Cardiovascular and Metabolic Diseases, cardiovascular diseases
Abstract

Atherosclerotic stenosis of common and internal carotid arteries is a well-recognized risk factor for ischemic stroke, and revascularization has been proven to be the main tool of prevention, particularly for patients with stenosis-related symptoms. While for many years surgical carotid endarterectomy (CEA) has been considered the gold-standard strategy to restore vascular patency, recently the endovascular treatment through percutaneous angioplasty and stent implantation (CAS) has become a valid alternative. In the last years, interesting data about the comparison of these strategies have emerged. CAS seems to cause more peri-procedural strokes, but may also avoid many adverse events related to surgery and general anaesthesia, including peri-procedural myocardial infarction. For these reasons, it was initially considered a second-choice strategy to be adopted in patients for whom surgery was contraindicated. However, more recent trials have shown that CAS might be considered an effective alternative to CEA. Moreover, the rapid evolution of CAS technique and materials suggests its potential to improve outcome and possible superiority compared to CEA in the next future. Purpose of this review is to discuss the most recent clinical evidences concerning the treatment of carotid artery stenosis, with a special focus on the endovascular treatment.

Published
2011

11. Adequacy of Airport Inventory for Future Requirements.

Author

NATIONAL INST FOR COMMUNITY DEVELOPMENT INC ARLINGTON VA, Herlihy,E, Miller,J, Visco,E, NATIONAL INST FOR COMMUNITY DEVELOPMENT INC ARLINGTON VA, Herlihy,E, Miller,J, and Visco,E

Abstract

The general objective of the study is to provide the FAA with tools that airport management and planning organizations can use for the assessment of inventory for future requirements. The contract effort is focused on air carrier operations in large metropolitan areas. An analysis of relevant literature is presented which identifies techniques for planning and forecasting, facility assessment and regional planning. A general regional assessment model is developed which recognizes analytical, organizational and political dimensions. Principal findings include: (1) an extensive and comprehensive literature exists, dealing with limited components of the problem such as airside and terminal operations; (2) no regional assessment technique can be identified that is in operational use; and (3) an assessment process, modified from the work of R.D. Shinn, is suggested. The process includes: facility inventory; activity forecasting; determination of gaps between inventory and need; identification of alternatives to meet need; evaluation; and, decisions and operations. An annotated bibliography is included.

Published
1979

12. Valve-in-Valve With Allegra Implantation in Failed Direct Flow Transcatheter Heart Valve

Author

Francesco Ancona, Saud Khawaja, Nicola Buzzatti, Eustachio Agricola, Matteo Montorfano, Alessandro Beneduce, Luca A. Ferri, Marco Ancona, Anna Palmisano, Barbara Bellini, Francesco Moroni, Antonio Esposito, Emanuele Visco, RT Vittorio Romano, Ancona, M. B., Visco, E., Khawaja, S., Romano, V., Moroni, F., Ferri, L., Bellini, B., Beneduce, A., Ancona, F., Agricola, E., Buzzatti, N., Palmisano, A., Esposito, A., and Montorfano, M.

Subjects
valve-in-valve, medicine.medical_specialty, Transcatheter aortic, business.industry, medicine.medical_treatment, Hemodynamics, 030204 cardiovascular system & hematology, medicine.disease, Direct flow, Valve in valve, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Valve replacement, direct flow, Internal medicine, Heart failure, Aortic valve surgery, medicine, Cardiology, Allegra, 030212 general & internal medicine, Heart valve, Cardiology and Cardiovascular Medicine, business
Abstract

An 87-year-old man with a history of transcatheter aortic valve replacement with a 6-year-old 27-mm Direct Flow bioprosthesis (Direct Flow Medical, Santa Rosa, California), presented with heart failure. Echocardiography showed normal transcatheter heart valve (THV) leaflets with no obstruction (mean

Published
2020
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13. Interatrial Septal Tear After Patent Foramen Ovale Closure With the NobleStitch Device

Author

Alessandro Beneduce, Luca A. Ferri, Marco Ancona, Luca Baldetti, Eustachio Agricola, Francesco Ancona, Emanuele Visco, Francesco Melillo, Matteo Montorfano, Alaide Chieffo, Barbara Bellini, Baldetti, L., Ferri, L. A., Ancona, M., Bellini, B., Visco, E., Melillo, F., Beneduce, A., Chieffo, A., Ancona, F., Agricola, E., and Montorfano, M.

Subjects
noble-stitch, medicine.medical_specialty, Percutaneous, business.industry, patent foramen ovale, iatrogenic, Hereditary thrombophilia, Context (language use), 030204 cardiovascular system & hematology, medicine.disease, transcatheter PFO closure, ASD, Surgery, 03 medical and health sciences, 0302 clinical medicine, stomatognathic system, Suture (anatomy), PFO, Patent foramen ovale, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, atrial septal tear
Abstract

A 46-year-old woman underwent percutaneous patent foramen ovale closure at another institution for recurrent cerebral transient ischemic attacks in the context of hereditary thrombophilia. Because anatomy was considered appropriate, the novel suture-based “deviceless” NobleStitch EL (Kardia

Published
2019

14. Endovascular treatment of carotid artery stenosis: evidences from randomized controlled trials and actual indications

Author

Giovanni Esposito, Fernando Scudiero, Gabriele G. Schiattarella, Emanuele Visco, Fabio Magliulo, Andreina Carbone, Bruno Trimarco, Federica Ilardi, Federica Serino, Giuseppe Carotenuto, Cinzia Perrino, Giuseppe Gargiulo, Marco Ferrone, Ilardi, F, Magliulol, F, Gargiulo, G, Schiattarella, Gg, Carotenuto, G, Serino, F, Ferrone, M, Visco, E, Scudiero, F, Carbone, A, Perrino, Cinzia, Trimarco, Bruno, and Esposito, Giovanni

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, lcsh:Medicine, Carotid endarterectomy, Revascularization, law.invention, CREST, CEA, Randomized controlled trial, law, Internal medicine, medicine, Vascular Patency, Humans, General anaesthesia, Carotid Stenosis, cardiovascular diseases, Myocardial infarction, Angioplasty, Balloon, Coronary, Adverse effect, Randomized Controlled Trials as Topic, Clinical Trials as Topic, Endarterectomy, Carotid, business.industry, Patient Selection, lcsh:R, stenosis, CAS, medicine.disease, Surgery, carotid, Stroke, Stenosis, Treatment Outcome, Cardiology, endovascular, Stents, Cardiology and Cardiovascular Medicine, business
Abstract

Atherosclerotic stenosis of common and internal carotid arteries is a well-recognized risk factor for ischemic stroke, and revascularization has been proven to be the main tool of prevention, particularly for patients with stenosis- related symptoms. While for many years surgical carotid endarterectomy (CEA) has been considered the gold-standard strategy to restore vascular patency, recently the endovascular treatment through percutaneous angioplasty and stent implantation (CAS) has become a valid alternative. In the last years, interesting data about the comparison of these strategies have emerged. CAS seems to cause more peri-procedural strokes, but may also avoid many adverse events related to surgery and general anaesthesia, including peri-procedural myocardial infarction. For these reasons, it was initially considered a second-choice strategy to be adopted in patients for whom surgery was contraindicated. However, more recent trials have shown that CAS might be considered an effective alternative to CEA. Moreover, the rapid evolution of CAS technique and materials suggests its potential to improve outcome and possible superiority compared to CEA in the next future. Purpose of this review is to discuss the most recent clinical evidences concerning the treatment of carotid artery stenosis, with a special focus on the endovascular treatment.

15. Cyclic Fasting-Mimicking Diet Plus Bortezomib and Rituximab Is an Effective Treatment for Chronic Lymphocytic Leukemia.

Author

Raucci F, Vernieri C, Di Tano M, Ligorio F, Blaževitš O, Lazzeri S, Shmahala A, Fragale G, Salvadori G, Varano G, Casola S, Buono R, Visco E, de Braud F, and Longo VD

Subjects
Humans, Animals, Mice, Bortezomib pharmacology, Bortezomib therapeutic use, Rituximab therapeutic use, Proteasome Endopeptidase Complex, Fasting, Leukemia, Lymphocytic, Chronic, B-Cell pathology, Antineoplastic Agents pharmacology, Antineoplastic Agents therapeutic use
Abstract

Cyclic fasting-mimicking diet (FMD) is an experimental nutritional intervention with potent antitumor activity in preclinical models of solid malignancies. FMD cycles are also safe and active metabolically and immunologically in cancer patients. Here, we reported on the outcome of FMD cycles in two patients with chronic lymphocytic leukemia (CLL) and investigated the effects of fasting and FMD cycles in preclinical CLL models. Fasting-mimicking conditions in murine CLL models had mild cytotoxic effects, which resulted in apoptosis activation mediated in part by lowered insulin and IGF1 concentrations. In CLL cells, fasting conditions promoted an increase in proteasome activity that served as a starvation escape pathway. Pharmacologic inhibition of this escape mechanism with the proteasome inhibitor bortezomib resulted in a strong enhancement of the proapoptotic effects of starvation conditions in vitro. In mouse CLL models, combining cyclic fasting/FMD with bortezomib and rituximab, an anti-CD20 antibody, delayed CLL progression and resulted in significant prolongation of mouse survival. Overall, the effect of proteasome inhibition in combination with FMD cycles in promoting CLL death supports the targeting of starvation escape pathways as an effective treatment strategy that should be tested in clinical trials., Significance: Chronic lymphocytic leukemia cells resist fasting-mimicking diet by inducing proteasome activation to escape starvation, which can be targeted using proteasome inhibition by bortezomib treatment to impede leukemia progression and prolong survival., (©2024 The Authors; Published by the American Association for Cancer Research.)

Published
2024
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16. Fasting renders immunotherapy effective against low-immunogenic breast cancer while reducing side effects.

Author

Cortellino S, Raveane A, Chiodoni C, Delfanti G, Pisati F, Spagnolo V, Visco E, Fragale G, Ferrante F, Magni S, Iannelli F, Zanardi F, Casorati G, Bertolini F, Dellabona P, Colombo MP, Tripodo C, and Longo VD

Subjects
B7-H1 Antigen metabolism, Glycolysis, Humans, Immunotherapy adverse effects, Immunotherapy methods, Tumor Microenvironment, Fasting, Triple Negative Breast Neoplasms drug therapy
Abstract

Immunotherapy is improving the prognosis and survival of cancer patients, but despite encouraging outcomes in different cancers, the majority of tumors are resistant to it, and the immunotherapy combinations are often accompanied by severe side effects. Here, we show that a periodic fasting-mimicking diet (FMD) can act on the tumor microenvironment and increase the efficacy of immunotherapy (anti-PD-L1 and anti-OX40) against the poorly immunogenic triple-negative breast tumors (TNBCs) by expanding early exhausted effector T cells, switching the cancer metabolism from glycolytic to respiratory, and reducing collagen deposition. Furthermore, FMD reduces the occurrence of immune-related adverse events (irAEs) by preventing the hyperactivation of the immune response. These results indicate that FMD cycles have the potential to enhance the efficacy of anti-cancer immune responses, expand the portion of tumors sensitive to immunotherapy, and reduce its side effects., Competing Interests: Declaration of interests V.D.L. holds intellectual property rights on clinical uses of FMD and equity interest in L-Nutra, a company that markets medical food., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2022
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17. Anesthetic management of carotid endarterectomy: an update from Italian guidelines.

Author

Bevilacqua S, Ticozzelli G, Orso M, Alba G, Capoccia L, Cappelli A, Cernetti C, Diomedi M, Dorigo W, Faggioli G, Giannace G, Giannandrea D, Giannetta M, Lessiani G, Marone EM, Mazzaccaro D, Migliacci R, Nano G, Pagliariccio G, Petruzzellis M, Plutino A, Pomatto S, Pulli R, Sirignano P, Vacirca A, Visco E, Moghadam SP, Lanza G, and Lanza J

Abstract

Background and Aims: In order to systematically review the latest evidence on anesthesia, intraoperative neurologic monitoring, postoperative heparin reversal, and postoperative blood pressure management for carotid endarterectomy. The present review is based on a single chapter of the Italian Health Institute Guidelines for diagnosis and treatment of extracranial carotid stenosis and stroke prevention., Methods and Results: A systematic article review focused on the previously cited topics published between January 2016 and October 2020 has been performed; we looked for both primary and secondary studies in the extensive archive of Medline/PubMed and Cochrane library databases. We selected 14 systematic reviews and meta-analyses, 13 randomized controlled trials, 8 observational studies, and 1 narrative review. Based on this analysis, syntheses of the available evidence were shared and recommendations were indicated complying with the GRADE-SIGN version methodology., Conclusions: From this up-to-date analysis, it has emerged that any type of anesthesia and neurological monitoring method is related to a better outcome after carotid endarterectomy. In addition, insufficient evidence was found to justify reversal or no-reversal of heparin at the end of surgery. Furthermore, despite a low evidence level, a suggestion for blood pressure monitoring in the postoperative period was formulated., (© 2022. The Author(s).)

Published
2022
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18. Impact of Left Ventricular Outflow Tract Calcification on Pacemaker Implantation After Transcatheter Aortic Valve Implantation With Second-Generation Devices.

Author

Ancona MB, Moroni F, Pagnesi M, Del Sole P, Demir O, Khawaja S, Bellini B, Ferri L, Beneduce A, Visco E, Capogrosso C, Agricola E, Esposito A, Palmisano A, Chieffo A, and Montorfano M

Subjects
Aortic Valve diagnostic imaging, Aortic Valve surgery, Humans, Italy, Multidetector Computed Tomography, Retrospective Studies, Treatment Outcome, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis surgery, Heart Valve Prosthesis adverse effects, Pacemaker, Artificial adverse effects, Transcatheter Aortic Valve Replacement adverse effects
Abstract

Objective: To evaluate the impact of left ventricular outflow tract calcification (LVOT-CA) localization and extension on permanent pacemaker implantation (PPI) rates after transcatheter aortic valve implantation (TAVI) with second-generation devices., Methods: This single-center retrospective study included all consecutive patients who underwent transfemoral TAVI with second-generation devices at San Raffaele Hospital in Milan, Italy from January 2014 to June 2017. The localization and extension of LVOT-CA were evaluated using computed tomography imaging; LVOT regions were categorized according to the overlying coronary cusps., Results: The study population consisted of 377 patients, of which LVOT-CA was present in 133 patients (35.3%). Patients with LVOT-CA had significantly a higher rate of post-TAVI PPI (32.0% vs 19.2% in patients with no LVOT-CA; P<.01). Multivariable analysis demonstrated LVOT-CA in the non-coronary cusp, as well as preprocedural right bundle-branch block, age, body mass index, and mechanically expanded prosthesis implantation, to be strong independent predictors of PPI., Conclusions: LVOT-CA in the non-coronary cusp is a strong independent predictor of PPI after TAVI with second-generation devices. Further studies are needed to confirm these data in a larger, multicenter population.

Published
2020
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19. Valve-in-Valve With Allegra Implantation in Failed Direct Flow Transcatheter Heart Valve.

Author

Ancona MB, Visco E, Khawaja S, Romano V, Moroni F, Ferri L, Bellini B, Beneduce A, Ancona F, Agricola E, Buzzatti N, Palmisano A, Esposito A, and Montorfano M

Subjects
Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Insufficiency diagnostic imaging, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency physiopathology, Heart Valve Prosthesis Implantation adverse effects, Hemodynamics, Humans, Male, Prosthesis Design, Recovery of Function, Treatment Outcome, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Prosthesis Failure, Transcatheter Aortic Valve Replacement instrumentation
Published
2020
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20. Interatrial Septal Tear After Patent Foramen Ovale Closure With the NobleStitch Device.

Author

Baldetti L, Ferri LA, Ancona M, Bellini B, Visco E, Melillo F, Beneduce A, Chieffo A, Ancona F, Agricola E, and Montorfano M

Subjects
Atrial Septum diagnostic imaging, Atrial Septum physiopathology, Cardiac Catheterization instrumentation, Female, Foramen Ovale, Patent diagnostic imaging, Foramen Ovale, Patent physiopathology, Heart Injuries diagnostic imaging, Heart Injuries physiopathology, Heart Injuries therapy, Humans, Middle Aged, Septal Occluder Device, Suture Techniques instrumentation, Treatment Outcome, Atrial Septum injuries, Foramen Ovale, Patent surgery, Heart Injuries etiology, Suture Techniques adverse effects
Published
2019
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21. Left ventricular reverse remodelling predicts long-term outcomes in patients with functional mitral regurgitation undergoing MitraClip therapy: results from a multicentre registry.

Author

Adamo M, Godino C, Giannini C, Scotti A, Liga R, Curello S, Fiorina C, Chiari E, Chizzola G, Abbenante A, Visco E, Branca L, Fiorelli F, Agricola E, Stella S, Lombardi C, Colombo A, Petronio AS, Metra M, and Ettori F

Subjects
Aged, Echocardiography, Female, Follow-Up Studies, Heart Ventricles diagnostic imaging, Humans, Male, Mitral Valve Insufficiency diagnosis, Mitral Valve Insufficiency surgery, Prognosis, Prosthesis Design, Retrospective Studies, Time Factors, Treatment Outcome, Heart Valve Prosthesis Implantation methods, Heart Ventricles physiopathology, Mitral Valve Insufficiency physiopathology, Registries, Ventricular Function, Left physiology, Ventricular Remodeling physiology
Abstract

Aims: To explore whether left ventricular reverse remodelling (LVRR) is a predictor of outcomes in patients with functional mitral regurgitation (FMR) undergoing MitraClip procedure., Methods and Results: We analysed 184 consecutive patients with FMR who underwent successful MitraClip procedure. LVRR was defined as a reduction in left ventricular end-systolic volume ≥ 10% from baseline to 6 months. LVRR was observed in 79 (42.9%) patients. Compared with non-LVRR, LVRR patients were more likely to be females, less likely to have an ischaemic aetiology of mitral regurgitation or a prior (<6 months) heart failure (HF) hospitalization, and had smaller left ventricular dimensions. New York Heart Association class improved from baseline up to 1-year follow-up in both groups. Higher rates of overall survival (87.3% vs. 75.2%, P = 0.039), freedom from HF hospitalization (77.2% vs. 60%, P = 0.020), and freedom from the composite endpoint (cardiovascular mortality or HF hospitalization) (74.7% vs. 55.2%; P = 0.012) were observed in LVRR vs. non-LVRR patients at 2-year follow-up. LVRR was associated with a significant reduction of the adjusted relative risk of mortality, HF hospitalization and composite endpoint [hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.20-0.96, P = 0.040; HR 0.55; 95% CI 0.32-0.97, P = 0.038; and HR 0.54; 95% CI 0.32-0.92, P = 0.023, respectively]. Female gender, absence of diabetes, freedom from prior HF hospitalization, non-ischaemic aetiology of mitral regurgitation, and left ventricular end-diastolic diameter < 75 mm were found to be independent predictors of LVRR., Conclusions: Left ventricular reverse remodelling is associated with better long-term outcomes in patients with FMR successfully treated with MitraClip. A careful patient selection may be useful as specific baseline features predict favourable left ventricular remodelling. [Correction added on 17 January 2019, after online publication: the preceding sentence has been changed.]., (© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.)

Published
2019
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22. Endovascular treatment of carotid artery stenosis: evidences from randomized controlled trials and actual indications.

Author

Ilardi F, Magliulo F, Gargiulo G, Schiattarella GG, Carotenuto G, Serino F, Ferrone M, Visco E, Scudiero F, Carbone A, Perrino C, Trimarco B, and Esposito G

Subjects
Carotid Stenosis surgery, Clinical Trials as Topic, Humans, Patient Selection, Randomized Controlled Trials as Topic, Stroke prevention & control, Treatment Outcome, Angioplasty, Balloon, Coronary methods, Carotid Stenosis therapy, Endarterectomy, Carotid, Stents
Abstract

Atherosclerotic stenosis of common and internal carotid arteries is a well-recognized risk factor for ischemic stroke, and revascularization has been proven to be the main tool of prevention, particularly for patients with stenosis-related symptoms. While for many years surgical carotid endarterectomy (CEA) has been considered the gold-standard strategy to restore vascular patency, recently the endovascular treatment through percutaneous angioplasty and stent implantation (CAS) has become a valid alternative. In the last years, interesting data about the comparison of these strategies have emerged. CAS seems to cause more peri-procedural strokes, but may also avoid many adverse events related to surgery and general anaesthesia, including peri-procedural myocardial infarction. For these reasons, it was initially considered a second-choice strategy to be adopted in patients for whom surgery was contraindicated. However, more recent trials have shown that CAS might be considered an effective alternative to CEA. Moreover, the rapid evolution of CAS technique and materials suggests its potential to improve outcome and possible superiority compared to CEA in the next future. Purpose of this review is to discuss the most recent clinical evidences concerning the treatment of carotid artery stenosis, with a special focus on the endovascular treatment.

Published
2011
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23. Cerebral autoregulation and CO2 reactivity in anterior and posterior cerebral circulation during sevoflurane anesthesia.

Author

Rozet I, Vavilala MS, Lindley AM, Visco E, Treggiari M, and Lam AM

Subjects
Adult, Basilar Artery, Blood Flow Velocity drug effects, Blood Pressure drug effects, Cerebrovascular Circulation drug effects, Female, Humans, Male, Middle Aged, Middle Cerebral Artery, Phenylephrine pharmacology, Sevoflurane, Ultrasonography, Doppler, Transcranial, Anesthesia, General, Anesthetics, Inhalation pharmacology, Carbon Dioxide physiology, Homeostasis drug effects, Methyl Ethers pharmacology
Abstract

The purpose of the study was to compare cerebral autoregulation (CA) and CO2 reactivity (CO2R) between the anterior and posterior circulation under sevoflurane anesthesia. We studied 9 adult ASA physical status I patients (22-47 yr) scheduled for elective orthopedic surgery. Blood flow velocity in the middle cerebral artery (Vmca) and in the basilar artery (Vba) were measured using transcranial Doppler ultrasonography. For CA testing, arterial blood pressure was increased using phenylephrine infusion. CA was quantified with the autoregulatory index (ARI). CO2R was investigated at PaCO2 of 30 +/- 2.8 mm Hg, 39.4 +/- 2.6 mm Hg, and 48.7 +/- 2.8 mm Hg. Linear regression analysis was used for CO2R. We found ARI was preserved in both arteries: ARImca (middle cerebral artery) = 0.72 +/- 0.2; ARIba (basilar artery) = 0.66 +/- 0.2; P = 0.5. With regard to CO2R, Vmca increased with slope of 1.7 cm/s/mm Hg PaCO2, Vba increased with slope of 1.5 cm/s/mm Hg PaCO2; P = 0.83. Absolute Vmca was higher compared with Vba; P < 0.05. We conclude that in healthy individuals under 0.5 MAC of sevoflurane and small-dose remifentanil: 1) mean flow velocities of BA are less than those of MCA; 2) autoregulation and CO2R are preserved in the basilar artery and are similar to those of MCA.

Published
2006
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24. Cerebral autoregulation in children during sevoflurane anaesthesia.

Author

Vavilala MS, Lee LA, Lee M, Graham A, Visco E, and Lam AM

Subjects
Adolescent, Adult, Aging physiology, Analysis of Variance, Anesthesia, General, Blood Flow Velocity drug effects, Cerebrovascular Circulation physiology, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Cerebral Artery diagnostic imaging, Middle Cerebral Artery physiology, Sevoflurane, Ultrasonography, Doppler, Transcranial, Anesthetics, Inhalation pharmacology, Cerebrovascular Circulation drug effects, Homeostasis drug effects, Methyl Ethers pharmacology
Abstract

Introduction: Little is known about cerebral autoregulation in children. The aim of this study was to examine cerebral autoregulation in children., Methods: Cerebral autoregulation testing was performed during less than 1 MAC sevoflurane anaesthesia in children (from 6 months to 14 yr) and in adults (18-41 yr). Mean middle cerebral artery flow velocities (V(MCA)) were measured using transcranial Doppler ultrasonography. Mean arterial pressure (MAP) was increased to whichever was greater: 20% above baseline or (i) 80 mm Hg for less than 9 yr, (ii) 90 mm Hg for 9-14 yr, and (iii) 100 mm Hg for adults. Cerebral autoregulation was considered intact if the autoregulatory index was > or =0.4., Results: There were 13 subjects less than 2 yr old (Group 1), 13 subjects 2-5 yr (Group II), 14 subjects 6-9 yr (Group III), 12 subjects 10-14 yr (Group IV), and 12 adults (Group V; control group). All subjects had an autoregulatory index > or =0.4. There was no difference in autoregulatory index between children in Groups I-IV or between children and adults., Discussion: We found no age-related differences in autoregulatory capacity during low-dose sevoflurane anaesthesia. We report no differences in autoregulatory capacity between children and adults.

Published
2003
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25. Propofol: relation between brain concentrations, electroencephalogram, middle cerebral artery blood flow velocity, and cerebral oxygen extraction during induction of anesthesia.

Author

Ludbrook GL, Visco E, and Lam AM

Subjects
Adult, Anesthetics, Inhalation metabolism, Anesthetics, Inhalation pharmacology, Blood Flow Velocity drug effects, Female, Humans, Male, Propofol metabolism, Propofol pharmacology, Tissue Distribution, Anesthesia, Inhalation, Anesthetics, Inhalation pharmacokinetics, Brain metabolism, Cerebrovascular Circulation drug effects, Electrocardiography drug effects, Propofol pharmacokinetics
Abstract

Background: The potential benefit of propofol dose regimens that use physiologic pharmacokinetic modeling to target the brain has been demonstrated in animals, but no data are available on the rate of propofol distribution to the brain in humans. This study measured the brain uptake of propofol in humans and the simultaneous effects on electroencephalography, cerebral blood flow velocity (V(mca)), and cerebral oxygen extraction., Methods: Seven subjects had arterial and jugular bulb catheters placed before induction. Electroencephalography and V(mca) were recorded during induction with propofol while blood samples were taken from both catheters for later propofol analysis. Brain uptake of propofol was calculated using mass balance principles, with effect compartment modeling used to quantitate the rate of uptake., Results: Bispectral index (electroencephalogram) values decreased to a minimum value of approximately 4 at around 7 min from the onset of propofol administration and then slowly recovered. This was accompanied by decreases in V(mca), reaching a minimum value of approximately 40% of baseline. Cerebral oxygen extraction did not change, suggesting parallel changes in cerebral metabolism. There was slow equilibrium of propofol between the blood and the brain (t(1/2keo) of 6.5 min), with a close relation between brain concentrations and bispectral index, although with considerable interpatient variability. The majority of the decreases in V(mca), and presumably cerebral metabolism, corresponded with bispectral index values reaching 40-50 and the onset of burst suppression., Conclusion: Description of brain distribution of propofol will allow development of physiologic pharmacokinetic models for propofol and evaluation of dose regimens that target the brain.

Published
2002
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26. Craniotomy procedures are associated with less analgesic requirements than other surgical procedures.

Author

Dunbar PJ, Visco E, and Lam AM

Subjects
Analgesics administration & dosage, Analgesics, Opioid administration & dosage, Analgesics, Opioid therapeutic use, Anesthesia Recovery Period, Anesthetics, Intravenous administration & dosage, Body Weight, Brain surgery, Brain Neoplasms surgery, Consciousness drug effects, Fentanyl administration & dosage, Glasgow Coma Scale, Humans, Intracranial Aneurysm surgery, Intraoperative Care, Laminectomy, Lumbar Vertebrae surgery, Mandible surgery, Maxilla surgery, Morphine administration & dosage, Morphine therapeutic use, Pain Measurement, Postoperative Care, Retrospective Studies, Time Factors, Analgesics therapeutic use, Craniotomy, Pain, Postoperative drug therapy
Abstract

Unlabelled: The conventional wisdom that neurosurgical patients experience minimal postoperative pain and require little analgesia has been challenged. To address this, we reviewed our anesthesia and postanesthesia care unit (PACU) records for 1995 and compared pain management in patients undergoing major intracranial and selected extracranial procedures. We recorded patient weight, operative time, time in the PACU, intraoperative and postoperative opioid use, PACU pain scores, and level of consciousness in patients who had undergone open fixation of mandible or maxilla (Group E), clipping of aneurysms or excision of tumors (Group I), or lumbar laminectomy (Group L). Group I (n = 78) patients received less fentanyl in the operating room (0.016 microg x kg(-1) x min(-1) versus 0.023 microg x kg(-1) x min(-1) for Group E [n = 134] and 0.023 microg x kg(-1) x min(-1) for Group L [n = 21]; P < 0.05), received less morphine in the PACU (0.0004 vs 0.0013 vs 0.0015 mg kg(-1) x min(-1); P < 0.005), reported lower pain scores (0.76 vs 2.5 vs 2.4; P < 0.05), and spent less time in the PACU (89.5 vs 109 vs 105 min; P < 0.05) than Group E or L patients. Our results were similar when only patients with Glasgow Coma Scale scores > or = 14 were used in a subset analysis. We conclude that patients suffer less pain and use fewer opioids in the PACU after intracranial surgery than after facial reconstruction or lumbar laminectomy. Our results confirm that the average craniotomy patient has less postoperative pain than patients who undergo other surgical procedures, although patients who undergo frontal craniotomy may require more aggressive pain management., Implications: This study compares the pain report and analgesic use in patients after intracranial versus extracranial surgery. The results confirm the commonly held but recently challenged belief that neurosurgery patients suffer less pain postoperatively than other patients. In this study, we found that most patients report minimal pain after intracranial surgery but that a small subset of patients, many of whom have undergone frontal craniotomies, require aggressive treatment of postoperative pain.

Published
1999
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