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1. Computed tomography evaluation of diaphragm alterations in 20 critically ill COVID-19 positive patients

Author: Oana Elena Branea, AnaMaria Romina Budeanu, Răzvan Gabriel Budeanu, Adrian Ștefan Chiuzan, Ioana Lăcrămioara Nazaret, Sanda Maria Copotoiu, and Alexandra Elena Lazăr
Subjects: General Pharmacology, Toxicology and Pharmaceutics, General Dentistry
Abstract: Objective: Diaphragmatic dysfunctions are multiple and critical illnesses often lead to the muscular atrophy that affects respiratory and peripheral muscles. The primary objective was to investigate diaphragm thickness in hospitalized patients. Secondary objectives were to assess clinical evolution and outcome. Methods: In a mean time period of 7.9 days, two different chest computed tomographies were used in order to examine diaphragm alterations of right and left diaphragm in 20 critically ill patients tested Real-Time Polymerase Chain Reaction positive to Severe Acute Respiratory Syndrome Coronavirus-2. Patients were divided in two groups (one group Results: Results showed that patients presented low 10 years predicted survival rate (Charlson Comorbidity Index > 7.7±3.08), marked inflammatory status (C-Reactive Protein = 98.22±73.35, Interleukine-6 = 168.31±255.28), high physiologic stress level (Neutrophil/Lymphocyte Ratio = 31.27±30.45), respectively altered acid-base equilibrium. Half of the investigated patients had decrease in diaphragm thickness by at least 5% (right diaphragm = −7.83%±11.11%, left diaphragm = −5.57%±10.63%). There were no statistically significant differences between those with decrease of diaphragm thickness and those without diaphragm thickness, regarding length of stay in Intensive Care Unit and in hospital, inflammatory markers, and acid-base disorders. Conclusions: Patients were admitted in Intensive Care Unit for acute respiratory failure and half of the investigated patients displayed diaphragm alterations at CT scan.
Published: 2022
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2. VEGF-C and podoplanin, as biomarkers of sepsis. An experimental study

Author: Gergo Raduly, Irina Saplacan, Sanda Maria Copotoiu, Janos Szederjesi, Emoke Almasy, Madalina Oprica, Bianca-Liana Grigorescu, Adrian Man, Alexandra Lazar, and Simona Gurzu
Subjects: biology, vascular endothelial growth factor, business.industry, VEGF receptors, lipopolysaccharide, medicine.disease, Sepsis, sepsis, podoplanin, Podoplanin, Cancer research, biology.protein, Medicine, business
Abstract: Background: Sepsis is the leading cause of morbidity and mortality in intensive care units. This study explored the possible role of vascular endothelial growth factor-C (VEGF-C) and podoplanin (PDPN) in sepsis. Methods: 22 Wistar rats were divided into three groups: two experimental (Group A and B, n=8/8) and a control (Group C, n=6). Sepsis was induced with intraperitoneal injection of ESBL (extended-spectrum beta-lactamases)-producing E-coli live bacteria for group A and with lipopolysaccharide for group B. Sterile saline solution was injected for group C. Blood samples were collected after 24 hours to determine the serum level of VEGF-C, and PDPN expression was examined in liver, kidney, and lung tissues. Bacteremia was assessed for group A. Results: Higher serum levels of VEGF-C were found in Group A vs C (p=0.05) and group B vs. C (p=0.004), respectively.VEGF-C was also increased in animals with negative- vs. positive blood cultures from group A (p=0.04) and from group B vs. those with positive blood cultures from group A (p=0.03). High intensity of PDPN tissue expression was observed in the pulmonary alveolocytes from Group A and epithelium of the proximal renal tubules in groups B and C, compared to group A. Conclusions: Circulating VEGF-C can be succesfuly used as a biomarker of sepsis with negative blood cultures and high risk of renal failure, whereas PDPN seems to exert a protective role against lung injuries in live bacteria-induced sepsis.
Published: 2021

3. Musculoskeletal Pain Evaluation: McGill Pain Questionnaire Versus Multidimensional Pain Evaluation Scale

Author: Sanda Maria Copotoiu, Monica Chiş, and Adriana Boţan
Subjects: 030203 arthritis & rheumatology, Musculoskeletal pain, medicine.medical_specialty, Scale (ratio), business.industry, General Medicine, 03 medical and health sciences, 0302 clinical medicine, McGill Pain Questionnaire, Pain evaluation, Physical therapy, Medicine, business, 030217 neurology & neurosurgery
Abstract: The first and most important step in pain management is to correctly assess it. Short-form McGill Pain Questionnaire-2(SF-MPQ-2) and Multidimensional Pain Evaluation Scale (MPES) are valid and reliable tools used in clinical practice and research. Our aim was to evaluate the efficacy of pharmacological and non-pharmacological treatments applied for pain relief. 27 patients were included in the study, of which 12 were outpatients and 15 were inpatients. Statistical and clinical significant differences were obtained only for the inpatient group on the MPES (p=0.00, difference between means=3.07) and for 3 out of 4 domains of the SF-MPQ-2 (p=0.01, 0.01 and 0.00 and the difference between means=2.60, 2.00 and 2.20 for continuous pain, neuropathic pain and affective descriptors, respectively). Outcomes of pain management are better for inpatients due to a combination of analgesic drugs with physical medicine and rehabilitation procedures and a strict monitoring during their hospitalization.
Published: 2020
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4. The Diagnostic and Prognostic Role of Vascular Endothelial Growth Factor C in Sepsis and Septic Shock

Author: Leonard Azamfirei, Valentina Negrea, Cristina Manasturean, Iudita Badea, Janos Szederjesi, Agota-Evelyn Timar, Marius Petrisor, Bianca Liana Grigorescu, Emoke Almasy, Oana Coman, Ario Santini, and Sanda Maria Copotoiu
Subjects: medicine.medical_specialty, Inflammation, vascular endothelial growth factor c, 030204 cardiovascular system & hematology, Gastroenterology, Group B, Sepsis, sepsis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, APACHE II, business.industry, Septic shock, RC86-88.9, Organ dysfunction, 030208 emergency & critical care medicine, Medical emergencies. Critical care. Intensive care. First aid, General Medicine, medicine.disease, lymphangiogenesis, Vascular endothelial growth factor C, Biomarker (medicine), septic shock, medicine.symptom, business, Research Article
Abstract: Introduction Variations in the expression of vascular endothelial growth factor (VEGF) could be used as a biomarker in critically ill patients with sepsis and septic shock. Inflammation potently upregulates VEGF-C expression via macrophages with an unpredictable response. This study aimed to assess one of the newer biomarkers (VEGF-C) in patients with sepsis or septic shock and its clinical value as a diagnostic and prognostic tool. Material and methods The study involved 142 persons divided into three groups. Group A consisted of fifty-eight patients with sepsis; Group B consisted of forty-nine patients diagnosed as having septic shock according to the Sepsis -3 criteria. A control group of thirty-five healthy volunteers comprised Group C. Severity scores, prognostic score and organ dysfunction score, were recorded at the time of enrolment in the study. The analysis included specificity and sensitivity of plasma VEGF-C for diagnosis of septic shock. Circulating plasma VEGF-C levels were correlated with the APACHE II, MODS and severity scores and mortality. Results The mean (SD) plasma VEGF-C levels in septic shock patients (1374(789) pg./m), on vasopressors at the time of admission to the ICU, were significantly higher 1374(789)pg./mL, compared the mean (SD) plasma VEGF-C levels in sepsis patients (934(468) pg./mL); (p = 0.0005, Student’s t-test.) Plasma VEGF-C levels in groups A and B were shown to be significantly correlated with the APACHE II (r = 0.21, p = 0.02; r = 0.45, p = 0.0009) and MODS score (r = 0.29, p = 0.03; r = 0.4, p = 0.003). There was no association between plasma VEGF-C levels and mortality [p = 0.1]. The cut-off value for septic shock was 1010 pg./ml. Conclusions VEGF-C may be used as a prognostic marker in sepsis and septic shock due to its correlation with APACHE II values and as an early marker to determine the likelihood of developing MODS. It could be used as an early biomarker for diagnosing patients with septic shock.
Published: 2020

5. Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

Author: Nijbroek, Sunny G, Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N T, Serpa Neto, Ary, Binnekade, Jan M, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J, Wolfgang Kroell, Helfried Metzler, Gerd Struber, Thomas Wegscheider, Hans Gombotz, Michael Hiesmayr, Werner Schmid, Bernhard Urbanek, David Kahn, Mona Momeni, Audrey Pospiech, Fernande Lois, Patrice Forget, Irina Grosu, Jan Poelaert, Veerle van Mossevelde, Marie-Claire van Malderen, Dimitri Dylst, Jeroen van Melkebeek, Maud Beran, Stefan de Hert, Luc De Baerdemaeker, Bjorn Heyse, Jurgen Van Limmen, Piet Wyffels, Tom Jacobs, Nathalie Roels, Ann De Bruyne, Stijn van de Velde, Brigitte Leva, Sandrine Damster, Benoit Plichon, Marina Juros-Zovko, Dejana Djonoviċ- Omanoviċ, Selma Pernar, Josip Zunic, Petar Miskovic, Antonio Zilic, Slavica Kvolik, Dubravka Ivic, Darija Azenic-Venzera, Sonja Skiljic, Hrvoje Vinkovic, Ivana Oputric, Kazimir Juricic, Vedran Frkovic, Jasminka Kopic, Ivan Mirkovic, Nenad Karanovic, Mladen Carev, Natasa Dropulic, Jadranka Pavicic Saric, Gorjana Erceg, Matea Bogdanovic Dvorscak, Branka Mazul-Sunko, Anna Marija Pavicic, Tanja Goranovic, Branka Maldini, Tomislav Radocaj, Zeljka Gavranovic, Inga Mladic-Batinica, Mirna Sehovic, Petr Stourac, Hana Harazim, Olga Smekalova, Martina Kosinova, Tomas Kolacek, Kamil Hudacek, Michal Drab, Jan Brujevic, Katerina Vitkova, Katerina Jirmanova, Ivana Volfova, Paula Dzurnakova, Katarina Liskova, Radovan Dudas, Radek Filipsky, Samir el Kafraw, Hisham Hosny Abdelwahab, Tarek Metwally, Ahmed Abdel-Razek, Ahmed Mostafa El-Shaarawy, Hany Yassin, Mohamed Magdy, Mahdy Abdelhady, Mohamed Mahran, Eiko Herodes, Peeter Kivik, Juri Oganjan, Annika Aun, Alar Sormus, Kaili Sarapuu, Merilin Mall, Juri Karjagin, Emmanuel Futier, Antoine Petit, Adeline Gerard, Emmanuel Marret, Marc Solier, Samir Jaber, Albert Prades, Jens Krassler, Simone Merzky, Marcel Gama de Abreu, Christopher Uhlig, Thomas Kiss, Anette Bundy, Thomas Bluth, Andreas Gueldner, Peter Spieth, Martin Scharffenberg, Denny Tran Thiem, Thea Koch, Tanja Treschan, Maximilian Schaefer, Bea Bastin, Johann Geib, Martin Weiss, Peter Kienbaum, Benedikt Pannen, Andre Gottschalk, Mirja Konrad, Diana Westerheide, Ben Schwerdtfeger, Hermann Wrigge, Philipp Simon, Andreas Reske, Christian Nestler, Dimitrios Valsamidis, Konstantinos Stroumpoulis, Georgios Antholopoulos, Antonis Andreou, Dimitris Karapanos, Kassiani Theodoraki, Georgios Gkiokas, Marios-Konstantinos Tasoulis, Tatiana Sidiropoulou, Foteini Zafeiropoulou, Panagiota Florou, Aggeliki Pandazi, Georgia Tsaousi, Christos Nouris, Chryssa Pourzitaki, Dmitri Bystritski, Reuven Pizov, Arieh Eden, Caterina Valeria Pesce, Annamaria Campanile, Antonella Marrella, Salvatore Grasso, Michele De Michele, Francesco Bona, Gianmarco Giacoletto, Elena Sardo, Luigi Giancarlo, Vicari Sottosanti, Maurizio Solca, Carlo Alberto Volta, Savino Spadaro, Marco Verri, Riccardo Ragazzi, Roberto Zoppellari, Gilda Cinnella, Pasquale Raimondo, Daniela La Bella, Lucia Mirabella, Davide D'antini, Paolo Pelosi, Alexandre Molin, Iole Brunetti, Angelo Gratarola, Giulia Pellerano, Rosanna Sileo, Stefano Pezzatto, Luca Montagnani, Laura Pasin, Giovanni Landoni, Alberto Zangrillo, Luigi Beretta, Ambra Licia Di Parma, Valentina Tarzia, Roberto Dossi, Marta Eugenia Sassone, Daniele Sances, Stefano Tredici, Gianluca Spano, Gianluca Castellani, Luigi Delunas, Sopio Peradze, Marco Venturino, Ines Arpino, Sara Sher, Concezione Tommasino, Francesca Rapido, Paola Morelli, Maria Vargas, Giuseppe Servillo, Andrea Cortegiani, Santi Maurizio Raineri, Francesca Montalto, Vincenzo Russotto, Antonino Giarratano, Marco Baciarello, Michela Generali, Giorgia Cerati, Yigal Leykin, Filippo Bressan, Vittoria Bartolini, Lucia Zamidei, Luca Brazzi, Corrado Liperi, Gabriele Sales, Laura Pistidda, Paolo Severgnini, Elisa Brugnoni, Giuseppe Musella, Alessandro Bacuzzi, Dalip Muhardri, Gecaj-Gashi Agreta, Fatos Sada, Adem Bytyqi, Aurika Karbonskiene, Ruta Aukstakalniene, Zivile Teberaite, Erika Salciute, Renatas Tikuisis, Povilas Miliauskas, Sipylaite Jurate, Egle Kontrimaviciute, Gabija Tomkute, John Xuereb, Maureen Bezzina, Francis Joseph Borg, Sabrine Hemmes, Marcus Schultz, Markus Hollmann, Irene Wiersma, Christa Boer, Anne Duvekot, Bas in ‘t Veld, Alice Werger, Paul Dennesen, Charlotte Severijns, Jasper De Jong, Jens Hering, Rienk van Beek, Stefan Ivars, Ib Jammer, Alena Breidablik, Katharina Skirstad Hodt, Frode Fjellanger, Manuel Vico Avalos, Jannicke Mellin-Olsen, Elisabeth Andersson, Amir Shafi-Kabir, Ruby Molina, Stanley Wutai, Erick Morais, Glória Tareco, Daniel Ferreira, Joana Amaral, Maria de Lurdes, Goncalves Castro, Susana Cadilha, Sofia Appleton, Suzana Parente, Mariana Correia, Diogo Martins, Angela Monteirosa, Ana Ricardo, Sara Rodrigues, Lucian Horhota, Ioana Marina Grintescu, Liliana Mirea, Ioana Cristina Grintescu, Dan Corneci, Silvius Negoita, Madalina Dutu, Ioana Popescu Garotescu, Daniela Filipescu, Alexandru Bogdan Prodan, Gabriela Droc, Ruxandra Fota, Mihai Popescu, Dana Tomescu, Ana Maria Petcu, Marian Irinel Tudoroiu, Alida Moise, Catalin-Traian Guran, Iorel Gherghina, Dan Costea, Iulia Cindea, Sanda-Maria Copotoiu, Ruxandra Copotoiu, Victoria Barsan, Zsolt Tolcser, Magda Riciu, Septimiu Gheorghe Moldovan, Mihaly Veres, Alexey Gritsan, Tatyana Kapkan, Galina Gritsan, Oleg Korolkov, Alexander Kulikov, Andrey Lubnin, Alexey Ovezov, Pavel Prokoshev, Alexander Lugovoy, Natalia Anipchenko, Andrey Babayants, Irina Komissarova, Karginova Zalina, Valery Likhvantsev, Sergei Fedorov, Aleksandra Lazukic, Jasmina Pejakovic, Dunja Mihajlovic, Zuzana Kusnierikova, Maria Zelinkova, Katarina Bruncakova, Lenka Polakovicova, Villiam Sobona, Barbka Novak-Supe, Ana Pekle-Golez, Miroljub Jovanov, Branka Strazisar, Jasmina Markovic-Bozi, Vesna Novak-Jankovic, Minca Voje, Andriy Grynyuk, Ivan Kostadinov, Alenka Spindler-Vesel, Victoria Moral, Mari Carmen Unzueta, Carlos Puigbo, Josep Fava, Jaume Canet, Enrique Moret, Mónica Rodriguez Nunez, Mar Sendra, Andrea Brunelli, Frederic Rodenas, Pablo Monedero, Francisco Hidalgo Martinez, Maria Jose Yepes Temino, Antonio Martínez Simon, Ana de Abajo Larriba, Alberto Lisi, Gisela Perez, Raquel Martinez, Manuel Granell, Jose Tatay Vivo, Cristina Saiz Ruiz, Jose Antonio de Andrés Ibañez, Ernesto Pastor, Marina Soro, Carlos Ferrando, Mario Defez, Cesar Aldecoa Alvares-Santullano, Rocio Perez, Jesus Rico, Monir Jawad, Yousif Saeed, Lars Gillberg, Zuleyha Kazak Bengisun, Baturay Kansu Kazbek, Nesil Coskunfirat, Neval Boztug, Suat Sanli, Murat Yilmaz, Necmiye Hadimioglu, Nuzhet Mert Senturk, Emre Camci, Semra Kucukgoncu, Zerrin Sungur, Nukhet Sivrikoz, Serpil Ustalar Ozgen, Fevzi Toraman, Onur Selvi, Ozgur Senturk, Mine Yildiz, Bahar Kuvaki, Ferim Gunenc, Semih Kucukguclu, Şule Ozbilgin, Jale Maral, Seyda Canli, Oguzhan Arun, Ali Saltali, Eyup Aydogan, Fatma Nur Akgun, Ceren Sanlikarip, Fatma Mine Karaman, Andriy Mazur, Sergiy Vorotyntsev, Guy Rousseau, Colin Barrett, Lucia Stancombe, Ben Shelley, Helen Scholes, James Limb, Amir Rafi, Lisa Wayman, Jill Deane, David Rogerson, John Williams, Susan Yates, Elaine Rogers, Mark Pulletz, Sarah Moreton, Stephanie Jones, Suresh Venkatesh, Maudrian Burton, Lucy Brown, Cait Goodall, Matthew Rucklidge, Debbie Fuller, Maria Nadolski, Sandeep Kusre, Michael Lundberg, Lynn Everett, Maka Zuleika, Peter Carvalho, Deborah Clements, Ben Creagh-Brown, Philip Watt, Parizade Raymode, Rupert Pearse, Otto Mohr, Ashok Raj, Thais Creary, Ahmed Chishti, Andrea Bell, Charley Higham, Alistair Cain, Sarah Gibb, Stephen Mowat, Danielle Franklin, Claire West, Gary Minto, Nicholas Boyd, Gary Mills, Emily Calton, Rachel Walker, Felicity Mackenzie, Branwen Ellison, Helen Roberts, Moses Chikungwa, Clare Jackson, Andrew Donovan, Jayne Foot, Elizabeth Homan, Jane Montgomery, David Portch, Pauline Mercer, Janet Palmer, Jonathan Paddle, Anna Fouracres, Amanda Datson, Alyson Andrew, Leanne Welch, Alastair Rose, Sandeep Varma, Karen Simeson, Mrutyunjaya Rambhatla, Jaysimha Susarla, Sudhakar Marri, Krishnan Kodaganallur, Ashok Das, Shivarajan Algarsamy, Julie Colley, Simon Davies, Margaret Szewczyk, Thomas Smith, Ana Fernandez- Bustamante, Elizabeth Luzier, Angela Almagro, Marcos Vidal Melo, Luiz Fernando, Demet Sulemanji, Juraj Sprung, Toby Weingarten, Daryl Kor, Federica Scavonetto, Yeo Tze, Nijbroek, Sunny G, Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N T, Serpa Neto, Ary, Binnekade, Jan M, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J,Wolfgang Kroell, Helfried Metzler, Gerd Struber, Thomas Wegscheider, Hans Gombotz, Michael Hiesmayr, Werner Schmid, Bernhard Urbanek, David Kahn, Mona Momeni, Audrey Pospiech, Fernande Lois, Patrice Forget, Irina Grosu, Jan Poelaert, Veerle van Mossevelde, Marie-Claire van Malderen, Dimitri Dylst, Jeroen van Melkebeek, Maud Beran, Stefan de Hert, Luc De Baerdemaeker, Bjorn Heyse, Jurgen Van Limmen, Piet Wyffels, Tom Jacobs, Nathalie Roels, Ann De Bruyne, Stijn van de Velde, Brigitte Leva, Sandrine Damster, Benoit Plichon, Marina Juros-Zovko, Dejana Djonoviċ- Omanoviċ, Selma Pernar, Josip Zunic, Petar Miskovic, Antonio Zilic, Slavica Kvolik, Dubravka Ivic, Darija Azenic-Venzera, Sonja Skiljic, Hrvoje Vinkovic, Ivana Oputric, Kazimir Juricic, Vedran Frkovic, Jasminka Kopic, Ivan Mirkovic, Nenad Karanovic, Mladen Carev, Natasa Dropulic, Jadranka Pavicic Saric, Gorjana Erceg, Matea Bogdanovic Dvorscak, Branka Mazul-Sunko, Anna Marija Pavicic, Tanja Goranovic, Branka Maldini, Tomislav Radocaj, Zeljka Gavranovic, Inga Mladic-Batinica, Mirna Sehovic, Petr Stourac, Hana Harazim, Olga Smekalova, Martina Kosinova, Tomas Kolacek, Kamil Hudacek, Michal Drab, Jan Brujevic, Katerina Vitkova, Katerina Jirmanova, Ivana Volfova, Paula Dzurnakova, Katarina Liskova, Radovan Dudas, Radek Filipsky, Samir el Kafraw, Hisham Hosny Abdelwahab, Tarek Metwally, Ahmed Abdel-Razek, Ahmed Mostafa El-Shaarawy, Hany Yassin, Mohamed Magdy, Mahdy Abdelhady, Mohamed Mahran, Eiko Herodes, Peeter Kivik, Juri Oganjan, Annika Aun, Alar Sormus, Kaili Sarapuu, Merilin Mall, Juri Karjagin, Emmanuel Futier, Antoine Petit, Adeline Gerard, Emmanuel Marret, Marc Solier, Samir Jaber, Albert Prades, Jens Krassler, Simone Merzky, Marcel Gama de Abreu, Christopher Uhlig, Thomas Kiss, Anette Bundy, Thomas Bluth, Andreas Gueldner, Peter Spieth, Martin Scharffenberg, Denny Tran Thiem, Thea Koch, Tanja Treschan, Maximilian Schaefer, Bea Bastin, Johann Geib, Martin Weiss, Peter Kienbaum, Benedikt Pannen, Andre Gottschalk, Mirja Konrad, Diana Westerheide, Ben Schwerdtfeger, Hermann Wrigge, Philipp Simon, Andreas Reske, Christian Nestler, Dimitrios Valsamidis, Konstantinos Stroumpoulis, Georgios Antholopoulos, Antonis Andreou, Dimitris Karapanos, Kassiani Theodoraki, Georgios Gkiokas, Marios-Konstantinos Tasoulis, Tatiana Sidiropoulou, Foteini Zafeiropoulou, Panagiota Florou, Aggeliki Pandazi, Georgia Tsaousi, Christos Nouris, Chryssa Pourzitaki, Dmitri Bystritski, Reuven Pizov, Arieh Eden, Caterina Valeria Pesce, Annamaria Campanile, Antonella Marrella, Salvatore Grasso, Michele De Michele, Francesco Bona, Gianmarco Giacoletto, Elena Sardo, Luigi Giancarlo, Vicari Sottosanti, Maurizio Solca, Carlo Alberto Volta, Savino Spadaro, Marco Verri, Riccardo Ragazzi, Roberto Zoppellari, Gilda Cinnella, Pasquale Raimondo, Daniela La Bella, Lucia Mirabella, Davide D'antini, Paolo Pelosi, Alexandre Molin, Iole Brunetti, Angelo Gratarola, Giulia Pellerano, Rosanna Sileo, Stefano Pezzatto, Luca Montagnani, Laura Pasin, Giovanni Landoni, Alberto Zangrillo, Luigi Beretta, Ambra Licia Di Parma, Valentina Tarzia, Roberto Dossi, Marta Eugenia Sassone, Daniele Sances, Stefano Tredici, Gianluca Spano, Gianluca Castellani, Luigi Delunas, Sopio Peradze, Marco Venturino, Ines Arpino, Sara Sher, Concezione Tommasino, Francesca Rapido, Paola Morelli, Maria Vargas, Giuseppe Servillo, Andrea Cortegiani, Santi Maurizio Raineri, Francesca Montalto, Vincenzo Russotto, Antonino Giarratano, Marco Baciarello, Michela Generali, Giorgia Cerati, Yigal Leykin, Filippo Bressan, Vittoria Bartolini, Lucia Zamidei, Luca Brazzi, Corrado Liperi, Gabriele Sales, Laura Pistidda, Paolo Severgnini, Elisa Brugnoni, Giuseppe Musella, Alessandro Bacuzzi, Dalip Muhardri, Gecaj-Gashi Agreta, Fatos Sada, Adem Bytyqi, Aurika Karbonskiene, Ruta Aukstakalniene, Zivile Teberaite, Erika Salciute, Renatas Tikuisis, Povilas Miliauskas, Sipylaite Jurate, Egle Kontrimaviciute, Gabija Tomkute, John Xuereb, Maureen Bezzina, Francis Joseph Borg, Sabrine Hemmes, Marcus Schultz, Markus Hollmann, Irene Wiersma, Christa Boer, Anne Duvekot, Bas in ‘t Veld, Alice Werger, Paul Dennesen, Charlotte Severijns, Jasper De Jong, Jens Hering, Rienk van Beek, Stefan Ivars, Ib Jammer, Alena Breidablik, Katharina Skirstad Hodt, Frode Fjellanger, Manuel Vico Avalos, Jannicke Mellin-Olsen, Elisabeth Andersson, Amir Shafi-Kabir, Ruby Molina, Stanley Wutai, Erick Morais, Glória Tareco, Daniel Ferreira, Joana Amaral, Maria de Lurdes, Goncalves Castro, Susana Cadilha, Sofia Appleton, Suzana Parente, Mariana Correia, Diogo Martins, Angela Monteirosa, Ana Ricardo, Sara Rodrigues, Lucian Horhota, Ioana Marina Grintescu, Liliana Mirea, Ioana Cristina Grintescu, Dan Corneci, Silvius Negoita, Madalina Dutu, Ioana Popescu Garotescu, Daniela Filipescu, Alexandru Bogdan Prodan, Gabriela Droc, Ruxandra Fota, Mihai Popescu, Dana Tomescu, Ana Maria Petcu, Marian Irinel Tudoroiu, Alida Moise, Catalin-Traian Guran, Iorel Gherghina, Dan Costea, Iulia Cindea, Sanda-Maria Copotoiu, Ruxandra Copotoiu, Victoria Barsan, Zsolt Tolcser, Magda Riciu, Septimiu Gheorghe Moldovan, Mihaly Veres, Alexey Gritsan, Tatyana Kapkan, Galina Gritsan, Oleg Korolkov, Alexander Kulikov, Andrey Lubnin, Alexey Ovezov, Pavel Prokoshev, Alexander Lugovoy, Natalia Anipchenko, Andrey Babayants, Irina Komissarova, Karginova Zalina, Valery Likhvantsev, Sergei Fedorov, Aleksandra Lazukic, Jasmina Pejakovic, Dunja Mihajlovic, Zuzana Kusnierikova, Maria Zelinkova, Katarina Bruncakova, Lenka Polakovicova, Villiam Sobona, Barbka Novak-Supe, Ana Pekle-Golez, Miroljub Jovanov, Branka Strazisar, Jasmina Markovic-Bozi, Vesna Novak-Jankovic, Minca Voje, Andriy Grynyuk, Ivan Kostadinov, Alenka Spindler-Vesel, Victoria Moral, Mari Carmen Unzueta, Carlos Puigbo, Josep Fava, Jaume Canet, Enrique Moret, Mónica Rodriguez Nunez, Mar Sendra, Andrea Brunelli, Frederic Rodenas, Pablo Monedero, Francisco Hidalgo Martinez, Maria Jose Yepes Temino, Antonio Martínez Simon, Ana de Abajo Larriba, Alberto Lisi, Gisela Perez, Raquel Martinez, Manuel Granell, Jose Tatay Vivo, Cristina Saiz Ruiz, Jose Antonio de Andrés Ibañez, Ernesto Pastor, Marina Soro, Carlos Ferrando, Mario Defez, Cesar Aldecoa Alvares-Santullano, Rocio Perez, Jesus Rico, Monir Jawad, Yousif Saeed, Lars Gillberg, Zuleyha Kazak Bengisun, Baturay Kansu Kazbek, Nesil Coskunfirat, Neval Boztug, Suat Sanli, Murat Yilmaz, Necmiye Hadimioglu, Nuzhet Mert Senturk, Emre Camci, Semra Kucukgoncu, Zerrin Sungur, Nukhet Sivrikoz, Serpil Ustalar Ozgen, Fevzi Toraman, Onur Selvi, Ozgur Senturk, Mine Yildiz, Bahar Kuvaki, Ferim Gunenc, Semih Kucukguclu, Şule Ozbilgin, Jale Maral, Seyda Canli, Oguzhan Arun, Ali Saltali, Eyup Aydogan, Fatma Nur Akgun, Ceren Sanlikarip, Fatma Mine Karaman, Andriy Mazur, Sergiy Vorotyntsev, Guy Rousseau, Colin Barrett, Lucia Stancombe, Ben Shelley, Helen Scholes, James Limb, Amir Rafi, Lisa Wayman, Jill Deane, David Rogerson, John Williams, Susan Yates, Elaine Rogers, Mark Pulletz, Sarah Moreton, Stephanie Jones, Suresh Venkatesh, Maudrian Burton, Lucy Brown, Cait Goodall, Matthew Rucklidge, Debbie Fuller, Maria Nadolski, Sandeep Kusre, Michael Lundberg, Lynn Everett, Maka Zuleika, Peter Carvalho, Deborah Clements, Ben Creagh-Brown, Philip Watt, Parizade Raymode, Rupert Pearse, Otto Mohr, Ashok Raj, Thais Creary, Ahmed Chishti, Andrea Bell, Charley Higham, Alistair Cain, Sarah Gibb, Stephen Mowat, Danielle Franklin, Claire West, Gary Minto, Nicholas Boyd, Gary Mills, Emily Calton, Rachel Walker, Felicity Mackenzie, Branwen Ellison, Helen Roberts, Moses Chikungwa, Clare Jackson, Andrew Donovan, Jayne Foot, Elizabeth Homan, Jane Montgomery, David Portch, Pauline Mercer, Janet Palmer, Jonathan Paddle, Anna Fouracres, Amanda Datson, Alyson Andrew, Leanne Welch, Alastair Rose, Sandeep Varma, Karen Simeson, Mrutyunjaya Rambhatla, Jaysimha Susarla, Sudhakar Marri, Krishnan Kodaganallur, Ashok Das, Shivarajan Algarsamy, Julie Colley, Simon Davies, Margaret Szewczyk, Thomas Smith, Ana Fernandez- Bustamante, Elizabeth Luzier, Angela Almagro, Marcos Vidal Melo, Luiz Fernando, Demet Sulemanji, Juraj Sprung, Toby Weingarten, Daryl Kor, Federica Scavonetto, Yeo Tze, Schultz, Marcus, J, Servillo, G, Vargas, M, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Graduate School, AII - Amsterdam institute for Infection and Immunity, Intensive Care Medicine, AII - Inflammatory diseases, ACS - Heart failure & arrhythmias, APH - Quality of Care, ACS - Pulmonary hypertension & thrombosis, APH - Global Health, ACS - Diabetes & metabolism, ACS - Microcirculation, Marcus, J (LAS VEGAS study investigator, the PROVE Network and the Clinical Trial Network of the European Society of, Anaesthesiology), Zangrillo, A, Beretta, L, and Landoni, G
Subjects: Adult, Male, medicine.medical_specialty, Intra operative, health care facilities, manpower, and services, [SDV]Life Sciences [q-bio], Critical Illness, Las Vegas Study, Article, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Internal medicine, Tidal Volume, medicine, Humans, General anaesthesia, Lung, Tidal volume, Female, Respiration, Artificial, Sex Characteristics, Las vegas, business.industry, Respiration, respiratory failure, sex, respiratory system, Sex difference, respiratory tract diseases, Anesthesiology and Pain Medicine, 030228 respiratory system, Relative risk, Artificial, Cohort, Breathing, Observational study, business, intra-operative tidal volume, circulatory and respiratory physiology
Abstract: BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (V(T)). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as V(T) of 8 ml kg(−1) or less predicted bodyweight (PBW). A V(T) was deemed ‘default’ if the set V(T) was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default V(T) was often set, both in women and men; mode V(T) was 500 ml. Median [IQR] V(T) was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg(−1) PBW, P*** < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P*** < 0.001]. In the mediation analysis, patients’ height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default V(T). CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher V(T) than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV. TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223
Published: 2021
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6. Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

Author: Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Martus, Peter, Laufenberg, Rita, Ferner, Marion, Schuster, Michael, Strys, Lydia, Mauff, Susanne, Skitek, Kornel, Zielinska-Skitek, Ewa, Schittek, Gregor, Hoeft, Andreas, Fleischer, Andreas, Matot, Idit, Wittmann, Maria, Kessler, Florian, Rohner, Anne, Kranke, Peter, Wunder, Christian, Jokinen, Johanna, Budow, Kristin, Prasser, Christopher, Werner, Eva, Balandin, Alina, Meier, Jens, Ahrens, Norbert, Zacharowski, Kai, Meybohm, Patrick, Theodoraki, Kassiani, Giokas, George, Marios-Konstantinos, Tasoulis, Pandazi, Ageliki, Kyttari, Aikaterini, Koursoumi, Eygenia, Anthopoulos, Georgios, Unterrainer, Axel, Andreou, Antonis, Rantis, Athanasios, Valsamidis, Dimitrios, Klimi, Pelagia, Katsanoulas, Konstantinos, Korfiotis, Demetrios, Soumelidis, Christos, Papaspyros, Fotios, Kiskira, Olga, Paraskeuopoulos, Tilemachos, Adelmann, Dieter, Buggy, Donal, Kelleher, Mortimer, Coghlan, Liz, Verenkin, Vladimir, Cattan, Anat, Bona, Francesco, Debernardi, Felicino, Cortegiani, Andrea, Raineri, Santi Maurizio, Accurso, Giuseppe, von Langen, Daniel, Gramigni, Elena, Cenni, Leonardo, Campiglia, Laura, Lorenzi, Irene, Militello, Maria Grazia, Biscioni, Tamara, Macas, Andrius, Apanaviciute, Daiva, Trepenaitis, Darius, Gelmanas, Arunas, Innerhofer, Petra, Bilshiene, Diana, Sipylaite, Jurate, Tomkute, Gabija, Kontrimaviciut, Egle, Tikuisis, Renatas, Borg, Francis, Chesov, Ion, Cobiletchi, Serghei, Moghildea, Victoria, Verdouw, Bas, Innerhofer-Pompernigg, Nicole, van Poorten, J. F., van Dasselaar, Nick, Lance, Marcus Daniel, de Waal, Britta, Kropman, Lucienne, van Noord, Peter, Preckel, Benedikt, Koers, Lena, Hollmann, Markus W., Baumann, Holger, De Hert, Stefan, Koopman-van Gemert, Ankie W. M. M., Reikvam, Tore, Hervig, Tore, Berthelsen, Kasper Gymoese, Sørvoll, Ingvild Hausberg, Czuczwar, Mirosław, Borys, Michał, Piwowarczyk, Paweł, Parente, Suzana, Martins, Diogo, De Baerdemaeker, Luc, Tareco, Gloria, Reis, Ligia, Amaral, Joana, Ferreira, Daniel, Gonçalves Aguiar, José Manuel, Moreira, Zélia, Lagarto, Filipa, Pereira, Filipa, Miranda, Maria Lina, Serra, Sofia, van Limmen, Jurgen, Carrilho, Alexandre, Pinto, José, Dias, Sandra, Poeria, Rita, Linda, Filipe, Pica, Silvia, Martinho, Helder, Matias, Francisco, Alves, Claudia, Almeida, Valentina, Wyffels, Piet, Marques, Margarida, Martires, Emilia, Gomes, Piedade, Pereira, Elizabete, Jesus, Joana, Carreira, Claudia, Seco, Carlos, Bento, Carlos, Vieira, Helena, Pereira, Luciane, Heyse, Björn, Pinto, Fernando, Silva, Luisa, Azenha, Marta, Zarif, Maged, Bernardino, Ana, Raimundo, Ana, Lopes, Ana, Fernandes, Melissa, Campos, Beatriz, Macedo, Ana, Vanderlaenen, Margot, Pinheiro, Filipe, Duarte, Sonia, Saraiva, Alexandra, Real, Catia, Paunescu, Marilena Alina, Bogdan Prodan, Alexandru, Stefan, Mihai, Boros, Cristian, Tifrea, Marius, Dragan, Anca, Beran, Maud, Lucian, Horhota, Moise, Alida, Arion-Balescu, Carmen, Mincu, Natalia, Gherghina, Viorel, Cindea, Iulia, Costea, Dan, Popescu, Ravzan, Tomescu, Dana, Scarlatescu, Ecaterina, Kahn, David, Calancea, Esenia, Copotoiu, Ruxandra, Copotoiu, Sanda Maria, Barsan, Victoria, Corneci, Dan, Manolescu, Rely, Diana, Toma, Nitu, Denisa, Popica, Georgian, Droc, Gabriela, Prospiech, Audrey, Jipa Lavina, Nicoleta, Ciobanasu, Roxana, Munteanu, Anna Maria, Anastase, Denisa, Grintescu, Iona, Mirea, Liliana, Manoleli, Alexandra, Elena, Ciobanu, Lupu, Mary Nicoleta, Sandu, Madalina Nina, Jamaer, Luc, Bacalbasa, Bicolae, Calarasu, Florenta, Grytsan, Alexey, Gasenkampf, Andrey, Kulikov, Alexander, Shmigelsky, Alexander, Nescovic, Vojislava, Vukovic, Rade, Petrovic, Uros, Veljovic, Milic, Mulders, Freya, Unic-Stojanovic, Dragana, Jovanovic, Gordana, Kvrgic, Ivana, Rakic, Dragana, Záhorec, Roman, Cintula, Daniel, Veselovsky, Tomas, Galkova, Katarina, Stevikova, Jordana, Číková, Andrea, Jacobs, Stefan, Flassikova, Zora, Dobisova, Anna, Markovic Bozic, Jasmina, Voje, Minca, Grynyuk, Andriy, Spindler Yesel, Alenka, Stivan, Sabina, Poredos, Peter, Kasnik, Darja, Uranjek, Jasna, Baeten, Wannes, Ferrandis, Raquel, Machado, Sofia, Henao, Liliana, Moreno, Tania, Izquierdo, Ana, Delgado, Carlos, Camps, Angela, Manrique, Susana, Arbelaez, Alejandro, Tormos, Pilar, Platteau, Sofie, Serrano, Helena, Garcia, Irene, Bisbe Vives, Elvira, Moltó, Luís, Villar, Tania, Moret, Enrique, Tolós, Raquel, Martínez, Esther, Basora, Misericordia, Tena, Beatriz, Maquoi, Isabelle, Pujol, Roger, Vera Bella, Jorge, Mallor, Thomas, Mondero, Pablo, Lopez, Luis, Hidalgo, Francisco, Bermudez Lopez, Maria, Velasco, Ana, Bascuas, Begona, Moral, Victoria, Lauwick, Severine, Gómez Martinez, Diana, Merten, Alfredo, Fernández, J. A., Kinast, Nadia Diana, Font, A., Genaro, Maggi, Guasch, Emilia, Gilsanz, Fernando, Martinez, Raul, Schiraldi, Renato, Senard, Marc, Martinez, Ever, Barquero López, Marta, Lopez Alvarez, Alexo, Sanchez Sanchez, Yvan Enrique, Roman Fernandez, Adriana, Varela Garcia, Olalla, Orallo Moran, Marian Angeles, Gonzalez Monzon, Veronica, Sánchez López, Óscar, Sanchez Perez, David, Ninane, Vincent, Molano Diaz, Pablo, Cassinello, Concepcion, Pilar Jubera, Maria, Soler Pedrola, Maria, Belmonte Cuenca, Julio, Söndergaard, Sören, Rudolph, Till, Åkeröy, Kristin, Jawad, Monir, Saeed, Yousif, Lecoq, Jean-Pierre, Safonov, Sergej, Andersson, Mona, Wernerman, Jan, Odeberg-Wernerman, Suzanne, Blom, Tommi, Deger Coskunfirat, Nesil, Bigat, Zekiye, Sanlı, Suat, Coskunfirat, O. Koray, Ramazanoğlu, Atilla, Boveroux, Pierre, Boztug Uz, Neval, Camci, Ali Emre, Aksoy, Omur, Saka, Esra, Arun, Oguzhan, Ozkardesler, Sevda, Omur, Dilek, Akan, Mert, Bengisun, Zuleyha Kazak, Yılmaz, Hakan, Hans, Grégory, Ekmekci, Perihan, Selvi, Onur, Alkis, Neslihan, Yıldırım, Çiğdem, Ceyda Meço, Başak, Alanoğlu, Zekeriyye, Vorotyntsev, Sergiy, Yakymenko, Yevgen, Troyan, Galina, Alousi, Mohammed, Vercauteren, Marcel, James, Sarah, Meale, Paula, Chishti, Ahmed, Garner, Matt, Singh, Rita, Hirschauer, Nicola, Higham, Charley, Bell, Andrea, Cain, Alistair, Perry, Chris, Leva, Brigitte, Davies, Katy, Leech, Claire, Calder, Verity, Jhanji, Shaman, Sandeep, Varma, Simeson, Karen, Watt, Philip, Dunk, Nigel, Ferrie, Rosemary, Wright, Margaret, Plichon, Benoit, Everett, Lynn, Ferguson, Andrew, Espie, Laura, Browne, Gail, Dickinson, Matthew, Nair, Ashok, Clements, Deborah, Carvalho, Peter, Collyer, Thomas, Bolten, Jens, Vujanovič, Vojislav, Zsisku, Lajos, Petri, Attila, Ramadan, Mohammed, Ellimah, Tracey, Suljevic, Ismet, Kelle, Hened, Gustin, Denis, Bogdanovic Dvorscak, Matea, Lupis, Tamara, Pavičić Šarić, Jadranka, Paklar, Nataša, Oberhofer, Dagmar, Skok, Ira, Kirigin, Borana, Visnja, Ikic, Kresic, Marina, Kvolik, Slavica, Krobot, Renatas, Cerny, Vladimir, Striteska, Jana, Bilska, Marcela, Filipescu, Daniela, Štourač, Petr, Harazim, Hana, Smékalová, Olga, Kosinová, Martina, Klučka, Jozef, Pacasová, Rita, Ekelund, Kim, Rätsep, Indrek, Oganjan, Juri, Smirnova, Nadezda, Kozek-Langenecker, Sibylle, Kivik, Peeter, Karjagin, Juri, Rokk, Alar, Sõrmus, Alar, Rozec, Bertrand, Rigal, Jean-Christophe, Gouraud, Jean-Pierre, Chupin, Anne-Marie, Ambrosi, Xavier, Brisard, Laurent, Llau Pitarch, Juan V., Decagny, Sylvie, Samama, Charles Marc, Lidzborski, Lionel, Boisson, Matthieu, Arcade, Anne-Laure, Lorre, Gilbert, Rosenberger, Peter, Merz, Hannah, Goebel, Ulrich, Schnitter, Bettina, Mallett, Susan, Buerkle, Hartmut, Tomasi, Roland, von Dossow-Hanfstingl, Vera, Brettner, Florian, Bayer, Andreas, Gottschalk, André, Jakobs, Nicolas, Coburn, Mark, Kowark, Ana, Rossaint, Rolf, Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Anesthesiology, ACS - Diabetes & metabolism, APH - Quality of Care, ACS - Heart failure & arrhythmias, APH - Global Health, and ACS - Microcirculation
Subjects: Clinical Oncology, Male, Science, Clinical Decision-Making, Cancer Treatment, Surgical and Invasive Medical Procedures, Geographical Locations, Diagnostic Medicine, Outcome Assessment, Health Care, Medicine and Health Sciences, Humans, Blood Transfusion, Prospective Studies, Aged, Aged, 80 and over, Intraoperative Care, Multidisciplinary, Transfusion Medicine, Anemia, Hematology, Clinical Laboratory Sciences, Health Care, Europe, Surgical Oncology, Oncology, Age Groups, Elective Surgical Procedures, People and Places, Medicine, Population Groupings, Female, Geriatric Care, Clinical Medicine, Erythrocyte Transfusion, Research Article
Abstract: PLOS ONE 17(1), e0262110 (2022). doi:10.1371/journal.pone.0262110, Published by PLOS, San Francisco, California, US
Published: 2022
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7. Going the Full Circle: Upgrading the Patient Field Chart and Tag for Electronic Mass Casualty Incidents Solutions in Romania

Author: Adrian Stănescu, Sanda Maria Copotoiu, and Cristian Boeriu
Subjects: triage tag, business.industry, Field (Bourdieu), dynamic triage, 030208 emergency & critical care medicine, medicine.disease, patient field chart, 03 medical and health sciences, Mass-casualty incident, 0302 clinical medicine, Chart, Medicine, 030212 general & internal medicine, Medical emergency, General Pharmacology, Toxicology and Pharmaceutics, business, electronic management, General Dentistry, mass casualty incidents
Abstract: Objective: Mass casualty incidents and disasters require functional and efficient patient data management systems, as well as smart interconnections with patient tracking applications. Various initiatives developed and tested patient field charts for large-scale events but there is no one definite general format accepted. The current research proposes an upgraded model of the official patient field chart issued by the Romanian Department for Emergency Situations in 2015 to be used for large-scale events. Measures: An upgraded model is created after a thorough content analysis, physical analysis, design upgrade and optimization process. Differences between the official and the upgraded model are measured and compared, and statistical computations are carried out. Results: The main distinctive features of the patient field chart are dynamic triage, unique code identification, QR visual codes, wireless tags and irreversible clear contamination status highlighting. The upgrade process results in almost doubling the available active area without the need to change the document size format of the product. Visual elements and features are included to optimize operation workflow. Conclusions: The upgraded model offers a variety of improvements for both the overall rescue effort as well as the end user of the product. It allows for previously unavailable features like unlimited dynamic triage and enables the use of electronic management solutions.
Published: 2018

8. Ultrasonography: New Insights in its Applicability to Explore Muscle Mass and Musculoskeletal Inflammation in Critically ill Patients

Author: Anamaria Romina Jugariu, Sanda Maria Copotoiu, Oana-Elena Branea, Monica Copotoiu, and Razvan-Gabriel Budeanu
Subjects: medicine.medical_specialty, business.industry, Critically ill, critically ill patients, Inflammation, ultrasonography, Muscle mass, sarcopenia, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, low muscle mass, medicine, Medicine, 030212 general & internal medicine, sense organs, General Pharmacology, Toxicology and Pharmaceutics, Ultrasonography, medicine.symptom, Intensive care medicine, business, skin and connective tissue diseases, General Dentistry
Abstract: Objective: The main aim of the study was to explore muscle mass changes and to investigate musculoskeletal inflammation in critically ill patients. Methods: A pure observational study that comprised two musculoskeletal analyses was conducted. Ultrasonography was used to determine the inflammatory process and muscle mass modifications. We assessed the presence of musculoskeletal inflammation and muscles area reduction. We recruited 26 patients and we performed both imaging investigations (shoulder and hip joints, biceps brachii and rectus femoris areas) and anthropometric measurements (mid-upper arm circumference). Results: More than 70% of patients were classified with low muscle mass, over one half of sarcopenic patients being over-weight and 17% being obese. The relationship between the length of stay in intensive care unit, mechanical ventilation and presence of low mid-upper arm circumference, highlighted a significant difference when comparing sarcopenic and non-sarcopenic groups. Musculoskeletal inflammation expressed by step-down lesions, calcifications and osteophytes, is common in these patients. Statistically significant results were obtained when comparing the dimensions of the investigated muscles. Good inter-observer variability in day 3 of assessment for biceps brachii and rectus femoris was noticed. Conclusions: More than 1/3 of critically ill patients included in the present study was classified with low muscle mass. The length of stay in intensive care unit and the length of mechanical ventilation had an important impact on sarcopenic patients. Musculoskeletal impairment was frequent, reflected by presence of enthesitis lesions in joints and by dynamic reduction of muscle area.
Published: 2018

9. Platelets and Infections

Author: Daniel – Emil Albu, Sanda Maria Copotoiu, Monica Copotoiu, and Peter Szmuk
Subjects: 0301 basic medicine, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Biochemistry, business.industry, Medicine, Platelet, 030204 cardiovascular system & hematology, business
Published: 2018
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10. Improving Clinical Performance of an Interprofessional Emergency Medical Team through a One-day Crisis Resource Management Training

Author: Marius Petrisor, Cristian Boeriu, Teodora Sorana Truta, Marc Lazarovici, Sanda Maria Copotoiu, and Irina Ban
Subjects: emergency department, education, Training (civil), Crisis resource management, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Health care, medicine, 030212 general & internal medicine, crisis resource management, Team composition, training, business.industry, RC86-88.9, Debriefing, 030208 emergency & critical care medicine, Medical emergencies. Critical care. Intensive care. First aid, General Medicine, Emergency department, medicine.disease, interprofessional, Checklist, clinical performance, Medical emergency, business, Research Article
Abstract: Introduction: Errors are frequent in health care and Emergency Departments are one of the riskiest areas due to frequent changes of team composition, complexity and variety of the cases and difficulties encountered in managing multiple patients. As the majority of clinical errors are the results of human factors and not technical in nature or due to the lack of knowledge, a training focused on these factors appears to be necessary. Crisis resource management (CRM), a tool that was developed initially by the aviation industry and then adopted by different medical specialties as anesthesia and emergency medicine, has been associated with decreased error rates. The aim of the study: To assess whether a single day CRM training, combining didactic and simulation sessions, improves the clinical performance of an interprofessional emergency medical team. Material and Methods: Seventy health professionals with different qualifications, working in an emergency department, were enrolled in the study. Twenty individual interprofessional teams were created. Each team was assessed before and after the training, through two in situ simulated exercises. The exercises were videotaped and were evaluated by two assessors who were blinded as to whether it was the initial or the final exercise. Objective measurement of clinical team performance was performed using a checklist that was designed for each scenario and included essential assessment items for the diagnosis and treatment of a critical patient, with the focus on key actions and decisions. The intervention consisted of a one-day training, combining didactic and simulation sessions, followed by instructor facilitated debriefing. All participants went through this training after the initial assessment exercises. Results: An improvement was seen in most of the measured clinical parameters. Conclusion: Our study supports the use of combined CRM training for improving the clinical performance of an interprofessional emergency team. Empirically this may improve the patient outcome.
Published: 2018

11. Impact of a One Day Crisis Resource Management Training on the Work Satisfaction among Emergency Department Healthcare Staff

Author: Teodora Sorana Truta, Diana Aniela Moldovan, Marius Petrisor, Cristian Boeriu, Sanda Maria Copotoiu, and Irina Ban
Subjects: training, ComputingMilieux_THECOMPUTINGPROFESSION, business.industry, education, 030208 emergency & critical care medicine, Emergency department, medicine.disease, Training (civil), Crisis resource management, 03 medical and health sciences, 0302 clinical medicine, Health care, Medicine, Job satisfaction, 030212 general & internal medicine, Medical emergency, General Pharmacology, Toxicology and Pharmaceutics, work satisfaction, business, crisis resource management, General Dentistry
Abstract: Objective: To evaluate the impact of a single day Crisis Resource Management (CRM) oriented team training, combining didactic and simulation sessions, on work satisfaction of the healthcare staff working in an Emergency Department. Methods: Seventy health professionals with different qualifications, working in an emergency department, were enrolled in the study. After enrollment, participants were asked to complete a work satisfaction questionnaire and to choose a day for the training session according to their availability. Each training session took place in the simulation center and consisted of several elements: didactic session and simulation session, followed by instructor facilitated debriefing. The lecture was focused on medical errors and CRM principles. Two months after, they were asked to complete again the work satisfaction questionnaire. Results: There were no significant improvements on the items evaluated through the work satisfaction questionnaire for none of the professional categories involved, except for ‘the possibility to refer the patient to a specialist whenever was considered necessary’ for the doctors. Improvements were seen for the same professional category on the following items: workload, leisure time, level of stress at work, time and energy spent on administrative tasks. Conclusions: The findings of this study do not support the effectiveness of a single day CRM training as a tool to improve the work satisfaction among medical staff in ED. Further research is necessary.
Published: 2018
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12. Moving Toward a Universal Digital Era in Mass Casualty Incidents and Disasters: Emergency Personnel's Perspective in Romania

Author: Peter Eliot Gordon, Sanda Maria Copotoiu, Adrian Stănescu, and Cristian Boeriu
Subjects: Adult, Male, Telemedicine, 020205 medical informatics, Attitude of Health Personnel, Poison control, Disaster Planning, Health Informatics, 02 engineering and technology, Suicide prevention, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Health Information Management, Injury prevention, 0202 electrical engineering, electronic engineering, information engineering, medicine, Electronic Health Records, Humans, Mass Casualty Incidents, 030212 general & internal medicine, Romania, business.industry, Communication, Information technology, Human factors and ergonomics, General Medicine, medicine.disease, Mass-casualty incident, Female, Medical emergency, business, Information Systems
Abstract: Despite a recognized need for improved communications and logistics in high acuity situations, the integration of telemedicine services into the mainstream health services has been difficult. This study reports on the opinions of Romanian professional responders to mass casualty incidents and disasters regarding the use and requirements of specific electronic medical documentation solutions.Doctors, nurses, paramedics, and fire department officers participated in a customized online structured questionnaire. To assess factors associated with the current use of information technology and the willingness to adopt an exclusive optimized electronic system, a multivariate analysis was performed. Logistic regression was used for free input key elements regarding the most useful technical and operative improvements and medical documentation solutions for large-scale events.A total of 536 respondents provided answers between the second half of the year 2014 and the first half of the year 2015. Doctors and nurses were the most frequent users of documentation techniques, especially if they were employed at a high-level emergency care center. Professionals' duties were perceived as increasingly impaired by the use of current electronic systems as those duties became more complex. All respondents favored an optimized large-scale event electronic solution, emphasizing the need for enhanced communications, technical equipment, cooperation, and workflow mainly by integrating mobile devices, dedicated software, remote databases, and interlink capabilities.Professionals support the implementation of an integrated electronic system for large-scale events if outlined requirements are met to maximize user acceptance.
Published: 2018
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13. Training in cardiopulmonary resuscitation provided by medical students, residents and specialists: A non-inferiority trial

Author: Natalia Hagău, Sanda Maria Copotoiu, Theodor Boț, Loredana Fărcaș, and Dan Sebastian Dîrzu
Subjects: Health professionals, business.industry, medicine.medical_treatment, education, 030208 emergency & critical care medicine, 030204 cardiovascular system & hematology, 03 medical and health sciences, School teachers, 0302 clinical medicine, Nursing, Emergency Medicine, medicine, Non inferiority trial, Cardiopulmonary resuscitation, business
Abstract: Introduction: No definitive answer has been given to the question ‘who should teach cardiopulmonary resuscitation?’ Healthcare professionals and high school teachers are mostly the trainers, but medical students are increasingly being used for this purpose. Methods: We divided 296 high school students in three groups based on trainer professional level. Medical students, anaesthesia and intensive care residents, and anaesthesia and intensive care specialists provided basic life support training. We tested their theoretical knowledge with the help of a multiple-choice question questionnaire and practical abilities with the help of a medical simulator, recording chest compression frequency as the primary outcome parameter. Results: The study shows comparable results in all groups, with the exception of the chest compression frequency which was higher in the students’ and residents’ groups (students: 134.7/min ± 14.1; residents: 137.9/min ± 15.9; specialists: 126.3/min ± 19.3). Increased rates were not associated with lower depths (39.0 mm ± 8.2, 40.5 mm ± 9.7, and 38.1 mm ± 8.2), so the quality of compressions provided may be seen as equivalent in all the study groups. Conclusion: Our data suggest that medical students may be as effective as anaesthesia and intensive care specialists and residents in cardiopulmonary resuscitation training.
Published: 2017
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14. Critical care admission following elective surgery was not associated with survival benefit

Author: Kahan, Brennan C., Desponia, Koulenti, Kostoula, Arvaniti, Vanessa, Beavis, Douglas, Campbell, Matthew, Chan, Rui, Moreno, Pearse, Rupert M., Scott, Beattie, Pierre-Alain, Clavien, Nicolas, Demartines, Lee, A Fleisher, Mike, Grocott, James, Haddow, Andreas, Hoeft, Peter, Holt, Naomi, Pritchard, Andrew, Rhodes, Duminda, Wijeysundera, Matt, Wilson, Tahania, Ahmed, Kirsty, Everingham, Russell, Hewson, Marta, Januszewska, Rupert, M Pearse, Mandeep-Kaur, Phull, Richard, Halliwell, Mark, Shulman, Paul, Myles, Werner, Schmid, Michael, Hiesmayr, Patrick, Wouters, Stefan de Hert, Suzana, Lobo, Xiangming, Fang, Lars, Rasmussen, Emmanuel, Futier, Matthieu, Biais, Aurélien, Venara, Karem, Slim, Michael, Sander, Despoina, Koulenti, Mathew, Chan, Atul, Kulkarni, Susilo, Chandra, Aida, Tantri, Emad, Geddoa, Muntadhar, Abbas, Giorgio Della Rocca, Datin, Sivasakthi, Marzida, Mansor, Pastor, Luna, Arthur, Bouwman, Wolfgang, Buhre, Tim, Short, Tunde, Osinaike, Ricardo, Matos, Ioana, Grigoras, Mikhail, Kirov, Denis, Protsenko, Bruce, Biccard, Cesar, Aldecoa, Michelle, Chew, Christoph, Hofer, Martin, Hubner, James, Ditai, Tamas, Szakmany, Lee, Fleisher, Marissa, Ferguson, Michael, Macmahon, Ritchie, Cherian, Helen, Currow, Kathirgamanathan, Kanathiban, David, Gillespie, Edward, Pathmanathan, Katherine, Phillips, Jenifer, Reynolds, Joanne, Rowley, Jeanene, Douglas, Ross, Kerridge, Sameer, Garg, Michael, Bennett, Megha, Jain, David, Alcock, Nico, Terblanche, Rochelle, Cotter, Kate, Leslie, Marcelle, Stewart, Nicolette, Zingerle, Antony, Clyde, Oliver, Hambidge, Adam, Rehak, Sharon, Cotterell, Wilson Binh Quan Huynh, Timothy, Mcculloch, Erez, Ben-Menachem, Thomas, Egan, Jennifer, Cope, Paul, Fellinger, Simone, Haselberger, Caroline, Holaubek, Paul, Lichtenegger, Florian, Scherz, Franz, Hoffer, Veronika, Cakova, Andreas, Eichwalder, Norbert, Fischbach, Reinhold, Klug, Elisabeth, Schneider, Martin, Vesely, Reinhart, Wickenhauser, Karl Gernot Grubmueller, Marion, Leitgeb, Friedrich, Lang, Nancy, Toro, Marlene, Bauer, Friedrich, Laengle, Thomas, Mayrhofer, Christian, Buerkle, Karin, Forstner, Reinhard, Germann, Harald, Rinoesl, Elke, Schindler, Ernst, Trampitsch, Gerhard, Fritsch, Christian, Szabo, Jawad, Bidgoli, Hans, Verdoodt, Patrice, Forget, David, Kahn, Fernande, Lois, Mona, Momeni, Caroline, Prégardien, Audrey, Pospiech, Arnaud, Steyaert, Laurent, Veevaete, Dirk De Kegel, Karen De Jongh, Luc, Foubert, Carine, Smitz, Marcel, Vercauteren, Jan, Poelaert, Veerle Van Mossevelde, Jacques, Abeloos, Stefaan, Bouchez, Marc, Coppens, Luc De Baerdemaeker, Isabel, Deblaere, Ann De Bruyne, Stefan De Hert, Kristine, Fonck, Bjorn, Heyse, Tom, Jacobs, Koen, Lapage, Anneliese, Moerman, Martine, Neckebroek, Aliaksandra, Parashchanka, Nathalie, Roels, Nancy Van Den Eynde, Michael, Vandenheuvel, Jurgen Van Limmen, Ann, Vanluchene, Caroline, Vanpeteghem, Piet, Wyffels, Christel, Huygens, Punitha, Vandenbempt, Marc Van de Velde, Dimitri, Dylst, Bruno, Janssen, Evelien, Schreurs, Fábia Berganton Aleixo, Keulle, Candido, Hugo Dias Batista, Mario, Guimarães, Jaqueline, Guizeline, João, Hoffmann, Suzana, M Lobo, Francisco Ricardo Lobo, Vinícius, Nascimento, Katia, Nishiyama, Lucas, Pazetto, Daniela, Souza, Rodrigo Souza Rodrigues, Ana Maria Vilela Dos Santos, Jaquelline, Jardim, Joao, Silva, Paulo do Nascimento Junior, Thalissa Hermínia Baio, Gabriel Isaac Pereira de Castro, Henri Roger Watanabe Oliveira, Cristina Prata Amendola, Gutemberg, Cardoso, Daniela, Ortega, Ana Flavia Brotto, Mirella Cristine De Oliveira, Álvaro, Réa-Neto, Fernando, Dias, Pedro, Azambuja, Marcos Freitas Knibel, Antonio, Martins, William, Almeida, Calim Neder Neto, Maria Angela Tardelli, Eliana, Caser, Marcio, Machado, Crisitiano, Aguzzoli, Sérgio, Baldisserotto, Fernanda Beck Tabajara, Fernanda, Bettega, La Hore Correa Rodrigues Júnior, Julia de Gasperi, Lais, Faina, Marcos Farias Nolasco, Bruna Ferreira da Costa Fischer, Mariana Fosch de Campos Ferreira, Cristina, Hartmann, Marta, Kliemann, Gustavo Luis Hubert Ribeiro, Julia Merladete Fraga, Thiago Motta Netto, Laura Valduga Pozza, Paulo Rafael Wendling, Caroline, Azevedo, Juliana, Garcia, Marcel, Lopes, Bernardo, Maia, Paula, Maselli, Ralph, Melo, Weslley, Mendes, Matheus, Neves, Jacqueline, Ney, Claudio, Piras, Christopher, Applewhaite, Adrienne, Carr, Lorraine, Chow, Kaylene, Duttchen, Julena, Foglia, Michael, Greene, Ashley, Hinther, Kendra, Houston, Thomas Jared McCormick, Jennifer, Mikhayel, Sam, Montasser, Alex, Ragan, Andrew, Suen, Adrianna, Woolsey, Hai Chuan Yu, Duane, Funk, Stephen, Kowalski, Regina, Legaspi, Heather, Mcdonald, Faisal, Siddiqui, Jeremy, Pridham, Bernadette, Rowe, Sonia, Sampson, Barton, Thiessen, Geoff, Zbitnew, Andre, Bernard, Ronald, George, Philip, Jones, Rita, Moor, Naveed, Siddiqui, Alexandra, Wolfer, Diem, Tran, Denyse, Winch, Gary, Dobson, Thomas, Mccormick, Osama, Montasser, Richard, Hall, Leyla, Baghirzada, Si Yuan Dai, Gregory, Hare, Esther, Lee, Uma, Shastri, Albert, Tsui, Anmol, Yagnik, Danielle, Alvares, Stephen, Choi, Heather, Dwyer, Kathrina, Flores, Colin, Mccartney, Priya, Somascanthan, Carroll, Jo, Janneth, Pazmino-Canizares, Noam, Ami, Vincent, Chan, Anahi, Perlas, Ruth, Argue, Katie, Lavis, Kelly, Mayson, Ying, Cao, Hong, Gao, Tingju, Hu, Jie, Lv, Jian, Yang, Yang, Yang, Zhong, Yi, Jing, Zhou, Xiaohua, Zou, Miao, He, Xiaoying, Li, Dihuan, Luo, Haiying, Wang, Tian, Yu, Liyong, Chen, Lijun, Wang, Yunfei, Cai, Zhongming, Cao, Yanling, Li, Jiaxin, Lian, Haiyun, Sun, Sheng, Wang, Zhipeng, Wang, Kenru, Wang, Zhu, Yi, Xindan, Du, Hao, Fan, Yunbin, Fu, Lixia, Huang, Yanming, Huang, Haifang, Hwan, Hong, Luo, Pi-Sheng, Qu, Fan, Tao, Zhen, Wang, Guoxiang, Wang, Shun, Wang, Yan, Zhang, Xiaolin, Zhang, Chao, Chen, Weixing, Wang, Zhengyuan, Liu, Lihua, Fan, Jing, Tang, Yijun, Chen, Yongjie, Chen, Yangyang, Han, Changshun, Huang, Guojin, Liang, Jing, Shen, Jun, Wang, Qiuhong, Yang, Jungang, Zhen, Haidong, Zhou, Junping, Chen, Zhang, Chen, Xiaoyu, Li, 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Bhavika, Daya, Leanne, Drummond, Ali, Elabib, Ehab Helmy Abdel Goad, Ismail, E Goga, Riaz, Goga, Harrichandparsad, R, Richard, E Hodgson, Jordaan, J, Nicky, Kalafatis, Christian, Kampik, T Landers, A, Emil, Loots, Rajhmum, Madansein, Anil, Madaree, Thandinkosi, E Madiba, Vukani, T Manzini, Mbali, Mbuyisa, Rajan, Moodley, Mduduzi, Msomi, Innocent, Mukama, Desigan, Naidoo, Rubeshan, Naidoo, Tesuven, K Naidu, Sindiswa, Ntloko, Eneshia, Padayachee, Lucelle, Padayachee, Martijn, Phaff, Bala, Pillay, Desigan, Pillay, Lutchmee, Pillay, Anupa, Ramnarain, Suren, R Ramphal, Paul, Ryan, Ahmed, Saloojee, Motshedisi, Sebitloane, Noluyolo, Sigcu, Jenna, L Taylor, Alexandra, Torborg, Linda, Visser, Philip, Anderson, Alae, Conradie, Mathew de Swardt, Martin de Villiers, Johan, Eikman, Riaan, Liebenberg, Johan, Mouton, Abbey, Paton, Louwrence van der Merwe, Candice, Wilscott-Davids, Wendy Joan Barrett, Marlet, Bester, Johan de Beer, Jacques, Geldenhuys, Hanni, Gouws, Jan-Hendrik, Potgieter, Magdel, Strydom, Edwin, Wilberforce-Turton, Rubendraj, R Chetty, Subash, Chirkut, Larissa, Cronje, Kim de Vasconcellos, Nokukhanya, Z Dube, N Sibusiso Gama, Garyth, M Green, Randolph, Green-Thompson, Suman Mewa Kinoo, Prenolin, Kistnasami, Kapil, Maharaj, Manogaran, S Moodley, Sibongile, J Mothae, Ruvashni, Naidoo, Aslam, M, Noorbhai, F, Vivesh, Rughubar, Jenendhiran, Reddy, Avesh, Singh, David, L Skinner, Murray, J Smith, Bhagwan, Singh, Ravi, Misra, Maheshwar, Naidoo, Pireshin, Ramdharee, Yvonne, Selibea, Selina, Sewpersad, Shailendra, Sham, Joseph, D Wessels, Cucu, Africander, Tarek, Bejia, Stephen, P Blakemore, Marisa, Botes, Bimalshakth, Bunwarie, Carlos, B Hernandez, Mohammud, A Jeeraz, Dagmara, A Legutko, Acela, G Lopez, Jenine, N De Meyer, Tanaka, Muzenda, Noel, Naidoo, Maryam, Patel, Rao, Pentela, Marina, Junge, Naj, Mansoor, Lana, Rademan, Pawel, Scislowski, Ismail, Seedat, Bianca van den Berg, Doreen van der Merwe, Steyn van Wyk, Komalan, Govender, Darshan, Naicker, Rajesh, Ramjee, 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Patricia, Salgado, Luis, Suarez, Alejandro, Suarez-de-la-Rica, María José Villagrán, José Ignacio Alonso, Estefania, Cabezuelo, Irene, Garcia-Saiz, Olga Lopez Del Moral, Silvia, Martín, Alba Perez Gonzalez, Sherezade Tovar Doncel, Martin Agüero Vera, Francisco José Ávila Sánchez, Beatriz, Castaño, Beatriz Castaño Moreira, Sahely Flores Risco, Daniel Paz Martín, Fernando Pérez Martín, Paloma, Poza, Adela, Ruiz, Wilson Fabio Serna Martínez, Bárbara Vázquez Vicente, Saul Velaz Dominguez, Salvador, Fernández, Alfonso, Munoz-López, Maria Jose Bernat, Arantxa, Mas, Kenneth, Planas, Monir, Jawad, Yousif, Saeed, Annika, Hedin, Helena, Levander, Sandra, Holmström, David, Lönn, Frank, Zoerner, Irene, Åkring, Carl, Widmark, Jan, Zettergren, Victor Aspelund Liljequist, Lena, Nystrom, Suzanne, Odeberg-Wernerman, Anders, Oldner, Patrik, Reje, Sara, Lyckner, Jesper, Sperber, Anne, Adolfsson, Bengt, Klarin, Katrin, Ögren, Jean-Pierre, Barras, Thomas, Bührer, Vasileios, Despotidis, Naeder, Helmy, 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Davies, Matthew, Martin, Sian, Thomas, Karen, Burns, Carol, Mcarthur, Panna, Patel, Gary, Lau, Natalie, Rich, Fiona, Davis, Rachel, Lyons, Beth, Port, Rachel, Prout, Christopher, Smith, Yemi, Adelaja, Victoria, Bennett, Heena, Bidd, Alexandra, Dumitrescu, Jacqui Fox Murphy, Abigail, Keen, Nhlanhla, Mguni, Cheng, Ong, George, Adams, Piers, Boshier, Richard, Brown, Izabella, Butryn, Jayanta, Chatterjee, Alexander, Freethy, Geoffrey, Lockwood, Maria, Tsakok, Sophia, Tsiligiannis, William, Peat, Lorraine, Stephenson, Mike, Bradburn, Sara, Pick, Pedro, Cunha, Olufemi, Olagbaiye, Salim, Tayeh, Caroline, Abernethy, Madhu, Balasubramaniam, Rachael, Bennett, David, Bolton, Victoria, Martinson, Charde, Naylor, Stephanie, Bell, Blaylock, Heather, Vlad, Kushakovsky, Liam, Alcock, Hazel, Alexander, Colette, Anderson, Paul, Baker, Morag, Brookes, Louise, Cawthorn, Emanuel, Cirstea, Kerry, Colling, Ian, Coulter, Suparna, Das, Kathryn, Haigh, Alhafidz, Hamdan, Keith, Hugill, Lucksy, Kottam, Emily, 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Vivian, Emer, Berntsen, Tracey, Nolan, Angus, Turner, Akbar, Vohra, Andrew, Brown, Richard, Clark, Elaine, Coughlan, Conway, Daniel, Chinmay, Patvardhan, Rachel, Pearson, Sheba, Predeep, Hesham, Saad, Mohanakrishnan, Shanmugam, Simon, Varley, Katharine, Wylie, Lucy, Cooper, Arystarch, Makowski, Beata, Misztal, Eliza, Moldovan, Claire, Pegg, Andrew, Donovan, Jayne, Foot, Simon, Large, Andrew, Claxton, Bhagyashree, Netke, Richard, Armstrong, Claire, Calderwood, Andy, Kwok, Otto, Mohr, Peter, Oyeniyi, Lisa, Patnaik, Benjamin, Post, Sarah, Ali, Homa, Arshad, Gerard, Baker, Laura, Brenner, Maximilian, Brincat, Annemarie, Brunswicker, Hannah, Cox, Octavian Ionut Cozar, Alexander, Durst, Lior, Fengas, Jim, Flatt, Georgina, Glister, Vishal, Narwani, Evangelos, Photi, Adeline, Rankin, Melissa, Rosbergen, Mark, Tan, Ceri, Beaton, Rachel, Horn, Jane, Hunt, Guy, Rousseau, Lucia, Stancombe, Mohammed, Absar, Joanne, Allsop, Zoe, Drinkwater, Tracey, Hodgkiss, Kirsty, Smith, Jamie, Brown, Farhad, 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Woon, Yuan Liang, Abd Hadi, Husni Zaeem, Ahmad Azam, Ummi Azmira, Alias, Abdul Hafiz, Kesut, Saiful Aizar, Lee, Jun May, Ooi, Dar Vin, Sulaiman, Hetty Ayuni, Tengku Lih, Tengku Alini, Veerakumaran, Jeyaganesh, Rojas, Eder, Resendiz, Gerardo Esteban Alvarez, Zapata, Darcy Danitza Mari, Aguilar López, Julio Cesar Jesú, Flores, Armando Adolfo Alvarez, Amador, Juan Carlosc Bravo, Avila, Erendira Jocelin Dominguez, Aquino, Laura Patricia González, Rodriguez, Ricardo Lopez, Landa, Mariana Torre, Urias, Emma, Hollmann, Marku, Hulst, Abraham, Kirzner, Osne, Preckel, Benedikt, Koopman-van Gemert, Ankie, Buise, Marc, Tolenaar, Noortje, Weber, Eric, de Fretes, Jennifer, Houweling, Peter, Ormskerk, Patricia, Van Bommel, Jasper, Lance, Marcu, Smit-Fun, Valerie, van Zundert, Tom, Baas, Peter, de Boer, Hans Donald, Sprakel, Joost, Elferink-Vonk, Renske, Noordzij, Peter, van Zeggeren, Laura, Brand, Bastiaan, spanjersberg, Rob, ten Bokkel-Andela, Janneke, Numan, Janneke, van Klei, Wilton, van Zaane, 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Sarki, Adamu Muhammad, Adekola, Oyebola, Akanmu, Olanrewaju, Durodola, Akanmu, Olukoju, Olusegun, Raji, Victor, Olajumoke, Tokunbo, Oyebamiji, Emmanuel, Adenekan, Anthony, Adetoye, Adenekan, Faponle, Folayemi, Olateju, Simeon, Owojuyigbe, Afolabi, Talabi, Ademola, Adenike, Odewabi, Adewale, Badru, Collins, Nwokoro, Ezekiel, Emmanuel, Fatungase, Oluwabunmi Motunrayo, Grace, Anuforo, Sola, Sotannde, Stella, Ogunmuyiwa, Ademola, Adeyinka, Adeolu, Augustine A., Adigun, Tinuolac, Akinwale, Mukaila, Fasina, Oluyemi, Gbolahan, Olalere, Idowu, Olusola, Olonisakin, Rotimi Peter, Osinaike, Babatunde Babasola, Asudo, Felicia, Mshelia, Danladi, Abdur-Rahman, Lukman, Agodirin, Olayide, Bello, Jibril, Bolaji, Benjamin, Oyedepo, Olanrewaju Olubukola, Ezike, Humphrey, Iloabachie, Ikechukwu, Okonkwo, Ikemefuna, Onuora, Elia, Onyeka, Tonia, Ugwu, Innocent, Umeh, Friday, Alagbe-Briggs, Olubusola, Dodiyi-Manuel, Amabra, Echem, Richard, Obasuyi, Bright, Onajin-Obembe, Bisola, Bandeira, Maria Expedito, Martins, Alda, Tomé, Miguel, Martins Costa, Ana Cristina Miranda, Krystopchuk, Andriy, Branco, Teresa, Esteves, Simao, Melo, Marco António, Monte, Júlia, Rua, Fernando, Martins, Isabel, Pinho-Oliveira, Vítor Miguel, Rodrigues, Carla Maria, Cabral, Raquel, Marques, Sofia, Rêgo, Sara, Teixeira Jesus, Joana Sofia, Conceição Marques, Maria, Romao, Cristina, Dias, Sandra, Santos, Ana Margarida, Alves, Maria Joao, Salta, Cristina, Cruz, Salome, Duarte, Célia, Furtado Paiva, António Armando, do Nascimento Cabral, Tiago, Fariae Maia, Dionisio, Correia da Silva, Rui Freitas Mendonça, Langner, Anuschka, Oliveira Resendes, Hernâni, da Conceição Soares, Maria, Abrunhosa, Alexandra, Faria, Filomena, Miranda, Lina, Pereira, Helena, Serra, Sofia, Ionescu, Daniela, Margarit, Simona, Mitre, Calin, Vasian, Horatiu, Manga, Gratiela, Stefan, Andreea, Tomescu, Dana, Filipescu, Daniela, Paunescu, Marilena-Alina, Stefan, Mihai, Stoica, Radu, Gavril, Laura, Pătrăşcanu, Emilia, Ristescu, Irina, Rusu, Daniel, Diaconescu, Ciresica, Iosep, Gabriel Florin, Pulbere, Dorin, Ursu, Irina, Balanescu, Andreea, Grintescu, Ioana, Mirea, Liliana, Rentea, Irina, Vartic, Mihaela, Lupu, Mary-Nicoleta, Stanescu, Dorin, Streanga, Lavinea, Antal, Oana, Hagau, Natalia, Patras, Dumitru, Petrisor, Cristina, Tosa, Flaviu, Tranca, Sebastian, Copotoiu, Sanda Maria, Ungureanu, Liviu Lucian, Harsan, Cristian Remu, Papurica, Mariu, Cernea, Daniela Denisa, Dragoescu, Nicoleta Alice, Aflori, Laura, Vaida, Carmen, Ciobotaru, Oana Roxana, Aignatoaie, Mariana, Carp, Cristina Paula, Cobzaru, Isabelle, Mardare, Oana, Purcarin, Bianca, Tutunaru, Valentin, Ionita, Victor, Arustei, Mirela, Codita, Anisoara, Busuioc, Mihai, Chilinciuc, Ion, Ciobanu, Cristina, Belciu, Ioana, Tincu, Eugen, Blaj, Mihaela, Grosu, Ramona-Mihaela, Sandu, Gigel, Bruma, Dana, Corneci, Dan, Dutu, Madalina, Krepil, Adriana, Copaciu, Elena, Dumitrascu, Clementina Oana, Jemna, Ramona, Mihaescu, Florentina, Petre, Raluca, Tudor, Cristina, Ursache, Elena, Kulikov, Alexander, Lubnin, Andrey, Grigoryev, Evgeny, Pugachev, Stanislav, Tolmasov, Alexander, Hussain, Ayyaz, Ilyina, Yana, Roshchina, Anna, Iurin, Aleksandr, Chazova, Elena, Dunay, Artem, Karelov, Alexey, Khvedelidze, Irina, Voldaeva, Olga, Belskiy, Vladislav, Dzhamullaev, Parvin, Grishkowez, Elena, Kretov, Vladimir, Levin, Valeriy, Molkov, Aleksandr, Puzanov, Sergey, Samoilenko, Aleksandr, Tchekulaev, Aleksandr, Tulupova, Valentina, Utkin, Ivan, Allorto, Nikki Leigh, Bishop, David Gray, Builu, Pierre Monji, Cairns, Carel, Dasrath, Ashish, de Wet, Jacque, den Hoedt, Marielle, Grey, Ben, Hayes, Morgan Philip, Küsel, Belinda Senta, Shangase, Nomcebo, Wise, Robert, Cacala, Sharon, Farina, Zane, Govindasamy, Vishendran, Kruse, Carl-Heinz, Lee, Carolyn, Marais, Leonard, Naidoo, Thinagrin Dhasarthun, Rajah, Chantal, Rodseth, Reitze Nil, Ryan, Lisa, von Rhaden, Richard, Adam, Suwayba, Alphonsus, Christella, Ameer, Yusuf, Anderson, Frank, Basanth, Sujith, Bechan, Sudha, Bhula, Chettan, 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Delgado García, David R., Zamudio, Diana, Garcia Del Valle, Santiago, Luz Serrano, M., Alonso, Eduardo, Anillo, Victor, Maseda, Emilio, Salgado, Patricia, Suarez, Lui, Suarez-de-la-Rica, Alejandro, Villagrán, María José, Alonso, José Ignacio, Cabezuelo, Estefania, Garcia-Saiz, Irene, Lopez del Moral, Olga, Martín, Silvia, Perez Gonzalez, Alba, Tovar Doncel, Sherezade, Vera, Martin Agüero, Ávila Sánchez, Francisco José, Castaño, Beatriz, Castaño Moreira, Beatriz, Flores Risco, Sahely, Paz Martín, Daniel, Pérez Martín, Fernando, Poza, Paloma, Ruiz, Adela, Serna Martínez, Wilson Fabio, Vicente, Bárbara Vázquez, Dominguez, Saul Velaz, Fernández, Salvador, Munoz-López, Alfonso, Bernat, Maria Jose, Mas, Arantxa, Planas, Kenneth, Jawad, Monir, Saeed, Yousif, Hedin, Annika, Levander, Helena, Holmström, Sandra, Lönn, David, Zoerner, Frank, Åkring, Irene, Widmark, Carl, Zettergren, Jan, Liljequist, Victor Aspelund, Nystrom, Lena, Odeberg-Wernerman, Suzanne, Oldner, Ander, Reje, Patrik, Lyckner, 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Bottrill, Fiona, Ramalingam, Ganesh, Webb, Stephen, Akerman, Nik, Antill, Philip, Bourner, Lynsey, Buckley, Sarah, Castle, Gail, Charles, Rob, Eggleston, Christopher, Foster, Rebecca, Gill, Satwant, Lindley, Kate, Lklouk, Mohamed, Lowery, Tracey, Martin, Oliver, Milne, David, O’Connor, Patrick, Ratcliffe, Andrew, Rose, Alastair, Smith, Annie, Varma, Sandeep, Ward, Jackie, Barcraft-Barnes, Helena, Camsooksai, Julie, Colvin, Carolyn, Reschreiter, Henrik, Tbaily, Lee, Venner, Nicola, Hamilton, Caroline, Kelly, Lewi, Toth-Tarsoly, Piroska, Dodsworth, Kerry, Foord, Denise, Gordon, Paul, Hawes, Elizabeth, Lamb, Nikki, Mouland, Johanna, Nightingale, Jeremy, Rose, Steve, Schrieber, Joe, Al ‘Amri, Khalid, Aladin, Hafiz, Arshad, Mohammed Asif, Barraclough, Jame, Bentley, Conor, Bergin, Colin, Carrera, Ronald, Clarkson, Aisling, Collins, Michelle, Cooper, Lauren, Denham, Samuel, Griffiths, Ewen, Ip, Peter, Jeyanthan, Somasundaram, Joory, Kavita, Kaur, Satwant, Marriott, Paul, Mitchell, Natalie, Nagaiah, Sukumar, Nilsson, Annette, Parekh, Nilesh, Pope, Martin, Seager, Joseph, Serag, Hosam, Tameem, Alifia, Thomas, Anna, Thunder, Joanne, Torrance, Andrew, Vohra, Ravinder, whitehouse, Arlo, Wong, Tony, Blunt, Mark, Wong, Kate, Giles, Julian, Reed, Isabelle, Weller, Debbie, Bell, Gillian, Birch, Julie, Damant, Rose, Maiden, Jane, Mewies, Clare, Prince, Claire, Radford, Jane, Balain, Birender, Banerjee, Robin, Barnett, Andrew, Burston, Ben, Davies, Kirsty, Edwards, Jayne, Evans, Chri, Ford, David, Gallacher, Pete, Hill, Simon, Jaffray, David, Karlakki, Sudheer, Kelly, Cormac, Kennedy, Julia, Kiely, Nigel, Lewthwaite, Simon, Marquis, Chri, Ockendon, Matthew, Phillips, Stephen, Pickard, Simon, Richardson, Jame, Roach, Richard, Smith, Tony, Spencer-Jones, Richard, Steele, Niall, Steen, Julie, Van Liefland, Marck, White, Steve, Faulds, Matthew, Harris, Meredyth, Kelly, Carrie, Nicol, Scott, Pearson, Sally Anne, Chukkambotla, Srikanth, Andrew, Alyson, Attrill, Elizabeth, Campbell, Graham, Datson, Amanda, Fouracres, Anna, Graterol, Juan, Graves, Lynne, Hong, Bosun, Ishimaru, Alexander, Karthikeyan, Arvind, King, Helen, Lawson, Tom, Lee, Gregory, Lyons, Saoirse, Macalister Hall, Andrew, Mathoulin, Sophie, Mcintyre, Eilidh, Mclaughlin, Danny, Mulcahy, Kathleen, Ratcliffe, Anna, Robbins, Jame, Sung, Weilin, Tayo, Adeoluwa, Trembath, Lisa, Venugopal, Suneetha, Walker, Robert, Wigmore, Geoffrey, Boereboom, Catherine, Downes, Charlotte, Humphries, Ryan, Melbourne, Susan, Smith, Coral, Tou, Samson, Ullah, Shafa, Batchelor, Nick, Boxall, Leigh, Broomby, Rupert, Deen, Tariq, Hellewell, Alistair, Helliwell, Laurence, Hutchings, Melanie, Hutchins, David, Keenan, Samantha, Mackie, Donna, Donna, Alison, Smith, France, Stone, Lucy, Thorpe, Kevin, Wassall, Richard, Woodgate, Andrew, Baillie, Shelley, Campbell, Tara, James, Sarah, King, Chri, Marques de Araujo, Daniela, Martin, Daniel, Morkane, Clare, Neely, Julia, Rajendram, Rajkumar, Burton, Megan, James, Kathryn, Keevil, Edward, Minik, Orsolya, Morgan, Jenna, Musgrave, Anna, Rajanna, Harish, Roberts, Tracey, Adamson, Michael, Jumbe, Sandra, Kendall, Jennie, Muthuswamy, Mohan Babu, Anderson, Charlotte, Cruikshanks, Andrew, Wrench, Ian, Zeidan, Lisa, Ardern, Diane, Harris, Benjamin, Hellstrom, Johanna, Martin, Jane, Thomas, Richard, Varsani, Nimu, Wrey Brown, Caroline, Docherty, Philip, Gillies, Michael, McGregor, Euan, Usher, Helen, Craig, Jayne, Smith, Andrew, Ahmad, Tahania, Bodger, Phoebe, Creary, Thai, Fowler, Alexander, Hewson, Ru, Ijuo, Eke, Jones, Timothy, Kantsedikas, Ilya, Lahiri, Sumitra, McLean, Aaron Lawson, Niebrzegowska, Edyta, Phull, Mandeep, Wang, Difei, Wickboldt, Nadine, Baldwin, Jacqueline, Doyle, Donna, Mcmullan, Sean, Oladapo, Michelle, Owen, Thoma, Williams, Alexandra, Daniel, Hull, Gregory, Peter, Husain, Tauqeer, Kirk-Bayley, Justin, Mathers, Edward, Montague, Laura, White, Stuart, Avis, Joanne, Cook, Tim, Dali-Kemmery, Lola, Kerslake, Ian, Lambourne, Victoria, Pearson, Annabel, Boyd, Christine, Callaghan, Mark, Lawson, Cathy, McCrossan, Roopa, Nesbitt, Vanessa, O’connor, Laura, Scott, Julia, Sinclair, Rhona, Farid, Nahla, Morgese, Ciro, Bhatia, Kailash, Karmarkar, Swati, Ahmed, Jamil, Branagan, Graham, Hutton, Monica, Swain, Andrew, Brookes, Jamie, Cornell, Jonathan, Dolan, Rachael, Hulme, Jonathan, Jansen van Vuuren, Amanda, Jowitt, Tom, Kalashetty, Gunasheela, Lloyd, Fran, Patel, Kiran, Sherwood, Nichola, Brown, Lynne, Chandler, Ben, Deighton, Kerry, Emma, Temlett, Haunch, Kirsty, Cheeseman, Michelle, Dent, Kathy, Garg, Sanjeev, Gray, Carol, Hood, Marion, Jones, Dawn, Juj, Joanne, Rao, Roshan, Walker, Tara, Al Anizi, Mashel, Cheah, Clarissa, Cheing, Yushio, Coutinho, Francisco, Gondo, Prisca, Hadebe, Bernard, Onie Hove, Mazvangu, khader, Ahamed, Krishnachetty, Bobby, Rhodes, Karen, Sokhi, Jagdish, Baker, Katie-Anne, Bertram, Wendy, Looseley, Alex, Mouton, Ronelle, Arnold, Glenn, Arya, Shobhit, Balfoussia, Danai, Baxter, Linden, Harris, Jame, Jones, Craig, Knaggs, Alison, Markar, Sheraz, Perera, Anisha, Scott, Alasdair, Shida, Asako, Sirha, Ravneet, Wright, Sally, Frost, Victoria, Gray, Catherine, MacGregor, Mark, Andrews, Emma, Arrandale, Lindsay, Barrett, Stephen, Cifra, Elna, Cooper, Mariese, Dragnea, Drago, Elna, Cifra, Maclean, Jennifer, Meier, Sonja, Milliken, Donald, Munns, Christopher, Ratanshi, Nadir, Salvana, Abegail, Watson, Anthony, Ali, Hani, Campbell, Gill, Critchley, Rebecca, Hicks, Catherine, Liddle, Alison, Pass, Marc, Ritchie, Charlotte, Thomas, Charlotte, Too, Lingxi, Welsh, Sarah, Gill, Talvinder, Johnson, Joanne, Reed, Joanne, Davis, Edward, Papadopoullos, Sam, Attwood, Clare, Biffen, Andrew, Boulton, Kerenza, Gray, Sophie, Hay, David, Mills, Sarah, Montgomery, Jane, Riddell, Rory, Simpson, Jame, Bhardwaj, Neeraj, Paul, Elaine, Uwubamwen, Nosakhare, Alexander, Maini, Arrich, Jame, Arumugam, Swarna, Blackwood, Dougla, Boggiano, Victoria, Brown, Robyn, Lam Chan, Yik, Chatterjee, Devnandan, Chhabra, Ashok, Christian, Rachel, Costelloe, Hannah, Coxwell Matthewman, Madeline, Dalton, Emma, Darko, Julia, Davari, Maria, Dave, Tejal, Deacon, Matthew, Deepak, Shantal, Edmond, Holly, Ellis, Jessica, El-Sayed, Ahmed, Eneje, Philip, English, Rose, Ewe, Renee, Foers, William, Franklin, John, Gallego, Laura, Garrett, Emily, Goldberg, Olivia, Goss, Harry, Greaves, Rosanna, Harris, Rudy, Hennings, Charle, Jones, Eleanor, Kamali, Nelson, Kokkinos, Naomi, Lewis, Cary, Lignos, Leda, Malgapo, Evaleen Victoria, Malik, Rizwana, Milne, Andrew, Mulligan, John-Patrick, Nicklin, Philippa, Palipane, Natasha, Parsons, Thoma, Piper, Rebecca, Prakash, Rohan, Ramesh, Byron, Rasip, Sarah, Reading, Jacob, Rela, Mariam, Reyes, Anna, Robert, Stephen, Rooms, Martin, Shah, Karishma, Simons, Henry, Solanki, Shalil, Spowart, Emma, Stevens, Amy, Thomas, Christopher, Waggett, Helena, Yassaee, Arrash, Kennedy, Anthony, Scott, Sara, Somanath, Sameer, Berg, Andrew, Hernandez, Miguel, Nanda, Rajesh, Tank, Ghanshyambhai, Wilson, Natalie, 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Tsang, M.S., Lai, M.L., Yip, C.P., Chan, HMH, Law, B., Li, W.S., Chu, H.M., Koo, EGY, Lam, CCJ, Cheng, K.H., Lam, T., Chu, S., Lam, W.Y., Wong, KWK, Kwok, D., Hung, CYJ, Chan, WKJ, LamWong, W., Chung, CKE, Ma, S.K., Kaushik, S., Shah, B., Shah, D., Shah, S., Ar, P., Muthuchellappan, R., Agarwal, V., Divatia, J., Mishra, S., Nimje, G., Pande, S., Savarkar, S., Shrivastava, A., Thomas, M., Yegnaram, S., Hidayatullah, R., Puar, N., Niman, S., Indra, I., Hamzah, Z., Yuliana, A., Abidin, U.N., Dursin, A.N., Kurnia, A., Susanti, A., Handayani, D., Aribawa, M.A., Arya, A., Senapathi, TGA, Utara, U.H., Wid, W.M., Wima, S., Wir, W.M., Jehosua, B., Kaunang, J., Lantang, E.Y., Najoan, R., Waworuntu, N., Awad, H., Fuad, A., Geddoa, B., Khalaf, A.R., Al Hussaini, S., Albaj, S., Kenber, M., Bettinelli, A., Spadaro, S., Volta, C.A., Giancarlo, L., Sottosanti, V., Spagnesi, L., Toretti, I., Alloj, C., Cardellino, S., Carmino, L., Costanzo, E., Fanfani, L.C., Novelli, M.T., Roasio, A., Bellandi, M., Bignami, E., Bocchino, S., Cabrini, L., Corti, D., Landoni, G., Meroni, R., Moizo, E., Monti, G., Pintaudi, M., Plumari, V.P., Taddeo, D., Testa, V., Winterton, D., Zangrillo, A., Cloro, L.M., Colangelo, C., Colangelo, A., Rotunno, G., Angel, M.P., Maria, C.P., Pata, A., Parrini, V., Gatta, A., Nastasi, M., Tinti, C., Arrigo, M., Benevento, A., Bottini, C., Cannavo', M., Gastaldi, C., Marchesi, A., Pascazio, A., Pata, F., Pozzi, E., Premoli, A., Tessera, G., Boschi, L., D'Andrea, R., Ghignone, F., Poggioli, G., Sibilio, A., Taffurelli, M., Ugolini, G., Ab Majid, M.A., Ab Rahman, R., Joseph, J., Pathan, F., Shah, MHS, Yap, H.L., Cheah, S., Chin, I.I., Looi, J.K., Tan, S.C., Visvalingam, S., Kwok, F.Y., Lee, C.K., Tan, T.S., Wong, S.M., Abdullah, N.H., Liew, C.F., Luxuman, L., Mohd Zin, N.H., Norddin, M.F., Alias, RLR, Wong, J.Y., Yong, J., Bin Mustapha, M.T., Chan, W.K., Dzulkipli, N., Kuan, P.X., Lee, Y.C., Alias, A., Guok, E.C., Jee, C.C., Ramon, B.R., Weng, C.W., Abd Ghafar, FNI, Aziz, F.Z., Hussain, N., Lee, H.S., Sukawi, I., Woon, Y.L., Abd Hadi, H.Z., Ahmad Azam, U.A., Alias, A.H., Kesut, S.A., Lee, J.M., Ooi, D.V., Sulaiman, H.A., Tengku Lih, T.A., Veerakumaran, J., Rojas, E., Resendiz, GEA, Zapata, DDM, Aguilar López, JCJ, Flores, AAA, Amador, JCB, Avila, EJD, Aquino, LPG, Rodriguez, R.L., Landa, M.T., Urias, E., Hollmann, M., Hulst, A., Kirzner, O., Preckel, B., Koopman-van Gemert, A., Buise, M., Tolenaar, N., Weber, E., de Fretes, J., Houweling, P., Ormskerk, P., Van Bommel, J., Lance, M., Smit-Fun, V., van Zundert, T., Baas, P., de Boer, H.D., Sprakel, J., Elferink-Vonk, R., Noordzij, P., van Zeggeren, L., Brand, B., Spanjersberg, R., Ten Bokkel-Andela, J., Numan, J., van Klei, W., van Zaane, B., Boer, C., van Duivenvoorde, Y., Hering, J.P., Zonneveldt, H., Hoare, S., Santa, S., Allen, S.J., Bell, R., Choi, H.D., Drake, M., Farrell, H., Higgie, K., Holmes, K., Jenkins, N., Kim, C.J., Kim, S., Law, K.C., McAllister, D., Park, K., Pedersen, K., Pfeifer, L., Salmond, T., Steynor, M., Tan, M., Waymouth, E., Ab Rahman, A.S., Armstrong, J., Dudson, R., Nilakant, J., Richard, S., Virdi, P., Dixon, L., Donohue, R., Farrow, M., Kennedy, R., Marissa, H., McKellow, M., Nicola, D., Pascoe, R., Roberts, S.J., Rowell, G., Sumner, M., Templer, P., Chandrasekharan, S., Fulton, G., Jammer, I., Ali, M., More, R., Wilson, L., Chang, Y.H., Chang, J., Fowler, C., Panckhurst, J., Sara, R., Stapelberg, F., Cherrett, V., Ganter, D.L., McCann, L., Foley, J., Gilmour, F., Lumsden, R., Moores, M., Olliff, S., Sardareva, E., Tai, J., Wikner, M., Wong, C., Chaddock, M., Czepanski, C., McKendry, P., Polakovic, D., Polakovich, D., Robert, A., Tormo Belda, M., Norton, T., Alherz, F., Barneto, L., Ramirez, A., Sayeed, A., Smith, N., Bennett, C., McQuoid, S., Jansen, T.L., Nico, Z., Scott, J., Freschini, D., Freschini, A., Hopkins, B., Manson, L., Stoltz, D., Bates, A., Davis, S., Freeman, V., McGaughran, L., Baskar Sharma, S., Burrows, T., Byrne, K., English, D., Johnson, R., Chai Law, K., Manikkam, B., Naidoo, S., Rumball, M., Whittle, N., Franks, R., Gibson-Lapsley, H., Salter, R., Walsh, D., Cooper, R., Perry, K., Obobolo, A., Sule, U.M., Ahmad, A., Atiku, M., Mohammed, A.D., Sarki, A.M., Adekola, O., Akanmu, O., Durodola, A., Olukoju, O., Raji, V., Olajumoke, T., Oyebamiji, E., Adenekan, A., Adetoye, A., Faponle, F., Olateju, S., Owojuyigbe, A., Talabi, A., Adenike, O., Adewale, B., Collins, N., Ezekiel, E., Fatungase, O.M., Grace, A., Sola, S., Stella, O., Ademola, A., Adeolu, A.A., Adigun, T., Akinwale, M., Fasina, O., Gbolahan, O., Idowu, O., Olonisakin, R.P., Osinaike, B.B., Asudo, F., Mshelia, D., Abdur-Rahman, L., Agodirin, O., Bello, J., Bolaji, B., Oyedepo, O.O., Ezike, H., Iloabachie, I., Okonkwo, I., Onuora, E., Onyeka, T., Ugwu, I., Umeh, F., Alagbe-Briggs, O., Dodiyi-Manuel, A., Echem, R., Obasuyi, B., Onajin-Obembe, B., Bandeira, M.E., Tomé, M., Martins Costa, ACM, Krystopchuk, A., Branco, T., Esteves, S., Melo, M.A., Monte, J., Rua, F., Martins, I., Pinho-Oliveira, V.M., Rodrigues, C.M., Cabral, R., Marques, S., Rêgo, S., Teixeira Jesus, J.S., Conceição Marques, M., Romao, C., Dias, S., Santos, A.M., Alves, M.J., Salta, C., Cruz, S., Duarte, C., Furtado Paiva, A.A., do Nascimento Cabral, T., Fariae Maia, D., Correia da Silva, RFM, Langner, A., Oliveira Resendes, H., da Conceição Soares, M., Abrunhosa, A., Faria, F., Miranda, L., Pereira, H., Serra, S., Ionescu, D., Margarit, S., Mitre, C., Vasian, H., Manga, G., Stefan, A., Tomescu, D., Filipescu, D., Paunescu, M.A., Stefan, M., Stoica, R., Gavril, L., Pătrăşcanu, E., Ristescu, I., Rusu, D., Diaconescu, C., Iosep, G.F., Pulbere, D., Ursu, I., Balanescu, A., Grintescu, I., Mirea, L., Rentea, I., Vartic, M., Lupu, M.N., Stanescu, D., Streanga, L., Antal, O., Hagau, N., Patras, D., Petrisor, C., Tosa, F., Tranca, S., Copotoiu, S.M., Ungureanu, L.L., Harsan, C.R., Papurica, M., Cernea, D.D., Dragoescu, N.A., Aflori, L., Vaida, C., Ciobotaru, O.R., Aignatoaie, M., Carp, C.P., Cobzaru, I., Mardare, O., Purcarin, B., Tutunaru, V., Ionita, V., Arustei, M., Codita, A., Busuioc, M., Chilinciuc, I., Ciobanu, C., Belciu, I., Tincu, E., Blaj, M., Grosu, R.M., Sandu, G., Bruma, D., Corneci, D., Dutu, M., Krepil, A., Copaciu, E., Dumitrascu, C.O., Jemna, R., Mihaescu, F., Petre, R., Tudor, C., Ursache, E., Kulikov, A., Lubnin, A., Grigoryev, E., Pugachev, S., Tolmasov, A., Hussain, A., Ilyina, Y., Roshchina, A., Iurin, A., Chazova, E., Dunay, A., Karelov, A., Khvedelidze, I., Voldaeva, O., Belskiy, V., Dzhamullaev, P., Grishkowez, E., Kretov, V., Levin, V., Molkov, A., Puzanov, S., Samoilenko, A., Tchekulaev, A., Tulupova, V., Utkin, I., Allorto, N.L., Bishop, D.G., Builu, P.M., Cairns, C., Dasrath, A., de Wet, J., den Hoedt, M., Grey, B., Hayes, M.P., Küsel, B.S., Shangase, N., Wise, R., Cacala, S., Farina, Z., Govindasamy, V., Kruse, C.H., Lee, C., Marais, L., Naidoo, T.D., Rajah, C., Rodseth, R.N., Ryan, L., von Rhaden, R., Adam, S., Alphonsus, C., 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Makowski, A., Misztal, B., Moldovan, E., Pegg, C., Donovan, A., Foot, J., Large, S., Claxton, A., Netke, B., Armstrong, R., Calderwood, C., Kwok, A., Mohr, O., Oyeniyi, P., Patnaik, L., Post, B., Ali, S., Arshad, H., Baker, G., Brenner, L., Brincat, M., Brunswicker, A., Cox, H., Cozar, O.I., Durst, A., Fengas, L., Flatt, J., Glister, G., Narwani, V., Photi, E., Rankin, A., Rosbergen, M., Beaton, C., Horn, R., Hunt, J., Rousseau, G., Stancombe, L., Absar, M., Allsop, J., Drinkwater, Z., Hodgkiss, T., Smith, K., Alexander-Sefre, F., Campey, L., Dudgeon, L., Hall, K., Hitchcock, R., James, L., Winstone, U., Ahmad, N., Bauchmuller, K., Harrison, J., Jeffery, H., Miller, D., Pinder, A., Pothuneedi, S., Rosser, J., Sanghera, S., Swift, D., Walker, R., Bester, D., Cavanagh, S., Cripps, H., Daniel, H., Lynch, J., Pyke, S., Scholefield, J., Whitworth, H., Bottrill, F., Ramalingam, G., Webb, S., Akerman, N., Antill, P., Bourner, L., Buckley, S., Castle, G., Charles, R., Eggleston, C., Foster, R., Gill, S., Lindley, K., Lklouk, M., Lowery, T., Martin, O., Milne, D., O'Connor, P., Ratcliffe, A., Rose, A., Smith, A., Varma, S., Ward, J., Barcraft-Barnes, H., Camsooksai, J., Colvin, C., Reschreiter, H., Tbaily, L., Venner, N., Hamilton, C., Kelly, L., Toth-Tarsoly, P., Dodsworth, K., Foord, D., Gordon, P., Hawes, E., Lamb, N., Mouland, J., Nightingale, J., Rose, S., Schrieber, J., Al 'Amri, K., Aladin, H., Arshad, M.A., Barraclough, J., Bentley, C., Bergin, C., Carrera, R., Clarkson, A., Collins, M., Denham, S., Griffiths, E., Ip, P., Jeyanthan, S., Joory, K., Kaur, S., Marriott, P., Mitchell, N., Nagaiah, S., Nilsson, A., Parekh, N., Pope, M., Seager, J., Serag, H., Tameem, A., Thomas, A., Thunder, J., Torrance, A., Vohra, R., Whitehouse, A., Wong, T., Blunt, M., Wong, K., Giles, J., Reed, I., Weller, D., Bell, G., Birch, J., Damant, R., Maiden, J., Mewies, C., Prince, C., Radford, J., Balain, B., Banerjee, R., Barnett, A., Burston, B., Edwards, J., Evans, C., Ford, D., Gallacher, P., Hill, S., Jaffray, D., Karlakki, S., Kennedy, J., Kiely, N., Lewthwaite, S., Marquis, C., Ockendon, M., Phillips, S., Pickard, S., Richardson, J., Roach, R., Smith, T., Spencer-Jones, R., Steele, N., Steen, J., Van Liefland, M., White, S., Faulds, M., Harris, M., Nicol, S., Pearson, S.A., Chukkambotla, S., Andrew, A., Attrill, E., Campbell, G., Datson, A., Fouracres, A., Graterol, J., Graves, L., Hong, B., Ishimaru, A., Karthikeyan, A., King, H., Lawson, T., Lee, G., Lyons, S., Macalister Hall, A., Mathoulin, S., Mcintyre, E., Mclaughlin, D., Mulcahy, K., Robbins, J., Sung, W., Tayo, A., Trembath, L., Venugopal, S., Wigmore, G., Boereboom, C., Downes, C., Humphries, R., Melbourne, S., Tou, S., Ullah, S., Batchelor, N., Boxall, L., Broomby, R., Deen, T., Hellewell, A., Helliwell, L., Hutchings, M., Hutchins, D., Keenan, S., Mackie, D., Donna, A., Smith, F., Stone, L., Thorpe, K., Wassall, R., Woodgate, A., Baillie, S., Campbell, T., James, S., King, C., Marques de Araujo, D., Martin, D., Morkane, C., Neely, J., Rajendram, R., Burton, M., James, K., Keevil, E., Minik, O., Morgan, J., Musgrave, A., Rajanna, H., Roberts, T., Adamson, M., Jumbe, S., Kendall, J., Muthuswamy, M.B., Cruikshanks, A., Wrench, I., Zeidan, L., Ardern, D., Harris, B., Hellstrom, J., Martin, J., Thomas, R., Varsani, N., Wrey Brown, C., Docherty, P., Gillies, M., McGregor, E., Usher, H., Craig, J., Ahmad, T., Bodger, P., Creary, T., Fowler, A., Ijuo, E., Jones, T., Kantsedikas, I., Lahiri, S., McLean, A.L., Niebrzegowska, E., Phull, M., Wickboldt, N., Baldwin, J., Doyle, D., Mcmullan, S., Oladapo, M., Owen, T., Williams, A., Gregory, P., Husain, T., Kirk-Bayley, J., Mathers, E., Montague, L., Avis, J., Cook, T., Dali-Kemmery, L., Kerslake, I., Lambourne, V., Pearson, A., Boyd, C., Callaghan, M., Lawson, C., McCrossan, R., Nesbitt, V., O'connor, L., Sinclair, R., Farid, N., Morgese, C., Bhatia, K., Karmarkar, S., Ahmed, J., Branagan, G., Hutton, M., Swain, A., Brookes, J., Cornell, J., Dolan, R., Hulme, J., Jansen van Vuuren, A., Jowitt, T., Kalashetty, G., Lloyd, F., Patel, K., Sherwood, N., Brown, L., Chandler, B., Deighton, K., Emma, T., Haunch, K., Cheeseman, M., Dent, K., Gray, C., Hood, M., Jones, D., Juj, J., Rao, R., Walker, T., Al Anizi, M., Cheah, C., Cheing, Y., Coutinho, F., Gondo, P., Hadebe, B., Onie Hove, M., Khader, A., Krishnachetty, B., Rhodes, K., Sokhi, J., Baker, K.A., Bertram, W., Looseley, A., Mouton, R., Arnold, G., Arya, S., Balfoussia, D., Baxter, L., Harris, J., Jones, C., Knaggs, A., Markar, S., Perera, A., Scott, A., Shida, A., Sirha, R., Wright, S., Frost, V., MacGregor, M., Andrews, E., Arrandale, L., Barrett, S., Cifra, E., Cooper, M., Dragnea, D., Elna, C., Maclean, J., Meier, S., Milliken, D., Munns, C., Ratanshi, N., Salvana, A., Watson, A., Ali, H., Critchley, R., Hicks, C., Liddle, A., Pass, M., Ritchie, C., Thomas, C., Too, L., Welsh, S., Gill, T., Johnson, J., Reed, J., Davis, E., Papadopoullos, S., Attwood, C., Biffen, A., Boulton, K., Gray, S., Hay, D., Mills, S., Montgomery, J., Riddell, R., Simpson, J., Bhardwaj, N., Paul, E., Uwubamwen, N., Alexander, M., Arrich, J., Arumugam, S., Blackwood, D., Boggiano, V., Lam Chan, Y., Chatterjee, D., Chhabra, A., Christian, R., Costelloe, H., Coxwell Matthewman, M., Dalton, E., Darko, J., Davari, M., Dave, T., Deacon, M., Deepak, S., Edmond, H., Ellis, J., El-Sayed, A., Eneje, P., English, R., Ewe, R., Foers, W., Franklin, J., Gallego, L., Garrett, E., Goldberg, O., Goss, H., Greaves, R., Harris, R., Hennings, C., Jones, E., Kamali, N., Kokkinos, N., Lewis, C., Lignos, L., Malgapo, E.V., Malik, R., Milne, A., Mulligan, J.P., Nicklin, P., Palipane, N., Parsons, T., Piper, R., Prakash, R., Ramesh, B., Rasip, S., Reading, J., Rela, M., Reyes, A., Robert, S., Rooms, M., Shah, K., Simons, H., Solanki, S., Spowart, E., Stevens, A., Waggett, H., Yassaee, A., Kennedy, A., Scott, S., Somanath, S., Berg, A., Hernandez, M., Nanda, R., Tank, G., Wilson, N., Wilson, D., Al-Soudaine, Y., Baldwin, M., Cornish, J., Davies, Z., Davies, L., Edwards, M., Frewer, N., Gallard, S., Glasbey, J., Harries, R., Hopkins, L., Kim, T., Koompirochana, V., Lawson, S., Lewis, M., Makzal, Z., Scourfield, S., Ahmad, Y., Bates, S., Blackwell, C., Bryant, H., Coulter, S., Cruickshank, R., Daniel, S., Daubeny, T., Golder, K., Hawkins, L., Helen, B., Hinxman, H., Levett, D., Skinner, B., Walsgrove, J., Dickson, J., Constantin, K., Karen, M., O'Brien, P., O'Donohoe, L., Payne, H., Sundayi, S., Walker, E., Brooke, J., Cardy, J., Humphreys, S., Kessack, L., Kubitzek, C., Kumar, S., Cotterill, D., Hodzovic, E., Hosdurga, G., Miles, E., Saunders, G., Campbell, M., Chan, P., Jemmett, K., Raj, A., Naik, A., Ramamoorthy, R., Shah, N., Sylvan, A., Blyth, K., Burtenshaw, A., Freeman, D., Johnson, E., Lo, P., Martin, T., Plunkett, E., Wollaston, J., Allison, J., Carroll, C., Craw, N., Craw, S., Pitt-Kerby, T., Rowland-Axe, R., Spurdle, K., McDonald, A., Simon, D., Sinha, V., Banner-Goodspeed, V., Boone, M., Campbell, K., Lu, F., Scannell, J., Sobol, J., Balajonda, N., Clemmons, K., Conde, C., Funk, B., Hopkins, T., Olaleye, O., Omer, O., Pender, M., Porto, A., Waweru, P., Yeh, E., Bodansky, D., Evans, A., Kleopoulos, S., Maril, R., Mathney, E., Sanchez, A., Tinuoye, E., Bateman, B., Eng, K., Jiang, N., Ladha, K., Needleman, J., Chen, L.L., Lane, R., Robinowitz, D., Ghushe, N., Irshad, M., Patel, S., Takemoto, S., Wallace, A., Mazzeffi, M., Rock, P., Wallace, K., Zhu, X., Chua, P., Mattera, M., Sharar, R., Thilen, S., Treggiari, M., Morgan, A., Sofjan, I., Subramaniam, K., Avidan, M., Maybrier, H., Muench, M., and Wildes, T.
Subjects: Male, HSJ UCI, Critical Care and Intensive Care Medicine, law.invention, Perioperative Care/methods, 0302 clinical medicine, Surgical procedures, 030202 anesthesiology, law, Critical care/utilisation, Postoperative care/methods, Postoperative care/statistics and numerical data, Surgical procedures, operative/mortality, statistics and numerical data, Prospective Studies, Postoperative Period, Postoperative care/methods, education.field_of_study, Postoperative care/method, Elective Surgical Procedures/mortality, fluid output, Middle Aged, fluid administration, Intensive care unit, Hospitalization, Length of Stay/statistics & numerical data, operative/mortality, Intensive Care Units/statistics & numerical data, outcome, Female, Elective Surgical Procedure, Human, Adult, medicine.medical_specialty, Logistic Model, Postoperative care/statistics and numerical data, Critical care/utilisation, Population, Intensive Care Unit, Elective Surgical Procedures/statistics & numerical data, Hospitalization/statistics & numerical data, Humans, Logistic Models, Surgical procedures, operative/mortality, Postoperative care, methods, Perioperative Care, NO, 03 medical and health sciences, Anesthesiology, Intensive care, medicine, Elective surgery, Intensive care medicine, education, business.industry, 030208 emergency & critical care medicine, Perioperative, Length of Stay, Clinical trial, Prospective Studie, septic shock, business
Abstract: PURPOSE: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. METHODS: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. RESULTS: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10-5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. CONCLUSIONS: We did not identify any survival benefit from critical care admission following surgery. info:eu-repo/semantics/publishedVersion
Published: 2017
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15. Rehabilitation in Patients with Anterior Cruciate Ligament Reconstruction Using Auxiliary Platelet-Rich Plasma Therapy

Author: Tiberiu Băţagă, Monica Copotoiu, Daniel – Emil Albu, Sanda Maria Copotoiu, and Răzvan Melinte
Subjects: 030222 orthopedics, medicine.medical_specialty, Rehabilitation, Anterior cruciate ligament reconstruction, business.industry, medicine.medical_treatment, 030229 sport sciences, musculoskeletal system, Surgery, rehabilitation, 03 medical and health sciences, 0302 clinical medicine, Platelet-rich plasma, platelets, cruciate ligament, Medicine, In patient, General Pharmacology, Toxicology and Pharmaceutics, business, General Dentistry, human activities, plasma
Abstract: Background: The main target after successful AnteriorCruciate Ligament (ACL) reconstruction is early rehabilitation. New options such as PRP (platelet rich plasma) may improve clinical outcomes. Objective: The aim of our study was to evaluate two consecutive series of patients who underwent ACL reconstruction, one with PRP treatment and one without it. Material and method: Two groups of consecutive patients underwent arthroscopic ACL reconstruction, using the SemiT and BPTB techniques. Postoperatively all patients included in this study followed the same standardized rehabilitation protocol. In addition, patients in the first group received three intraarticular PRP injections as auxiliary therapy. Injections were performed at week two, four and six. The patients were evaluated at enrolment and every four and twelve weeks using the Tegner Lysholm Knee Scoring Scale (Scoring Scale: poor 90). Each patient was operated on and evaluated afterwards by the same team of surgeons. Results: At 12 weeks interval, Group A had a higher mean clinical score than Group B (94.67 vs 92.50) although marginally not statistically significant (p=0.0503, 95% CI: −4.336 to 0.002911). Regarding pain in patients from Group A compared with patients from Group B, we saw a statistically significant difference at 4 weeks interval (16.90 vs. 18.89, p=0.0370, 95% CI: 0.1260 to 3.842) and no significant difference at 12 weeks interval (21.19 vs. 21.94, p=0.3744, 95%CI: −0.9452 to 2.453). In terms of swelling points scored between the two groups, there was no statistically significant difference at 4 week interval (5.048 vs. 4.00, p=0.1979, 95% CI: −2.667 to 0.5714) but there is a significant difference in favor of patients from Group A at 12 weeks interval (8.475 vs. 5.556, p=0.0002, 95% CI: −4.323 to −1.159). Conclusions: In the short term, the local treatment showed improvement on the overall clinical status of the patients (less pain, improved mobility, less swelling) undergoing rehabilitation after ACL reconstruction, although further studies are required.
Published: 2016

16. Ang-2, Tie-2, and Ang-2/Tie-2 ratio serum levels as diagnostic and prognostic biomarkers of sepsis in critically ill patients

Author: Alexandra Lazar, Ario Santini, Emőke Almásy, Sanda Maria Copotoiu, Anca Meda Georgescu, Leonard Azamfirei, Janos Szederjesi, and Adina Hutanu
Subjects: Oncology, medicine.medical_specialty, Critically ill, business.industry, critically ill, 030208 emergency & critical care medicine, 030204 cardiovascular system & hematology, medicine.disease, ang-2, tie-2, Sepsis, sepsis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, cardiovascular system, Biomarker (medicine), biomarker, Medicine, Intensive care medicine, business
Abstract: Sepsis represents one the main cause of death in patients admitted to the intensive care. Biomarkers offer an alternative approach to the diagnostic and prognostic evaluation and improve the outcomes. Angiopoietin 2 (Ang-2) and Tyrosine kinase 2 (Tie-2) are biomarkers which may be involved in sepsis, Ang-2 being responsible for vascular remodelling while Tie-2 is their endothelial receptor. The aim of the study: To assess the Ang-2, Tie-2 and Ang-2/Tie-2 ratio serum levels in septic and non-septic patients and to investigate the independent value of circulating Ang-2, Tie-2, and Ang-2/Tie-2 ratios as predictors of prognosis in critically ill medical patients. Study design: The study included 74 adults admitted to an intensive care unit (ICU). The patients were separated in two groups: Group A [sepsis: n=40] and Group B [no-sepsis: n= 34] patients. Serum levels of Ang-2 and Tie-2 were determined in the first 12 hours after admission and were correlated with ICU severity scores, APACHE II, SOFA and SAPS and with the death rate. Results: Group A gave significantly higher values (p=0.01), for serum Ang-2 (11.07±9.21 ng/ml) compared to Group B (6.18±5.28 ng/ml). The level of Tie-2 was also higher (11.03±5.12 ng/ml) in Group A compared to Group B (9.46±4.99 ng/ml) (p=0.19). In Group A, the Ang-2/Tie2 ratio showed higher values than Group B (p=0.02). There was a positive association between severity scores (APACHE II, SAPS, and SOFA) and Ang-2, and Ang-2/ Tie-2 ratio, but not for Tie2. Conclusions: In our study Ang-2 and Ang-2/Tie-2 ratio serum levels had independent diagnostic value in patients with sepsis, as measured on admission.
Published: 2016

17. Much Ado About the New Definitions of Sepsis

Author: Sanda Maria Copotoiu and Ruxandra Copotoiu
Subjects: medicine.medical_specialty, RC86-88.9, business.industry, Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Review, medicine.disease, law.invention, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Epidemiology, medicine, 030212 general & internal medicine, sepsis-3, Intensive care medicine, business, sepsis definition
Abstract: Following the publication of the new definition of sepsis (Sepsis-3), a plethora of articles have been published in medical journals. Recognizing the epidemiological importance of the previous definitions, first issued in 1992 (Sepsis-1), and subsequently revised in 2001 (Sepsis-2), the most recent opinion emphasizes the failure “to provide adequate groups of patients with homogenous aetiologies, presentations and outcomes”, and blamed one of the causes “for the failure of several randomized controlled trials (RCTs), that tested the efficacy of adjuvant sepsis therapies”. This review summarizes the recent advances in sepsis definition.
Published: 2016
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18. Intersphincteric Resection for Low Rectal Cancer – Case Report

Author: Varlam Claudiu Molnar, Sanda Maria Copotoiu, Mircea Gherghinescu, Cristian Russu, Claudiu Sărăcuț, Calin Molnar, and Constantin Copotoiu
Subjects: medicine.medical_specialty, business.industry, Intersphincteric resection, Surgery, 03 medical and health sciences, 0302 clinical medicine, Low rectal cancer, intersphincteric resection, 030220 oncology & carcinogenesis, interdisciplinary, Medicine, low rectal cancer, 030211 gastroenterology & hepatology, General Pharmacology, Toxicology and Pharmaceutics, business, General Dentistry, radiotherapy
Abstract: Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter’s function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome. Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions) followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up. Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.
Published: 2016
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19. Mass Casualty Incidents and Disaster Participation in Real versus Simulated Events in Romania

Author: Cristian Boeriu, Sanda Maria Copotoiu, and Adrian Stănescu
Subjects: 020205 medical informatics, business.industry, 030208 emergency & critical care medicine, 02 engineering and technology, simulation, medicine.disease, disasters, mci, 03 medical and health sciences, Mass-casualty incident, 0302 clinical medicine, Environmental protection, 0202 electrical engineering, electronic engineering, information engineering, Medicine, Medical emergency, General Pharmacology, Toxicology and Pharmaceutics, romania, business, mass casualty incidents, General Dentistry
Abstract: Background: The current study outlines some of the main particularities of both real and simulated mass casualty incidents (MCI) and disasters in Romania as reported by medical and paramedical participating personnel. Methods: A non-profit organization in Romania trained 1250 doctors, nurses and paramedics for proper MCI interventions through a dedicated programme for the last part of the year 2013. Half a year later, an email with a unique link to an online questionnaire was sent to each participant to assess their opinion over the participation in real or already simulated MCI or disasters. The questionnaire consisted of 25 specific topics, out of which only a fraction were considered for the current study. Results: Out of all participants, 145 doctors, 184 nurses and 115 paramedics provided valid answers, totaling 444 responders. Most participants were satisfied with the information about the location and type of the incident they would respond to. The amplitude of a given event is generally well anticipated under simulation conditions as compared to real events, where the amplitude tends to be higher rather than lower than expected (p=0.0082). About three quarters of participants under real or simulated events repeated or demanded repeating the information trafficked through mobile radios, almost a quarter misinterpreted the information, and almost a half reported delayed operations due to miscommunication. Conclusions: Simulations are a proper method of communication evaluation for mass casualty incidents and disasters, which can also stress the common communication issues encountered during a real MCI unfolding.
Published: 2016
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20. Improving nontechnical skills of an interprofessional emergency medical team through a one day crisis resource management training

Author: Marius Petrisor, Emilia Turucz, Dan Vatau, Cristian Boeriu, Teodora Sorana Truta, Sanda Maria Copotoiu, and Marc Lazarovici
Subjects: Male, Health Knowledge, Attitudes, Practice, Inservice Training, Time Factors, Attitude of Health Personnel, MEDLINE, Nurses, Training (civil), Crisis resource management, 03 medical and health sciences, 0302 clinical medicine, Physicians, Health care, Medicine, Humans, Resource management, 030212 general & internal medicine, Prospective Studies, Simulation Training, Team composition, Patient Care Team, business.industry, Internship and Residency, 030208 emergency & critical care medicine, General Medicine, medicine.disease, Quality Improvement, Variety (cybernetics), Emergency Medicine, Medical team, Female, Medical emergency, Clinical Competence, business, Emergency Service, Hospital
Abstract: Errors are frequent in healthcare, but Emergency Departments are among the highest risk areas due to frequent changes in team composition, complexity and variety of cases, and difficulties encountered in managing multiple patients simultaneously.Crisis resource management (CRM) training has been associated with decreased error rates in the aviation industry as well as in certain areas of acute medical care, such as anesthesia and emergency medicine. In this study, we assessed whether a single day CRM training, combining didactic and simulation sessions, improves nontechnical skills (NTS) of interprofessional emergency medical teams.Seventy health professionals with different qualifications, working in an emergency department, were enrolled in the study. Twenty individual interprofessional teams were created. Each team was assessed before and after the training, through 2 in situ simulated exercises. The exercises were videotaped and were evaluated by 2 assessors who were blinded as to whether it was the initial or the final exercise. They used a new tool designed specifically for the assessment of emergency physicians' NTS. The intervention consisted of one-day training, combining didactic and simulation sessions, followed by an instructor facilitated debriefing. All participants went through this training after the initial assessment exercises.A significant improvement (P 0.05) was shown for all the NTS assessed, in all professional categories involved, regardless of the duration of prior work experience in the Emergency Department.This study shows that even a short intervention, such as a single day CRM training, can have a significant impact in improving NTS, and can potentially improve patient safety.
Published: 2018

21. The effectiveness of using medical students for training high school students in cardiopulmonary resuscitation

Author: Natalia Hagău, Loredana Fărcaş, Dan Sebastian Dîrzu, Sanda Maria Copotoiu, and Theodor Boţ
Subjects: training, business.industry, medicine.medical_treatment, education, high school students, effectiveness, medical students, 030208 emergency & critical care medicine, 030204 cardiovascular system & hematology, medicine.disease, cardiopulmonary resuscitation, 03 medical and health sciences, 0302 clinical medicine, Medicine, Cardiopulmonary resuscitation, Medical emergency, General Pharmacology, Toxicology and Pharmaceutics, business, General Dentistry
Abstract: Introduction: Training for cardiopulmonary resuscitation is a very important topic for society, trainers and researchers. However it is not yet established who should be trained and by whom nor how the training programmes should be accomplished. We developed a study to evaluate an existing programme where medical students train high school students in cardiopulmonary resuscitation using instrumented mannequins to teach and collect performance data. Method: The students of four randomly selected high school classes were trained by four randomly selected medical students and were evaluated by an independent evaluator. The level of knowledge provided and the level of technical skills acquired were analysed. Results: One hour of lecturing was enough to increase the mean of correct answers from 39.52% to 78.48% when we tested knowledge. Testing for skills retention we found that that 92.75% of trained students taped the shoulder; 95.65% asked loudly “Are you all right?” at the right moment; 97.1% shouted for help at the right moment, the entire group remembered to check the breathing at the right moment, and 92.75% executed a correct head tilt chin lift manoeuvre; 86.9% remembered to call 112 at the right moment. Automatic recordings showed that mean flow fraction was 80.74%, mean no flow time was 18.9 seconds, mean frequency of chest compressions was 134.7/min and mean compression depth was 39.06 mm. Conclusions: The results showed that high school students achieved a good level of knowledge and acceptable cardiopulmonary resuscitation skills when trained by medical students.
Published: 2016
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22. The surgical safety checklist and patient outcomes after surgery

Author: T.E.F. Abbott, T. Ahmad, M.K. Phull, A.J. Fowler, R. Hewson, B.M. Biccard, M.S. Chew, M. Gillies, R.M. Pearse, Rupert M. Pearse, Scott Beattie, Pierre-Alain Clavien, Nicolas Demartines, Lee A. Fleisher, Mike Grocott, James Haddow, Andreas Hoeft, Peter Holt, Rui Moreno, Naomi Pritchard, Andrew Rhodes, Duminda Wijeysundera, Matt Wilson, Tahania Ahmed, Kirsty Everingham, Russell Hewson, Marta Januszewska, Mandeep-Kaur Phull, Richard Halliwell, Mark Shulman, Paul Myles, Werner Schmid, Michael Hiesmayr, Patrick Wouters, Stefan de Hert, Suzana Lobo, Xiangming Fang, Lars Rasmussen, Emmanuel Futier, Matthieu Biais, Aurélien Venara, Karem Slim, Michael Sander, Despoina Koulenti, Kostoula Arvaniti, Mathew Chan, Atul Kulkarni, Susilo Chandra, Aida Tantri, Emad Geddoa, Muntadhar Abbas, Giorgio Della Rocca, Datin Sivasakthi, Marzida Mansor, Pastor Luna, Arthur Bouwman, Wolfgang Buhre, Vanessa Beavis, Douglas Campbell, Tim Short, Tunde Osinaike, Ricardo Matos, Ioana Grigoras, Mikhail Kirov, Denis Protsenko, Bruce Biccard, Cesar Aldecoa, Michelle Chew, Christoph Hofer, Martin Hubner, James Ditai, Tamas Szakmany, Lee Fleisher, Marissa Ferguson, Michael MacMahon, Ritchie Cherian, Helen Currow, Kathirgamanathan Kanathiban, David Gillespie, Edward Pathmanathan, Katherine Phillips, Jenifer Reynolds, Joanne Rowley, Jeanene Douglas, Ross Kerridge, Sameer Garg, Michael Bennett, Megha Jain, David Alcock, Nico Terblanche, Rochelle Cotter, Kate Leslie, Marcelle Stewart, Nicolette Zingerle, Antony Clyde, Oliver Hambidge, Adam Rehak, Sharon Cotterell, Wilson Binh Quan Huynh, Timothy McCulloch, Erez Ben-Menachem, Thomas Egan, Jennifer Cope, Paul Fellinger, Markus Haisjackl, Simone Haselberger, Caroline Holaubek, Paul Lichtenegger, Florian Scherz, Franz Hoffer, Veronika Cakova, Andreas Eichwalder, Norbert Fischbach, Reinhold Klug, Elisabeth Schneider, Martin Vesely, Reinhart Wickenhauser, Karl Gernot Grubmueller, Marion Leitgeb, Friedrich Lang, Nancy Toro, Marlene Bauer, Friedrich Laengle, Claudia Haberl, Thomas Mayrhofer, Christoph Trybus, Christian Buerkle, Karin Forstner, Reinhard Germann, Harald Rinoesl, Elke Schindler, Ernst Trampitsch, Gerhard Bogner, Daniel Dankl, Martin 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Collins, Suzanne Coulter, Ross Cruickshank, Sonya Daniel, Thomas Daubeny, Mark Edwards, Kim Golder, Lesley Hawkins, Bryant Helen, Honor Hinxman, Denny Levett, Karen Salmon, Leanne Seaward, Ben Skinner, Bryony Tyrell, Beverley Wadams, Joseph Walsgrove, Jane Dickson, Kathryn Constantin, Markwell Karen, Peter O'Brien, Lynn O'Donohoe, Hannah Payne, Saul Sundayi, Elaine Walker, Jenny Brooke, Jon Cardy, Sally Humphreys, Laura Kessack, Christiane Kubitzek, Suhas Kumar, Donna Cotterill, Emil Hodzovic, Gurunath Hosdurga, Edward Miles, Glenn Saunders, Marta Campbell, Peter Chan, Kim Jemmett, Ashok Raj, Aditi Naik, Ayo Oshowo, Rajarajan Ramamoorthy, Nimesh Shah, Axel Sylvan, Katharine Blyth, Andrew Burtenshaw, David Freeman, Emily Johnson, Philip Lo, Terry Martin, Emma Plunkett, Julie Wollaston, Joanna Allison, Christine Carroll, Nicholas Craw, Sarah Craw, Tressy Pitt-Kerby, Rebecca Rowland-Axe, Katie Spurdle, Andrew McDonald, Davies Simon, Vivek Sinha, Thomas Smith, Valerie Banner-Goodspeed, Myles Boone, Kathleen Campbell, Fengxin Lu, Joseph Scannell, Julia Sobol, Naraida Balajonda, Karen Clemmons, Carlos Conde, Magdi Elgasim, Bonita Funk, Roger Hall, Thomas Hopkins, Omowunmi Olaleye, Omer Omer, Michelle Pender, Angelo Porto, Alice Stevens, Peter Waweru, Erlinda Yeh, Daniella Bodansky, Adam Evans, Steven Kleopoulos, Robert Maril, Edward Mathney, Angela Sanchez, Elizabeth Tinuoye, Brian Bateman, Kristen Eng, Ning Jiang, Karim Ladha, Joseph Needleman, Lee-lynn Chen, Rondall Lane, David Robinowitz, Neil Ghushe, Mariam Irshad, John O'Connor, Samir Patel, Steven Takemoto, Art Wallace, Michael Mazzeffi, Peter Rock, Karin Wallace, Xiaomao Zhu, Pandora Chua, Matthew Mattera, Rebecca Sharar, Stephan Thilen, Miriam Treggiari, Angela Morgan, Iwan Sofjan, Kathirvel Subramaniam, Michael Avidan, Hannah Maybrier, Maxwell Muench, Troy Wildes, Faculty of Economic and Social Sciences and Solvay Business School, Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Queen Mary University of London (QMUL), Royal Free Hospital [London, UK], NHS Foundation Trust [London], The Royal Marsden, University of Cape Town, Linköping university hospital, University of Edinburgh, Abbott, T E F, Ahmad, T, Phull, M K, Fowler, A J, Hewson, R, Biccard, B M, Chew, M S, Gillies, M, Pearse RM, Beattie S, Clavien PA, Demartines N, Fleisher LA, Grocott M, Haddow J, Hoeft A, Holt P, Moreno R, Pritchard N, Rhodes A, Wijeysundera D, Wilson M, Ahmed T, Everingham K, Hewson R, Januszewska M, Phull MK, Halliwell R, Shulman M, Myles P, Schmid W, Hiesmayr M, Wouters P, de Hert S, Lobo S, Fang X, Rasmussen L, Futier E, Biais M, Venara A, Slim K, Sander M, Koulenti D, Arvaniti K, Chan M, Kulkarni A, Chandra S, Tantri A, Geddoa E, Abbas M, Della Rocca G, Sivasakthi D, Mansor M, Luna P, Bouwman A, Buhre W, Beavis V, Campbell D, Short T, Osinaike T, Matos R, Grigoras I, Kirov M, Protsenko D, Biccard B, Aldecoa C, Chew M, Hofer C, Hubner M, Ditai J, Szakmany T, Fleisher L, Ferguson M, MacMahon M, Cherian R, Currow H, Kanathiban K, Gillespie D, Pathmanathan E, Phillips K, Reynolds J, Rowley J, Douglas J, Kerridge R, Garg S, Bennett M, Jain M, Alcock D, Terblanche N, Cotter R, Leslie K, Stewart M, Zingerle N, Clyde A, Hambidge O, Rehak A, Cotterell S, Huynh WBQ, McCulloch T, Ben-Menachem E, Egan T, Cope J, Fellinger P, Haisjackl M, Haselberger S, Holaubek C, Lichtenegger P, Scherz F, Hoffer F, Cakova V, Eichwalder A, Fischbach N, Klug R, Schneider E, Vesely M, Wickenhauser R, Grubmueller KG, Leitgeb M, Lang F, Toro N, Bauer M, Laengle F, Haberl C, Mayrhofer T, Trybus C, Buerkle C, Forstner K, Germann R, Rinoesl H, Schindler E, Trampitsch E, Bogner G, Dankl D, Duenser M, Fritsch G, Gradwohl-Matis I, Hartmann A, Hoelzenbein T, Jaeger T, Landauer F, Lindl G, Lux M, Steindl J, Stundner O, Szabo C, Bidgoli J, Verdoodt H, Forget P, Kahn D, Lois F, Momeni M, Prégardien C, Pospiech A, Steyaert A, Veevaete L, De Kegel D, De Jongh K, Foubert L, Smitz C, Vercauteren M, Poelaert J, Van Mossevelde V, Abeloos J, Bouchez S, Coppens M, De Baerdemaeker L, Deblaere I, De Bruyne A, Fonck K, Heyse B, Jacobs T, Lapage K, Moerman A, Neckebroek M, Parashchanka A, Roels N, Van Den Eynde N, Vandenheuvel M, Limmen J, Vanluchene A, Vanpeteghem C, Wyffels P, Huygens C, Vandenbempt P, Van de Velde M, Dylst D, Janssen B, Schreurs E, Aleixo FB, Candido K, Batista HD, Guimarães M, Guizeline J, Hoffmann J, Lobo FRM, Nascimento V, Nishiyama K, Pazetto L, Souza D, Rodrigues RS, Vilela Dos Santos AM, Jardim J, Sá Malbouisson LM, Silva J, Nascimento Junior PD, Baio TH, Pereira de Castro GI, Watanabe Oliveira HR, Amendola CP, Cardoso G, Ortega D, Brotto AF, De Oliveira MC, Réa-Neto Á, Dias F, Travi ME, Zerman L, Azambuja P, Knibel MF, Martins A, Almeida W, Neto CN, Tardelli MA, Caser E, Machado M, Aguzzoli C, Baldisserotto S, Tabajara FB, Bettega F, Rodrigues Júnior HC, de Gasperi J, Faina L, Nolasco MF, Ferreira da Costa Fischer B, Fosch de Campos Ferreira M, Hartmann C, Kliemann M, Hubert Ribeiro GL, Fraga JM, Netto TM, Pozza LV, Wendling PR, Azevedo C, Garcia J, Lopes M, Maia B, Maselli P, Melo R, Mendes W, Neves M, Ney J, Piras C, Applewhaite C, Carr A, Chow L, Duttchen K, Foglia J, Greene M, Hinther A, Houston K, McCormick TJ, Mikhayel J, Montasser S, Ragan A, Suen A, Woolsey A, Yu HC, Funk D, Kowalski S, Legaspi R, McDonald H, Siddiqui F, Pridham J, Rowe B, Sampson S, Thiessen B, Zbitnew G, Bernard A, George R, Jones P, Moor R, Siddiqui N, Wolfer A, Tran D, Winch D, Dobson G, McCormick T, Montasser O, Hall R, Baghirzada L, Curley G, Dai SY, Hare G, Lee E, Shastri U, Tsui A, Yagnik A, Alvares D, Choi S, Dwyer H, Flores K, McCartney C, Somascanthan P, Carroll J, Pazmino-Canizares J, Wolfer A, Ami N, Chan V, Perlas A, Argue R, Huang Y, Lavis K, Mayson K, Cao Y, Gao H, Hu T, Lv J, Yang J, Yang Y, Zhong Y, Zhou J, Zou X, He M, Li X, Luo D, Wang H, Yu T, Chen L, Wang L, Cai Y, Cao Z, Li Y, Lian J, Sun H, Wang S, Wang Z, Wang K, Zhu Y, Du X, Fan H, Fu Y, Huang L, Huang Y, Hwan H, Luo H, Qu PS, Tao F, Wang Z, Wang G, Wang S, Zhang Y, Zhang X, Chen C, Wang W, Liu Z, Fan L, Tang J, Chen Y, Chen Y, Han Y, Huang C, Liang G, Shen J, Wang J, Yang Q, Zhen J, Zhou H, Chen J, Chen Z, Li X, Meng B, Ye H, Zhang X, Bi Y, Cao J, Guo F, Lin H, Liu Y, Lv M, Shi P, Song X, Sun C, Sun Y, Wang Y, Wang S, Zhang M, Chen R, Hou J, Leng Y, Meng QT, Qian L, Shen ZY, Xia ZY, Xue R, Zhang Y, Zhao B, Zhou XJ, Chen Q, Guo H, Guo Y, Qi Y, Wang Z, Wei J, Zhang W, Zheng L, Bao Q, Chen Y, Chen Y, Fei Y, Hu N, Hu X, Lei M, Li X, Lv X, Miao F, Ouyang L, Qian L, Shen C, Sun Y, Wang Y, Wang D, Wu C, Xu L, Yuan J, Zhang L, Zhang H, Zhang Y, Zhao J, Zhao C, Zhao L, Zheng T, Zhou D, Zhou H, Zhou C, Lu K, Zhao T, He C, Chen H, Chen S, Cheng B, He J, Jin L, Li C, Li H, Pan Y, Shi Y, Wen XH, Wu S, Xie G, Zhang K, Zhao B, Lu X, Chen F, Liang Q, Lin X, Ling Y, Liu G, Tao J, Yang L, Zhou J, Chen F, Cheng Z, Dai H, Feng Y, Hou B, Gong H, Hu CH, Huang H, Huang J, Jiang Z, Li M, Lin J, Liu M, Liu W, Liu Z, Liu Z, Luo F, Ma L, Min J, Shi X, Song Z, Wan X, Xiong Y, Xu L, Yang S, Zhang Q, Zhang H, Zhang H, Zhang X, Zhao L, Zhao W, Zhao W, Zhu X, Bai Y, Chen L, Chen S, Dai Q, Geng W, Han K, He X, Huang L, Ji B, Jia D, Jin S, Li Q, Liang D, Luo S, Lwang L, Mo Y, Pan Y, Qi X, Qian M, Qin J, Ren Y, Shi Y, Wang J, Wang J, Wang L, Xie J, Yan Y, Yao Y, Zhang M, Zhao J, Zhuang X, Ai Y, Du F, He L, Huang L, Li Z, Li H, Li Y, Li L, Meng S, Yuan Y, Zhang E, Zhang J, Zhao S, Ji Z, Pei L, Wang L, Chen C, Dong B, Li J, Miao Z, Mu H, Qin C, Su L, Wen Z, Xie K, Yu Y, Yuan F, Hu X, Zhang Y, Xiao W, Zhu Z, Dai Q, Fu K, Hu R, Hu X, Huang S, Li Y, Liang Y, Yu S, Guo Z, Jing Y, Tang N, Wu J, Yuan D, Zhang R, Zhao X, Li Y, Bai HP, Liu CX, Liu FF, Ren W, Wang XL, Xu GJ, Hu N, Li B, Ou Y, Tang Y, Yao S, Zhang S, Kong CC, Liu B, Wang T, Xiao W, Lu B, Xia Y, Zhou J, Cai F, Chen P, Hu S, Wang H, Xu Q, Hu L, Jing L, Li B, Liu Q, Liu Y, Lu X, Peng ZD, Qiu X, Ren Q, Tong Y, Wang J, Wen Y, Wu Q, Xia J, Xie J, Xiong X, Xu S, Yang T, Ye H, Yin N, Yuan J, Zeng Q, Zhang B, Zheng K, Cang J, Chen S, Fan Y, Fu S, Ge X, Guo B, Huang W, Jiang L, Jiang X, Liu Y, Pan Y, Ren Y, Shan Q, Wang J, Wang F, Wu C, Zhang X, Christiansen IC, Granum SN, Rasmussen BS, Daugaard M, Gambhir R, Brandsborg B, Steingrímsdóttir GE, Jensen-Gadegaard P, Olsen KS, Siegel H, Eskildsen KZ, Gätke MR, Wibrandt I, Heintzelmann SB, Wiborg Lange KH, Lundsgaard RS, Amstrup-Hansen L, Hovendal C, Larsen M, Lenstrup M, Kobborg T, Larsen JR, Pedersen AB, Smith SH, Oestervig RM, Afshari A, Andersen C, Ekelund K, Secher EL, Beloeil H, Lasocki S, Ouattara A, Sineus M, Molliex S, Legouge ML, Wallet F, Tesniere A, Gaudin C, Lehur P, Forsans E, de Rudnicki S, Maudet VS, Mutter D, Sojod G, Ouaissi M, Regimbeau JM, Desbordes J, Comptaer N, Manser DE, Ethgen S, Lebuffe G, Auer P, Härtl C, Deja M, Legashov K, Sonnemann S, Wiegand-Loehnert C, Falk E, Habicher M, Angermair S, Laetsch B, Schmidt K, Von Heymann C, Ramminger A, Jelschen F, Pabel S, Weyland A, Czeslick E, Gille J, Malcharek M, Sablotzki A, Lueke K, Wetzel P, Weimann J, Lenhart FP, Reichle F, Schirmer F, Hüppe M, Klotz K, Nau C, Schön J, Mencke T, Wasmund C, Bankewitz C, Baumgarten G, Fleischer A, Guttenthaler V, Hack Y, Kirchgaessner K, Männer O, Schurig-Urbaniak M, Struck R, van Zyl R, Wittmann M, Goebel U, Harris S, Veit S, Andreadaki E, Souri F, Katsiadramis I, Skoufi A, Vasileiou M, Aimoniotou-Georgiou E, Katsourakis A, Veroniki F, Vlachogianni G, Petra K, Chlorou D, Oloktsidou E, Ourailoglou V, Papapostolou K, Tsaousi G, Daikou P, Dedemadi G, Kalaitzopoulos I, Loumpias C, Bristogiannis S, Dafnios N, Gkiokas G, Kontis E, Kozompoli D, Papailia A, Theodosopoulos T, Bizios C, Koutsikou A, Moustaka A, Plaitakis I, Armaganidis A, Christodoulopoulou T, Lignos M, Theodorakopoulou M, Asimakos A, Ischaki E, Tsagkaraki A, Zakynthinos S, Antoniadou E, Koutelidakis I, Lathyris D, Pozidou I, Voloudakis N, Dalamagka M, Elena G, Chronis C, Manolakaki D, Mosxogiannidis D, Slepova T, Tsakiridou IS, Lampiri C, Vachlioti A, Panagiotakis C, Sfyras D, Tsimpoukas F, Tsirogianni A, Axioti E, Filippopoulos A, Kalliafa E, Kassavetis G, Katralis P, Komnos I, Pilichos G, Ravani I, Totis A, Apagaki E, Efthymiadi A, Kampagiannis N, Paraforou T, Tsioka A, Georgiou G, Vakalos A, Bairaktari A, Charitos E, Markou G, Niforopoulou P, Papakonstantinou N, Tsigou E, Xifara A, Zoulamoglou M, Gkioni P, Karatzas S, Kyparissi A, Mainas E, Papapanagiotou I, Papavasilopoulou T, Fragandreas G, Georgopoulou E, Katsika E, Psarras K, Synekidou E, Verroiotou M, Vetsiou E, Zaimi D, Anagnou A, Apostolou K, Melissopoulou T, Rozenberg T, Tsigris C, Boutsikos G, Kalles V, Kotsalas N, Lavdaiou C, Paikou F, Panagou GL, Spring A, Botis I, Drimala M, Georgakakis G, Kiourtzieva E, Ntouma P, Prionas A, Xouplidis K, Dalampini E, Giannaki C, Iasonidou C, Ioannidis O, Lavrentieva A, Lavrentieva A, Papageorgiou G, Kokkinoy M, Stafylaraki M, Gaitanakis S, Karydakis P, Paltoglou J, Ponireas P, Chaloulis P, Provatidis A, Sousana A, Gardikou VV, Konstantivelli M, Lataniotou O, Lisari E, Margaroni M, Stamatiou K, Nikolaidis E, Pnevmatikos I, Sertaridou E, Andreou A, Arkalaki E, Athanasakis E, Chaniotaki F, Chatzimichali CA, Christofaki M, Dermitzaki D, Fiorentza K, Frantzeskos G, Geromarkaki E, Kafkalaki K, Kalogridaki M, Karydi K, Kokkini S, Kougentakis G, Lefaki T, Lilitsis E, Makatounaki A, Malliotakis P, Michelakis D, Neonaki M, Nyktari V, Palikyra I, Papadakis E, Papaioannou A, Sfakianakis K, Sgouraki M, Souvatzis X, Spartinou A, Stefanidou N, Syrogianni P, Tsagkaraki G, Arnaoutoglou E, Arnaoutoglou C, Bali C, Bouris V, Doumos R, Gkini KP, Kapaktsi C, Koulouras V, Lena A, Lepida D, Michos E, Papadopoulos D, Paschopoulos M, Rompou VA, Siouti I, Tsampalas S, Ververidou O, Zilis G, Charlalampidoy A, Christodoulidis G, Flossos A, Stamoulis K, Chan M, Tsang MSC, Tsang MS, Lai ML, Yip CP, Heymans Chan HM, Law B, Li WS, Chu HM, Koo EGY, Lam CCJ, Cheng KH, Lam T, Chu S, Lam WY, Wong KWK, Kwok D, Hung CYJ, Chan WKJ, Wong WL, Chung CKE, Ma SK, Kaushik S, Shah B, Shah D, Shah S, Ar P, Muthuchellappan R, Agarwal V, Divatia J, Mishra S, Nimje G, Pande S, Savarkar S, Shrivastava A, Thomas M, Yegnaram S, Hidayatullah R, Puar N, Niman S, Indra I, Hamzah Z, Yuliana A, Abidin UN, Dursin AN, Kurnia A, Susanti A, Handayani D, Alit MA, Arya A, Senapathi TGA, Utara UH, Wid WM, Wima S, Wir WM, Jehosua B, Kaunang J, Lantang EY, Najoan R, Waworuntu N, Awad H, Fuad A, Geddoa B, Khalaf AR, Al Hussaini S, Albaj S, Kenber M, Bettinelli A, Spadaro S, AlbertoVolta C, Giancarlo L, Sottosanti V, Copetti E, Spagnesi L, Toretti I, Alloj C, Cardellino S, Carmino L, Costanzo E, Fanfani LC, Novelli MT, Roasio A, Bellandi M, Beretta L, Bignami E, Bocchino S, Cabrini L, Corti D, Landoni G, Meroni R, Moizo E, Monti G, Pintaudi M, Plumari VP, Taddeo D, Testa V, Winterton D, Zangrillo A, Cloro LM, Colangelo C, Colangelo A, Rotunno G, Paludi MA, Maria CP, Pata A, Parrini V, Gatta A, Nastasi M, Tinti C, Baroselli A, Arrigo M, Benevento A, Bottini C, Cannavo' M, Gastaldi C, Marchesi A, Pascazio A, Pata F, Pozzi E, Premoli A, Tessera G, Boschi L, D'Andrea R, Ghignone F, Poggioli G, Sibilio A, Taffurelli M, Ugolini G, Ab Majid MA, Ab Rahman R, Joseph J, Pathan F, Sybil Shah MH, Yap HL, Cheah S, Chin II, Looi JK, Tan SC, Visvalingam S, Kwok FY, Lee CK, Tan TS, Wong SM, Abdullah NH, Liew CF, Luxuman L, Mohd Zin NH, Norddin MF, Raja Alias RL, Wong JY, Yong J, Bin Mustapha MT, Chan WK, Dzulkipli N, Kuan PX, Lee YC, Alias A, Guok EC, Jee CC, Ramon BR, Wong CW, Abd Ghafar FNI, Aziz FZ, Hussain N, Lee HS, Sukawi I, Woon YL, Abd Hadi HZ, Ahmad Azam UA, Alias AH, Kesut SA, Lee JM, Ooi DV, Sulaiman HA, Lih TAT, Veerakumaran J, Rojas E, Resendiz GEA, Zapata DDM, López JCJA, Flores AAA, Amador JCB, Avila EJD, Aquino LPG, Rodriguez RL, Landa MT, Urias E, Hollmann M, Hulst A, Benedikt Preckel OK, Gemert AK, Buise M, Tolenaar N, Weber E, de Fretes J, Houweling P, Ormskerk P, Van Bommel J, Lance M, Smit-Fun V, van Zundert T, Baas P, de Boer HD, Sprakel J, Elferink-Vonk R, Noordzij P, van Zeggeren L, Brand B, Spanjersberg R, Bokkel-Andela JT, Numan S, van Klei W, van Zaane B, Boer C, van Duivenvoorde Y, Hering JP, van Rossum S, Zonneveldt H, Campbell D, Hoare S, Santa S, Ali M, Allen SJ, Beavis V, Bell R, Choi HD, Drake M, Farrell H, Hayes K, Higgie K, Holmes K, Jenkins N, Kim CJ, Kim S, Law KC, McAllister D, Park K, Pedersen K, Pfeifer L, Pozaroszczyk A, Salmond T, Steynor M, Tan M, Waymouth E, Ab Rahman AS, Armstrong J, Dudson R, Jenkins N, Nilakant J, Richard S, Virdi P, Dixon L, Donohue R, Farrow M, Kennedy R, Marissa H, McKellow M, Nicola D, Pascoe R, Roberts SJ, Rowell G, Sumner M, Templer P, Chandrasekharan S, Fulton G, Jammer I, More R, Wilson L, Chang YH, Foley J, Fowler C, Panckhurst J, Sara R, Stapelberg F, Cherrett V, Ganter DL, McCann L, Gilmour F, Lumsden R, Moores M, Olliff S, Sardareva E, Tai J, Wikner M, Wong C, Chaddock M, Czepanski C, McKendry P, Polakovic D, Polakovich D, Robert A, Belda MT, Norton T, Alherz F, Barneto L, Ramirez A, Sayeed A, Smith N, Bennett C, McQuoid S, Jansen TL, Nico Z, Scott J, Freschini D, Freschini A, Hopkins B, Manson L, Stoltz D, Bates A, Davis S, Freeman V, McGaughran L, Williams M, Sharma SB, Burrows T, Byrne K, English D, Johnson R, Manikkam B, Naidoo S, Rumball M, Whittle N, Franks R, Gibson-Lapsley H, Salter R, Walsh D, Cooper R, Perry K, Obobolo A, Sule UM, Ahmad A, Atiku M, Mohammed AD, Sarki AM, Adekola O, Akanmu O, Durodola A, Olukoju O, Raji V, Olajumoke T, Oyebamiji E, Adenekan A, Adetoye A, Faponle F, Olateju S, Owojuyigbe A, Talabi A, Adenike O, Adewale B, Collins N, Ezekiel E, Fatungase OM, Grace A, Sola S, Stella O, Ademola A, Adeolu AA, Adigun T, Akinwale M, Fasina O, Gbolahan O, Idowu O, Olonisakin RP, Osinaike BB, Asudo F, Mshelia D, Abdur-Rahman L, Agodirin O, Bello J, Bolaji B, Oyedepo OO, Ezike H, Iloabachie I, Okonkwo I, Onuora E, Onyeka T, Ugwu I, Umeh F, Alagbe-Briggs O, Dodiyi-Manuel A, Echem R, Obasuyi B, Onajin-Obembe B, Bandeira ME, Martins A, Tomé M, Costa ACMM, Krystopchuk A, Branco T, Esteves S, Melo MA, Monte J, Rua F, Martins I, Pinho-Oliveira VM, Rodrigues CM, Cabral R, Marques S, Rêgo S, Jesus JST, Marques MC, Romao C, Dias S, Santos AM, Alves MJ, Salta C, Cruz S, Duarte C, Paiva AAF, Cabral TDN, Faria E Maia D, Correia da Silva RFM, Langner A, Resendes HO, Soares MDC, Abrunhosa A, Faria F, Miranda L, Pereira H, Serra S, Ionescu D, Margarit S, Mitre C, Vasian H, Manga G, Stefan A, Tomescu D, Filipescu D, Paunescu MA, Stefan M, Stoica R, Gavril L, Pătrășcanu E, Ristescu I, Rusu D, Diaconescu C, Iosep GF, Pulbere D, Ursu I, Balanescu A, Grintescu I, Mirea L, Rentea I, Vartic M, Lupu MN, Stanescu D, Streanga L, Antal O, Hagau N, Patras D, Petrisor C, Tosa F, Tranca S, Copotoiu SM, Ungureanu LL, Harsan CR, Papurica M, Cernea DD, Dragoescu NA, CarmenVaida LA, Ciobotaru OR, Aignatoaie M, Carp CP, Cobzaru I, Mardare O, Purcarin B, Tutunaru V, Ionita V, Arustei M, Codita A, Busuioc M, Chilinciuc I, Ciobanu C, Belciu I, Tincu E, Blaj M, Grosu RM, Sandu G, Bruma D, Corneci D, Dutu M, Krepil A, Copaciu E, Dumitrascu CO, Jemna R, Mihaescu F, Petre R, Tudor C, Ursache E, Kulikov A, Lubnin A, Grigoryev E, Pugachev S, Tolmasov A, Hussain A, Ilyina Y, Roshchina A, Iurin A, Chazova E, Dunay A, Karelov A, Khvedelidze I, Voldaeva O, Belskiy V, Dzhamullaev P, Grishkowez E, Kretov V, Levin V, Molkov A, Puzanov S, Samoilenko A, Tchekulaev A, Tulupova V, Utkin I, Allorto NL, Bishop DG, Builu PM, Cairns C, Dasrath A, de Wet J, Hoedt MD, Grey B, Hayes MP, Küsel BS, Shangase N, Wise R, Cacala S, Farina Z, Govindasamy V, Kruse CH, Lee C, Marais L, Naidoo TD, Rajah C, Rodseth RN, Ryan L, von Rhaden R, Adam S, Alphonsus C, Ameer Y, Anderson F, Basanth S, Bechan S, Bhula C, Biccard BM, Biyase T, Buccimazza I, Cardosa J, Chen J, Daya B, Drummond L, Elabib A, Abdel Goad EH, Goga IE, Goga R, Harrichandparsad R, Hodgson RE, Jordaan J, Kalafatis N, 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M, Shah K, Simons H, Solanki S, Spowart E, Stevens A, Thomas C, Waggett H, Yassaee A, Kennedy A, Scott S, Somanath S, Berg A, Hernandez M, Nanda R, Tank G, Wilson N, Wilson D, Al-Soudaine Y, Baldwin M, Cornish J, Davies Z, Davies L, Edwards M, Frewer N, Gallard S, Glasbey J, Harries R, Hopkins L, Kim T, Koompirochana V, Lawson S, Lewis M, Makzal Z, Scourfield S, Ahmad Y, Bates S, Blackwell C, Bryant H, Collins H, Coulter S, Cruickshank R, Daniel S, Daubeny T, Edwards M, Golder K, Hawkins L, Helen B, Hinxman H, Levett D, Salmon K, Seaward L, Skinner B, Tyrell B, Wadams B, Walsgrove J, Dickson J, Constantin K, Karen M, O'Brien P, O'Donohoe L, Payne H, Sundayi S, Walker E, Brooke J, Cardy J, Humphreys S, Kessack L, Kubitzek C, Kumar S, Cotterill D, Hodzovic E, Hosdurga G, Miles E, Saunders G, Campbell M, Chan P, Jemmett K, Raj A, Naik A, Oshowo A, Ramamoorthy R, Shah N, Sylvan A, Blyth K, Burtenshaw A, Freeman D, Johnson E, Lo P, Martin T, Plunkett E, Wollaston J, Allison J, Carroll C, Craw N, Craw S, Pitt-Kerby T, Rowland-Axe R, Spurdle K, McDonald A, Simon D, Sinha V, Smith T, Banner-Goodspeed V, Boone M, Campbell K, Lu F, Scannell J, Sobol J, Balajonda N, Clemmons K, Conde C, Elgasim M, Funk B, Hall R, Hopkins T, Olaleye O, Omer O, Pender M, Porto A, Stevens A, Waweru P, Yeh E, Bodansky D, Evans A, Kleopoulos S, Maril R, Mathney E, Sanchez A, Tinuoye E, Bateman B, Eng K, Jiang N, Ladha K, Needleman J, Chen LL, Lane R, Robinowitz D, Ghushe N, Irshad M, O'Connor J, Patel S, Takemoto S, Wallace A, Mazzeffi M, Rock P, Wallace K, Zhu X, Chua P, Mattera M, Sharar R, Thilen S, Treggiari M, Morgan A, Sofjan I, Subramaniam K, Avidan M, Maybrier H, Muench M, Wildes T., Université de Lille, CHU Lille, Queen Mary University of London [QMUL], Graduate School, Medical Microbiology and Infection Prevention, Clinical Immunology and Rheumatology, 01 Internal and external specialisms, ACS - Heart failure & arrhythmias, AGEM - Endocrinology, metabolism and nutrition, APH - Quality of Care, ACS - Diabetes & metabolism, AII - Amsterdam institute for Infection and Immunity, ACS - Microcirculation, Pearse, R M, International Surgical Outcomes Study (ISO), Group, Zangrillo, A, Landoni, G, Beretta, L., International Surgical Outcomes Study (ISOS) group, Pearse, R.M., Beattie, S., Clavien, P.A., Demartines, N., Fleisher, L.A., Grocott, M., Haddow, J., Hoeft, A., Holt, P., Moreno, R., Pritchard, N., Rhodes, A., Wijeysundera, D., Wilson, M., Ahmed, T., Everingham, K., Hewson, R., Januszewska, M., Phull, M.K., Halliwell, R., Shulman, M., Myles, P., Schmid, W., Hiesmayr, M., Wouters, P., de Hert, S., Lobo, S., Fang, X., Rasmussen, L., Futier, E., Biais, M., Venara, A., Slim, K., Sander, M., Koulenti, D., Arvaniti, K., Chan, M., Kulkarni, A., Chandra, S., Tantri, A., Geddoa, E., Abbas, M., Della Rocca, G., Sivasakthi, D., Mansor, M., Luna, P., Bouwman, A., Buhre, W., Beavis, V., Campbell, D., Short, T., Osinaike, T., Matos, R., Grigoras, I., Kirov, M., Protsenko, D., 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Rubio, C., Artiles, T.S., Soro, M., Valls, P., Laguarda, G.A., Benavent, P., Cuenca, V.C., Cueva, A., Lafuente, M., Parra, A.M., Rodrigo, A.R., Sanchez-Morcillo, S., Tormo, S., Redondo, F.J., De Andrés Ibanez, J.A., Diago, L.G., José Hernández Cádiz, M., Manuel, G.G., Peris, R., Saiz, C., Vivo, J.T., Soto, MTT, Brunete, T., Cancho, D., Delgado García, D.R., Zamudio, D., Del Valle, S.G., Serrano, M.L., Alonso, E., Anillo, V., Maseda, E., Salgado, P., Suarez, L., Suarez-de-la-Rica, A., Villagrán, M.J., Alonso, J.I., Cabezuelo, E., Garcia-Saiz, I., Lopez Del Moral, O., Martín, S., Gonzalez, A.P., Doncel, MST, Vera, M.A., José Ávila Sánchez, F., Castaño, B., Moreira, B.C., Risco, S.F., Martín, D.P., Martín, F.P., Poza, P., Ruiz, A., Serna Martínez, W.F., Vicente, B.V., Dominguez, S.V., Fernández, S., Munoz-López, A., Bernat, M.J., Mas, A., Planas, K., Jawad, M., Saeed, Y., Hedin, A., Levander, H., Holmström, S., Lönn, D., Zoerner, F., Åkring, I., Widmark, C., Zettergren, J., Liljequist, V.A., Nystrom, L., Odeberg-Wernerman, S., Oldner, A., Fagerlund, M.J., Reje, P., Lyckner, S., Sperber, J., Adolfsson, A., Klarin, B., Ögren, K., Barras, J.P., Bührer, T., Despotidis, V., Helmy, N., Holliger, S., Raptis, D.A., Schmid, R., Meyer, A., Jaquet, Y., Kessler, U., Muradbegovic, M., Nahum, S.R., Rotunno, T., Schiltz, B., Voruz, F., Worreth, M., Christoforidis, D., Popeskou, S.G., Furrer, M., Prevost, G.A., Stocker, A., Lang, K., Breitenstein, S., Ganter, M.T., Geisen, M., Soll, C., Korkmaz, M., Lubach, I., Schmitz, M., Meyer Zu Schwabedissen, M., Moritz, MZS, Zingg, U., Hillermann, T., Wildi, S., Pinto, B.B., Walder, B., Mariotti, G., Slankamenac, K., Namuyuga, M., Kyomugisha, E., Kituuka, O., Shikanda, A.W., Kakembo, N., Tom, C.O., Antonina, W., Bua, E., Ssettabi, E.M., Epodoi, J., Kabagenyi, F., Kirya, F., Dempsey, G., Seasman, C., Nawaz Khan, R.B., Kurasz, C., Macgregor, M., Shawki, B., Francis, D., Hariharan, V., Chau, S., Ellis, K., Butt, G., Chicken, D.W., Christmas, N., Allen, S., Daniel, G.D., Dempster, A., Kemp, J., Matthews, L., Mcglone, P., Tambellini, J., Trodd, D., Freitas, K., Garg, A., Gupta, J.K., Karpate, S., O'Hara, C., Troko, J., Angus, K., Bradley, J., Brennan, E., Brooks, C., Brown, J., Brown, G., Finch, A., Gratrix, K., Hesketh, S., Hill, G., Jeffs, C., Morgan, M., Pemberton, C., Slawson, N., Spickett, H., Swarbrick, G., Van Duyvenvoorde, G., Brennan, A., Briscoe, R., Cooper, S., Lawton, T., Northey, M., Senaratne, R., Stanworth, H., Burrows, L., Cain, H., Craven, R., Davies, K., Jonas, A., Pachucki, M., Walkden, G., Davies, H., Gudaca, M., Hobrok, M., Arawwawala, D., Fergey, L., Gardiner, M., Gunn, J., Johnson, L., Lofting, A., Lyle, A., Neela, F.M., Smolen, S., Topliffe, J., Williams, S., Bland, M., Balaji, P., Kaura, V., Lanka, P., Ahmed, A., Myatt, J., Shenoy, R., Soon, W.C., Tan, J., Karadia, S., Self, J., Durant, E., Tripathi, S., Bullock, C., Ghosh, A., Hughes, T., Zsisku, L., Bengeri, S., Cowton, A., Khalid, M.S., Limb, J., McAdam, C., Porritt, M., Rafi, M.A., Shekar, P., Adams, D., Harden, C., Hollands, H., King, A., March, L., Minto, G., Patrick, A., Squire, R., Waugh, D., Kumara, P., Simeson, K., Yarwood, J., Browning, J., Hatton, J., Julian, H., Mitra, A., Newton, M., Pernu, P.K., Wilson, A., Commey, T., Foot, H., Glover, L., Gupta, A., Lancaster, N., Levin, J., Mackenzie, F., Mestanza, C., Nofal, E., Pout, L., Varden, R., Wild, J., Jones, S., Moreton, S., Pulletz, M., Davies, C., Martin, M., Thomas, S., Burns, K., McArthur, C., Patel, P., Lau, G., Rich, N., Davis, F., Lyons, R., Port, B., Prout, R., Smith, C., Adelaja, Y., Bennett, V., Bidd, H., Dumitrescu, A., Murphy, J.F., Keen, A., Mguni, N., Ong, C., Adams, G., Boshier, P., Brown, R., Butryn, I., Chatterjee, J., Freethy, A., Lockwood, G., Tsakok, M., Tsiligiannis, S., Peat, W., Stephenson, L., Bradburn, M., Pick, S., Cunha, P., Olagbaiye, O., Tayeh, S., Packianathaswamy, B., Abernethy, C., Balasubramaniam, M., Bennett, R., Bolton, D., Martinson, V., Naylor, C., Bell, S., Heather, B., Kushakovsky, V., Alcock, L., Alexander, H., Anderson, C., Baker, P., Brookes, M., Cawthorn, L., Cirstea, E., Clarkson, R., Colling, K., Coulter, I., Das, S., Haigh, K., Hamdan, A., Hugill, K., Kottam, L., Lisseter, E., Mawdsley, M., McGivern, J., Padala, K., Phelps, V., Ramesh Kumar, V., Stewart, K., Towse, K., Tregonning, J., Vahedi, A., Walker, A., Baines, D., Bilolikar, A., Chande, S., Copley, E., Dunk, N., Kulkarni, R., Kumar, P., Metodiev, Y., Ncomanzi, D., Raithatha, B., Raymode, P., Szafranski, J., Twohey, L., Watt, P., Weatherall, L., Weatherill, J., Whitman, Z., Wighton, E., Abayasinghe, C., Chan, A., Darwish, S., Gill, J., Glasgow, E., Hadfield, D., Harris, C., Hopkins, P., Kochhar, A., Kunst, G., Mellis, C., Pool, A., Riozzi, P., Selman, A., Smith, E.J., Vele, L., Gercek, Y., Guy, K., Holden, D., Watson, N., Whysall, K., Andreou, P., Hales, D., Thompson, J., Bowrey, S., McDonald, S., Gilmore, J., Hills, V., Kelly, C., Kelly, S., Lloyd, G., Abbott, T., Gall, L., Torrance, H., Vivian, M., Berntsen, E., Nolan, T., Turner, A., Vohra, A., Brown, A., Clark, R., Coughlan, E., Daniel, C., Patvardhan, C., Pearson, R., Predeep, S., Saad, H., Shanmugam, M., Varley, S., Wylie, K., Cooper, L., Makowski, A., Misztal, B., Moldovan, E., Pegg, C., Donovan, A., Foot, J., Large, S., Claxton, A., Netke, B., Armstrong, R., Calderwood, C., Kwok, A., Mohr, O., Oyeniyi, P., Patnaik, L., Post, B., Ali, S., Arshad, H., Baker, G., Brenner, L., Brincat, M., Brunswicker, A., Cox, H., Cozar, O.I., Cheong, E., Durst, A., Fengas, L., Flatt, J., Glister, G., Narwani, V., Photi, E., Rankin, A., Rosbergen, M., Beaton, C., Horn, R., Hunt, J., Rousseau, G., Stancombe, L., Absar, M., Allsop, J., Drinkwater, Z., Hodgkiss, T., Smith, K., Alexander-Sefre, F., Campey, L., Dudgeon, L., Hall, K., Hitchcock, R., James, L., Winstone, U., Ahmad, N., Bauchmuller, K., Harrison, J., Jeffery, H., Miller, D., Pinder, A., Pothuneedi, S., Rosser, J., Sanghera, S., Swift, D., Walker, R., Bester, D., Cavanagh, S., Cripps, H., Daniel, H., Lynch, J., Pyke, S., Scholefield, J., Whitworth, H., Bottrill, F., Ramalingam, G., Webb, S., Akerman, N., Antill, P., Bourner, L., Buckley, S., Castle, G., Charles, R., Eggleston, C., Foster, R., Gill, S., Lindley, K., Lklouk, M., Lowery, T., Martin, O., Milne, D., O'Connor, P., Ratcliffe, A., Rose, A., Smith, A., Varma, S., Ward, J., Barcraft-Barnes, H., Camsooksai, J., Colvin, C., Reschreiter, H., Tbaily, L., Venner, N., Hamilton, C., Kelly, L., Toth-Tarsoly, P., Dodsworth, K., Foord, D., Gordon, P., Hawes, E., Lamb, N., Mouland, J., Nightingale, J., Rose, S., Schrieber, J., Al'Amri, K., Aladin, H., Arshad, M.A., Barraclough, J., Bentley, C., Bergin, C., Carrera, R., Clarkson, A., Collins, M., Denham, S., Griffiths, E., Ip, P., Jeyanthan, S., Joory, K., Kaur, S., Marriott, P., Mitchell, N., Nagaiah, S., Nilsson, A., Parekh, N., Pope, M., Seager, J., Serag, H., Tameem, A., Thomas, A., Thunder, J., Torrance, A., Vohra, R., Whitehouse, A., Wong, T., Blunt, M., Wong, K., Giles, J., Reed, I., Weller, D., Bell, G., Birch, J., Damant, R., Maiden, J., Mewies, C., Prince, C., Radford, J., Reynolds, T., Balain, B., Banerjee, R., Barnett, A., Burston, B., Edwards, J., Evans, C., Ford, D., Gallacher, P., Hill, S., Jaffray, D., Karlakki, S., Kennedy, J., Kiely, N., Lewthwaite, S., Marquis, C., Ockendon, M., Phillips, S., Pickard, S., Richardson, J., Roach, R., Smith, T., Spencer-Jones, R., Steele, N., Steen, J., Van Liefland, M., White, S., Faulds, M., Harris, M., Nicol, S., Pearson, S.A., Chukkambotla, S., Andrew, A., Attrill, E., Campbell, G., Datson, A., Fouracres, A., Graterol, J., Graves, L., Hong, B., Ishimaru, A., Karthikeyan, A., King, H., Lawson, T., Lee, G., Lyons, S., Hall, A.M., Mathoulin, S., Mcintyre, E., Mclaughlin, D., Mulcahy, K., Paddle, J., Robbins, J., Sung, W., Tayo, A., Trembath, L., Venugopal, S., Wigmore, G., Boereboom, C., Downes, C., Humphries, R., Melbourne, S., Tou, S., Ullah, S., Batchelor, N., Boxall, L., Broomby, R., Deen, T., Hellewell, A., Helliwell, L., Hutchings, M., Hutchins, D., Keenan, S., Mackie, D., Potter, A., Smith, F., Stone, L., Thorpe, K., Wassall, R., Woodgate, A., Baillie, S., Campbell, T., James, S., King, C., Marques de Araujo, D., Martin, D., Morkane, C., Neely, J., Rajendram, R., Burton, M., James, K., Keevil, E., Minik, O., Morgan, J., Musgrave, A., Rajanna, H., Roberts, T., Adamson, M., Jumbe, S., Kendall, J., Muthuswamy, M.B., Cruikshanks, A., Wrench, I., Zeidan, L., Ardern, D., Harris, B., Hellstrom, J., Martin, J., Thomas, R., Varsani, N., Brown, C.W., Docherty, P., Gillies, M., McGregor, E., Usher, H., Craig, J., Ahmad, T., Bodger, P., Creary, T., Fowler, A., Ijuo, E., Jones, T., Kantsedikas, I., Lahiri, S., McLean, A.L., Niebrzegowska, E., Phull, M., Wickboldt, N., Baldwin, J., Doyle, D., Mcmullan, S., Oladapo, M., Owen, T., Williams, A., Gregory, P., Husain, T., Kirk-Bayley, J., Mathers, E., Montague, L., Harper, M., Jack, J., Ridley, C., Avis, J., Cook, T., Dali-Kemmery, L., Kerslake, I., Lambourne, V., Pearson, A., Boyd, C., Callaghan, M., Lawson, C., McCrossan, R., Nesbitt, V., O'connor, L., Sinclair, R., Farid, N., Morgese, C., Bhatia, K., Karmarkar, S., Ahmed, J., Branagan, G., Hutton, M., Swain, A., Brookes, J., Cornell, J., Dolan, R., Hulme, J., Jansen van Vuuren, A., Jowitt, T., Kalashetty, G., Lloyd, F., Patel, K., Sherwood, N., Brown, L., Chandler, B., Deighton, K., Emma, T., Haunch, K., Cheeseman, M., Dent, K., Gray, C., Hood, M., Jones, D., Juj, J., Rao, R., Walker, T., Al Anizi, M., Cheah, C., Cheing, Y., Coutinho, F., Gondo, P., Hadebe, B., Hove, M.O., Khader, A., Krishnachetty, B., Rhodes, K., Sokhi, J., Baker, K.A., Bertram, W., Looseley, A., Mouton, R., Hanna, G., Arnold, G., Arya, S., Balfoussia, D., Baxter, L., Harris, J., Jones, C., Knaggs, A., Markar, S., Perera, A., Scott, A., Shida, A., Sirha, R., Wright, S., Frost, V., Andrews, E., Arrandale, L., Barrett, S., Cifra, E., Cooper, M., Dragnea, D., Elna, C., Maclean, J., Meier, S., Milliken, D., Munns, C., Ratanshi, N., Ramessur, S., Salvana, A., Watson, A., Ali, H., Critchley, R., Endersby, S., Hicks, C., Liddle, A., Pass, M., Ritchie, C., Thomas, C., Too, L., Welsh, S., Gill, T., Johnson, J., Reed, J., Davis, E., Papadopoullos, S., Attwood, C., Biffen, A., Boulton, K., Gray, S., Hay, D., Mills, S., Montgomery, J., Riddell, R., Simpson, J., Bhardwaj, N., Paul, E., Uwubamwen, N., Alexander, M., Arrich, J., Arumugam, S., Blackwood, D., Boggiano, V., Chan, Y.L., Chatterjee, D., Chhabra, A., Christian, R., Costelloe, H., Matthewman, M.C., Dalton, E., Darko, J., Davari, M., Dave, T., Deacon, M., Deepak, S., Edmond, H., Ellis, J., El-Sayed, A., Eneje, P., English, R., Ewe, R., Foers, W., Franklin, J., Gallego, L., Garrett, E., Goldberg, O., Goss, H., Greaves, R., Harris, R., Hennings, C., Jones, E., Kamali, N., Kokkinos, N., Lewis, C., Lignos, L., Malgapo, E.V., Malik, R., Milne, A., Mulligan, J.P., Nicklin, P., Palipane, N., Parsons, T., Piper, R., Prakash, R., Ramesh, B., Rasip, S., Reading, J., Rela, M., Reyes, A., Stephens, R., Rooms, M., Shah, K., Simons, H., Solanki, S., Spowart, E., Stevens, A., Waggett, H., Yassaee, A., Kennedy, A., Scott, S., Somanath, S., Berg, A., Hernandez, M., Nanda, R., Tank, G., Wilson, N., Wilson, D., Al-Soudaine, Y., Baldwin, M., Cornish, J., Davies, Z., Davies, L., Edwards, M., Frewer, N., Gallard, S., Glasbey, J., Harries, R., Hopkins, L., Kim, T., Koompirochana, V., Lawson, S., Lewis, M., Makzal, Z., Scourfield, S., Ahmad, Y., Bates, S., Blackwell, C., Bryant, H., Collins, H., Coulter, S., Cruickshank, R., Daniel, S., Daubeny, T., Golder, K., Hawkins, L., Helen, B., Hinxman, H., Levett, D., Salmon, K., Seaward, L., Skinner, B., Tyrell, B., Wadams, B., Walsgrove, J., Dickson, J., Constantin, K., Karen, M., O'Brien, P., O'Donohoe, L., Payne, H., Sundayi, S., Walker, E., Brooke, J., Cardy, J., Humphreys, S., Kessack, L., Kubitzek, C., Kumar, S., Cotterill, D., Hodzovic, E., Hosdurga, G., Miles, E., Saunders, G., Campbell, M., Chan, P., Jemmett, K., Raj, A., Naik, A., Oshowo, A., Ramamoorthy, R., Shah, N., Sylvan, A., Blyth, K., Burtenshaw, A., Freeman, D., Johnson, E., Lo, P., Martin, T., Plunkett, E., Wollaston, J., Allison, J., Carroll, C., Craw, N., Craw, S., Pitt-Kerby, T., Rowland-Axe, R., Spurdle, K., McDonald, A., Simon, D., Sinha, V., Banner-Goodspeed, V., Boone, M., Campbell, K., Lu, F., Scannell, J., Sobol, J., Balajonda, N., Clemmons, K., Conde, C., Elgasim, M., Funk, B., Hopkins, T., Olaleye, O., Omer, O., Pender, M., Porto, A., Waweru, P., Yeh, E., Bodansky, D., Evans, A., Kleopoulos, S., Maril, R., Mathney, E., Sanchez, A., Tinuoye, E., Bateman, B., Eng, K., Jiang, N., Ladha, K., Needleman, J., Chen, L.L., Lane, R., Robinowitz, D., Ghushe, N., Irshad, M., O'Connor, J., Patel, S., Takemoto, S., Wallace, A., Mazzeffi, M., Rock, P., Wallace, K., Chua, P., Mattera, M., Sharar, R., Thilen, S., Treggiari, M., Morgan, A., Sofjan, I., Subramaniam, K., Avidan, M., Maybrier, H., Muench, M., and Wildes, T.
Subjects: Male, Postoperative Complications/epidemiology, Hospital mortality, [SDV]Life Sciences [q-bio], surgery, Postoperative Complications, 0302 clinical medicine, cohort studies, 030202 anesthesiology, patient safety, 030212 general & internal medicine, Postoperative Period, Medicine(all), Middle Aged, Checklist, 3. Good health, Treatment Outcome, operative/mortality, Elective Surgical Procedures, Surgical Procedures, Operative, Meta-analysis, Cohort, Cohort studies, Female, Elective Surgical Procedure, postoperative care/methods, postoperative care/statistics and numerical data, surgical procedures, Anesthesiology and Pain Medicine, Cohort study, Adult, medicine.medical_specialty, Evidence-based medicine, NO, 03 medical and health sciences, Patient safety, medicine, postoperative care/method, Humans, Elective Surgical Procedures/standards, Aged, Cohort Studies, Evidence-Based Medicine, Hospital Mortality, Patient Safety, Postoperative Complications/mortality, Postoperative Complications/prevention & control, Surgical Procedures, Operative/methods, business.industry, Odds ratio, Surgery, Observational study, business, cohort studie
Abstract: BACKGROUND: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool.METHODS: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals.RESULTS: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32-0.77); PCONCLUSIONS: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.
Published: 2018
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23. Effectiveness versus efficiency in a medical skills laboratory

Author: Dan Sebastian, Dîrzu and Sanda Maria, Copotoiu
Subjects: ComputingMilieux_COMPUTERSANDEDUCATION, Articles
Abstract: Medical educators are facing the new challenge of using medical simulation for teaching purposes. The use of simulators seems attractive for trainers and for trainees, but prices of simulators may be prohibitive. In an era of limited resources it is mandatory when using such an expensive tool as simulation, to prove its benefits. Despite the fact that simulation provides opportunity for training, additional advantages are far from being established. The supposed benefits of using medical simulators in teaching and examination needs to be proven regarding two aspects: effectiveness and efficiency.Formatorul din învăţământul medical trebuie să facă faţă unei noi provocări: folosirea simulatoarelor medicale în scopuri educative. Utilizarea simulatoarelor medicale pare atrăgătoare atât pentru student cât şi pentru formator, dar preţurile simulatoarelor pot fi prohibitive. Într-o epocă a resurselor limitate este obligatoriu ca folosirea unor instrumente atât de scumpe să îşi demonstreze beneficiile. Deşi simularea oferă oportunitatea pentru formare, avantajele suplimentare sunt departe de a fi stabilite. Presupusele beneficii ale folosirii simulatoarelor medicale trebuie să fie demonstrate ţinând cont de două aspecte: eficacitate şi eficienţă.
Published: 2017

24. Blood sampling as a cause of anemia in a general ICU - a pilot study

Author: Adrian, Cioc, Raluca, Fodor, Orsolya, Benedek, Alina, Moldovan, and Sanda-Maria, Copotoiu
Subjects: Articles
Abstract: The objective of our pilot study was to evaluate the influence of daily phlebotomy on patients' haemoglobin levels from our general intensive care unit.We prospectively enrolled 35 patients who did not present with acute haemorrhage or developed it during the study period. For each patient we recorded: the diagnosis, age, sex, haemoglobin, hematocrit, SOFA and APACHE II score, blood volume drawn in standardized vials, number of blood tests ordered per day, fluid balance per day, number of ICU days. The collected data were analyzed using the linear regression model, paired t-test, receiver operating characteristic curves, and descriptive analysis. Statistical analysis was performed with SPSS v.17 trial version (IBM, NY, USA).The mean volume of blood drawn per day was 18.1 (SD ± 14.4) ml and the number of blood tests was 3.8 (SD ± 1.75) per day. On univariate linear regression analysis both the blood volume drawn daily (p = 0.04) and the number of blood tests per day (p = 0.009) correlated with a drop in mean haemoglobin concentration. The difference in the mean value of haemoglobin at admission and discharge correlated with overall mortality (p = 0.03). The sensitivity of admission haemoglobin equal to 10.6 g/dL in predicting mortality was 82.4% with a specificity of 50%, (p = 0.019, AUC = 0.732).We evidenced the predictive power of blood sampling and number of blood tests done on haemoglobin concentration. Besides the main objective of the study we noticed that the difference in the mean value of haemoglobin at admission and discharge correlated with overall mortality. Considering that blood sampling contributes to anemia among ICU patients, we should limit the daily tests undertaken, to the tests absolutely necessary for guiding our therapy.Acest studiu pilot a avut ca obiectiv stabilirea influenţei flebotomiei iatrogene asupra valorii hemoglobinei a pacienţilor critici din secţia noastră.Au fost înrolaţi prospectiv un număr de 35 de pacienţi care nu s-au prezentat la internare cu hemoragie sau au prezentat un episod hemoragic în timpul internării. Pentru fiecare pacient am documentat: diagnosticul, vârsta, sexul, hemoglobina şi hematocritul la internare, volumul de sânge recoltat în fiecare zi alături de numărul de recoltări, bilanţul hidric, numărul de zile de internare, scorul SOFA şi APACHE. Datele au fost analizate folosind modelul de regresie liniară, testul t, curbe ROC precum şi analiză statistică descriptivă. Softul folosit pentru analiza statistică a fost SPSS v.17 trial version (IBM, NY, USA).Volumul mediu de sânge recoltat per zi a fost de 18,1 (SD ± 14,4) ml şi numărul de recoltări per zi a fost de 3,8 (SD ± 1,75). Folosind modelul de regresie liniară, atât volumul de sânge recoltat per zi (p = 0,04) cât şi numărul de recoltări per zi (p = 0,009) s-au corelat cu o scădere a valorii medii a hemoglobinei. Diferenţa între valoarea hemoglobinei la internare şi externare s-a corelat statistic cu mortalitatea (p = 0,03). Valoarea hemoglobinei la internare asociată cu o creştere a mortalităţii a fost de 10,6 g/dl având o specificitate de 50% şi sensibilitate 82,4% (p = 0,019, AUC = 73,2%).Studiul de faţă demonstrează influenţa flebotomiei iatrogene asupra valorii hemoglobinei la pacienţii critici. În afara obiectivului primar al studiului valoarea hemoglobinei la internare s-a corelat cu o creştere a mortalităţii. Având în vedere numărul de recoltări per zi la pacienţii critici precum şi asocierea anemiei cu o mortalitate crescută, este necesară restricţia acestor teste la numărul minim necesar ghidării terapiei.
Published: 2017

25. Evaluation of O-POSSUM vs ASA and APACHE II scores in patients undergoing oesophageal surgery

Author: Raluca, Fodor, Adrian, Cioc, Bianca, Grigorescu, Bogdan, Lăzescu, and Sanda Maria, Copotoiu
Subjects: Original Papers
Abstract: Risk and prognostic scores quantify the patient's risk of death or complication according to the severity of his illness. The aim of this study was to evaluate the predictive accuracy of O-POSSUM vs ASA and APACHE II models on patients undergoing oesophageal surgery.In this observational retrospective study 55 patients were enrolled who had undergone surgical interventions of excision and reconstruction of the oesophagus for neoplastic oesophageal stenosis, in the Surgical Clinics (I and II) of the Clinical County Emergency Hospital Mures, between January 2011 and January 2014. By using patients file records after extracting the data we calculated the predictive mortality, according to the prognostic scores O-POSSUM, ASA and APACHE II and we analyzed its correlations with the postoperative evolution. We evaluated the discriminatory power of the three scores using the ROC (receiver-operating characteristic) curves. According to the cut-off value corresponding to each score, we compared the Kaplan Meier survival curves during the hospitalization period.ROC curves analysis revealed that O-POSSUM had a better discriminatory power for mortality compared to the other two scores: AUC = 0.73 for O-POSSUM, AUC = 0.57 for APACHE II and AUC = 0.64 for ASA (p0.001). The cut-off value was statistically significant only in case of O-POSSUM, as it derives from the statistical analysis of the survival curves (p = 0.035).O-POSSUM predicts mortality more accurately compared to ASA or APACHE II in patients undergoing oesophageal surgery.Scorurile de risc şi prognostic cuantifică riscul de deces sau complicaţie a pacientului pe baza severităţii bolilor. Obiectivul acestui studiu a constat în evaluarea acurateţei predictive a scorurilor O-POSSUM vs ASA şi APACHE II la pacienţii supuşi chirurgiei esofagiene.În acest studiu observaţional, retrospectiv au fost înrolaţi 55 de pacienţi care au necesitat intervenţii chirurgicale de rezecţie şi reconstrucţie esofagiană pentru stenoze de etiologie neoplazică în Clinicile Chirurgie I şi II ale Spitalului Clinic Judeţean de Urgenţă Tîrgu Mureş în perioada 2011 – ianuarie 2014. Am calculat mortalitatea predictivă potrivit scorurilor de prognostic O-POSSUM, ASA şi APACHE II şi am corelato cu evoluţia postoperatorie a pacienţilor. Evaluarea capacităţii discriminatorii a celor trei scoruri s-a realizat utilizând curbele ROC (receiver-operating characteristic). În funcţie de valoarea de cutoff aferentă fiecărui scor, am comparat curbele de supravieţuire Kaplan Meier pe perioada internării.Analiza curbelor ROC a arătat o mai bună capacitate discriminatorie în ceea ce priveşte mortalitatea pentru O-POSSUM (AUC = 0,73 pentru O-POSSUM, AUC = 0,57 pentru APACHE II şi AUC = 0,64 pentru ASA) (p0,001). Valoarea de cut-off a fost semnificativă statistic numai pentru O-POSSUM, informaţie derivată din analiza curbelor de supravieţuire (p = 0.035).Scorul O-POSSUM a prezentat cea mai bună capacitate de discriminare în predicţia mortalităţii la pacienţii supuşi chirurgiei esofagiene.
Published: 2017

26. Caspase 3 expression and plasma level of Fas ligand as apoptosis biomarkers in inflammatory endotoxemic lung injury

Author: Raluca Ştefania, Fodor, Anca Meda, Georgescu, Bianca Liana, Grigorescu, Adrian Dan, Cioc, Mihaly, Veres, Ovidiu Simion, Cotoi, Pal, Fodor, Sanda Maria, Copotoiu, and Leonard, Azamfirei
Subjects: Male, Fas Ligand Protein, Caspase 3, Animals, Humans, Apoptosis, Lung Injury, Rats, Wistar, Rats
Abstract: The objective of this study is to evaluate if the immunohistochemical expression of a pulmonary apoptosis marker and plasma level of Fas ligand (FasL) correlates with the dose- and time-dependent severity of lung injury, induced by the administration of lipo-polysaccharide (LPS) in an endotoxemic rat model.Our study included 30 male Wistar rats, randomly divided into three groups: one control group (n=6) and two experimental groups (n=12÷group), in whom we induced endotoxemia by intraperitoneal injection of progressively increasing doses of LPS (5, 10 mg÷kg). We measured FasL plasma levels of the rats at different time points and analyzed the relationships with markers of lung injury. To investigate the level of caspase 3-protein expression, the immunohistochemistry of the lung tissue was assessed.The median percentage of caspase 3-stained cells for the 5 mg÷kg LPS dose was 0.36%, for the 10 mg÷kg LPS dose was 0.4% and for the control group was 0.03% (p0.0001). The elevated expression levels of caspase 3 were consistent with the altered lung morphologies observed (rs=0.88). LPS administration in rats resulted in a significant dose-dependent increase in the levels of plasma FasL (p0.0001). These levels correlated with markers of lung injury: degree of hypoxemia (rs=-0.42), histological measured lung injury score (rs=0.72), the density of the caspase 3 staining cells in the immunohistochemistry assessment of apoptosis (rs=0.81) and with the plasma RAGE (receptor for advanced glycated end-products) values (rs=0.70).Apoptosis is increased in edotoxemia induced lung injury and is likely to contribute to alveolar injury.
Published: 2016

27. Tracheal Intubation Using Trueview® Videolaryngoscopy Versus Direct Macintosh® Laryngoscopy: An observational, Case-control Study

Author: A Emoke, J Szederjesi, Alexandra Lazar, Sanda Maria Copotoiu, L Azamfirei, and A Szabo
Subjects: medicine.diagnostic_test, business.industry, medicine.medical_treatment, Anesthesia, Laryngoscopy, Tracheal intubation, medicine, Case-control study, Observational study, General Medicine, business
Published: 2016
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28. Simulation-based Training as Perceived by Young Anesthesiology and Intensive Care Residents

Author: Ruxandra Copotoiu and Sanda Maria Copotoiu
Subjects: medicine.medical_specialty, RC86-88.9, business.industry, MEDLINE, Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, 030206 dentistry, 03 medical and health sciences, Editorial, 0302 clinical medicine, Nursing, Anesthesiology, Intensive care, medicine, business, Simulation based
Published: 2017
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29. Combination of Ropivacaine and Lidocaine for Long Lasting Locoregional Anesthesia

Author: Sanda Maria Copotoiu, Leonard Azamfirei, Alexandra Lazar, Ruxandra Copotoiu, and Janos Szederjesi
Subjects: ropivacaine, Long lasting, brachial plexus, medicine.medical_specialty, Lidocaine, ultrasound, business.industry, Ropivacaine, Ultrasound, Surgery, Locoregional anaesthesia, Anesthesia, lidocaine, Anesthetic, medicine, Medicine, General Pharmacology, Toxicology and Pharmaceutics, regional anesthesia, business, General Dentistry, Brachial plexus, medicine.drug, Brachial plexus block
Abstract: Objective: The aim of this study was to evaluate the clinical utility of Ropivacaine 0.5% and Lidocaine 0.5% anestethic combination in performing locoregional anesthesia, using either peripheral nerve stimulator or ultrasounds for brachial plexus block. Study design: A prospective randomized clinical study was performed at the County Emergency Clinical Hospital of Tîrgu Mureș, between January and May 2013 on patients undergoing elective or emergency surgical interventions on upper limbs with locoregional anesthesia. Brachial plexus block with axillary approach was performed in 65 patients using randomly the nerve stimulator or the ultrasound guided technique. The parameters recorded were the duration of the anesthetic technique, the installation time and the length of anesthesia. All anesthetic incidents during and after anesthesia were observed as well. The recorded data were analyzed and statistically processed. Results: We enrolled 40 (61.5%) patients for the nerve stimulation technique and 25 (38.5%) patients for ultrasound guidance. The quality of the block was acceptable, an inadequate anesthesia was reported in 9 patients (13.8%). The mean time of installation of anesthesia was 34.36 (± 11.56) minutes, time recorded from the initiation of the anesthetic technique until complete motor block. The mean duration of the motor block was 481.3 (± 128.6) minutes which represents over 8 hours. None of the patients required conversion of the anesthesia due to the extended period of the surgical intervention. One patient presented a mild allergic reaction to the anesthetic drugs. Conclusion: Combination of the ropivacaine and lidocaine can be safely used for locoregional anesthesia, especially in those cases where long surgical intervention time is anticipated or in order to achieve a better postoperative analgesia
Published: 2014
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30. Time- and dose-dependent severity of lung injury in a rat model of sepsis

Author: Raluca-Ştefania, Fodor, Anca Meda, Georgescu, Adrian-Dan, Cioc, Bianca Liana, Grigorescu, Ovidiu Simion, Cotoi, Pal, Fodor, Sanda Maria, Copotoiu, and Leonard, Azamfirei
Subjects: Inflammation, Lipopolysaccharides, Male, Time Factors, Platelet Count, Receptor for Advanced Glycation End Products, Alanine Transaminase, Arteries, Lung Injury, Epithelium, Blood Urea Nitrogen, Oxygen, Disease Models, Animal, Leukocyte Count, Creatinine, Sepsis, Animals, Aspartate Aminotransferases, Lactic Acid, Blood Gas Analysis, Rats, Wistar, Lung
Abstract: Different animal models of experimental lung injury have been used to investigate mechanisms of lung injury. Lipopolysaccharide (LPS) administration is the most often used approach to model the consequences of bacterial sepsis. We created an endotoxemia rat model, simulating sepsis-related lung injury, in order to quantify the time and dose dependent severity lesions induced by the administration of lipopolysaccharide. Our study included 42 male Wistar rats, randomly divided into four groups: one control group (n=6) and three experimental groups (n=12/group) in whom we induced sepsis by intraperitoneal injection of progressively increasing doses of LPS (3, 5, 10 mg/kg). At six hours, the animals included in the groups with higher doses of LPS developed thrombocytopenia, elevated lactate levels, and liver and renal injury in a dose and time dependent manner. The severity of hypoxemia at six hours correlated with the increasing doses of LPS, with a slight improvement at 24 hours. Lung injury scores became more severe with increased dose and time of exposure to LPS without reaching the level of hyaline membranes formation. We also demonstrated translocation of a protein from the airspaces into plasma (RAGE - receptor for advanced glycation end products). Induction of sepsis using LPS is a known experimental model, but LPS treatment in rats does not cause the severe endothelial and epithelial injury that occurs in humans with acute respiratory distress syndrome (ARDS). In our study, the clinical, laboratory and histopathological findings confirmed sepsis and the damage of the alveolar-capillary membrane in a dose-dependent manner.
Published: 2016

31. Ischemic preconditioning and inflammatory response syndrome after reperfusion injury: an experimental model in diabetic rats

Author: Bianca Liana, Grigorescu, Anca Meda, Georgescu, Adrian-Dan, Cioc, Raluca-Ştefania, Fodor, Ovidiu Simion, Cotoi, Pal, Fodor, Sanda Maria, Copotoiu, and Leonard, Azamfirei
Subjects: Inflammation, Ions, Male, Disease Models, Animal, Organ Specificity, Reperfusion Injury, Receptor for Advanced Glycation End Products, Animals, Syndrome, Rats, Wistar, Hypoxia, Ischemic Preconditioning, Diabetes Mellitus, Experimental
Abstract: Quantification of local ischemia and inflammatory response syndrome correlated with histological changes associated with ischemia-reperfusion injury (IRI) after revascularization techniques. We included 12 adult male Wistar rats, aged eight weeks that were randomly divided into two groups. The first group acted as the control and at the second group, we induced diabetes by intraperitoneal streptozotocin administration (60 mg/kg). After eight weeks, the rats were subject to ischemic preconditioning for 10 minutes at three regular intervals. Twenty-four hours post-preconditioning, both groups were subject to ischemia for 20 minutes, followed by 30 minutes of reperfusion. Oxygen extraction was higher in Group 1, the arterio-venous CO2 gradient was higher in the control group, but not significant. The lactate production was higher in Group 1. The second group had a higher Na+ and also a significant difference in K+ values. Receptor for Advanced Glycation End (RAGE) values were higher in the second group but with no significant difference (RAGE1=0.32 ng/mL versus RAGE2=0.40 ng/mL). The muscle samples from the control group displayed significant rhabdomyolysis, damage to the nucleus, while the preconditioned group showed almost normal morphological characteristics. The lungs and kidneys were most damaged in the control group, with damage expressed as thickened alveolar septa, neutrophil infiltrates, eosinophilic precipitates in the proximal convolute tubule. Ischemic preconditioning significantly attenuates the ischemic reperfusion injury.
Published: 2016

32. Soluble urokinase-type plasminogen activator receptor (suPAR) – a possible biomarker for bacteremia in sepsis / Forma solubilă a receptorului pentru activatorul de plasminogen de tip urokinază (suPAR) – un biomarker posibil pentru bacteriemie în sepsis

Author: Leonard Azamfirei, Sanda Maria Copotoiu, Adina Huțanu, Anca-Meda Georgescu, Janos Szederjesi, Minodora Dobreanu, and Septimiu Voidazan
Subjects: medicine.medical_specialty, Gastroenterology, sepsis, Sepsis, Internal medicine, medicine, mortalitate, bacteremia, Receptor, Urokinase, biomarkeri, business.industry, biomarkers, medicine.disease, mortality, bacteriemie, supar, Surgery, SuPAR, Bacteremia, Medicine, Biomarker (medicine), business, Plasminogen activator, medicine.drug
Abstract: Background. Validating new sepsis biomarkers can contribute to early diagnosis and initiation of therapy. The aim of this study is to evaluate the sepsis predictive capacity of soluble urokinase plasminogen receptor (suPAR) and its role in evaluating the prognosis of bloodstream infections. Material and method. We conducted a prospective pilot study on 49 systemic inflammatory response syndrome (SIRS) patients admitted to the intensive care unit (ICU), that were divided, on the basis of bacteremia in group A (SIRS with bacteremia, n=14) and group B (SIRS without bacteremia, n=35). Hemoculture and blood samples were drawn on the first day to determine suPAR, C-reactive protein (CRP) and procalcitonin (PCT). We set to identify significant cut-off values in estimating bacteremia and mortality in septic patients. Results. In group A, suPAR values were 14.3 ng/mL (range 10-45.5 ng/mL) and in group B, 9.85 ng/mL (range 3.4-48 ng/mL) p=0.008. Area under the curve (AUC) for suPAR was 0.745 (95% CI: 0.600-0.859), for CRP 0.613 (95% CI: 0.522-0.799) and for PCT 0.718 (95% CI: 0.477-0.769). Cut-off value for suPAR in bacteremia prediction was 9.885 ng/mL, with 100% sensibility and 51.43% specificity. Mortality in group A was 85.7% (12/14) and in group B 74.3% (26/39), p>0.05. Area under the curve (AUC) for suPAR was 0.750 (95% CI: 0.455-0.936), for CRP 0.613 (95% CI: 0.413-0.913) and for PCT 0.618 (95% CI: 0.373-0.888). Cut-off value of suPAR in predicting mortality was 11.5 ng/mL, with 66.67% sensibility and 100% specificity. Conclusions. In our study suPAR had a predictive capacity for bacteremia and seems to be an independent factor for mortality prognosis in septic patients.
Published: 2015
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33. Viability Changes in Leucocytes in a Critical Trauma Patient: Monocyte, Lymphocyte, Granulocyte Response to the Acute Phase: Case Report

Author: Orsolya, Benedek, primary, Minodora, Dobreanu, additional, Leonard, Azamfirei, additional, Mihaly, Veres, additional, and Sanda-Maria, Copotoiu, additional
Published: 2016
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34. Minimally Invasive Treatment with Platelet Rich Plasma in Patients with Knee Osteoarthritis

Author: Albu, Daniel–Emil, primary, Monica, Copotoiu, additional, Cristina, Jeremias, additional, Mihaela, Susca, additional, Răzvan, Melinte, additional, Tiberiu, Băţagă, additional, and Sanda-Maria, Copotoiu, additional
Published: 2016
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35. Fading Sugammadex, or Just Cautiously (re) Considered?!

Author: Sanda Maria Copotoiu
Subjects: Editorial, business.industry, RC86-88.9, Speech recognition, medicine, Fading, Medical emergencies. Critical care. Intensive care. First aid, business, Sugammadex, medicine.drug
Published: 2015

36. Clinico-pathological particularities of the shock-related pancreatitis

Author: J Jung, Sanda Maria Copotoiu, Janos Szederjesi, Simona Gurzu, Ruxandra Copotoiu, Leonard Azamfirei, and Judit Kovacs
Subjects: Adult, Male, Cancer Research, medicine.medical_specialty, Adolescent, Gastroenterology, Pathology and Forensic Medicine, Intensive care, Internal medicine, medicine, Humans, Intensive care medicine, Child, Aged, Retrospective Studies, Hypocalcemia, business.industry, Septic shock, Histocytochemistry, Pancreatitis, Acute Necrotizing, Infant, Retrospective cohort study, Shock, General Medicine, Middle Aged, medicine.disease, medicine.anatomical_structure, Oncology, Shock (circulatory), Child, Preschool, Hyperglycemia, Acute pancreatitis, Pancreatitis, Female, Autopsy, medicine.symptom, Pancreatic injury, Hypotension, business, Pancreas
Abstract: Acute pancreatitis can develop in patients with shock due to the underlying diseases, surgical interventions or because of severe hypoperfusion. The aim of our work was to study the histological alterations of the pancreas in patients dying after cardiogenic, hypovolemic or septic shock, to demonstrate the presence and severity of pancreatic injury. We performed a retrospective study which included patients who died and who were autopsied after different types of shock, hospitalized between 2007-2009 in general and cardiac intensive care units. We excluded the patients with known pancreatic diseases. From 223 patients included in our study 39 presented necrotising hemorrhagic alteration of the pancreatic tissue. There were no differences in histological and immunohistochemical findings between the different etiopathogenetic types of shock. None of the patients had characteristic clinical signs for acute pancreatitis. The digestive symptoms, they presented, could be related to the underlying disease or to postoperative state. The common findings in these patients were prolonged and severe hypotension, associated renal dysfunction, leucocytosis, hyperglycemia and hypocalcemia. Pancreatitis can occur in patients with shock, due to prolonged hypoperfusion of the pancreas. It is difficult to diagnose it because clinical signs are altered due to severity of underlying disease or analgo-sedation commonly used in intensive care. We therefore recommend in patients with shock to consider the possible development of ischemic pancreatitis for prompt and efficient treatment.
Published: 2011

37. The Assessment of Reperfusion Inflammatory Injury in Ischemic Preconditioned Diabetic Rats

Author: Bianca-Liana, Grigorescu, primary, Ştefania, Fodor Raluca, additional, Alina, Scridon, additional, Marcel, Perian, additional, Iudita, Badea, additional, Adrian Dan, Cioc, additional, Simion, Cotoi Ovidiu, additional, Sanda-Maria, Copotoiu, additional, and Leonard, Azamfirei, additional
Published: 2015
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38. Looking for the best management of myasthenia gravis at the Tg.Mureş Clinic of Anesthesia and Intensive Care

Author: Sanda-Maria, Copotoiu, C, Copotoiu, V, Bud, C, Molnar, L, Azamfirei, Ioana, Ghitescu, M, Măruşteri, Maria, Dogaru, and Klara, Brânzaniuc
Subjects: Patient Care Team, Intensive Care Units, Sternum, Treatment Outcome, Romania, Thoracic Surgery, Video-Assisted, Myasthenia Gravis, Humans, Prospective Studies, Thymectomy
Abstract: Thymectomy is one of the current management strategies for myasthenia gravis. This is observational study focused on the evolution of the surgical and anesthesiological strategies applied to the patients submitted to thymectomy initially by maximal sternotomy (in the years 1994-1998), followed by unconditioned reorientation towards thymectomy by VATS. A number of 103 patients are included, 51 thymectomy by left VATS. All the thoracoscopic thymectomy were performed in general anesthesia, the lungs were separated by left selective intubation, and the left lung was deflated during the surgical procedure. The surgical complications appeared mainly in the VATS group: one pericardial and one myocardial lesion leading to sternotomy (minimal blood loss, uneventful recovery), contralateral pleural lesion with pneumothorax. The classical approach accounted for one hemothorax. The postoperative mortality was zero in the VATS group vs. 6 out of 52 pts in the sternotomy group. The postoperative evolution confronted the anesthesiologist with the classical crises of myasthenia. Death occurred within the first three weeks following surgery. The demise in 3 cases was due to cardiac complications (preexisting cardiomyopathy complicated by ventricular arrhythmia) and respiratory failure plus sepsis (for the remaining cases that we lost). The treatment options in the ICU are discussed: plasmapheresis, immunosuppression, ventilatory support. VATS is appropriate for almost all thymectomy, but the outcome is heavily based on a team approach: neurologist, surgeon and anesthetist.
Published: 2007

39. [Investigating the possibility of aerosol therapy individualization using the stochastic lung model]

Author: Klara, Brâzaniuc, Z, Sárkány, Sanda Maria, Copotoiu, M, Măruşteri, L, Azamfirei, Boér, Kinga, and I, Balásházy
Subjects: Aerosols, Respiratory Therapy, Stochastic Processes, Administration, Inhalation, Respiratory Tract Diseases, Tidal Volume, Humans, Computer Simulation, Equipment Design, Particle Size
Abstract: The aim of our study is to examine the possibility of individualizing aerosol therapy, by determining the ideal diameter of the inhaled particles and the optimal breathing pattern, using a computerized simulation program. In order to find the optimal breathing pattern, we used different variations of the tidal volume and breathing period. We tried to determine the ideal particle diameter by carrying out a series of simulations for particles with diameters ranging from 1 to 10 microns. Our results show that increasing the particle diameter will lead to higher deposition values in the upper respiratory regions and bronchi, and smaller values in the acinary regions of the lung. Repeated simulations have led to two different ideal particle diameters, according to the localization of the desired effect. This way, for the bronchial regions the ideal particle diameter is 10 microns, and for the acinary regions 2 microns.
Published: 2007

40. Complete blindness after optic neuropathy induced by short-term linezolid treatment in a patient suffering from muscle dystrophy

Author: Klara Branzaniuc, Janos Szederjesi, Leonard Azamfirei, Sanda Maria Copotoiu, Cristina Berteanu, and Ruxandra Copotoiu
Subjects: Adult, Epidemiology, Blindness, Drug Administration Schedule, Muscular Dystrophies, Optic neuropathy, chemistry.chemical_compound, Anti-Infective Agents, Antibiotic therapy, Acetamides, Optic Nerve Diseases, Complete Blindness, medicine, Bronchopneumonia, Humans, Pharmacology (medical), Muscular dystrophy, Oxazolidinones, business.industry, Linezolid, Muscle dystrophy, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, medicine.disease, Pneumonia, chemistry, Anesthesia, Female, business
Abstract: We present a case of severe optic neuropathy following linezolid treatment, which led to complete irreversible blindness, in a patient with progressive muscular dystrophy, treated with linezolid for 16 days for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Interruption of antibiotic therapy did not lead to remission of ocular symptoms. Administration of linezolid may lead to severe neuropathy even in the case of short-term treatment. Copyright © 2006 John Wiley & Sons, Ltd.
Published: 2006

41. Intraabdominal Pressure (IAP) Variations Measured Simultaneously (Transvesically and Intraperitoneally) in Patients Who Underwent Laparoscopic Surgery While Being Hemodynamically Monitored With NICO

Author: Sanda Maria Copotoiu, Constantin Copotoiu, Bianca Liana Grigorescu, Ruxandra Copotoiu, Leonard Azamfirei, and Raluca Solomon
Subjects: Pulmonary and Respiratory Medicine, Laparoscopic surgery, medicine.medical_specialty, business.industry, medicine.medical_treatment, Anesthesia, medicine, Intraabdominal pressure, In patient, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, business, Surgery
Published: 2010
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42. RELATIONSHIP BETWEEN LUNG TISSUE EXPRESSION AND PLASMATIC LEVEL OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME

Author: Ruxandra Copotoiu, Simona Gurzu, Klara Branzaniuc, Sanda Maria Copotoiu, Janos Szederjesi, Ioan Jung, Leonard Azamfirei, and Raluca Solomon
Subjects: Pulmonary and Respiratory Medicine, Lung, business.industry, Acute respiratory distress, Critical Care and Intensive Care Medicine, Vascular endothelial growth factor, Vascular endothelial growth factor A, chemistry.chemical_compound, medicine.anatomical_structure, chemistry, Immunology, RESPIRATORY DISTRESS SYNDROME ADULT, Medicine, In patient, Cardiology and Cardiovascular Medicine, business, Diffuse alveolar damage, Lung tissue
Published: 2009
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43. DELIRIUM DIAGNOSIS IN AN ACADEMIC ICU

Author: Sanda Maria Copotoiu, Ioana Ghitescu, Janos Szederjesi, Leonard Azamfirei, and Ruxandra Copotoiu
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, law, medicine, Delirium, medicine.symptom, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Intensive care medicine, business, Intensive care unit, law.invention
Published: 2009
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44. Decreased vascular endothelial growth factor expression in lung tissue during acute respiratory distress syndrome

Author: Sanda Maria Copotoiu, Raluca Solomon, Klara Branzaniuc, Ioan Jung, Ruxandra Copotoiu, Simona Gurzu, and Leonard Azamfirei
Subjects: Pathology, medicine.medical_specialty, Prognostic factor, ARDS, biology, business.industry, Angiogenesis, VEGF receptors, Acute respiratory distress, Critical Care and Intensive Care Medicine, medicine.disease, Vascular endothelial growth factor, chemistry.chemical_compound, chemistry, Poster Presentation, biology.protein, Medicine, business, Lung tissue
Abstract: Endothelial injury is an important prognostic factor in acute respiratory distress syndrome (ARDS) [1,2]. Vascular endothelial growth factor (VEGF) plays a critical role in endothelial destruction and angiogenesis [3]. The expression of VEGF in ARDS varies, depending on epithelial and endothelial damage [4,5]. The objective of this study was to investigate the expression of VEGF in lung tissue from ARDS patients.
Published: 2009

45. Study on the Resuscitations Performed in the Emergency Department of the Clinical Emergency County Hospital from Târgu Mureş in 2009.

Author: Simona, Bratu and Sanda-Maria, Copotoiu
Subjects: *RESUSCITATION, *COUNTY hospitals, *CARDIAC arrest, *SEPSIS, *PNEUMONIA, *RESEARCH methodology, *PATIENTS
Abstract: Objectives: The study assesses the results of the cardiac arrest resuscitations performed by the medical staff of the Emergency Department of The Clinical Emergency County Hospital from Târgu-Mureş in the year 2009. Method: We conducted a prospective study between 01.01-31.12.2009, including the cardiac arrest cases occurred in the ED or brought with ongoing resuscitation from the pre-hospital setting. For the statistical study we used SPSS program, version 17; the 2 tests and p values were determined to compare the data. Results: We had a total of 186 cases of cardiac arrest, representing 0.47% of the total 39.074 patients assisted in the ED in 2009. The gender distribution of the cases showed a higher incidence in male (61%) and the most affected age groups ranged between 60-80 years. The patients with cardiac arrests presented various diagnosis: the highest incidence is acute coronary syndrome 32 patients (17%), followed by sepsis/MSOF 20 (11%), pneumonia/asthma 17 (9%), pulmonary embolism 17 (9%), stroke 13 (7%), etc. We have resuscitated successfully 42 patients, representing 22.58 % of the total 186 cases. All 42 patients were transferred to the hospitals departments. Out of the hospitalized patients, 25 died later on the wards and 17 (40.47%) survived and were discharged home, 6 from the Intensive Care Department and 11 from the Coronary Unit. Conclusions: The results are comparable with the reported international data. The cases with cardiac arrest due to acute coronary syndrome, ventricular rhythms and those witnessed and treated early in the ED are having a better outcome. [ABSTRACT FROM AUTHOR]
Published: 2011

46. Study on the Activity of the Cardiac Arrest Teams from the Emergency Department of the Clinical Emergency County Hospital from Tîrgu Mureș, Romania, in 2009.

Author: Simona, Bratu and Sanda-Maria, Copotoiu
Subjects: *EMERGENCY medical services, *MEDICAL emergencies, *ASSISTANCE in emergencies, *EMERGENCY medical personnel, *CARDIAC arrest, *FIRST aid in illness & injury, *RESUSCITATION, *HOSPITAL emergency services
Abstract: Objective: To evaluate the activity of the Cardiac Arrest Team (CAT) from the Emergency Department, called to perform resuscitation for patients admitted in different departments of the Clinical County Hospital. Methods: We conducted a prospective study between 01/01-12/31/2009. We included all the patients we performed CPR on, regardless of indication. Results: We had a total of 110 cases, representing 0.28% of the 39,074 patients assisted by the department in 2009. We noticed an increased incidence of calls in internal medicine and surgery departments, with 50% and 17% of the cases respectively. The most frequent diagnosis was cardiac arrest for respiratory failure and malignant tumors, each representing 17%, even though malignancy does not have an indication for resuscitation. There was no causal relationship between the outcome of resuscitation and age groups (p = 0.552), type of wards (p = 0.36), or the Basic Life Support (BLS) performed by the staff, before the CAT arrived (p = 0.76). Medical staff from wards started BLS in 40.1% of cases, in 32% of these cases only chest compressions were performed, without ventilation.The proportion of resuscitated versus deceased cases is 49.1% to 50.9%, so immediate results are good, unfortunately the late outcome is bad, 52 cases out of the 54 died later in ICU, 2 patients being discharged in good condition. Conclusions: CAT should be called according to Do Not resuscitate criteria. Medical staff from the wards should be trained to start CPR and have basic equipment. The early outcome is comparable with the international data, the poor late results binds to resuscitation without indication. [ABSTRACT FROM AUTHOR]
Published: 2011

47. Study on the Pre-hospital Cardiac Arrest Resuscitations Of the Mobile Intensive Care Ambulance Teams From Tîrgu Mureș, Romania, in 2009.

Author: Sanda-Maria, Copotoiu and Simona, Bratu
Subjects: *CARDIAC resuscitation, *ASSISTANCE in emergencies, *EMERGENCY medical personnel, *AMBULANCE service, *EMERGENCY medical services, *CRITICAL care medicine, *CARDIAC arrest
Abstract: Objective: To analyze the results of the resuscitation efforts of the SMURD medical teams, in pre-hospital, in 2009. Methods: We conducted a prospective study between 01/01/2009 - 12/31/2009. We included in the study all the cases with cardiac arrest at the arrival, those that occurred during transport and all the CPR attempts performed together with the first aid teams. For the statistical study we used SPSS program version 17, χ² test and p values were determined to compare the data obtained. Results: In 2009, the team had 250 cardiac arrest cases, 16.7% of the total of 1490 calls. Resuscitation was performed on 67.6% of patients.The good outcome of the resuscitation was statistically correlated with the distance to the case p = 0.01. The acute coronary syndrome was responsible for 27% of the cardiac arrest cases, severe trauma for 11%. The initial cardiac arrest rhythm was in 83.2% of cases asystole. BLS was performed, before the arrival of the team, to a number of 41 patients, bystander CPR representing only 2.36%. The SMURD team resuscitated a number of 58 patients in pre-hospital, 34.32% out of the 169 that had CPR, 41 died in the Emergency Department and 17 were hospitalized; 4 patients were discharged in good condition. Conclusions: The early resuscitation outcome is good, comparable with the international data reported, the rate of late survival is smaller. The proportion of ventricular rhythms with a good prognosis is lower, which correlates with longer distances traveled to the scene and less involvement of the population in BLS. [ABSTRACT FROM AUTHOR]
Published: 2011

48. The AKIN and the RIFLE Limping Criteria to Predict Renal Injury and Mortality Following Cardiac Surgery.

Author: Sanda-Maria, Copotoiu
Subjects: *ACUTE kidney failure, *KIDNEY injuries, *CARDIAC surgery, *MORTALITY, *KIDNEY transplantation
Abstract: The author reflects on a study by investigators at a local Clinic of Cardiovascular Surgery which determines the ability of acute kidney injury network (AKIN) and risk, injury, failure, loss, endstage (RIFLE) limping criteria in predicting mortality and renal injury after cardiac surgery. She states that the study has examined 178 patients who underwent renal replacement therapy (RRT). She adds that AKIN criteria were found to be more sensitive in detecting renal injury after cardiac surgery.
Published: 2012

49. On Communication Analysis and Repair as an Alternative for Miscommunication.

Author: Sanda-Maria, Copotoiu
Subjects: *PHYSICIAN-patient relations, *CONVERSATION, *PSYCHOLOGY
Abstract: An introduction is presented in which the editor dscusses various reports within the issue on topics including the proper conversation of a physician and his patient, conversation repairs, and the growing beauracracy among hospitals.
Published: 2013

50. The Show Goes On.

Author: Sanda-Maria, Copotoiu
Subjects: *ANESTHESIA, *CARDIAC surgery
Abstract: An introduction is presented in which the editor discusses various reports within the issue on topics including the effectiveness of sevoflurane on cardiac patients submitted to non-cardiac surgery, pro-inflammatory markers, and anesthesia.
Published: 2012

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