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RISS 인기검색어
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- 저자 : Andrea Rodriguez (검색결과 4 건)
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Andrea B. Stefansdottir,Luis Vieira,Arni Johnsen,Daniel Isacson,Andres Rodriguez,Maria Mani Korean Society of Plastic and Reconstructive Surge 2024 Archives of Plastic Surgery Vol.51 No.2
Background Perioperative management in autologous breast reconstruction has gained focus in recent years. This study compares two pain management protocols in patients undergoing abdominal-based free flap breast reconstruction: a past protocol (PP) and a current protocol (CP)-both intended to reduce opioid consumption postoperatively. The PP entails use of a pain catheter in the abdominal wound and the CP consists of an intraoperative nerve block in addition to refinements in the oral pain management. We hypothesize that the CP reduces opioid consumption compared to PP. Methods From December 2017 to January 2020, 102 patients underwent breast reconstruction with an abdominal-based free flap. Two postoperative pain management strategies were used during the period; from December 2017 to September 2018, the PP was used which entailed the use of a pain catheter with ropivacaine applied in the abdominal wound with continuous distribution postoperatively in addition to paracetamol orally and oxycodone orally pro re nata (PRN). From October 2018 to January 2020, the CP was used. This protocol included a combination of intraoperative subfascial nerve block and a postoperative oral pain management regime that consisted of paracetamol, celecoxib, and gabapentin as well as oxycodone PRN. Results The CP group (n = 63) had lower opioid consumption compared to the PP group (n = 39) when examining all aspects of opioid consumption, including daily opioid usage in morphine milligram equivalents and total opioid usage during the stay (p < 0.001). The CP group had shorter length of hospital stay (LOS). Conclusion Introduction of the CP reduced opioid use and LOS was shorter.
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Donor Islet Endothelial Cells in Pancreatic Islet Revascularization
Nyqvist, Daniel,Speier, Stephan,Rodriguez-Diaz, Rayner,Molano, R. Damaris,Lipovsek, Saš,a,Rupnik, Marjan,Dicker, Andrea,Ilegems, Erwin,Zahr-Akrawi, Elsie,Molina, Judith,Lopez-Cabeza, Maite,Villat American Diabetes Association 2011 Diabetes Vol.60 No.10
<P><B>OBJECTIVE</B></P><P>Freshly isolated pancreatic islets contain, in contrast to cultured islets, intraislet endothelial cells (ECs), which can contribute to the formation of functional blood vessels after transplantation. We have characterized how donor islet endothelial cells (DIECs) may contribute to the revascularization rate, vascular density, and endocrine graft function after transplantation of freshly isolated and cultured islets.</P><P><B>RESEARCH DESIGN AND METHODS</B></P><P>Freshly isolated and cultured islets were transplanted under the kidney capsule and into the anterior chamber of the eye. Intravital laser scanning microscopy was used to monitor the revascularization process and DIECs in intact grafts. The grafts’ metabolic function was examined by reversal of diabetes, and the ultrastructural morphology by transmission electron microscopy.</P><P><B>RESULTS</B></P><P>DIECs significantly contributed to the vasculature of fresh islet grafts, assessed up to 5 months after transplantation, but were hardly detected in cultured islet grafts. Early participation of DIECs in the revascularization process correlated with a higher revascularization rate of freshly isolated islets compared with cultured islets. However, after complete revascularization, the vascular density was similar in the two groups, and host ECs gained morphological features resembling the endogenous islet vasculature. Surprisingly, grafts originating from cultured islets reversed diabetes more rapidly than those originating from fresh islets.</P><P><B>CONCLUSIONS</B></P><P>In summary, DIECs contributed to the revascularization of fresh, but not cultured, islets by participating in early processes of vessel formation and persisting in the vasculature over long periods of time. However, the DIECs did not increase the vascular density or improve the endocrine function of the grafts.</P>
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Speckle Tracking Imaging in Patients with Pulmonary Hypertension
Omar Prieto,Tomás Francisco Cianciulli,Alejandro Stewart-Harris,Andrea Rodriguez,María Cristina Saccheri,Jorge Alberto Lax,Lucia Raquel Kazelián,Laura Vanina Argento,Gerardo Manuel Marambio,Juan Alber 한국심초음파학회 2021 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.29 No.3
BACKGROUND: Right ventricular (RV) systolic dysfunction is a strong predictor of mortality in pulmonary hypertension (PH). The goal of this study was to investigate whether right atrium (RA) and RV myocardial strain related to PH using speckle tracking echocardiography provide a superior estimation of RV systolic function than 2-dimensional (2D)-echo. METHODS: This cross-sectional study analyzed 22 patients with a diagnosis of PH stratified by right heart catheterization, and they were compared to a control group of 22 age- and sex-matched healthy subjects. RESULTS: Global longitudinal peak systolic strain measured in the RV free wall from the apical 4 chamber view was −15% vs. −14.5% when measured from the subcostal view (p = 0.99). Mean longitudinal strain during reservoir phase, and longitudinal strain rate during atrial reservoir and passive conduit function was significantly impaired measured in the right atrial free wall in patients with PH. CONCLUSIONS: This study showed impaired LV contractility in patients with PH assessed by speckle tracking strain. RV free wall longitudinal strain does not correlate with any of the measurements of RV systolic function obtained by 2D echocardiography. A major strength of RV longitudinal strain is its ability to assess the RV function without the limitations of 2D parameters. The subcostal RV strain is a feasible and accurate alternative to conventional RV strain from the apical view in patients with poor acoustic apical 4-chamber windows. The RA strain and strain rates values may be a valuable additive to assess right-sided heart function.
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Prolonged intensive care: muscular functional, and nutritional insights from the COVID-19 pandemic
Miguel Ángel Martínez-Camacho,Robert Alexander Jones-Baro,Alberto Gómez-González,Dalia Sahian Lugo-García,Pía Carolina Gallardo Astorga,Andrea Melo-Villalobos,Bárbara Kassandra Gonzalez-Rodriguez,Ánge 대한중환자의학회 2024 Acute and Critical Care Vol.39 No.1
During the coronavirus disease 2019 (COVID-19) pandemic, clinical staff learned how to manage patients enduring extended stays in an intensive care unit (ICU). COVID-19 patients requiring critical care in an ICU face a high risk of experiencing prolonged intensive care (PIC). The use of invasive mechanical ventilation in individuals with severe acute respiratory distress syndrome can cause numerous complications that influence both short-term and long-term morbidity and mortality. Those risks underscore the importance of proactively addressing functional complications. Mitigating secondary complications unrelated to the primary pathology of admission is imperative in minimizing the risk of PIC. Therefore, incorporating strategies to do that into daily ICU practice for both COVID-19 patients and those critically ill from other conditions is significantly important.
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