The acute phase management of spinal cord injury affecting polytrauma patients : the ASAP study

Publisher Copyright: © 2022, The Author(s).Background: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic. Methods: The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia. Results: There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80–90 mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7 g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80–100 mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35–40 mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count > 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) < 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents. Conclusions: Our survey has shown a great worldwide variability in clinical practices for acute phase management of tSCI patients with polytrauma. These findings can be helpful to define future research in order to optimize the care of patients suffering tSCI.Peer reviewe

Survey of the interventional cardiology procedures in Italy

Interventional cardiology procedures are increasing because they offer many advantages to patients compared with other techniques: therefore the Italian National Institution for Insurance against Accidents at Work decided to start a survey for monitoring the state-of-the-art regarding the professionals involved in those procedures. The survey covered six cardiology and medical physics Italian departments. Each centre was asked to record 10 examinations for five types of procedures: coronary angiography (CA), electrophysiology studies (ES), pacemaker implantation (PI), percutaneous transluminal coronary angioplasty (PTCA) and radiofrequency catheter ablation (RA). For each examination all the centres were requested to fill in a questionnaire containing information regarding the operator performing the examination, the patient and the procedure. A total of 290 examinations were recorded: 103 CA, 14 ES, 68 PI, 79 PTCA and 26 RA. As occupational doses are strongly related to patient doses, both patients and operators radiation dose data are reported. Ratios of maximum to minimum mean patient doses across the hospitals surveyed were 2.0, 3.9, 7.0, 1.8 and 1.4 for CA, ES, PI, PTCA and RA, respectively. The calculated rounded mean dose-area product values across all participating hospitals were comparable with other values reported in the literature. In general, specific radiation protection tools were used by all operators performing different procedures in all hospitals. A major issue in this survey was the absence of information about correlation between staff and patient doses in a single procedure: future studies could be more aimed to prospective goals where occupational exposures per procedure are monitored specifically. © The Author 2012. Published by Oxford University Press. All rights reserved

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Rad ne sadrži sažetak

Negative regulation of erythropoiesis by caspase-mediated cleavage of GATA-1

The production of red blood cells follows the sequential formation of proerythroblasts and basophilic, polychromatophilic and orthochromatic erythroblasts, and is promoted by the hormone erythropoietin (Epo) in response to tissue hypoxia. However, little is known about the negative regulation of this process. Death receptors are a family of surface molecules that trigger caspase activation and apoptosis in a variety of cell types. Here we show that immature erythroid cells express several death receptors whose ligands are produced by mature erythroblasts. Exposure of erythroid progenitors to mature erythroblasts or death-receptor ligands resulted in caspase-mediated degradation of the transcription factor GATA-1, which is associated with impaired erythroblast development. Expression of a caspase- resistant GATA-1 mutant, but not of the wild-type gene, completely restored erythroid expansion and differentiation following the triggering of death receptors, indicating that there is regulatory feedback between mature and immature erythroblasts through caspase-mediated cleavage of GATA-1. Similarly, erythropoiesis blockade following Epo deprivation was largely prevented by the expression of caspase-inhibitory proteins or caspase- resistant GATA-1 in erythroid progenitors. Caspase-mediated cleavage of GATA- 1 may therefore represent an important negative control mechanism in erythropoiesis

Sì canta l’empia…: Rinascimento e Opera. Seminari « L’Opéra narrateur » 2013-2014 (Saint-Denis, Université Paris 8-Paris, Institut National d’Histoire de l’Art)

International audienceCe volume inclut vingt-deux essais sur les sources Renaissance dans le livret d'opéra. Structuré en quatre parties, il recueille des études sur les adaptations opératiques du Roland Furieux («L’Arioste et le Furieux»), de La Jérusalem Délivrée («Le Tasso et Armide») et de leurs «Epigones» (Cervantès, Métastase), en plus d'une section consacrée à la réception lyrique des personnages de la Renaissance (Mona Lisa, les Médicis, Christophe Colomb, Pier Luigi Farnese, Beatrice Cenci, Torquato Tasso lui-même). Il rend publics les résultats de la troisième phase des séminaires consacrés à «L’Opéra narrateur», Renaissance et Opéra (2013–2014) qui se sont tenus dans le cadre du Laboratoire d’Études Romanes de l’Université Paris 8. Il analyse la manière dont la scène musicale a su intégrer à ses propres fins les poèmes chevaleresques et privilégie le lien entre modèle littéraire et écriture pour le théâtre en musique, sans toutefois négliger les questions de mise en scène, de scénographie et de chorégraphie.Il presente volume include ventidue saggi sulle fonti rinascimentali nella librettistica. Strutturato in quattro parti, raccoglie studi sugli adattamenti operistici dell’Orlando furioso («L’Ariosto e il Furioso»), de La Gerusalemme liberata («Il Tasso e Armida») e dei loro «Epigoni» (Cervantes, Metastasio), oltre a una sezione dedicata alle recezione lirica dei personaggi del Rinascimento (Monna Lisa, i Medici, Cristoforo Colombo, Pier Luigi Farnese, Beatrice Cenci, lo stesso Torquato Tasso). Rende pubblici i risultati della terza fase dei seminari dedicati a «L’Opéra narrateur», Rinascimento e Opera (2013–2014), tenutisi nell’ambito del Laboratoire d’Études Romanes dell’Università Paris 8. Analizza il modo in cui la scena musicale ha saputo interpretare ai propri fini i poemi cavallereschi, privilegiando il nesso tra modello letterario e scrittura per il teatro in musica, pur senza trascurare le questioni inerenti alla messinscena, alla scenografia e alla coreografia

Tradizione, Traduzione, Trasformazione

Il volume offre un punto di sintesi sulla teoria e pratica della traduzione letteraria tra il Giappone e le lingue europee, proponendo un percorso transdisciplinare di traduzione tra lingue, usi antropologici e codici culturali

The acute phase management of spinal cord injury affecting polytrauma patients: the ASAP study.

BACKGROUND: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic. METHODS: The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia. RESULTS: There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80-90&nbsp;mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7&nbsp;g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80-100&nbsp;mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35-40&nbsp;mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count &gt; 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) &lt; 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents. CONCLUSIONS: Our survey has shown a great worldwide variability in clinical practices for acute phase management of tSCI patients with polytrauma. These findings can be helpful to define future research in order to optimize the care of patients suffering tSCI

: Verdi narratore. Atti del convegno internazionale (Saint-Denis, Université Paris 8-Parigi, Institut National d’Histoire de l’Art, 23-26 ottobre 2013)

International audienceLa vera storia ci narra racchiude trentaquattro saggi di musicologi, studiosi di storia della musica, del teatro e del cinema, letterati, biografi, specialisti dei media contemporanei, direttori d’orchestra, registi e cantanti lirici. E' suddiviso in quattro sezioni: «Il tempo della narrazione», «La costruzione dell’opera», «La narrazione scenica e cinematografica», «Verdi narrato».La vera storia ci narra recueille trente-quatre essais de musicologues, d'historiens de la musique, du théâtre et du cinéma, de littéraires, de biographes, de spécialistes des médias contemporains, de chefs d'orchestre, de metteurs en scène et de chanteurs d'opéra. Il s'articule en quatre sections : «Le temps de la narration », «La construction de l’oeuvre », «La narration scénique et cinématographique », «Verdi narré »