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Cardiac Biomarker Release after CABG with Different Surgical Techniques

Objective: To investigate the release of cardiac biomarkers (troponin I and CK-MB) in patients undergoing coronary artery bypass graft (CABG) with or without cardiopulmonary bypass (CPB). Design: Prospective study, Setting: University tertiary hospital. Participants: Sixty-five consecutive patients undergoing coronary artery bypass grafting (â\u89¥2 vessel disease, ejection fraction â\u89¥0.35%, elective procedure). Interventions: Cardiac biomarkers were measured before surgery, at intensive care unit arrival, 4 and 18 hours after the end of the procedure. Measurements and Main Results: Cardiac biomarker release was higher in on-pump than in off-pump patients at every time point. On multivariate analysis, CPB (p â\u89¤ 0.0001), number of distal grafts (p = 0.005), and hypertension treatment (p = 0.03) were the only independent predictors of peak cardiac troponin release. Conclusions: Cardiac troponin I release after multivessel CABG is associated with the technique. Different values for the normal range should be considered. OPCABG is minimally invasive for the heart as far as myocardial marker release is concerned. © 2004 Elsevier Inc. All rights reserved

Myocardial damage prevented by volatile anesthetics: A multicenter randomized controlled study

Objective: The purpose of this study was to evaluate the effects of volatile anesthesia versus total intravenous anesthesia on cardiac troponin release in off-pump coronary artery bypass grafting (OPCAB). Design: The authors performed a multicenter randomized controlled study to compare cardiac troponin release in patients receiving either volatile anesthetics or total intravenous anesthesia for cardiac surgery on the beating heart, which is an excellent model of human myocardial ischemia. Setting: Three university hospitals. Participants: The authors randomly assigned 57 patients to desflurane (volatile anesthetic) and 55 patients to propofol (intravenous anesthetic) in addition to an opiate-based anesthesia for OPCAB. Interventions: The 2 groups of patients received either desflurane (volatile anesthetic) or propofol in addition to an opiate-based anesthesia for OPCAB. Peak postoperative troponin I release was measured as a marker of myocardial necrosis. Prolonged hospitalization was considered as a secondary outcome. Measurements and Main Results: Patient mean age was 69 years, and 82% were men. There was a significant (p 7 days), 7 (12%) versus 20 (36%) in the 2 groups (p 0.005). One patient receiving total intravenous anesthesia died within 30 days of surgery. Conclusions: Myocardial damage measured by cardiac troponin release could be reduced by volatile anesthetics during OPCAB. Because patients underwent cardiac surgery on the beating heart, these results could have implications for cardiac patients undergoing noncardiac surgery

Ludwig Binswanger: esperienza della soggettivit\ue0 e trascendenza dell'altro. I margini di un'esplorazione fenomenologico-psichiatrica

Il pensiero filosofico e scientifico di Ludwig Binswanger in dialogo con i suoi contemporanei e in relazione all'attuale indagine fenomenologico-psichiatrica

A Novel Approach to β-Decay : PANDORA, a New Experimental Setup for Future In-Plasma Measurements

Theoretical predictions as well as experiments performed at storage rings have shown that the lifetimes of β-radionuclides can change significantly as a function of the ionization state. In this paper we describe an innovative approach, based on the use of a compact plasma trap to emulate selected stellar-like conditions. It has been proposed within the PANDORA project (Plasmas for Astrophysics, Nuclear Decay Observation and Radiation for Archaeometry) with the aim to measure, for the first time in plasma, nuclear β-decay rates of radionuclides involved in nuclear-astrophysics processes. To achieve this task, a compact magnetic plasma trap has been designed to reach the needed plasma densities, temperatures, and charge-states distributions. A multi-diagnostic setup will monitor, on-line, the plasma parameters, which will be correlated with the decay rate of the radionuclides. The latter will be measured through the detection of the γ-rays emitted by the excited daughter nuclei following the β-decay. An array of 14 HPGe detectors placed around the trap will be used to detect the emitted γ-rays. For the first experimental campaign three isotopes, 176Lu, 134Cs, and 94Nb, were selected as possible physics cases. The newly designed plasma trap will also represent a tool of choice to measure the plasma opacities in a broad spectrum of plasma conditions, experimentally poorly known but that have a great impact on the energy transport and spectroscopic observations of many astrophysical objects. Status and perspectives of the project will be highlighted in the paper.peerReviewe

Adapted Physical Activity for the Promotion of Health and the Prevention of Multifactorial Chronic Diseases: the Erice Charter

The Erice Charter was unanimously approved at the conclusion of the 47th Residential Course "Adapted Physical Activity in Sport, Wellness and Fitness: New Challenges for Prevention and Health Promotion", held on 20-24 April 2015 in Erice, Italy, at the "Ettore Majorana" Foundation and Centre for Scientific Culture, and promoted by the International School of Epidemiology and Preventive Medicine "G. D'Alessandro" and the Study Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health. After an intense discussion the participants identified the main points associated with the relevance of physical activity for Public Health, claiming the pivotal role of the Department of Prevention in coordinating and managing preventive actions. The participants underlined the importance of the physicians specialized in Hygiene, Preventive Medicine and Public Health. The contribution of other operators such as physicians specialized in Sport Medicine was stressed. Further, the holders of the new degree in Human Movement and Sport Sciences were considered fundamental contributors for the performance of physical activity and their presence was seen as a promising opportunity for the Departments of Prevention. Primary prevention based on recreational physical activities should become easily accessible for the population, avoiding obstacles such as certification steps or complex bureaucracy. The Sport Doctor is recognized as the principal referent for preliminary physical evaluation and clinical monitoring in secondary and tertiary prevention actions based on adapted physical activities. Developing research in the field is essential as well as implementing higher education on physical activity management in Schools of Public Health