50 research outputs found
Sex-Specific Relationships Between Interoceptive Accuracy and Emotion Regulation
Over the last years, there has been a resurge in the interest to study the relationship between interoception and emotion. By now, it is well established that interoception contributes to the experience of emotions. However, it may also be possible that interoception contributes to the regulation of emotions. To test this possibility, we studied the relationship between interoception and emotion regulation in a sample of healthy individuals (n = 84). We used a similar heartbeat detection task and a similar self-report questionnaire for the assessment of interoceptive accuracy and emotion regulation as in previous studies. In contrast to previous studies, we differentiated between male and female individuals in our analyses and controlled our analyses for individual characteristics that may affect the relationship between interoceptive accuracy and emotion regulation. We found sex-differences in interoceptive accuracy and emotion regulation that amounted to a sex-specific relationship between interoceptive accuracy and emotion regulation: Whereas interoceptive accuracy was related to reappraisal but not to suppression in male individuals, interoceptive accuracy was unrelated to reappraisal and suppression in female individuals. These findings indicate that the relationship between interoception and emotion regulation is far more complex than has been suggested by previous findings. However, these findings nonetheless support the view that interoception is essential for both, the regulation and experience of emotions
Direct thrombolysis of multiple thrombi in both right and left heart atrium in a patient on extracorporeal membrane oxygenation support following urgent double-lung transplantation: a case report
Cultivation of circulating tumor cells in esophageal cancer
The presence of circulating tumor cells (CTCs) in patients with metastatic carcinoma is generally associated with poor clinical outcome. There have been many investigations showing a possible use of CTCs as minimally invasive predictive and prognostic biomarker in cancer medicine. In this report a size-based method (MetaCell®) for quick and easy enrichment and cultivation of CTCs is presented to enable possible CTCs use in esophageal cancer (EC) management. In total, 43 patients with diagnosed EC, 20 with adenocarcinoma (AdenoCa) and 23 with squamous cell carcinoma (SCC), were enrolled into the adaptive prospective-like study .All the patients were candidates for surgery. The CTCs were detected in 27 patients (62.8%), with a higher rate in adenocarcinoma (75%) than SCC (52%). Finally, there were 26 patients with resectable tumors exhibiting CTCs-positivity in 69.2% and 17 patients with non-resectable tumors with 41.7% CTCs-positivity. Interestingly, in the patients undergoing neoadjuvant therapy, the CTCs were detected at time of surgery in 55.5% (10/18). The overall size-based filtration approach enabled to isolate viable CTCs and evaluate to their cytomorphological features by means of vital fluorescent staining. The CTCs were cultured in vitro for further downstream applications including immunohistochemical analysis. This is the first report of the successful culturing of esophageal cancer CTCs. The detection of CTCs presence could help in the future to guide timing of surgical treatment in EC patients
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Induction therapy in lung transplantation: initial single-center experience comparing daclizumab and anti-thymocyte globulin BACKGROUND: Acute and chronic rejection remain unresolved problems after lung transplantation, despite heavy multidrug immunosuppression. In turn, the strong immunosuppression has been responsible for mortality and pervasive morbidity. Because acute rejection is associated with inferior outcomes in lung transplantation, we have routinely employed anti-thymocyte globulin (ATG), or daclizumab as adjuncts to reduce rejection. Daclizumab is a human monoclonal antibody that binds to the interleukin-2 receptor. METHOD: We performed a controlled clinical trial of these 2 therapies to determine differences in post-operative rejection, infection, bronchiolitis obliterans syndrome (BOS) and survival. 25 consecutive lung transplant patients received ATG (n = 12)(Group 1) and daclizumab (n = 13)(Group2) as induction agents. The groups had similar demographics and immunosuppression protocols differing only in induction agents used. RESULTS: No differences were observed in immediate post-operative outcomes such as length of hospitalization, ICU stay, or time on ventilators. No patient receiving daclizumab developed drug specific side-effects. There were no significant differences in the..
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PĹ™edloĹľená práce obsahuje teoretickou část, která zahrnuje v zakladnĂch bodech celou problematiku souvisejĂcĂ s transplantacemi plic. Vzhledem tĂ©matu je detailnÄ› rozpracována kapitola 8, zabĂ˝vajĂcĂ se problematikou imunosupresivnĂ terapie a jejĂch komplikacĂ, tĂ©to kapitole se rovněž vztahujĂ literárnĂ odkazy uvedenĂ© na konci teoretickĂ© části. V klinickĂ© části jsou prezentovány základnĂ statistickĂ© Ăşdaje o vĂ˝sledcĂch programu transplantacĂ plic v ÄŚeskĂ© republice. Dále je prezentována studie, zabĂ˝vajĂcĂ se vĂ˝sledky srovnánĂ dvou protokolĹŻ imunosupresivnĂ terapie lišĂcĂch se zvolenĂ˝m preparátem indukÄŤnĂ terapii kazuistika projevu cyklosporinovĂ© neurotoxicity u pacienta po bilaterálnĂ transplantaci plic pro cystickou fibrĂłzu indikaÄŤnĂ kritĂ©ria uĹľitĂ sirolimu v našem centru studie zabávajĂcĂ se prvnĂmi zkušenostmi uĹľitĂm sirolimu u pacientĹŻ s renálnĂ dysfunkcĂ v dĹŻsledku nefrotoxicity kalcineurinovĂ˝ch inhibitorĹŻ. Ke kaĹľdĂ© části se vztahujĂ samostatnĂ© literárnĂ citace.Induction therapy in lung transplantation: initial single-center experience comparing daclizumab and anti-thymocyte globulin BACKGROUND: Acute and chronic rejection remain unresolved problems after lung transplantation, despite heavy multidrug immunosuppression. In turn, the strong immunosuppression has been responsible for mortality and pervasive morbidity. Because acute rejection is associated with inferior outcomes in lung transplantation, we have routinely employed anti-thymocyte globulin (ATG), or daclizumab as adjuncts to reduce rejection. Daclizumab is a human monoclonal antibody that binds to the interleukin-2 receptor. METHOD: We performed a controlled clinical trial of these 2 therapies to determine differences in post-operative rejection, infection, bronchiolitis obliterans syndrome (BOS) and survival. 25 consecutive lung transplant patients received ATG (n = 12)(Group 1) and daclizumab (n = 13)(Group2) as induction agents. The groups had similar demographics and immunosuppression protocols differing only in induction agents used. RESULTS: No differences were observed in immediate post-operative outcomes such as length of hospitalization, ICU stay, or time on ventilators. No patient receiving daclizumab developed drug specific side-effects. There were no significant differences in the...3rd Department of Surgery First Faculty of Medicine and University Hospital MotolIII. chirurgická klinika 1. LF UK a FN Motol v PrazeFirst Faculty of Medicine1. lĂ©kaĹ™ská fakult
Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
Abstract Background Acquired benign bronchoesophageal fistula (BEF) is rare and develops as a complication of other diseases, mostly of inflammatory processes and traumas of the chest. The treatment of choice is a surgical repair, which is considered definitive and leads to successful outcomes. However, incidence of recurrence after the primary repair based on limited data is up to 10% and its treatment is challenging. We report a surgical case of a patient with recurrent acquired benign BEF after primary resection and ensuing successful definitive repair with esophageal bypass surgery after temporary esophageal stenting. Case report A 46-year-old male was referred to our department with a symptomatic left-sided bronchoesophageal fistula as a complication of severe acute necrotizing mediastinitis that originated from odontogenic abscess. Previously, several cervicotomies and bilateral thoracotomy were performed at an external medical facility to manage the acute condition. We performed resection of the fistula through re-thoracotomy. Postprocedural esophagography demonstrated a recurrence of bronchoesophageal communication. Postinflammatory adhesions excluded further repair through thoracotomy, therefore a stent was introduced in the esophagus for 12 weeks. Thereafter, an esophageal bypass surgery using a substernaly interposed gastric conduit was performed and resulted in an excellent long-term outcome. Conclusions Esophageal bypass surgery using a substernaly interposed gastric conduit may be considered if the standard surgical repair of acquired benign bronchoesophageal fistula is not successful or feasible
Efficacy and efficiency of indoor nighttime human external cargo mission simulation in a high-fidelity training centre
Background
The human external cargo (HEC) operations conducted by Helicopter Emergency Medical Services (HEMS) rarely take place at night, making it difficult for crew members to attain and maintain the level of expertise needed to perform winch operations in the dark. As EASA requirements for training cannot currently be met, we evaluated whether simulation training could be an option.
Methods
This paper reports on a training concept using indoor simulation for the training of nighttime HEC operations. Participants’ experience and perceptions were evaluated with a survey and the procedural and economic advantages of the simulation approach were compared with those of the usual outdoor HEC training.
Results
Most participants had limited exposure to real-life nighttime HEC missions before undergoing the simulation-based training. The frequency of training cycles in simulation was much higher compared to conventional training (60 cycles indoors vs. 20 outdoors for HEMS-TC, 20 cycles indoors vs. 4 outdoors for MCM). Trainees perceived that their technical and non-technical skills (NTS) improved with the training. The estimated costs of standard outdoor-based nighttime HEC training (138€ per cycle) are at least 6.5 times higher than the costs of indoor simulated training (approximately 21€ per cycle). With a change to simulation, carbon dioxide emissions could potentially be reduced by more than 35 tons.
Conclusions
Indoor simulation training of night HEC operations has advantages with regard to cost-effectiveness, environmental friendliness, and self-reported improvements in skills and knowledge. Its use is feasible and could improve crew and patient safety and fulfill regulatory demands for training intensity.publishedVersio