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Gaitini L.A.,Bnai Zion Medical Center | Yanovski B.,Bnai Zion Medical Center | Mustafa S.,Bnai Zion Medical Center | Hagberg C.A.,University of Houston | And 2 more authors.
Anesthesia and Analgesia | Year: 2013

BACKGROUND: The VivaSight Single Lumen™ (SL) is new endotracheal tube with a video camera and a light source in the tip allowing continuous visual observation of the airway. In this study, we checked the feasibility of endotracheal intubation with a VivaSight-SL through the Fastrach Laryngeal Mask Airway® (FT-LMA). METHODS: We studied 50 patients with normal airways, scheduled for elective surgery during general anesthesia requiring endotracheal intubation. The FT-LMA was inserted and once adequate ventilation was achieved, the VivaSight-SL was passed through the FT-LMA into the trachea under visual control. The following criteria were used to score the laryngeal view: grade 1: full view of the arytenoids and glottis; grade 2: epiglottis, arytenoids or glottic opening are partly visible, the structure of cords is difficult to see; grade 3: dark areas indicating an open space; and grade 4: no part of the larynx can be identified. RESULTS: The FT-LMA was placed successfully in 49 patients at the first attempt. One patient was excluded from the study after 2 failed attempts to ventilate with the FT-LMA. All 49 patients were successfully intubated with the VivaSight-SL, (95% confidence interval [CI] 0.89-0.99), 47 patients at the first attempt (95% CI, 0.83-0.98) and 2 patients at the second attempt. (95% CI, 0.004-0.13). The time to achieve an effective airway with the FT-LMA was 15.4 ± 6 (mean ± SD) seconds. The time to achieve a laryngeal view with the VivaSight-SL was 28.8 ± 5 seconds. Correct position of the VivaSight-SL was confirmed with visualization of the carina. Time of successful intubation with VivaSight-SL from picking up the VivaSight-SL to observing a end-tidal CO2 curve was 45 ± 7 seconds. After introducing the VivaSight-SL through the intubating channel of the FT-LMA, a grade 1 view was obtained in 18 patients, grade 2 in 18 patients, a grade 3 in 4 patients, and grade 4 in 9 patients. CONCLUSION: The high first-attempt intubation success rate using the VivaSight-SL to intubate the trachea through a FT-LMA makes this technique an attractive and promising concept. Copyright © 2013 International Anesthesia Research Society.

Di Minno G.,University of Naples Federico II | Perno C.F.,University of Rome Tor Vergata | Tiede A.,Hannover Medical School | Navarro D.,University of Valencia | And 3 more authors.
Blood Reviews | Year: 2016

The pathogen safety of blood/plasma-derived products has historically been a subject of significant concern to the medical community. Measures such as donor selection and blood screening have contributed to increase the safety of these products, but pathogen transmission does still occur. Reasons for this include lack of sensitivity/specificity of current screening methods, lack of reliable screening tests for some pathogens (e.g. prions) and the fact that many potentially harmful infectious agents are not routinely screened for. Methods for the purification/inactivation of blood/plasma-derived products have been developed in order to further reduce the residual risk, but low concentrations of pathogens do not necessarily imply a low level of risk for the patient and so the overall challenge of minimising risk remains. This review aims to discuss the variable level of pathogenic risk and describes the current screening methods used to prevent/detect the presence of pathogens in blood/plasma-derived products. © 2015.

Lozano M.,University of Barcelona | Cid J.,University of Barcelona | Areal C.,Galicia Blood Transfusion Center | Romon I.,Santander University | Muncunill J.,Son Espases University Hospital
Transfusion and Apheresis Science | Year: 2013

The Spanish Apheresis Group is a scientific association of physicians and nurses representing most of the medical centers in the country that are involved in apheresis. The group developed a survey in order to get information about the types and number of apheresis procedures performed in Spain. We received responses from 66 centers and we were able to collect data from at least one center of each autonomous region. There were 7 centers (11%) that did not perform any kind of apheresis procedures, 26 (39%) centers performed therapeutic apheresis procedures only, 18 (27%) centers performed apheresis donations only, and 15 (23%) centers performed both types of apheresis procedures. Regarding therapeutic apheresis in adult patients, plasma exchange (34%) and stem cell collections (30%) were the two therapeutic procedures most frequently reported, followed by erythrocytapheresis (13%) and extracorporeal photochemotherapy (11%). Regarding apheresis donation, our survey showed that the most frequent was multicomponent donation (45%) followed by plasmapheresis (28%) and single plateletapheresis (21%). When analyzing the current instrumentation for performing apheresis procedures, centers used the Spectra, Optia, and Trima devices (TerumoBCT) as the most frequent ones, followed by the MCS. +. (Haemonetics), Amicus (Fenwal), and Fresenius devices. In conclusion, we report here the first nationwide survey performed in Spain in order to get information about apheresis activities in our country. The survey is representative of Spain because we were able to collect data from at least one center from each of the different 17 autonomous regions, and we found a wide variety of therapeutic and donation procedures, as well as instrumentation used. © 2013 Elsevier Ltd.

Garcia-Banda G.,University of the Balearic Islands | Chellew K.,University of the Balearic Islands | Fornes J.,University of the Balearic Islands | Perez G.,Son Espases University Hospital | And 2 more authors.
International Journal of Psychophysiology | Year: 2014

Background: There are strong theoretical arguments that those high on Neuroticism (N) should normally exhibit higher prevailing levels of the stress-linked hormone cortisol (C), but findings are inconsistent, probably reflecting methodological weaknesses especially in taking account of C's diurnal cycle. Methods: High and low N students [Total N=. 118; mean age. =. 20.99. years] were recruited and their salivary cortisol measured, ensuring that saliva samples were numerically adequate to assess C's diurnal cycle over two days with objective verification of sample timing. Results: Cortisol secretion was approximately 20% higher in High N than low N participants in the period of 12. h after awakening (. p<. .008), but no differences in secretion were evident during the first 0.75 of this period, when typically the Cortisol Awakening Response (CAR) rapidly takes cortisol to its daily peak. N effects were thus confined to the 0.75. h-12. h period (. p<. .007). Males had approximately 25% higher cortisol secretion levels than females, also confined to the 0.75. h-12. h period (. p<. .003). No significant differences between N groups were evident for dynamic measures of cortisol change, viz. the magnitude of CAR rise and subsequent diurnal fall. All effects were controlled for cohort date of study entry, age, smoking status, study day and time of awakening. Discussion: With careful control, it appears that an important theoretically predicted effect exists, and is replicated in different student intake cohorts recruited in different years. Most importantly, findings support several lines of evidence that the period of massive rise in the brief 0-0.75. h CAR period should be seen as quite separate from the rest of the diurnal cycle, underpinned by different control mechanisms, and with potentially different correlates. © 2013 Elsevier B.V.

Hervas J.A.,Son Espases University Hospital | Hervas J.A.,University of the Balearic Islands | Martin-Santiago A.,University of the Balearic Islands | Hervas D.,University of the Balearic Islands | And 4 more authors.
Pediatric Infectious Disease Journal | Year: 2012

We present a case of a child with Leishmania infantum cutaneous leishmaniasis unresponsive to 2 courses of intravenous liposomal amphotericin B, a treatment failure that has not been reported in this Leishmania species. The patient responded to topical imiquimod and had no relapse. We review the literature on the treatment failure of liposomal amphotericin B for cutaneous leishmaniasis. © 2012 Lippincott Williams & Wilkins.

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