Tolvaptan in autosomal dominant polycystic kidney disease.

in New England Journal of Medicine [=NEJM] (2013), 368(13), 1258-9

Detection of Thermal Emission from a Super-Earth

in Astrophysical Journal Letters (2012), 751(2), 28

We report on the detection of infrared light from the super-Earth 55 Cnc e, based on four occultations obtained with Warm Spitzer at 4.5 microns. Our data analysis consists of a two-part process. In a ... [more ▼]

We report on the detection of infrared light from the super-Earth 55 Cnc e, based on four occultations obtained with Warm Spitzer at 4.5 microns. Our data analysis consists of a two-part process. In a first step, we perform individual analyses of each dataset and compare several baseline models to optimally account for the systematics affecting each lightcurve. We apply independent photometric correction techniques, including polynomial detrending and pixel-mapping, that yield consistent results at the 1-sigma level. In a second step, we perform a global MCMC analysis including all four datasets, that yields an occultation depth of 131+-28ppm, translating to a brightness temperature of 2360+-300 K in the IRAC-4.5 micron channel. This occultation depth suggests a low Bond albedo coupled to an inefficient heat transport from the planetary dayside to the nightside, or else possibly that the 4.5-micron observations probe atmospheric layers that are hotter than the maximum equilibrium temperature (i.e., a thermal inversion layer or a deep hot layer). The measured occultation phase and duration are consistent with a circular orbit and improves the 3-sigma upper limit on 55 Cnc e's orbital eccentricity from 0.25 to 0.06. [less ▲]

Immune Reconstitution Inflammatory Syndrome in Natalizumab-Associated PML

in Neurology (2012), 78(1), 73

Role of folate receptor autoantibodies in infantile autism

in Molecular Psychiatry (2012)

Machine perfusion in clinical trials : "machine vs. solution effects"

in Transplant International (2012), 25

WASP-43b: The closest-orbiting hot Jupiter

in Astronomy and Astrophysics (2011), 535

We report the discovery of WASP-43b, a hot Jupiter transiting a K7V star every 0.81 d. At 0.6-Msun the host star has the lowest mass of any star hosting a hot Jupiter. It also shows a 15.6-d rotation ... [more ▼]

We report the discovery of WASP-43b, a hot Jupiter transiting a K7V star every 0.81 d. At 0.6-Msun the host star has the lowest mass of any star hosting a hot Jupiter. It also shows a 15.6-d rotation period. The planet has a mass of 1.8 Mjup, a radius of 0.9 Rjup, and with a semi-major axis of only 0.014 AU has the smallest orbital distance of any known hot Jupiter. The discovery of such a planet around a K7V star shows that planets with apparently short remaining lifetimes owing to tidal decay of the orbit are also found around stars with deep convection zones. [less ▲]

Paricalcitol for reduction of albuminuria in diabetes

in Journal-Lancet (The) (2011), 377

Liver graft procurement in donors with central nervous system cancers.

in Liver Transplantation (2010), 16(7), 914-5

Complications and recommendations concerning intravenous immunoglobulins in alloimmune hemolytic disease of the newborn

in Archives Françaises de Pédiatrie (2010), 17(3), 299-300

Allocation of ECD Kidneys Based on Donor GFR: The Choice of the Estimating Equation Matters

in American Journal of Transplantation (2010), 10

Effects of fibrates on cardiovascular outcomes.

in Lancet (2010), 376(9746), 1051

Prescribed regimen is effective.

in BMJ (Clinical Research ed.) (2010), 341

Reanalysis of death risk in long-term follow-up in infliximab patients versus controls

in Gut (2010), 59

Refractory insulin allergy : pancreas transplantation or immunosuppressive therapy alone?

in Transplant International (2010)

Defining a "reference population": no easy task.

in Journal of Bone and Mineral Research (2009), 24(9), 1638

Extended criteria donors: the case for liver procurement in donors with a central nervous system malignancy

in Liver Transplantation (2009), 15

Equine atypical myopathy. Letters (equine health)

in Veterinary Record : Journal of the British Veterinary Association (2009), 165

A Staging Model to Guide Psychological Interventions in Psychosis

in Psychiatric Services (2009), 60

On the demanding necessity of properly evaluating renal graft function in clinical trials.

in Transplant International (2009), 22(2), 247-8

Auditory-verbal hallucinations and ordinary verbal thought

in Psychological Medicine (2009), 39

Operational Determination of Multiqubit Entanglement Classes via Tuning of Local Operations

in Physical Review Letters (2009), 102

We present a physical setup with which it is possible to produce arbitrary symmetric long-lived multiqubit entangled states in the internal ground levels of photon emitters, including the paradigmatic ... [more ▼]

We present a physical setup with which it is possible to produce arbitrary symmetric long-lived multiqubit entangled states in the internal ground levels of photon emitters, including the paradigmatic Greenberger-Horne-Zeilinger and W states. In the case of three emitters, where each tripartite entangled state belongs to one of two well-defined entanglement classes, we prove a one-to-one correspondence between well-defined sets of experimental parameters, i.e., locally tunable polarizer orientations, and multiqubit entanglement classes inside the symmetric subspace. [less ▲]

Polarization vortices in germanium telluride nanoplatelets: A theoretical study

in Physical Review Letters (2009), 103

Using first-principles calculations based on density functional theory, we study the properties of germanium telluride crystalline nanoplatelets and nanoparticles. Above a diameter of 2.7 nm, we predict ... [more ▼]

Using first-principles calculations based on density functional theory, we study the properties of germanium telluride crystalline nanoplatelets and nanoparticles. Above a diameter of 2.7 nm, we predict the appearance of polarization vortices giving rise to an unusual ferrotoroidic ground state with a spontaneous and reversible toroidal moment of polarization. We highlight the crucial role of inhomogeneous strain in stabilizing polarization vortices. Combined with the phase-change properties of germanium telluride, the ferrotoroidic properties could be of practical interest for ternary logic applications. [less ▲]

Moderate patient-prosthesis mismatch can impact on mortality after aortic valve replacement

in Heart (2009), 95(7), 592

Hard X-ray emission from eta Carinae

in Astronomy and Astrophysics (2008), 477

Context: If relativistic particle acceleration takes place in colliding-wind binaries, hard X-rays and gamma-rays are expected through inverse Compton emission, but to date these have never been ... [more ▼]

Context: If relativistic particle acceleration takes place in colliding-wind binaries, hard X-rays and gamma-rays are expected through inverse Compton emission, but to date these have never been unambiguously detected. Aims: To detect this emission, observations of eta Carinae were performed with INTEGRAL, leveraging its high spatial resolution. Methods: Deep hard X-ray images of the region of eta Car were constructed in several energy bands. Results: The hard X-ray emission previously detected by BeppoSax around eta Car originates from at least 3 different point sources. The emission of eta Car itself can be isolated for the first time, and its spectrum unambiguously analyzed. The X-ray emission of eta Car in the 22-100 keV energy range is very hard (Gamma ~= 1 ± 0.4) and its luminosity is 7 × 10^33 erg s^-1. Conclusions: The observed emission is in agreement with the predictions of inverse Compton models, and corresponds to about 0.1% of the energy available in the wind collision. eta Car is expected to be detected in the GeV energy range. [less ▲]

Transmission of lymphoma via organ transplantation

in American Journal of Transplantation (2008), 8

Vitamin D treatment in chronic kidney disease: what we really need to know.

in Archives of Internal Medicine (2008), 168(18), 20452046

Cystatin C, renal function, and cardiovascular risk.

in Annals of Internal Medicine (2008), 148(4), 323

Creatinine calibration in NHANES: is a revised MDRD study formula needed?

in American Journal of Kidney Diseases (2008), 51(4), 709709-10

Introducing atmospheric attenuation within a diffusion model room-acoustic predictions

in Journal of the Acoustical Society of America (2008), 123(6), 4040-4043

This paper presents an extension of a diffusion model for room acoustics to handle the atmospheric attenuation. This phenomenon is critical at high frequencies and in large rooms to obtain correct ... [more ▼]

This paper presents an extension of a diffusion model for room acoustics to handle the atmospheric attenuation. This phenomenon is critical at high frequencies and in large rooms to obtain correct acoustic predictions. An additional term is introduced in the diffusion equation as well as in the diffusion constant, in order to take the atmospheric attenuation into account. The modified diffusion model is then compared with the statistical theory and a cone-tracing software. Three typical room-acoustic configurations are investigated: a proportionate room, a long room and a flat room. The modified diffusion model agrees well with the statistical theory (when applicable, as in proportionate rooms) and with the cone-tracing software, both in terms of sound pressure levels and reverberation times. [less ▲]

Analytical quality of calcitonin determination and its effect on the adequacy of screening for medullary carcinoma of the thyroid.

in Clinical Chemistry (2008), 54(5), 929-30

Acetylcysteine and Enzymatic Creatinine: Beware of Laboratory Artefact!

in Intensive Care Medicine (2007)

Vitex agnus castus might enrich the pharmacological armamentarium for medical treatment of prolactinoma

in European Journal of Obstetrics & Gynecology & Reproductive Biology (2007), 135(1), 139-140

Type II collagen markers in osteoarthritis: what do they indicate?

in Current Opinion in Rheumatology (2007), 19(5), 444-450

Purpose of review We provide a critical review of recent in-vitro, animal and human clinical studies on type II collagen biomarkers. In describing the human studies, we have applied the BIPED (burden of ... [more ▼]

Purpose of review We provide a critical review of recent in-vitro, animal and human clinical studies on type II collagen biomarkers. In describing the human studies, we have applied the BIPED (burden of disease, investigative, prognostic, efficacy of intervention, and diagnostic) classification scheme recently proposed by the Osteoarthritis Biomarkers Network (a consortium of five US National Institutes of Health designated sites). Based on this analysis, we propose an update to the classification of the type II collagen biomarkers. Recent findings Various type II collagen epitopes have been described as potential biomarkers for osteoarthritis. Some have demonstrated ability in the following areas: classification of individuals as either diseased or nondiseased; assessment of severity or extent of osteoarthritis; prediction of future onset of osteoarthritis among those without osteoarthritis at baseline or the progression of osteoarthritis among those with existing disease; and monitoring treatment efficacy. Summary Type II collagen biomarkers provide useful information for clinical and research applications. Furthermore, they are promising tools for the monitoring the influence of drug treatment on cartilage metabolism in joint diseases such as osteoarthritis. [less ▲]

Preconditioning and protection against ischaemia-reperfusion in non-cardiac organs: a place for volatile anaesthetics?

in European Journal of Anaesthesiology (2007), 24(9), 733-745

There is an increasing body of evidence that volatile anaesthetics protect myocardium against ischaemic insult by a mechanism termed 'anaesthetic preconditioning'. Anaesthetic preconditioning and ... [more ▼]

There is an increasing body of evidence that volatile anaesthetics protect myocardium against ischaemic insult by a mechanism termed 'anaesthetic preconditioning'. Anaesthetic preconditioning and ischaemic preconditioning share several common mechanisms of action. Since ischaemic preconditioning has been demonstrated in organs other than the heart, anaesthetic preconditioning might also apply in these organs and have significant clinical applications in surgical procedures carrying a high risk of ischaemia-reperfusion injury. After a brief review on myocardial preconditioning, experimental and clinical data on preconditioning in non-cardiac tissues will be presented. Potential benefits of anaesthetic preconditioning during non-cardiac surgery will be addressed. [less ▲]

Obscured and unobscured AGN populations in a hard-X-ray selected sample of the XMDS survey

in Astronomy and Astrophysics (2007), 467(1), 73-91

Aims. Our goal is to probe the populations of obscured and unobscured AGN investigating their optical-IR and X-ray properties as a function of X-ray flux, luminosity and redshift within a hard X-ray ... [more ▼]

Aims. Our goal is to probe the populations of obscured and unobscured AGN investigating their optical-IR and X-ray properties as a function of X-ray flux, luminosity and redshift within a hard X-ray selected sample with wide multiwavelength coverage. Methods. We selected a sample of 136 X-ray sources detected at a significance of >= 3 sigma in the 2-10 keV band (F2-10 greater than or similar to 10(-1)4 erg cm(-2) s(-1)) in a similar to 1 deg(2) area in the XMM Medium Deep Survey (XMDS). The XMDS area is covered with optical photometry from the VVDS and CFHTLS surveys and infrared Spitzer data from the SWIRE survey. Based on the X-ray luminosity and X-ray to optical ratio, 132 sources are likely AGN, of which 122 have unambiguous optical - IR identification. The observed optical and IR spectral energy distributions of all identified sources are fitted with AGN/galaxy templates in order to classify them and compute photometric redshifts. X-ray spectral analysis is performed individually for sources with a sufficient number of counts and using a stacking technique for subsamples of sources at different flux levels. Hardness ratios are used to estimate X-ray absorption in individual weak sources. Results. 70% of the AGN are fitted by a type 2 AGN or a star forming galaxy template. We group them together in a single class of "optically obscured" AGN. These have "red" optical colors and in about 60% of cases show significant X-ray absorption (N-H > 10(22) cm(-2)). Sources with SEDs typical of type 1 AGN have "blue" optical colors and exhibit X-ray absorption in about 30% of cases. The stacked X-ray spectrum of obscured AGN is flatter than that of type 1 AGN and has an average spectral slope of Gamma = 1.6. The subsample of objects fitted by a star forming galaxy template has an even harder stacked spectrum, with Gamma similar to 1.2-1.3. The obscured fraction is larger at lower fluxes, lower redshifts and lower luminosities. X-ray absorption is less common than "optical" obscuration and its incidence is nearly constant with redshift and luminosity. This implies that at high luminosities X-ray absorption is not necessarily related to optical obscuration. The estimated surface densities of obscured, unobscured AGN and type 2 QSOs are respectively 138, 59 and 35 deg(-2) at F > 10-14 erg cm(-2) s(-1). [less ▲]

Drawbacks and prognostic value of formulas estimating renal function in patients with chronic heart failure and systolic dysfunction

in Circulation (2007), 115(11), 333

Estimated glomerular filtration rate

in Annals of Internal Medicine (2007), 146(1), 74-74

Bovine herpesvirus 1 infection and infectious bovine rhinotracheitis

in Veterinary Research (2007), 38(2), 181-209

Bovine herpesvirus 1 (BoHV-1), classified as an alphaherpesvirus, is a major pathogen of cattle. Primary infection is accompanied by various clinical manifestations such as infectious bovine ... [more ▼]

Bovine herpesvirus 1 (BoHV-1), classified as an alphaherpesvirus, is a major pathogen of cattle. Primary infection is accompanied by various clinical manifestations such as infectious bovine rhinotracheitis, abortion, infectious pustular vulvovaginitis, and systemic infection in neonates. When animals survive, a life-long latent infection is established in nervous sensory ganglia. Several reactivation stimuli can lead to viral re-excretion, which is responsible for the maintenance of BoHV-1 within a cattle herd. This paper focuses on an updated pathogenesis based on a molecular characterization of BoHV-1 and the description of the virus cycle. Special emphasis is accorded to the impact of the latency and reactivation cycle on the epidemiology and the control of BoHV-1. Several European countries have initiated BoHV-1 eradication schemes because of the significant losses incurred by disease and trading restrictions. The vaccines used against BoHV-1 are described in this context where the differentiation of infected from vaccinated animals is of critical importance to achieve BoHV-1 eradication. [less ▲]

Transition metal transport

in FEBS Letters (2007), 581(12 Sp. Iss. SI), 2263-2272

Transition metal transporters are of central importance in the plant metal homeostasis network which maintains internal metal concentrations within physiological limits. An overview is given of the ... [more ▼]

Transition metal transporters are of central importance in the plant metal homeostasis network which maintains internal metal concentrations within physiological limits. An overview is given of the functions of known transition metal transporters in the context of the unique chemical properties of their substrates. The modifications of the metal homeostasis network associated with the adaptation to an extreme metalliferous environment are illustrated in two Brassicaceae metal hyperaccumulator model plants based on cross-species transcriptomics studies. In a comparison between higher plants and unicellular algae, hypotheses are generated for evolutionary changes in metal transporter complements associated with the transition to multicellularity. (c) 2007 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved. [less ▲]

Generation of Symmetric Dicke States of Remote Qubits with Linear Optics

in Physical Review Letters (2007), 99

We propose a method for generating all symmetric Dicke states, either in the long-lived internal levels of N massive particles or in the polarization degrees of freedom of photonic qubits, using linear ... [more ▼]

We propose a method for generating all symmetric Dicke states, either in the long-lived internal levels of N massive particles or in the polarization degrees of freedom of photonic qubits, using linear optical tools only. By means of a suitable multiphoton detection technique, erasing Welcher-Weg information, our proposed scheme allows the generation and measurement of an important class of entangled multiqubit states. [less ▲]

Mapping, fine mapping, and molecular dissection of quantitative trait loci in domestic animals

in Annual Review of Genomics & Human Genetics (2007), 8

Artificial selection has created myriad breeds of domestic animals, each characterized by unique phenotypes pertaining to behavior, morphology, physiology, and disease. Most domestic animal populations ... [more ▼]

Artificial selection has created myriad breeds of domestic animals, each characterized by unique phenotypes pertaining to behavior, morphology, physiology, and disease. Most domestic animal populations share features with isolated founder populations, making them well suited for positional cloning. Genome sequences are now available for most domestic species, and with them a panoply of tools including high-density single-nucleotide polymorphism panels. As a result, domestic animal populations are becoming invaluable resources for studying the molecular architecture of complex traits and of adaptation. Here we review recent progress and issues in the positional identification of genes underlying complex traits in domestic animals. As many phenotypes studied in animals are quantitative, we focus on mapping, fine mapping, and cloning of quantitative trait loci. [less ▲]

Quantum Imaging with Incoherent Photons

in Physical Review Letters (2007), 99

We propose a technique to obtain subwavelength resolution in quantum imaging with potentially 100% contrast using incoherent light. Our method requires neither path-entangled number states nor multiphoton ... [more ▼]

We propose a technique to obtain subwavelength resolution in quantum imaging with potentially 100% contrast using incoherent light. Our method requires neither path-entangled number states nor multiphoton absorption. The scheme makes use of N photons spontaneously emitted by N atoms and registered by N detectors. It is shown that for coincident detection at particular detector positions a resolution of lambda/N can be achieved. [less ▲]

Treating gliomas with glucocorticoids: from bedside to bench

in Acta Neuropathologica (2006), 112(6), 651-664

Glucocorticoids are used in the treatment of gliomas to decrease tumour-associated oedema and to reduce the risk of acute encephalopathy associated with radiotherapy. However, the mechanisms by which ... [more ▼]

Glucocorticoids are used in the treatment of gliomas to decrease tumour-associated oedema and to reduce the risk of acute encephalopathy associated with radiotherapy. However, the mechanisms by which glucocorticoids work are still largely unknown. In this paper, we survey the experimental and clinical evidence for the effects of glucocorticoids on tumour cell proliferation, apoptosis and sensitivity to chemotherapy, angiogenesis and vascular permeability. We then review current guidelines on the choice of molecule, dose and duration of glucocorticoid treatment for gliomas. [less ▲]

Carbon dioxide in European coastal waters

in Estuarine Coastal & Shelf Science (2006), 70(3), 375-387

We compiled from literature annually integrated air-water fluxes of carbon dioxide (CO2) computed from field measurements, in 20 coastal European environments that were gathered into 3 main ecosystems ... [more ▼]

We compiled from literature annually integrated air-water fluxes of carbon dioxide (CO2) computed from field measurements, in 20 coastal European environments that were gathered into 3 main ecosystems: inner estuaries, upwelling continental shelves and non-upwelling continental shelves. The comparison of annual cycles of the partial pressure of CO2 (pCO(2)) in 5 contrasting continental shelves provided insights into the biogeochemical drivers of the CO2 fluxes. The latter were also investigated by comparing CO2 fluxes to net ecosystem (NEP) and net community production (NCP) in 3 contrasted coastal ecosystems. Air-water CO2 fluxes were scaled at European regional level and compared to fluxes of atmospheric CO2 in other aquatic and terrestrial compartments. Continental shelves are significant sinks for atmospheric CO2 at an average rate of -1.9 molC m(-2) yr(-1) that scaled at European level corresponds to an absorption of atmospheric CO2 of -68.1 TgC yr(-1). This sink is equivalent to the one reported for the terrestrial biosphere of -66.1 TgC yr(-1), based on carbon-stock change models. Estuaries are significant sources of CO2 to the atmosphere at an average rate of 49.9 molC m(-2) yr(-1) that is higher than the CO2 emission to the atmosphere from rivers, streams and lakes. The scaled emission of CO2 to the atmosphere from inner estuaries of about 67.0 TgC yr(-1) would almost fully balance the sink of atmospheric CO2 computed for continental shelves. However, the scaled emission of CO2 from estuaries to the atmosphere is inconsistent with the potential emission of CO2 based on the fate of river organic carbon during estuarine transit. This discrepancy is most probably due to the poorly constrained surface area estimate of inner estuaries. (c) 2006 Elsevier Ltd. All rights reserved. [less ▲]

NF-kappa B activation by double-strand breaks

in Biochemical Pharmacology (2006), 72(9), 1132-1141

Cellular response to DNA damage is complex and relies on the simultaneous activation of different networks. It involves DNA damage recognition, repair, and induction of signalling cascades leading to cell ... [more ▼]

Cellular response to DNA damage is complex and relies on the simultaneous activation of different networks. It involves DNA damage recognition, repair, and induction of signalling cascades leading to cell cycle checkpoint activation, apoptosis, and stress related responses. The fate of damaged cells depends on the balance between pro- and antiapoptotic signals. in this decisive life or death choice, the transcription factor NF-kappa B has emerged as a prosurvival actor in most cell types. As corollary, it appears to be associated with tumorigenic process and resistance to therapeutic strategies as it protects cancerous cells from death. in this review, we will focus on NF-kappa B activation by double-strand breaks inducing agents, such as ionizing radiation and DNA topoisomerase I and II inhibitors routinely used in cancer therapy. Coinciding with the 20th anniversary of the NF-kappa B discovery, major steps of the DSB-triggered cascade have been recently identified. Two parallel cascades are necessary for NF-kappa B activation. The first one depends on ATM (activated by double-strand breaks) and the second on PIDD (activated by an unknown stress signal). The phosphorylation of NEMO by ATM is the point of convergence of these two cascades. The identification of ATM/NEMO complex as the long searched "nuclear to cytoplasm" signal leading to IKK activation is also a major piece of the puzzle. The knowledge of the precise steps leading to DSB-initiated NF kappa B activation will allow the development of specific blocking compounds reducing its prosurvival function. (c) 2006 Elsevier Inc. All rights reserved. [less ▲]

Lessons learnt from carotid artery trials

in Acta Chirurgica Belgica (2006), 106(5), 489-499

The objective of the authors is to assess the natural history of carotid artery disease and the role of carotid intervention in preventing ipsilateral stroke. The development of endovascular techniques ... [more ▼]

The objective of the authors is to assess the natural history of carotid artery disease and the role of carotid intervention in preventing ipsilateral stroke. The development of endovascular techniques for correction of carotid artery stenoses made this less invasive technique very popular, with an inherent risk of unregulated overuse by a variety of medical specialists, who are not always well informed on the natural history of carotid artery disease. It re-opened the discussion on the value of carotid endarterectomy for stroke prophylaxis. This ongoing debate offers the opportunity to distil evidence-based guidelines for the management of extracranial carotid artery stenoses. In recent papers, some authors expressed doubts on the validity and general applicability of the results of the pivotal randomised trials of carotid endarterectomy. The excellent results in terms of operative outcome and long term stroke prevention would, according to certain comments, not be attainable in routine practice. Another criticism of carotid endarterectomy is its higher operative morbidity in terms of cranial nerve lesions and myocardial infarctions, compared to endovascular procedures. This consideration is, for some authors, the main reason to espouse carotid artery stenting as a better alternative to carotid endarterectomy. Any evidence supporting this point of view is missing. The supposed equivalence or non-inferiority of carotid artery stenting is purely speculative. The aim of this review paper is to summarize the crude data of carotid surgery trials. The authors aim to answer four questions. For which lesions is carotid endarterectomy most beneficial ? Are the results of randomised carotid surgery trials biased by the selection of patients ? Is operative morbidity, other than stroke, under-estimated ? Is carotid artery stenting safe and efficacious ? An in-depth review with a critical analysis is made of recently published and on-going trials, comparing carotid surgery with percutaneous carotid angioplasty. [less ▲]

Why the MDRD equation should not be used in patients with normal renal function (and normal creatinine values)?

in Clinical Nephrology (2006), 66(2), 147-148

New approaches and old controversies to postoperative pain control following cardiac surgery

in European Journal of Anaesthesiology (2006), 23(7), 539-550

Objective: To evaluate the effect of postoperative pain control in cardiac surgical patients on morbidity, mortality and other outcome measures. Background: New approaches in pain control have been ... [more ▼]

Objective: To evaluate the effect of postoperative pain control in cardiac surgical patients on morbidity, mortality and other outcome measures. Background: New approaches in pain control have been introduced over the past decade. The impact of these interventions, either alone or in combination, on perioperative outcome was evaluated in cardiac surgical patients. Methods: We searched Medline for the period of 1980 to the present using the key terms analgesics, opioid, non-steroidal anti-inflammatory drugs, cardiac surgery, regional analgesia, spinal, epidural, fast-track cardiac anaesthesia, fast-track cardiac surgery, myocardial ischaemia, myocardial infarction, postoperative care, accelerated care programmes, postoperative complications, and we examined and discussed the articles that were identified to be included in this review. Results: Pain management in cardiac surgery is becoming more important with the establishment of minimally invasive direct coronary artery bypass surgery and fast-track management of conventional cardiac surgery patients. Advances have been made in this area and encompass specific techniques, such as central neuraxial blockade or selective nerve blocks, and drugs (opioids, sedative-hypnotics and non-steroidal anti-inflammatory drugs). Ideally, these therapies provide not only patient comfort but also mitigate untoward cardiovascular responses, pulmonary responses, and other inflammatory and secondary sympathetic responses. The introduction of these newer approaches to perioperative care has reduced morbidity, but not mortality, in cardiac surgical patients. Conclusions: Understanding perioperative pathophysiology and implementation of care regimes to reduce the stress of cardiac surgery, will continue to accelerate rehabilitation associated with decreased hospitalization and increased satisfaction and safety after discharge. Reorganization of the perioperative team (anaesthesiologists, surgeons, nurses and physical therapists) will be essential to achieve successful fast-track cardiac surgical programmes. Developments and improvements of multimodal interventions within the context of 'fast-track' cardiac surgery programmes represents the major challenge for the medical professionals working to achieve a 'pain and risk free' perioperative course. [less ▲]

Is brain estradiol a hormone or a neurotransmitter?

in Trends in Neurosciences (2006), 29(5), 241-249

Mounting evidence indicates that, besides their well-known hormonal mode of action at the genetic level, estrogens such as 17 beta-estradiol also influence brain function by direct effects on neuronal ... [more ▼]

Mounting evidence indicates that, besides their well-known hormonal mode of action at the genetic level, estrogens such as 17 beta-estradiol also influence brain function by direct effects on neuronal membranes. Experimentally induced rapid changes in estradiol bioavailability in the brain have been shown to alter the expression of male sexual behavior significantly within minutes - probably too quickly to be accounted for by conventional genetic mechanisms. In parallel, recent studies indicate that aromatase, the enzyme that converts testosterone to estradiol in the brain, is expressed in presynaptic terminals and modulated within minutes by Ca2+-dependent phosphorylation. In this article, we develop the hypothesis that brain estrogens display many, if not all, functional characteristics of neuromodulators or even neurotransmitters. [less ▲]

Importance of the creatinine calibration in the estimation of GFR by MDRD equation

in Nephrology Dialysis Transplantation (2006), 21(4), 1130-1130