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  1. Article ; Online: Perioperative oxygenation-what's the stress?

    Larvin, Joseph / Edwards, Mark / Martin, Daniel S / Feelisch, Martin / Grocott, Michael P W / Cumpstey, Andrew F

    BJA open

    2024  Volume 10, Page(s) 100277

    Abstract: Oxygen is the most used drug in anaesthesia. Despite such widespread use, optimal perioperative oxygen administration remains highly controversial because of concerns about the competing harms of both hyperoxia and hypoxia. Notwithstanding a Cochrane ... ...

    Abstract Oxygen is the most used drug in anaesthesia. Despite such widespread use, optimal perioperative oxygen administration remains highly controversial because of concerns about the competing harms of both hyperoxia and hypoxia. Notwithstanding a Cochrane review concluding that routinely administering a fractional inspired oxygen concentration (FiO
    Language English
    Publishing date 2024-03-20
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2772-6096
    ISSN (online) 2772-6096
    DOI 10.1016/j.bjao.2024.100277
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: What dose of tranexamic acid is most effective and safe for adult patients undergoing cardiac surgery?

    Hodgson, Sam / Larvin, Joseph T / Dearman, Charles

    Interactive cardiovascular and thoracic surgery

    2015  Volume 21, Issue 3, Page(s) 384–388

    Abstract: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: what dose of tranexamic acid is most effective and safe for adult patients undergoing cardiac surgery? Altogether 586 papers were found ... ...

    Abstract A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: what dose of tranexamic acid is most effective and safe for adult patients undergoing cardiac surgery? Altogether 586 papers were found using the reported search, of which 12 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Current evidence shows clinical benefit of using high-dose tranexamic acid (>80 mg/kg total dose) as opposed to low-dose tranexamic acid (<50 mg/kg total dose) in cardiac surgery with cardiopulmonary bypass. Evidence from a large randomized controlled trial shows that patients receiving high-dose tranexamic acid lose less blood postoperatively than patients receiving low-dose tranexamic acid (590 vs 820 ml, P = 0.01). Patients receiving high-dose tranexamic acid also require fewer units of blood product transfusion (2.5 units vs 4.1 units; P = 0.02) and are less likely to undergo repeat surgery to achieve haemostasis. This effect is larger in those who are at high risk of bleeding. Several prospective studies comparing doses found no difference in clinical outcomes between high- and low-dose regimens, but excluded patients at high risk of bleeding. However, data from numerous observational studies demonstrate that tranexamic acid use is associated with an increased risk of postoperative seizure; one analysis showed tranexamic acid use to be a very strong independent predictor (odds ratio = 14.3, P < 0.001). There is also evidence that this risk of seizure is dose-dependent, with the greatest risk at higher doses of tranexamic acid. We conclude that, in general, patients with a high risk of bleeding should receive high-dose tranexamic acid, while those at low risk of bleeding should receive low-dose tranexamic acid with consideration given to potential dose-related seizure risk. We recommend the regimens of high-dose (30 mg kg(-1) bolus + 16 mg kg(-1) h(-1) + 2 mg kg(-1) priming) and low-dose (10 mg kg(-1) bolus + 1 mg kg(-1) h(-1) + 1 mg kg(-1) priming) tranexamic acid, as these are well established in terms of safety profile and have the strongest evidence for efficacy.
    MeSH term(s) Adult ; Angina, Unstable/surgery ; Antifibrinolytic Agents/administration & dosage ; Blood Loss, Surgical/prevention & control ; Coronary Artery Bypass ; Dose-Response Relationship, Drug ; Humans ; Male ; Postoperative Hemorrhage/prevention & control ; Tranexamic Acid/administration & dosage ; Treatment Outcome
    Chemical Substances Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
    Language English
    Publishing date 2015-09
    Publishing country England
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivv134
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5730: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Do trauma courses change practice? A qualitative review of 20 courses in East, Central and Southern Africa.

    Ologunde, Rele / Le, Grace / Turner, Jim / Pandit, Hemant / Peter, Noel / Maurer, David / Hodgson, Sam / Larvin, Joseph / Lavy, Chris

    Injury

    2017  Volume 48, Issue 9, Page(s) 2010–2016

    Abstract: Background: Trauma courses have been shown to improve clinical knowledge and patient outcomes. However, little is known about the individual drivers of change in practice amongst course participants in their home clinic environment.: Methods: Front- ... ...

    Abstract Background: Trauma courses have been shown to improve clinical knowledge and patient outcomes. However, little is known about the individual drivers of change in practice amongst course participants in their home clinic environment.
    Methods: Front-line healthcare workers participated in a two-day Primary Trauma Care (PTC) course. Immediately after the course participants completed an evaluation survey on intended change in the management of trauma patients. Six months after the course, participants completed a survey on actual changes that had occurred.
    Results: A total of 451 participants were sampled, with 321 responding at 6 months, from 40 courses across East, Central and Southern Africa. The most commonly reported intended change was the adoption of an ABCDE/systematic approach (53%). Six months after the course, 92.7% of respondents reported that they had made changes in their management, with adoption of an ABCDE/systematic approach (50.0%) remaining most common. 77% of participants reported an improvement in departmental trauma management, 26% reported an increase in staffing, 29% an increase in equipment and 68% of participants had gone on to train other healthcare workers in PTC.
    Conclusion: The findings suggest that PTC courses not only improve individual management of trauma patients but also but is also associated with beneficial effects for participants' host institutions with regards to staffing, equipment and training.
    MeSH term(s) Africa ; Attitude of Health Personnel ; Clinical Competence/standards ; Education, Medical, Continuing/organization & administration ; Evaluation Studies as Topic ; Health Personnel/standards ; Health Resources ; Humans ; Program Development ; Quality Improvement ; Quality of Health Care/standards ; Traumatology/education ; Traumatology/standards
    Language English
    Publishing date 2017-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2017.06.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 778: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 10: Show issues

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  4. Article ; Online: Distinct developmental origins manifest in the specialized encoding of movement by adult neurons of the external globus pallidus.

    Dodson, Paul D / Larvin, Joseph T / Duffell, James M / Garas, Farid N / Doig, Natalie M / Kessaris, Nicoletta / Duguid, Ian C / Bogacz, Rafal / Butt, Simon J B / Magill, Peter J

    Neuron

    2015  Volume 86, Issue 2, Page(s) 501–513

    Abstract: Transcriptional codes initiated during brain development are ultimately realized in adulthood as distinct cell types performing specialized roles in behavior. Focusing on the mouse external globus pallidus (GPe), we demonstrate that the potential ... ...

    Abstract Transcriptional codes initiated during brain development are ultimately realized in adulthood as distinct cell types performing specialized roles in behavior. Focusing on the mouse external globus pallidus (GPe), we demonstrate that the potential contributions of two GABAergic GPe cell types to voluntary action are fated from early life to be distinct. Prototypic GPe neurons derive from the medial ganglionic eminence of the embryonic subpallium and express the transcription factor Nkx2-1. These neurons fire at high rates during alert rest, and encode movements through heterogeneous firing rate changes, with many neurons decreasing their activity. In contrast, arkypallidal GPe neurons originate from lateral/caudal ganglionic eminences, express the transcription factor FoxP2, fire at low rates during rest, and encode movements with robust increases in firing. We conclude that developmental diversity positions prototypic and arkypallidal neurons to fulfil distinct roles in behavior via their disparate regulation of GABA release onto different basal ganglia targets.
    MeSH term(s) Action Potentials/physiology ; Animals ; Cell Lineage/physiology ; Enkephalins/metabolism ; Forkhead Transcription Factors/metabolism ; Globus Pallidus/cytology ; Globus Pallidus/embryology ; Globus Pallidus/growth & development ; Mice ; Movement/physiology ; Neurons/classification ; Neurons/metabolism ; Nuclear Proteins/metabolism ; Protein Precursors/metabolism ; ROC Curve ; Repressor Proteins/metabolism ; Thyroid Nuclear Factor 1 ; Transcription Factors/metabolism ; gamma-Aminobutyric Acid/metabolism
    Chemical Substances Enkephalins ; Forkhead Transcription Factors ; Foxp2 protein, mouse ; Nkx2-1 protein, mouse ; Nuclear Proteins ; Protein Precursors ; Repressor Proteins ; Thyroid Nuclear Factor 1 ; Transcription Factors ; gamma-Aminobutyric Acid (56-12-2) ; preproenkephalin (93443-35-7)
    Language English
    Publishing date 2015-04-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 808167-0
    ISSN 1097-4199 ; 0896-6273
    ISSN (online) 1097-4199
    ISSN 0896-6273
    DOI 10.1016/j.neuron.2015.03.007
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    Zs.A 2496: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
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    Zs.MG 92: Show issues

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  5. Article ; Online: Prototypic and arkypallidal neurons in the dopamine-intact external globus pallidus.

    Abdi, Azzedine / Mallet, Nicolas / Mohamed, Foad Y / Sharott, Andrew / Dodson, Paul D / Nakamura, Kouichi C / Suri, Sana / Avery, Sophie V / Larvin, Joseph T / Garas, Farid N / Garas, Shady N / Vinciati, Federica / Morin, Stéphanie / Bezard, Erwan / Baufreton, Jérôme / Magill, Peter J

    The Journal of neuroscience : the official journal of the Society for Neuroscience

    2015  Volume 35, Issue 17, Page(s) 6667–6688

    Abstract: Studies in dopamine-depleted rats indicate that the external globus pallidus (GPe) contains two main types of GABAergic projection cell; so-called "prototypic" and "arkypallidal" neurons. Here, we used correlative anatomical and electrophysiological ... ...

    Abstract Studies in dopamine-depleted rats indicate that the external globus pallidus (GPe) contains two main types of GABAergic projection cell; so-called "prototypic" and "arkypallidal" neurons. Here, we used correlative anatomical and electrophysiological approaches in rats to determine whether and how this dichotomous organization applies to the dopamine-intact GPe. Prototypic neurons coexpressed the transcription factors Nkx2-1 and Lhx6, comprised approximately two-thirds of all GPe neurons, and were the major GPe cell type innervating the subthalamic nucleus (STN). In contrast, arkypallidal neurons expressed the transcription factor FoxP2, constituted just over one-fourth of GPe neurons, and innervated the striatum but not STN. In anesthetized dopamine-intact rats, molecularly identified prototypic neurons fired at relatively high rates and with high regularity, regardless of brain state (slow-wave activity or spontaneous activation). On average, arkypallidal neurons fired at lower rates and regularities than prototypic neurons, and the two cell types could be further distinguished by the temporal coupling of their firing to ongoing cortical oscillations. Complementing the activity differences observed in vivo, the autonomous firing of identified arkypallidal neurons in vitro was slower and more variable than that of prototypic neurons, which tallied with arkypallidal neurons displaying lower amplitudes of a "persistent" sodium current important for such pacemaking. Arkypallidal neurons also exhibited weaker driven and rebound firing compared with prototypic neurons. In conclusion, our data support the concept that a dichotomous functional organization, as actioned by arkypallidal and prototypic neurons with specialized molecular, structural, and physiological properties, is fundamental to the operations of the dopamine-intact GPe.
    MeSH term(s) Action Potentials/genetics ; Action Potentials/physiology ; Adrenergic Agents/toxicity ; Animals ; Animals, Newborn ; Dopamine/metabolism ; ELAV Proteins/metabolism ; ELAV-Like Protein 3 ; Female ; Forkhead Transcription Factors/metabolism ; Globus Pallidus/cytology ; Green Fluorescent Proteins/genetics ; Green Fluorescent Proteins/metabolism ; In Vitro Techniques ; Neural Pathways/drug effects ; Neural Pathways/physiology ; Neurons/drug effects ; Neurons/physiology ; Nuclear Proteins/metabolism ; Oxidopamine/toxicity ; Parvalbumins/metabolism ; Rats ; Statistics, Nonparametric ; Subthalamic Nucleus/cytology ; Thyroid Nuclear Factor 1 ; Transcription Factors/metabolism
    Chemical Substances Adrenergic Agents ; ELAV Proteins ; ELAV-Like Protein 3 ; Elavl3 protein, rat ; Forkhead Transcription Factors ; Foxp2 protein, rat ; Nkx2-1 protein, rat ; Nuclear Proteins ; Parvalbumins ; Thyroid Nuclear Factor 1 ; Transcription Factors ; enhanced green fluorescent protein ; Green Fluorescent Proteins (147336-22-9) ; Oxidopamine (8HW4YBZ748) ; Dopamine (VTD58H1Z2X)
    Language English
    Publishing date 2015-04-29
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 604637-x
    ISSN 1529-2401 ; 0270-6474
    ISSN (online) 1529-2401
    ISSN 0270-6474
    DOI 10.1523/JNEUROSCI.4662-14.2015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1668: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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