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  1. Article ; Online: Antithrombotic therapy-A simple algorithm for the interventional pathologist: A case series.

    Villar-Zarra, Karen / Nieves-Alonso, Jesús / Torres-Rivas, Héctor-Enrique

    Cytopathology : official journal of the British Society for Clinical Cytology

    2024  

    Abstract: We can safely manage patients on antithrombotic therapy in the interventional pathology practice with this practical algorithm based on the new Antithrombotic Therapy Management Guidelines. This new algorithm helps ensure safe care for patients on ... ...

    Abstract We can safely manage patients on antithrombotic therapy in the interventional pathology practice with this practical algorithm based on the new Antithrombotic Therapy Management Guidelines. This new algorithm helps ensure safe care for patients on antithrombotic therapy undergoing interventional pathology procedures. #interventionalpathology.
    Language English
    Publishing date 2024-03-25
    Publishing country England
    Document type Editorial
    ZDB-ID 1034190-0
    ISSN 1365-2303 ; 0956-5507 ; 1350-4037
    ISSN (online) 1365-2303
    ISSN 0956-5507 ; 1350-4037
    DOI 10.1111/cyt.13377
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    In stock of ZB MED Cologne/Königswinter

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  2. Article: Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.

    Ramasco, Fernando / Nieves-Alonso, Jesús / García-Villabona, Esther / Vallejo, Carmen / Kattan, Eduardo / Méndez, Rosa

    Journal of personalized medicine

    2024  Volume 14, Issue 2

    Abstract: Sepsis and septic shock are associated with high mortality, with diagnosis and treatment remaining a challenge for clinicians. Their management classically encompasses hemodynamic resuscitation, antibiotic treatment, life support, and focus control; ... ...

    Abstract Sepsis and septic shock are associated with high mortality, with diagnosis and treatment remaining a challenge for clinicians. Their management classically encompasses hemodynamic resuscitation, antibiotic treatment, life support, and focus control; however, there are aspects that have changed. This narrative review highlights current and avant-garde methods of handling patients experiencing septic shock based on the experience of its authors and the best available evidence in a context of uncertainty. Following the first recommendation of the Surviving Sepsis Campaign guidelines, it is recommended that specific sepsis care performance improvement programs are implemented in hospitals, i.e., "Sepsis Code" programs, designed ad hoc, to achieve this goal. Regarding hemodynamics, the importance of perfusion and hemodynamic coherence stand out, which allow for the recognition of different phenotypes, determination of the ideal time for commencing vasopressor treatment, and the appropriate fluid therapy dosage. At present, this is not only important for the initial timing, but also for de-resuscitation, which involves the early weaning of support therapies, directed elimination of fluids, and fluid tolerance concept. Finally, regarding blood purification therapies, those aimed at eliminating endotoxins and cytokines are attractive in the early management of patients in septic shock.
    Language English
    Publishing date 2024-02-03
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm14020176
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  3. Article ; Online: In-hospital cardiac arrest: Incidence, prognostic factors and results.

    Santa Cruz Hernando, Alvar Santa / Nieves-Alonso, Jesús Manuel / Mjertan, Amadea / Gutiérrez Martínez, Diego / Planas Roca, Antonio

    Revista espanola de anestesiologia y reanimacion

    2023  Volume 70, Issue 7, Page(s) 373–380

    Abstract: Background and aims: In-hospital cardiac arrest (CA) is a clinical entity with high morbidity and mortality that occurs in up to 2% of hospitalized patients. It is a public health problem with important economic, social, and medical repercussions, and ... ...

    Abstract Background and aims: In-hospital cardiac arrest (CA) is a clinical entity with high morbidity and mortality that occurs in up to 2% of hospitalized patients. It is a public health problem with important economic, social, and medical repercussions, and as such its incidence needs to be reviewed and improved. The aim of this study was to determine the incidence of in-hospital CA, return of spontaneous circulation (ROSC), and survival rates at Hospital de la Princesa, and to define the clinical and demographic characteristics of patients with in-hospital CA.
    Patients and methods: Retrospective observational chart review of patients presenting in-hospital CA and treated by anaesthesiologists from the hospital's rapid intervention team. Data were collected over 1 year.
    Results: Forty four patients were included in the study, of which 22 (50%) were women. Mean age was 75.7 years (±15.78 years), and incidence of in-hospital CA was 2.88 per 100,000 hospital admissions. Twenty two patients (50%) achieved ROSC and 11 patients (25%) survived until discharge home. The most prevalent comorbidity was arterial hypertension (63.64%); 66.7% of cases were not witnessed, and only 15.9% presented a shockable rhythm.
    Conclusions: These results are similar to those reported in other larger studies. We recommend introducing immediate intervention teams and devoting time to training hospital staff in in-hospital CA.
    MeSH term(s) Aged ; Female ; Humans ; Male ; Cardiopulmonary Resuscitation ; Heart Arrest/epidemiology ; Heart Arrest/therapy ; Hospitals ; Incidence ; Prognosis ; Retrospective Studies ; Middle Aged ; Aged, 80 and over
    Language English
    Publishing date 2023-03-20
    Publishing country Spain
    Document type Journal Article
    ISSN 2341-1929
    ISSN (online) 2341-1929
    DOI 10.1016/j.redare.2022.06.006
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  4. Article ; Online: Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage: an autopsy study with clinical correlation and review of the literature.

    Valdivia-Mazeyra, Mariel F / Salas, Clara / Nieves-Alonso, Jesús M / Martín-Fragueiro, Luz / Bárcena, Carmen / Muñoz-Hernández, Patricia / Villar-Zarra, Karen / Martín-López, Javier / Ramasco-Rueda, Fernando / Fraga, Javier / Jiménez-Heffernan, José A

    Virchows Archiv : an international journal of pathology

    2020  Volume 478, Issue 3, Page(s) 487–496

    Abstract: Pulmonary megakaryocytes participate in the pathogenesis of lung damage, particularly in acute lung injury. Although megakaryocytes are not mentioned as a characteristic histologic finding associated to pulmonary injury, a few studies reveal that their ... ...

    Abstract Pulmonary megakaryocytes participate in the pathogenesis of lung damage, particularly in acute lung injury. Although megakaryocytes are not mentioned as a characteristic histologic finding associated to pulmonary injury, a few studies reveal that their number is increased in diffuse alveolar damage (DAD). In this autopsy study, we have observed a relevant number of pulmonary megakaryocytes in COVID-19 patients dying with acute lung injury (7.61 ± 5.59 megakaryocytes per 25 high-power fields vs. 1.14 ± 0.86 for the control group, p < 0.05). We analyzed samples of 18 patients, most of whom died after prolonged disease and use of mechanical ventilation. Most patients showed advanced DAD and abnormal coagulation parameters with high levels of fibrinogen, D-dimers, and variable thrombocytopenia. For comparison, pulmonary samples from a group of 14 non-COVID-19 patients dying with DAD were reviewed. They showed similar pulmonary histopathologic findings and an increase in the number of megakaryocytes (4 ± 4.17 vs. 1.14 ± 0.86 for the control group, p < 0.05). Megakaryocyte count in the COVID-19 group was greater but did not reach statistical significance (7.61 ± 5.59 vs. 4 ± 4.17, p = 0.063). Regardless of the cause, pulmonary megakaryocytes are increased in patients with DAD. Their high number seen in COVID-19 patients suggests a relation with the thrombotic events so often seen these patients. Since the lung is considered an active site of megakaryopoiesis, a prothrombotic status leading to platelet activation, aggregation and consumption may trigger a compensatory pulmonary response.
    MeSH term(s) Adult ; Aged ; Autopsy ; COVID-19/pathology ; COVID-19/virology ; Female ; Humans ; Lung/pathology ; Lung/virology ; Male ; Megakaryocytes/pathology ; Megakaryocytes/virology ; Middle Aged ; SARS-CoV-2/physiology ; Thrombosis/pathology ; Thrombosis/virology
    Keywords covid19
    Language English
    Publishing date 2020-09-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1184867-4
    ISSN 1432-2307 ; 0945-6317
    ISSN (online) 1432-2307
    ISSN 0945-6317
    DOI 10.1007/s00428-020-02926-1
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    In stock of ZB MED Cologne/Königswinter

    Ud III Zs.10: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
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  5. Article: Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage: an autopsy study with clinical correlation and review of the literature

    Valdivia-Mazeyra, Mariel F / Salas, Clara / Nieves-Alonso, Jesús M / Martín-Fragueiro, Luz / Bárcena, Carmen / Muñoz-Hernández, Patricia / Villar-Zarra, Karen / Martín-López, Javier / Ramasco-Rueda, Fernando / Fraga, Javier / Jiménez-Heffernan, José A

    Virchows arch

    Abstract: Pulmonary megakaryocytes participate in the pathogenesis of lung damage, particularly in acute lung injury. Although megakaryocytes are not mentioned as a characteristic histologic finding associated to pulmonary injury, a few studies reveal that their ... ...

    Abstract Pulmonary megakaryocytes participate in the pathogenesis of lung damage, particularly in acute lung injury. Although megakaryocytes are not mentioned as a characteristic histologic finding associated to pulmonary injury, a few studies reveal that their number is increased in diffuse alveolar damage (DAD). In this autopsy study, we have observed a relevant number of pulmonary megakaryocytes in COVID-19 patients dying with acute lung injury (7.61 ± 5.59 megakaryocytes per 25 high-power fields vs. 1.14 ± 0.86 for the control group, p < 0.05). We analyzed samples of 18 patients, most of whom died after prolonged disease and use of mechanical ventilation. Most patients showed advanced DAD and abnormal coagulation parameters with high levels of fibrinogen, D-dimers, and variable thrombocytopenia. For comparison, pulmonary samples from a group of 14 non-COVID-19 patients dying with DAD were reviewed. They showed similar pulmonary histopathologic findings and an increase in the number of megakaryocytes (4 ± 4.17 vs. 1.14 ± 0.86 for the control group, p < 0.05). Megakaryocyte count in the COVID-19 group was greater but did not reach statistical significance (7.61 ± 5.59 vs. 4 ± 4.17, p = 0.063). Regardless of the cause, pulmonary megakaryocytes are increased in patients with DAD. Their high number seen in COVID-19 patients suggests a relation with the thrombotic events so often seen these patients. Since the lung is considered an active site of megakaryopoiesis, a prothrombotic status leading to platelet activation, aggregation and consumption may trigger a compensatory pulmonary response.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #754539
    Database COVID19

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  6. Article ; Online: Increased number of pulmonary megakaryocytes in COVID-19 patients with diffuse alveolar damage

    Valdivia-Mazeyra, Mariel F. / Salas, Clara / Nieves-Alonso, Jesús M. / Martín-Fragueiro, Luz / Bárcena, Carmen / Muñoz-Hernández, Patricia / Villar-Zarra, Karen / Martín-López, Javier / Ramasco-Rueda, Fernando / Fraga, Javier / Jiménez-Heffernan, José A.

    Virchows Archiv ; ISSN 0945-6317 1432-2307

    an autopsy study with clinical correlation and review of the literature

    2020  

    Keywords Pathology and Forensic Medicine ; Cell Biology ; Molecular Biology ; General Medicine ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    DOI 10.1007/s00428-020-02926-1
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial.

    Ferrando, Carlos / Carramiñana, Albert / Piñeiro, Patricia / Mirabella, Lucia / Spadaro, Savino / Librero, Julián / Ramasco, Fernando / Scaramuzzo, Gaetano / Cervantes, Oriol / Garutti, Ignacio / Parera, Ana / Argilaga, Marta / Herranz, Gracia / Unzueta, Carmen / Vives, Marc / Regi, Kevin / Costa-Reverte, Marta / Sonsoles Leal, María / Nieves-Alonso, Jesús /
    García, Esther / Rodríguez-Pérez, Aurelio / Fariña, Roberto / Cabrera, Sergio / Guerra, Elisabeth / Gallego-Ligorit, Lucia / Herrero-Izquierdo, Alba / Vallés-Torres, J / Ramos, Silvia / López-Herrera, Daniel / De La Matta, Manuel / Gokhan, Sertcakacilar / Kucur, Evrim / Mugarra, Ana / Soro, Marina / García, Laura / Sastre, José Alfonso / Aguirre, Pilar / Salazar, Claudia Jimena / Ramos, María Carolina / Morocho, Diego Rolando / Trespalacios, Ramón / Ezequiel-Fernández, Félix / Lamanna, Angella / Pia Cantatore, Leonarda / Laforgia, Donato / Bellas, Soledad / López, Carlos / Navarro-Ripoll, Ricard / Martínez, Samira / Vallverdú, Jordi / Jacas, Adriana / Yepes-Temiño, María José / Belda, Francisco Javier / Tusman, Gerardo / Suárez-Sipmann, Fernando / Villar, Jesús

    The Lancet. Respiratory medicine

    2023  Volume 12, Issue 3, Page(s) 195–206

    Abstract: Background: It is uncertain whether individualisation of the perioperative open-lung approach (OLA) to ventilation reduces postoperative pulmonary complications in patients undergoing lung resection. We compared a perioperative individualised OLA (iOLA) ...

    Abstract Background: It is uncertain whether individualisation of the perioperative open-lung approach (OLA) to ventilation reduces postoperative pulmonary complications in patients undergoing lung resection. We compared a perioperative individualised OLA (iOLA) ventilation strategy with standard lung-protective ventilation in patients undergoing thoracic surgery with one-lung ventilation.
    Methods: This multicentre, randomised controlled trial enrolled patients scheduled for open or video-assisted thoracic surgery using one-lung ventilation in 25 participating hospitals in Spain, Italy, Turkey, Egypt, and Ecuador. Eligible adult patients (age ≥18 years) were randomly assigned to receive iOLA or standard lung-protective ventilation. Eligible patients (stratified by centre) were randomly assigned online by local principal investigators, with an allocation ratio of 1:1. Treatment with iOLA included an alveolar recruitment manoeuvre to 40 cm H
    Findings: Between Sept 11, 2018, and June 14, 2022, we enrolled 1380 patients, of whom 1308 eligible patients (670 [434 male, 233 female, and three with missing data] assigned to iOLA and 638 [395 male, 237 female, and six with missing data] to standard lung-protective ventilation) were included in the final analysis. The proportion of patients with the composite outcome of severe postoperative pulmonary complications within the first 7 postoperative days was lower in the iOLA group compared with the standard lung-protective ventilation group (40 [6%] vs 97 [15%], relative risk 0·39 [95% CI 0·28 to 0·56]), with an absolute risk difference of -9·23 (95% CI -12·55 to -5·92). Recruitment manoeuvre-related adverse events were reported in five patients.
    Interpretation: Among patients subjected to lung resection under one-lung ventilation, iOLA was associated with a reduced risk of severe postoperative pulmonary complications when compared with conventional lung-protective ventilation.
    Funding: Instituto de Salud Carlos III and the European Regional Development Funds.
    MeSH term(s) Adult ; Humans ; Female ; Male ; Adolescent ; One-Lung Ventilation ; Respiration ; Continuous Positive Airway Pressure ; Lung/surgery ; Oxygen
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-12-05
    Publishing country England
    Document type Randomized Controlled Trial ; Multicenter Study ; Journal Article
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(23)00346-6
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    Zs.A 7041: Show issues Location:
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