Potential users’ preferences towards cardiac telemedicine: A discrete choice experiment investigation in Sardinia

Background

Potential users’ preferences for telemedicine services directed to cardio-vascular diseases are investigated applying a discrete choice experiment (DCE). Given the potential of telemedicine to minimize costs without reducing overall efficiency, assessing preferences for these types of services represents a priority for policy makers. This is especially true for those pathologies that absorb a relatively high quota of total health expenditure. The empirical setting is Sardinia (Italy) because of its insularity and the underdeveloped internal transport network. Telemedicine is likely to mitigate distance between healthcare providers and final users.

Effect of Lactoferrin on Consequences of Acute Experimental Hemorrhagic Anemia in Rats

The effect of human lactoferrin on the arrest of experimental hemorrhagic anemia consequences was studied in rats. After six blood losses (days 1-4 and 7-8 of the experiment), the rats developed acute anemia: hemoglobin concentration decreased to 59% of the initial level, serum iron level decreased 3-fold. Intraperitoneal injections of lactoferrin (10 mg/day) for 4 days starting from day 7 led to an increase in hemoglobin level to 109% and of serum iron to 125% on day 14. In controls, hemoglobin level on day 14 was 70% and iron content 49% of the initial level. Ferroxidase activity of ceruloplasmin in blood serum decreased after 5 blood losses returned to normal only in rats receiving lactoferrin. The results indicate that lactoferrin modifi ed ceruloplasmin activity in vivo, promoting normalization of iron metabolism     

Synthesis,Antimicrobial Activity,and Behavioral Response Effects of N-Substituted 4-Aryl-2-Hydroxy-4-Oxobut-2-Enoic Acid Hydrazides and Their Metal Complexes

Pharmaceutical Chemistry Journal - N-Substituted 4-aryl-2-hydroxy-4-oxobut-2-enoic acid hydrazides and their complexes with Ni(II), Mn(II), Co(II), Cu(II), and Zn(II) were prepared. Their...     

Synthesis and Antimicrobial Activity of Complexes Based on 4-aryl-2-hydroxy-4-oxo-2-butenoic Acid <Emphasis Type="Italic">N</Emphasis>-heterylamides

Reaction of 4-aryl-2-hydroxy-4-oxo-2-butenoic acid N-hetarylamides with copper, zinc, and cadmium dichlorides led to the formation of bis[3-aryl-1-(N-hetaryl)carboxamido-1,3-propanedionato]copper,-zinc, and-cadmium, respectively. Compounds with high antimicrobial activity were found among these products. Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 42, No. 7, pp. 14–16, July, 2008.     

Synthesis and biological activity of substituted 4-aryl-2-methylenehydrazino-4-oxobut-2-enoic acids and their derivatives

Aseries of substituted 2-methylenehydrazino-4-aryl-4-oxobut-2-enoic acids and their anilides and esters were obtained using reactions of 4-aryl-2-hydroxy-4-oxobut-2-enoic acids and their amides and esters with benzophenone hydrazone, benzyl monohydrazone, and triphenylphosphazines. The methyl ester of 2-(1,2-diphenyl-2-oxoethylidenehydrazino)-4-(4-chlorophenyl)-4-oxobut-2-enoic acid was also synthesized by decyclization of 3-(1,2-diphenyl-2-oxoethylidenehydrazino)-5-(4-chlorophenyl)-3H-furan-2-one using methanol. The synthesized compounds exhibit moderate anti-inflammatory, analgesic, and antimicrobial activity.     

Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia

BACKGROUND AND OBJECTIVES: Thoracic epidural analgesia (TEA) is increasingly used for perioperative analgesia. If patients with TEA develop sepsis or systemic inflammatory response subsequent to extended surgery the question arises if it would be safe to continue TEA with its beneficial effects of improving gastrointestinal perfusion and augmenting tissue oxygenation. A major concern in this regard is hemodynamic instability that might ensue from TEA-induced vasodilation. The objective of the present study was to assess the effects of TEA on systemic and pulmonary hemodynamics in a sepsis model of hyperdynamic endotoxemia. METHODS: After a baseline measurement in healthy sheep (n = 14), Salmonella thyphosa endotoxin was continuously infused at a rate of 10 ngxkg(-1)xmin(-1) over 16 hours. The surviving animals (n = 12) were then randomly assigned to 1 of 2 study groups. In the treatment group (n = 6), continuous TEA was initiated with 0.1 mLxkg(-1) bupivacaine 0.125% and maintained with 0.1 mLxkg(-1)xh(-1). In the control group (n = 6) the same amount of isotonic sodium saline solution was injected at the same rate through the epidural catheter. RESULTS: In both experimental groups cardiac index increased and systemic vascular resistance decreased concurrently (each P < .05). Functional epidural blockade in the TEA group was confirmed by sustained suppression of the cutaneous (or panniculus) reflex. During the observational period of 6 hours neither systemic nor pulmonary circulatory variables were impaired by TEA. CONCLUSIONS: From a hemodynamic point of view, TEA presents as a safe treatment option in sepsis or systemic inflammatory response syndrome.     

Synthesis and hypoglycemic and anti-inflammatory activity of metal complexes of 4-aryl-2-hydroxy-4-oxo-2-butenoic acid <Emphasis Type="Italic">N</Emphasis>-heterylamides

The reaction of 4-aryl-2-hydroxy-4-oxo-2-butenoic acid N-heterylamides with dichlorides of manganese, cobalt, and nickel forms the bis[3-aryl-1-(N-heteryl)carboxamido-1, 3-propanedionato] complexes of manganese, cobalt, and nickel, respectively. The hypoglycemic and anti-inflammatory activities of the synthesized compounds and the previously obtained complexes of copper, zinc, and cadmium were investigated. Several highly active substances with two pharmacological effects were found among these products.     

Ventilator-associated pneumonia and ICU mortality in severe ARDS patients ventilated according to a lung-protective strategy

ABSTRACT: INTRODUCTION: Ventilator-associated pneumonia (VAP) may contribute to the mortality associated with acute respiratory distress syndrome (ARDS). We aimed to determine the incidence, outcome, and risk factors of bacterial VAP complicating severe ARDS in patients ventilated by using a strictly standardized lung-protective strategy. METHODS: This prospective epidemiologic study was done in all the 339 patients with severe ARDS included in a multicenter randomized, placebo-controlled double-blind trial of cisatracurium besylate in severe ARDS patients. Patients with suspected VAP underwent bronchoalveolar lavage to confirm the diagnosis. RESULTS: Ninety-eight (28.9%) patients had at least one episode of microbiologically documented bacterial VAP, including 41 (41.8%) who died in the ICU, compared with 74 (30.7%) of the 241 patients without VAP (P = 0.05). After adjustment, age and severity at baseline, but not VAP, were associated with ICU death. Cisatracurium besylate therapy within 2 days of ARDS onset decreased the risk of ICU death. Factors independently associated with an increased risk to develop a VAP were male sex and worse admission Glasgow Coma Scale score. Tracheostomy, enteral nutrition, and the use of a subglottic secretion-drainage device were protective. CONCLUSIONS: In patients with severe ARDS receiving lung-protective ventilation, VAP was associated with an increased crude ICU mortality which did not remain significant after adjustment.