Subject(s)
Archaeology , Beer/history , Bread/history , Diet/history , Edible Grain/history , Agriculture/history , Animals , Austria , Dental Plaque/chemistry , Dental Plaque/microbiology , Diet, Paleolithic , Dietary Carbohydrates , Feces/chemistry , History, Ancient , Humans , Meat/history , Neanderthals , Netherlands , Turkey , Vegetables/history , Vegetarians/historyABSTRACT
BACKGROUND: The risk of complications, including death, is substantially increased in patients with pulmonary hypertension (PH) undergoing anaesthesia for surgical procedures, especially in those with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH). Sedation also poses a risk to patients with PH. Physiological changes including tachycardia, hypotension, fluid shifts, and an increase in pulmonary vascular resistance (PH crisis) can precipitate acute right ventricular decompensation and death. METHODS: A systematic literature review was performed of studies in patients with PH undergoing non-cardiac and non-obstetric surgery. The management of patients with PH requiring sedation for endoscopy was also reviewed. Using a framework of relevant clinical questions, we review the available evidence guiding operative risk, risk assessment, preoperative optimisation, and perioperative management, and identifying areas for future research. RESULTS: Reported 30 day mortality after non-cardiac and non-obstetric surgery ranges between 2% and 18% in patients with PH undergoing elective procedures, and increases to 15-50% for emergency surgery, with complications and death usually relating to acute right ventricular failure. Risk factors for mortality include procedure-specific and patient-related factors, especially markers of PH severity (e.g. pulmonary haemodynamics, poor exercise performance, and right ventricular dysfunction). Most studies highlight the importance of individualised preoperative risk assessment and optimisation and advanced perioperative planning. CONCLUSIONS: With an increasing number of patients requiring surgery in specialist and non-specialist PH centres, a systematic, evidence-based, multidisciplinary approach is required to minimise complications. Adequate risk stratification and a tailored-individualised perioperative plan is paramount.
Subject(s)
Consensus , Expert Testimony/standards , Hypertension, Pulmonary/surgery , Perioperative Care/standards , Postoperative Complications/prevention & control , Expert Testimony/methods , Humans , Hypertension, Pulmonary/diagnosis , Perioperative Care/methods , Postoperative Complications/diagnosisSubject(s)
Attitude , Entrepreneurship/organization & administration , Entrepreneurship/trends , Federal Government , Organizational Culture , Research/organization & administration , Research/trends , Child , Entrepreneurship/economics , Entrepreneurship/statistics & numerical data , Germany , Heart Valves/abnormalities , Humans , Inventions/economics , Inventions/trends , Research/economics , Research Personnel/economics , Research Personnel/psychologySubject(s)
Animal Identification Systems , Animal Migration , Animals, Wild/physiology , Conservation of Natural Resources/methods , Endangered Species/statistics & numerical data , Environmental Monitoring/instrumentation , Environmental Monitoring/methods , Internet , Animal Identification Systems/economics , Animals , Astronauts , Birds , Cell Phone , Cues , Earthquakes/statistics & numerical data , Energy Metabolism , Environmental Monitoring/economics , Geographic Information Systems , Germany , Light , Magnetic Fields , Mobile Applications , Moscow , Radio , Satellite Communications/instrumentation , Satellite Communications/trends , Spacecraft , United States , United States National Aeronautics and Space Administration/organization & administrationSubject(s)
Interdisciplinary Research/organization & administration , Interdisciplinary Research/trends , Learning/physiology , Multilingualism , Neurosciences/organization & administration , Neurosciences/trends , Adult , Animals , Anthropology , Brain Mapping , Case-Control Studies , Dementia , Depression , Diabetes Complications , Diabetes Mellitus , Endocrinology/organization & administration , Epigenesis, Genetic , Female , Germany , Humans , Insulin Resistance , Interdisciplinary Communication , Interdisciplinary Research/education , Magnetic Resonance Imaging , Male , Mice , Museums , Neurosciences/methods , Psychological Trauma/genetics , Psychology/organization & administration , Refugees/psychology , Research Personnel/organization & administration , Research Personnel/psychology , Spectroscopy, Near-Infrared , Syria/ethnology , WorkforceABSTRACT
For years, an artificial pancreas was a pipe dream. Now, we're closer than ever to systems that will automatically adjust background insulin. Here's what's in the works--and what's still to come.
Subject(s)
Blood Glucose/metabolism , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Mobile Applications , Pancreas, Artificial , Blood Glucose Self-Monitoring/instrumentation , Cost of Illness , Diabetes Mellitus, Type 1/metabolism , Humans , Insulin Infusion Systems , Monitoring, Ambulatory/instrumentation , SmartphoneSubject(s)
Dairying/history , Lactose Intolerance/history , Milk/history , Adult , Animals , Archaeology , Cattle , Ceramics/history , Cheese/history , Child , Diet/history , Europe , Genetics, Population , History, Ancient , Humans , Lactase/deficiency , Lactase/genetics , Lactase/metabolism , Lactose Intolerance/genetics , Meat/history , Middle East , Point Mutation/geneticsABSTRACT
Ancient DNA shows continuity between living and ancient Maya communities.
Subject(s)
Ceremonial Behavior , Civilization , DNA, Ancient , Twins , Female , Humans , Male , History, Ancient , Twins/history , Child , Civilization/historyABSTRACT
Complex tools from 300,000-year-old deposit at Schöningen in Germany point to a "wood age".
Subject(s)
Neanderthals , Wood , Animals , Archaeology , Germany , Neanderthals/psychologyABSTRACT
Among Europeans, risk of multiple sclerosis rises with genes from Bronze Age Yamnaya herders.
Subject(s)
DNA, Ancient , Multiple Sclerosis , Humans , Europe/epidemiology , Genome, Human , Multiple Sclerosis/epidemiology , Multiple Sclerosis/genetics , Multiple Sclerosis/historySubject(s)
Archaeology , Emigration and Immigration/history , Americas , Animals , DNA, Mitochondrial/genetics , Fossils , History, Ancient , Humans , Mastodons , Radiometric Dating , Ribs , Sequence Analysis, DNAABSTRACT
Genes reveal striking diversity within similar ice age cultures.
Subject(s)
Cultural Diversity , DNA, Ancient , Europe , HumansABSTRACT
Analysis reveals the chemicals applied to corpses in a 2700-year-old mummification workshop.
Subject(s)
Mummies , Humans , Cadaver , Egypt , History, Ancient , Mummies/historyABSTRACT
Meat from the butchered beasts would have fed hundreds.