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3. Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in europe. the ACVC-EAPCI EORP STEMI registry of the european society of cardiology

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Zeymer, U., Ludman, P., Danchin, N., Kala, P., Laroche, C., Sadeghi, M., Caporale, R., Shaheen, S. M., Legutko, J., Iakobsishvili, Z., Alhabib, K. F., Motovska, Z., Studencan, M., Mimoso, J., Becker, D., Alexopoulos, D., Kereseselidze, Z., Stojkovic, S., Zelveian, P., Goda, A., Mirrakhimov, E., Bajraktari, G., Al-Farhan, H., Serpytis, P., Raungaard, B., Marandi, T., Moore, A. M., Quinn, M., Karjalainen, P. P., Tatu-Chitolu, G., Gale, C. P., Maggioni, A. P., Weidinger, F., Sinnaeve, P., Ferrari, R., Karamfilov, K., Lidon, R. -M., Kereselidze, Z., Iakobishvili, Z., Erglis, A., Kedev, S., Dudek, D., Tatu-Chitoiu, G., Shlyakhto, E., Bunc, M., Mourali, M. S., Konte, M., Larras, F., Lefrancq, E. F., Mekhaldi, S., Shuka, N., Pavli, E., Tafaj, E., Gishto, T., Dibra, A., Duka, A., Gjana, A., Kristo, A., Knuti, G., Demiraj, A., Dado, E., Hasimi, E., Simoni, L., Siqeca, M., Sisakian, H., Hayrapetyan, H., Markosyan, S., Galustyan, L., Arustamyan, N., Kzhdryan, H., Pepoyan, S., Zirkik, A., Von Lewinski, D., Paetzold, S., Kienzl, I., Matyas, K., Neunteufl, T., Nikfardjam, M., Neuhold, U., Mihalcz, A., Glaser, F., Steinwender, C., Reiter, C., Grund, M., Hrncic, D., Hoppe, U., Hammerer, M., Hinterbuchner, L., Hengstenberg, C., Delle Karth, G., Lang, I., Winkler, W., Hasun, M., Kastner, J., Havel, C., Derntl, M., Oberegger, G., Hajos, J., Adlbrecht, C., Publig, T., Leitgeb, M. -C., Wilfing, R., Jirak, P., C. -Y., Ho, Puskas, L., Schrutka, L., Spinar, J., Parenica, J., Hlinomaz, O., Fendrychova, V., Semenka, J., Sikora, J., Sitar, J., Groch, L., Rezek, M., Novak, M., Kramarikova, P., Stasek, J., Dusek, J., Zdrahal, P., Polasek, R., Karasek, J., Seiner, J., Sukova, N., Varvarovsky, I., Lazarak, T., Novotny, V., Matejka, J., Rokyta, R., Volovar, S., Belohlavek, J., Siranec, M., Kamenik, M., Kralik, R., Ravkilde, J., Jensen, S. E., Villadsen, A., Villefrance, K., Schmidt Skov, C., Maeng, M., Moeller, K., Hasan-Ali, H., Ahmed, T. A., Hassan, M., Elguindy, A., Farouk Ismail, M., Ibrahim Abd El-Aal, A., El-Sayed Gaafar, A., Magdy Hassan, H., Ahmed Shafie, M., Nabil El-Khouly, M., Bendary, A., Darwish, M., Ahmed, Y., Amin, O. A., Abdelhakim, A., Abosaif, K., Kandil, H., Galal, M. A. G., El Hefny, E. E., El Sayed, M., Aly, K., Mokarrab, M., Osman, M., Abdelhamid, M., Mantawy, S., Ali, M. R., Kaky, S. D., Khalil, V. A., Saraya, M. E. A., Talaat, A., Nabil, M., Mounir, W. M., Mahmoud, K., Aransa, A., Kazamel, G., Anwar, S., Al-Habbaa, A., Abd El Monem, M., Ismael, A., Amin Abu-Sheaishaa, M., Abd Rabou, M. M., Hammouda, T. M. A., Moaaz, M., Elkhashab, K., Ragab, T., Rashwan, A., Rmdan, A., Abdelrazek, G., Ebeid, H., Soliman Ghareeb, H., Farag, N., Zaki, M., Seleem, M., Torki, A., Youssef, M., Allah Nasser, N. A., Rafaat, A., Selim, H., Makram, M. M., Khayyal, M., Malasi, K., Madkour, A., Kolib, M., Alkady, H., Nagah, H., Yossef, M., Wafa, A., Mahfouz, E., Faheem, G., Magdy Moris, M., Ragab, A., Ghazal, M., Mabrouk, A., El-Masry, M., Naseem, M., Samir, S., Reinmets, J., Allvee, M., Saar, A., Ainla, T., Vaide, A., Kisseljova, M., Pakosta, U., Eha, J., Lotamois, K., Sia, J., Myllymaki, J., Pinola, T., Paana, T., Mikkelsson, J., Ampio, M., Tsivilasvili, J., Zurab, P., Agladze, R., Melia, A., Gogoberidze, D., Khubua, N., Totladze, L., Metreveli, I., Chikovani, A., Eitel, I., Poss, J., Werner, M., Constantz, A., Ahrens, C., Tolksdorf, H., Klinger, S., Sack, S., Heer, T., Lekakis, J., Kanakakis, I., Xenogiannis, I., Ermidou, K., Makris, N., Ntalianis, A., Katsaros, F., Revi, E., Kafkala, K., Mihelakis, E., Diakakis, G., Grammatikopoulos, K., Voutsinos, D., Xanthopoulou, I., Mplani, V., Foussas, S., Papakonstantinou, N., Patsourakos, N., Dimopoulos, A., Derventzis, A., Athanasiou, K., Vassilikos, V. P., Papadopoulos, C., Tzikas, S., Vogiatzis, I., Datsios, A., Galitsianos, I., Koutsampasopoulos, K., Grigoriadis, S., Douras, A., Baka, N., Spathis, S., Kyrlidis, T., Hatzinikolaou, H., Kiss, R. G., Nowotta, F., Toth, K., Szabo, S., Lakatos, C., Jambrik, Z., Ruzsa, J., Ruzsa, Z., Rona, S., Toth, J., Vargane Kosik, A., Toth, K. S. B., Nagy, G. G., Ondrejko, Z., Koromi, Z., Botos, B., Pourmoghadas, M., Salehi, A., Massoumi, G., Soleimani, A., Sarrafzadegan, N., Roohafza, H., Azarm, M., Mirmohammadsadeghi, A., Rajabi, D., Rahmani, Y., Siabani, S., Najafi, F., Hamzeh, B., Karim, H., Siabani, H., Saleh, N., Charehjoo, H., Zamzam, L., Al-Temimi, G., Al-Yassin, A., Mohammad, A., Ridha, A., Al-Saedi, G., Atabi, N., Sabbar, O., Mahmood, S., Dakhil, Z., Yaseen, I. F., Almyahi, M., Alkenzawi, H., Alkinani, T., Alyacopy, A., Kearney, P., Twomey, K., Shlomo, N., Beigel, R., Caldarola, P., Rutigliano, D., Sublimi Saponetti, L., Locuratolo, N., Palumbo, V., Scherillo, M., Formigli, D., Canova, P., Musumeci, G., Roncali, F., Metra, M., Lombardi, C., Visco, E., Rossi, L., Meloni, L., Montisci, R., Pippia, V., Marchetti, M. F., Congia, M., Cacace, C., Luca, G., Boscarelli, G., Indolfi, C., Ambrosio, G., Mongiardo, A., Spaccarotella, C., De Rosa, S., Canino, G., Critelli, C., Chiappetta, D., Battista, F., Gabrielli, D., Marziali, A., Bernabo, P., Navazio, A., Guerri, E., Manca, F., Gobbi, M., Oreto, Giuseppe, Andò, Giuseppe, Carerj, Scipione, Saporito, Francesco, Cimmino, Michele, Rigo, F., Zuin, G., Tuccillo, B., Scotto DI Uccio, F., Irace, L., Lorenzoni, G., Meloni, I., Merella, P., Polizzi, G. M., Pino, R., Marzilli, M., Morrone, D., Caravelli, P., Orsini, E., Mosa, S., Piovaccari, G., Santarelli, A., Cavazza, C., Romeo, F., Fedele, F., Mancone, M., Straito, M., Salvi, N., Scarparo, P., Severino, P., Razzini, C., Massaro, G., Cinque, A., Gaudio, C., Barilla, F., Torromeo, C., Porco, L., Mei, M., Iorio, R., Nassiacos, D., Barco, B., Sinagra, G., Falco, L., Priolo, L., Perkan, A., Strana, M., Percuku, L., Berisha, G., Mziu, B., Beishenkulov, M., Abdurashidova, T., Toktosunova, A., Kaliev, K., Serpytis, R., Butkute, E., Lizaitis, M., Broslavskyte, M., Xuereb, R. G., Mercieca Balbi, M., Paris, E., Buttigieg, L., Musial, W., Dobrzycki, S., Dubicki, A., Kazimierczyk, E., Tycinska, A., Wojakowski, W., Kalanska-Lukasik, B., Ochala, A., Wanha, W., Dworowy, S., Sielski, J., Janion, M., Janion-Sadowska, A., Wojtasik-Bakalarz, J., Bryniarski, L., Peruga, J. Z., Jonczyk, M., Jankowski, L., Klecha, A., Michalowska, J., Brzezinski, M., Kozmik, T., Kowalczyk, T., Adamczuk, J., Maliszewski, M., Kuziemka, P., Plaza, P., Jaros, A., Pawelec, A., Sledz, J., Bartus, S., Zmuda, W., Bogusz, M., Wisnicki, M., Szastak, G., Adamczyk, M., Suska, M., Czunko, P., Opolski, G., Kochman, J., Tomaniak, M., Miernik, S., Paczwa, K., Witkowski, A., Opolski, M. P., Staruch, A. D., Kalarus, Z., Honisz, G., Mencel, G., Swierad, M., Podolecki, T., Marques, J., Azevedo, P., Pereira, M. A., Gaspar, A., Monteiro, S., Goncalves, F., Leite, L., Manuel Lopes Dos Santos, W., Amado, J., Pereira, D., Silva, B., Caires, G., Neto, M., Rodrigues, R., Correia, A., Freitas, D., Lourenco, A., Ferreira, F., Sousa, F., Portugues, J., Calvo, L., Almeida, F., Alves, M., Silva, A., Caria, R., Seixo, F., Militaru, C., Ionica, E., Istratoaie, O., Florescu, M., Lipnitckaia, E., Osipova, O., Konstantinov, S., Bukatov, V., Vinokur, T., Egorova, E., Nefedova, E., Levashov, S., Gorbunova, A., Redkina, M., Karaulovskaya, N., Bijieva, F., Babich, N., Smirnova, O., Filyanin, R., Eseva, S., Kutluev, A., Chlopenova, A., Shtanko, A., Kuppar, E., Shaekhmurzina, E., Ibragimova, M., Mullahmetova, M., Chepisova, M., Kuzminykh, M., Betkaraeva, M., Namitokov, A., Khasanov, N., Baleeva, L., Galeeva, Z., Magamedkerimova, F., Ivantsov, E., Tavlueva, E., Kochergina, A., Sedykh, D., Kosmachova, E., Skibitskiy, V., Porodenko, N., Litovka, K., Ulbasheva, E., Niculina, S., Petrova, M., Harkov, E., Tsybulskaya, N., Lobanova, A., Chernova, A., Kuskaeva, A., Kuskaev, A., Ruda, M., Zateyshchikov, D., Gilarov, M., Konstantinova, E., Koroleva, O., Averkova, A., Zhukova, N., Kalimullin, D., Borovkova, N., Tokareva, A., Buyanova, M., Khaisheva, L., Pirozhenko, A., Novikova, T., Yakovlev, A., Tyurina, T., Lapshin, K., Moroshkina, N., Kiseleva, M., Fedorova, S., Krylova, L., Duplyakov, D., Semenova, Y., Rusina, A., Ryabov, V., Syrkina, A., Demianov, S., Reitblat, O., Artemchuk, A., Efremova, E., Makeeva, E., Menzorov, M., Shutov, A., Klimova, N., Shevchenko, I., Elistratova, O., Kostyuckova, O., Islamov, R., Budyak, V., Ponomareva, E., Ullah Jan, U., Alshehri, A. M., Sedky, E., Alsihati, Z., Mimish, L., Selem, A., Malik, A., Majeed, O., Altnji, I., Alshehri, M., Aref, A., Alhabib, K., Aldosary, M., Tayel, S., Abd Alrahman, M., Asfina, K. N., Abdin Hussein, G., Butt, M., Markovic Nikolic, N., Obradovic, S., Djenic, N., Brajovic, M., Davidovic, A., Romanovic, R., Novakovic, V., Dekleva, M., Spasic, M., Dzudovic, B., Jovic, Z., Cvijanovic, D., Veljkovic, S., Ivanov, I., Cankovic, M., Jarakovic, M., Kovacevic, M., Trajkovic, M., Mitov, V., Jovic, A., Hudec, M., Gombasky, M., Sumbal, J., Bohm, A., Baranova, E., Kovar, F., Samos, M., Podoba, J., Kurray, P., Obona, T., Remenarikova, A., Kollarik, B., Verebova, D., Kardosova, G., Alusik, D., Macakova, J., Kozlej, M., Bayes-Genis, A., Sionis, A., Garcia Garcia, C., Duran Cambra, A., Labata Salvador, C., Rueda Sobella, F., Sans Rosello, J., Vila Perales, M., Oliveras Vila, T., Ferrer Massot, M., Baneras, J., Lekuona, I., Zugazabeitia, G., Fernandez-Ortiz, A., Viana Tejedor, A., Ferrera, C., Alvarez, V., DIaz-Castro, O., Agra-Bermejo, R. M., Gonzalez-Cambeiro, C., Gonzalez-Babarro, E., Domingo-Del Valle, J., Royuela, N., Burgos, V., Canteli, A., Castrillo, C., Cobo, M., Ruiz, M., Abu-Assi, E., Garcia Acuna, J., Zeymer, U., Ludman, P., Danchin, N., Kala, P., Laroche, C., Sadeghi, M., Caporale, R., Shaheen, S. M., Legutko, J., Iakobsishvili, Z., Alhabib, K. F., Motovska, Z., Studencan, M., Mimoso, J., Becker, D., Alexopoulos, D., Kereseselidze, Z., Stojkovic, S., Zelveian, P., Goda, A., Mirrakhimov, E., Bajraktari, G., Al-Farhan, H., Serpytis, P., Raungaard, B., Marandi, T., Moore, A. M., Quinn, M., Karjalainen, P. P., Tatu-Chitolu, G., Gale, C. P., Maggioni, A. P., Weidinger, F., Sinnaeve, P., Ferrari, R., Karamfilov, K., Lidon, R. -M., Kereselidze, Z., Iakobishvili, Z., Erglis, A., Kedev, S., Dudek, D., Tatu-Chitoiu, G., Shlyakhto, E., Bunc, M., Mourali, M. S., Konte, M., Larras, F., Lefrancq, E. F., Mekhaldi, S., Shuka, N., Pavli, E., Tafaj, E., Gishto, T., Dibra, A., Duka, A., Gjana, A., Kristo, A., Knuti, G., Demiraj, A., Dado, E., Hasimi, E., Simoni, L., Siqeca, M., Sisakian, H., Hayrapetyan, H., Markosyan, S., Galustyan, L., Arustamyan, N., Kzhdryan, H., Pepoyan, S., Zirkik, A., Von Lewinski, D., Paetzold, S., Kienzl, I., Matyas, K., Neunteufl, T., Nikfardjam, M., Neuhold, U., Mihalcz, A., Glaser, F., Steinwender, C., Reiter, C., Grund, M., Hrncic, D., Hoppe, U., Hammerer, M., Hinterbuchner, L., Hengstenberg, C., Delle Karth, G., Lang, I., Winkler, W., Hasun, M., Kastner, J., Havel, C., Derntl, M., Oberegger, G., Hajos, J., Adlbrecht, C., Publig, T., Leitgeb, M. -C., Wilfing, R., Jirak, P., Ho, C. -Y., Puskas, L., Schrutka, L., Spinar, J., Parenica, J., Hlinomaz, O., Fendrychova, V., Semenka, J., Sikora, J., Sitar, J., Groch, L., Rezek, M., Novak, M., Kramarikova, P., Stasek, J., Dusek, J., Zdrahal, P., Polasek, R., Karasek, J., Seiner, J., Sukova, N., Varvarovsky, I., Lazarak, T., Novotny, V., Matejka, J., Rokyta, R., Volovar, S., Belohlavek, J., Siranec, M., Kamenik, M., Kralik, R., Ravkilde, J., Jensen, S. E., Villadsen, A., Villefrance, K., Schmidt Skov, C., Maeng, M., Moeller, K., Hasan-Ali, H., Ahmed, T. A., Hassan, M., Elguindy, A., Farouk Ismail, M., Ibrahim Abd El-Aal, A., El-Sayed Gaafar, A., Magdy Hassan, H., Ahmed Shafie, M., Nabil El-Khouly, M., Bendary, A., Darwish, M., Ahmed, Y., Amin, O. A., Abdelhakim, A., Abosaif, K., Kandil, H., Galal, M. A. G., El Hefny, E. E., El Sayed, M., Aly, K., Mokarrab, M., Osman, M., Abdelhamid, M., Mantawy, S., Ali, M. R., Kaky, S. D., Khalil, V. A., Saraya, M. E. A., Talaat, A., Nabil, M., Mounir, W. M., Mahmoud, K., Aransa, A., Kazamel, G., Anwar, S., Al-Habbaa, A., Abd El Monem, M., Ismael, A., Amin Abu-Sheaishaa, M., Abd Rabou, M. M., Hammouda, T. M. A., Moaaz, M., Elkhashab, K., Ragab, T., Rashwan, A., Rmdan, A., Abdelrazek, G., Ebeid, H., Soliman Ghareeb, H., Farag, N., Zaki, M., Seleem, M., Torki, A., Youssef, M., Allah Nasser, N. A., Rafaat, A., Selim, H., Makram, M. M., Khayyal, M., Malasi, K., Madkour, A., Kolib, M., Alkady, H., Nagah, H., Yossef, M., Wafa, A., Mahfouz, E., Faheem, G., Magdy Moris, M., Ragab, A., Ghazal, M., Mabrouk, A., El-Masry, M., Naseem, M., Samir, S., Reinmets, J., Allvee, M., Saar, A., Ainla, T., Vaide, A., Kisseljova, M., Pakosta, U., Eha, J., Lotamois, K., Sia, J., Myllymaki, J., Pinola, T., Paana, T., Mikkelsson, J., Ampio, M., Tsivilasvili, J., Zurab, P., Agladze, R., Melia, A., Gogoberidze, D., Khubua, N., Totladze, L., Metreveli, I., Chikovani, A., Eitel, I., Poss, J., Werner, M., Constantz, A., Ahrens, C., Tolksdorf, H., Klinger, S., Sack, S., Heer, T., Lekakis, J., Kanakakis, I., Xenogiannis, I., Ermidou, K., Makris, N., Ntalianis, A., Katsaros, F., Revi, E., Kafkala, K., Mihelakis, E., Diakakis, G., Grammatikopoulos, K., Voutsinos, D., Xanthopoulou, I., Mplani, V., Foussas, S., Papakonstantinou, N., Patsourakos, N., Dimopoulos, A., Derventzis, A., Athanasiou, K., Vassilikos, V. P., Papadopoulos, C., Tzikas, S., Vogiatzis, I., Datsios, A., Galitsianos, I., Koutsampasopoulos, K., Grigoriadis, S., Douras, A., Baka, N., Spathis, S., Kyrlidis, T., Hatzinikolaou, H., Kiss, R. G., Nowotta, F., Toth, K., Szabo, S., Lakatos, C., Jambrik, Z., Ruzsa, J., Ruzsa, Z., Rona, S., Toth, J., Vargane Kosik, A., Toth, K. S. B., Nagy, G. G., Ondrejko, Z., Koromi, Z., Botos, B., Pourmoghadas, M., Salehi, A., Massoumi, G., Soleimani, A., Sarrafzadegan, N., Roohafza, H., Azarm, M., Mirmohammadsadeghi, A., Rajabi, D., Rahmani, Y., Siabani, S., Najafi, F., Hamzeh, B., Karim, H., Siabani, H., Saleh, N., Charehjoo, H., Zamzam, L., Al-Temimi, G., Al-Yassin, A., Mohammad, A., Ridha, A., Al-Saedi, G., Atabi, N., Sabbar, O., Mahmood, S., Dakhil, Z., Yaseen, I. F., Almyahi, M., Alkenzawi, H., Alkinani, T., Alyacopy, A., Kearney, P., Twomey, K., Shlomo, N., Beigel, R., Caldarola, P., Rutigliano, D., Sublimi Saponetti, L., Locuratolo, N., Palumbo, V., Scherillo, M., Formigli, D., Canova, P., Musumeci, G., Roncali, F., Metra, M., Lombardi, C., Visco, E., Rossi, L., Meloni, L., Montisci, R., Pippia, V., Marchetti, M. F., Congia, M., Cacace, C., Luca, G., Boscarelli, G., Indolfi, C., Ambrosio, G., Mongiardo, A., Spaccarotella, C., De Rosa, S., Canino, G., Critelli, C., Chiappetta, D., Battista, F., Gabrielli, D., Marziali, A., Bernabo, P., Navazio, A., Guerri, E., Manca, F., Gobbi, M., Oreto, G., Ando, G., Carerj, S., Saporito, F., Cimmino, M., Rigo, F., Zuin, G., Tuccillo, B., Scotto DI Uccio, F., Irace, L., Lorenzoni, G., Meloni, I., Merella, P., Polizzi, G. M., Pino, R., Marzilli, M., Morrone, D., Caravelli, P., Orsini, E., Mosa, S., Piovaccari, G., Santarelli, A., Cavazza, C., Romeo, F., Fedele, F., Mancone, M., Straito, M., Salvi, N., Scarparo, P., Severino, P., Razzini, C., Massaro, G., Cinque, A., Gaudio, C., Barilla, F., Torromeo, C., Porco, L., Mei, M., Iorio, R., Nassiacos, D., Barco, B., Sinagra, G., Falco, L., Priolo, L., Perkan, A., Strana, M., Percuku, L., Berisha, G., Mziu, B., Beishenkulov, M., Abdurashidova, T., Toktosunova, A., Kaliev, K., Serpytis, R., Butkute, E., Lizaitis, M., Broslavskyte, M., Xuereb, R. G., Mercieca Balbi, M., Paris, E., Buttigieg, L., Musial, W., Dobrzycki, S., Dubicki, A., Kazimierczyk, E., Tycinska, A., Wojakowski, W., Kalanska-Lukasik, B., Ochala, A., Wanha, W., Dworowy, S., Sielski, J., Janion, M., Janion-Sadowska, A., Wojtasik-Bakalarz, J., Bryniarski, L., Peruga, J. Z., Jonczyk, M., Jankowski, L., Klecha, A., Michalowska, J., Brzezinski, M., Kozmik, T., Kowalczyk, T., Adamczuk, J., Maliszewski, M., Kuziemka, P., Plaza, P., Jaros, A., Pawelec, A., Sledz, J., Bartus, S., Zmuda, W., Bogusz, M., Wisnicki, M., Szastak, G., Adamczyk, M., Suska, M., Czunko, P., Opolski, G., Kochman, J., Tomaniak, M., Miernik, S., Paczwa, K., Witkowski, A., Opolski, M. P., Staruch, A. D., Kalarus, Z., Honisz, G., Mencel, G., Swierad, M., Podolecki, T., Marques, J., Azevedo, P., Pereira, M. A., Gaspar, A., Monteiro, S., Goncalves, F., Leite, L., Manuel Lopes Dos Santos, W., Amado, J., Pereira, D., Silva, B., Caires, G., Neto, M., Rodrigues, R., Correia, A., Freitas, D., Lourenco, A., Ferreira, F., Sousa, F., Portugues, J., Calvo, L., Almeida, F., Alves, M., Silva, A., Caria, R., Seixo, F., Militaru, C., Ionica, E., Istratoaie, O., Florescu, M., Lipnitckaia, E., Osipova, O., Konstantinov, S., Bukatov, V., Vinokur, T., Egorova, E., Nefedova, E., Levashov, S., Gorbunova, A., Redkina, M., Karaulovskaya, N., Bijieva, F., Babich, N., Smirnova, O., Filyanin, R., Eseva, S., Kutluev, A., Chlopenova, A., Shtanko, A., Kuppar, E., Shaekhmurzina, E., Ibragimova, M., Mullahmetova, M., Chepisova, M., Kuzminykh, M., Betkaraeva, M., Namitokov, A., Khasanov, N., Baleeva, L., Galeeva, Z., Magamedkerimova, F., Ivantsov, E., Tavlueva, E., Kochergina, A., Sedykh, D., Kosmachova, E., Skibitskiy, V., Porodenko, N., Litovka, K., Ulbasheva, E., Niculina, S., Petrova, M., Harkov, E., Tsybulskaya, N., Lobanova, A., Chernova, A., Kuskaeva, A., Kuskaev, A., Ruda, M., Zateyshchikov, D., Gilarov, M., Konstantinova, E., Koroleva, O., Averkova, A., Zhukova, N., Kalimullin, D., Borovkova, N., Tokareva, A., Buyanova, M., Khaisheva, L., Pirozhenko, A., Novikova, T., Yakovlev, A., Tyurina, T., Lapshin, K., Moroshkina, N., Kiseleva, M., Fedorova, S., Krylova, L., Duplyakov, D., Semenova, Y., Rusina, A., Ryabov, V., Syrkina, A., Demianov, S., Reitblat, O., Artemchuk, A., Efremova, E., Makeeva, E., Menzorov, M., Shutov, A., Klimova, N., Shevchenko, I., Elistratova, O., Kostyuckova, O., Islamov, R., Budyak, V., Ponomareva, E., Ullah Jan, U., Alshehri, A. M., Sedky, E., Alsihati, Z., Mimish, L., Selem, A., Malik, A., Majeed, O., Altnji, I., Alshehri, M., Aref, A., Alhabib, K., Aldosary, M., Tayel, S., Abd Alrahman, M., Asfina, K. N., Abdin Hussein, G., Butt, M., Markovic Nikolic, N., Obradovic, S., Djenic, N., Brajovic, M., Davidovic, A., Romanovic, R., Novakovic, V., Dekleva, M., Spasic, M., Dzudovic, B., Jovic, Z., Cvijanovic, D., Veljkovic, S., Ivanov, I., Cankovic, M., Jarakovic, M., Kovacevic, M., Trajkovic, M., Mitov, V., Jovic, A., Hudec, M., Gombasky, M., Sumbal, J., Bohm, A., Baranova, E., Kovar, F., Samos, M., Podoba, J., Kurray, P., Obona, T., Remenarikova, A., Kollarik, B., Verebova, D., Kardosova, G., Alusik, D., Macakova, J., Kozlej, M., Bayes-Genis, A., Sionis, A., Garcia Garcia, C., Duran Cambra, A., Labata Salvador, C., Rueda Sobella, F., Sans Rosello, J., Vila Perales, M., Oliveras Vila, T., Ferrer Massot, M., Baneras, J., Lekuona, I., Zugazabeitia, G., Fernandez-Ortiz, A., Viana Tejedor, A., Ferrera, C., Alvarez, V., DIaz-Castro, O., Agra-Bermejo, R. M., Gonzalez-Cambeiro, C., Gonzalez-Babarro, E., Domingo-Del Valle, J., Royuela, N., Burgos, V., Canteli, A., Castrillo, C., Cobo, M., Ruiz, M., Abu-Assi, E., and Garcia Acuna, J.

Subjects
Registrie, medicine.medical_specialty, medicine.medical_treatment, Cardiology, Myocardial Reperfusion, 030204 cardiovascular system & hematology, 03 medical and health sciences, Hospital, 0302 clinical medicine, Reperfusion therapy, Percutaneous Coronary Intervention, Internal medicine, Fibrinolysis, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Registries, Prospective Studies, Prospective cohort study, Observational studies, observational studies, reperfusion therapy, business.industry, Mortality rate, Primary percutaneous coronary intervention, ST-elevation myocardial infarction, Europe, Hospitals, Treatment Outcome, ST Elevation Myocardial Infarction, Percutaneous coronary intervention, medicine.disease, primary percutaneous coronary intervention, Observational studie, 3. Good health, Prospective Studie, Cohort, Conventional PCI, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Aims The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset Conclusions The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.

Published
2021

9. The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Author

Zeymer, U., Ludman, P., Danchin, N., Kala, P., Maggioni, A. P., Weidinger, F, P Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, P Maggioni, A, K Nagy, V, Nedoshivin, A, A-S, Petronio, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Franz, Weidinger, Uwe, Zeymer, Nicolas, Danchin, Peter, Ludman, Peter, Sinnaeve, Petr, Kala, Roberto, Ferrari, Maggioni, Aldo P., Artan, Goda, Parounak, Zelveian, Kiril, Karamfilov, Zuzana, Motovska, Bent, Raungaard, Toomas, Marandi, Sameh Mohamed Shaheen, Rosa-Maria, Lidon, Pasi Paavo Karjalainen, Zviad, Kereselidze, Dimitrios, Alexopoulos, David, Becker, Martin, Quinn, Zaza, Iakobishvili, Hasan, Al-Farhan, Masoumeh, Sadeghi, Roberto, Caporale, Francesco, Romeo, Erkin, Mirrakhimov, Pranas, Serpytis, Andrejs, Erglis, Sasko, Kedev, Matthew Mercieca Balbi, Alice May Moore, Dariusz, Dudek, Jacek, Legutko, Jorge, Mimoso, Gabriel, Tatu-Chitoiu, Sinisa, Stojkovic, Evgeny, Shlyakhto, Khalid, F AlHabib, Matjaz, Bunc, Martin, Studencan, Mohamed Sami Mourali, Gani, Bajraktari, Marème, Konte, Florian, Larras, Elin Folkesson Lefrancq, Souad, Mekhaldi, Cécile, Laroche, Goda, A, Shuka, N, Pavli, E, Tafaj, E, Gishto, T, Dibra, A, Duka, A, Gjana, A, Kristo, A, Knuti, G, Demiraj, A, Dado, E, Hasimi, E, Simoni, L, Siqeca, M, Sisakian, H, Hayrapetyan, H, Markosyan, S, Galustyan, L, Arustamyan, N, Kzhdryan, H, Pepoyan, S, Zirkik, A, D Von Lewinski, Paetzold, S, Kienzl, I, Matyas, K, Neunteufl, T, Nikfardjam, M, Neuhold, U, Mihalcz, A, Glaser, F, Steinwender, C, Reiter, C, Grund, M, Hrncic, D, Hoppe, U, Hammerer, M, Hinterbuchner, L, Hengstenberg, C, G Delle Karth, Lang, I, Winkler, W, Hasun, M, Kastner, J, Havel, C, Derntl, M, Oberegger, G, Hajos, J, Adlbrecht, C, Publig, T, M-C, Leitgeb, Wilfing, R, Jirak, P, C-Y, Ho, Puskas, L, Schrutka, L, Spinar, J, Parenica, J, Hlinomaz, O, Fendrychova, V, Semenka, J, Sikora, J, Sitar, J, Groch, L, Rezek, M, Novak, M, Kramarikova, P, Stasek, J, Dusek, J, Zdrahal, P, Polasek, R, Karasek, J, Seiner, J, Sukova, N, Varvarovsky, I, Lazarák, T, Novotny, V, Matejka, J, Rokyta, R, Volovar, S, Belohlavek, J, Motovska, Z, Siranec, M, Kamenik, M, Kralik, R, Raungaard, B, Ravkilde, J, E Jensen, S, Villadsen, A, Villefrance, K, C Schmidt Skov, Maeng, M, Moeller, K, Hasan-Ali, H, A Ahmed, T, Hassan, M, Elguind, A, M Farouk Ismail, A Ibrahim Abd El-Aal, A El-sayed Gaafar, H Magdy Hassan, M Ahmed Shafie, M Nabil El-khouly, Bendary, A, Darwish, M, Ahmed, Y, Amin, O, Abdelhakim, A, Abosaif, K, Kandil, H, M A, G Galal, E El Hefny, E, M El Sayed, Aly, K, Mokarrab, M, Osman, M, Abdelhamid, M, Mantawy, S, R Ali, M, D Kaky, S, A Khalil, V, M E, A Saraya, Talaat, A, Nabil, M, M Mounir, W, Aransa, K. Mahmoud A., Kazamel, G, Anwar, S, Al-Habbaa, A, M Abd el Monem, Ismael, A, Amin Abu-Sheaishaa, M., M Abd Rabou, M, T M, A Hammouda, Moaaz, M, Elkhashab, K, Ragab, T, Rashwan, A, Rmdan, A, Abdelrazek, G, Ebeid, H, H Soliman Ghareeb, Farag, N, Zaki, M, Seleem, M, Torki, A, Youssef, M, A AlLah Nasser, N, Rafaat, A, Selim, H, M Makram, M, Khayyal, M, Malasi, K, Madkou, A, Kolib, M, Alkady, H, Nagah, A, Yossef, M, Wafa, A, Mahfouz, E, Faheem, G, M Magdy Moris, Ragab, A, Ghazal, M, Mabrouk, A, El-Masry, M, Naseem, M, Samir, S, Marandi, T, Reinmets, J, Allvee, M, Saar, A, Ainla, T, Vaide, A, Kisseljova, M, Pakosta, U, Eha, J, Lotamois, K, Sia, J, Myllymaki, J, Pinola, T, P Karjalainen, P, Paana, P, Mikkelsson, J, Ampio, M, Tsivilasvili, J, Zurab, P, Kereselidze, Z, Agladze, R, Melia, A, Gogoberidze, D, Khubua, N, Totladze, L, Metreveli, I, Chikovani, A, Eitel, I, Pöss, J, Werner, M, Constantz, A, Ahrens, C, Tolksdorf, H, Klinger, S, Sack, S, Heer, T, Lekakis, J, Kanakakis, I, Xenogiannis, I, Ermidou, K, Makris, N, Ntalianis, A, Katsaros, F, Revi, E, Kafkala, K, Mihelakis, E, Diakakis, G, Grammatikopoulos, K, Voutsinos, D, Alexopoulos, D, Xanthopoulou, I, Mplani, V, Foussas, S, Papakonstantinou, N, Patsourakos, N, Dimopoulos, A, Derventzis, A, Athanasiou, K, P Vassilikos, V, Papadopoulos, C, Tzikas, S, Vogiatzis, I, Datsios, A, Galitsianos, I, Koutsampasopoulos, K, Grigoriadis, S, Douras, A, Baka, N, Spathis, S, Kyrlidis, T, Hatzinikolaou, H, G Kiss, R, Becker, D, Nowotta, F, Tóth, K, Szabó, S, Lakatos, C, Jambrik, Z, Ruzsa, J, Ruzsa, Z, Róna, S, Toth, J, A Vargane Kosik, K S, B Toth, G Nagy, G, Ondrejkó, Z, Körömi, Z, Botos, B, Pourmoghadas, M, Salehi, A, Massoumi, G, Sadeghi, M, Soleimani, A, Sarrafzadegan, N, Roohafza, H, Azarm, M, Mirmohammadsadeghi, A, Rajabi, D, Rahmani, Y, Siabani, S, Najafi, F, Hamzeh, B, Karim, H, Siabani, H, Saleh, N, Charehjoo, H, Zamzam, L, Al-Temimi, T, Al-Farhan, H, Al-Yassin, A, Mohammad, A, Ridha, A, Al-Saedi, G, Atabi, N, Sabbar, O, Mahmood, S, Dakhil, Z, F Yaseen, I, Almyahi, M, Alkenzawi, H, Alkinani, T, Alyacopy, A, Kearney, P, Twomey, K, Iakobishvili, Z, Shlomo, N, Beigel, R, Caldarola, P, Rutigliano, D, L Sublimi Saponetti, Locuratolo, N, Palumbo, V, Scherillo, M, Formigli, D, Canova, P, Musumeci, G, Roncali, F, Metra, M, Lombardi, C, Visco, E, Rossi, L, Meloni, L, Montisci, R, Pippia, V, F Marchetti, M, Congia, M, Cacace, C, Luca, G, Boscarelli, G, Indolfi, C, Ambrosio, G, Mongiardo, A, Spaccarotella, C, S De Rosa, Canino, G, Critelli, C, Caporale, R, Chiappetta, D, Battista, F, Gabrielli, D, Marziali, A, Bernabò, P, Navazio, A, Guerri, E, Manca, F, Gobbi, M, Oreto, G, Andò, G, Carerj, S, Saporito, F, Cimmino, M, Rigo, F, Zuin, G, Tuccillo, B, F Scotto di Uccio, L Scotto di Uccio, Lorenzoni, G, Meloni, I, Merella, P, M Polizzi, G, Pino, R, Marzilli, M, Morrone, D, Caravelliorsini, P, Orsini, E, Mosa, S, Piovaccari, G, Santarelli, A, Cavazza, C, Romeo, F, Fedele, F, Mancone, M, Straito, M, Salvi, N, Scarparo, P, Severino, P, Razzini, C, Massaro, G, Cinque, A, Gaudio, C, Barillà, F, Torromeo, C, Porco, L, Mei, M, Lorio, R, Nassiacos, D, Barco, B, Sinagra, G, Falco, L, Priolo, L, Perkan, A, Strana, M, Bajraktari, G, Percuku, L, Berisha, G, Mziu, B, Beishenkulov, M, Abdurashidova, T, Toktosunova, A, Kaliev, K, Serpytis, P, Serpytis, R, Butkute, E, Lizaitis, M, Broslavskyte, M, G Xuereb, R, M Moore, A, M Mercieca Balbi, Paris, E, Buttigieg, L, Musial, W, Dobrzycki, S, Dubicki, A, Kazimierczyk, E, Tycinska, A, Wojakowski, W, Kalanska-Lukasik, B, Ochala, A, Wanha, W, Dworowy, S, Sielski, J, Janion, M, Janion-Sadowska, A, Dudek, D, Wojtasik-Bakalarz, J, Bryniarski, L, Z Peruga, J, Jonczyk, M, Jankowski, L, Klecha, A, Legutko, J, Michalowska, J, Brzezinski, M, Kozmik, T, Kowalczyk, T, Adamczuk, J, Maliszewski, M, Kuziemka, P, Plaza, P, Jaros, A, Pawelec, A, Sledz, J, Bartus, S, Zmuda, W, Bogusz, M, Wisnicki, M, Szastak, G, Adamczyk, M, Suska, M, Czunko, P, Opolski, G, Kochman, J, Tomaniak, M, Miernik, S, Paczwa, K, Witkowski, A, P Opolski, M, D Staruch, A, Kalarus, Z, Honisz, G, Mencel, G, Swierad, M, Podolecki, T, Marques, J, Azevedo, P, A Pereira, M, Gaspar, A, Monteiro, S, Goncalves, F, Leite, L, Mimoso, J, Manuel Lopes dos Santos, W., Amado, J, Pereira, D, Silva, B, Caires, G, Neto, M, Rodrigues, R, Correia, A, Freitas, D, Lourenco, A, Ferreira, F, Sousa, F, Portugues, J, Calvo, J, Almeida, F, Alves, M, Silva, A, Caria, R, Seixo, F, Militaru, C, Ionica, E, Tatu-Chitoiu, G, Istratoaie, O, Florescu, M, Lipnitckaia, E, Osipova, O, Konstantinov, S, Bukatov, V, Vinokur, T, Egorova, E, Nefedova, E, Levashov, S, Gorbunova, A, Redkina, M, Karaulovskaya, N, Bijieva, F, Babich, N, Smirnova, O, Filyanin, R, Eseva, S, Kutluev, A, Chlopenova, A, Shtanko, A, Kuppar, E, Shaekhmurzina, E, Ibragimova, M, Mullahmetova, M, Chepisova, M, Kuzminykh, M, Betkaraeva, M, Namitokov, A, Khasanov, N, Baleeva, L, Galeeva, Z, Magamedkerimova, F, Ivantsov, E, Tavlueva, E, Kochergina, A, Sedykh, D, Kosmachova, E, Skibitskiy, V, Porodenko, N, Litovka, K, Ulbasheva, E, Niculina, S, Petrova, M, Harkov, E, Tsybulskaya, N, Lobanova, A, Chernova, A, Kuskaeva, A, Kuskaev, A, Ruda, M, Zateyshchikov, D, Gilarov, M, Konstantinova, E, Koroleva, O, Averkova, A, Zhukova, N, Kalimullin, D, Borovkova, N, Tokareva, A, Buyanova, M, Khaisheva, L, Pirozhenko, T, Novikova, T, Yakovlev, A, Tyurina, T, Lapshin, K, Moroshkina, N, Kiseleva, M, Fedorova, S, Krylova, L, Duplyakov, D, Semenova, Y, Rusina, A, Ryabov, V, Syrkina, A, Demianov, S, Reitblat, O, Artemchuk, A, Efremova, E, Makeeva, E, Menzorov, M, Shutov, A, Klimova, N, Shevchenko, I, Elistratova, O, Kostyuckova, O, Islamov, R, Budyak, V, Ponomareva, E, U Ullah Jan, M Alshehri, A, Sedky, E, Alsihati, Z, Mimish, L, Selem, A, Malik, A, Majeed, O, Altnji, I, Alshehri, M, Aref, A, Alhabib, K, Aldosary, M, Tayel, S, M Abd AlRahman, N Asfina, K, G Abdin Hussein, Butt, M, N Markovic Nikolic, Obradovic, S, Djenic, N, Brajovic, M, Davidovic, A, Romanovic, R, Novakovic, V, Dekleva, M, Spasic, M, Dzudovic, B, Jovic, Z, Cvijanovic, D, Cvijanovic, S, Ivanov, I, Cankovic, M, Jarakovic, M, Kovacevic, M, Trajkovic, M, Mitov, V, Jovic, A, Hudec, M, Gombasky, M, Sumbal, J, Bohm, A, Baranova, E, Kovar, F, Samos, M, Podoba, J, Kurray, P, Obona, T, Remenarikova, A, Kollarik, B, Verebova, D, Kardosova, G, Studencan, M, Alusik, D, Macakova, J, Kozlej, M, Bayes-Genis, A, Sionis, A, C Garcia Garcia, R-M, Lidon, A Duran Cambra, C Labata Salvador, F Rueda Sobella, J Sans Rosello, M Vila Perales, T Oliveras Vila, M Ferrer Massot, Bañeras, J, Lekuona, I, Zugazabeitia, G, Fernandez-Ortiz, A, A Viana Tejedor, Ferrera, C, Alvarez, V, Diaz-Castro, O, M Agra-Bermejo, R, Gonzalez-Cambeiro, C, Gonzalez-Babarro, E, J Domingo-Del Valle, Royuela, N, Burgos, V, Canteli, A, Castrillo, C, Cobo, M, Ruiz, M, Abu-Assi, E, M Garcia Acuna, J, U., Zeymer, P., Ludman, N., Danchin, P., Kala, A. P., Maggioni, F., Weidinger, STEMI Investigators, Ac, and Spaccarotella, C.

Subjects
Registrie, medicine.medical_specialty, Acute coronary syndrome, Registry, medicine.medical_treatment, Cardiology, Reperfusion therapy, Retrospective Studie, Medical, medicine, Humans, cardiovascular diseases, Myocardial infarction, Registries, Disease management (health), Acute Coronary Syndrome, Societies, Medical, Quality of Health Care, Retrospective Studies, Acca, biology, business.industry, Health Policy, Primary percutaneous coronary intervention, Percutaneous coronary intervention, Disease Management, Retrospective cohort study, medicine.disease, biology.organism_classification, primary percutaneous coronary intervention, registry, reperfusion therapy, ST-elevation myocardial infarction, Cardiac surgery, Europe, surgical procedures, operative, Emergency medicine, ST Elevation Myocardial Infarction, Societies, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Aims The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI. Methods and results Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission. Conclusion The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Published
2019

11. Short-term early exposure to thirdhand cigarette smoke increases lung cancer incidence in mice

Author

Hang, B, Wang, Y, Huang, Y, Wang, P, Langley, SA, Bi, L, Sarker, AH, Schick, SF, Havel, C, Jacob, P, Benowitz, N, Destaillats, H, Tang, X, Xia, Y, Jen, KY, Gundel, LA, Mao, JH, and Snijders, AM

Abstract

© 2018 The Author(s). Exposure to thirdhand smoke (THS) is a recently described health concern that arises in many indoor environments. However, the carcinogenic potential of THS, a critical consideration in risk assessment, remains untested. Here we investigated the effects of short-term early exposure to THS on lung carcinogenesis in A/J mice. Forty weeks after THS exposure from 4 to 7 weeks of age, the mice had increased incidence of lung adenocarcinoma, tumor size and, multiplicity, compared with controls. In vitro studies using cultured human lung cancer cells showed that THS exposure induced DNA double-strand breaks and increased cell proliferation and colony formation. RNA sequencing analysis revealed that THS exposure induced endoplasmic reticulum stress and activated p53 signaling. Activation of the p53 pathway was confirmed by an increase in its targets p21 and BAX. These data indicate that early exposure to THS is associated with increased lung cancer risk.

Published
2018

12. Nicotine delivery, retention and pharmacokinetics from various electronic cigarettes

Author

St.Helen, G, Havel, C, Dempsey, DA, Jacob, P, and Benowitz, NL

Abstract

© 2016 Society for the Study of Addiction. Aims: To measure the systemic retention of nicotine, propylene glycol (PG) and vegetable glycerin (VG) in electronic cigarette (e-cigarette) users, and assess the abuse liability of e-cigarettes by characterizing nicotine pharmacokinetics. Design: E-cigarette users recruited over the internet participated in a 1-day research ward study. Subjects took 15 puffs from their usual brand of e-cigarette. Exhaled breath was trapped in gas-washing bottles and blood was sampled before and several times after use. Setting: San Francisco, California, USA. Participants: Thirteen healthy, experienced adult e-cigarette users (six females and seven males). Measurements: Plasma nicotine was analyzed by gas chromatography-mass spectrometry (GC-MS/MS) and nicotine, VG and PG in e-liquids and gas traps were analyzed by LC-MS/MS. Heart rate changes and subjective effects were assessed. Findings: E-cigarettes delivered an average of 1.33 (0.87-1.79) mg [mean and 95% confidence interval (CI)] of nicotine, and 93.8% of the inhaled dose, 1.22 (0.80-1.66) was systemically retained. Average maximum plasma nicotine concentration (Cmax) was 8.4 (5.4-11.5) ng/ml and time of maximal concentration (Tmax) was 2-5 minutes. One participant had Tmaxof 30minutes. 84.4% and 91.7% of VG and PG, respectively, was systemically retained. Heart rate increased by an average of 8.0 beats per minute after 5minutes. Withdrawal and urge to smoke decreased and the e-cigarettes were described as satisfying. Conclusions: E-cigarettes can deliver levels of nicotine that are comparable to or higher than typical tobacco cigarettes, with similar systemic retention. Although the average maximum plasma nicotine concentration in experienced e-cigarette users appears to be generally lower than what has been reported from tobacco cigarette use, the shape of the pharmacokinetic curve is similar, suggesting addictive potential.

Published
2016

13. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest

Author

Holzer, M, Cerchiari, E, Martens, P, Roine, R, Sterz, F, Eisenburger, P, Havel, C, Kofler, J, Oschatz, E, Rohrbach, K, Scheinecker, W, Schorkhuber, W, Behringer, W, Zeiner, A, Valentin, A, De Meyer, M, Takunen, O, Tiainen, M, Hachimi-Idrissi, S, Huyghens, L, Fischer, M, Walger, P, Bartsch, A, Foedisch, M, Bonizzoli, M, Pagni, E, Laggner, AN, Kaff, A, Schneider, B, Mullner, M, Intensive care medicine, ACS - Diabetes & metabolism, AII - Infectious diseases, Faculty of Arts and Philosophy, Staf and Secretary, Internal Medicine Specializations, and Critical Care

Subjects
Resuscitation, medicine.medical_treatment, Targeted temperature management, Return of spontaneous circulation, Hypothermia, Induced, Multicenter trial, medicine, Humans, Single-Blind Method, Brain Diseases, business.industry, Standard treatment, General Medicine, Hypothermia, medicine.disease, Survival Analysis, Cardiopulmonary Resuscitation, Heart Arrest, Logistic Models, Treatment Outcome, Anesthesia, Ventricular fibrillation, Hypoxia-Ischemia, Brain, Ventricular Fibrillation, medicine.symptom, business, Clinical death
Abstract

Background: Cardiac arrest with widespread cerebral ischemia frequently leads to severe neurologic impairment. We studied whether mild systemic hypothermia increases the rate of neurologic recovery after resuscitation from cardiac arrest due to ventricular fibrillation. Methods: In this multicenter trial with blinded assessment of the outcome, patients who had been resuscitated after cardiac arrest due to ventricular fibrillation were randomly assigned to undergo therapeutic hypothermia (target temperature, 32°C to 34°C, measured in the bladder) over a period of 24 hours or to receive standard treatment with normothermia. The primary end point was a favorable neurologic outcome within six months after cardiac arrest; secondary end points were mortality within six months and the rate of complications within seven days. Results: Seventy-five of the 136 patients in the hypothermia group for whom data were available (55 percent) had a favorable neurologic outcome (cerebral-performance category, 1 [good recovery] or 2 [moderate disability]), as compared with 54 of 137 (39 percent) in the normothermia group (risk ratio, 1.40; 95 percent confidence interval, 1.08 to 1.81). Mortality at six months was 41 percent in the hypothermia group (56 of 137 patients died), as compared with 55 percent in the normothermia group (76 of 138 patients; risk ratio, 0.74; 95 percent confidence interval, 0.58 to 0.95). The complication rate did not differ significantly between the two groups. Conclusions: In patients who have been successfully resuscitated after cardiac arrest due to ventricular fibrillation, therapeutic mild hypothermia increased the rate of a favorable neurologic outcome and reduced mortality.

Published
2002

15. Thirdhand smoke causes DNA damage in human cells

Author

Hang, B., primary, Sarker, A. H., additional, Havel, C., additional, Saha, S., additional, Hazra, T. K., additional, Schick, S., additional, Jacob, P., additional, Rehan, V. K., additional, Chenna, A., additional, Sharan, D., additional, Sleiman, M., additional, Destaillats, H., additional, and Gundel, L. A., additional

Published
2013
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21. Vasopressors for shock

Author

Müllner, M, primary, Urbanek, B, additional, Havel, C, additional, Losert, H, additional, and Gamper, G, additional

Published
2002
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23. An electrocardiogram technician improves in-hospital first medical contact-to-electrocardiogram times: a cluster randomized controlled interventional trial.

Author

van Tulder R, Roth D, Weiser C, Heidinger B, Herkner H, Schreiber W, and Havel C

Abstract

BACKGROUND: In the case of chest pain, the current guidelines require electrocardiogram (ECG) recording and patient assessment within 10 minutes upon arrival in the emergency department. METHODS: We investigated the effect of an ECG technician (ECG-T) on in-hospital first medical contact-to-ECG times (iFMC-to-ECG) investigated in a cluster randomized, controlled trial. Allocation of intervention was concealed. Staff satisfaction and feasibility was defined as a secondary outcome. Delays between ECG and the availability of an emergency physician and the assessment of ECG were additionally evaluated. RESULTS: A total of 163 (44 clusters) and 191 (47 clusters) patients were allocated to control and intervention, respectively. Twenty-seven (17%) of 163 patients in the control group vs 110 (58%) of 191 patients in the intervention group received ECG registration within 10 minutes (risk ratio, 3.40 [2.24-5.15]; P < .001). The iFMC-to-ECG time was 23 (95% confidence interval [CI], 20-27) minutes for the control group vs 9 (95% CI, 8-11) minutes for the intervention group (P < .001). Nursing staff judged the feasibility of intervention with a median of 1 (interquartile range [IQR], 1-1 (on a scale of 1 [best] to 5 [worst]), perceived workload alleviation with a median of 1 (IQR, 1-1), and improvement of quality of care with a median of 1 (IQR, 1-2). The ECG-to-EP time was 78 (95% CI, 64-92) seconds, and diagnosis was made within 17 (95% CI, 16-18) seconds. CONCLUSIONS: Delays of iFMC-to-ECG can be effectively addressed by implementation of an ECG-T. The service of an ECG-T is feasible and improves staff satisfaction. Both ECG-to-EP time and ECG assessment constitute no relevant delay. [ABSTRACT FROM AUTHOR]

Published
2012
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24. Safety, feasibility, and hemodynamic and blood flow effects of active compression-decompression of thorax and abdomen in patients with cardiac arrest.

Author

Havel C, Berzlanovich A, Sterz F, Domanovits H, Herkner H, Zeiner A, Behringer W, and Laggner AN

Abstract

OBJECTIVE: During closed chest compression for cardiac arrest, any increase in coronary perfusion pressure accounts for a proportional increase in myocardial blood flow and therefore the resuscitability of the patient. The objectives of this study were to evaluate the safety, feasibility, and hemodynamic effects of phased chest and abdominal compression-decompression and to compare it with mechanical chest compression during cardiopulmonary resuscitation. DESIGN: In this prospective, single-center, phase II study, we compared patients treated with the Datascope Lifestick Resuscitator with patients who had been treated with mechanical precordial compression. SETTING: Emergency department of a tertiary care university hospital. PATIENTS: We included 31 patients with cardiac arrest who had received cardiopulmonary resuscitation in the emergency department. INTERVENTIONS: The Lifestick device was used in 20 patients. In 11 patients, mechanical chest compression with the Thumper device was used as a control intervention. MEASUREMENTS AND MAIN RESULTS: We evaluated the safety, feasibility, and hemodynamic effects of both interventions and observed, with the help of echocardiography, the mechanisms through which blood flow was generated. We found no significant difference between the use of the Lifestick device and standard chest compression with the Thumper device in resuscitations. Most operators regarded the Lifestick as a feasible alternative to the Thumper. We could observe a mean increase in coronary perfusion pressure of 9.33 mm Hg (interquartile range, 1.96-14.36; p = .08) and an increase of end-tidal CO2 of 10 mm Hg (interquartile range, 5-16; p = .003) (1333Pa [interquartile range, 665-2133]) during resuscitation with the Lifestick compared with using the Thumper. CONCLUSION: In this preliminary study, resuscitation with the Lifestick was found to be safe and feasible. The design of the study and small number of patients included in it limit the conclusions about the hemodynamic effects of the Lifestick. [ABSTRACT FROM AUTHOR]

Published
2008
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29. Isopentenoid synthesis in isolated embryonic Drosophila cells. Farnesol catabolism and omega-oxidation.

Author

Gonzalez-Pacanowska, D, Arison, B, Havel, C M, and Watson, J A

Abstract

Kc cells divert minimally 40% of their mevalonate carbon to n-fatty acids and unidentified compounds covalently linked to macromolecules (Havel, C., Rector, E. R., II, and Watson, J. A. (1986) J. Biol. Chem. 261, 10150-10156). Furthermore mevalonate carbon diversion appears to occur at the polyprenyl 1-pyrophosphate level. This report summarizes initial efforts to define the mevalonate carbon diversion pathway. We demonstrate that Kc cell extracts readily metabolize [14C]farnesyl 1-pyrophosphate and [14C]farnesol, via common intermediates, to identical 14C-products. Two of the major 14C-products were identified as trans,trans-3,7,11-trimethyl-2,6,10-dodecatrien-1,12-dioic acid and trans-3,7-dimethyl-2,6-decadien-1,10-dioic acid. Similar acids were also synthesized by supplemented rat liver extracts incubated with [14C]farnesol. We conclude that (a) mevalonate carbon diversion at the level of polyprenyl 1-pyrophosphate is a viable metabolic strategy, (b) polyprenols are oxidized to alpha,omega-prenyl dicarboxylic acids which are catabolized from the omega-terminus, and (c) this metabolic process is not limited to insect cells.

Published
1988
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30. Isoprene synthesis in isolated embryonic Drosophila cells. I. Sterol-deficient eukaryotic cells.

Author

Silberkang, M, Havel, C M, Friend, D S, McCarthy, B J, and Watson, J A

Abstract

Since insects are cholesterol auxotrophs, we analyzed the apparent paradox presented by an established cell line (Kc cells) from Drosophila embryos which grew in media which contained less than 0.05 micrograms/ml of sterols. Fresh Drosophila embryos contained 3.7 micrograms of 3 beta-hydroxysterols/mg of protein; however, Kc cells had maximally 0.50 micrograms of 3 beta-hydroxysterols/mg of protein. Kc cells, grown in media which contained cholesterol, showed the presence of sterol in their plasma and intracellular membranes. Kc cells did not synthesize sterols or any apparent replacement lipophilic molecule. However, two major compounds which comigrated with ubiquinone and dolichol were synthesized from radioactive mevalonate and acetate. Cholesterol incorporation into Kc cell membranes did not significantly alter total phospholipid head or acyl group composition. Similar observations were obtained with Schneider's Drosophila cell line I and a mosquito (Aedes albopictus) cell line. Our results (a) challenged current concepts that sterols or related replacement isopentenoid molecules were required for eukaryotic membrane structure, (b) demonstrated that marked alterations in eukaryotic membrane sterol composition was insufficient to change total phospholipid head and/or acyl group composition, and (c) set the stage for the use of a eukaryotic cell to examine the regulation of 3-hydroxy,3-methylglutaryl coenzyme A reductase activity independent of a requirement for sterol synthesis.

Published
1983
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31. Isoprene synthesis in isolated embryonic Drosophila cells. II. Regulation of 3-hydroxy-3-methylglutaryl coenzyme A reductase activity.

Author

Brown, K, Havel, C M, and Watson, J A

Abstract

We used an established Drosophila cell line (Kc cells), which neither synthesized nor required cholesterol for growth, to determine if sterol and nonsterol modulators of vertebrate 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity were also active in this biological system. Drosophila HMG-CoA reductase was membrane-bound and required NADPH for catalysis. In contrast to the vertebrate enzyme, Kc cell HMG-CoA reductase activity was not modulated by cholesterol (10 micrograms/ml), human low density lipoprotein (83 micrograms of cholesterol/ml), or oxygenated sterols (5-10 micrograms/ml). However, mevalonate caused a rapid strong suppression of Kc HMG-CoA reductase activity; 18 microM R-mevalonate produced 50% suppression of the enzyme within 24 h. Compactin, a competitive inhibitor, decreased HMG-CoA reductase activity in Drosophila embryo cell-free extracts with an apparent Ki of 1.0 nM. Kc cells, grown in the presence of compactin, had a HMG-CoA reductase specific activity 5- to 10-fold higher than untreated cells. Mevalonate blocked this increase. We have concluded that HMG-CoA reductase activity in Kc cells is (a) not responsive to feedback inhibition by sterols, and (b) is controlled by a fundamental sterol-independent regulatory process. The signal for modulation of HMG-CoA reductase activity may be mevalonate and/or its magnitude conversion to a nonsterol isopentenoid precursor and/or end product. These observations may have broader validity, not only for other insect cells, but for eukaryotic cells in general.

Published
1983
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32. Isoprenoid synthesis in isolated embryonic Drosophila cells. Sterol-independent regulatory signal molecule is distal to isopentenyl 1-pyrophosphates.

Author

Watson, J A, Havel, C M, Lobos, D V, Baker, F C, and Morrow, C J

Abstract

Embryonic Drosophila cells (Kc cells) were used to further characterize sterol-independent modulation of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity. 3-Methyl-3-5-dihydroxyvalerate (mevalonate), 3-fluoromethyl-3,5-dihydroxyvalerate (fluoromevalonate), and 3-ethyl-3,5-dihydroxyvalerate (homomevalonate) were tested as modulators. Although mevalonate caused a rapid, reversible suppression of reductase activity, fluoro- and homomevalonate increased activity; fluoromevalonate was more effective than homomevalonate. Mevalonate, added simultaneously with fluoromevalonate, blocked the analogue's effect on Kc cell reductase activity. However, mevalonate did not suppress an established fluoromevalonate increase in HMG-CoA reductase activity. Fluoromevalonate blocked [1-14C, 5-3H]mevalonate conversion to 14CO2- and 3H-labeled lipids and [3H] mevalonate 5-pyrophosphate accumulated. Neither protein nor RNA synthesis were required for mevalonate-mediated suppression of reductase activity. However, fluoromevalonate's effect on reductase activity required protein synthesis. Furthermore, in the absence of protein synthesis, fluoromevalonate-stabilized Kc cell HMG-CoA reductase activity. We have concluded that mevalonate, fluoromevalonate, homomevalonate, and compactin (mevinolin) modulated HMG-CoA reductase activity because they altered isoprenoid carbon flow to a post-isopentenyl 1-pyrophosphate regulatory, signal molecule.

Published
1985
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33. Isopentenoid synthesis in isolated embryonic Drosophila cells. Possible regulation of 3-hydroxy-3-methylglutaryl coenzyme A reductase activity by shunted mevalonate carbon.

Author

Havel, C, Rector, E R, and Watson, J A

Abstract

Our previous studies (Watson, J. A., Havel, C. M., Lobos, D. V., Baker, F. C., and Morrow, C. J. (1985) J. Biol. Chem. 260, 14083-14091) suggested that a matabolite, distal to isopentenyl 1-pyrophospate (IPP), served as a regulatory signal for sterol-independent modulation of Kc cell 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity. This report summarizes efforts to localize the potential source of the post-IPP regulatory signal molecule. We found no direct correlation between mevalonate-mediated suppression of Kc cell HMG-CoA reductase activity and the rates of [1-14C]-, [3-14C]-, [5-14C]-, or [5-3H]mevalonate incorporation into either carbon dioxide, neutral lipids, water, or water-soluble isopentenoid pyrophosphate esters. [1-14C]Mevalonate's rate of conversion to 14CO2 (a measure of total isopentenyl 1-pyrophosphate synthesis) was minimally 5-fold greater than that for neutral isopentenoid lipid synthesis (measured with either [5-3H]-, [3-14C]-, or [5-14C]mevalonate). However, [5-3H]mevalonate's rate of conversion into [3H]H2O (measure of shunted mevalonate carbon) was equivalent or greater than that measured for neutral isopentenoid lipid synthesis. [5-14C]Mevalonate radioactivity was incorporated into macromolecules and n-fatty acids. Kc cell extracts (100,000 X g supernatant fluid) readily oxidized alcohols with the following activity sequence: geraniol = nerol greater than farnesol = dimethylallyl alcohol greater than geranylgeraniol, isopentenyl alcohol, and allyl alcohol. Oxidation required NAD, and ethanol was not a substrate. We conclude that (a) Kc cells shunted a significant fraction (greater than or equal to 40%) of their post-IPP carbon to prenols for oxidative catabolism and (b) that shunted mevalonate carbon may play a significant role in the mevalonate-mediated regulation of Kc cell HMG-CoA reductase activity.

Published
1986
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34. Isoprenoid synthesis in Halobacterium halobium. Modulation of 3-hydroxy-3-methylglutaryl coenzyme a concentration in response to mevalonate availability.

Author

Cabrera, J A, Bolds, J, Shields, P E, Havel, C M, and Watson, J A

Abstract

Halobacterium halobium was evaluated as a potentially simpler biological model to study the regulation of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity (content) in response to mevalonate availability. H. halobium's HMG-CoA reductase was soluble and required NADPH as its reduced coenzyme. Maximum HMG-CoA reductase activity (4-10 nmol/min/mg of soluble protein) was obtained in buffers which contained 3.5 M KCl. Mevinolin (a) blocked growth of H. halobium, (b) was a competitive inhibitor of HMG-CoA reductase (Ki = 20 nM), (c) did not cause the paradoxical increase in assayable reductase activity, as reported for eukaryotic cells, and (d) caused a rapid (within 30 min) 8-12-fold accumulation of intracellular HMG-CoA. Mevalonate blocked and reversed mevinolin-mediated HMG-CoA accumulation. Although mevinolin-treated cell's growth was restored by mevalonate, HMG-CoA reductase's activity was not. Thus, H. halobium is a unique biological model which allows one to study the regulation of intracellular HMG-CoA concentration and not HMG-CoA reductase activity (content) in response to mevalonate availability.

Published
1986
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36. Scrime studio report

Author

Desainte-Catherine, M., Pierre Hanna, Havel, C., Kurtag, G., Lagrange, M., Marchand, S., Nicouleau, E., Raspaud, M., Robine, M., Strandh, R., Laboratoire Bordelais de Recherche en Informatique (LaBRI), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Électronique, Informatique et Radiocommunications de Bordeaux (ENSEIRB), and Hanna, Pierre

Subjects
[INFO.INFO-SD]Computer Science [cs]/Sound [cs.SD], ComputingMilieux_PERSONALCOMPUTING, [INFO.INFO-SD] Computer Science [cs]/Sound [cs.SD], GeneralLiterature_MISCELLANEOUS, ComputingMilieux_MISCELLANEOUS
Abstract

International audience; SCRIME Studio Report

42. Hypothermia for neuroprotection in adults after cardiac arrest.

Author

Arrich J, Schütz N, Oppenauer J, Vendt J, Holzer M, Havel C, and Herkner H

Subjects
Adult, Humans, Neuroprotection, Hypokalemia complications, Hypokalemia therapy, Heart Arrest therapy, Pneumonia therapy, Hypothermia, Induced adverse effects, Hypothermia, Induced methods
Abstract

Background: Good neurological outcome after cardiac arrest is difficult to achieve. Interventions during the resuscitation phase and treatment within the first hours after the event are critical for a favourable prognosis. Experimental evidence suggests that therapeutic hypothermia is beneficial, and several clinical studies on this topic have been published. This review was originally published in 2009; updated versions were published in 2012 and 2016., Objectives: To evaluate the benefits and harms of therapeutic hypothermia after cardiac arrest in adults compared to standard treatment., Search Methods: We used standard, extensive Cochrane search methods. The latest search date was 30 September 2022., Selection Criteria: We included randomised controlled trials (RCTs) and quasi-RCTs in adults comparing therapeutic hypothermia after cardiac arrest with standard treatment (control). We included studies with adults cooled by any method, applied within six hours of cardiac arrest, to target body temperatures of 32 °C to 34 °C. Good neurological outcome was defined as no or only minor brain damage allowing people to live an independent life., Data Collection and Analysis: We used standard Cochrane methods. Our primary outcome was 1. neurological recovery. Our secondary outcomes were 2. survival to hospital discharge, 3. quality of life, 4. cost-effectiveness and 5., Adverse Events: We used GRADE to assess certainty., Main Results: We found 12 studies with 3956 participants reporting the effects of therapeutic hypothermia on neurological outcome or survival. There were some concerns about the quality of all the studies, and two studies had high risk of bias overall. When we compared conventional cooling methods versus any type of standard treatment (including a body temperature of 36 °C), we found that participants in the therapeutic hypothermia group were more likely to reach a favourable neurological outcome (risk ratio (RR) 1.41, 95% confidence interval (CI) 1.12 to 1.76; 11 studies, 3914 participants). The certainty of the evidence was low. When we compared therapeutic hypothermia with fever prevention or no cooling, we found that participants in the therapeutic hypothermia group were more likely to reach a favourable neurological outcome (RR 1.60, 95% CI 1.15 to 2.23; 8 studies, 2870 participants). The certainty of the evidence was low. When we compared therapeutic hypothermia methods with temperature management at 36 °C, there was no evidence of a difference between groups (RR 1.78, 95% CI 0.70 to 4.53; 3 studies; 1044 participants). The certainty of the evidence was low. Across all studies, the incidence of pneumonia, hypokalaemia and severe arrhythmia was increased amongst participants receiving therapeutic hypothermia (pneumonia: RR 1.09, 95% CI 1.00 to 1.18; 4 trials, 3634 participants; hypokalaemia: RR 1.38, 95% CI 1.03 to 1.84; 2 trials, 975 participants; severe arrhythmia: RR 1.40, 95% CI 1.19 to 1.64; 3 trials, 2163 participants). The certainty of the evidence was low (pneumonia, severe arrhythmia) to very low (hypokalaemia). There were no differences in other reported adverse events between groups., Authors' Conclusions: Current evidence suggests that conventional cooling methods to induce therapeutic hypothermia may improve neurological outcomes after cardiac arrest. We obtained available evidence from studies in which the target temperature was 32 °C to 34 °C., (Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)

Published
2023
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44. Active expectancy as alternative to treatment for cervical intraepithelial neoplasia grade 2 in women aged 25 to 30 years: ExCIN2-a prospective clinical multicenter cohort study.

Author

Kylebäck K, Ekeryd-Andalen A, Greppe C, Björkenfeldt Havel C, Zhang C, and Strander B

Abstract

Background: The management of cervical intraepithelial neoplasia grade 2 is a clinical dilemma. Cervical intraepithelial neoplasia grade 3 is considered a cancer precursor and is always treated with excision. Most of the cervical intraepithelial neoplasia grade 1 cases regress spontaneously, and it is internationally mostly monitored with expectant management. Surgical treatment of cervical intraepithelial neoplasia entails increased risk of preterm birth in future pregnancies. Cervical intraepithelial neoplasia grade 2 in women aged under 25 years is quite well-studied; the regression rate is high and the cervical cancer risk is low. Cervical intraepithelial neoplasia grade 2 in women aged 25 years and above, in whom the risk of occult cancer is higher, has been less studied., Objective: This study aimed to evaluate the natural course, over 2 years, of untreated cervical intraepithelial neoplasia grade 2 in women aged 25 to 30 years and its association with human papillomavirus 16., Study Design: The study was conducted as a prospective longitudinal multicenter clinical study during February 2017 to June 2021 at 5 colposcopy clinics managing referrals after abnormal cervical screening in Region Västra Götaland, Sweden. The per protocol group comprised 127 women, aged 25 to 30 years, with fully visible squamocolumnar junction and histologically verified cervical intraepithelial neoplasia grade 2. The patients were followed up for 2 years with colposcopy, cytology, human papillomavirus tests, and at least 2 cervical biopsies every 6 months until progression or regression. The main outcome measures were the rates of regression of cervical intraepithelial neoplasia grade 2 at 6, 12, 18, and 24 months in cases with human papillomavirus 16 and those without human papillomavirus 16. The secondary outcomes were persistence and progression., Results: In the per protocol analysis, partial or total regression during the 2-year period was found in 72% of patients (95% confidence interval, 63-79). In patients with human papillomavirus 16, the regression rate was 51% (95% confidence interval, 36-66) and the progression rate was 47% (95% confidence interval, 32-62). In the human papillomavirus-non-16 group, 83% (95% confidence interval, 73-90) regressed and 16% (95% confidence interval, 9-26) progressed. Most of the regression and progression in both the groups occurred within 15 months. The difference in regression between human papillomavirus 16 and human papillomavirus-non-16 cases was statistically significant (P value=.0001), as was the difference in progression (P=.0002)., Conclusion: The regression rate of cervical intraepithelial neoplasia grade 2 is high, and human papillomavirus 16 is a strong determinant of the natural course. Patients aged 25 to 30 years with a fully visible squamocolumnar junction and without human papillomavirus 16 should generally be recommended active surveillance for 15 months, whereas immediate treatment should be considered in cases with human papillomavirus 16., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2022
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45. Impact of more conservative European Society of Cardiology guidelines on the management of patients with acute chest pain.

Author

Kienbacher CL, Fuhrmann V, van Tulder R, Havel C, Schreiber W, Rasoul-Rockenschaub S, Wrba T, Herkner H, Laggner AN, and Roth D

Subjects
Adult, Aged, Biomarkers, Chest Pain diagnosis, Chest Pain etiology, Chest Pain therapy, Emergency Service, Hospital, Female, Humans, Male, Middle Aged, Troponin T, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome therapy, Cardiology
Abstract

Objective: Early diagnosis or rule-out of acute coronary syndrome (ACS) is a key competence of emergency medicine. Changes in the NSTE-ACS guidelines of the European Society of Cardiology (ESC) in 2015 and 2020 both warranted a henceforth more conservative approach regarding high-sensitivity troponin t (hsTnt) testing. We aimed to assess the impact of more conservative guidelines on the frequency of early rule-out and prolonged observation with repeated hsTnt testing at a high-volume tertiary care emergency department., Patients and Methods: We conducted a pre- and post-changeover analysis 3 months before and 3 months after transition from less (hsTnt cut-off 30 ng/L, 3-hour rule-out) to more conservative (hsTnt cut-off 14 ng/L, 1-hour rule-out) guidelines in 2015, comparing proportions of patients requiring repeated testing., Results: We included 5442 cases of symptoms suspicious of acute cardiac origin (3451 before, 1991 after, 2370 (44%) female, age 55 (SD 19) years). The proportion of patients fulfilling early-rule out criteria decreased from 68% (2348 patients) before to 60% (1195 patients) with the 2015 guidelines (P < .01). Those requiring repeated testing significantly (P < .01) increased from 22% (743 patients) to 25% (494 patients). Positive results in repeated testing significantly (P = .02) decreased from 43% (320 patients) to 37% (181 patients). Invasive diagnostics were performed in 91 patients (2.6%) before and in 75 patients (3.8%) after (P = .02) the guideline revision., Conclusion: The implementation of the more conservative 2015 ESC guidelines led to a minor rise in prolonged observations because of an increase in negative repeated testing and to an increase in invasive procedures., (© 2021 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd.)

Published
2021
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46. Biomarkers of Exposure for Dual Use of Electronic Cigarettes and Combustible Cigarettes: Nicotelline, NNAL, and Total Nicotine Equivalents.

Author

Jacob P, St Helen G, Yu L, Nardone N, Havel C, Cheung P, and Benowitz NL

Subjects
Female, Humans, Male, Biomarkers urine, Carcinogens analysis, Electronic Nicotine Delivery Systems statistics & numerical data, Environmental Exposure adverse effects, Nicotine urine, Nitrosamines urine, Tobacco Smoking adverse effects
Abstract

Introduction: Dual use of electronic cigarettes (e-cigarettes) and combustible cigarettes is a major public health issue. It is generally accepted that exclusive e-cigarette use is less harmful than exclusive combustible cigarette use, but most e-cigarette users continue to smoke combustible cigarettes as well. To what extent the use of e-cigarettes reduces harm in people who continue to smoke combustible cigarettes has been debated. The aim of this study was to explore the utility of biomarkers as measures of dual use., Methods: In two human studies of participants who used e-cigarettes only or both combustible cigarettes and e-cigarettes, we measured urine concentrations of the metabolites of nicotine (total nicotine equivalents) as well as two biomarkers of tobacco exposure: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a tobacco-specific carcinogen metabolite, and nicotelline, a tobacco alkaloid not found in significant concentrations in e-cigarette products., Results: The presence of nicotine metabolites indicates either e-cigarette or combustible cigarette use. Nicotelline (half-life of 2-3 hours) indicates recent combustible cigarette use and NNAL (half-life of 10 days or more), indicates combustible cigarette use occurring within several weeks prior to sample collection., Conclusions: Nicotelline and NNAL are useful biomarkers for combustible tobacco use in users e-cigarettes. The application of these biomarkers provides a tool to help assess whether, or to what extent, dual use of e-cigarettes and combustible cigarettes reduces harm compared to sole use of combustible cigarettes. These biomarkers can also verify exclusive use of e-cigarettes over short (24 hour) or long (several week) time periods., Implications: To what extent dual use of e-cigarettes and combustible cigarettes reduce harm compared to smoking combustible cigarettes only is of considerable public health interest. We show that the levels of the minor tobacco alkaloid nicotelline and the nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) are extremely low in electronic cigarette fluids. The urine biomarkers nicotelline and the NNK metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) are indicative of cigarette smoking and can be used to assess recent and past smoking in dual users., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.)

Published
2020
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47. Differences in nicotine intake and effects from electronic and combustible cigarettes among dual users.

Author

St Helen G, Nardone N, Addo N, Dempsey D, Havel C, Jacob P 3rd, and Benowitz NL

Subjects
Adult, Affect, Craving, Cross-Over Studies, Female, Humans, Male, San Francisco, Substance Withdrawal Syndrome, Electronic Nicotine Delivery Systems, Nicotine blood, Nicotine pharmacokinetics, Smoking psychology, Tobacco Products
Abstract

Aim: To describe systemic nicotine exposure and subjective effects of electronic cigarettes (e-cigarettes) in people who use both e-cigarettes and cigarettes (dual users), including within-subject comparisons of e-cigarette and cigarette use., Design: Two-arm, counterbalanced cross-over study. Participants used their usual brand of e-cigarette or cigarette during a standardized session in a 2-week study., Setting: Hospital research ward, San Francisco, CA, USA., Participants: Thirty-six healthy (eight women, 28 men) participants., Measurements: Plasma nicotine was analyzed by gas chromatography-tandem mass spectrometry; nicotine withdrawal, urge to smoke and vape, affective states, craving, satisfaction and psychological reward were measured by standardized questionnaires., Findings: Compared with cigarettes, average maximum plasma nicotine concentration (C max ) was lower with e-cigarettes [6.1 ± 5.5 ng/ml, mean ± standard deviation (SD) versus 20.2 ± 11.1 ng/ml, P < 0.001] and time of maximal concentration (T max ) was longer (6.5 ± 5.4 versus 2.7 ± 2.4 minutes, P < 0.001). Use of both products resulted in a reduction in the severity of withdrawal symptoms, negative affect and urge to use either product. E-cigarettes were less rewarding and satisfying and reduced craving to a lesser degree than cigarettes. We were not able to detect any differences in withdrawal symptoms, affective states and urge to smoke cigarettes between e-cigarette and cigarette use., Conclusion: Systemic nicotine exposure was, on average, lower with single use of e-cigarettes compared with cigarettes, and e-cigarettes were judged to be less satisfying and rewarding and reduced craving less than cigarettes., (© 2020 Society for the Study of Addiction.)

Published
2020
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48. Impact of an Intensive Care Information System on the Length of Stay of Surgical Intensive Care Unit Patients: Observational Study.

Author

Havel C, Selim J, Besnier E, Gouin P, Veber B, and Clavier T

Abstract

Background: The implementation of computerized monitoring and prescription systems in intensive care has proven to be reliable in reducing the rate of medical error and increasing patient care time. They also showed a benefit in reducing the length of stay in the intensive care unit (ICU). However, this benefit has been poorly studied, with conflicting results., Objective: This study aimed to show the impact of computerization on the length of stay in ICUs., Methods: This was a before-after retrospective observational study. All patients admitted in the surgical ICU at the Rouen University Hospital were included, from June 1, 2015, to June 1, 2016, for the before period and from August 1, 2016, to August 1, 2017, for the after period. The data were extracted from the hospitalization report and included the following: epidemiological data (age, sex, weight, height, and body mass index), reason for ICU admission, severity score at admission, length of stay and mortality in ICU, mortality in hospital, use of life support during the stay, and ICU readmission during the same hospital stay. The consumption of antibiotics, biological analyses, and the number of chest x-rays during the stay were also analyzed., Results: A total of 1600 patients were included: 839 in the before period and 761 in the after period. Only the severity score Simplified Acute Physiology Score II was significantly higher in the postcomputerization period (38 [SD 20] vs 40 [SD 21]; P<.05). There was no significant difference in terms of length of stay in ICU, mortality, or readmission during the stay. There was a significant increase in the volume of prescribed biological analyses (5416 [5192-5956] biological exams prescribed in the period before Intellispace Critical Care and Anesthesia [ICCA] vs 6374 [6013-6986] biological exams prescribed in the period after ICCA; P=.002), with an increase in the total cost of biological analyses, to the detriment of hematological and biochemical blood tests. There was also a trend toward reduction in the average number of chest x-rays, but this was not significant (0.55 [SD 0.39] chest x-rays per day per patient before computerization vs 0.51 [SD 0.37] chest x-rays per day per patient after computerization; P=.05). On the other hand, there was a decrease in antibiotic prescribing in terms of cost per patient after the implementation of computerization (€149.50 [$164 USD] per patient before computerization vs €105.40 [$155 USD] per patient after computerization)., Conclusions: Implementation of an intensive care information system at the Rouen University Hospital in June 2016 did not have an impact on reducing the length of stay., (©Camille Havel, Jean Selim, Emmanuel Besnier, Philippe Gouin, Benoit Veber, Thomas Clavier. Originally published in JMIR Perioperative Medicine (http://periop.jmir.org), 04.09.2019.)

Published
2019
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49. Butanediol Conversion to Gamma-Hydroxybutyrate Markedly Reduced by the Alcohol Dehydrogenase Blocker Fomepizole.

Author

Liakoni E, Gugelmann H, Dempsey DA, Wiegand TJ, Havel C, Jacob P, and Benowitz NL

Subjects
Adult, Cross-Over Studies, Double-Blind Method, Drug Monitoring methods, Enzyme Inhibitors administration & dosage, Enzyme Inhibitors pharmacokinetics, Healthy Volunteers, Humans, Male, Metabolic Clearance Rate drug effects, Psychotropic Drugs pharmacokinetics, Solvents pharmacokinetics, Treatment Outcome, Alcohol Dehydrogenase antagonists & inhibitors, Butylene Glycols pharmacokinetics, Fomepizole administration & dosage, Fomepizole pharmacokinetics, Sodium Oxybate pharmacokinetics
Abstract

1,4-Butanediol (BDO)-used as solvent and abused for its euphoric effects-is converted to gamma-hydroxybutyrate (GHB) by the enzyme alcohol dehydrogenase. This double-blind, placebo-controlled crossover study with six healthy volunteers is the first to date investigating the role of the ADH inhibitor fomepizole (4-methylpyrazole (4MP)) in moderating this conversion in humans. Participants received on two different days either intravenous placebo or 15 mg/kg 4MP followed by oral administration of 25 mg/kg BDO. Pretreatment with 4MP resulted in significantly higher BDO maximal plasma concentration (P = 0.001) and area under the concentration-time curve (AUC; P = 0.028), confirming that ADH is the primary pathway for the conversion of BDO to GHB in humans. With 4MP, the mean arterial pressure was significantly lower at 105 minutes compared to baseline (P = 0.003), indicating that blood pressure lowering, observed not with a temporal relationship to 4MP administration but after the maximum BDO concentration was reached, may be an intrinsic effect of BDO., (© 2018 The Authors Clinical Pharmacology & Therapeutics © 2018 American Society for Clinical Pharmacology and Therapeutics.)

Published
2019
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50. Effect of γ-hydroxybutyrate (GHB) on driving as measured by a driving simulator.

Author

Liakoni E, Dempsey DA, Meyers M, Murphy NG, Fiorentino D, Havel C, Haller C, and Benowitz NL

Subjects
Adjuvants, Anesthesia adverse effects, Adjuvants, Anesthesia blood, Administration, Oral, Adult, Cross-Over Studies, Double-Blind Method, Female, Humans, Male, Narcolepsy blood, Narcolepsy drug therapy, Sodium Oxybate adverse effects, Sodium Oxybate blood, Adjuvants, Anesthesia administration & dosage, Automobile Driving psychology, Computer Simulation, Driving Under the Influence psychology, Sodium Oxybate administration & dosage
Abstract

Rationale: Gamma-hydroxybutyrate acid (GHB), a GABA B receptor agonist approved for treatment of narcolepsy, impairs driving ability, but little is known about doses and plasma concentrations associated with impairment and time course of recovery., Objective: To assess effects of oral GHB (Xyrem®) upon driving as measured by a driving simulator, and to determine plasma concentrations associated with impairment and the time course of recovery., Methods: Randomized, double-blind, two-arm crossover study, during which 16 participants received GHB 50 mg/kg orally or placebo. GHB blood samples were collected prior to and at 1, 3, and 6 h post dosing. Driving simulator sessions occurred immediately after blood sampling., Results: Plasma GHB was not detectable at baseline or 6 h post dosing. Median GHB concentrations at 1 and 3 h were 83.1 mg/L (range 54-110) and 24.4 mg/L (range 7.2-49.7), respectively. Compared to placebo, at 1 h post GHB dosing, significant differences were seen for the life-threatening outcome collisions (p < 0.001) and off-road accidents (p = 0.018). Although driving was not faster, there was significantly more weaving and erratic driving with GHB as measured by speed deviation (p = 0.002) and lane position deviation (p = 0.004). No significant impairment regarding driving outcomes was found in the GHB group at 3 and 6 h post dose., Conclusion: GHB in doses used to treat narcolepsy resulted in severe driving impairment at 1 h post dosing. After 3 to 6 h, there was full recovery indicating that safe driving is expected the next morning after bedtime therapeutic GHB use in the absence of other substances.

Published
2018
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