Is the GraftConnector a valid alternative to running suture in end-to-side coronary arteries anastomoses?

BACKGROUND: An animal study was carried out to compare long-term patency rates of coronary anastomoses performed with the GraftConnector versus running suture technique. METHODS: 10 sheep, 45 to 55 kg, underwent off-pump coronary artery bypass grafting (right internal mammary artery to left anterior descending artery). In 5 animals, the anastomosis was performed with a GraftConnector and in 5 animals with 7-0 running suture. Intraoperative fluoroscopy and a fluoroscopic control at 6 months were performed. After 6 months, the animals were sacrificed and the anastomoses were examined histologically. RESULTS: All animals survived at 6 months with 100% anastomosis patency rates in both groups. In the GraftConnector group, the anastomosis diameter at 6 months fluoroscopy was 118% of native left anterior descending artery versus 97% of the control group. Luminal anastomotic width at histology was 1.7 +/- 0.2 mm in the device group versus 1.6 +/- 0.1 mm in the control group. Mean intimal hyperplasia thickness was 0.21 +/- 0.1 mm in the device group versus 0.01 mm in the control group. CONCLUSIONS: The GraftConnector provides a consistent and reproducible coronary artery anastomosis and reduces technical demand and manual dexterity in coronary operations. Long-term results demonstrate that off-pump coronary artery bypass grafting performed with the GraftConnector had the same patency rate and luminal width as those performed with running suture.

Correlating the end-Triassic mass extinction and flood basalt volcanism at the 100 ka level

New high-precision U/Pb geochronology from volcanic ashes shows that the Triassic-Jurassic boundary and end-Triassic biological crisis from two independent marine stratigraphic sections correlate with the onset of terrestrial flood volcanism in the Central Atlantic Magmatic Province to <150 ka. This narrows the correlation between volcanism and mass extinction by an order of magnitude for any such catastrophe in Earth history. We also show that a concomitant drop and rise in sea level and negative delta C-13 spike in the very latest Triassic occurred locally in <290 ka. Such rapid sea-level fluctuations on a global scale require that global cooling and glaciation were closely associated with the end-Triassic extinction and potentially driven by Central Atlantic Magmatic Province volcanism.

End of life care standards for people with dementia

End of life care standards for people with dementiaThis project, funded under Call 1 of CARDI’s Grants Programme and led by Dr Suzanne Cahill, School of Social Work and Social Policy, Trinity College Dublin, highlights the need for guaranteed standards of care for older people with dementia at the end of their lives.The research recommends the introduction of standards as a matter of urgency because of the huge increases in the number of people affected, and the number likely to be affected in the future. It is estimated that the number of people with dementia in the Republic of Ireland will rise from 44,000 to 104,000 by 2036 and in Northern Ireland from 16,000 to 47,000 in 2051.The research draws attention to the importance of agreeing new standards in Ireland, North and South, by proposing guidelines to develop policies and practices that can reflect the best available throughout the world.Research Team:•������ Dr Suzanne Cahill, School of Social Work and Social Policy, Trinity College Dublin•������ Ms Daphne Doran, Quality Initiatives, Belfast•������ Dr Max Watson, University of Ulster and Northern Ireland HospiceResearch briefingFull report��

Medication use in patients with end of life dementia:Presentations

CARDI recently launched a new report (Friday 6 July 2012) which finds considerable uncertainty and variation in the medicines doctors say they would prescribe for patients with dementia at the end of life when presented with clinical scenarios. The all-Ireland research, led by a team at QUB, finds evidence that GPs and hospital physicians indicate they would continue with dementia medications and statins and actively prescribe antibiotics when there is limited evidence of benefits to patients with dementia at end of life.Links to presentations are below:Assessment of factors which influence decision-making regarding medication use in patients with dementia at the end of life: Prof Carmel HughesMedication use in patients with end of life dementia: Dr Shaun O'Keefe

CARDI Research Brief: Medication use in patients with dementia at the end of life

��Palliative care and medication use are important issues in dealing with end-of-life stage dementia. As research into palliative care for patients with advanced dementia has been limited to date, CARDI funded a project, led by Dr. Carole Parsons of Queen’s University Belfast, as part of its grants programme. This project aimed to evaluate the extent to which patient-related factors influenced clinical decision-making with regard to medication use in patients with endstagedementia. This research brief presents a summary of the findings from the full report, Assessment of factors which influence physician decisionmaking regarding medication use in patients with dementia at the end of life (Parsons, et al., 2012).Read the research brief here: Medication use in patients with dementia at the end of lifeRead the press release here

Guidance on starting end of life care conversations with people affected by dementia

Dementia UK, as a member of the Dying Matters coalition, contributed to a new leaflet that discusses how to begin conversations around end of life care for people with dementia. Aimed at GPs and families who have recently received a dementia diagnosis, this leaflet provides at-a-glance information about having this very necessary conversation and includes information about when to talk about it and tips about what to say. Download the leaflet

Bentho-planktonic evidence from the Austrian Alps for a decline in sea-surface carbonate production at the end of the Triassic

A high-resolution micropalaeontological study, combined with geochemical and sedimentological analyses was performed on the Tiefengraben, Schlossgraben and Eiberg sections (Austrian Alps) in order to characterize sea-surface carbonate production during the end-Triassic crisis. At the end-Rhaetian, the dominant calcareous nannofossil Prinsiosphaera triassica shows a decrease in abundance and size and this is correlated with a increase in delta O-18 and a gradual decline in delta C-13(carb) values. Simultaneously, benthic foraminiferal assemblages show a decrease in diversity and abundance of calcareous taxa and a dominance of infaunal agglutinated taxa. The smaller size of calcareous nannofossils disturbed the vertical export balance of the biological carbon pump towards the sea-bottom, resulting in changes in feeding strategies within the benthic foraminiferal assemblages from deposit feeders to detritus feeders and bacterial scavengers. These micropalaeontological data combined with geochemical proxies suggest that changes in seawater chemistry and/or cooling episodes might have occurred in the latest Triassic, leading to a marked decrease of carbonate production. This in turn culminated in the quasi-absence of calcareous nannofossils and benthic foraminifers in the latest Triassic. The aftermath (latest Triassic earliest Jurassic) was characterised by abundance peaks of ``disaster'' epifaunal agglutinated foraminifera Trochammina on the sea-floor. Central Atlantic Magmatic Province (CAMP) paroxysmal activity, superimposed on a major worldwide regressive phase, is assumed to be responsible for a deterioration in marine palaeoenvironments. CAMP sulfuric emissions might have been the trigger for cooling episodes and seawater acidification leading to disturbance of the surface carbonate production at the very end-Triassic.

Dynamic responses of oxygen uptake at the onset and end of moderate and heavy exercise in trained subjects.

Inconsistencies about dynamic asymmetry between the on- and off-transient responses in VO2 are found in the literature. Therefore the purpose of this study was to examine VO2 on- and off-transients during moderate- and heavy-intensity cycling exercise in trained subjects. Ten men underwent an initial incremental test for the estimation of ventilatory threshold (VT) and, on different days, two bouts of square-wave exercise at moderate (<VT) and heavy (>VT) intensities. VO2 kinetics in exercise and recovery were better described by a single exponential model (<VT), or by a double exponential with two time delays (>VT). For moderate exercise, we found a symmetry of VO2 kinetics between the on- and off-transients (i.e., fundamental component), consistent with a system manifesting linear control dynamics. For heavy exercise, a slow component superimposed on the fundamental phase was expressed in both the exercise and recovery, with similar parameter estimates. But the on-transient values of the time constant were appreciably faster than the associated off-transient, and independent of the work rate imposed (<VT and >VT). Our results do not support a dynamically linear system model of VO2 during cycling exercise in the heavy-intensity domain.

Dynamic responses of O2 uptake at the onset and end of exercise in trained subjects.

Inconsistencies about dynamic asymmetry between the on- and off-transient responses in .VO2 are found in the literature. Therefore the purpose of this study was to examine .VO2on- and off-transients during moderate- and heavy-intensity cycling exercise in trained subjects. Ten men underwent an initial incremental test for the estimation of ventilatory threshold (VT) and, on different days, two bouts of square-wave exercise at moderate (<VT) and heavy (>VT) intensities. .VO2 kinetics in exercise and recovery were better described by a single exponential model (<VT) or by a double exponential with two time delays (>VT). For moderate exercise, we found a symmetry of .VO2 kinetics between the on- and off-transients (i.e., fundamental component), consistent with a system manifesting linear control dynamics. For heavy exercise, a slow component superimposed on the fundamental phase was expressed in both the exercise and recovery, with similar parameter estimates. But the on-transient values of the time constant were appreciably faster than the associated off-transient, and independent of the work rate imposed (<VT and >VT). Our results do not support a dynamically linear system model of .VO2 during cycling exercise in the heavy-intensity domain.

HPV vaccination: the beginning of the end of cervical cancer? - A Review

Human papillomavirus (HPV) is responsible for all cases of cervical cancer, as well as a great percentage of other anogenital tumors and oropharyngeal tumors. Since the main etiologic factor for these diseases is a virus, prophylactic measures are the best way to reduce the burden caused by the infection and associated disease. This review brings up to date information on the two commercially available prophylactic HPV vaccines against HPV, as well as presenting the ongoing research on HPV peptide, protein and dendritic cell based therapeutic vaccines.