Current opinion in anaesthesiology
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Predatory publishing poses a serious educational end ethical threat to the credibility of science. The aim of this review is to discuss the main features of this deceptive open-access model, its potential consequences and relevance for the whole scientific community. ⋯ Predatory journals and conferences are two sides of the same coin. As here reviewed, their deceptive practices have negative implications for scientists and clinicians, both educational and ethical. These range from publication of experimental data that are unreliable and poorly verified to inflated curricula and 'doped' academic careers. Because clinical practice is heavily based on research data, a solution is needed to ultimately ensure patients' safety.
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Curr Opin Anaesthesiol · Apr 2020
ReviewOld, older, the oldest: red blood cell storage and the potential harm of using older red blood cell concentrates.
Over the last decades, clinical studies have suggested that transfusion of red blood cells (RBCs) might negatively impact patient outcomes. Even though large randomized clinical trials did not show differences in mortality when transfusing fresh versus standard-issue RBC units, data imply that RBCs at the very end of storage could elicit negative effects. ⋯ Further research to improve the quality of RBC units and to study populations potentially at risk is warranted. Until the question whether transfusion of old blood is detrimental for specific patient populations has been answered, a deliberate use of RBC transfusion should be implemented.
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Curr Opin Anaesthesiol · Apr 2020
ReviewInsights into basic science: what basic science can teach us about iron homeostasis in trauma patients.
This review summarizes recent basic science studies on homeostasis of iron, an essential dietary nutrient and potentially toxic metal, and explores the relevance of these studies to our understanding of trauma and related severe, acute events. ⋯ Perturbations in iron homeostasis can contribute significantly to an individual's predisposition to trauma and their ability to recover posttrauma, whereas pharmacologic targeting of ferroptosis may attenuate severity of trauma-induced organ dysfunction.
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Red cell transfusions are commonly used in management of hemorrhage in trauma patients. The appropriate indications and criteria for transfusion are still debated. Here, we summarize the recent findings on the use of red cell transfusion in trauma setting. ⋯ Although the debate on hemoglobin thresholds for transfusion continues, clinicians should not overlook proper management of the underlying issue (anemia).
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Organ transplantation has largely expanded over the last decades and despite several improvements have been made in the complex process occurring between the identification of organ donors and organ transplant, there is still a chronic inability to meet the needs of patients. Consequently, the optimization of the transplant process through its different steps is crucial, and the role of the intensivists is fundamental as it requires clinical, managerial and communication skills to avoid the loss of potential donors. The purpose of this review is to provide an update on the transplant process from the early identification of the donor, to transplant. The two main pathways of organ donation will be discussed: donation after death by neurologic criteria and the donation after cardiac death (DCD). ⋯ The major change in the process of organ donation has been to implement parallel DCD and donation after brain death pathways. However, more research is needed for improving quality and number of transplanted organs.