Minerva anestesiologica
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From the initial hypothesis considering 30 years ago the gut as the "motor" of multiple organ failure (MOF) related to an induced hyperpermeability leading to bacterial translocation into the systemic circulation, the reality becomes significantly more complex. The gut contains three interplaying components - the epithelium, the microbiome, and the immune system - that have to cooperate to maintain two opposite function: adsorption of nutrients and maintenance of a barrier to prevent the crossing of intraluminal microbes or their products to avoid host response. ⋯ This review tries to give a comprehensive description of these mechanisms, focused on induced sepsis. Some new therapeutic strategies are discussed.
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Minerva anestesiologica · Jun 2020
Review Meta AnalysisValue of new ST-Segment / T-Wave changes for prediction of major adverse cardiac events after vascular surgery: a meta-analysis.
The aim of this review is to examine current evidence on value of new ST-segment or T-wave changes for prediction of major adverse cardiac events (MACE) after vascular surgery. ⋯ Current evidence suggests that in the setting of vascular surgery, new ST-segment/T-wave changes could serve as predictor of MACE with reasonable accuracy. Heterogeneity across studies, possibility of publication bias and paucity of eligible studies are potential limitations to these conclusions.