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Abramovich I, Crisan I, Sobreira Fernandes D, De Hert S, Lukic A, Norte G, Matias B, Majić M, Berger-Estilita J. Anaesthesia training designs across Europe: A survey-based study from the trainees committee of the European Society of Anaesthesiology and Intensive Care. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00074-X. [PMID: 38636795 DOI: 10.1016/j.redare.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/13/2023] [Indexed: 04/20/2024]
Abstract
BACKGROUND Anaesthesiology training programs in Europe vary in duration, content, and requirements for completion. This survey-based study conducted by the Trainees Committee of the European Society of Anaesthesiology and Intensive Care explores current anaesthesia training designs across Europe. METHODS Between May and July 2018, we sent a 41-item online questionnaire to all National Trainee Representatives, members of the National Anaesthesiologists Societies Committee, and Council Representatives of the European Society of Anaesthesiology and Intensive Care (ESAIC) of all member countries. We cross-validated inconsistent data with different country representatives. RESULTS Forty-three anaesthesiologists from all 39 associated ESAIC countries completed the questionnaire. Results showed considerable variability in teaching formats, frequency of teaching sessions during training, and differences in assessments made during and at the end of training. The reported duration of training was 60 months in 59% (n = 23) of participating countries, ranging from 24 months in Russia and Ukraine to 84 months in the UK. CONCLUSION This study shows the significant differences in anaesthesiology training formats across Europe, and highlights the importance of developing standardised training programs to ensure a consistent level of training and to improve patient safety. This study provides valuable insights into European anaesthesia training, and underlines the need for further research and collaboration to improve requirements.
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Affiliation(s)
- I Abramovich
- Charité - Universitätsmedizin Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany.
| | - I Crisan
- Universitätsspital Zürich, Department of Emergency Medicine, Zürich, Switzerland
| | - D Sobreira Fernandes
- Centro Hospitalario de Póvoa de Varzim y Vila de Conde, Póvoa de Varzim, Portugal
| | - S De Hert
- Department of Anaesthsiology and Peri-operative Medicine, Ghent University, Ghent, Belgium
| | - A Lukic
- Department of Anaesthesiology, Reanimateology and Intensive Care, General Hospital Varaždin, Varaždin, Croatia
| | - G Norte
- Department of Anaesthesiology, Centro Hospitalar Trás-os-Montes y Alto Douro, Vila Real, Portugal
| | - B Matias
- Department of Anaesthesiology, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - M Majić
- Department of Anaesthesiology and ICU, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Berger-Estilita
- Institute for Medical Education, University of Bern, Bern, Switzerland; Institute of Anaesthsiology and Intensive Care, Salemspital, Hirslanden Medical Group, Bern, Switzerland; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, Porto, Portugal
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Saragovi A, Zilberman T, Yasur G, Turjeman K, Abramovich I, Kuchersky M, Gottlieb E, Barenholz Y, Berger M. Analysis of cellular water content in T cells reveals a switch from slow metabolic water gain to rapid water influx prior to cell division. J Biol Chem 2022; 298:101795. [PMID: 35248530 PMCID: PMC9034303 DOI: 10.1016/j.jbc.2022.101795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/05/2022] Open
Abstract
Cell growth is driven by the acquisition and synthesis of both dry biomass and water mass. In this study, we examine the increase of water mass in T cell during cell growth. We found that T-cell growth is characterized by an initial phase of slow increase in cellular water, followed by a second phase of rapid increase in water content. To study the origin of the water gain, we developed a novel methodology we call cold aqua trap-isotope ratio mass spectrometry, which allows analysis of the isotope composition of intracellular water. Applying cold aqua trap-isotope ratio mass spectrometry, we discovered that glycolysis-coupled metabolism of water accounts on average for 11 fl out of the 20 fl of water gained per cell during the initial slow phase. In addition, we show that at the end of the rapid phase before initiation of cell division, a water influx occurs, increasing the cellular water mass by threefold. Thus, we conclude that activated T cells switch from metabolizing water to rapidly taking up water from the extracellular medium prior to cell division. Our work provides a method to analyze cell water content as well as insights into the ways cells regulate their water mass.
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Affiliation(s)
- A Saragovi
- The Lautenberg center for Immunology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Medical School, Jerusalem, Israel.
| | - T Zilberman
- Department of Geochemistry, Geological Survey of Israel, Jerusalem, Israel
| | - G Yasur
- Department of Geochemistry, Geological Survey of Israel, Jerusalem, Israel
| | - K Turjeman
- Laboratory of Membrane and Liposome Research, Department of Biochemistry and Molecular Biology, Institute for Medical Research Israel-Canada (IMRIC), The Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - I Abramovich
- The Ruth and Bruce Rappaport, Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - M Kuchersky
- The Lautenberg center for Immunology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Medical School, Jerusalem, Israel
| | - E Gottlieb
- The Ruth and Bruce Rappaport, Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Y Barenholz
- Laboratory of Membrane and Liposome Research, Department of Biochemistry and Molecular Biology, Institute for Medical Research Israel-Canada (IMRIC), The Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - M Berger
- The Lautenberg center for Immunology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Medical School, Jerusalem, Israel.
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Baskin P, Ben Jehuda R, Abramovich I, Agranovich B, Davidor M, Mekies L, Milman H, Shulman M, Arad M, Gottlieb E, Binah O. Bioenergetic and metabolic aberrations in induced pluripotent stem cell-derived cardiomyocytes generated from PRKAG2-mutated, WPW patient. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Familial hypertrophic cardiomyopathy (HCM) is caused by over 400 mutations affecting mostly key sarcomere components, such as titin and myosin. However, HCM also results from mutations in non-structural genes such as PRKAG2 which is involved directly in a variety of bioenergetic and metabolic pathways. When the metabolic processes fail to work properly or effectively, structural and functional aberrations resulting in cardiac dysfunction can occur. Thus, mutations in the human PRKAG2 gene lead to HCM, autosomal dominant ventricular pre-excitation - Wolff-Parkinson-White syndrome (WPW), a progressive conduction system disease and vacuolar glycogen accumulation in cardiomyocytes.
Purpose
To investigate the hypothesis that intervening with the bioenergetic and metabolic consequences of the R302Q mutation in the PRKAG2 gene causing inherited cardiomyopathy, will attenuate the cardiac impairments.
Methods
We generated mutated and isogenic induced Pluripotent Stem Cell-derived cardiomyocytes (iPSC-CMs) from a WPW patient carrying the R302Q mutation. As additional control, we used healthy volunteers' iPSC-CMs. Bioenergetic (Oxygen Consumption Rate, OCR) and metabolic status were measured using the Seahorse Flux Analyzer and LC-MS, respectively. To decipher the molecular basis underlying the bioenergetic and metabolic deficits, RNA-seq analysis was performed.
Results
The OCR results demonstrated in PRKAG2-mutated compared to isogenic and healthy iPSC-CMs, a 2-fold increase in maximal respiration rate and a 3.75-fold increase in spare respiratory capacity, while basal OCR parameters were similar in all groups. Importantly, when treated with the AMPK activator metformin (2.5 [mM]), all the abovementioned OCR parameters were similar in the three groups. RNA-seq analysis demonstrated that of the 553 differently expressed genes (DEGs), and of the 99 DEGs mutually differentially expressed, compared to isogenic and healthy cells, the most relevant altered pathways were glycolysis, carbon metabolism, biosynthesis of amino acids, HIF-1 signaling and fructose and mannose metabolism. These findings are consistent with the LC-MS results demonstrating in PRKAG2-mutated versus isogenic and healthy iPSC-CMs, at least a 3-fold decrease in metabolites linked to the abovementioned pathways: butyryl-carnitine, creatine, docosahexaenoic acid, GMP, IMP, myristoyl-carnitine, palmitoyl-carnitine, succinyl-Cys, UMP, UTP, UDP-GlcNAc.
Conclusion
PRKAG2-mutated iPSC-CMs exhibit bioenergetic and metabolic aberrations, which contribute to the cardiac pathological aspects of WPW syndrome. Importantly, treatment with the AMPK activator metformin eliminated the bioenergetic abnormalities in the mutated cells, while isogenic and healthy control cells remained unaffected. Based on these novel findings, a new therapeutic modality in WPW patients may be considered.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Israel Science Foundation (ISF)
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Affiliation(s)
- P Baskin
- Technion - Israel Institute of Technology, Haifa, Israel
| | - R Ben Jehuda
- Technion - Israel Institute of Technology, Haifa, Israel
| | - I Abramovich
- Technion - Israel Institute of Technology, Haifa, Israel
| | - B Agranovich
- Technion - Israel Institute of Technology, Haifa, Israel
| | - M Davidor
- Technion - Israel Institute of Technology, Haifa, Israel
| | - L.N Mekies
- Technion - Israel Institute of Technology, Haifa, Israel
| | - H Milman
- Technion - Israel Institute of Technology, Haifa, Israel
| | - M Shulman
- Technion - Israel Institute of Technology, Haifa, Israel
| | - M Arad
- Sheba Medical Center, Ramat Gan, Israel
| | - E Gottlieb
- Technion - Israel Institute of Technology, Haifa, Israel
| | - O Binah
- Technion - Israel Institute of Technology, Haifa, Israel
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Willi L, Agranovich B, Abramovich I, Freimark D, Arad M, Gottlieb E, Binah O. Bioenergetic and metabolic impairments in Duchenne Muscular Dystrophy (DMD) patients' iPSC-derived cardiomyocytes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
DMD, an X-linked muscle degenerative fatal disease, is caused by mutations in the dystrophin gene. Dilated cardiomyopathy (DCM) is a major cause of morbidity and mortality in DMD patients. Treatments for DCM in DMD are limited to steroids and standard heart failure medications such as β-blockers and ACE-inhibitors, and therefore novel therapeutic modalities are urgently needed.
Purpose
We hypothesized that dystrophin mutations in DMD lead to cardiomyopathy-causing bioenergetic/metabolic impairments, which can be therapeutically targeted for improving cardiac function.
Methods
Induced Pluripotent Stem Cell-derived cardiomyocytes (iPSC-CMs) were generated from healthy volunteer and 3 DMD patients: young male (YM), adult male (AM) and adult female (AF). We investigated the bioenergetics, electrophysiology, mitochondrial and metabolic features of healthy and DMD iPSC-CMs using the Seahorse Flux analyzer, patch clamp, confocal fluorescence microscopy and Liquid chromatography mass spectrometry (LC-MS) technologies, respectively.
Results
To test the hypothesis, we measured respiration and glycolytic rates of healthy and DMD iPSC-CMs. Compared to healthy iPSC-CMs, in both AM and AF DMD, but not in YM DMD cardiomyocytes, there was a 75% decrease in ATP production, and 80% and 45% decrease in basal respiration, respectively. In agreement with the healthy-like bioenergetic status of YM, the iPSC-CMs showed no arrhythmias, in contrast to the prominent arrhythmias in AM and AF cardiomyocytes. To determine whether the impairment in the phosphorylation pathway (OXPHOS) affects glycolysis, we measured the cardiomyocytes' response to glycolytic stress test. These experiments showed that the glycolytic rates were similar in healthy and DMD iPSC-CMs. In agreement with impaired OXPHOS, mitochondrial activity measured by 3D life confocal microscopy was attenuated in the DMD male by 35%, compared to healthy cardiomyocytes. Furthermore, the metabolomic LC-MS analyses demonstrated significant differences in metabolite levels in YM, AM and AF DMD iPSC-CMs relative to healthy iPSC-CMs. For example, compared to healthy iPSC-CMs, there was a dramatic fall to undetected levels in phosphocreatine in both AM and AF, but not in YM DMD, indicating a dysfunctional phosphocreatine energy system.
Conclusions
DMD iPSC-CMs exhibit bioenergetic/metabolic impairments, which constitute novel targets for alleviating the cardiomyopathy in DMD patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): ISF - Israel Science Foundation
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Affiliation(s)
- L Willi
- Technion - Israel Institute of Technology, Department of Physiology, Biophysics and Systems Biology, Haifa, Israel
| | - B Agranovich
- Technion - Israel Institute of Technology, Department of Cell Biology and Cancer Science, Haifa, Israel
| | - I Abramovich
- Technion - Israel Institute of Technology, Department of Cell Biology and Cancer Science, Haifa, Israel
| | - D Freimark
- Sheba Medical Center, Leviev Heart Center, Ramat Gan, Israel
| | - M Arad
- Sheba Medical Center, Leviev Heart Center, Ramat Gan, Israel
| | - E Gottlieb
- Technion - Israel Institute of Technology, Department of Cell Biology and Cancer Science, Haifa, Israel
| | - O Binah
- Technion - Israel Institute of Technology, Department of Physiology, Biophysics and Systems Biology, Haifa, Israel
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Ben Jehuda R, Abramovich I, Mekies L, Willi L, Eisen B, Shemer Y, Baskin P, Arad M, Gottlieb E, Binah O. Metabolism and Ca2+ handling abnormalities in PRKAG2-mutated induced pluripotent stem cells-derived cardiomyocytes. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mekies L, Ben Jehuda R, Eisen B, Willi L, Abramovich I, Shemer Y, Baskin P, Michele D, Arad M, Gottlieb E, Binah O. Depressed beta-adrenergic inotropic responsiveness, altered intracellular calcium handling and metabolic deficits in Duchenne Muscular Dystrophy patients’ induced pluripotent stem cell-derived cardiomyocytes. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Aliperti V, Aragone S, Abramovich I, Figar S, Camera M, de Quiros FGB. P2-7 Mortality and cardiovascular events in patients under treatment with clopidogrel and omeprazole. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976h.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gross M, Abramovich I, Weiss EI. Microleakage at the abutment-implant interface of osseointegrated implants: a comparative study. Int J Oral Maxillofac Implants 1999; 14:94-100. [PMID: 10074758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Microleakage can occur at the abutment-implant (A-I) interface in osseointegrated implants and may cause malodor and inflammation of peri-implant tissues. The degree of microleakage at the A-I interface of 5 implant systems was comparatively assessed at varying closing torques. Using colored tracing probes driven by a 2-atm pressure system, the interface microleakage of Brånemark, Sulzer Calcitek, 3i, ITI, and Steri-Oss implants was determined spectrophotometrically. Microleakage through the A-I interface occurred in all systems, with variability between systems, samples, and closing torques. As closing torque increased from 10 Ncm to 20 Ncm to manufacturers' recommended closing torques, microleakage decreased significantly (P < .005) for all systems. Analysis of variance showed significant interaction between closing torques and the time course of microleakage, and between systems and the time course of microleakage (P < .001). The results indicate that fluids and small molecules are capable of passing through the interface of all the A-I assemblies studied. Presumably in an in situ situation, fluids containing bacterial byproducts and nutrients required for bacterial growth may pass through the interface gap, contributing in part to clinically observed malodor and peri-implantitis.
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Affiliation(s)
- M Gross
- Department of Oral Rehabilitation, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel.
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Grossmann RM, Abramovich I, Lefèvre AB. [Epileptic headache: study of a case with electroencephalographic registration during a crisis]. Arq Neuropsiquiatr 1971; 29:198-206. [PMID: 5159767 DOI: 10.1590/s0004-282x1971000200008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
É relatado o caso de uma paciente com 9 anos de idade, na qual foi feito o EEG durante 3 crises de cefaléia sem caráter de enxaqueca. Simultaneamente com as crises foram observadas, no EEG, anormalidades caracterizadas por ondas agudas ritmadas de projeção difusa no hemisfério cerebral direito, predominando na região occipital. São feitos comentários sobre a raridade do relato de anormalidades do tipo irritativo durante crises de cefaléia, sendo ressaltado o valor de tais achados para a classificação dessas cefaléias dentro do conceito de epilepsia.
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