ORCID Profile
0000-0002-3825-6699
Current Organisation
Inselspital Universitätsspital Bern Universitätsklinik für Anästhesiologie und Schmerztherapie
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Publisher: MDPI AG
Date: 18-05-2022
Abstract: Endothelial progenitor cells (EPC) may influence the integrity and stability of the vascular endothelium. The association of an altered total EPC number and function with cardiovascular diseases (CVD) and risk factors (CVF) was discussed however, their role and applicability as biomarkers for clinical purposes have not yet been defined. Endothelial dysfunction is one of the key mechanisms in CVD. The assessment of endothelial dysfunction in vivo remains a major challenge, especially for a clinical evaluation of the need for therapeutic interventions or for primary prevention of CVD. One of the main challenges is the heterogeneity of this particular cell population. Endothelial cells (EC) can become senescent, and the majority of circulating endothelial cells (CEC) show evidence of apoptosis or necrosis. There are a few viable CECs that have properties similar to those of an endothelial progenitor cell. To use EPC levels as a biomarker for vascular function and cumulative cardiovascular risk, a correct definition of their phenotype, as well as an update on the clinical application and practicability of current isolation methods, are an urgent priority.
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.BPA.2022.05.002
Abstract: Today's effective leaders create opportunities for their teams to develop both technical and non-technical skills. In the perioperative arena, the focus until now mainly has been on improving non-technical skills, with only few studies analyzing the relationship between technical skills and patient outcomes. Technical competence requires assessment of one's own strengths and weaknesses, inclusion of deliberate goal-oriented practice, objective structured feedback assessment, and a focus on best practice and improved patient outcomes. In this article, we address the prerequisites, assessment, and implications of technical skills for perioperative leadership, and provide key metrics impacting patient outcomes and leadership development.
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.BPA.2022.05.003
Abstract: Healthcare institutions are currently under enormous financial, political and social pressure. Especially in the perioperative setting, various professional groups with differing agendas, dynamic teams, high-stress levels and erging stakeholder interests are contributing to tension on a variety of levels. These players ask for guidance that goes beyond defined goals, clear structures or rules for process optimization. The impact of culture, which is influenced by core values, unspoken behaviours and practices, a shared purpose and implicit norms, has been often neglected. However, culture is a key factor in the search for optimal patient outcomes, quality of care, protection and long-time retention of staff, as well as economic success. In this review, we discuss important aspects to consider in building a great perioperative workplace, discuss indispensable adaptations in times of crisis and touch on urgently needed further investigations to optimize the art of developing, protecting, and cultivating a well-balanced culture.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 26-07-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-04-2019
DOI: 10.1213/XAA.0000000000001043
Abstract: Eye drops such as topical β-blockers are widely used to treat glaucoma and other ocular diseases. We provide an overview of ophthalmic solutions, including β-adrenergic receptor antagonists, for anesthesiologists and others involved in perioperative care. We summarize current evidence about systemic effects of topical β-blockers and other commonly used ophthalmic agents such as parasympathomimetic eye drops, carbonic anhydrase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), and emerging products such as combinations of multiple substances. We call for careful preoperative assessment and perioperative management of in iduals using eye drops, especially critically ill patients, children, or those undergoing major surgery.
Publisher: Springer Science and Business Media LLC
Date: 09-04-2022
Publisher: Springer Science and Business Media LLC
Date: 03-2022
DOI: 10.1007/S11916-022-01036-8
Abstract: Postcraniotomy headache (PCH) is a highly underappreciated and very common adverse event following craniotomy. Analgetic medication with opioids often interferes with neurologic evaluation in the acute phase of recovery and should be kept to a minimal, in general, in the treatment of chronic pain as well. We provide an update on the latest evidence for the management of acute and chronic PCH. Especially in the neurosurgical setting, enhanced recovery after surgery protocols need to include a special focus on pain control. Patients at risk of developing chronic pain must be identified and treated as early as possible.
Publisher: Springer Science and Business Media LLC
Date: 2021
DOI: 10.1007/S11916-020-00920-5
Abstract: We review the relevance of quantitative sensory testing (QST) in light of acute and chronic postoperative pain and associated challenges. Predicting the occurrence of acute and chronic postoperative pain with QST can help identify patients at risk and allows proactive preventive management. Generally, central QST testing, such as temporal summation of pain (TSP) and conditioned pain modulation (CPM), appear to be the most promising modalities for reliable prediction of postoperative pain by QST. Overall, QST testing has the best predictive value in patients undergoing orthopedic procedures. Current evidence underlines the potential of preoperative QST to predict postoperative pain in patients undergoing elective surgery. Implementing QST in routine preoperative screening can help advancing traditional pain therapy toward personalized perioperative pain medicine.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-03-2021
Publisher: Elsevier BV
Date: 10-2019
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.BPA.2022.04.003
Abstract: Efficient operating room (OR) management is a constant balancing act between optimal OR capacity, allocation of ORs to surgeons, assignment of staff, ordering of materials, and reliable scheduling, while according the highest priority to patient safety. We provide an overview of common concepts in OR management, specifically addressing the areas of strategic, tactical, and operational decision making (DM), and parameters to measure OR efficiency. For optimal OR productivity, a surgical suite needs to define its main stakeholders, identify and create strategies to meet their needs, and ensure staff and patient satisfaction. OR planning should be based on real-life data at every stage and should apply newly developed algorithms.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Springer Science and Business Media LLC
Date: 08-05-2023
DOI: 10.1007/S11916-023-01111-8
Abstract: The implementation of shared decision-making (SDM) in acute pain services (APS) is still in its infancies especially when compared to other medical fields. Emerging evidence fosters the value of SDM in various acute care settings. We provide an overview of general SDM practices and possible advantages of incorporating such concepts in APS, point out barriers to SDM in this setting, present common patient decisions aids developed for APS and discuss opportunities for further development. Especially in the APS setting, patient-centred care is a key component for optimal patient outcome. SDM could be included into everyday clinical practice by using structured approaches such as the “seek, help, assess, reach, evaluate” (SHARE) approach, the 3 “MAking Good decisions In Collaboration”(MAGIC) questions, the “Benefits, Risks, Alternatives and doing Nothing”(BRAN) tool or the “the multifocal approach to sharing in shared decision-making”(MAPPIN’SDM) as guidance for participatory decision-making. Such tools aid in the development of a patient–clinician relationship beyond discharge after immediate relief of acute pain has been accomplished. Research addressing patient decision aids and their impact on patient-reported outcomes regarding shared decision-making, organizational barriers and new developments such as remote shared decision-making is needed to advance participatory decision-making in acute pain services.
Publisher: Springer Science and Business Media LLC
Date: 07-06-2023
DOI: 10.1007/S11916-023-01119-0
Abstract: We aim to present current understanding and evidence for meditation, mostly referring to mindfulness meditation, for the management of acute pain and potential opportunities of incorporating it into the acute pain service practice. There is conflicting evidence concerning meditation as a remedy in acute pain. While some studies have found a bigger impact of meditation on the emotional response to a painful stimulus than on the reduction in actual pain intensities, functional Magnet Resonance Imaging has enabled the identification of various brain areas involved in meditation-induced pain relief. Potential benefits of meditation in acute pain treatment include changes in neurocognitive processes. Practice and Experience are necessary to induce pain modulation. In the treatment of acute pain, evidence is emerging only recently. Meditative techniques represent a promising approach for acute pain in various settings.
Publisher: Springer Science and Business Media LLC
Date: 13-08-2022
Publisher: Elsevier BV
Date: 08-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-01-2012
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-07-2022
DOI: 10.1097/ACO.0000000000001151
Abstract: The scope of procedures conducted by neurointerventionalists is expanding quickly, with lacking consensus over the best anesthesia modality. Although the procedures involve all age groups, the interventions may be complex and lengthy and may be provided in hospitals currently not yet familiar with the field. Here we review current literature addressing elective outpatient neurointerventional procedures and aim to provide an update on the management of intervention-specific crises, address special patient populations, and provide key learning points for everyday use in the neurointerventional radiology suite. Various studies have compared the use of different anesthesia modalities and preinterventional and postinterventional care. Monitored anesthesia care is generally recommended for elderly patients, whereas children are preferably treated with general anesthesia. Additional local anesthesia is beneficial for procedures, such as percutaneous kyphoplasty and vascular access. Combining different anesthetic modalities is a valuable approach in the neurointerventional radiology suite. More interventional and patient population-specific studies are needed to improve evidence-based perioperative management.
Publisher: Frontiers Media SA
Date: 08-11-2021
DOI: 10.3389/FPHYS.2021.766511
Abstract: Indoleamine-2,3-dioxygenase (IDO) is the “rate-limiting” enzyme in the kynurenine (Kyn) pathway of the tryptophan (Trp) catabolism. By its immune-modulatory effect, IDO initiates changes to the physiologically balanced immune state and plays a key role in the pathogenesis of various diseases, as well as in the perioperative setting during surgery. In autoimmune processes, highly malignant cancers such as glioblastoma or organ transplantation, IDO’s involvement has been studied extensively. However, in severe systemic infections, as present in sepsis, it is not yet completely understood. Hereafter, in this narrative review, we present the current knowledge of IDO’s implication on such complex immune-related processes. Moreover, we address the role of IDO as a predictive biomarker as well as a therapeutic target for immune-mediated diseases. Finally, we discuss IDO in the setting of surgical trauma-induced stress and highlight its promising use as a biomarker in the pre-operative setting for all disciplines involved in the decision-making process and treatment of patients undergoing surgery.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 12-2022
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.BPA.2022.05.005
Abstract: Bottlenecks limit the maximum output of a system and indicate operational congestion points in process management. Bottlenecks also affect perioperative care and include dimensions such as infrastructure, architectural design and limitations, inefficient equipment and material supply chains, communication-related limitations on the flow of information, and patient- or staff-related factors. Improvement of workflow is, therefore, becoming a priority in most healthcare settings. We provide an overview of bottleneck management in the perioperative setting and introduce dimensions, including aligned strategic decision-making, tactical planning, and operational adjustments.
Location: Switzerland
Location: Switzerland
Location: Switzerland
No related grants have been discovered for Corina Manuela Bello.