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10 results

  • Relationship between anaesthesia strategy and intracardiac hemodynamics during paediatric cardiac catheterisation

  • Andrew H. Smith, Steven J. Healan, Genevieve E. Staudt, George T. Nicholson, Dana R. Janssen, Thomas P. Doyle, Heidi A. Smith, William A. McEachern, Nathan E. Hill, Fred S. Lamb
  • Journal:
    Cardiology in the Young / Volume 35 / Issue 9 / September 2025
    Published online by Cambridge University Press:
    01 September 2025, pp. 1863-1870
  • Objectives:

    Describe the hemodynamic implications of anaesthetic choice among children with heart disease undergoing cardiac catheterisation.

    Methods:

    Study 1 was a secondary analysis of data obtained during catheterisation-based hemodynamic assessment of infants with hypoplastic left heart syndrome following Stage 1 palliation, randomised in the Single Ventricle Reconstruction trial. Measured and calculated hemodynamics including pulmonary and systemic vascular resistance indexed to body surface area (PVRi and SVRi respectively) and pulmonary/systemic blood flow (Qp/Qs) were analysed with respect to anaesthetic employed during catheterisation, classified as moderate sedation or general anaesthesia. Study 2 consisted of a single centre, prospective analysis of patients requiring percutaneous closure of a patent ductus arteriosus or endomyocardial biopsy after orthotopic heart transplant. Participants underwent hemodynamic assessment first using inhaled volatile anaesthesia (IA), and then transitioned to total intravenous anaesthesia, comparing hemodynamic measures with respect to anaesthetic approach.

    Results:

    In Study 1, independent of shunt type, PVRi, and patient size, moderate sedation was associated with a greater than two-fold odds of a Qp/Qs >1 (OR 2.12, 95%CI 1.18–3.87, p = 0.013). In Study 2, while PVRi was similar, SVRi was significantly higher using total intravenous anaesthesia. Among the patent ductus arteriosus subgroup, Qp/Qs increased significantly with a total intravenous anaesthesia relative to IA (p = 0.003); additionally, among the orthotopic heart transplant subgroup, left ventricular end diastolic pressure increased following a transition to total intravenous anaesthesia (p = 0.002).

    Conclusions:

    Analyses of hemodynamics during catheterisation support a significant impact of anaesthetic type on hemodynamic values including SVRi, left ventricular end diastolic pressure, and Qp/Qs. Anaesthesia choice and intraprocedural management of SVRi are important considerations when making clinical decisions based on hemodynamic data.

  • Chronology of hominin activity at Vindija Cave, Croatia: new dates recorded via standard and ultrafiltration AMS

  • Ivor Karavanić, Ines Krajcar Bronić, Andreja Sironić, Siniša Radović, Marko Banda, Fred H. Smith
  • Journal:
    Antiquity / Volume 98 / Issue 398 / April 2024
    Published online by Cambridge University Press:
    15 February 2024, e7
    Print publication:
    April 2024
    • Article
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  • The project ‘Last Neanderthals at the Crossroads of Central Europe and the Mediterranean’ (NECEM) combines lithic analyses of previously excavated material with new sampling for dating and environmental DNA. New radiocarbon dates from Vindija, presented here, help clarify the chronology of late Neanderthal and early modern human occupations in South-eastern and Central Europe.

  • New research on the Late Pleistocene in the Lim Channel, Istria

  • Ivor Janković, Darko Komšo, James C.M. Ahern, Rory Becker, Katarina Gerometta, Jacobo Weinstock, Antonela Barbir, Nikola Vukosavljević, Barbara Cvitkušić, Krunoslav Zubčić, Sanjin Mihelić, Fred H. Smith
  • Journal:
    Antiquity / Volume 91 / Issue 359 / October 2017
    Published online by Cambridge University Press:
    20 September 2017, e4
    Print publication:
    October 2017
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  • As a part of the multidisciplinary project entitled ‘Archaeological Investigations into the Late Pleistocene and Early Holocene of the Lim Channel, Istria’, archaeological research has been conducted at four sites: Romuald's Cave, Abri Kontija 002, Pećina at Rovinjsko Selo and Lim 001 (Figure 1). There is much debate on issues related to biological and behavioural continuity, to patterns of changes and adaptations during this crucial period, and to external factors (e.g. changes in ecology and climate). For example, a clearer insight is needed into how climatic change affects the ecology of specific regions, including changing sea levels. Additionally, there continues to be debate centring on who produced the earliest (Initial) Upper Palaeolithic industries in Europe. To achieve a more precise insight into long-term diachronic changes and cultural relations around the Adriatic, and to document the presence of Middle and Upper Palaeolithic humans in Istria, we concentrated on a single microregion (the Lim Channel in Istria, Croatia). Here we report work on the two sites that to date have yielded Pleistocene material: Romuald's Cave and Abri Kontija 002.

  • 19 - Assimilation and modern human origins in the African peripheries

  • from Part III - Modern human origins: patterns and processes
  • Edited by Sally C. Reynolds, University of the Witwatersrand, Johannesburg, Andrew Gallagher, University of Johannesburg
  • Book:
    African Genesis
    Published online:
    05 April 2012
    Print publication:
    29 March 2012, pp 365-393

  • Summary

    Abstract

    The vast majority of pertinent genetic and human palaeontological evidence indicates that an early transition from archaic to modern humans occurs in Africa. Interestingly, the earliest well dated modern human fossils all derive from eastern Africa: Omo Kibish KHS (196 ka to 172 ka) and Herto (160 ka to 154 ka), both in Ethiopia (ka = thousand years ago). This suggests that modern humans may have originated in, and ultimately radiated out of, eastern Africa into the ‘peripheral’ regions of Africa, defined here as northern Africa and southern Africa, as well as into Eurasia. Evidence of the earliest presence of purported modern humans from both African ‘peripheral’ regions is assessed in this study. These include the Klasies River Mouth (KRM) sample from southern Africa and the Aterian-associated remains from North Africa, particularly the fragmentary subadult maxilla from Mugharet el ‘Aliya (High cave) near Tangier, Morocco. Both samples are maximally dated to ~130 ka and thus are significantly younger than the earliest eastern African modern humans. The KRM sample exhibits a significant amount of size and morphological variation, the latter reflecting a mosaic of archaic/modern anatomy. We interpret this morphological pattern as reflecting an admixed sample. The northern African evidence is less clear, but the morphology of the Tangier maxilla demonstrates archaic elements in the Aterian population, and this may well reflect the same pattern of admixture. We conclude that the evidence from the African ‘peripheries’ is consistent with admixture and that this broadly supports the assimilation model of modern human origins.