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https://www.readbyqxmd.com/read/28346013/the-physiology-of-blood-loss-and-shock-new-insights-from-a-human-laboratory-model-of-hemorrhage
#1
Alicia M Schiller, Jeffrey T Howard, Victor A Convertino
The ability to quickly diagnose hemorrhagic shock is critical for favorable patient outcomes. Therefore, it is important to understand the time course and involvement of the various physiological mechanisms that are active during volume loss and that have the ability to stave off hemodynamic collapse. This review provides new insights about the physiology that underlies blood loss and shock in humans through the development of a simulated model of hemorrhage using lower body negative pressure. In this review, we present controlled experimental results through utilization of the lower body negative pressure human hemorrhage model that provide novel insights on the integration of physiological mechanisms critical to the compensation for volume loss...
April 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28345540/epidemiological-features-of-nontraumatic-spontaneous-subarachnoid-hemorrhage-in-china-a-nationwide-hospital-based-multicenter-study
#2
Jian-Ping Song, Wei Ni, Yu-Xiang Gu, Wei Zhu, Liang Chen, Bin Xu, Bin Leng, Yan-Long Tian, Ying Mao
BACKGROUND: Nontraumatic spontaneous subarachnoid hemorrhage (SAH) is associated with a high mortality. This study was conducted to investigate the epidemiological features of nontraumatic spontaneous SAH in China. METHODS: From January 2006 to December 2008, the clinical data of patients with nontraumatic SAH from 32 major neurosurgical centers of China were evaluated. Emergent digital subtraction angiography (DSA) was performed for the diagnosis of SAH sources in the acute stage of SAH (≤3 days)...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28345186/use-of-the-fetal-myocardial-performance-index-in-assessment-and-management-of-the-small-for-gestational-age-fetus-a-cohort-and-nested-case-control-study
#3
Amanda Henry, Jennifer Alphonse, Dominique Tynan, Alec W Welsh
OBJECTIVES: To assess the clinical utility of the fetal Myocardial Performance Index (MPI) in assessment and management of the fetus referred to Fetal Medicine services for Small for Gestational Age/Intrauterine Growth Restriction (SGA/IUGR). METHODS: Prospective cohort study in metropolitan Australia. Consenting patients referred at 24-38 weeks' gestation for suspected singleton SGA/IUGR (estimated fetal weight [EFW] <10(th) centile for gestation and/or abnormal umbilical artery [UA] Doppler) had MPI performed in addition to routine measures, and were followed through to birth...
March 27, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28345123/traumatic-pseudoaneurysms-of-the-head-in-war-time-report-of-two-unusual-cases
#4
Tayfun Hakan, Ahmet Cemil Kaur
Either intracranial or extracranial pseudoaneurysms due to penetrating head injuries with gunshot are very rare entities. As the pseudoaneurysms of the superficial temporal artery are represented commonly with a pulsating mass lesion beneath scalp, the intracranial pseudoaneurysms are represented with symptoms including decreased conscious level, seizure, or focal neurological deficits. Here, two patients with combat related pseudoaneurysms are reported; one was in distal cortical branch of anterior cerebral artery and one was in superficial temporal artery...
February 27, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28343295/identification-of-sphingosine-1-phosphate-receptor-subtype-1-s1p1-as-a-pathogenic-factor-in-transient-focal-cerebral-ischemia
#5
Bhakta Prasad Gaire, Chi-Ho Lee, Arjun Sapkota, Sang Yeul Lee, Jerold Chun, Hee Jun Cho, Tae-Gyu Nam, Ji Woong Choi
Medically relevant roles of receptor-mediated sphingosine 1-phosphate (S1P) signaling have become a successful or promising target for multiple sclerosis or cerebral ischemia. Animal-based proof-of-concept validation for the latter is particularly through the neuroprotective efficacy of FTY720, a non-selective S1P receptor modulator, presumably via activation of S1P1. In spite of a clear link between S1P signaling and cerebral ischemia, it remains unknown whether the role of S1P1 is pathogenic or neuroprotective...
March 25, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28343250/apparent-diffusion-coefficient-changes-predict-survival-after-intra-arterial-bevacizumab-treatment-in-recurrent-glioblastoma
#6
Naveen Galla, Gloria Chiang, Shamik Chakraborty, Ranjodh Singh, A John Tsiouris, John Boockvar, Ilhami Kovanlikaya
PURPOSE: Superselective intra-arterial cerebral infusion (SIACI) of bevacizumab (BV) has emerged as a novel therapy in the treatment of recurrent glioblastoma (GB). This study assessed the use of apparent diffusion coefficient (ADC) in predicting length of survival after SIACI BV and overall survival in patients with recurrent GB. METHODS: Sixty-five patients from a cohort enrolled in a phase I/II trial of SIACI BV for treatment of recurrent GB were retrospectively included in this analysis...
March 25, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28343223/sildenafil-enhances-quantity-of-immature-neurons-and-promotes-functional-recovery-in-the-developing-ischemic-mouse-brain
#7
Jonas Engels, Natalie Elting, Lisa Braun, Ivo Bendix, Josephine Herz, Ursula Felderhoff-Müser, Mark Dzietko
BACKGROUND: Hypoxic-ischemic (HI) injury to the developing brain occurs in 1 out of 1,000 live births and remains a major cause of significant morbidity and mortality. A large number of survivors suffer from long-term sequelae including seizures and neurological deficits. However, the pathophysiological mechanisms of recovery after HI insult are not clearly understood, and preventive measures or clinical treatments are nonexistent or not sufficiently effective in the clinical setting...
March 25, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#8
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28343073/breviscapine-confers-a-neuroprotective-efficacy-against-transient-focal-cerebral-ischemia-by-attenuating-neuronal-and-astrocytic-autophagy-in-the-penumbra
#9
Zhang Pengyue, Guo Tao, He Hongyun, Yang Liqiang, Deng Yihao
Breviscapine is a flavonoid derived from a traditional Chinese herb Erigerin breviscapus (Vant.) Hand-Mazz, and has been extensively used in clinical treatment for cerebral stroke in China, but the underlying pharmacological mechanisms are still unclear. In present study, we investigated whether breviscapine could confer a neuroprotection against cerebral ischemia injury by targeting autophagy mechanisms. A cerebral stroke model in Sprague-Dawley rats was prepared by middle cerebral artery occlusion (MCAO), rats were then randomly divided into 5 groups: MCAO+Bre group, rats were treated with breviscapine; MCAO+Tat-Beclin-1 group, animals were administrated with specific autophagy inducer Tat-Beclin-1; MCAO+Bre+Tat-Beclin-1 group, rats were treated with both breviscapine and Tat-Beclin-1, MCAO+saline group, rats received the same volume of physiological saline, and Sham surgery group...
March 23, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28342896/neuroprotective-and-axonal-outgrowth-promoting-effects-of-tetramethylpyrazine-nitrone-in-chronic-cerebral-hypoperfusion-rats-and-primary-hippocampal-neurons-exposed-to-hypoxia
#10
Tao Zhang, Jianbo Gu, Liangmiao Wu, Ning Li, Yewei Sun, Pei Yu, Yuqiang Wang, Gaoxiao Zhang, Zaijun Zhang
Chronic cerebral hypoperfusion is an important risk factor for vascular dementia and other brain dysfunctions, for which there are currently no effective medications available. We investigated the neuroprotective and axonal outgrowth promoting effects of tetramethylpyrazine nitrone (TBN) in a permanent bilateral occlusion of the common carotid arteries (2VO) rat model and in primary hippocampal neurons exposed to oxygen glucose deprivation (OGD). At 6th week after 2VO, TBN increased the time spent in novel arms in the Y-maze test and improved the discrimination ratio in object reorganization task...
March 22, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28342655/tacrolimus-induced-reversible-cerebral-vasoconstriction-syndrome-with-delayed-multi-segmental-vasoconstriction
#11
Satoshi Kodama, Tatsuo Mano, Akihiro Masuzawa, Yasutaka Hirata, Yuki Nagasako, Kagari Koshi Mano, Masashi Hamada, Yasuo Terao, Toshihiro Hayashi, Minoru Ono, Shoji Tsuji
Reversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular syndrome characterized by multi-segmental constrictions of the cerebral arteries that resolves spontaneously within 3 months. Although RCVS is considered to be due to transient dysregulation of vascular tone, the exact pathomechanism remains unclear. We describe the case of a 15-year-old girl with RCVS induced by tacrolimus, who developed generalized seizure during the postoperative course of orthotropic heart transplantation. Magnetic resonance imaging at symptom onset showed a few vasoconstrictions accompanying brain edema and convexity subarachnoid hemorrhage...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28342212/high-speed-whole-brain-oximetry-by-golden-angle-radial-mri
#12
Wen Cao, Yulin V Chang, Erin K Englund, Hee Kwon Song, Suliman Barhoum, Zachary B Rodgers, Michael C Langham, Felix W Wehrli
PURPOSE: To determine whole-brain cerebral metabolic rate of oxygen (CMRO2 ), an improved imaging approach, based on radial encoding, termed radial OxFlow (rOxFlow), was developed to simultaneously quantify draining vein venous oxygen saturation (SvO2 ) and total cerebral blood flow (tCBF). METHODS: To evaluate the efficiency and precision of the rOxFlow sequence, 10 subjects were studied during a paradigm of repeated breath-holds with both rOxFlow and Cartesian OxFlow (cOxFlow) sequences...
March 25, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28342045/effects-of-an-alveolar-recruitment-maneuver-on-subdural-pressure-brain-swelling-and-mean-arterial-pressure-in-patients-undergoing-supratentorial-tumour-resection-a-randomized-crossover-study
#13
Alana M Flexman, Peter A Gooderham, Donald E Griesdale, Ruth Argue, Brian Toyota
PURPOSE: Although recruitment maneuvers have been advocated as part of a lung protective ventilation strategy, their effects on cerebral physiology during elective neurosurgery are unknown. Our objectives were to determine the effects of an alveolar recruitment maneuver on subdural pressure (SDP), brain relaxation score (BRS), and cerebral perfusion pressure among patients undergoing supratentorial tumour resection. METHODS: In this prospective crossover study, patients scheduled for resection of a supratentorial brain tumour were randomized to undergo either a recruitment maneuver (30 cm of water for 30 sec) or a "sham" maneuver (5 cm of water for 30 sec), followed by the alternative intervention after a 90-sec equilibration period...
March 24, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28341719/brain-perivascular-spaces-as-biomarkers-of-vascular-risk-results-from-the-northern-manhattan-study
#14
J Gutierrez, M S V Elkind, C Dong, M Di Tullio, T Rundek, R L Sacco, C B Wright
BACKGROUND AND PURPOSE: Dilated perivascular spaces in the brain are associated with greater arterial pulsatility. We hypothesized that perivascular spaces identify individuals at higher risk for systemic and cerebral vascular events. MATERIALS AND METHODS: Stroke-free participants in the population-based Northern Manhattan Study had brain MR imaging performed and were followed for myocardial infarction, any stroke, and death. Imaging analyses distinguished perivascular spaces from lesions presumably ischemic...
March 24, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28341559/-moyamoya-disease-associated-with-kidney-angiodysplasia-in-a-child
#15
A Dibi, Z Maana, F Jabourik, A Bentahila
INTRODUCTION: Moyamoya disease is a progressive, chronic occlusive vascular disease of the circle of Willis arteries leading to the development of collateral circulation to compensate the occlusion. CASE REPORT: An 11-year-old girl presented an abrupt loss of consciousness and a right-sided motor deficit. Clinical examination found hypertension with 220/120mmHg arterial blood pressure. Brain magnetic resonance imaging showed a large left hemispheric ischemic lesion...
March 21, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28341347/remote-limb-ischemic-post-conditioning-during-early-reperfusion-alleviates-cerebral-ischemic-reperfusion-injury-via-gsk-3%C3%AE-creb-bdnf-pathway
#16
Sruthi Ramagiri, Rajeev Taliyan
Remote limb ischemic post conditioning (RIPOC) has been reported to attenuate cerebral ischemic reperfusion (I/R) injury, while the molecular mechanisms remain elusive. Various studies have highlighted the involvement of glycogen synthase kinase (GSK-3β) in cerebral I/R injury and cognitive disorders. Hence, the present study was designed to explore the role of GSK-3β and its downstream regulators in RIPOC mediated neuroprotection against cerebral I/R injury and associated cognitive impairment. Male Wistar rats are randomly assigned into four groups: Sham, bilateral common carotid arteries occlusion (BCCAO), RIPOC and BCCAO+RIPOC...
March 21, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28341040/hyperdense-middle-cerebral-artery-sign-as-the-only-radiological-manifestation-of-hyperacute-ischemic-stroke-in-computed-tomography
#17
Robert Chrzan, Agnieszka Gleń, Andrzej Urbanik
OBJECTIVES: The main aim of the study was to find the effect of hyperdense middle cerebral artery sign (HMCAS), as the only admission computed tomography (CT) manifestation of ischemic stroke involving middle cerebral artery (MCA) region, on the extent of stroke measured by Alberta Stroke Program Early CT score (ASPECTS) in the follow-up CT. The secondary aim was to determine the correlation between length of hyperdense MCA segment on admission CT and ASPECTS in follow-up CT. METHODS: The group analyzed consisted of 118 patients with ischemic MCA region stroke, with no early signs of brain tissue ischemia on admission CT, but infarcts confirmed in follow-up CT, with extent evaluated using ASPECTS...
January 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28339483/temporal-evolution-of-vasospasm-and-clinical-outcome-after-intra-arterial-vasodilator-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#18
Laleh Daftari Besheli, Can Ozan Tan, Donnie L Bell, Joshua A Hirsch, Rajiv Gupta
Intra-arterial (IA) vasodilator therapy is one of the recommended treatments to minimize the impact of aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm refractory to standard management. However, its usefulness and efficacy is not well established. We evaluated the effect IA vasodilator therapy on middle cerebral artery blood flow and on discharge outcome. We reviewed records for 115 adults admitted to Neurointensive Care Unit to test whether there was a difference in clinical outcome (discharge mRS) in those who received IA infusions...
2017: PloS One
https://www.readbyqxmd.com/read/28338438/learning-brain-aneurysm-microsurgical-skills-in-a-human-placenta-model-predictive-validity
#19
Marcelo Magaldi Ribeiro de Oliveira, Carlos Eduardo Ferrarez, Taise Mosso Ramos, Jose Augusto Malheiros, Arthur Nicolato, Carla Jorge Machado, Mauro Tostes Ferreira, Fellype Borges de Oliveira, Cecília Félix Penido Mendes de Sousa, Pollyana Helena Vieira Costa, Sebastiao Gusmao, Giuseppe Lanzino, Rolando Del Maestro
OBJECTIVE Surgery for brain aneurysms is technically demanding. In recent years, the process to learn the technical skills necessary for these challenging procedures has been affected by a decrease in the number of surgical cases available and progressive restrictions on resident training hours. To overcome these limitations, surgical simulators such as cadaver heads and human placenta models have been developed. However, the effectiveness of these models in improving technical skills is unknown. This study assessed concurrent and predictive validity of brain aneurysm surgery simulation in a human placenta model compared with a "live" human brain cadaveric model...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#20
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
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