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https://www.readbyqxmd.com/read/29452687/diagnostic-challenges-in-epilepsy-seizure-under-reporting-and-seizure-detection
#1
REVIEW
Christian E Elger, Christian Hoppe
Epileptic seizures vary greatly in clinical phenomenology and can markedly affect the patient's quality of life. As therapeutic interventions focus on reduction or elimination of seizures, the accurate documentation of seizure occurrence is essential. However, patient self-evaluation compared with objective evaluation by video-electroencephalography (EEG) monitoring or long-term ambulatory EEG revealed that patients document fewer than 50% of their seizures, on average, and that documentation accuracy varies significantly over time...
March 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29452324/microsurgical-clipping-of-intracranial-aneurysms-assisted-by-neurophysiological-monitoring-microvascular-flow-probe-and-icg-va-outcomes-and-intraoperative-data-on-a-multimodal-strategy
#2
Alessandro Della Puppa, Marta Rossetto, Francesco Volpin, Oriela Rustemi, Alberto Grego, Alessandra Gherardi, Riccardo Ortolan, Francesco Causin, Marina Munari, Renato Scienza
OBJECTVE: The aim of this study is to report data on a multimodal monitoring strategy based on the intraoperative use of neurophysiological monitoring, flowmetry by microflow probe and intraoperative indocyanine green-videoangiography (ICG-VA) during microsurgical clipping of intracranial aneurysms. METHODS: This retrospective analysis was performed on 85 consecutive patients undergoing clipping of 96 intracranial aneurysms with the present monitoring strategy. Patient outcomes were evaluated by assessing rate of aneurysm exclusion and post-operative occurrence of ischemic injury...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29443029/in-vivo-multimodal-imaging-and-analysis-of-mouse-laser-induced-choroidal-neovascularization-model
#3
Symantas Ragauskas, Eva Kielczewski, Joseph Vance, Simon Kaja, Giedrius Kalesnykas
Laser-induced choroidal neovascularization (CNV) is a well-established model to mimic the wet form of age-related macular degeneration (AMD). In this protocol, we aim to guide the reader not simply through the technical considerations of generating laser-induced lesions to trigger neovascular processes, but rather focus on the powerful information that can be obtained from multimodal longitudinal in vivo imaging throughout the follow-up period. The laser-induced mouse CNV model was generated by a diode laser administration...
January 21, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29440719/prefrontal-gaba-levels-hippocampal-resting-perfusion-and-the-risk-of-psychosis
#4
Gemma Modinos, Fatma Şimşek, Matilda Azis, Matthijs Bossong, Ilaria Bonoldi, Carly Samson, Beverly Quinn, Jesus Perez, Matthew R Broome, Fernando Zelaya, David J Lythgoe, Oliver D Howes, James M Stone, Anthony A Grace, Paul Allen, Philip McGuire
Preclinical models propose that the onset of psychosis is associated with hippocampal hyperactivity, thought to be driven by cortical GABAergic interneuron dysfunction and disinhibition of pyramidal neurons. Recent neuroimaging studies suggest that resting hippocampal perfusion is increased in subjects at ultra-high risk (UHR) for psychosis, but how this may be related to GABA concentrations is unknown. The present study used a multimodal neuroimaging approach to address this issue in UHR subjects. Proton magnetic resonance spectroscopy and pulsed-continuous arterial spin labeling imaging were acquired to investigate the relationship between medial prefrontal (MPFC) GABA+ levels (including some contribution from macromolecules) and hippocampal regional cerebral blood flow (rCBF) in 36 individuals at UHR of psychosis, based on preclinical evidence that MPFC dysfunction is involved in hippocampal hyperactivity...
January 30, 2018: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29431176/phd-forum-multimodal-iot-and-emr-based-smart-health-application-for-asthma-management-in-children
#5
Utkarshani Jaimini
According to a study done in 2014 by National Health Interview Survey around 6.3 million children in United States suffer from asthma [1]. Asthma remains one of the leading reasons for pediatric admissions to children's hospitals, and has a prevalence rate of approximately 10% in children and it leads to missed days from school and other societal costs. This occurs despite improved medications to control asthma symptoms. Asthma management is challenging as it involves understanding asthma causes and avoiding asthma triggers that are both multi-factorial and individualistic in nature...
May 2017: Proc Int Conf Smart Comput SMARTCOMP
https://www.readbyqxmd.com/read/29429015/transcranial-doppler-ultrasound-in-neurocritical-care
#6
REVIEW
Pablo Blanco, Anselmo Abdo-Cuza
Multimodality monitoring is a common practice in caring for neurocritically ill patients, and consists mainly in clinical assessment, intracranial pressure monitoring and using several imaging methods. Of these imaging methods, transcranial Doppler (TCD) is an interesting tool that provides a non-invasive, portable and radiation-free way to assess cerebral circulation and diagnose and follow-up (duplex method) intracranial mass-occupying lesions, such as hematomas and midline shift. This article reviews the basics of TCD applied to neurocritical care patients, offering a rationale for its use as well as tips for practitioners...
February 10, 2018: Journal of Ultrasound
https://www.readbyqxmd.com/read/29423905/a-case-of-longitudinal-care-of-a-patient-with-cardiac-sarcoidosis
#7
Rayan Saab, Pradeep Bhambhvani, Ami E Iskandrian, Fadi G Hage
Cardiac sarcoidosis has long been an evasive diagnosis with a spectrum of clinical presentations that extend from asymptomatic to ventricular arrhythmias and sudden cardiac death. The diagnosis has traditionally relied on histology which suffers from the low sensitivity of endomyocardial biopsy due to the patchy nature of the disease in addition to its invasive nature. Due to significant advancements in imaging, it is now possible to accurately identify cardiac sarcoidosis using non-invasive imaging modalities even without histological confirmation...
February 8, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29422408/special-considerations-for-diagnosing-behavior-problems-in-older-pets
#8
REVIEW
Eranda Rajapaksha
Aging is a complex process that involves changes in sensory perception, cognition, and physical strength. Physiologic, metabolic, and emotional changes of the aging process can lead to behavioral problems in older pets. Treatment of behavior problems in older pets requires a multimodal therapeutic approach. Frequent follow-up visits are required to monitor pets and comment on prognosis. Clients should be informed of the prognosis and should be educated to evaluate pain, discomfort, and general quality of life of the aging pet...
February 5, 2018: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/29419556/determining-the-upper-and-lower-limits-of-cerebral-autoregulation-with-cerebral-oximetry-autoregulation-curves-a-case-series
#9
Lucia Rivera-Lara, Andres Zorrilla-Vaca, Ryan J Healy, Wendy Ziai, Charles Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Marek A Mirski
OBJECTIVE: Critical care guidelines recommend a single target value for mean arterial blood pressure in critically ill patients. However, growing evidence regarding cerebral autoregulation challenges this concept and supports individualizing mean arterial blood pressure targets to prevent brain and kidney hypo- or hyperperfusion. Regional cerebral oxygen saturation derived from near-infrared spectroscopy is an acceptable surrogate for cerebral blood flow and has been validated to measure cerebral autoregulation...
February 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29416859/applying-realistic-medicine-to-intrathecal-opioid-utilisation-in-scotland-do-we-have-a-standardised-approach
#10
Robert Hart, Gordon Burns, Susan Smith
Intrathecal opioids (ITOs) are commonly administered as part of a multimodal anaesthetic strategy for a variety of surgical procedures. The evolution of laparoscopic surgical techniques has seen the popularity of ITOs increase as they are effective, well tolerated and lack the cardiovascular side effects associated with epidural infusions. The risk of delayed respiratory depression remains a concern; therefore, high-quality post-operative monitoring is vital. The evidence regarding the practicalities of ITO administration such as opioid dose, type, side effect prevalence and ideal post-operative care arrangements are sparse...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29401912/novel-optical-fiber-spr-temperature-sensor-based-on-mmf-pcf-mmf-structure-and-gold-pdms-film
#11
Yong Wang, Qing Huang, Wenjie Zhu, Minghong Yang, Elfed Lewis
In this paper, a novel optical fiber temperature sensor based on surface plasmon resonance (SPR) is presented. The sensor consists of multimode fiber-photonic crystal fiber-multimode fiber (MMF-PCF-MMF) structure coated with gold film, whose refractive index (RI) sensitivity was found to range from 1060.78 nm/RIU to 4613.73 nm/RIU in the RI range of 1.3330-1.3904. Through simulation and experimental results, the RI sensitivity of the MMF-PCF-MMF structure is found to be higher than that of multimode fiber-single mode fiber-multimode fiber (MMF-SMF-MMF) structure...
January 22, 2018: Optics Express
https://www.readbyqxmd.com/read/29401746/intracranial-pressure-monitoring-review-and-avenues-for-development
#12
REVIEW
Maya Harary, Rianne G F Dolmans, William B Gormley
Intracranial pressure (ICP) monitoring is a staple of neurocritical care. The most commonly used current methods of monitoring in the acute setting include fluid-based systems, implantable transducers and Doppler ultrasonography. It is well established that management of elevated ICP is critical for clinical outcomes. However, numerous studies show that current methods of ICP monitoring cannot reliably define the limit of the brain's intrinsic compensatory capacity to manage increases in pressure, which would allow for proactive ICP management...
February 5, 2018: Sensors
https://www.readbyqxmd.com/read/29397959/neuromonitoring-in-the-neonatal-ecmo-patient
#13
REVIEW
Nan Lin, John Flibotte, Daniel J Licht
Utilization of extraocorporeal membrane oxygenation (ECMO) has become increasingly widespread as a bridging therapy for neonates with severe, reversible respiratory or cardiac diseases. While significant risks remain, due to advances in medical and surgical management, overall mortality has decreased. However, short and long-term neurological morbidity has remained high. Therefore, increasing attention has been focused on multimodal neuromonitoring to track and optimally, minimize or prevent intracranial injury...
February 2, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29385755/liposomes-clinical-applications-and-potential-for-image-guided-drug-delivery
#14
REVIEW
Narottam Lamichhane, Thirupandiyur S Udayakumar, Warren D D'Souza, Charles B Simone Ii, Srinivasa R Raghavan, Jerimy Polf, Javed Mahmood
Liposomes have been extensively studied and are used in the treatment of several diseases. Liposomes improve the therapeutic efficacy by enhancing drug absorption while avoiding or minimizing rapid degradation and side effects, prolonging the biological half-life and reducing toxicity. The unique feature of liposomes is that they are biocompatible and biodegradable lipids, and are inert and non-immunogenic. Liposomes can compartmentalize and solubilize both hydrophilic and hydrophobic materials. All these properties of liposomes and their flexibility for surface modification to add targeting moieties make liposomes more attractive candidates for use as drug delivery vehicles...
January 30, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29377287/multimodal-assessment-of-orbital-immune-cell-infiltration-and-tissue-remodeling-during-development-of-graves-disease-by-1-h19-f-mri
#15
Ulrich Flögel, Anke Schlüter, Christoph Jacoby, Sebastian Temme, J Paul Banga, Anja Eckstein, Jürgen Schrader, Utta Berchner-Pfannschmidt
PURPOSE: To evaluate key molecular and cellular features of Graves orbitopathy (GO) by simultaneous monitoring of alterations in morphology, inflammatory patterns, and tissue remodeling. METHODS: To this end, we utilized a murine model of GO induced by immunization with a human thyroid-stimulating hormone receptor A-subunit plasmid. Altogether, 52 mice were used: 27 GOs and 25 controls (Ctrl) immunized with β-galactasidose plasmid. From these, 17 GO and 12 Ctrl mice were subjected to multimodal MRI at 9...
January 27, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29376234/multimodal-imaging-in-diabetic-macular-edema
#16
Dhariana Acón, Lihteh Wu
Throughout ophthalmic history it has been shown that progress has gone hand in hand with technological breakthroughs. In the past, fluorescein angiography and fundus photographs were the most commonly used imaging modalities in the management of diabetic macular edema (DME). Today, despite the moderate correlation between macular thickness and functional outcomes, spectral domain optical coherence tomography (SD-OCT) has become the DME workhorse in clinical practice. Several SD-OCT biomarkers have been looked at including presence of epiretinal membrane, vitreomacular adhesion, disorganization of the inner retinal layers, central macular thickness, integrity of the ellipsoid layer, and subretinal fluid, among others...
January 29, 2018: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/29372857/early-experience-of-placing-image-guided-minimally-invasive-pedicle-screws-without-k-wires-or-bone-anchored-trackers
#17
Gregory M Malham, Rhiannon M Parker
OBJECTIVE Image guidance for spine surgery has been reported to improve the accuracy of pedicle screw placement and reduce revision rates and radiation exposure. Current navigation and robot-assisted techniques for percutaneous screws rely on bone-anchored trackers and Kirchner wires (K-wires). There is a paucity of published data regarding the placement of image-guided percutaneous screws without K-wires. A new skin-adhesive stereotactic patient tracker (SpineMask) eliminates both an invasive bone-anchored tracker and K-wires for pedicle screw placement...
January 26, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29359885/mechano-based-transductive-sensing-for-wearable-healthcare
#18
REVIEW
Ting Wang, Hui Yang, Dianpeng Qi, Zhiyuan Liu, Pingqiang Cai, Han Zhang, Xiaodong Chen
Wearable healthcare presents exciting opportunities for continuous, real-time, and noninvasive monitoring of health status. Even though electrochemical and optical sensing have already made great advances, there is still an urgent demand for alternative signal transformation in terms of miniaturization, wearability, conformability, and stretchability. Mechano-based transductive sensing, referred to the efficient transformation of biosignals into measureable mechanical signals, is claimed to exhibit the aforementioned desirable properties, and ultrasensitivity...
January 23, 2018: Small
https://www.readbyqxmd.com/read/29355869/gold-nanorods-decorated-with-a-cancer-drug-for-multimodal-imaging-and-therapy
#19
Resmi V Nair, Hema Santhakumar, Ramapurath S Jayasree
Cancer, a condition with uncontrolled cell division, is the second leading cause of death worldwide. The currently available techniques for the imaging and treatment of cancer have their own limitations and hence a combination of more than one modality is expected to increase the efficacy of both diagnosis and treatment. In the present study, we have developed a multimodal imaging and therapeutic system by incorporating a chemotherapeutic drug, mitoxantrone (MTX) onto PEG coated gold nanorods (GNR). Strong absorption in the near-infrared (NIR) and visible regions qualifies GNR as an efficient photothermal (PTT) agent upon irradiation with either a NIR or visible laser...
January 22, 2018: Faraday Discussions
https://www.readbyqxmd.com/read/29354496/the-current-status-and-clinical-value-of-circulating-tumor-cells-and-circulating-cell-free-tumor-dna-in-bladder-cancer
#20
REVIEW
Sabine Riethdorf, Armin Soave, Michael Rink
Urothelial carcinoma of the bladder (UCB) is a complex disease, which is associated with highly aggressive tumor biologic behavior, especially in patients with muscle-invasive and advanced tumors. Despite multimodal therapy options including surgery, radiotherapy and chemotherapy, UCB patients frequently suffer from poor clinical outcome. Indeed, the potential of diverse opportunities for modern targeted therapies is not sufficiently elucidated in UCB yet. To improve the suboptimal treatment situation in UCB, biomarkers are urgently needed that help detecting minimal residual disease (MRD), predicting therapy response and subsequently prognosis as well as enabling patient stratification for further therapies and therapy monitoring, respectively...
December 2017: Translational Andrology and Urology
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