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Multimodality monitoring

Mariana Ingolotti, Enrique Alfonso Roig Melo-Granados, Pedro Mario González-Madrigal, Humberto Ruiz García
PURPOSE: To report a case of central retinal artery occlusion in a patient with macular telangiectasia Type 2 using multimodal imaging. METHODS: Observational case report. RESULTS: A 58-year-old woman who presented with acute painless unilateral vision loss was diagnosed with central retinal artery occlusion in her right eye with macular telangiectasia Type 2 findings in both eyes. Fundus examination revealed retinal whitening with unusual cherry-red spot plus small crystalline deposits in the temporal macula...
June 13, 2018: Retinal Cases & Brief Reports
Chengxi Wu, Carolyn L Bayer
The function of the placenta is challenging to characterize and as a result is understudied, despite the growing awareness of the impact of the placental environment on human health and development. Medical imaging has the potential to improve our ability to screen for diseases associated with placental insufficiency, and improve the monitoring and treatment of complex obstetric patients. This review provides an overview of clinical and preclinical imaging modalities currently available for assessing placental function, with an emphasis on emerging preclinical imaging modalities; as a group, these emerging modalities provide exceptional contrast and sensitivity for multimodal functional and molecular imaging of the placenta...
June 14, 2018: Physics in Medicine and Biology
Mengting Li, Yichun Wang, Mei Liu, Xiaoli Lan
Molecular imaging has played an important role in the noninvasive exploration of multiple biological processes. Reporter gene imaging is a key part of molecular imaging. By combining with a reporter probe, a reporter protein can induce the accumulation of specific signals that are detectable by an imaging device to provide indirect information of reporter gene expression in living subjects. There are many types of reporter genes and each corresponding imaging technique has its own advantages and drawbacks. Fused reporter genes or single reporter genes with products detectable by multiple imaging modalities can compensate for the disadvantages and potentiate the advantages of each modality...
2018: Theranostics
David J Kirby, Harry C Dietz, Paul D Sponseller
BACKGROUND: We studied the prevalence and treatment outcomes of spondylolisthesis in patients with Loeys-Dietz syndrome (LDS). METHODS: Clinical data and lumbosacral imaging of 138 patients with LDS were reviewed. Spondylolisthesis (L4-L5 or L5-S1) and spondylolysis were characterized by multimodal imaging and correlated with clinical data. Treatments and outcomes were characterized for patients with spondylolisthesis. Associations were determined using the Fisher exact, Mann-Whitney, and Student t tests (α=0...
June 8, 2018: Journal of Pediatric Orthopedics
Pedro Jesus Saturno, Daniel Angel-García, Ismael Martínez-Nicolás, Francisco López Soriano, Maria Pilar Escolar Reina, María Beatriz Guerrero Díaz, María Encarnación Ros Martínez, Francesc Medina Mirapeix, Mayo Saturno Marcos
OBJECTIVES: This study was designed to address the current relative void of valid measures by developing evidence-based quality indicators for pain management of chronic non-malignant pain. METHODS: We performed a 10-year literature search to identify guidelines and review articles on chronic pain management to identify evidence-based recommendations for the different conditions associated to chronic pain. A complementary search of indicators and indicator-related articles was also performed...
June 8, 2018: Pain Practice: the Official Journal of World Institute of Pain
Ahmed Jalal, Fahmida Alam, Sohini RoyChoudhury, Yogeswaran Umasankar, Nezih Pala, Shekhar Bhansali
The chemical signatures of volatile organic compounds (VOCs) in humans can be utilized for point-of-care (POC) di-agnosis. Apart from toxic exposure studies, VOCs generated in humans can provide insights into one's healthy and dis-eased metabolic states, acting as a biomarker for identifying numerous diseases non-invasively. VOC sensors and the technology of e-nose have received significant attention for continuous and selective monitoring of various physiolog-ical and pathophysiological conditions of an individual...
June 8, 2018: ACS Sensors
Sarah H Peacock, Amanda D Tomlinson
Neuromonitoring is important for patients with acute brain injury. The bedside neurologic examination is standard for neurologic monitoring; however, a clinical examination may not reliably detect subtle changes in intracranial physiology. Changes found during neurologic examinations are often late signs. The assessment of multiple physiological variables in real time can provide new clinical insights into treatment decisions. No single monitoring modality is ideal for all patients. Simultaneous assessment of cerebral hemodynamics, oxygenation, and metabolism, such as in multimodal monitoring, allows an innovative approach to individualized patient care...
2018: AACN Advanced Critical Care
Erie G Gutierrez, Nathan E Crone, Joon Y Kang, Yaretson I Carmenate, Gregory L Krauss
Sudden unexpected death in epilepsy (SUDEP) is a common cause of death in epilepsy and frequently occurs following generalized tonic-clonic seizures (GTCS). Non-electroencephalography (EEG) seizure detection systems using mobile sensor devices permit caregivers to assist patients during seizures and may reduce risks for complications of seizures such as injuries and SUDEP. We review changes in accelerometry, electrodermal activity, and heart rate associated with tonic-clonic seizures and their use in detection systems, including multimodal detectors...
June 2018: Epilepsia
Liesbeth Thewissen, Alexander Caicedo, Petra Lemmers, Frank Van Bel, Sabine Van Huffel, Gunnar Naulaers
Introduction: Cerebral autoregulation (CAR), the ability of the human body to maintain cerebral blood flow (CBF) in a wide range of perfusion pressures, can be calculated by describing the relation between arterial blood pressure (ABP) and cerebral oxygen saturation measured by near-infrared spectroscopy (NIRS). In literature, disturbed CAR is described in different patient groups, using multiple measurement techniques and mathematical models. Furthermore, it is unclear to what extent cerebral pathology and outcome can be explained by impaired CAR...
2018: Frontiers in Pediatrics
Matthew J Hoptman, Emily M Parker, Sangeeta Nair-Collins, Elisa C Dias, Marina E Ross, Joanna N DiCostanzo, Pejman Sehatpour, Daniel C Javitt
Patients with schizophrenia show response inhibition deficits equal to or greater than those seen in impulse-control disorders, and these deficits contribute to poor outcome. However, little is known about the circuit abnormalities underlying this impairment. To address this, we examined stop signal task performance in 21 patients with schizophrenia and 21 healthy controls using event related potential (ERP) and resting state functional connectivity. Patients showed prolonged stop signal reaction time (SSRT) and reduced N1, N2, and P3 amplitudes compared to controls...
2018: NeuroImage: Clinical
Daniel Pinggera, Ondra Petr, Gabriel Putzer, Claudius Thomé
Multimodal neuromonitoring has become a fundamental part of management for many neurosurgical disorders such as subarachnoid hemorrhage and severe traumatic brain injury. Obviously, brain tissue oxygen tension monitoring requires insertion of a probe into the brain parenchyma through a single multiple lumen bolt, or in a subcutaneously tunneled fashion. As those patients often require early magnetic resonance imaging(MRI), typically used bolts are disadvantageous due to massive metal artifact. Similarly, subcutaneous tunneling is often problematic as suture fixation can loosen over time...
May 30, 2018: World Neurosurgery
Alec Peniche, Lawrence Poree, Mark Schumacher, Xiaobing Yu
Intrathecal patient-controlled analgesia (IT-PCA) through implanted intrathecal infusion pumps has been increasingly utilized for severe cancer and chronic noncancer pain management. However, its application for acute postoperative pain management has not been reported to date. We present a case of a patient with an implanted intrathecal pump for chronic nonmalignant back pain who underwent an extensive spinal fusion surgery. The IT-PCA functionality of her intrathecal pump was successfully integrated into her postoperative multimodal pain regimen...
June 1, 2018: A&A practice
M Agerskov, H Sørensen, J Højlund, N H Secher, N B Foss
BACKGROUND: In a frail patient group often suffering from dehydration, hip fracture is potentially fatal partly because of the blood loss and thus deteriorated circulation. An important goal for haemodynamic monitoring and resuscitation is early detection of insufficient tissue perfusion. "The peripheral perfusion index" reflects changes in peripheral perfusion and blood volume. We hypothesize that hip fracture patients are hypovolaemic with poor peripheral perfusion and accordingly respond to controlled fluid resuscitation...
May 30, 2018: Acta Anaesthesiologica Scandinavica
Marc N Gallay, David Moser, Daniel Jeanmonod
OBJECTIVE Since the first clinical application of the incisionless magnetic resonance-guided focused ultrasound (MRgFUS) technology only small series of patients have been reported, and thus only extrapolations of the procedure-related risks could be offered. In this study, the authors analyze side-effects and targeting accuracy in 180 consecutive treatments with MRgFUS for chronic therapy-resistant idiopathic Parkinson's disease (PD), essential tremor (ET), cerebellar tremor (CT), and neuropathic pain (NP), all performed in their dedicated center...
May 25, 2018: Journal of Neurosurgery
Eva Češková
Despite of tremendous development in CNS research, current treatment is suboptimal especially in severe mental disorders. In medicine, there are two main methods of improving the healthcare provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring, but also implementation of general trends into the clinical practice. New pharmacological options include drugs aimed at other than monoaminergic systems and old drugs used before the psychopharmacological era...
2018: Casopís Lékar̆ů C̆eských
Mahesh Tiwari, Sanjay Kumar Sahu, Rahul C Bhangare, P Y Ajmal, Gauri Girish Pandit
The levels of 15 polybrominated diphenyl ether (PBDE) congeners in grab sediment and sediment cores from the Thane creek were monitored for their spatial and temporal distribution. Total PBDE (ΣPBDE) concentrations in grab sediments were ranging from 15.98 to 132.72 ng g-1 dry weight. BDE-209 was the most abundant congener with percentage contribution in the range of 19-35% to total PBDEs. Total PBDE show multimode concentration with depth in sediment, among which mode at a depth of 10 cm is predominant...
May 22, 2018: Environmental Geochemistry and Health
Chia-Feng Lu, Fei-Ting Hsu, Kevin Li-Chun Hsieh, Yu-Chieh Jill Kao, Sho-Jen Cheng, Justin Bo-Kai Hsu, Ping-Huei Tsai, Ray-Jade Chen, Chao-Ching Huang, Yun Yen, Cheng-Yu Chen
PURPOSE: The new classification announced by the World Health Organization in 2016 recognized five molecular subtypes of diffuse gliomas based on isocitrate dehydrogenase (IDH) and 1p/19q genotypes in addition to histological phenotypes. We aim to determine whether clinical magnetic resonance imaging (MRI) can stratify these molecular subtypes to benefit the diagnosis and monitoring of gliomas. EXPERIMENTAL DESIGN: The data from 456 subjects with gliomas were obtained from The Cancer Imaging Archive...
May 22, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Ryan J Healy, Andres Zorrilla-Vaca, Wendy Ziai, Marek A Mirski, Charles W Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Lucia Rivera-Lara
BACKGROUND: The Glasgow Coma Scale (GCS) is an essential coma scale in critical care for determining the neurological status of patients and for estimating their long-term prognosis. Similarly, cerebral autoregulation (CA) monitoring has shown to be an accurate technique for predicting clinical outcomes. However, little is known about the relationship between CA measurements and GCS scores among neurological critically ill patients. This study aimed to explore the association between noninvasive CA multimodal monitoring measurements and GCS scores...
May 18, 2018: Journal of Neurosurgical Anesthesiology
(no author information available yet)
Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman's ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother-infant dyad...
May 17, 2018: Obstetrics and Gynecology
Sachi R Patel, Stavros N Moysidis, Nicole Koulisis, Philip P Storey, Amir H Kashani, Narsing A Rao, Damien C Rodger
Purpose: To report the clinical presentation, multimodal imaging, and management of a patient with metastatic melanoma who presented with cystoid macular edema (CME). Observations: We report a case of a 71-year-old Caucasian male with metastatic melanoma who presented with bilateral cystoid macular edema after being on treatment with a programmed T cell death ligand 1 inhibitor, MPDL3280, for 1 year. Multimodal imaging techniques, including color fundus photographs, autofluorescence, spectral domain optical coherence tomography (OCT), fluorescein angiography (Spectralis, Heidelberg, Germany), and spectral-domain OCT angiography (Zeiss; California, USA) were performed to evaluate the etiology of his CME and to monitor his response to treatment...
June 2018: American Journal of Ophthalmology Case Reports
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