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Neuromuscular monitoring

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https://www.readbyqxmd.com/read/29658266/enzyme-based-electrochemical-biosensor-for-therapeutic-drug-monitoring-of-anticancer-drug-irinotecan
#1
Maria Domenica Alvau, Stefano Tartaggia, Anna Meneghello, Bruno Casetta, Giammario Calia, Pier Andrea Serra, Federico Polo, Giuseppe Toffoli
Therapeutic drug monitoring (TDM) is the clinical practice of measuring pharmaceutical drug concentrations in patients' biofluids at designated intervals, thus allowing a close and timely control of their dosage. To date, TDM in oncology can only be performed by trained personnel in centralized laboratories and core facilities employing conventional analytical techniques (e.g. MS). CPT-11 is an antineoplastic drug that inhibits topoisomerase type I, causing cell death, and is widely used in the treatment of colorectal cancer...
April 16, 2018: Analytical Chemistry
https://www.readbyqxmd.com/read/29652477/targeted-nanoparticles-for-selective-marking-of-neuromuscular-junctions-and-ex-vivo-monitoring-of-endogenous-acetylcholine-hydrolysis
#2
Alsu R Mukhametshina, Svetlana V Fedorenko, Alexey M Petrov, Guzel F Zakyrjanova, Konstantin A Petrov, Leniz F Nurullin, Irek R Nizameev, Asiya R Mustafina, Oleg G Sinyashin
The present work for the first time introduces nanosensors for luminescent monitoring of acetylcholinesterase (AChE)-catalyzed hydrolysis of endogenous acetylcholine (AСh) released in neuromuscular junctions of isolated muscles. The sensing function results from the quenching of Tb(III)-centered luminescence due to proton-induced degradation of luminescent Tb(III) complexes doped into silica nanoparticles (SNs, 23 nm), when acetic acid is produced from the enzymatic hydrolysis of ACh. The targeting of the silica nanoparticles by α-bungarotoxin was used for selective staining of the synaptic space in the isolated muscles by the nanosensors...
April 13, 2018: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29651162/quantitative-methods-to-monitor-rna-biomarkers-in-myotonic-dystrophy
#3
Marzena Wojciechowska, Krzysztof Sobczak, Piotr Kozlowski, Saam Sedehizadeh, Agnieszka Wojtkowiak-Szlachcic, Karol Czubak, Robert Markus, Anna Lusakowska, Anna Kaminska, J David Brook
Myotonic dystrophy type 1 (DM1) and type 2 (DM2) are human neuromuscular disorders associated with mutations of simple repetitive sequences in affected genes. The abnormal expansion of CTG repeats in the 3'-UTR of the DMPK gene elicits DM1, whereas elongated CCTG repeats in intron 1 of ZNF9/CNBP triggers DM2. Pathogenesis of both disorders is manifested by nuclear retention of expanded repeat-containing RNAs and aberrant alternative splicing. The precise determination of absolute numbers of mutant RNA molecules is important for a better understanding of disease complexity and for accurate evaluation of the efficacy of therapeutic drugs...
April 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29643557/reversal-agents-do-we-need-to-administer-with-neuromuscular-monitoring-an-observational-study
#4
Shilpa Goyal, Nikhil Kothari, Deepak Chaudhary, Shilpi Verma, Pooja Bihani, Mahaveer Singh Rodha
Background and Aims: In clinical practice, in the majority of patients, recovery from the effect of muscle relaxants is assessed using subjective methods such as head lift, eye-opening, or by sustained hand grip after giving anticholinesterases (neostigmine) at the end of surgery. We planned a prospective observational cohort study to test the hypothesis that objective neuromuscular monitoring can help us in avoiding the use of anticholinesterases for reversal. Methods: The patients posted for surgery of <2 h duration were included in the study...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#5
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29621672/oyster-transcriptome-response-to-alexandrium-exposure-is-related-to-saxitoxin-load-and-characterized-by-disrupted-digestion-energy-balance-and-calcium-and-sodium-signaling
#6
Audrey M Mat, Christophe Klopp, Laura Payton, Céline Jeziorski, Morgane Chalopin, Zouher Amzil, Damien Tran, Gary H Wikfors, Hélène Hégaret, Philippe Soudant, Arnaud Huvet, Caroline Fabioux
Harmful Algal Blooms are worldwide occurrences that can cause poisoning in human seafood consumers as well as mortality and sublethal effets in wildlife, propagating economic losses. One of the most widespread toxigenic microalgal taxa is the dinoflagellate Genus Alexandrium, that includes species producing neurotoxins referred to as PST (Paralytic Shellfish Toxins). Blooms cause shellfish harvest restrictions to protect human consumers from accumulated toxins. Large inter-individual variability in toxin load within an exposed bivalve population complicates monitoring of shellfish toxicity for ecology and human health regulation...
March 27, 2018: Aquatic Toxicology
https://www.readbyqxmd.com/read/29614692/determination-of-qpcr-reference-genes-suitable-for-normalizing-gene-expression-in-a-canine-model-of-duchenne-muscular-dystrophy
#7
John C W Hildyard, Frances Taylor-Brown, Claire Massey, Dominic J Wells, Richard J Piercy
BACKGROUND: Dogs with dystrophin-deficient muscular dystrophy are valuable models of the equivalent human disease, Duchenne Muscular Dystrophy (DMD): unlike the mdx mouse, these animals present a disease severity and progression that closely matches that found in human patients. Canine models are however less thoroughly characterised than the established mdx mouse in many aspects, including gene expression. Analysis of expression in muscle plays a key role in the study of DMD, allowing monitoring and assessment of disease progression, evaluation of novel biomarkers and gauging of therapeutic intervention efficacy...
March 26, 2018: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/29609909/-why-is-the-morbidly-obese-patient-at-high-risk-of-anesthetic-complications
#8
Audrey De Jong, Daniel Verzilli, Marie Geniez, Gérald Chanques, David Nocca, Samir Jaber
Obesity is often associated with obstructive sleep apnea (OSA), which increases the risk of intraoperative and postoperative complications. The role of preoperative screening of OSA is crucial, with adequate management based on continuous positive pressure before, during and after surgery. The obese patient is at risk of postoperative complications: difficult airway management, acute respiratory failure following extubation due to atelectasis and airway obstruction, added to morphine overdosing. Optimal management of difficult mask ventilation and intubation, protective ventilation, combined to the reduction of sedatives and analgesics and the sitting position as soon as possible with a postoperative monitoring should decrease the occurrence of complications...
March 30, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29579078/a-novel-high-throughput-immunofluorescence-analysis-method-for-quantifying-dystrophin-intensity-in-entire-transverse-sections-of-duchenne-muscular-dystrophy-muscle-biopsy-samples
#9
Valentina Sardone, Matthew Ellis, Silvia Torelli, Lucy Feng, Darren Chambers, Deborah Eastwood, Caroline Sewry, Rahul Phadke, Jennifer E Morgan, Francesco Muntoni
Clinical trials using strategies aimed at inducing dystrophin expression in Duchenne muscular dystrophy (DMD) are underway or at advanced planning stage, including splice switching antisense oligonucleotides (AON), drugs to induce read-through of nonsense mutations and viral mediated gene therapy. In all these strategies, different dystrophin proteins, often internally deleted, are produced, similar to those found in patients with the milder DMD allelic variant, Becker muscular dystrophy (BMD). The primary biological endpoint of these trials is to induce functional dystrophin expression...
2018: PloS One
https://www.readbyqxmd.com/read/29574805/investigation-of-the-relationship-between-electrical-stimulation-frequency-and-muscle-frequency-response-under-submaximal-contractions
#10
Caluê Papcke, Eddy Krueger, Marcia Olandoski, Guilherme Nunes Nogueira-Neto, Percy Nohama, Eduardo Mendonça Scheeren
Neuromuscular electrical stimulation (NMES) is a common tool that is used in clinical and laboratory experiments and can be combined with mechanomyography (MMG) for biofeedback in neuroprostheses. However, it is not clear if the electrical current applied to neuromuscular tissues influences the MMG signal in submaximal contractions. The objective of this study is to investigate whether the electrical stimulation frequency influences the mechanomyographic frequency response of the rectus femoris muscle during submaximal contractions...
March 25, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29566571/respiratory-measures-in-amyotrophic-lateral-sclerosis
#11
Noah Lechtzin, Merit E Cudkowicz, Mamede de Carvalho, Angela Genge, Orla Hardiman, Hiroshi Mitsumoto, Jesus S Mora, Jeremy Shefner, Leonard H Van den Berg, Jinsy A Andrews
OBJECTIVE: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes skeletal muscle weakness, including muscles involved with respiration. Death often results from respiratory failure within 3-5 years. Monitoring respiratory status is therefore critical to ALS management, as respiratory/pulmonary function tests (PFTs) are used to make decisions including when to initiate noninvasive ventilation. Understanding the different respiratory and PFTs as they relate to disease progression and survival may help determine which tests are most suitable...
March 23, 2018: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29557601/sedation-and-analgesia-in-patients-on-mechanical-ventilation-in-pediatric-intensive-care-units-in-argentina
#12
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29547745/stem-cell-derived-phenotypic-human-neuromuscular-junction-model-for-dose-response-evaluation-of-therapeutics
#13
Navaneetha Santhanam, Lee Kumanchik, Xiufang Guo, Frank Sommerhage, Yunqing Cai, Max Jackson, Candace Martin, George Saad, Christopher W McAleer, Ying Wang, Andrea Lavado, Christopher J Long, James J Hickman
There are currently no functional neuromuscular junction (hNMJ) systems composed of human cells that could be used for drug evaluations or toxicity testing in vitro. These systems are needed to evaluate NMJs for diseases such as amyotrophic lateral sclerosis, spinal muscular atrophy or other neurodegenerative diseases or injury states. There are certainly no model systems, animal or human, that allows for isolated treatment of motoneurons or muscle capable of generating dose response curves to evaluate pharmacological activity of these highly specialized functional units...
February 27, 2018: Biomaterials
https://www.readbyqxmd.com/read/29543137/repeatability-and-reliability-of-muscle-relaxation-properties-induced-by-motor-cortical-stimulation
#14
Joery P Molenaar, Nicol C Voermans, Lysanne A de Jong, Dick F Stegeman, Jonne Doorduin, Baziel G van Engelen
Impaired muscle relaxation is a feature of many neuromuscular disorders. However, there are few tests available to quantify muscle relaxation. Transcranial magnetic stimulation (TMS) of the motor cortex can induce muscle relaxation by abruptly inhibiting corticospinal drive. The aim of our study is to investigate if repeatability and reliability of TMS-induced relaxation is greater than voluntary relaxation. Furthermore, effects of sex, cooling and fatigue on muscle relaxation properties were studied. Muscle relaxation of deep finger flexors was assessed in twenty-five healthy subjects (14 M and 11 F, aged 39...
March 15, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29520678/intraoperative-feasibility-of-bulbocavernosus-reflex-monitoring-during-untethering-surgery-in-infants-and-children
#15
Takeaki Shinjo, Hironobu Hayashi, Tsunenori Takatani, Eishu Boku, Hiroyuki Nakase, Masahiko Kawaguchi
Bulbocavernosus reflex (BCR) monitoring is used to assess the integrity of urinary and bowel function. In this study, we evaluated the feasibility of BCR monitoring during untethering surgery in infants and children to predict postoperative urinary and bowel dysfunction. The records of 22 patients ranging from 4 days to 10 years old (mean 2.7 ± 3.3 years) were reviewed. Anesthesia was maintained by propofol or sevoflurane/opioid without neuromuscular blockade. BCR waveforms induced by electrical stimulation (20-40 mA, train-of-four pulses with 500 Hz) to the penis or clitoris were recorded from bilateral external anal sphincters...
March 8, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29517695/optimal-dose-of-combined-rocuronium-and-cisatracurium-during-minor-surgery-a-randomized-trial
#16
Woo Young Park, Jae Chan Choi, Hey Jeong Yun, Yeong Gwan Jeon, Gisoon Park, Jong Bum Choi
BACKGROUND: Combined rocuronium and cisatracurium have synergistic effects. We investigated whether reduced doses are effective during coadministration, by monitoring neuromuscular relaxation during surgery. METHODS: This randomized, controlled clinical trial was registered at http://clinicaltrials.gov (registration number NCT02495038). The participants were 81 patients scheduled for elective mastoidectomy and tympanoplasty. Participants were assigned to groups, including the intubating dose group (Group I, n = 27; combined ED95 rocuronium and ED95 cisatracurium), the small reduction group (Group S, n = 27; dose reduced by 10% of each ED95), or the large reduction group (Group L, n = 27; dose reduced by 20% of each ED95)...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29511921/increased-rate-of-force-development-during-periodized-maximum-strength-and-power-training-is-highly-individual
#17
Heikki Peltonen, Simon Walker, Anthony C Hackney, Janne Avela, Keijo Häkkinen
Maximum strength training induces various improvements in the rate of force development (RFD) on a group level, but no study has investigated inter-individual adaptations in RFD. Fourteen men (28 ± 6 years old) performed the same 10-week maximum strength and then a 10-week power training program. Maximal force and RFD were recorded during maximal isometric leg extension voluntary contractions repeatedly before every 7th training session (2 sessions/week). After the intervention, subjects were retrospectively divided into three groups based on their RFD improvements: (1) improved only during the maximum strength period (MS-responders, + 100 ± 35%), (2) improved only during the power period (P-responders, + 53 ± 27%) or (3) no improvement at all (non-responders, + 3 ± 9%)...
March 6, 2018: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29497763/-deep-neuromuscular-blockade-benefits-and-risks
#18
REVIEW
C Unterbuchner, M Blobner
Neuromuscular blockade (TOF count = 0) can improve tracheal intubation and microlaryngeal surgery. It is also frequently used in many surgical fields including both nonlaparoscopic and laparoscopic surgery to improve surgical conditions and to prevent sudden muscle contractions. Currently there is a controversy regarding the need and the clinical benefits of deep neuromuscular blockade for different surgical procedures. Deep neuromuscular relaxation improves laparoscopic surgical space conditions only marginally when using low intra-abdominal pressure...
March 1, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29497496/recent-advances-in-neuromuscular-block-during-anesthesia
#19
REVIEW
Martijn Boon, Christian Martini, Albert Dahan
Muscle relaxation is a routine part of anesthesia and has important advantages. However, the lingering effects of muscle relaxants in the postoperative period have historically been associated with postoperative adverse events. Neuromuscular reversal, together with neuromuscular monitoring, is a recognized strategy to reduce the rate of postoperative residual relaxation but has only marginally improved outcome in the past few decades. Sugammadex, a novel reversal agent with unique encapsulating properties, has changed the landscape of neuromuscular reversal and opened up new opportunities to improve patient care...
2018: F1000Research
https://www.readbyqxmd.com/read/29496709/residual-neuromuscular-blockade-in-the-critical-care-setting
#20
Nicole Stawicki, Patty Gessner
Residual neuromuscular blockade is a widespread challenge for providers in the acute care setting that, if left unrecognized or untreated, places patients at higher risk for morbidity and mortality. The condition is estimated to occur in 26% to 88% of patients undergoing general anesthesia. The role of the advanced practice nurse in the acute care setting is to facilitate a safe recovery process by identifying early signs of deterioration and supporting the patient until full muscular strength has returned...
2018: AACN Advanced Critical Care
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