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https://www.readbyqxmd.com/read/28643998/survey-in-expert-clinicians-on-validity-of-automated-calculation-of-optimal-cerebral-perfusion-pressure
#1
Romy Steijn, Roy Stewart, Marek Czosnyka, Joseph Donnelly, Ari Ercole, Antony Absalom, Jan W Elting, Christina Haubrich, Peter Smielewski, Marcel Aries
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) targeting in traumatic brain injury (TBI) patients constitutes an active and controversial area of research. It has been suggested that an autoregulation guided CPP therapy may improve TBI outcome. Prerequisites of a CPPopt intervention study would be objective criteria for the CPPopt detection.. This study compared the agreement between automated and visual CPPopt detection. METHODS: Twenty-five clinicians from 18 centres worldwide, familiar with brain monitoring and using dedicated software, reviewed ten 4-hour CPPopt screenshots at 48 hrs after ictus in selected TBI patients...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28639837/measuring-cerebrovascular-autoregulation-in-preterm-infants-using-near-infrared-spectroscopy-an-overview-of-the-literature
#2
Elisabeth M W Kooi, Elise A Verhagen, Jan Willem J Elting, Marek Czosnyka, Topun Austin, Flora Y Wong, Marcel J H Aries
The preterm born infant's ability to regulate its cerebral blood flow (CBF) is crucial in preventing secondary ischemic and hemorrhagic damage in the developing brain. The relationship between arterial blood pressure (ABP) and CBF estimates, such as regional cerebral oxygenation as measured by near-infrared spectroscopy (NIRS), is an attractive option for continuous non-invasive assessment of cerebrovascular autoregulation. Areas covered: The authors performed a literature search to provide an overview of the current literature on various current clinical practices and methods to measure cerebrovascular autoregulation in the preterm infant by NIRS...
June 22, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28625244/-establishment-of-porcine-model-of-prolonged-cardiac-arrest-and-cardiopulmonary-resuscitation-electrically-induced-by-ventricular-fibrillation
#3
Cai Wen, Heng Li, Xiaozhu Zhai, Youde Ding, Huatao Zhou, Zhiming Ouyang, Zhengfei Yang, Longyuan Jiang, Wanchun Tang, Tao Yu
OBJECTIVE: To investigate the optimal injury time point of cardiac arrest (CA) induced electrically, and establish a reproducible prolonged CA and cardiopulmonary resuscitation (CPR) model in pigs. METHODS: Forty healthy domestic male pigs were randomly divided into four groups, which were ventricular fibrillation (VF) 8, 10, 11, and 12 minutes groups, each group for 10 animals. In these groups, VF was induced by alternating current delivered to right ventricular endocardium and untreated for 8, 10, 11, and 12 minutes, respectively, followed by 6 minutes of CPR procedure...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28624185/the-formation-of-nanoparticles-between-small-interfering-rna-and-amphipathic-cell-penetrating-peptides
#4
Ly Pärnaste, Piret Arukuusk, Kent Langel, Tanel Tenson, Ülo Langel
Cell-penetrating peptides (CPPs) are delivery vectors widely used to aid the transport of biologically active cargoes to intracellular targets. These cargoes include small interfering RNAs (siRNA) that are not naturally internalized by cells. Elucidating the complexities behind the formation of CPP and cargo complexes is crucial for understanding the processes related to their delivery. In this study, we used modified analogs of the CPP transportan10 and investigated the binding properties of these CPPs to siRNA, the formation parameters of the CPP/siRNA complexes, and their stabiliy to enzymatic degradation...
June 16, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28486883/monitoring-of-optimal-cerebral-perfusion-pressure-in-traumatic-brain-injured-patients-using-a-multi-window-weighting-algorithm
#5
Xiuyun Liu, Natasha M Maurits, Marcel J H Aries, Marek Czosnyka, Ari Ercole, Joseph Donnelly, Danilo Cardim, Dong-Joo Kim, Celeste Dias, Manuel Cabeleira, Peter Smieleweski
Methods to identify an autoregulation guided 'optimal' cerebral perfusion pressure (CPPopt) for traumatic brain injury patients (TBI) have been reported through several studies. An important drawback of existing methodology is that CPPopt can be calculated only in approximately 50-60% of the monitoring time. In this study, we hypothesized that the CPPopt yield and the continuity can be improved significantly through application of a multi-window and weighting calculation algorithm, without adversely affecting preservation of its prognostic value...
May 9, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28414340/comparison-of-chirped-probe-pulse-and-hybrid-femtosecond-picosecond-coherent-anti-stokes-raman-scattering-for-combustion-thermometry
#6
Daniel R Richardson, Hans U Stauffer, Sukesh Roy, James R Gord
A comparison is made between two ultrashort-pulse coherent anti-Stokes Raman scattering (CARS) thermometry techniques-hybrid femtosecond/picosecond (fs/ps) CARS and chirped-probe-pulse (CPP) fs-CARS-that have become standards for high-repetition-rate thermometry in the combustion diagnostics community. These two variants of fs-CARS differ only in the characteristics of the ps-duration probe pulse; in hybrid fs/ps CARS a spectrally narrow, time-asymmetric probe pulse is used, whereas a highly chirped, spectrally broad probe pulse is used in CPP fs-CARS...
April 10, 2017: Applied Optics
https://www.readbyqxmd.com/read/28383324/cerebral-autoregulation-oriented-therapy-at-the-bedside-a-comprehensive-review
#7
Lucia Rivera-Lara, Andres Zorrilla-Vaca, Romergryko G Geocadin, Ryan J Healy, Wendy Ziai, Marek A Mirski
This comprehensive review summarizes the evidence regarding use of cerebral autoregulation-directed therapy at the bedside and provides an evaluation of its impact on optimizing cerebral perfusion and associated functional outcomes. Multiple studies in adults and several in children have shown the feasibility of individualizing mean arterial blood pressure and cerebral perfusion pressure goals by using cerebral autoregulation monitoring to calculate optimal levels. Nine of these studies examined the association between cerebral perfusion pressure or mean arterial blood pressure being above or below their optimal levels and functional outcomes...
April 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28361248/increased-risk-of-critical-cbf-levels-in-sah-patients-with-actual-cpp-below-calculated-optimal-cpp
#8
Ulf Johnson, Henrik Engquist, Anders Lewén, Tim Howells, Pelle Nilsson, Elisabeth Ronne-Engström, Elham Rostami, Per Enblad
BACKGROUND: Cerebral pressure autoregulation can be quantified with the pressure reactivity index (PRx), based on the correlation between blood pressure and intracranial pressure. Using PRx optimal cerebral perfusion pressure (CPPopt) can be calculated, i.e., the level of CPP where autoregulation functions best. The relation between cerebral blood flow (CBF) and CPPopt has not been examined. The objective was to assess to which extent CPPopt can be calculated in SAH patients and to investigate CPPopt in relation to CBF...
June 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28269231/hemodynamic-effects-of-synchronizing-an-intra-aortic-vad-in-reverse-rotation-control-with-left-ventricle-a-mock-loop-study
#9
Yaxin Wang, P Alex Smith, Daniel L Timms, Po-Lin Hsu, Richard A McMahon
The IntraVAD is an intra-aortic left ventricular assist device (LVAD) to be located in the ascending aorta. In order to enhance unloading and promote coronary flow for the left ventricle (LV), an operating mechanism, reverse-rotation control (RRc) mode, has been developed for the IntraVAD and tested in vitro in a mock circulation loop (MCL). The RRc mode consists of forward rotation (FR) and reverse rotation (RR). The synchronization between the IntraVAD and the LV was studied to offload the ventricle more effectively and to improve myocardial perfusion...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28254076/computational-simulation-of-passive-leg-raising-effects-on-hemodynamics-during-cardiopulmonary-resuscitation
#10
Dong Ah Shin, Jiheum Park, Jung Chan Lee, Sang Do Shin, Hee Chan Kim
BACKGROUND AND OBJECTIVE: The passive leg-raising (PLR) maneuver has been used for patients with circulatory failure to improve hemodynamic responsiveness by increasing cardiac output, which should also be beneficial and may exert synergetic effects during cardiopulmonary resuscitation (CPR). However, the impact of the PLR maneuver on CPR remains unclear due to difficulties in monitoring cardiac output in real-time during CPR and a lack of clinical evidence. METHODS: We developed a computational model that couples hemodynamic behavior during standard CPR and the PLR maneuver, and simulated the model by applying different angles of leg raising from 0° to 90° and compression rates from 80/min to 160/min...
March 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28250136/definition-and-reliability-assessment-of-elementary-ultrasonographic-findings-in-calcium-pyrophosphate-deposition-disease-a-study-by-the-omeract-calcium-pyrophosphate-deposition-disease-ultrasound-subtask-force
#11
Georgios Filippou, Carlo A Scirè, Nemanja Damjanov, Antonella Adinolfi, Greta Carrara, Valentina Picerno, Carmela Toscano, George A Bruyn, Maria Antonietta D'Agostino, Andrea Delle Sedie, Emilio Filippucci, Marwin Gutierrez, Mihaela Micu, Ingrid Möller, Esperanza Naredo, Carlos Pineda, Francesco Porta, Wolfgang A Schmidt, Lene Terslev, Violeta Vlad, Pascal Zufferey, Annamaria Iagnocco
OBJECTIVE: To define the ultrasonographic characteristics of calcium pyrophosphate crystal (CPP) deposits in joints and periarticular tissues and to evaluate the intra- and interobserver reliability of expert ultrasonographers in the assessment of CPP deposition disease (CPPD) according to the new definitions. METHODS: After a systematic literature review, a Delphi survey was circulated among a group of expert ultrasonographers, who were members of the CPPD Ultrasound (US) Outcome Measures in Rheumatology (OMERACT) subtask force, to obtain definitions of the US characteristics of CPPD at the level of fibrocartilage (FC), hyaline cartilage (HC), tendon, and synovial fluid (SF)...
March 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28249552/hypertension-induced-enhanced-myogenic-constriction-of-cerebral-arteries-is-preserved-after-traumatic-brain-injury
#12
Nikolett Szarka, Krisztina Amrein, Peter Horvath, Ivan Ivic, Endre Czeiter, Andras Buki, Akos Koller, Peter Toth
Traumatic brain injury (TBI) was shown to impair pressure-induced myogenic response of cerebral arteries, which is associated with vascular and neural dysfunction and increased mortality of TBI patients. Hypertension was shown to enhance myogenic tone of cerebral arteries via increased vascular production of 20-hydroxyeicosatrienoic acid (HETE). This adaptive mechanism protects brain tissue from pressure/volume overload; however, it can also lead to increased susceptibility to cerebral ischemia. Although both effects may potentiate the detrimental vascular consequences of TBI, it is not known how hypertension modulates the effect of TBI on myogenic responses of cerebral vessels...
April 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28227463/hemodynamic-effects-of-synchronizing-an-intra-aortic-vad-in-reverse-rotation-control-with-left-ventricle-a-mock-loop-study
#13
Yaxin Wang, P Alex Smith, Daniel L Timms, Po-Lin Hsu, Richard A McMahon, Yaxin Wang, P Alex Smith, Daniel L Timms, Po-Lin Hsu, Richard A McMahon, Richard A McMahon, Daniel L Timms, Po-Lin Hsu, Yaxin Wang, P Alex Smith
The IntraVAD is an intra-aortic left ventricular assist device (LVAD) to be located in the ascending aorta. In order to enhance unloading and promote coronary flow for the left ventricle (LV), an operating mechanism, reverse-rotation control (RRc) mode, has been developed for the IntraVAD and tested in vitro in a mock circulation loop (MCL). The RRc mode consists of forward rotation (FR) and reverse rotation (RR). The synchronization between the IntraVAD and the LV was studied to offload the ventricle more effectively and to improve myocardial perfusion...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28215591/the-effect-of-resuscitation-position-on-cerebral-and-coronary-perfusion-pressure-during-mechanical-cardiopulmonary-resuscitation-in-porcine-cardiac-arrest-model
#14
Taeyun Kim, Sang Do Shin, Kyoung Jun Song, Yong Joo Park, Hyun Ho Ryu, Guillaume Debaty, Keith Lurie, Ki Jeong Hong
OBJECTIVE: It is unknown whether patient position is associated with the optimal cerebral (CePP) and coronary (CoPP) perfusion pressure. METHODS: This study utilized a randomized experimental design and anesthetized, intubated and paralyzed female pigs (n=12) (mean 42, SD 3kg). After 6min of untreated ventricular fibrillation, mechanical CPR with was performed for 3min in 0° supine position. The CPR was then performed for 5min in a position randomly assigned to either 1) head-up tilt (HUT) by three angles (30°, 45°, or 60°) or 2) head-down tilt (HDT) by three angles (30°, 45°, or 60°) and at 3) supine position between HUT and HDT positions...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/28209057/saturated-fatty-acid-analogues-of-cell-penetrating-peptide-pepfect14-role-of-fatty-acid-modification-in-complexation-and-delivery-of-splice-correcting-oligonucleotides
#15
Tõnis Lehto, Luis Vasconcelos, Helerin Margus, Ricardo Figueroa, Margus Pooga, Mattias Hällbrink, Ülo Langel
Modifying cell-penetrating peptides (CPPs) with fatty acids has long been used to improve peptide-mediated nucleic acid delivery. In this study we have revisited this phenomenon with a systematic approach where we developed a structure-activity relationship to describe the role of the acyl chain length in the transfection process. For that we took a well-studied CPP, PepFect14, as the basis and varied its N-terminal acyl chain length from 2 to 22 carbons. To evaluate the delivery efficiency, the peptides were noncovalently complexed with a splice-correcting oligonucleotide (SCO) and tested in HeLa pLuc705 reporter cell line...
March 15, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/28171804/hemodynamic-and-neuro-monitoring-for-neurocritically-ill-patients-an-international-survey-of-intensivists
#16
Sanjeev Sivakumar, Fabio S Taccone, Mohammed Rehman, Holly Hinson, Neeraj Naval, Christos Lazaridis
PURPOSE: To investigate multimodality systemic and neuro-monitoring practices in acute brain injury (ABI) and to analyze differences among "neurointensivists" (NI; clinical practice comprised >1/3 by neurocritical care), and other intensivists (OI). METHODS: Anonymous 22-question Web-based survey among physician members of SCCM and ESICM. RESULTS: Six hundred fifty-five responded (66% completion rate); 422 (65%) were OI, and 226 (35%) were NI...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28126560/formulation-and-optimization-of-doxorubicin-loaded-polymeric-nanoparticles-using-box-behnken-design-ex-vivo-stability-and-in-vitro-activity
#17
Muhammad Vaseem Shaikh, Manika Kala, Manish Nivsarkar
Biodegradable nanoparticles (NPs) have gained tremendous interest for targeting chemotherapeutic drugs to the tumor environment. Inspite of several advances sufficient encapsulation along with the controlled release and desired size range have remained as considerable challenges. Hence, the present study examines the formulation optimization of doxorubicin loaded PLGA NPs (DOX-PLGA-NPs), prepared by single emulsion method for cancer targeting. Critical process parameters (CPP) were selected by initial screening...
March 30, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28012940/development-of-nanostructured-lipid-carriers-containing-salicyclic-acid-for-dermal-use-based-on-the-quality-by-design-method
#18
A Kovács, Sz Berkó, E Csányi, I Csóka
The aim of our present work was to evaluate the applicability of the Quality by Design (QbD) methodology in the development and optimalization of nanostructured lipid carriers containing salicyclic acid (NLC SA). Within the Quality by Design methology, special emphasis is layed on the adaptation of the initial risk assessment step in order to properly identify the critical material attributes and critical process parameters in formulation development. NLC SA products were formulated by the ultrasonication method using Compritol 888 ATO as solid lipid, Miglyol 812 as liquid lipid and Cremophor RH 60® as surfactant...
March 1, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27982555/how-to-manage-blood-pressure-after-brain-injury
#19
Laurent Carteron, Fabio S Taccone, Mauro Oddo
Manipulation of blood pressure (BP) is a mainstay of therapy in patients with acute brain injury (ABI). In the early emergent phase (first hours from injury), depending on intracranial pathology, BP manipulation aims to: 1) limit the progression of parenchymal hematomas or hemorrhagic transformation (in patients with ischemic/hemorrhagic stroke and aneurysmal subarachnoid hemorrhage [SAH]), and 2) attenuate hypoperfusion and secondary cerebral ischemic insults (in patients with traumatic brain injury [TBI])...
April 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27850399/761-improvements-to-the-optimal-cerebral-perfusion-pressure-calculation
#20
Christopher Hawthorne, Martin Shaw, Laura Moss, Ian Piper, Richard Elliott, Christine Lee, John Kinsella
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
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