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https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#1
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28633394/diagnostic-accuracy-of-somatosensory-evoked-potential-monitoring-in-evaluating-neurological-complications-during-endovascular-aneurysm-treatment
#2
William J Ares, Ramesh M Grandhi, David M Panczykowski, Gregory M Weiner, Parthasarathy Thirumala, Miguel E Habeych, Donald J Crammond, Michael B Horowitz, Brian T Jankowitz, Ashutosh Jadhav, Tudor G Jovin, Andrew F Ducruet, Jeffrey Balzer
BACKGROUND: Somatosensory evoked potential (SSEP) monitoring is used extensively for early detection and prevention of neurological complications in patients undergoing many different neurosurgical procedures. However, the predictive ability of SSEP monitoring during endovascular treatment of cerebral aneurysms is not well detailed. OBJECTIVE: To evaluate the performance of intraoperative SSEP in the prediction postprocedural neurological deficits (PPNDs) after coil embolization of intracranial aneurysms...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28630395/cerebral-infarction-by-paradoxical-gas-embolism-during-laparoscopic-liver-resection-with-injury-of-the-hepatic-vessels-in-a-patient-without-a-right-to-left-systemic-shunt
#3
Toshiyasu Kawahara, Masahiro Hagiwara, Hiroyuki Takahashi, Mariko Tanaka, Koji Imai, Jun Sawada, Takayuki Kunisawa, Hiroyuki Furukawa
BACKGROUND Carbon dioxide (CO2) is believed to be the safest gas for laparoscopic surgery, which is a standard procedure. We experienced severe cerebral infarction caused by paradoxical CO2 embolism during laparoscopic liver resection with injury of the hepatic vessels despite the absence of a right-to-left systemic shunt. CASE REPORT A 60-year-old man was diagnosed with hepatocellular carcinoma in the right hepatic lobe secondary to alcoholic liver disease. We planned the laparoscopy-assisted liver resection...
June 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28628847/the-importance-of-declining-insulin-requirements-during-pregnancy-in-patients-with-pre-gestational-gestational-diabetes-mellitus
#4
Maya Ram, Larissa Feinmesser, Shiri Shinar, Sharon Maslovitz
OBJECTIVE: In patients with pre-gestational and gestational diabetes mellitus (GDM), insulin requirements often increase during the third trimester of pregnancy in order to maintain proper glycemic control. However, a fraction of patients demonstrate a significant decrease in insulin requirements in late gestation. We aimed to evaluate the clinical significance of decreasing insulin requirements in patients with pre-gestational diabetes and GDM with respect to fetal wellbeing and pregnancy outcome...
June 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28627374/characterization-of-the-concurrent-metabolic-changes-in-brain-and-plasma-during-insulin-induced-moderate-hypoglycemia-using-1-h-nmr-spectroscopy-in-juvenile-rats
#5
Kathleen Ennis, Elizabeth Lusczek, Raghavendra Rao
Treatment of hypoglycemia in children is currently based on plasma glucose measurements. This approach may not ensure neuroprotection since plasma glucose does not reflect the dynamic state of cerebral energy metabolism. To determine whether cerebral metabolic changes during hypoglycemia could be better characterized using plasma metabolomic analysis, insulin-induced acute hypoglycemia was induced in 4-week-old rats. Brain tissue and concurrent plasma samples were collected from hypoglycemic (N=7) and control (N=7) rats after focused microwave fixation to prevent post-mortem metabolic changes...
June 14, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28627088/astrogliosis-and-impaired-aquaporin-4-and-dystrophin-systems-in-idiopathic-normal-pressure-hydrocephalus
#6
Per Kristian Eide, Hans-Arne Hansson
AIMS: Idiopathic normal pressure hydrocephalus (iNPH) is one subtype of dementia that may improve following drainage of cerebrospinal fluid (CSF). This prospective observational study explored whether expression of the water channel aquaporin-4 (AQP4) and the anchoring molecule dystrophin 71 (Dp71) are altered at astrocytic perivascular endfeet and in adjacent neuropil of iNPH patient. Observations were related to measurements of pulsatile and static intracranial pressure (ICP). METHODS: The study included iNPH patients undergoing overnight monitoring of the pulsatile/static ICP, in whom a biopsy was taken from the frontal cerebral cortex during placement of the ICP sensor...
June 19, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28626873/assessing-prefrontal-cortex-oxygenation-after-sport-concussion-with-near-infrared-spectroscopy
#7
Scott A Bishop, J Patrick Neary
BACKGROUND: Clinicians typically rely on neuropsychological and balance tests to track concussion recovery. The aforementioned tests imply impairments that are based on performance, but these tests do not directly measure brain physiology throughout concussion recovery. Because of these issues, an objective biomarker that can index severity and the recovery timeline is needed. Moreover, the number of concussions occurring at a recreational level requires the biomarker to be easily administered in a cost effective manner, and the results easily interpreted...
June 18, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28625785/cerebral-ischemia-repefusion-injury-from-bench-space-to-bedside
#8
REVIEW
Z Nagy, S Nardai
While stroke research represents the primary interface between circulation and brain research, the hemostasis system also carries a pivotal role in the mechanism of vascular brain injury. The complex interrelated events triggered by the energy crisis have a specific spatial and temporal pattern arching from the initial damage to the final events of brain repair. The complexity of the pathophysiology make it difficult to model this disease, therefore it is challenging to find appropriate therapeutic targets...
June 15, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28625752/neurologic-complications-of-extracorporeal-membrane-oxygenation-a-review
#9
REVIEW
Ashleigh Xie, Phillip Lo, Tristan D Yan, Paul Forrest
OBJECTIVE: To review the evidence on neurologic complications in adult extracorporeal membrane oxygenation (ECMO) patients with regard to incidence, pathophysiology, risk factors, diagnosis, monitoring techniques, prevention, and management. DESIGN: Literature review. SETTING: Observational studies and case reports from a variety of institutions. PARTICIPANTS: Adult ECMO patients. INTERVENTIONS: Six electronic databases were searched from their dates of inception to October 2016...
March 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28625587/a-rabbit-model-of-aneurysmal-subarachnoid-hemorrhage-by-ear-central-artery-suprasellar-cistern-shunt
#10
Jing Lu, Fuxiang Chen, Bing Cai, Fan Chen, Dezhi Kang
Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening hemorrhagic cerebrovascular disease. The concept of early brain injury (EBI), induced by sharply increased intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) with cerebral global ischemia following aneurysm rupture, has been increasingly accepted. However, EBI has not been well studied partly due to lack of an ideal animal model. The purpose of this study was to establish a new aSAH model which can mimic the pathophysiological damage of EBI...
June 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28625370/rationale-and-design-of-the-apixaban-for-the-reduction-of-thrombo-embolism-in-patients-with-device-detected-sub-clinical-atrial-fibrillation-artesia-trial
#11
Renato D Lopes, Marco Alings, Stuart J Connolly, Heather Beresh, Christopher B Granger, Juan Benezet Mazuecos, Giuseppe Boriani, Jens C Nielsen, David Conen, Stefan H Hohnloser, Georges H Mairesse, Philippe Mabo, A John Camm, Jeffrey S Healey
BACKGROUND: Device-detected subclinical atrial fibrillation (AF) refers to infrequent, short-lasting, asymptomatic AF that is detected only with long-term continuous monitoring. Subclinical AF is common and associated with an increased risk of stroke; however, the risk of stroke with subclinical AF is lower than for clinical AF, and very few patients with subclinical AF alone have been included in large AF anticoagulation trials. The net benefit of anticoagulation in patients with subclinical AF is unknown...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28622210/serotonin-syndrome-following-combined-administration-of-dopaminergic-and-noradrenergic-agents-in-a-patient-with-akinetic-mutism-after-frontal-intracerebral-hemorrhage-a-case-report
#12
Dae Geun Jeon, Yong Wook Kim, Na Young Kim, Jung Hyun Park
BACKGROUND: Serotonin syndrome (SS) is a potentially life-threatening condition that can be caused by use of proserotonergic drugs. Several studies have reported that combined administration of various medications may induce SS. We report a case of SS in a patient who was being treated with dopaminergic and noradrenergic drugs. CASE PRESENTATION: A 55-year-old man with a right frontal intracerebral hemorrhage extending to the left cerebral hemisphere presented with clinical features of akinetic mutism...
June 16, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28620756/preliminary-data-on-utility-of-subcutaneous-unfractionated-heparin-in-patients-with-deep-cerebral-venous-thrombosis
#13
Girish Baburao Kulkarni, Abbas Masoom Mirza, Subasree Ramakrishnan, Veerendrakumar Mustare
Subcutaneous unfractionated heparin (SCUFH) has been proved effective in puerperal cerebral venous thrombosis (CVT), but its efficacy in the more serious form of the disease such as deep CVT patients (DCVT) unreported. We describe the outcomes of 37 (isolated:combined: 11:26) patients of DCVT diagnosed by MRI, treated with SCUFH in a tertiary care stroke unit. It was a prospective observational cohort study using 5000 U of SCUFH every 6 hourly for 10 days with oral Acenocoumarol started on day 7, with monitoring...
June 15, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28618012/metabolomic-signature-of-brain-cancer
#14
Renu Pandey, Laura Caflisch, Alessia Lodi, Andrew J Brenner, Stefano Tiziani
Despite advances in surgery and adjuvant therapy, brain tumours represent one of the leading causes of cancer-related mortality and morbidity in both adults and children. Gliomas constitute about 60% of all cerebral tumours, showing varying degrees of malignancy. They are difficult to treat due to dismal prognosis and limited therapeutics. Metabolomics is the untargeted and targeted analyses of endogenous and exogenous small molecules, which characterizes the phenotype of an individual. This emerging "omics" science provides functional readouts of cellular activity that contribute greatly to the understanding of cancer biology including brain tumour biology...
June 15, 2017: Molecular Carcinogenesis
https://www.readbyqxmd.com/read/28616347/intraoperative-care-for-aortic-surgery-using-circulatory-arrest
#15
REVIEW
Félix Ezequiel Fernández Suárez, David Fernández Del Valle, Adrián González Alvarez, Blanca Pérez-Lozano
The total circulatory arrest (CA) is necessary to achieve optimal surgical conditions in certain aortic pathologies, especially in those affecting the ascending aorta and aortic arch. During this procedure it is necessary to protect all the organs of ischemia, especially those of the central nervous system and for this purpose several strategies have been developed. The first and most important protective method is systemic hypothermia. The degree of hypothermia and the route of application have been evolving and currently tend to use moderate hypothermia (MH) (20...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#16
Omar S Akbik, Mark Krasberg, Edwin M Nemoto, Howard Yonas
The effectiveness of cerebrospinal fluid (CSF) drainage in lowering high intracranial pressure (ICP) is well established in severe traumatic brain injury (TBI). However, recently the use of external ventricular drains and intracranial pressure monitors in traumatic brain injury has come under question. The aim of this retrospective study was to investigate the effect of CSF drainage on brain tissue oxygenation (PbtO2). Using a multimodality monitoring system, we continuously monitored brain tissue oxygenation (PbtO2) and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe traumatic brain injury (TBI)...
June 14, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28605557/practice-patterns-for-neurosurgical-utilization-and-outcome-in-acute-intracerebral-hemorrhage-intensive-blood-pressure-reduction-in-acute-cerebral-hemorrhage-trials-1-and-2-studies
#17
Rui Guo, David J Blacker, Xia Wang, Hisatomi Arima, Pablo M Lavados, Richard I Lindley, John Chalmers, Craig S Anderson, Thompson Robinson
BACKGROUND: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence. OBJECTIVES: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT). METHODS: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28602046/exercise-interventions-for-cerebral-palsy
#18
REVIEW
Jennifer M Ryan, Elizabeth E Cassidy, Stephen G Noorduyn, Neil E O'Connell
BACKGROUND: Cerebral palsy (CP) is a neurodevelopmental disorder resulting from an injury to the developing brain. It is the most common form of childhood disability with prevalence rates of between 1.5 and 3.8 per 1000 births reported worldwide. The primary impairments associated with CP include reduced muscle strength and reduced cardiorespiratory fitness, resulting in difficulties performing activities such as dressing, walking and negotiating stairs.Exercise is defined as a planned, structured and repetitive activity that aims to improve fitness, and it is a commonly used intervention for people with CP...
June 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28599908/fluorescein-angiography-in-intracranial-aneurysm-surgery-a-helpful-method-to-evaluate-the-security-of-clipping-and-to-observe-blood-flow
#19
Cristian Kakucs, Ioan-Alexandru Florian, Gheorghe Ungureanu, Ioan-Stefan Florian
OBJECTIVE: In cerebral aneurysm surgery, a number of tools are employed to evaluate blood flow, such as Doppler ultrasonography, conventional cerebral angiography, and electrophysiological monitoring. Fluorescein and indocyanine green are widely used in vascular and central nervous system tumor neurosurgery. Nevertheless, their routine utilization in aneurysmal surgery is uncommon, despite the fact that they allow direct visualization of blood flow after an aneurysmal sac occlusion, enabling the observation of vessel permeability and the effectiveness of aneurysmal obliteration...
June 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28598874/transverse-split-sternotomy-a-mini-invasive-approach-for-repair-of-congenital-cardiac-defects
#20
Pankaj Garg, Arvind Kumar Bishnoi, Kartik Patel, Chandrashekaran Annanthnarayan, Jigar Patel, Malkesh Talsariya, Komal Shah, Sanjay Patel
OBJECTIVE: In this article, we aim to review our mini-invasive technique of transverse sternal split (TSS) with or without cervical cannulation for cardiopulmonary bypass (CPB), its usefulness, and efficiency for repair of congenital cardiac defects. METHODS: Between January 2013 and June 2015, 34 infants and small children were operated through TSS in third or fourth intercostal space [Tetralogy of Fallot 11, perventricular ventricular septal defect (VSD) device closure 23]...
June 8, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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