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https://www.readbyqxmd.com/read/29775114/oxygen-dependency-of-mitochondrial-metabolism-indicates-outcome-of-newborn-brain-injury
#1
Gemma Bale, Subhabrata Mitra, Isabel de Roever, Magdalena Sokolska, David Price, Alan Bainbridge, Roxana Gunny, Cristina Uria-Avellanal, Giles S Kendall, Judith Meek, Nicola J Robertson, Ilias Tachtsidis
There is a need for a method of real-time assessment of brain metabolism during neonatal hypoxic-ischaemic encephalopathy (HIE). We have used broadband near-infrared spectroscopy (NIRS) to monitor cerebral oxygenation and metabolic changes in 50 neonates with HIE undergoing therapeutic hypothermia treatment. In 24 neonates, 54 episodes of spontaneous decreases in peripheral oxygen saturation (desaturations) were recorded between 6 and 81 h after birth. We observed differences in the cerebral metabolic responses to these episodes that were related to the predicted outcome of the injury, as determined by subsequent magnetic resonance spectroscopy derived lactate/N-acetyl-aspartate...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#2
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770889/autoregulation-in-the-neuro-icu
#3
REVIEW
Anson Wang, Santiago Ortega-Gutierrez, Nils H Petersen
PURPOSE OF REVIEW: The purpose of this review is to briefly describe the concept of cerebral autoregulation, to detail several bedside techniques for measuring and assessing autoregulation, and to outline the impact of impaired autoregulation on clinical and functional outcomes in acute brain injury. Furthermore, we will review several autoregulation studies in select forms of acute brain injuries, discuss the potential for its use in patient management in the ICU, and suggest further avenues for research...
May 17, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29768642/-rhinocerebral-mucormycosis
#4
Anke Mertens, Christoph Arens, Doreen Barche, Laszlo Scheinpflug, Friedrich Gunther Scholz, Stefan Vielhaber, Cordula Scherlach, Uwe Tröger, Gernot Geginat, Jacqueline Färber
Mucormycosis is a rare but serious type of fungal infection, which can progress rapidly especially in immunsupressed patients.We report about a 47 year old female patient with ptosis on the left eye. The ophthalmological report offered no further pathologic findings. Diabetes mellitus was known and the blood sugar value was very high.A computed tomography of the paranasal sinuses showed a shadow in the ethmoid bone and in an additonally performed MRI-scan, an increase of orbital fat and an extension of the ocular muscle were visible...
May 16, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29768283/cerebral-oxygenation-as-a-monitoring-parameter-for-mortality-during-venoarterial-extracorporeal-membrane-oxygenation
#5
Hyoung Soo Kim, Sang Ook Ha, Kyung-Ho Yu, Mi Sun Oh, Sunghoon Park, Sun Hee Lee, Sang Jin Han, Hyun-Sook Kim, In Bok Chang, Jun Hyong Ahn
There are no recommended guidelines for monitoring parameters during venoarterial extracorporeal membrane oxygenation (VA-ECMO). We evaluated whether regional cerebral oxygen saturation (rScO2) could be a monitoring parameter for mortality during VA-ECMO. We retrospectively searched our database for adult patients who underwent VA-ECMO between April 2015 and October 2016 and identified 21 patients with rScO2 data. Their baseline and clinical characteristics during the first 7 days (vital signs, arterial blood gas results, ECMO variables, rScO2, Swan-Ganz catheter parameters, transthoracic echocardiography parameters, and outcomes) were collected and evaluated for associations with 28 day mortality...
May 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29764869/tele-upcat-study-protocol-of-a-randomised-controlled-trial-of-a-home-based-tele-monitored-upper-limb-children-action-observation-training-for-participants-with-unilateral-cerebral-palsy
#6
Giuseppina Sgandurra, Francesca Cecchi, Elena Beani, Irene Mannari, Martina Maselli, Francesco Paolo Falotico, Emanuela Inguaggiato, Silvia Perazza, Elisa Sicola, Hilde Feys, Katrijn Klingels, Adriano Ferrari, Paolo Dario, Roslyn N Boyd, Giovanni Cioni
INTRODUCTION: A new rehabilitative approach, called UPper Limb Children Action Observation Training (UPCAT), based on the principles of action observation training (AOT), has provided promising results for upper limb rehabilitation in children with unilateral cerebral palsy (UCP). This study will investigate if a new information and communication technology platform, named Tele-UPCAT, is able to deliver AOT in a home setting and will test its efficacy on children and young people with UCP...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29763712/cerebral-tissue-oximetry-levels-during-prehospital-management-of-cardiac-arrest-a-prospective-observational-study
#7
Gregor Prosen, Strnad Matej, Stephanie J Doniger, Andrej Markota, Andraž Stožer, Vesna Borovnik-Lesjak, Dušan Mekiš
INTRODUCTION: Near-infrared spectroscopy (NIRS) enables continuous monitoring of regional oximetry (rSO2 ). The aim of this study was to describe dynamics of regional cerebral oximetry levels during out of hospital cardiac arrest (OHCA) resuscitation, specifically around the time of restoration of spontaneous circulation (ROSC). METHODS: This prospective observational study was performed in the prehospital setting during cardio-pulmonary resuscitation (CPR) of OHCA patients...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29761891/processed-electroencephalogram-and-evoked-potential-techniques-for-amelioration-of-postoperative-delirium-and-cognitive-dysfunction-following-non-cardiac-and-non-neurosurgical-procedures-in-adults
#8
REVIEW
Yodying Punjasawadwong, Waraporn Chau-In, Malinee Laopaiboon, Sirivimol Punjasawadwong, Pathomporn Pin-On
BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) may complicate a patient's postoperative recovery in several ways. Monitoring of processed electroencephalogram (EEG) or evoked potential (EP) indices may prevent or minimize POD and POCD, probably through optimization of anaesthetic doses. OBJECTIVES: To assess whether the use of processed EEG or auditory evoked potential (AEP) indices (bispectral index (BIS), narcotrend index, cerebral state index, state entropy and response entropy, patient state index, index of consciousness, A-line autoregressive index, and auditory evoked potentials (AEP index)) as guides to anaesthetic delivery can reduce the risk of POD and POCD in non-cardiac surgical or non-neurosurgical adult patients undergoing general anaesthesia compared with standard practice where only clinical signs are used...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29760990/spatial-and-temporal-identification-of-cerebral-infarctions-based-on-multiphoton-microscopic-imaging
#9
Shu Wang, Huiping Du, Bingbing Lin, Chenxi Liao, Xiaoqin Zhu, Xingfu Wang, Hong Chen, Shuangmu Zhuo, Liwei Jiang, Lianhuang Li, Haohua Tu, Jianxin Chen
Ischemic stroke is a leading cause of death and permanent disability worldwide. Middle cerebral artery occlusion (MCAO) of variable duration times could be anticipated to result in varying degrees of injury that evolve spatially over time. Therefore, investigations following strokes require information concerning the spatiotemporal dimensions of the ischemic core as well as of perilesional areas. In the present study, multiphoton microscopy (MPM) based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) was applied to image such pathophysiological events...
May 1, 2018: Biomedical Optics Express
https://www.readbyqxmd.com/read/29760374/overview-of-cerebral-edema-during-correction-of-hyperglycemic-crises
#10
Daniel Varela, Natalie Held, Stuart Linas
BACKGROUND Hyperglycemic crises can cause severe neurologic impairment. One of the most dreaded consequences of hyperglycemic crises is cerebral edema, a rare complication seen during the treatment of hyperglycemic crises resulting from overly-aggressive fluid resuscitation and rapid correction of hyperglycemia and hyperosmolarity. CASE REPORT We present a case of profound hyperglycemic crisis with blood glucose greater than 2000 mg/dL, complicated by the development of new neurologic deficits after rapid correction of hyperglycemia...
May 15, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29757059/quantitative-hemodynamic-analysis-of-cerebral-blood-flow-and-neurovascular-coupling-using-optical-coherence-tomography-angiography
#11
Paul Shin, WooJhon Choi, JongYoon Joo, Wang-Yuhl Oh
Functional hyperemia in the rat cortex was investigated using high-speed optical coherence tomography (OCT) angiography and Doppler OCT. OCT angiography (OCTA) was performed to image the hemodynamic stimulus-response over a wide field of view. Temporal changes in vessel diameters in different vessel compartments, which were determined as the diameters of erythrocyte flows in OCT angiograms, were measured in order to monitor localized hemodynamic changes. Our results showed that the dilation of arterioles at the site of activation was accompanied by the dilation of upstream arteries...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29750804/temporal-compartmental-changes-in-viral-rna-and-neuronal-injury-in-a-primate-model-of-neuroaids
#12
R Gilberto González, Robert Fell, Julian He, Jennifer Campbell, Tricia H Burdo, Patrick Autissier, Lakshmanan Annamalai, Faramarz Taheri, Termara Parker, Jeffrey D Lifson, Elkan F Halpern, Mark Vangel, Eliezer Masliah, Susan V Westmoreland, Kenneth C Williams, Eva-Maria Ratai
Despite the advent of highly active anti-retroviral therapy HIV-associated neurocognitive disorders (HAND) continue to be a significant problem. Furthermore, the precise pathogenesis of this neurodegeneration is still unclear. The objective of this study was to examine the relationship between infection by the simian immunodeficiency virus (SIV) and neuronal injury in the rhesus macaque using in vivo and postmortem sampling techniques. The effect of SIV infection in 23 adult rhesus macaques was investigated using an accelerated NeuroAIDS model...
2018: PloS One
https://www.readbyqxmd.com/read/29750744/experience-and-prognosis-of-systemic-neonatal-thrombosis-at-a-level-iii-nicu
#13
Sevim Unal, Deniz Gönülal, Betül Siyah Bilgin, Vildan Koşan Çulha, Neşe Yarali
OBJECTIVE: The objective of this article was to evaluate neonates diagnosed systemic thrombosis and their outcomes. METHODS: We retrospectively evaluated data of neonatal systemic thrombosis between January 2011 and December 2016. RESULTS: Among 4376 hospitalized, 30 neonates (0.69%) were diagnosed systemic thrombosis. Their mean birth weight was 2422±1152 g (680 to 4750 g), gestational age was 35±5.4 weeks (25 to 41 wk). There were 25 neonates (83...
May 10, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29750694/impact-of-2-distinct-levels-of-mean-arterial-pressure-on-near-infrared-spectroscopy-during-cardiac-surgery-secondary-outcome-from-a-randomized-clinical-trial
#14
Frederik Holmgaard, Anne G Vedel, Theis Lange, Jens C Nilsson, Hanne B Ravn
BACKGROUND: Near-infrared spectroscopy (NIRS) is used worldwide to monitor regional cerebral oxygenation (rScO2) during cardiopulmonary bypass (CPB). Intervention protocols meant to mitigate cerebral desaturation advocate to increase mean arterial pressure (MAP) when cerebral desaturation occurs. However, the isolated effect of MAP on rScO2 is uncertain. The aim of the present study was in a randomized, blinded design to elucidate the effect of 2 distinct levels of MAP on rScO2 values during CPB...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29749881/reversible-ventriculoperitoneal-shunt-dysfunction-and-chronic-constipation-case-report
#15
Barbara A Morais, Daniel D Cardeal, Fernanda G Andrade, Wellingson S Paiva, Hamilton Matushita, Manoel J Teixeira
Constipation can cause transient malfunction of the ventriculoperitoneal shunt (VPS). Patients with myelomeningocele or cerebral palsy are often diagnosed with hydrocephalus and constipation due to neurogenic bowel. These patients are more prone to VPS dysfunction, often requiring surgical revision. The authors report the case of a 6-year-old girl with a VPS that had been implanted due to hydrocephalus secondary to myelomeningocele. The patient was brought to the emergency department with intermittent headache, vomiting, constipation, and abdominal distension and pain...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29746644/relationships-between-selective-neuronal-loss-and-microglial-activation-after-ischaemic-stroke-in-man
#16
Rhiannon S Morris, P Simon Jones, Josef A Alawneh, Young T Hong, Tim D Fryer, Franklin I Aigbirhio, Elizabeth A Warburton, Jean-Claude Baron
Modern ischaemic stroke management involves intravenous thrombolysis followed by mechanical thrombectomy, which allows markedly higher rates of recanalization and penumbral salvage than thrombolysis alone. However, <50% of treated patients eventually enjoy independent life. It is therefore important to identify complementary therapeutic targets. In rodent models, the salvaged penumbra is consistently affected by selective neuronal loss, which may hinder recovery by interfering with plastic processes, as well as by microglial activation, which may exacerbate neuronal death...
May 9, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29743683/rivaroxaban-does-not-influence-hemorrhagic-transformation-in-a-diabetes-ischemic-stroke-and-endovascular-thrombectomy-model
#17
Feng-Di Liu, Rong Zhao, Xiao-Yan Feng, Yan-Hui Shi, Yi-Lan Wu, Xiao-Lei Shen, Ge-Fei Li, Yi-Sheng Liu, Ying Zhao, Xin-Wei He, Jia-Wen Yin, Mei-Ting Zhuang, Bing-Qiao Zhao, Jian-Ren Liu
Managing endovascular thrombectomy (ET) in diabetic ischemic stroke (IS) with novel anticoagulants is challenging due to putative risk of intracerebral hemorrhage. The study evaluates increased hemorrhagic transformation (HT) risk in Rivaroxaban-treated diabetic rats post ET. Diabetes was induced in male Sprague-Dawley rats by intraperitoneal injection of 60 mg/kg streptozotocin. After 4-weeks, rats were pretreated orally with 30 mg/kg Rivaroxaban/saline; prothrombin time was monitored. IS and ET was induced after 1 h, by thread-induced transient middle cerebral artery occlusion (tMCAO) that mimicked mechanical ET for proximal MCA occlusion at 60 min...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29743609/salivary-levels-of-total-huntingtin-are-elevated-in-huntington-s-disease-patients
#18
Jody Corey-Bloom, Ameera S Haque, Sungmee Park, Ajay S Nathan, Robert W Baker, Elizabeth A Thomas
Patients with Huntington's disease (HD), an autosomal-dominant neurodegenerative disease, show substantial variability in age-of-onset, symptom severity and course of illness, warranting the need for biomarkers to anticipate and monitor these features. The HD gene encodes the disease protein huntingtin (Htt), a potentially useful biomarker for this disease. In the current study, we determined whether total Htt protein (normal plus mutant; "tHtt") could be reliably measured in human saliva, a body fluid that is much more accessible compared to cerebral spinal fluid or even blood, and whether salivary levels of tHtt were clinically meaningful...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29742889/intraoperative-neurophysiological-monitoring-a-review-of-techniques-used-for-brain-tumor-surgery-in-children
#19
REVIEW
Keewon Kim, Charles Cho, Moon-Suk Bang, Hyung-Ik Shin, Ji-Hoon Phi, Seung-Ki Kim
Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues...
May 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29739183/comparison-between-cerebral-state-index-and-bispectral-index-during-desflurane-anesthesia
#20
Sang-Hyeon Cho, Sung-Su Kim, Dong-Min Hyun, Hyeong-Suk Yoon, JungWoo Han, Jin Sun Kim
Background: Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different EEG signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia. Methods: Thirty-three patients were recruited...
May 9, 2018: Korean Journal of Anesthesiology
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