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https://www.readbyqxmd.com/read/28743094/a-personalized-medicine-approach-to-the-design-of-dry-powder-inhalers-selecting-the-optimal-amount-of-bypass
#1
Thomas Kopsch, Darragh Murnane, Digby Symons
In dry powder inhalers (DPIs) the patient's inhalation manoeuvre strongly influences the release of drug. Drug release from a DPI may also be influenced by the size of any air bypass incorporated in the device. If the amount of bypass is high less air flows through the entrainment geometry and the release rate is lower. In this study we propose to reduce the intra- and inter-patient variations of drug release by controlling the amount of air bypass in a DPI. A fast computational method is proposed that can predict how much bypass is needed for a specified drug delivery rate for a particular patient...
July 22, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28742871/comprehensive-immune-profiling-reveals-substantial-immune-system-alterations-in-a-subset-of-patients-with-amyotrophic-lateral-sclerosis
#2
Michael P Gustafson, Nathan P Staff, Svetlana Bornschlegl, Greg W Butler, Mary L Maas, Mohamed Kazamel, Adeel Zubair, Dennis A Gastineau, Anthony J Windebank, Allan B Dietz
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with a median lifespan of 2-3 years after diagnosis. There are few meaningful treatments that alter progression in this disease. Preclinical and clinical studies have demonstrated that neuroinflammation may play a key role in the progression rate of ALS. Despite this, there are no validated biomarkers of neuroinflammation for use in clinical practice or clinical trials. Biomarkers of neuroinflammation could improve patient management, provide new therapeutic targets, and possibly help stratify clinical trial selection and monitoring...
2017: PloS One
https://www.readbyqxmd.com/read/28742869/ultrasound-non-invasive-measurement-of-intracranial-pressure-in-neurointensive-care-a-prospective-observational-study
#3
Chiara Robba, Danilo Cardim, Tamara Tajsic, Justine Pietersen, Michael Bulman, Joseph Donnelly, Andrea Lavinio, Arun Gupta, David K Menon, Peter J A Hutchinson, Marek Czosnyka
BACKGROUND: The invasive nature of the current methods for monitoring of intracranial pressure (ICP) has prevented their use in many clinical situations. Several attempts have been made to develop methods to monitor ICP non-invasively. The aim of this study is to assess the relationship between ultrasound-based non-invasive ICP (nICP) and invasive ICP measurement in neurocritical care patients. METHODS AND FINDINGS: This was a prospective, single-cohort observational study of patients admitted to a tertiary neurocritical care unit...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742827/the-relationship-between-coronary-artery-distensibility-and-fractional-flow-reserve
#4
Andy S C Yong, Ashkan Javadzadegan, William F Fearon, Abouzar Moshfegh, Jerrett K Lau, Stephen Nicholls, Martin K C Ng, Leonard Kritharides
Discordance between angiography-based anatomical assessment of coronary stenosis severity and fractional flow reserve (FFR) has been attributed to several factors including lesion length and irregularity, and the myocardial territory supplied by the target vessel. We sought to examine if coronary arterial distensibility is an independent contributor to this discordance. There were two parts to this study. The first consisted of "in silico" models of 26 human coronary arteries. Computational fluid dynamics-derived FFR was calculated for fully rigid, partially distensible and fully distensible models of the 26 arteries...
2017: PloS One
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#5
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742650/reliable-and-easy-to-use-liquid-chromatography-tandem-mass-spectrometry-method-for-simultaneous-analysis-of-fluconazole-isavuconazole-itraconazole-hydroxy-itraconazole-posaconazole-and-voriconazole-in-human-plasma-and-serum
#6
Carsten Müller, David Gehlen, Cornelia Blaich, Domenik Prozeller, Blasius Liss, Thomas Streichert, Martin H J Wiesen
BACKGROUND: A fast and easy-to-use liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination and quantification of six triazoles (fluconazole (FLZ), isavuconazole (ISZ), itraconazole (ITZ), hydroxy-itraconazole (OH-ITZ), posaconazole (PSZ), voriconazole (VRZ)) in human plasma and serum was developed and validated for therapeutic drug monitoring (TDM). METHODS: Sample preparation was based on protein precipitation with acetonitrile and subsequent centrifugation...
July 24, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28742649/thoracoscopic-implantation-of-an-array-electrode-in-the-pericardium-transverse-sinus-to-reduce-defibrillation-threshold
#7
Antonio Curnis, Claudio Muneretto, Gianluigi Bisleri, Manuel Cerini, Lorenza Inama, Francesca Salghetti, Raffaella De Vito, Laura Giroletti, Fabrizio Rosati, Daniele Giacopelli, Francesca Vassanelli, Luca Bontempi
Among the implantable cardioverter defibrillator recipients, there is still a subgroup of patients in whom the defibrillation threshold is too high and the maximal shock output of the implantable cardioverter defibrillator can fail to terminate a ventricular arrhythmia. We report a new thoracoscopic minimally invasive approach to place a standard array electrode in the transverse pericardial sinus of a patient implanted with a cardiac resynchronization and defibrillation therapy device with persistent high defibrillation threshold...
July 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28742550/can-concurrent-abnormalities-in-free-light-chains-and-immunoglobulin-concentrations-identify-a-target-population-for-immunoglobulin-trials-in-sepsis
#8
Manu Shankar-Hari, Mervyn Singer, Jo Spencer
OBJECTIVES: Light chains κ and λ are immunoglobulin constituents but also circulate independently in blood as free light chains. We investigated whether a concomitant abnormality in free light chain and immunoglobulin levels could identify a high risk of death sepsis subpopulation to inform future IV immunoglobulin trials. We tested whether light chain allelic inclusion occurs in circulating B cells. DESIGN: Prospective cohort study. SETTING: Adult general ICUs...
July 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28742380/the-role-of-radiology-in-the-diagnostic-process-information-communication-and-teamwork
#9
David B Larson, Curtis P Langlotz
OBJECTIVE: The diagnostic radiology process represents a partnership between clinical and radiology teams. As such, breakdowns in interpersonal interactions and communication can result in patient harm. CONCLUSION: We explore the role of radiology in the diagnostic process, focusing on key concepts of information and communication, as well as key interpersonal interactions of teamwork, collaboration, and collegiality, all based on trust. We propose 10 principles to facilitate effective information flow in the diagnostic process...
July 25, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28742328/attachable-pulse-sensors-integrated-with-inorganic-optoelectronic-devices-for-monitoring-heart-rates-at-various-body-locations
#10
Juho Kim, Namyun Kim, Minjeong Kwon, Jongho Lee
Monitoring cardiovascular signals such as heart rate and blood flow provides critically important healthcare information about patients under medical care. However, when the sensors are worn for extended times, the sensors sometimes require higher mechanical compatibility with soft deformable tissues. In this paper, we report an attachable and flexible pulse sensor (bending radius: 2.4 mm), integrated with micro-inorganic photodetectors (thickness: 4.1 μm, photocurrent: 8.99 μA under 1.5 mW/cm(2)) and a red light emitting diode (620 nm), to monitor vital signals for extended times...
July 25, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28742199/cyramza-induces-apoptosis-of-hcc4006-cell-by-affecting-the-level-of-bcl-w
#11
L Fang, Z Li, Y-J Chen, G-M Xiao
OBJECTIVE: Lung cancer seriously threats to patient's life and health. Cyramza is a therapeutic drug for inhibition of vessel formation and growth in clinical practice. The aim of this study was to investigate the effect of cyramza on growth and apoptosis of non-small lung cancer HCC4006 and explore the related mechanisms. MATERIALS AND METHODS: Cell viability and apoptosis were examined by MTT assay and flow cytometry, respectively. Western blot was employed to examine the effect of cyramza on the apoptotic protein Bcl-w...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28742142/effects-of-water-drinking-test-on-ocular-blood-flow-waveform-parameters-a-laser-speckle-flowgraphy-study
#12
Mehwish Saba Bhatti, Tong Boon Tang, Augustinus Laude
The water-drinking test (WDT) is a provocative test used in glaucoma research to assess the effects of elevated intraocular pressure (IOP). Defective autoregulation due to changes in perfusion pressure may play a role in the pathophysiology of several ocular diseases. This study aims to examine the effects of WDT on ocular blood flow (in the form of pulse waveform parameters obtained using laser speckle flowgraphy) to gain insight into the physiology of ocular blood flow and its autoregulation in healthy individuals...
2017: PloS One
https://www.readbyqxmd.com/read/28742098/pathological-manifestations-in-lymphatic-filariasis-correlate-with-lack-of-inhibitory-properties-of-igg4-antibodies-on-ige-activated-granulocytes
#13
Ulrich F Prodjinotho, Charlotte von Horn, Alex Y Debrah, Linda Batsa Debrah, Anna Albers, Laura E Layland, Achim Hoerauf, Tomabu Adjobimey
Helminth parasites are known to be efficient modulators of their host's immune system. To guarantee their own survival, they induce alongside the classical Th2 a strong regulatory response with high levels of anti-inflammatory cytokines and elevated plasma levels of IgG4. This particular antibody was shown in different models to exhibit immunosuppressive properties. How IgG4 affects the etiopathology of lymphatic filariasis (LF) is however not well characterized. Here we investigate the impact of plasma and affinity-purified IgG/IgG4 fractions from endemic normals (EN) and LF infected pathology patients (CP), asymptomatic microfilaraemic (Mf+) and amicrofilaraemic (Mf-) individuals on IgE/IL3 activated granulocytes...
July 24, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28742031/patient-specific-left-ventricular-flow-simulations-from-transthoracic-echocardiography-robustness-evaluation-and-validation-against-ultrasound-doppler-and-magnetic-resonance-imaging
#14
David Larsson, Jeannette H Spuhler, Sven Petersson, Tim Nordenfur, Massimiliano Colarieti-Tosti, Johan Hoffman, Reidar Winter, Matilda Larsson
The combination of medical imaging with computational fluid dynamics (CFD) has enabled the study of 3D blood flow on a patient-specific level. However, with models based on gated high-resolution data, the study of transient flows, and any model implementation into routine cardiac care, is challenging. The present paper presents a novel pathway for patient-specific CFD modelling of the left ventricle (LV), using 4D transthoracic echocardiography (TTE) as input modality. To evaluate the clinical usability, two sub-studies were performed...
July 21, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28741093/fetal-right-ventricular-prominence-associated-postnatal-abnormalities-and-coarctation-clinical-prediction-tool
#15
Alyssa Power, Alberto Nettel-Aguirre, Deborah Fruitman
Fetal right ventricular (RV) prominence is a known indicator of possible left-sided structural heart disease with a low positive predictive value for aortic coarctation. There is a paucity of data on identifying which fetuses with RV prominence will have postnatal arch obstruction. Our study objectives were to create a clinical prediction tool for coarctation and to describe the diagnostic outcomes of our cohort with fetal RV prominence. We performed a retrospective review of patients referred with fetal RV prominence from January 2009 to October 2015...
July 24, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28740960/prognostic-factors-in-patients-with-acute-mesenteric-ischemia
#16
Doğan Yıldırım, Adnan Hut, Cihad Tatar, Turgut Dönmez, Muzaffer Akıncı, Mehmet Toptaş
OBJECTIVE: Acute mesenteric ischemia, one of the causes of acute abdominal pain due to occlusion of the superior mesenteric artery, has a fatal course as a result of intestinal necrosis. There is no specific laboratory test to diagnose acute mesenteric ischemia. The basis of treatment in cases of acute mesenteric ischemia is composed of early diagnosis, resection of intestinal sections with infarction, regulation of intestinal blood flow, second look laparotomy when required, and intensive care support...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28740950/lymphedema-from-diagnosis-to-treatment
#17
REVIEW
Oğuz Kayıran, Carolyn De La Cruz, Kaori Tane, Atilla Soran
Lymphedema is a chronic and progressive disorder resulting from impaired lymphatic system function. In developed countries, upper extremity lymphedema is mainly the consequence of breast cancer surgery in which axillary lymph node dissection and radiation alter upper extremity lymphatic flow. Diagnosis of lymphedema is made clinically. Nevertheless, there are numerous diagnostic tools available for disease staging. Recently, a new technology namely magnetic resonance lymphangiography has emerged in the medical field to assist in both diagnosis and management...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28740493/impact-of-enhancer-of-zeste-homolog-2-on-t-helper-cell-mediated-allergic-rhinitis
#18
Tsung-Yun Hou, Ming-Rong Chen, Yu-Ching Chou, Po-Chieh Kan, Yi-Ta Tsai, Tai-Lung Cha
Enhancer of zeste homolog 2 (Ezh2) has been shown to play a role in the differentiation of T helper (Th) 1 and 2 cells in mice studies using Ezh2-deficient T cells. However, the results have been inconsistent, and the function of Ezh2 in human Th1 and Th2 cell differentiation and its association with disease remains controversial. We measured the expression of Ezh2 in Th1 and Th2 cells in peripheral blood mononuclear cells after acute challenge with house dust mite using flow cytometry in patients with allergic rhinitis (AR) and controls...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28740398/focusing-on-a-complete-blood-cell-parameter-mean-platelet-volume-levels-may-be-a-predictor-of-coronary-slow-flow
#19
Mücahid Yılmaz, Mustafa Necati Dağlı, Ökkeş Uku, Mehmet Nail Bilen, Hasan Korkmaz, Kenan Erdem, Ertuğrul Kurtoğlu
BACKGROUND: The relationship between increased mean platelet volume (MPV) and atherosclerosis is well known. In the present study, MPV in patients with coronary slow flow (CSF) and in cases with normal coronary anatomy (NCA) was investigated and compared with the aim of identifying the relationship between CSF and MPV. PATIENTS AND METHODS: We studied 40 patients previously determined via coronary angiography as having NCA and 40 patients with CSF in the coronary blood stream, as identified by thrombolysis in myocardial infarction square...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28740386/quantum-dots-based-lateral-flow-immunoassay-combined-with-image-analysis-for-semiquantitative-detection-of-ige-antibody-to-mite
#20
Yan Zhao, Qiang Zhang, Qingfeng Meng, Fenglian Wu, Lihua Zhang, Yao Tang, Yuanyuan Guan, Lixin An
Semiquantitative and rapid detection of specific IgE (sIgE) with well clinical relevance to house dust mite (HDM) are promising for prevalence rhinitis and asthma patients due to the increasing air pollution. However, the conventional IgE measurement systems are time-consuming, complicated and require special instruments. Herein, we overcome the above limitations of sIgE to HDM detection system by developing a quantum dot nanobeads-based lateral flow immunoassay and an image analysis procedure. The proposed detection system could semiquantitatively measure the IgE in a linear range of 0...
2017: International Journal of Nanomedicine
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