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1.
Adv Exp Med Biol ; 1380: 83-110, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36306095

RESUMEN

Phantom objects are commonly employed in MRI systems as stable substitutes for biological tissues to ensure systems for measuring images are operating correctly and safely. For magnetic resonance electrical impedance tomography (MREIT) and magnetic resonance electrical property tomography (MREPT), conductivity or permittivity phantoms play an important role in checking MRI pulse sequences, MREIT equipment performance, and algorithm validation. The construction of these phantoms is explained in this chapter. In the first part, materials used for phantom construction are introduced. Ingredients for modifying the electromagnetic properties and relaxation times are presented, and the advantages and disadvantages of aqueous, gel, and hybrid conductivity phantoms are explained. The devices and methods used to confirm phantom electromagnetic properties are explained. Next, different types of MREIT electrode materials and the constant current sources used for MREIT studies are discussed. In the last section, we present the results of previous MREIT and MREPT studies.


Asunto(s)
Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Procesamiento de Imagen Asistido por Computador/métodos , Impedancia Eléctrica , Fantasmas de Imagen , Imagen por Resonancia Magnética/métodos , Tomografía/métodos , Algoritmos , Conductividad Eléctrica
2.
Adv Exp Med Biol ; 1380: 111-134, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36306096

RESUMEN

Magnetic resonance electrical impedance tomography (MREIT) can provide internal conductivity distributions at low frequency (below 1 kHz) induced by an external injecting current. In MREIT, we inject current I using at least one pair of electrodes into an object to produce internal current density J = (Jx, Jy, Jz) and magnetic flux density B = (Bx, By, Bz) in the object. An MRI scanner with its main magnetic field pointing the z direction is used to measure the induced magnetic flux density (Bz) caused by external current injection. To avoid the interaction of external current injection with MRI acquisitions, it is important to synchronize the current injection with MRI sequence. In the first part of this chapter, we will discuss the practical aspects of a successful MREIT experiment. Following a brief introduction to the experiment setup, we will then summarize various MRI sequences used for MREIT, magnetic flux density measurement, and image reconstructions for MREIT experiments.


Asunto(s)
Algoritmos , Imagen por Resonancia Magnética , Fantasmas de Imagen , Impedancia Eléctrica , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética , Procesamiento de Imagen Asistido por Computador/métodos , Conductividad Eléctrica , Tomografía/métodos
3.
Indian J Crit Care Med ; 26(4): 482-486, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35656048

RESUMEN

Background: In pandemic situations, it is essential that the limited resources are used judiciously to achieve most benefits. Prediction of the disease severity at the earliest will help in better allocation, thus, positively affecting prognosis and treatment. Aim and objective: To investigate patient characteristics and specific biomarkers as possible early predictors of disease severity of SARS-COV-2 infection. Materials and methods: Retrospective single-centric observational study conducted at 70-bedded intensive care unit of tertiary care hospital at Haryana, India. 100 consecutive RT-PCR positive coronavirus disease-2019 (COVID-19) adult patients. Demographics, acute physiology and chronic health evaluation II (Apache-II) score, and Inflammatory markers were compared with respect to oxygenation defect (PaO2/FiO2 ratio: <300 or ≥300 mm Hg), need of invasive ventilation, ICU length of stay and 28-day mortality. Findings: Mean age was significantly more in lower PF ratio group (58.01 ± 15.33 vs 50.97 ± 13.78, p = 0.023) whereas sex ratio was comparable among patients in two groups. Significantly, higher APACHE-II score (p ≤0.001) and presence of hypertension (43.54% vs 23.68%; p = 0·045) in low PF ratio group along with higher C-reactive protein (171.78 ± 124.45 vs 101.52 ± 88.70), IL-6 (173.51 vs 53.18) and ferritin (1677.60 ± 2271.13 vs 643.54 ± 718.68) levels. Procalcitonin, lactate dehydrogenase, and creatine phosphokinase (CPK) levels were not significant. Interpretation: Age and APACHE II score and among laboratory parameters CRP, ferritin, and IL-6 levels were significantly higher in low PF ratio group, patients requiring invasive ventilation and in mortality group. Use of this triad (CRP, ferritin, and IL-6 levels) at admission may predict the disease severity early in the course. Addition of APACHE-II may further improve the accuracy of the score. How to cite this article: Gupta D, Jain A, Chauhan M, Dewan S. Inflammatory Markers as Early Predictors of Disease Severity in COVID-19 Patients Admitted to Intensive Care Units: A Retrospective Observational Analysis. Indian J Crit Care Med 2022;26(4):482-486.

4.
Magn Reson Med ; 84(4): 2103-2116, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32301176

RESUMEN

PURPOSE: Deep brain stimulation electrodes composed of carbon fibers were tested as a means of administering and imaging magnetic resonance electrical impedance tomography (MREIT) currents. Artifacts and heating properties of custom carbon-fiber deep brain stimulation (DBS) electrodes were compared with those produced with standard DBS electrodes. METHODS: Electrodes were constructed from multiple strands of 7-µm carbon-fiber stock. The insulated carbon electrodes were matched to DBS electrode diameter and contact areas. Images of DBS and carbon electrodes were collected with and without current flow and were compared in terms of artifact and thermal effects in phantoms or tissue samples in 7T imaging conditions. Effects on magnetic flux density and current density distributions were also assessed. RESULTS: Carbon electrodes produced magnitude artifacts with smaller FWHM values compared to the magnitude artifacts around DBS electrodes in spin echo and gradient echo imaging protocols. DBS electrodes appeared 269% larger than actual size in gradient echo images, in sharp contrast to the negligible artifact observed in diameter-matched carbon electrodes. As expected, larger temperature changes were observed near DBS electrodes during extended RF excitations compared with carbon electrodes in the same phantom. Magnitudes and distribution of magnetic flux density and current density reconstructions were comparable for carbon and DBS electrodes. CONCLUSION: Carbon electrodes may offer a safer, MR-compatible method for administering neuromodulation currents. Use of carbon-fiber electrodes should allow imaging of structures close to electrodes, potentially allowing better targeting, electrode position revision, and the facilitation of functional imaging near electrodes during neuromodulation.


Asunto(s)
Estimulación Encefálica Profunda , Campos Electromagnéticos , Carbono , Electrodos , Electrodos Implantados , Imagen por Resonancia Magnética
5.
Indian J Crit Care Med ; 24(9): 879-881, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33132578

RESUMEN

Diffuse alveolar hemorrhage (DAH) is a rare but life-threatening disease. Mortality is very high in those patients who require mechanical ventilation. Traditionally, active bleeding has been considered a contraindication for extracorporeal membrane oxygenation (ECMO) support. There is limited evidence for ECMO in DAH as rescue therapy. Herein, we describe a case of antineutrophil cytoplasmic antibodies-associated DAH with intractable hypoxemic respiratory failure. An appropriate ventilator strategy failed to improve her hypoxemia leading to imminent risk to her life. The patient was rescued with veno-venous ECMO targeting lower than usual range of anticoagulation. ECMO proved to be lifesaving in our patient who was initiated on prompt immunosuppressive therapy and plasmapheresis along with continuous veno-venous hemodiafiltration and hemodynamic support. We feel that ECMO could be considered as adjunctive therapy in severe hypoxemic respiratory failure associated with DAH after careful consideration of the risk of bleeding and a restrictive anticoagulation strategy. How to cite this article: Goel MK, Chauhan M, Kumar A, Wadwa P, Maitra G, Talegaonkkar M, et al. A Case of Refractory Hypoxemic Respiratory Failure due to Antineutrophil Cytoplasmic Antibodies-associated Diffuse Alveolar Hemorrhage Rescued by Extracorporeal Membrane Oxygenation. Indian J Crit Care Med 2020;24(9):879-881.

6.
Magn Reson Med ; 81(1): 602-614, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-29770490

RESUMEN

PURPOSE: A direct method of imaging neural activity was simulated to determine typical signal sizes. METHODS: An active bidomain finite-element model was used to estimate approximate perturbations in MR phase data as a result of neural tissue activity, and when an external MR electrical impedance tomography imaging current was added to the region containing neural current sources. RESULTS: Modeling-predicted, activity-related conductivity changes should produce measurable differential phase signals in practical MR electrical impedance tomography experiments conducted at moderate resolution at noise levels typical of high field systems. The primary dependence of MR electrical impedance tomography phase contrast on membrane conductivity changes, and not source strength, was demonstrated. CONCLUSION: Because the injected imaging current may also affect the level of activity in the tissue of interest, this technique can be used synergistically with neuromodulation techniques such as deep brain stimulation, to examine mechanisms of action.


Asunto(s)
Impedancia Eléctrica , Imagen por Resonancia Magnética , Tejido Nervioso/diagnóstico por imagen , Neuronas/fisiología , Algoritmos , Simulación por Computador , Medios de Contraste , Conductividad Eléctrica , Electrodos , Análisis de Elementos Finitos , Humanos , Procesamiento de Imagen Asistido por Computador , Microscopía de Contraste de Fase , Modelos Teóricos , Método de Montecarlo , Distribución Normal , Fantasmas de Imagen , Propiedades de Superficie
7.
Magn Reson Med ; 81(4): 2264-2276, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30450638

RESUMEN

PURPOSE: Artifacts observed in experimental magnetic resonance electrical impedance tomography images were hypothesized to be because of magnetohydrodynamic (MHD) effects. THEORY AND METHODS: Simulations of MREIT acquisition in the presence of MHD and electrical current flow were performed to confirm findings. Laminar flow and (electrostatic) electrical conduction equations were bidirectionally coupled via Lorentz force equations, and finite element simulations were performed to predict flow velocity as a function of time. Gradient sequences used in spin-echo and gradient echo acquisitions were used to calculate overall effects on MR phase images for different electrical current application or phase-encoding directions. RESULTS: Calculated and experimental phase images agreed relatively well, both qualitatively and quantitatively, with some exceptions. Refocusing pulses in spin echo sequences did not appear to affect experimental phase images. CONCLUSION: MHD effects were confirmed as the cause of observed experimental phase changes in MREIT images obtained at high fields. These findings may have implications for quantitative measurement of viscosity using MRI techniques. Methods developed here may be also important in studies of safety and in vivo artifacts observed in high field MRI systems.


Asunto(s)
Impedancia Eléctrica , Campos Magnéticos , Imagen por Resonancia Magnética/instrumentación , Imagen por Resonancia Magnética/métodos , Tomografía/instrumentación , Tomografía/métodos , Algoritmos , Artefactos , Simulación por Computador , Conductividad Eléctrica , Análisis de Elementos Finitos , Hidrodinámica , Fantasmas de Imagen , Viscosidad
8.
Magn Reson Med ; 79(1): 71-82, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28205251

RESUMEN

PURPOSE: Magnetic resonance electrical impedance tomography (MREIT) sequences typically use conventional spin or gradient echo-based acquisition methods for reconstruction of conductivity and current density maps. Use of MREIT in functional and electroporation studies requires higher temporal resolution and faster sequences. Here, single and multishot echo planar imaging (EPI) based MREIT sequences were evaluated to see whether high-quality MREIT phase data could be obtained for rapid reconstruction of current density, conductivity, and electric fields. METHODS: A gel phantom with an insulating inclusion was used as a test object. Ghost artifact, geometric distortion, and MREIT correction algorithms were applied to the data. The EPI-MREIT-derived phase-projected current density and conductivity images were compared with simulations and spin-echo images as a function of EPI shot number. RESULTS: Good agreement among measures in simulated, spin echo, and EPI data was achieved. Current density errors were stable and below 9% as the shot number decreased from 64 to 2, but increased for single-shot images. Conductivity reconstruction relative contrast ratios were stable as the shot number decreased. The derived electric fields also agreed with the simulated data. CONCLUSIONS: The EPI methods can be combined successfully with MREIT reconstruction algorithms to achieve fast imaging of current density, conductivity, and electric field. Magn Reson Med 79:71-82, 2018. © 2017 International Society for Magnetic Resonance in Medicine.


Asunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Tomografía/métodos , Algoritmos , Simulación por Computador , Imagen Eco-Planar/métodos , Conductividad Eléctrica , Impedancia Eléctrica , Electrodos , Campos Electromagnéticos , Electroporación , Diseño de Equipo , Cabeza/diagnóstico por imagen , Humanos , Rodilla/diagnóstico por imagen , Fantasmas de Imagen , Relación Señal-Ruido
9.
Neural Plast ; 2018: 8525706, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30627150

RESUMEN

Background: Phosphene generation is an objective physical measure of potential transcranial alternating current stimulation (tACS) biological side effects. Interpretations from phosphene analysis can serve as a first step in understanding underlying mechanisms of tACS in healthy human subjects and assist validation of computational models. Objective/Hypothesis: This preliminary study introduces and tests methods to analyze predicted phosphene occurrence using computational head models constructed from tACS recipients against verbal testimonies of phosphene sensations. Predicted current densities in the eyes and the occipital lobe were also verified against previously published threshold values for phosphenes. Methods: Six healthy subjects underwent 10 Hz tACS while being imaged in an MRI scanner. Two different electrode montages, T7-T8 and Fpz-Oz, were used. Subject ratings of phosphene experience were collected during tACS and compared against current density distributions predicted in eye and occipital lobe regions of interest (ROIs) determined for each subject. Calculated median current densities in each ROI were compared to minimum thresholds for phosphene generation. Main Results: All subjects reported phosphenes, and predicted median current densities in ROIs exceeded minimum thresholds for phosphenes found in the literature. Higher current densities in the eyes were consistently associated with decreased phosphene generation for the Fpz-Oz montage. There was an overall positive association between phosphene perceptions and current densities in the occipital lobe. Conclusions: These methods may have promise for predicting phosphene generation using data collected during in-scanner tACS sessions and may enable better understanding of phosphene origin. Additional empirical data in a larger cohort is required to fully test the robustness of the proposed methods. Future studies should include additional montages that could dissociate retinal and occipital stimulation.


Asunto(s)
Fosfenos/fisiología , Estimulación Transcraneal de Corriente Directa , Corteza Visual/fisiología , Adulto , Humanos , Imagen por Resonancia Magnética , Corteza Visual/diagnóstico por imagen , Adulto Joven
10.
Int J Hyperthermia ; 30(7): 447-55, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25329351

RESUMEN

PURPOSE: This study shows the potential of magnetic resonance electrical impedance tomography (MREIT) as a non-invasive RF ablation monitoring technique. MATERIALS AND METHODS: We prepared bovine muscle tissue with a pair of needle electrodes for RF ablation, a temperature sensor, and two pairs of surface electrodes for conductivity image reconstructions. We used the injected current non-linear encoding with multi-echo gradient recalled echo (ICNE-MGRE) pulse sequence in a series of MREIT scans for conductivity imaging. We acquired magnetic flux density data induced by externally injected currents, while suppressing other phase artefacts. We used an 8-channel RF head coil and 8 echoes to improve the signal-to-noise ratio (SNR) in measured magnetic flux density data. Using the measured data, we reconstructed a time series of 180 conductivity images at every 10.24 s during and after RF ablation. RESULTS: Tissue conductivity values in the lesion increased with temperature during RF ablation. After reaching 60 °C, a steep increase in tissue conductivity values occurred with relatively little temperature increase. After RF ablation, tissue conductivity values in the lesion decreased with temperature, but to values different from those before ablation due to permanent structural changes of tissue by RF ablation. CONCLUSION: We could monitor temperature and also structural changes in tissue during RF ablation by producing spatio-temporal maps of tissue conductivity values using a fast MREIT conductivity imaging method. We expect that the new monitoring method could be used to estimate lesions during RF ablation and improve the efficacy of the treatment.


Asunto(s)
Impedancia Eléctrica , Imagen por Resonancia Magnética/métodos , Ondas de Radio , Estudios Transversales
11.
Transplantation ; 108(2): 545-555, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37641175

RESUMEN

BACKGROUND: There is no robust evidence-based data for ABO-incompatible kidney transplantation (ABOiKT) from emerging countries. METHODS: Data from 1759 living donor ABOiKT and 33 157 ABO-compatible kidney transplantations (ABOcKT) performed in India between March 5, 2011, and July 2, 2022, were included in this retrospective, multicenter (n = 25) study. The primary outcomes included management protocols, mortality, graft loss, and biopsy-proven acute rejection (BPAR). RESULTS: Protocol included rituximab 100 (232 [13.18%]), 200 (877 [49.85%]), and 500 mg (569 [32.34%]); immunoadsorption (IA) (145 [8.24%]), IVIG (663 [37.69%]), and no induction 200 (11.37%). Mortality, graft loss, and BPAR were reported in 167 (9.49%), 136 (7.73%), and 228 (12.96%) patients, respectively, over a median follow-up of 36.3 mo. In cox proportional hazard model, mortality was higher with IA (hazard ratio [HR]: 2.53 [1.62-3.97]; P < 0.001), BPAR (HR: 1.83 [1.25-2.69]; P = 0.0020), and graft loss (HR: 1.66 [1.05-2.64]; P = 0.0310); improved graft survival was associated with IVIG (HR: 0.44 [0.26-0.72]; P = 0.0010); higher BPAR was reported with conventional tube method (HR: 3.22 [1.9-5.46]; P < 0.0001) and IA use (HR: 2 [1.37-2.92]; P < 0.0001), whereas lower BPAR was reported in the prepandemic era (HR: 0.61 [0.43-0.88]; P = 0.008). Primary outcomes were not associated with rituximab dosing or high preconditioning/presurgery anti-A/anti-B titers. Incidence of overall infection 306 (17.39%), cytomegalovirus 66 (3.75%), and BK virus polyoma virus 20 (1.13%) was low. In unmatched univariate analysis, the outcomes between ABOiKT and ABOcKT were comparable. CONCLUSIONS: Our largest multicenter study on ABOiKT provides insights into various protocols and management strategies with results comparable to those of ABOcKT.


Asunto(s)
Trasplante de Riñón , Humanos , Trasplante de Riñón/métodos , Rituximab/uso terapéutico , Inmunosupresores/uso terapéutico , Estudios Retrospectivos , Inmunoglobulinas Intravenosas/uso terapéutico , Incompatibilidad de Grupos Sanguíneos , Sistema del Grupo Sanguíneo ABO , Rechazo de Injerto/epidemiología , Rechazo de Injerto/prevención & control , Supervivencia de Injerto , Donadores Vivos , Estudios Multicéntricos como Asunto
12.
Biomed Eng Online ; 12: 82, 2013 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-23981409

RESUMEN

BACKGROUND: Magnetic resonance electrical impedance tomography (MREIT) has been introduced as a non-invasive method for visualizing the internal conductivity and/or current density of an electrically conductive object by externally injected currents. The injected current through a pair of surface electrodes induces a magnetic flux density distribution inside the imaging object, which results in additional magnetic flux density. To measure the magnetic flux density signal in MREIT, the phase difference approach in an interleaved encoding scheme cancels out the systematic artifacts accumulated in phase signals and also reduces the random noise effect by doubling the measured magnetic flux density signal. For practical applications of in vivo MREIT, it is essential to reduce the scan duration maintaining spatial-resolution and sufficient contrast. In this paper, we optimize the magnetic flux density by using a fast gradient multi-echo MR pulse sequence. To recover the one component of magnetic flux density Bz, we use a coupled partial Fourier acquisitions in the interleaved sense. METHODS: To prove the proposed algorithm, we performed numerical simulations using a two-dimensional finite-element model. For a real experiment, we designed a phantom filled with a calibrated saline solution and located a rubber balloon inside the phantom. The rubber balloon was inflated by injecting the same saline solution during the MREIT imaging. We used the multi-echo fast low angle shot (FLASH) MR pulse sequence for MRI scan, which allows the reduction of measuring time without a substantial loss in image quality. RESULTS: Under the assumption of a priori phase artifact map from a reference scan, we rigorously investigated the convergence ratio of the proposed method, which was closely related with the number of measured phase encode set and the frequency range of the background field inhomogeneity. In the phantom experiment with a partial Fourier acquisition, the total scan time was less than 6 seconds to measure the magnetic flux density Bz data with 128×128 spacial matrix size, where it required 10.24 seconds to fill the complete k-space region. CONCLUSION: Numerical simulation and experimental results demonstrated that the proposed method reduces the scanning time and provides the recovered Bz data comparable to what we obtained by measuring complete k-space data.


Asunto(s)
Conductividad Eléctrica , Análisis de Fourier , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Algoritmos , Estudios de Factibilidad , Modelos Teóricos , Fantasmas de Imagen , Control de Calidad , Factores de Tiempo
13.
Int J Hyperthermia ; 29(7): 643-52, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24102394

RESUMEN

PURPOSE: The aim of this study was to show the potential of magnetic resonance electrical impedance tomography (MREIT) conductivity imaging in terms of its capability to detect ablated lesions and differentiate tissue conditions in liver radiofrequency (RF) ablation. MATERIALS AND METHODS: RF ablation procedures were performed in bovine livers using a LeVeen RF needle electrode. Ablation lesions were created using a power-controlled mode at 30, 50, and 70 W for 1, 3, and 5 min of exposure time, respectively. After the ablation, the liver was cut into several blocks including the ablated lesion, and positioned inside a phantom filled with agarose gel. Electrodes were attached on the side of the phantom and it was placed inside the MRI bore. For MREIT imaging, multi-spin-echo pulse sequence was used to obtain the magnetic flux density data according to the injection currents. RESULTS: The conductivity of ablation lesions was significantly changed with the increase of exposure time (pKW < 0.01, Kruskal-Wallis test). With RF powers of 30 and 50 W, significant differences between the coagulation necrosis and hyperaemic rim were observed for more than 5 min and 3 min, respectively (pMW < 0.01, Mann-Whitney test). At 70 W, all cases showed significant differences except 3 min (pMW < 0.01). The positive correlation between the exposure time and tissue conductivity was observed in both two ablation areas (pSC < 0.01, Spearman correlation). CONCLUSIONS: This ex vivo feasibility study demonstrates that current MREIT conductivity imaging can detect liver RF ablation lesions without using any contrast media or additional MR scan.


Asunto(s)
Ablación por Catéter , Hígado/cirugía , Imagen por Resonancia Magnética/métodos , Animales , Bovinos , Conductividad Eléctrica , Estudios de Factibilidad
14.
Paediatr Anaesth ; 23(4): 355-9, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23137103

RESUMEN

BACKGROUND: Use of propofol in pediatric age group has been marred by reports of its adverse effects like hypertriglyceridemia and acute pancreatitis, although a causal relation has not yet been established. OBJECTIVES: This prospective, clinical trial was carried out to evaluate the effects of short-term propofol administration on serum lipid profile and serum pancreatic enzymes in children of ASA physical status I and II aged between 1 month and 36 months. METHODS: Anesthesia was induced with Propofol (1%) in the dose of 3 mg·kg(-1) intravenously and was maintained by propofol infusion (0.5%) at the rate of 12 mg·kg(-1·) h(-1) for the first 20 min and at 8 mg·kg(-1·) h(-1) thereafter. The mean dose of propofol administered was 12.02 ± 2.75 mg·kg(-1) (fat load of 120.2 ± 27.5 mg·kg(-1) ). Lipid profile, serum amylase, and lipase were measured before induction of anesthesia, at 90 min, 4 h, and finally 24 h after induction. RESULTS: Serum lipase levels (P < 0.05), serum triglyceride levels (P < 0.05), and serum very low-density lipoproteins VLDL levels (P < 0.05) were raised significantly after propofol administration from baseline although remained within normal limits. Serum cholesterol levels and serum low-density lipoproteins LDL levels showed a statistically significant fall over 24 h. No significant changes in serum pancreatic amylase levels were seen (P > 0.05). None of the patients developed any clinical features of pancreatitis in the postoperative period. CONCLUSION: We conclude that despite a small, transient increase in serum triglycerides and pancreatic enzymes, short-term propofol administration in recommended dosages in children of ASA status I and II aged between 1 month and 36 months does not produce any clinically significant effect on serum lipids and pancreatic enzymes.


Asunto(s)
Anestesia Intravenosa , Anestésicos Intravenosos , Metabolismo de los Lípidos/efectos de los fármacos , Páncreas/efectos de los fármacos , Páncreas/enzimología , Propofol , Amilasas/sangre , Anestesia Intravenosa/efectos adversos , Anestésicos Intravenosos/efectos adversos , Presión Arterial/efectos de los fármacos , Preescolar , Colesterol/sangre , Método Doble Ciego , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Lactante , Lipasa/sangre , Lípidos/sangre , Lipoproteínas VLDL/sangre , Masculino , Propofol/efectos adversos
15.
Indian J Crit Care Med ; 17(5): 275-82, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24339638

RESUMEN

AIM: To study the clinical characteristics and outcome of admitted patients of H1N1 (hemagglutinin -H neuraminidase -N) influenza in a tertiary level hospital, from Oct 2009 to Dec 2010. MATERIALS AND METHODS: A retrospective analysis of 77 confirmed patients admitted in this unit with H1N1 infection. RESULTS: Of the 77 patients studied, 33 (42.8%) were female. Mean age was 40.88 ± 13.45 years, majority (70.13%) being less than 50 years. Thirty eight (49.3%) patients had at least one co-morbidity, diabetes mellitus being the most common (n = 15, 19.5%). The most common presenting symptom was fever in 75 (97.4%) patients, cough in 67 (87%) and dyspnoea in 59 (76.6%) patients. At admission, mean PaO2/FiO2 ratio was 213.16 ± 132.75 mmHg (n = 60) while mean PaCO2 was 40.14 ± 14.86 mmHg. One or more organ failure was present in 45 (58.4%) patients. Nineteen (24.60%) patients required invasive mechanical ventilation. Circulatory failure was observed in 10 (13%) patients while 2 patients required hemodialysis. Overall, 13% mortality (n = 10) was observed. PaCO2 level at admission (OR 1.093; 95% confidence interval: 1.002-1.193; P = 0.044) and number of organ failure (OR 8.089; 95% confidence interval: 1.133-57.778; P = 0.037) were identified as independent risk- factors for mortality. CONCLUSION: Increased duration of dyspnoea prior to admission, pneumonia, low PaO2/FiO2 ratio at admission and 24 hours later, higher PaCO2 values on admission, higher O2 requirement, number of organ failures and use of corticosteroids and delay in specialized treatment were associated with a poorer outcome.

16.
Indian J Crit Care Med ; 17(2): 107-10, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23983417

RESUMEN

Urea cycle disorders (UCD) are common during neonatal period, and it is rarely reported in adults. We are reporting a patient presenting with post-partum neuropsychiatric symptoms rapidly progressing to coma. Markedly raised serum ammonia level on presentation with an initial normal magnetic resonance imaging (MRI) of brain and normal liver function tests led to the suspicion of UCD, which was confirmed on the basis of urine orotic acid and elevated serum amino acid levels. We had to resort to hemodialysis to correct the hyperammonemic coma, which was unresponsive to conventional anti-ammonia measures. She exhibited remarkable improvement with a progressive decline in serum ammonia with repeated hemodialysis and made a full recovery. Timely diagnosis and early institution of hemodialysis in the setting of a poor neurological status maybe considered a suitable treatment option.

17.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 6725-6727, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34892651

RESUMEN

Neuromodulation caused by transcranial electrical stimulation (TES) has been used successfully to treat various neuro-degenerative diseases. Simulation models provide an essential tool to study brain and nerve stimulation. Simulation models of TES provide an opportunity to research personalization of therapy without extensive animal and human testing. A computer model of a realistic sensory axon was built by finding actual geometry of the trigeminal nerve through tractography. A finite element model of the head was solved to obtain electric potential distribution caused by TES. Different waveforms were defined to test transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) with varying amplitude and frequency. Neural activity patterns were observed. The strength-duration curve was plotted to verify the model.


Asunto(s)
Trastornos Mentales , Estimulación Transcraneal de Corriente Directa , Animales , Axones , Encéfalo , Simulación por Computador , Humanos
18.
PLoS One ; 16(7): e0254690, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34293014

RESUMEN

Diffusion tensor magnetic resonance electrical impedance tomography (DT-MREIT) is a newly developed technique that combines MR-based measurements of magnetic flux density with diffusion tensor MRI (DT-MRI) data to reconstruct electrical conductivity tensor distributions. DT-MREIT techniques normally require injection of two independent current patterns for unique reconstruction of conductivity characteristics. In this paper, we demonstrate an algorithm that can be used to reconstruct the position dependent scale factor relating conductivity and diffusion tensors, using flux density data measured from only one current injection. We demonstrate how these images can also be used to reconstruct electric field and current density distributions. Reconstructions were performed using a mimetic algorithm and simulations of magnetic flux density from complementary electrode montages, combined with a small-scale machine learning approach. In a biological tissue phantom, we found that the method reduced relative errors between single-current and two-current DT-MREIT results to around 10%. For in vivo human experimental data the error was about 15%. These results suggest that incorporation of machine learning may make it easier to recover electrical conductivity tensors and electric field images during neuromodulation therapy without the need for multiple current administrations.


Asunto(s)
Algoritmos , Imagen de Difusión Tensora/instrumentación , Conductividad Eléctrica , Campos Electromagnéticos , Aprendizaje Automático , Fantasmas de Imagen , Humanos
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 4068-4071, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34892123

RESUMEN

Neurostimulation with multiple scalp electrodes has shown enhanced effects in recent studies. However, visualizations of stimulation-induced internal current distributions in brain is only possible through simulated current distributions obtained from computer model of human head. While magnetic resonance current density imaging (MRCDI) has a potential for direct in-vivo measurement of currents induced in brain with multi-electrode stimulation, existing MRCDI methods are only developed for two-electrode neurostimulation. A major bottleneck is the lack of a current switching device which is typically used to convert the DC current of neurostimulation devices into user-defined waveforms of positive and negative polarity with delays between them. In this work, we present a design of a four-electrode current switching device to enable simultaneous switching of current flowing through multiple scalp electrodes.


Asunto(s)
Encéfalo , Imagen por Resonancia Magnética , Encéfalo/diagnóstico por imagen , Electrodos , Humanos , Espectroscopía de Resonancia Magnética , Cuero Cabelludo
20.
Phys Med Biol ; 65(22): 225016, 2020 11 17.
Artículo en Inglés | MEDLINE | ID: mdl-32987377

RESUMEN

Conventional magnetic resonance electrical impedance tomography (MREIT) reconstruction methods require administration of two linearly independent currents via at least two electrode pairs. This requires long scanning times and inhibits coordination of MREIT measurements with electrical neuromodulation strategies. We sought to develop an isotropic conductivity reconstruction algorithm in MREIT based on a single current injection, both to decrease scanning time by a factor of two and enable MREIT measurements to be conveniently adapted to general transcranial- or implanted-electrode neurostimulation protocols. In this work, we propose and demonstrate an iterative algorithm that extends previously published MREIT work using two-current administration approaches. The proposed algorithm is a single-current adaptation of the harmonic B z algorithm. Forward modeling of electric potentials is used to capture changes of conductivity along current directions that would normally be invisible using data from a single-current administration. Computational and experimental results show that the reconstruction algorithm is capable of reconstructing isotropic conductivity images that agree well in terms of L 2 error and structural similarity with exact conductivity distributions or two-current-based MREIT reconstructions. We conclude that it is possible to reconstruct high quality electrical conductivity images using MREIT techniques and one current injection only.


Asunto(s)
Conductividad Eléctrica , Procesamiento de Imagen Asistido por Computador/métodos , Tomografía , Algoritmos , Impedancia Eléctrica , Fantasmas de Imagen
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