ABSTRACT
4D-flow MRI is a promising technique for assessing vessel hemodynamics. However, its utilization is currently limited by the lack of reference values, particularly for pulmonary vessels. In this work, we have analysed flow and velocity in the pulmonary trunk (PT), left and right pulmonary arteries (LPA and RPA, respectively) in Landrace pigs at both rest and stress through the software MEVISFlow. Nine healthy Landrace pigs were acutely instrumented closed-chest and transported to the CMR facility for evaluation. After rest measurements, dobutamine was administered to achieve a 25% increase in heart rate compared to rest. 4D-flow MRI images have been analysed through MEVISFlow by two independent observers. Inter- and intra-observer reproducibility was quantified using intraclass correlation coefficient. A significant difference between rest and stress regarding flow and velocity in all the pulmonary vessels was observed. Mean flow increased 55% in PT, 75% in LPA and 40% in RPA. Mean peak velocity increased 55% in PT, 75% in LPA and 66% in RPA. A good-to-excellent reproducibility was observed in rest and stress for flow measurements in all three arteries. An excellent reproducibility for velocity was found in PT at rest and stress, a good one for LPA and RPA at rest, while poor reproducibility was found at stress. The current study showed that pulmonary flow and velocity assessed through 4D-flow MRI follow the physiological alterations during cardiac cycle and after stress induced by dobutamine. A clinical translation to assess pulmonary diseases with 4D-flow MRI under stress conditions needs investigation.
ABSTRACT
Liquid biopsy approaches are powerful strategies that potentially allow the diagnosis and prognosis of a number of diseases. The field is continuously and rapidly growing, encouraging the discovery of novel predictory biomarkers. Antibodies are usually exploited in sensors to validate biomarker candidates. Unfortunately, the immobilization of antibodies on the surface of sensors represents a challenging task. Immobilization strategies need to be optimized for each antibody, representing a huge obstacle to overcome in the discovery of new biomarkers. Herein we propose a novel strategy for the immobilization of antibodies, based on the use of a streptavidin-binding aptamer. Using this approach it is possible to immobilize antibodies on the surface of sensors with no need for optimization, with the only requirement for antibody to be biotinylated. The proposed strategy potentially paves the way towards a straightforward immobilization of antibodies on biosensors, making their use in biomarker validation more accessible.
Subject(s)
Biosensing Techniques , Biotin , Streptavidin , Antibodies , OligonucleotidesSubject(s)
Humans , Female , Aged, 80 and over , Rupture/diagnostic imaging , Diaphragm/injuries , Diagnostic Imaging , Early Diagnosis , Point-of-Care TestingABSTRACT
Los pacientes que sobreviven a un cáncer tienen una menor supervivencia a largo plazo, en parte debido al incremento de las enfermedades cardiovasculares (ECV). Hasta el 30% de los fallecimientos de pacientes con cáncer pueden ser de causa cardiovascular. El cáncer puede causar ateroesclerosis por diferentes mecanismos, los más frecuentes son las secuelas de los fármacos antitumorales, la radioterapia y el trasplante de células hematopoyéticas. Los factores de riesgo cardiovascular son prevalentes en los supervivientes de cáncer. Estos pacientes deberían ser considerados en alto riesgo cardiovascular. Se aconseja recomendar hábitos de vida saludables y un control estricto de los factores de riesgo. Hay una necesidad inmediata para ampliar la disponibilidad de servicios preventivos cardiovasculares de cara a reducir los efectos adversos tardíos de la quimioterapia y la radiación. La intervención precoz podría ayudar a mejorar el perfil de riesgo cardiovascular. (AU)
Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile (AU)
Subject(s)
Humans , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Antineoplastic Agents , Neoplasms/complications , Neoplasms/epidemiology , Prevalence , Risk FactorsABSTRACT
La mayor disponibilidad de nuevos tratamientos oncológicos en los últimos años ha conllevado una mejoría del pronóstico e incremento de la expectativa de vida de los pacientes con cáncer, si bien a expensas de un incremento del riesgo cardiovascular. Por este motivo ha surgido la necesidad de la creación de equipos multidisciplinares para la valoración conjunta de estos pacientes y así lograr optimizar la salud cardiovascular y la supervivencia global de estos pacientes, minimizando las interrupciones de los tratamientos onco-hematológicos. Existe un amplio abanico de toxicidades cardiovasculares asociadas a los diferentes tratamientos del cáncer. El control estructurado del riesgo cardiovascular antes, durante y después del tratamiento oncológico permite seguir estrategias de prevención, detección temprana y tratamiento precoz de las cardiotoxicidades. (AU)
The increased availability of new cancer treatments in recent years has led to improved prognosis and increased life expectancy for cancer patients, but at the expense of increased cardiovascular risk. For this reason, multidisciplinary teams need to be formed for the joint evaluation of these patients to optimise the cardiovascular health and overall survival of these patients and minimise interruptions to onco-haematological treatments. A wide range of cardiovascular toxicities are associated with the various cancer treatments. The structured control of cardiovascular risk before, during and after oncological treatment will enable strategies for the prevention, early detection and early treatment of cardiotoxicities. (AU)
Subject(s)
Humans , Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/epidemiology , Neoplasms/complications , Neoplasms/therapy , Cardiotoxicity/etiology , PrognosisABSTRACT
Cancer survivors have lower long-term survival, in part due to increased cardiovascular disease (CVD). Up to 30% of the deaths of patients with cancer may be due to cardiovascular causes. Cancer can cause atherosclerosis by different mechanisms, the most frequent being the sequelae of antitumour drugs, radiotherapy, and haematopoietic cell transplantation. Cardiovascular risk factors are prevalent in cancer survivors. These patients should be considered at high cardiovascular risk. It is advisable to recommend healthy lifestyle habits and strict control of risk factors. There is an immediate need to expand the availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention could help improve cardiovascular risk profile.
Subject(s)
Antineoplastic Agents , Cardiovascular Diseases , Neoplasms , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Heart Disease Risk Factors , Humans , Neoplasms/complications , Neoplasms/epidemiology , Risk FactorsABSTRACT
The increased availability of new cancer treatments in recent years has led to improved prognosis and increased life expectancy for cancer patients, but at the expense of increased cardiovascular risk. For this reason, multidisciplinary teams need to be formed for the joint evaluation of these patients to optimise the cardiovascular health and overall survival of these patients and minimise interruptions to onco-haematological treatments. A wide range of cardiovascular toxicities are associated with the various cancer treatments. The structured control of cardiovascular risk before, during and after oncological treatment will enable strategies for the prevention, early detection and early treatment of cardiotoxicities.
Subject(s)
Cardiovascular Diseases , Neoplasms , Cardiotoxicity/etiology , Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/epidemiology , Humans , Neoplasms/complications , Neoplasms/therapy , PrognosisABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Intubation, Gastrointestinal/instrumentation , Medical Errors , Ultrasonography , Abdomen/diagnostic imaging , Abdomen/pathologyABSTRACT
Las diferencias etiológicas y fisiopatológicas entre las entidades que pueden requerir una intervención neuroquirúrgica o el establecimiento de cuidados neurocríticos hace imposible hablar del control de la presión arterial en el paciente neurocrítico o neuroquirúrgico de un modo genérico. Con este razonamiento en mente, decidimos revisar por separado el control de la presión arterial en algunas de las entidades patológicas a las que más frecuentemente nos enfrentamos en la práctica clínica. Los temas revisados son: traumatismo craneoencefálico, ictus isquémico agudo, cirugía de los aneurismas intracraneales, cirugía de las malformaciones arteriovenosas cerebrales, cirugía tumoral encefálica, cirugía medular y cuidados de la lesión medular aguda
The etiological and pathophysiological differences between diseases that may require a neurosurgical intervention or the establishment of neurocritical care make it impossible to talk about the control of blood pressure in the neurocritical or neurosurgical patient in a generic manner. With this reasoning in mind, we decided to review separately the control of blood pressure in some of the pathologies we most frequently faced in clinical practice. The topics reviewed are: cranial brain trauma, acute ischemic stroke, intracranial aneurysm surgery, cerebral arteriovenous malformation surgery, brain tumor surgery, spinal cord surgery and acute spinal cord injury
Subject(s)
Humans , Craniocerebral Trauma/surgery , Intracranial Aneurysm/surgery , Intracranial Arteriovenous Malformations/surgery , Brain Neoplasms/surgery , Hypertension/drug therapy , Neurosurgical Procedures/methods , Critical Care/methods , Monitoring, Intraoperative/methodsSubject(s)
Intubation, Gastrointestinal , Medical Errors , Abdomen/diagnostic imaging , Aged, 80 and over , Humans , Male , UltrasonographyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Child , Young Adult , Anaphylaxis/chemically induced , Honey/adverse effects , Enema/adverse effects , Administration, RectalABSTRACT
Introducción y objetivos: Los pacientes ingresados en unidades de cuidados intensivos son susceptibles de complicaciones pulmonares por múltiples causas (enfermedad de base, inmovilización, riesgo de infección, etc.). La principal intervención para prevenirlas y tratarlas es la fisioterapia respiratoria (FR), práctica habitual en el día a día de enfermería. Por ello se realizó esta revisión bibliográfica, con el objetivo de describir los métodos de FR más eficaces para la prevención y tratamiento de las complicaciones pulmonares en los pacientes ingresados en unidades de cuidados intensivos, diferenciando paciente intubado y no intubado. Metodología: Se llevó a cabo una revisión narrativa de la literatura en las bases de datos Pubmed, Cinahl y Cochrane Library. Los límites fueron el idioma, la evidencia de los últimos 15 años y la edad. Resultados: Las técnicas de expansión pulmonar, tos, vibración, percusión, drenaje postural, espirometría incentivada y los sistemas oscilatorios y no oscilatorios presentan controversia en cuanto a la eficacia como método de fisioterapia respiratoria. En cambio, la ventilación mecánica no invasiva muestra clara evidencia de su beneficio. En el paciente intubado, la hiperinsuflación manual y la aspiración de secreciones son métodos eficaces para la prevención de complicaciones respiratorias. El resto de métodos de FR aplicados de forma aislada no han demostrado una clara eficacia. Discusión y conclusiones: Las técnicas de FR que han demostrado mejores resultados son la ventilación mecánica no invasiva para el paciente no intubado y la hiperinsuflación manual para el paciente intubado. Respecto al resto de técnicas existe mayor controversia. En ambos grupos de pacientes, la literatura muestra que la terapia combinada es la más eficaz
Introduction and aims: Patients in intensive care unit are susceptible to complications due to different causes (underlying disease, immobilisation, infection risk...) The current main intervention in order to prevent these complications is respiratory physiotherapy, a common practice for nurses on a daily basis. Therefore, we decided to carry out this bibliographic review to describe the most efficient respiratory physiotherapy methods for the prevention and treatment of lung complications in patients in intensive care, taking into account the differences between intubated and non-intubated patients. Methodology: The bibliographic narrative review was carried out on literature available in Pubmed, Cinahl and Cochrane Library. The established limits were language, evidence over the last 15 years and age. Results: Techniques involving lung expansion, cough, vibration, percussion, postural drainage, incentive inspirometry and oscillatory and non-oscillatory systems are controversial regarding their efficacy as respiratory physiotherapy methods. However, non-invasive mechanical ventilation shows clear benefits. In the case of intubated patients, manual hyperinflation and secretion aspirations are highly efficient methods for the prevention of the potential complications mentioned above. In this case, other RP methods showed no clear efficiency when used individually. DiscusSion and conclusions: Non-invasive mechanical ventilation (for non-intubated patients) and manual hyperinflation (for intubated patients) proved to be the respiratory physiotherapy methods with the best results. The other techniques are more controversial and the results are not so clear. In both types of patients this literature review suggests that combined therapy is the most efficient
Subject(s)
Humans , Critical Care/methods , Lung Diseases/therapy , Physical Therapy Modalities , Respiratory Therapy , Intensive Care Units , Spirometry/methods , Respiration, Artificial/methodsABSTRACT
Europe's Blue Growth strategy promotes the intensification of human activities at sea and increases the environmental risk such as the decline of the provision of key ecosystem services and potential conflicts among human activities. The fishing sector, in the Alboran Sea, is economically and culturally one of the most important and relies on overexploited target species such as European hake (Merlucius merlucius). Here we identified and quantified the impact of human pressures on the capacity of marine habitats to support the provision of food as an important ecosystem service. We modelled the spatial distribution of nursery areas of European hake in the Alboran Sea, using General Additive Models (GAM) and overlaid those with European Nature Information System (EUNIS) habitats. A sensitivity analysis of hake nursery areas to cumulative human impacts identified the Bay of Malaga as the most sensitive area with trawling frequencies up to 60 times higher than the habitats recovery time. Further, we identified an increased conflict potential among human activities such as trawling and extraction with the presence of Marine Protected Areas (MPAs), which provide MPAs a high vulnerability similar to that found in unprotected areas. Future scenarios considering the increase of renewable energy and alternative food production show conflicts between aquaculture and MPAs as well as offshore wind farms and offshore shipping. Hence, our results show strong arguments for an integrated spatial management approach, including benthic trawling. We also suggest restricting trawling activities inside MPAs to safeguard the habitats capacity to support ecosystem services. Our spatially explicit assessment framework is transparent and transferable to other Mediterranean regions. Thus, it can function as a model on how to incorporate cumulative effect assessments in marine spatial planning processes.
Subject(s)
Conservation of Natural Resources/methods , Ecosystem , Fisheries , Gadiformes , Models, Statistical , Animals , Europe , Humans , Oceans and SeasABSTRACT
INTRODUCTION AND AIMS: Patients in intensive care unit are susceptible to complications due to different causes (underlying disease, immobilisation, infection risk ) The current main intervention in order to prevent these complications is respiratory physiotherapy, a common practice for nurses on a daily basis. Therefore, we decided to carry out this bibliographic review to describe the most efficient respiratory physiotherapy methods for the prevention and treatment of lung complications in patients in intensive care, taking into account the differences between intubated and non-intubated patients. METHODOLOGY: The bibliographic narrative review was carried out on literature available in Pubmed, Cinahl and Cochrane Library. The established limits were language, evidence over the last 15 years and age. RESULTS: Techniques involving lung expansion, cough, vibration, percussion, postural drainage, incentive inspirometry and oscillatory and non-oscillatory systems are controversial regarding their efficacy as respiratory physiotherapy methods. However, non-invasive mechanical ventilation shows clear benefits. In the case of intubated patients, manual hyperinflation and secretion aspirations are highly efficient methods for the prevention of the potential complications mentioned above. In this case, other RP methods showed no clear efficiency when used individually. DISCUSSION AND CONCLUSIONS: Non-invasive mechanical ventilation (for non-intubated patients) and manual hyperinflation (for intubated patients) proved to be the respiratory physiotherapy methods with the best results. The other techniques are more controversial and the results are not so clear. In both types of patients this literature review suggests that combined therapy is the most efficient.
Subject(s)
Critical Care/methods , Lung Diseases/therapy , Physical Therapy Modalities , Respiratory Therapy , Humans , Intensive Care UnitsABSTRACT
No disponible
Subject(s)
Humans , Neurosciences/methods , Neurosciences/trends , Pain Management/instrumentation , Pain Management/methods , Anesthesia/standards , Anesthesia , Neurosurgery/methods , Societies, Medical/standardsABSTRACT
No disponible
