Electrical Diuretics: Dorsal Root Ganglion Stimulation to Increase Diuresis.

BACKGROUND: Stimulation of diuresis is an essential component of heart failure treatment to reduce fluid overload. Over time, increasing doses of loop diuretics are required to achieve adequate urine output, and approximately 30% to 45% of patients develop diuretic resistance. We investigated the feasibility of affecting renal afferent sensory nerves by dorsal root ganglion neurostimulation as an alternative to medication to increase diuresis. MATERIALS AND METHODS: Acute volume overload with an elevated and stable pulmonary capillary wedge pressure (PCWP) was induced by infusion of isotonic fluid in swine (N = 7). In each experiment, diuresis and blood electrolyte levels were measured during cycles of up to two hours (baseline, stimulation, poststimulation) through bladder catheterization. Efficacy was tested using bilateral dorsal root ganglion (bDRG) stimulation at the T11 and/or T12 vertebral levels. RESULTS: An elevated, stable PCWP (15 ± 4 mm Hg, N = 7) was obtained after uploading. Under these conditions, average diuresis increased 20% to 205% compared with no stimulation. Side effects such as motor stimulation were mitigated by decreasing current or terminated spontaneously without intervention. There was no negative effect on acute kidney function because blood electrolyte concentrations remained stable. When stimulation was deactivated, urine output decreased significantly but did not return to baseline levels, suggesting a carry-over effect of up to two hours. CONCLUSIONS: Electrical stimulation (bDRG) at T11 and/or T12 increased diuresis in an acute volume overload model. Side effects caused by unintended (motor) stimulation could be eliminated by reducing the electrical current while sustaining increased diuresis.

The effect of sunlight and UV lamp exposure on EPR signals in X-ray irradiated touch screens of mobile phones.

Electron paramagnetic resonance (EPR) signals generated by ionizing radiation in touch-screen glasses have been reported as useful for personal dosimetry in people accidently exposed to ionizing radiation. This article describes the effect of light exposure on EPR spectra of various glasses obtained from mobile phones. This effect can lead to significant inaccuracy of the radiation doses reconstructed by EPR. The EPR signals from samples unexposed and exposed to X-rays and/or to natural and artificial light were numerically separated into three model spectra: those due to background (BG), radiation-induced signal (RIS), and light-induced signal (LIS). Although prolonged exposures of mobile phones to UV light are rather implausible, the article indicates errors underestimating the actual radiation doses in dose reconstruction in glasses exposed to UV light even for low fluences equivalent to several minutes of sunshine, if one neglects the effects of light in applied dosimetric procedures. About 5 min of exposure to sunlight or to light from common UV lamps reduced the intensity of the dosimetric spectral components by 20-60% as compared to non-illuminated samples. This effect strongly limits the achievable accuracy of retrospective dosimetry using EPR in glasses from mobile phones, unless their exposure to light containing a UV component can be excluded or the light-induced reduction in intensity of the RIS can be quantitatively estimated. A method for determination of a correction factor accounting for the perturbing light effects is proposed on basis of the determined relation between the dosimetric signal and intensity of the light-induced signal.

THE EFFECT OF BACKGROUND SIGNAL AND ITS REPRESENTATION IN DECONVOLUTION OF EPR SPECTRA ON ACCURACY OF EPR DOSIMETRY IN BONE.

This study is about the accuracy of EPR dosimetry in bones based on deconvolution of the experimental spectra into the background (BG) and the radiation-induced signal (RIS) components. The model RIS's were represented by EPR spectra from irradiated enamel or bone powder; the model BG signals by EPR spectra of unirradiated bone samples or by simulated spectra. Samples of compact and trabecular bones were irradiated in the 30-270 Gy range and the intensities of their RIS's were calculated using various combinations of those benchmark spectra. The relationships between the dose and the RIS were linear (R2 > 0.995), with practically no difference between results obtained when using signals from irradiated enamel or bone as the model RIS. Use of different experimental spectra for the model BG resulted in variations in intercepts of the dose-RIS calibration lines, leading to systematic errors in reconstructed doses, in particular for high- BG samples of trabecular bone. These errors were reduced when simulated spectra instead of the experimental ones were used as the benchmark BG signal in the applied deconvolution procedures.