CoaguChek and Coag-Sense PT2 Meter Point of Care INR Device Validation.

OBJECTIVE: To standardize international normalized ratio (INR) measurements and improve data integrity by enabling electronic result transmission for warfarin monitoring, two point-of-care (POC) devices were evaluated against an internal plasma INR reference method. METHODS: A multicenter study was pursued (January 24, 2022, through October 19, 2022) to compare concordance of two commercially available POC devices, Coag-Sense PT2 Meter (Coag-Sense) and CoaguChek XS Pro and Plus devices (CoaguChek), against an internal plasma INR method among patients treated with warfarin. Bias and linear regression analysis were assessed for these devices including dosing decision accuracy compared with plasma INR reference. RESULTS: Two hundred ninety-nine patients treated with warfarin across three Mayo Clinic sites agreed to participate. Atrial fibrillation (n=191, 63.9%), venous thromboembolism (n=65; 21.7%), and heart valve prosthesis (n=46; 15.4%) were common anticoagulant indications with a 2.5 INR target for 280 (93.6%) of patients. For the CoaguChek devices, 243 (81.3%) of values fell within 0.2 INR units with plasma INR referent and 285 (95.3%) within 0.4 units (R2=0.93). For the Coag-Sense device, 102 (34.1%) of values fell within 0.2 INR units and 180 (60.2%) within 0.4 INR units of plasma INR values, (R2=0.83; P<.0001). Using the plasma INR as the gold standard, appropriate dosing recommendations would have occurred for 292 (97.7%) of the CoaguChek and 244 (81.6%) of the Coag-Sense results. CONCLUSION: Compared with a plasma referent, INR values obtained from the CoaguChek devices exhibited less systematic bias compared with Coag-Sense measures. This translates to a greater percentage of concordant management decisions between POC and laboratory INR methods.

Silicone pneumonitis, diffuse alveolar hemorrhage and acute respiratory distress syndrome from gluteal silicone injections.

Fatal complications from illegal cosmetic injection of nonmedical-grade liquid silicone (polydimethylsiloxane) by unlicensed providers are becoming more common. Silicone embolization syndrome (SES) can rapidly progress to pneumonitis and diffuse alveolar hemorrhage. Prompt and aggressive management with high-dose steroids and lung-protective ventilation strategies to minimize acute respiratory distress syndrome (ARDS) can be lifesaving. We present the case of a patient presenting with abdominal pain and shortness of breath who quickly developed respiratory failure. The patient recently had received bilateral gluteal silicone injections from an unlicensed provider.

Evaluación de diferentes combinaciones fitohormonales en la regeneración de Solanum tuberosum (Solanaceae) Var. Pastusa Suprema a partir de explantes internodales / Evaluation of different phytohormonal combinations in Solanum tuberosum (Solanaceae) Var. Pastusa Suprema regeneration from intermodal explants

La regeneración de plantas mediante el cultivo de tejidos es un importante componente de la biotecnología que es requerido para procesos tales como la obtención de plantas transgénicas. Se estableció un sistema eficiente de regeneración para la especie Solanum tuberosum L. var. Pastusa Suprema, susceptible de ser transformada genéticamente. Se evaluó el efecto de las fitohormonas zeatina ribósido (ZR), ácido naftalénacetico (ANA) y ácido gibérelico (AG3), utilizadas en combinaciones específicas, sobre la inducción de callo, la regeneración y el número de brotes producidos por explante. La presencia de ANA demostró ser esencial en la respuesta callogénica y regenerativa de los explantes. Se encontró que la adición de 3,0 mg/L de ZR, 0,02 mg/L de ANA y 1,0 mg/L de AG3 sobre un medio básico M-S, es una formulación hormonal adecuada para inducir el proceso de organogénesis indirecta sobre la variedad de papa Pastusa Suprema; produce callogénesis y regeneración en porcentajes superiores al 90%, con un promedio de seis regenerantes por explante.

Plant regeneration using tissue culture represents an important biotechnological tool which is necessary in processes such as obtaining transgenic plants. An efficient regeneration system was established for Solanum tuberosum L. var. Pastusa Suprema; this specie is susceptible to being genetically transformed. The effect of zeatin riboside (ZR), gibberellic acid (GA3) and naphthalene acetic acid (NAA) phytohormones used in specific combinations was evaluated regarding callus induction and bud regeneration and number per explant.The presence of NAA was seen to be essential in explants’ callogenic and regenerative response. Adding 3.0 mg/L ZR, 0.02 mg/L NAA and 1.0mg/L GA3 to a basic M-S medium was an appropriate hormonal combination for inducing indirect organogenesis in the Pastusa Suprema potato variety; it produced more than 90% callus genesis and plant regeneration and an average of six regenerants per explant.

An investigation of the cortical control of forepaw gripping after cervical hemisection injuries in rats.

Previous studies in mice have demonstrated that forepaw gripping ability, as measured by a grip strength meter (GSM), is dependent on the contralateral sensorimotor cortex, but this dependency changes after hemisection injury at cervical level 4 (C4). Initially, the mouse fails to grip with the forepaw ipsilateral to the hemisection but gripping recovers. Additionally, a mouse's gripping by the contralateral paw becomes independent of the sensorimotor cortex, indicating a reorganization of cortical control of gripping function (Blanco, J.E., Anderson, K.D., Steward, O. 2007. Recovery of forepaw gripping ability and reorganization of cortical motor control following cervical spinal cord injuries in mice. Exp. Neurol. 203, 333-348.). Here we explore whether a similar reorganization occurs after cervical hemisection injuries in rats. We show that as in mice, unilateral lesions of the sensorimotor cortex impair rats' griping by the contralateral paw. We also confirm from previous studies that cervical hemisections impair rats' griping by the ipsilateral paw. In contrast to mice, however there is minimal recovery of gripping after complete lateral hemisections and secondary lesions of the sensorimotor cortex continue to impair rats' gripping by the contralateral paw. Thus, forelimb gripping ability as measured by the GSM is dependent on the contralateral sensorimotor cortex in rats even after a cervical hemisection.

Recovery of forepaw gripping ability and reorganization of cortical motor control following cervical spinal cord injuries in mice.

Previous studies using a grip strength meter (GSM) revealed a loss of gripping ability following cervical hemisection injuries in mice, followed by partial recovery. Here, we assess whether normal gripping ability and the recovered gripping ability after cervical hemisection depend on the cerebral cortex. First, we assessed grip strength of both forepaws of 18-week-old C57Bl/6 mice before and after a left sensorimotor cortex lesion or right lateral hemisection at C5. Both lesions led to a complete loss of gripping ability by the right forepaw and caused only minor deficits in the left. After cortical lesions, gripping ability re-appeared at about 17 days post-injury, and grip strength recovered to near-normal levels by 24 days post-injury. After C5 hemisections, gripping ability re-appeared after 31 days post-injury in 50% of the mice. Follow-up experiments were then carried out in which 10-week-old mice received C4 hemisection injuries and were tested for 28 days; then mice received secondary lesions of the sensorimotor cortex ipsi- or contralateral to the hemisection. Younger mice with cervical hemisections recovered gripping ability between 12 and 28 days post-hemisection. Cortical lesions on the side contralateral to the hemisection led to a complete loss of recovered gripping ability in all mice; cortical lesions on the side ipsilateral to the hemisection also disrupted recovered gripping ability in some animals. Surprisingly, lesions of the cortex ipsilateral to the hemisection did not impair gripping ability of the contralateral (left) forepaw. Finally, we assessed the effects of a third lesion of whichever side of the sensorimotor cortex remained, so that the sensorimotor cortex was ablated bilaterally. Remarkably, gripping function by the forepaw contralateral to the original hemisection was completely unaffected, and the recovered gripping function by the forepaw ipsilateral to the hemisection was disrupted in only some of the animals. These results indicate a substantial reorganization of motor control of gripping function after cervical injuries in mice so that gripping ability by both forepaws becomes largely independent of cortical control.