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1.
Sci Rep ; 12(1): 145, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34997056

RESUMO

In this study, optical Bloch equations with and without neighboring hyperfine states near the degenerate two-level system (DTLS) in the challenging case of [Formula: see text]Rb D2 transition, which involves the Doppler broadening effect, are solved. The calculated spectra agree well with the experimental results obtained based on the coupling-probe scheme with orthogonal linear polarizations of the coupling and probe fields. The mechanisms of electromagnetically induced absorption (electromagnetically induced transparency) for the open [Formula: see text] and 3 transitions (open [Formula: see text] and 3 transitions) are determined to be the effect of the strong closed [Formula: see text] transition line (strong closed [Formula: see text] transition line); this finding is based on a comparison between the calculated absorption profiles of the DTLS without neighboring states and those of all levels with neighboring states, depending on the coupling and probe power ratios. Furthermore, based on the aforementioned comparison, the crucial factors that enhance or reduce the coherence effects and lead to the transformation between electromagnetically induced absorption and electromagnetically induced transparency, are (1) the power ratios between the coupling and probe beams, (2) the openness of the excited state, and (3) effects of the neighboring states due to Doppler broadening in a real atomic system.

3.
Perioper Med (Lond) ; 10(1): 45, 2021 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-34886885

RESUMO

BACKGROUND: TOFscan is a three-dimensional acceleromyography neuromuscular monitoring device that does not require initial calibration before muscle relaxant injection. This study aimed to compare TOFscan with TOF-Watch SX, the currently widely accepted uni-dimensional acceleromyography, for use among the pediatric population. We aimed to assess the agreement between TOFscan with TOF-Watch SX in the pediatric population's neuromuscular recovery. METHODS: A total of 35 children aged 6-12 years were enrolled. Prior to any muscle relaxant injection, TOFscan and TOF-Watch SX were applied at each opposite arm and monitoring began concurrently throughout neuromuscular recovery. Calibration was performed for TOF-Watch SX, and train-of-four values were recorded every 15 s. Agreement between the two devices was evaluated with Modified Bland-Altman analysis. RESULTS: The bias between TOF-Watch SX and TOFscan were all within the 95% limits of agreement. The bias and standard deviation were smaller and the limit of agreement was narrower in the normalized group than in the non-normalized group [normalized bias -0.002 (95% CI, -0.013 to 0.010), standard deviation (SD) 0.111 vs non-normalized bias 0.010 (95% CI, -0.003 to 0.0236), SD 0.127]. CONCLUSIONS: TOFscan reliably demonstrated lack of bias and good concordance with TOF-Watch SX throughout the neuromuscular recovery, especially when normalized. Despite technical limitations, the two devices were unbiased along the path of spontaneous and pharmacological reversal in pediatric patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT03775603. Registered on 13 March 2018.

4.
Paediatr Anaesth ; 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34843146

RESUMO

BACKGROUND: Perioperative central venous catheters are required but may be associated with various complications. AIMS: The purpose of our study was to assess the incidence and perioperative risk factors for catheter-related internal jugular vein thrombosis in pediatric surgical patients. METHODS: This prospective observational study included children under 6 years of age who were scheduled to undergo central venous catheterization of the right internal jugular vein under general anesthesia. A central venous catheter was inserted under real-time ultrasound guidance. An investigator examined for thrombosis using ultrasonography at predetermined time points. The primary aim was the incidence of catheter-related thrombosis from insertion until the 5th day postoperatively or the removal of the central venous catheter. The secondary aim was the determination of the risk factors for thrombosis. RESULTS: Eighty patients completed the study. Internal jugular vein thrombi were found in 31 patients (38.8%, 95% CI 28.0-49.4). On multiple logistic regression analyses, the number of insertion attempts was the only influencing factor for catheter-related thrombosis (p < .001). More than two insertion attempts increased the risk of thrombosis (odds ratio 5.6; 95% CI 1.7 - 18.7, p = .004). Anesthesia time (p = .017; mean difference 166.4 min; 95% CI 55.7-277.1), intraoperative red blood cell transfusion (p = .001; median difference 21.1 ml kg-1 ; 95% CI 6.6-34.4), and intensive care unit stay (p = .001; median difference 100.0 h; 95% CI 48-311) differed between patients with transient thrombosis and those with thrombosis lasting for more than 3 days. CONCLUSION: Internal jugular vein thrombosis was frequently detected by ultrasound following central venous catheterization in pediatric surgical patients. Multiple insertion attempts may be associated with the incidence of thrombosis. The clinical relevance of thrombi detected via ultrasound surveillance has not been determined.

5.
Br J Anaesth ; 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34686309

RESUMO

BACKGROUND: Limited data exist regarding optimal intraoperative ventilation strategies for the paediatric population. This study aimed to determine the optimal combination of PEEP and tidal volume (VT) based on intratidal compliance profiles in healthy young children undergoing general anaesthesia. METHODS: During anaesthesia, infants (1 month-1 yr), toddlers (1-3 yr), and children (3-6 yr) were assigned serially to four ventilator settings: PEEP 8 cm H2O/VT 8 ml kg-1 (PEEP8/VT8), PEEP 10 cm H2O/VT 5 ml kg-1 (PEEP10/VT5), PEEP 10 cm H2O/VT 8 ml kg-1 (PEEP10/VT8), and PEEP 12 cm H2O/VT 5 ml kg-1 (PEEP12/VT5). The primary outcome was intratidal compliance profile, classified at each ventilator setting as horizontal (indicative of optimal alveolar ventilatory conditions), increasing, decreasing, or combinations of increasing/decreasing/horizontal compliance. Secondary outcomes were peak inspiratory, plateau, and driving pressures. RESULTS: Intratidal compliance was measured in 15 infants, 13 toddlers, and 15 children (15/43 [35%] females). A horizontal compliance profile was most frequently observed with PEEP10/VT5 (60.5%), compared with PEEP10/VT8, PEEP8/VT8, and PEEP12/VT5 (23.3-34.9%; P<0.001). Decreasing compliance profiles were most frequent when VT increased to 8 ml kg-1, PEEP increased to 12 cm H2O, or both. Plateau airway pressures were lower at PEEP8/VT8 (16.9 cm H2O [2.2]) and PEEP10/VT5 (16.7 cm H2O [1.7]), compared with PEEP10/VT8 (19.5 cm H2O [2.1]) and PEEP12/VT5 (19.0 cm H2O [2.0]; P<0.001). Driving pressure was lowest with PEEP10/VT5 (4.6 cm H2O), compared with other combinations (7.0 cm H2O [2.0]-9.5 cm H2O [2.1]; P<0.001). CONCLUSIONS: VT 5 ml kg-1 combined with 10 cm H2O PEEP may reduce atelectasis and overdistension, and minimise driving pressure in the majority of mechanically ventilated children <6 yr. The effect of these PEEP and VT settings on postoperative pulmonary complications in children undergoing surgery requires further study. CLINICAL TRIAL REGISTRATION: NCT04633720.

6.
Proc Natl Acad Sci U S A ; 118(43)2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34663725

RESUMO

Early identification of atypical infant movement behaviors consistent with underlying neuromotor pathologies can expedite timely enrollment in therapeutic interventions that exploit inherent neuroplasticity to promote recovery. Traditional neuromotor assessments rely on qualitative evaluations performed by specially trained personnel, mostly available in tertiary medical centers or specialized facilities. Such approaches are high in cost, require geographic proximity to advanced healthcare resources, and yield mostly qualitative insight. This paper introduces a simple, low-cost alternative in the form of a technology customized for quantitatively capturing continuous, full-body kinematics of infants during free living conditions at home or in clinical settings while simultaneously recording essential vital signs data. The system consists of a wireless network of small, flexible inertial sensors placed at strategic locations across the body and operated in a wide-bandwidth and time-synchronized fashion. The data serve as the basis for reconstructing three-dimensional motions in avatar form without the need for video recordings and associated privacy concerns, for remote visual assessments by experts. These quantitative measurements can also be presented in graphical format and analyzed with machine-learning techniques, with potential to automate and systematize traditional motor assessments. Clinical implementations with infants at low and at elevated risks for atypical neuromotor development illustrates application of this system in quantitative and semiquantitative assessments of patterns of gross motor skills, along with body temperature, heart rate, and respiratory rate, from long-term and follow-up measurements over a 3-mo period following birth. The engineering aspects are compatible for scaled deployment, with the potential to improve health outcomes for children worldwide via early, pragmatic detection methods.

7.
BMC Anesthesiol ; 21(1): 222, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503455

RESUMO

BACKGROUND: Continuous infusion of propofol has been used to achieve sedation in children. However, the relationship between the effect-site concentration (Ce) of propofol and sedation scale has not been previously examined. The objective of this study was to investigate the relationship between the Ce of propofol and the University of Michigan Sedation Scale (UMSS) score in children with population pharmacodynamic modeling. METHODS: A total of 30 patients (aged 3 to 6 years) who underwent surgery under general anesthesia with propofol and remifentanil lasting more than 1 h were enrolled in this study. Sedation levels were evaluated using the UMSS score every 20 s by a 1 µg/mL stepwise increase in the Ce of propofol during the induction of anesthesia. The pharmacodynamic relationship between the Ce of propofol and UMSS score was analyzed by logistic regression with nonlinear mixed-effect modeling. RESULTS: The estimated Ce50 (95% confidence interval) of propofol to yield UMSS scores equal to or greater than n were 1.84 (1.54-2.14), 2.64 (2.20-3.08), 3.98 (3.66-4.30), and 4.78 (4.53-5.03) µg/mL for n = 1, 2, 3, and 4, respectively. The slope steepness for the relationship of the Ce versus sedative response to propofol (95% confidence interval) was 5.76 (4.00-7.52). CONCLUSIONS: We quantified the pharmacodynamic relationship between the Ce of propofol and UMSS score, and this finding may be helpful to predict the sedation score at the target Ce of propofol in children. TRIAL REGISTRATION: http://www.clinicaltrials.gov (No.: NCT03195686 , Date of registration: 22/06/2017).

8.
Food Funct ; 12(20): 10196-10209, 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34542136

RESUMO

Inflammatory cytokine tumor necrosis factor-α (TNFα) has been demonstrated to accelerate the progression and metastasis of various carcinomas. In this study, we investigated the effect of amentoflavone on inhibiting the migration and invasion of TNFα-induced breast cancer cells. Results showed that amentoflavone significantly blocked the cellular migration and invasion of MCF10DCIS.com and MDA-MB-231 cells at a concentration of 10 µM but did not affect the cell viability. The mRNA and protein levels of matrix metalloproteinase (MMP)-9, significantly activated by TNFα, were reversed by amentoflavone treatment in a dose-dependent manner in MCF10DCIS.com cells. Congruent with the protein level, the activity of MMP-9 was significantly suppressed by amentoflavone treatment. Additionally, we found that amentoflavone dampened Gli1-dependent noncanonical hedgehog signaling, which is a key factor in the regulation of migration and invasion in TNFα-induced human breast cancer cells. Further study elucidated that TNFα enhanced Gli1 through the activation of the AKT/mTOR/S6K1 cascade, whereas it receded after amentoflavone treatment in human breast cancer cells. In summary, amentoflavone abrogated Gli1 activation in TNFα-induced mammary tumor cells, resulting in a decrease of invasiveness in human breast cancer cells via mediating AKT/mTOR/S6K1 signaling. Amentoflavone should be considered as a potent food ingredient for the retardation of mammary tumorigenesis.

9.
BMC Anesthesiol ; 21(1): 221, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34496754

RESUMO

BACKGROUND: Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle of needle insertion during spinal anesthesia in patients with and without lumbar spondylolisthesis using ultrasound. METHODS: We recruited 40 patients, 20 with and 20 without lumbar spondylolisthesis (group S and N, respectively). Ultrasonography was performed in the transverse midline and parasagittal oblique views at the spondylolisthesis level and the adjacent upper level. We measured the probe application angle with the longest interlaminar height of the ligamentum flavum-dura mater complex (LFD), depth from the skin to the LFD, depth from the skin to the anterior complex, and intrathecal space width. A positive angle represented a cephalad angulation. RESULTS: The optimal needle insertion angle in the transverse midline view at the spondylolisthesis level was (-) 2.7 ± 3.4° in group S and 0.8 ± 2.5° in group N (P [Formula: see text] 0.001). In the parasagittal oblique view, it was (-) 2.7 ± 4.5° in group S and 1.0 ± 3.2° in group N (P = 0.004). There were no between-group differences in the angles at the upper level, with all cephalad angles in both views. Other ultrasound image data were comparable between groups. CONCLUSION: In patients with spondylolisthesis, caudad angulation of the spinal needle can aid successful spinal puncture at spondylolisthesis level, both in the midline and paramedian approaches. TRIAL REGISTRATION: www.ClinicalTrials.gov ( NCT04426916 ); registered 11 June 2020.

10.
Phytomedicine ; 92: 153715, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34474353

RESUMO

BACKGROUND: The regulative effects of caudatin, a C-21 steroid that is identified from Cynanchum bungee roots, on adipogenesis and obesity have not been studied. Many studies have demonstrated that the activation of hedgehog (Hh) signaling can help prevent obesity. Therefore, we hypothesized that caudatin can inhibit adipogenesis and obesity via activating the Hh signaling pathway. METHODS: To investigate the effects of caudatin on adipogenesis in 3T3-L1 preadipocytes and high-fat diet induced obesity in C57BL/6 mice, in vitro and in vivo experiments were performed. For in vitro evaluation, Oil red O staining were used to represent lipid accumulation in differentiated 3T3-L1 adipocytes. For in vivo assessment, male 5 week-old C57BL/6 mice were fed with standard chow diet, high-fat diet (HFD), HFD with 25 mg/kg caudatin, HFD with 1mg/kg purmorpharmine for 10 weeks, respectively. Hh signaling and key adipogenic marker involved in adipogenesis were evaluated by real-time PCR and western blot. The adipocyte size of white adopose tissue and lipid storage of liver were visualized by hematoxylin and eosin staining. In addition, the expression of Gli1 and peroxisome proliferator-activated receptor γ (PPARγ) in white adipose tissue were investigated by immunohistochemistry staining. RESULTS: Caudatin suppressed the accumulation of lipid droplets and downregulated the expression of key adipogenic factors, i.e., peroxisome proliferator-activated receptor γ PPARγ and CCAAT-enhancer binding protein α (C/EBPα), through activating Hh signaling in differentiated 3T3-L1 cells. Furthermore, caudatin and the Hh activator purmorpharmine significantly decreased body weight gain and white adipose tissue (WAT) weight in HFD-induced mice and affected adipogenic markers and Hh signaling mediators in WAT, which were in line with the in vitro experimental results. CONCLUSION: To our best knowledge, it is the first report to demonstrate that caudatin downregulated adipocyte differentiation and suppressed HFD-induced body weight gain through activating the Hh signaling pathway, suggesting that caudatin can potentially counteract obesity.


Assuntos
Adipogenia , Fármacos Antiobesidade , Células 3T3-L1 , Adipócitos , Animais , Fármacos Antiobesidade/farmacologia , Dieta Hiperlipídica/efeitos adversos , Glicosídeos , Proteínas Hedgehog , Masculino , Camundongos , Camundongos Endogâmicos C57BL , PPAR gama , Transdução de Sinais , Esteroides/farmacologia , Ganho de Peso
11.
Nature ; 597(7877): 503-510, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34552257

RESUMO

Large, distributed collections of miniaturized, wireless electronic devices1,2 may form the basis of future systems for environmental monitoring3, population surveillance4, disease management5 and other applications that demand coverage over expansive spatial scales. Aerial schemes to distribute the components for such networks are required, and-inspired by wind-dispersed seeds6-we examined passive structures designed for controlled, unpowered flight across natural environments or city settings. Techniques in mechanically guided assembly of three-dimensional (3D) mesostructures7-9 provide access to miniature, 3D fliers optimized for such purposes, in processes that align with the most sophisticated production techniques for electronic, optoelectronic, microfluidic and microelectromechanical technologies. Here we demonstrate a range of 3D macro-, meso- and microscale fliers produced in this manner, including those that incorporate active electronic and colorimetric payloads. Analytical, computational and experimental studies of the aerodynamics of high-performance structures of this type establish a set of fundamental considerations in bio-inspired design, with a focus on 3D fliers that exhibit controlled rotational kinematics and low terminal velocities. An approach that represents these complex 3D structures as discrete numbers of blades captures the essential physics in simple, analytical scaling forms, validated by computational and experimental results. Battery-free, wireless devices and colorimetric sensors for environmental measurements provide simple examples of a wide spectrum of applications of these unusual concepts.

12.
Anesthesiology ; 135(4): 612-620, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34352073

RESUMO

BACKGROUND: Hand-eye coordination and ergonomics are important for the success of delicate ultrasound-guided medical procedures. These can be improved using smart glasses (head-mounted display) by decreasing the head movement on the ultrasound screen. The hypothesis was that the smart glasses could improve the success rate of ultrasound-guided pediatric radial arterial catheterization. METHODS: This prospective, single-blinded, randomized controlled, single-center study enrolled pediatric patients (n = 116, age less than 2 yr) requiring radial artery cannulation during general anesthesia. The participants were randomized into the ultrasound screen group (control) or the smart glasses group. After inducing general anesthesia, ultrasound-guided radial artery catheterization was performed. The primary outcome was the first-attempt success rate. The secondary outcomes included the first-attempt procedure time, the overall complication rate, and operators' ergonomic satisfaction (5-point scale). RESULTS: In total, 116 children were included in the analysis. The smart glasses group had a higher first-attempt success rate than the control group (87.9% [51/58] vs. 72.4% [42/58]; P = 0.036; odds ratio, 2.78; 95% CI, 1.04 to 7.4; absolute risk reduction, -15.5%; 95% CI, -29.8 to -12.8%). The smart glasses group had a shorter first-attempt procedure time (median, 33 s; interquartile range, 23 to 47 s; range, 10 to 141 s) than the control group (median, 43 s; interquartile range, 31 to 67 s; range, 17 to 248 s; P = 0.007). The overall complication rate was lower in the smart glasses group than in the control group (5.2% [3/58] vs. 29.3% [17/58]; P = 0.001; odds ratio, 0.132; 95% CI, 0.036 to 0.48; absolute risk reduction, 24.1%; 95% CI, 11.1 to 37.2%). The proportion of positive ergonomic satisfaction (4 = good or 5 = best) was higher in the smart glasses group than in the control group (65.5% [38/58] vs. 20.7% [12/58]; P <0.001; odds ratio, 7.3; 95% CI, 3.16 to 16.8; absolute risk reduction, -44.8%; 95% CI, -60.9% to -28.8%). CONCLUSIONS: Smart glasses-assisted ultrasound-guided radial artery catheterization improved the first-attempt success rate and ergonomic satisfaction while reducing the first-attempt procedure time and overall complication rates in small pediatric patients.


Assuntos
Cateterismo Periférico/normas , Artéria Radial/diagnóstico por imagem , Artéria Radial/cirurgia , Óculos Inteligentes/normas , Ultrassonografia de Intervenção/normas , Cateterismo Periférico/métodos , Ergonomia/métodos , Ergonomia/normas , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Método Simples-Cego , Ultrassonografia de Intervenção/métodos
13.
Eur J Med Res ; 26(1): 97, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433488

RESUMO

BACKGROUND: Interventricular septal hematoma is an extremely rare complication following congenital heart surgery. During cardiac surgery, interventricular septal hematomas can be detected only by intraoperative transesophageal echocardiography. Here, we report an interesting case of interventricular septal hematoma that was accidentally found in an infant following ventricular septal defect (VSD) closure. CASE PRESENTATION: Transesophageal echocardiography images were acquired from a 1-month-old boy after surgical repair of a large (6.5 mm) perimembranous outlet VSD with interventricular septal flattening. Surgical correction was performed with auto-pericardium and 7-0 Prolene sutures. The patient was successfully weaned from cardiopulmonary bypass, and transesophageal echocardiography showed no VSD leakage and good ventricular function. However, approximately 30 min later, two anechoic masses were found within the interventricular septum, which were suspected to be interventricular septal hematomas; the larger mass measured 1.51 [Formula: see text] 1.48 cm. The swollen interventricular septum showed decreased contractility and compressed both the right and left ventricles. However, there was no change in the size of hematomas or a significant hemodynamic instability for 30 min of observation. Therefore, expecting spontaneous resolution of the hematomas, the interventricular septum was not explored, and the patient was removed from cardiopulmonary bypass. On postoperative day 4, follow-up transthoracic echocardiography revealed thrombi filling the hematomas. The patient was discharged on postoperative day 15 and followed up with regular echocardiographic evaluations. CONCLUSIONS: We describe a unique case of interventricular septal hematoma after VSD closure. Surgical manipulation of perimembranous VSD and injury of the septal perforating artery may contribute to the development of an interventricular septal hematoma. Moreover, conservative treatment and serial echocardiographic evaluation generally show gradual hematoma resolution in hemodynamically stable patients. Pediatric cardiac anesthesiologists should be aware of this rare complication after VSD repair.


Assuntos
Comunicação Interventricular/cirurgia , Hematoma/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Septo Interventricular/patologia , Ecocardiografia , Hematoma/etiologia , Hematoma/patologia , Humanos , Lactente , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia
14.
Lab Chip ; 21(16): 3094-3104, 2021 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-34259277

RESUMO

We report an ion concentration polarization (CP) system that exceeds ohmic scaling, a barrier that has stood for more than four decades, by more than one order of magnitude. CP is used in many important applications, including the enrichment of trace analytes in microfluidic systems and water purification by electrodialysis. The mechanisms that control the current through these systems have been largely discovered, but the reduced currents and loss of efficiency imparted by the high resistance of the CP ion depleted zone have not been overcome. To obtain high currents, an ion permselective element with a microscale cross-section is interfaced with a macroscale reservoir. Confocal fluorescence microscopy and microparticle tracking velocimetry (µ-PTV) are used to characterize the depleted zone that emanates vertically from the CP inducing nanoporous gel into the macroscale reservoir. The shape and growth of the depleted zone and velocity in the surrounding bulk solution are consistent with natural convection being the driver of the depleted zone morphology and eliminating the high resistance created by the depleted zone in 1D and 2D systems. Once the resistance of the depleted zone is negated, the high currents are hypothesized to result from enhancement of counter-ion concentration in the nanoporous gel-filled microchannel. In contrast with conventional systems, the current increases monotonically and remains stable at a high quasi-steady level in the reported systems. These results may be used to increase the efficiency and performance of future devices that utilize CP, while the ability to collect purified water with this geometry is demonstrated.


Assuntos
Convecção , Microfluídica
15.
Anesth Pain Med (Seoul) ; 16(3): 273-278, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34233410

RESUMO

BACKGROUND: Pediatric patients with moyamoya disease are vulnerable to ischemic attacks following physical or emotional stress, such as those experienced during blood sampling. A central venous catheter might be beneficial for blood sampling, and a peripherally inserted central catheter (PICC) is a considerable option for central venous access. However, PICC insertion during anesthetic management is relatively rare. CASE: Thirty cases of ultrasound-guided PICC insertion were performed in children undergoing surgery for moyamoya disease after anesthetic induction. Positioning was successful in 22 cases, and 5 were malpositioned. In three cases, the peripheral insertion failed. Adjustment of the insertion depth was performed in nine cases. No complications related to catheterization were observed during the procedure or the catheter indwelling period. CONCLUSIONS: We report the successful use of PICC in children undergoing surgery for moyamoya disease with a considerable success rate and low incidence of malpositioning or complications.

16.
J Microbiol Biotechnol ; 31(9): 1256-1261, 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34226405

RESUMO

Rubus coreanus Miquel (bokbunja), Korean black raspberry, is known to possess various phytochemicals that exert antioxidative, anti-inflammatory, and anti-cancer effects. However, most studies on Rubus coreanus Miquel have been performed with the solvent extracts and/or a single component to demonstrate the efficacy, while studies evaluating the effect of the whole fructus of Rubus coreanus Miquel are limited. In this study, therefore, we employed the isoproterenol (IPN)-induced myocardial infarction model and investigated the effect of freeze-dried powder of Rubus coreanus Miquel (RCP) on oxidative stress and prevention of organ damage. Oral administration of RCP reduced the level of toxicity markers, alanine transaminase (ALT), aspartate transaminase (AST), and lactate dehydrogenase (LDH) without affecting body weight and diet intake. The oxidative stress marker glutathione (GSH) increased about 45% and malonaldehyde (MDA) decreased about 27% compared to the IPN group with RCP-H (3%) administration. By histological analysis, IPN induced significant myocardial damage in the heart and vascular injury in the liver, and RCP administration ameliorated the damages in a dose-dependent manner. Taken together, RCP activated the antioxidant system leading to prevention of damage to organs by IPN in rats, making it possible to expect beneficial efficacies by consuming the whole fructus of Rubus coreanus Miquel.

17.
Sci Rep ; 11(1): 11922, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34099790

RESUMO

Many pharmacologic agents were investigated for the effect to prevent delirium. We aimed to comprehensively compare the effect of the pharmacological interventions to prevent postoperative delirium. A Bayesian network meta-analysis of randomized trials was performed using random effects model. PubMed, the Cochrane Central Register of Controlled Trials, and Embase were searched on 20 January 2021. Randomized trials comparing the effect of a drug to prevent postoperative delirium with another drug or placebo in adult patients undergoing any kind of surgery were included. Primary outcome was the postoperative incidence of delirium. Eighty-six trials with 26,992 participants were included. Dexmedetomidine, haloperidol, and atypical antipsychotics significantly decreased the incidence of delirium than placebo [dexmedetomidine: odds ratio 0.51, 95% credible interval (CrI) 0.40-0.66, moderate quality of evidence (QOE); haloperidol: odds ratio 0.59, 95% CrI 0.37-0.95, moderate QOE; atypical antipsychotics: odds ratio 0.27, 95% CrI 0.14-0.51, moderate QOE]. Dexmedetomidine and atypical antipsychotics had the highest-ranking probabilities to be the best. However, significant heterogeneity regarding diagnostic time window as well as small study effects precludes firm conclusion.


Assuntos
Teorema de Bayes , Delírio/prevenção & controle , Preparações Farmacêuticas/administração & dosagem , Complicações Pós-Operatórias/prevenção & controle , Adulto , Antipsicóticos/administração & dosagem , Delírio/etiologia , Haloperidol/administração & dosagem , Humanos , Metanálise em Rede , Preparações Farmacêuticas/classificação , Complicações Pós-Operatórias/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
18.
Paediatr Anaesth ; 31(8): 894-901, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34018647

RESUMO

BACKGROUND: The development of hypotension on administration of intravenous propofol is common and independently associated with adverse outcomes. Identifying patients with a high risk for anesthesia-induced hypotension may help anesthesiologists prepare for such an event. AIM: The authors hypothesized that propofol-induced hypotension is predictable by variables related to fluid responsiveness and investigated such variables to determine the factors which can predict hypotensive events. METHODS: Patients 3-6 years of age who underwent general were included. Intravenous midazolam 0.1 mg kg-1 was administered as premedication, and preoperative noninvasive blood pressure, heart rate, perfusion index, pleth variability index, and respiratory variation of pulse oximetry plethysmographic waveform were measured. Intravenous propofol 2.5 mg kg-1 was given, and blood pressure was measured 5 times at 1-min intervals. Subjects with significant hypotension (mean blood pressure decrease ≥20%) were allocated to the hypotensive group; those without significant hypotension were allocated to the relatively normotensive group. RESULTS: Of 77 patients, 50 (64.9%) developed significant hypotension. Patients in the hypotensive group exhibited significantly higher respiratory variation of pulse oximetry plethysmographic waveform (mean difference 11 [3.3] [95% confidence interval 4.9-18.1]; p = .001) and higher pleth variability index (mean difference 7.1 [2.8] [95% confidence interval 1.6-12.6]; p = .013) than the normotensive group. The areas under the receiver operating characteristic curve for respiratory variation of pulse oximetry plethysmographic waveform and pleth variability index were 0.722 and 0.649, respectively. CONCLUSION: High preoperative respiratory variation of pulse oximetry plethysmographic waveform and pleth variability index were both independently associated with propofol-induced hypotension in children.


Assuntos
Anestesia , Hipotensão Controlada , Hipotensão , Propofol , Pressão Sanguínea , Criança , Humanos , Hipotensão/induzido quimicamente , Hipotensão/diagnóstico , Oximetria , Pletismografia , Propofol/efeitos adversos
19.
Adv Healthc Mater ; 10(17): e2100383, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33938638

RESUMO

Indwelling arterial lines, the clinical gold standard for continuous blood pressure (BP) monitoring in the pediatric intensive care unit (PICU), have significant drawbacks due to their invasive nature, ischemic risk, and impediment to natural body movement. A noninvasive, wireless, and accurate alternative would greatly improve the quality of patient care. Recently introduced classes of wireless, skin-interfaced devices offer capabilities in continuous, precise monitoring of physiologic waveforms and vital signs in pediatric and neonatal patients, but have not yet been employed for continuous tracking of systolic and diastolic BP-critical for guiding clinical decision-making in the PICU. The results presented here focus on materials and mechanics that optimize the system-level properties of these devices to enhance their reliable use in this context, achieving full compatibility with the range of body sizes, skin types, and sterilization schemes typically encountered in the PICU. Systematic analysis of the data from these devices on 23 pediatric patients, yields derived, noninvasive BP values that can be quantitatively validated against direct recordings from arterial lines. The results from this diverse cohort, including those under pharmacological protocols, suggest that wireless, skin-interfaced devices can, in certain circumstances of practical utility, accurately and continuously monitor BP in the PICU patient population.


Assuntos
Cuidados Críticos , Sinais Vitais , Pressão Sanguínea , Criança , Humanos , Recém-Nascido , Monitorização Fisiológica , Pele
20.
Sci Adv ; 7(20)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33980495

RESUMO

Soft, skin-integrated electronic sensors can provide continuous measurements of diverse physiological parameters, with broad relevance to the future of human health care. Motion artifacts can, however, corrupt the recorded signals, particularly those associated with mechanical signatures of cardiopulmonary processes. Design strategies introduced here address this limitation through differential operation of a matched, time-synchronized pair of high-bandwidth accelerometers located on parts of the anatomy that exhibit strong spatial gradients in motion characteristics. When mounted at a location that spans the suprasternal notch and the sternal manubrium, these dual-sensing devices allow measurements of heart rate and sounds, respiratory activities, body temperature, body orientation, and activity level, along with swallowing, coughing, talking, and related processes, without sensitivity to ambient conditions during routine daily activities, vigorous exercises, intense manual labor, and even swimming. Deployments on patients with COVID-19 allow clinical-grade ambulatory monitoring of the key symptoms of the disease even during rehabilitation protocols.


Assuntos
Acelerometria/instrumentação , Acelerometria/métodos , Eletrocardiografia Ambulatorial/instrumentação , Eletrocardiografia Ambulatorial/métodos , Dispositivos Eletrônicos Vestíveis , Temperatura Corporal , COVID-19 , Exercício Físico/fisiologia , Frequência Cardíaca , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , SARS-CoV-2
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