Background
Dual antiplatelet therapy is a pre-requisite for flow diverter (FD) implantation. The purpose of this study was to assess the thrombogenicity of the p48 FD, coated with the newly developed ...phenox Hydrophilic Polymer Coating (p48_HPC, phenox GmbH, Germany) in comparison with uncoated p48 FDs in an in vitro flow model (Chandler Loop).
Methods
p48 and p48_HPC FDs were implanted into silicon tubes filled with whole human blood and incubated at 37 °C under pulsating flow. After 120 min, platelet count was determined in the blood. Platelet activation markers (PAR1) and formation of microparticles were analyzed in a flow cytometer. Fluorescence microscopy of CD42a positive cells and scanning electron microscopy was used to detect adherent platelets on the wire surface.
Results
Platelets in contact with the uncoated p48 FDs are significantly more activated than those incubated with p48_HPC (73 ± 9% vs. 65 ± 6%,
p
< 0.05) and release more microparticles (1.8 ± 0.5 vs. 1.4 ± 0.4,
p
< 0.05). The platelet count after 120-min circulation in the Chandler Loop was significantly lower for the uncoated p48 compared to the p48_HPC indicating significantly greater adherence of the platelets to the p48 (71 ± 8% vs. 87 ± 5%,
p
< 0.05). SEM and fluorescent antibody imaging revealed minimal platelet adherence to the surface of the p48_HPC compared to the uncoated p48.
Conclusion
The pHPC coating significantly reduces thrombogenicity of the p48 FD. This may help to reduce the risk of thromboembolic complications when using these devices. A reduction in antiplatelet therapy may be possible.
Distrust and social dysfunction are characteristic in psychosis and may arise from attachment insecurity, which is elevated in the disorder. The relationship between trust and attachment in the early ...stages of psychosis is unknown, yet could help to understand interpersonal difficulties and disease progression. This study aimed to investigate whether trust is reduced in patients with early psychosis and whether this is accounted for by attachment avoidance and attachment anxiety.
We used two trust games with a cooperative and unfair partner in a sample of 39 adolescents with early psychosis and 100 healthy controls.
Patients had higher levels of attachment anxiety, but the groups did not differ in attachment avoidance. Basic trust was lower in patients than controls, as indicated by lower initial investments. During cooperation patients increased their trust towards levels of controls, i.e. they were able to learn and to override initial suspiciousness. Patients decreased their trust less than controls during unfair interactions. Anxious attachment was associated with higher basic trust and higher trust during unfair interactions and predicted trust independent of group status. Discussion Patients showed decreased basic trust but were able to learn from the trustworthy behaviour of their counterpart. Worries about the acceptance by others and low self-esteem are associated with psychosis and attachment anxiety and may explain behaviour that is focused on conciliation, rather than self-protection.
Psychosis is characterized by a profound lack of trust and disturbed social interactions. Investigating the neural basis of these deficits is difficult because of medication effects but first-degree ...relatives show qualitatively similar abnormalities to patients with psychosis on various tasks. This study aimed to investigate neural activation in siblings of patients in response to an interactive task. We hypothesized that, compared to controls, siblings would show (i) less basic trust at the beginning of the task and (ii) reduced activation of the brain reward and mentalizing systems.
Functional magnetic resonance imaging (fMRI) data were acquired on 50 healthy siblings of patients with psychosis and 33 healthy controls during a multi-round trust game with a cooperative counterpart. An a priori region-of-interest (ROI) analysis of the caudate, temporoparietal junction (TPJ), superior temporal sulcus (STS), insula and medial prefrontal cortex (mPFC) was performed focusing on the investment and repayment phases. An exploratory whole-brain analysis was run to test for group-wise differences outside these ROIs.
The siblings' behaviour during the trust game did not differ significantly from that of the controls. At the neural level, siblings showed reduced activation of the right caudate during investments, and the left insula during repayments. In addition, the whole-brain analysis revealed reduced putamen activation in siblings during investments.
The findings suggest that siblings show aberrant functioning of regions traditionally involved in reward processing in response to cooperation, which may be associated with the social reward deficits observed in psychosis.
Objective:
Repetitive transcranial magnetic stimulation (rTMS) has been shown to have clinically beneficial effects in altering the perception of auditory hallucinations (AH) in patients with ...schizophrenia. However, the mode of action is not clear. Recent neuroimaging findings indicate that rTMS has the potential to induce not only local effects but also changes in remote, functionally connected brain regions. Frontotemporal dysconnectivity has been proposed as a mechanism leading to psychotic symptoms in schizophrenia. The current study examines functional connectivity between temporal and frontal brain regions after rTMS and the implications for AH in schizophrenia.
Method:
A connectivity analysis was conducted on the fMRI data of 11 healthy controls receiving rTMS, compared with 11 matched subjects receiving sham TMS, to the temporoparietal junction, before engaging in a task associated with robust frontotemporal activation.
Results:
Compared to the control group, the rTMS group showed an altered frontotemporal connectivity with stronger connectivity between the right temporoparietal cortex and the dorsolateral prefrontal cortex and the angular gyrus.
Conclusion:
This finding provides preliminary evidence for the hypothesis that normalizing the functional connectivity between the temporoparietal and frontal brain regions may underlie the therapeutic effect of rTMS on AH in schizophrenia.
A wireless acceleration measurement system was applied to free-moving cows and horses. Sensors were available as a collar and a flat box for measuring leg or trunk movements. Results were transmitted ...simultaneously by radio or stored in an 8-MB internal memory. As analytical procedures, frequency distributions with standard deviations, spectral analyses, and fractal analyses were applied. Bymeans of the collar sensor, basic behavior patterns (standing, grazing, walking, ruminating, drinking, and hay uptake) could be identified in cows. Lameness could be detected in cows and horses by means of the leg sensor. The portion of basic and harmonic spectral components was reduced; the fractal dimension was reduced. The system can be used for the detection and analysis of even small movements of free-moving humans or animals over several hours. It is convenient for the analysis of basic behaviors, emotional reactions, or events causing flight or fright or for comparing different housing elements, such as floors or fences.
The focusing properties of a one-dimensional multilayer Laue lens (MLL) were investigated using monochromatic soft X-ray radiation from a table-top, laser-produced plasma source. The MLL was ...fabricated by a focused ion beam (FIB) structuring of pulsed laser deposited ZrO
2
/Ti multilayers. This novel method offers the potential to overcome limitations encountered in electron lithographic processes. Utilizing this multilayer Laue lens, a line focus of XUV radiation from a laser-induced plasma in a nitrogen gas puff target could be generated. The evaluated focal length is close to the designed value of 220 μm for the measurement wavelength of 2.88 nm. Divergence angle and beam waist diameter are measured by a moving knife edge and a far-field experiment, determining all relevant second-order moments based beam parameters. The waist diameter has been found to be approximately 370 nm (FWHM).
BACKGROUND AND OBJECTIVE:Four percent gelatine is an alkaline compound due to NH2 groups, whereas 6% hydroxyethyl starch 130/0.4 (HES130) has acidic features. We investigated whether these solutions ...lead to differences in acid-base balance in pigs during acidaemia and correction of pH.
METHODS:Anaesthetized pigs were randomized to HES130 or gelatine infusion (n = 5 per group). Animals received acid infusion (0.4 M solution of lactic acid and HCl diluted in normal saline) and low tidal volume ventilation (6-7 mL kg, PaCO2 of 80-85 mmHg, pH 7.19-7.24). Measurements were made before and after induction of acidaemia, before and after correction of pH with haemofiltration (continuous venovenous haemofiltration) and tris-hydroxymethylaminomethane infusion. We measured parameters describing acid-base balance according to Stewartʼs approach, ketone body formation, oxygen delivery, haemodynamics, diuresis and urinary pH.
RESULTS:Acid-base balance did not differ significantly between the groups. In HES130-treated pigs, the haemodilution-based drop of haemoglobin (1.4 ± 1.0 g dL, median ± SD) was paralleled by an increase in the cardiac output (0.5 ± 0.4 L min). Lacking increases in cardiac output, gelatine-treated pigs demonstrated a reduction in oxygen delivery (149.4 ± 106.0 mL min). Tris-hydroxymethylaminomethane volumes required for pH titration to desired values were significantly higher in the gelatine group (0.7 ± 0.1 mL kg h vs. HES1300.5 ± 0.2 mL kg h).
CONCLUSION:The buffer capacity of gelatine did not lead to favourable differences in acid-base balance in comparison to HES130.
Aims:
SOFA has an increasing role in the prediction of mortality and morbidity in cardiac surgical patients. As patients after HTx receive inotropes early postoperatively due to the pathophysiology ...of heart transplantation, identifying patients at high risk of mortality may be difficult. We therefore evaluated the application of SOFA in this setting.
Methods:
We retrospectively studied 126 consecutive heart transplant recipients (age: median 47, 12–70 years). The SOFA was calculated postoperatively and daily until intensive care unit (ICU) discharge or for a maximum of 7 days. C-reactive protein (CRP) values and white blood cell count (WBC) were reviewed. Lengths of ICU stay (L-ICU) and 30-day mortality were assessed.
Results:
From the 1st until the 7th postoperative day only SOFA values were significantly higher in non-survivors (12.5%) than in survivors (p<0.001). For SOFA, area under the receiver operating characteristic curve (ROC-AUC) for risk of 30-day mortality at ICU admission was 0.90 (95% CI 0.83 to 0.98). In survivors the maximum of SOFA correlated significantly with the L-ICU.
The main organ dysfunction responsible for the higher SOFA in non-survivors was renal dysfunction, followed by thrombocytopenia and respiratory dysfunction.
Conclusion:
Although patients after HTx need catecholamines in the early postoperative period, SOFA can be used to grade the severity of morbidity and to identify the risk of 30-day mortality. Renal function and thrombocytopenia are to be focused on in this condition. As an independent score, SOFA is therefore helpful in early therapeutic decision making in heart transplanted patients.
The APACHE II score is highly recommended worldwide for the assessment of severe pancreatitis (interstitial and necrotizing), and a score of at least eight points on admission to the hospital is said ...to indicate severe pancreatitis.
To evaluate this assumption and to check whether an APACHE II score of at least eight points really indicates necrotizing pancreatitis as shown by contrast-enhanced computed tomography (CT).
This study included 326 patients with a first attack of acute pancreatitis and is part of a prospective study on the natural course of acute pancreatitis. All patients underwent contrast-enhanced CT within 72 hours of admission. The following parameters for the severity of the disease were used: respiratory and renal failure according to the Atlanta classification; indication for dialysis, ventilation, and surgery; time spent in intensive care unit and total hospital stay; Ranson score adjusted for cause; Imrie score; and Balthazar score (CT).
Of the 326 patients, 262 (80%) had interstitial pancreatitis and 64 (20%) had necrotizing pancreatitis. In 74 (28%) of the 262 patients with interstitial pancreatitis, the APACHE II score was at least eight points, indicating severe pancreatitis (overestimation of the disease), whereas the score was less than eight in 41 (64%) of 64 patients with necrotizing pancreatitis (underestimation). Sensitivity was 36%; specificity was 72%; the positive predictive value was 24%; and the negative predictive value was 82%.
The evaluation of sensitivity, specificity, and positive and negative predictive value for all APACHE II score points showed that there was not a "golden" cutoff to detect necrotizing pancreatitis. We conclude that the APACHE II score on admission to the hospital is unreliable to diagnose necrotizing pancreatitis.
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