The impact of preanalytical sample handling on lipid stability has been assessed in human plasma using targeted LC-MS/MS quantification of endocannabinoids, sphingolipids and LPA, complemented by ...non-targeted lipidomics screening with LC-QTOFMS. The study involved incubation of whole blood and plasma from healthy volunteers at room temperature or in ice water for time periods ranging from 20 min to 24 h. The impact of two different anticoagulants, K3EDTA and sodium fluoride/citrate, on lipid stability was evaluated. It was found that the concentrations determined for several endogenous lipids vary when whole blood and plasma samples are processed at room temperature, whereas the concentrations of most lipids were stable for 4 h in ice water. Surprisingly, the detected amounts of endocannabinoids 1- and 2-arachidonoyl glycerol and arachidonoyl ethanolamide increased markedly by 60, 95, and 30% in K3EDTA whole blood after storage in ice water for only 20 min. When using sodium fluoride/citrate blood collection tubes, the stability of several lipids, including that of the endocannabinoids, was improved. Accordingly, it is absolutely necessary to keep the blood sampling and plasma processing time below 1 h to avoid ex-vivo formation of endocannabinoids. It is worth mentioning that baseline lipid levels differ when using K3EDTA or sodium fluoride/citrate blood sampling tubes, which emphasizes the importance of traceability of reported plasma concentrations to the used anticoagulant.
Experimental setup and results for the stability study of lipids in human plasma at room temperature and in ice water as well as the stability in whole blood at room temperature and in ice water. The experiment was conducted for each test subject (n = 10) with two different blood sampling tubes with either K3EDTA or sodium fluoride/citrate as anticoagulant. Time-dependent changes could be observed for endocannabinoids stored in ice water as well as for lysophosphatidic acids stored at room temperature. Display omitted
•Stability study in human whole blood and plasma using different anticoagulants.•LC-MS analysis of endocannabinoids, LPA, sphingolipids, and non-targeted screening.•LPA increased in K3EDTA blood and plasma after 20 min at RT, but not on wet ice.•Endocannabinoids increased in K3EDTA whole blood stored on ice after 20 min.•Combination of fluoride and citrate improves lipid stability.
A pseudospectral method for the solution of incompressible flow problems based on an iterative solver involving an implicit treatment of linearized convective terms is presented. The method is ...designed for moderately complex geometries by means of a multi-domain approach. Key components are a Chebyshev collocation discretization, a special pressure-correction scheme and a restarted GMRES method with a preconditioner derived from a fast direct solver. The performance of the method with respect to the multi-domain functionality is investigated and compared to finite-volume approaches.
Sport und Arthrose Schäfer, M.; Dreinhöfer, K.
Zeitschrift für Rheumatologie,
12/2009, Letnik:
68, Številka:
10
Journal Article
Recenzirano
Zusammenfassung
Die Arthose als polyätiologisches Krankheitsbild stellt eine der häufigsten Gelenkerkrankungen im mittleren und älteren Lebensalter dar. Sportliche Betätigung kann als Ursache ...angesehen werden, wird aber zunehmend auch in der Prävention und Therapie der Arthrose eingesetzt. In tierexperimentellen und epidemiologischen Studien konnte gezeigt werden, dass moderates Lauftraining bezüglich des Arthroserisikos geringer einzuschätzen ist als intensives Training oder Wettkampfsportarten. Speziell intensive Stoß- und Rotationsbelastungen sind mit erhöhtem Arthroserisiko verbunden. Aber auch Sportarten mit erhöhter Verletzungsgefahr haben im Verlauf ein erhöhtes Arthroserisiko. Aus präventivmedizinischer Sicht der Arthrose scheint der gezielte Muskelaufbau entscheidend zu sein. Sporttherapeutisch gibt es vielfältige Ansätze, die in Zukunft mit Sicherheit von zunehmender Bedeutung sein werden. Sporttherapie sollte ein zentraler Teil der konservativen Arthrosetherapie unabhängig von Alter, Begleiterkrankungen, Schmerzen und Beeinträchtigungen sein. Im Vordergrund stehen dabei ein aerobes Training und lokale Muskelkräftigungen.
Objectives The purpose of this article is to report early and mid-term outcomes of the ACCESS-EU study (ACCESS-Europe A Two-Phase Observational Study of the MitraClip System in Europe), a European ...prospective, multicenter, nonrandomized post-approval study of MitraClip therapy (Abbott Vascular, Inc., Santa Clara, California). Background MitraClip has been increasingly performed in Europe after approval; the ACCESS-EU registry provides a snapshot of the real-world clinical demographic data and outcomes. Methods A total of 567 patients with significant mitral valve regurgitation (MR) underwent MitraClip therapy at 14 European sites. Mean logistic European System for Cardiac Operative Risk Evaluation at baseline was 23.0 ± 18.3; 84.9% patients were in New York Heart Association functional class III or IV, and 52.7% of patients had an ejection fraction ≤40%. Results The MitraClip implant rate was 99.6%. A total of 19 patients (3.4%) died within 30 days after the MitraClip procedure. The Kaplan-Meier survival at 1 year was 81.8%. Intensive care unit and hospital length of stay was 2.5 ± 6.5 days and 7.7 ± 8.2 days, respectively. Single leaflet device attachment was reported in 27 patients (4.8%). There were no MitraClip device embolizations. Thirty-six subjects (6.3%) required mitral valve surgery within 12 months after the MitraClip implant procedure. There was improvement in the severity of MR at 12 months, compared with baseline (p < 0.0001), with 78.9% of patients free from MR, severity of >2+ at 12 months. At 12 months, 71.4% of patients had New York Heart Association functional class II or class I. Six-min-walk-test improved 59.5 ± 112.4 m, and Minnesota-living-with-heart-failure score improved 13.5 ± 20.5 points. Conclusions In the real-world, post-approval experience in Europe, patients undergoing the MitraClip therapy are high-risk, elderly patients, mainly affected by functional MR. In this patient population, the MitraClip procedure is effective with low rates of hospital mortality and adverse events.
Insect larvae that live in temporary ponds must cope with a rapidly diminishing resource. We tested the hypothesis that floodwater mosquitoes would react to diminishing water levels by accelerating ...larval development time and emerging as smaller adults. Since a reduction in habitat size leads to increased larval densities, we also included two larval densities. Newly-hatched floodwater mosquito larvae, Aedes vexans (87.9% of emerged adults) and Ochlerotatus sticticus (12.0% of emerged adults), were taken from the field and randomly assigned to one of three water level schedules. Survival to adult emergence was significantly affected by the water level schedule. Ae. vexans adults emerged later in the decreasing schedule than the constant water schedule, but time to emergence was not affected by larval density. In the drying water schedule, Ae. vexans adults emerged 6 to 14 days after complete water removal. Adult size was significantly affected by both water level schedule and larval density. Adults of Oc. sticticus emerged earlier in the decreasing than the constant water schedule which was in accordance with our hypothesis, but size was not affected. Our results indicate two different responses of two floodwater mosquito species to diminishing larval habitat. Oc. sticticus accelerated larval development while Ae. vexans larvae showed remarkable survival in humid soil. Both species are often numerous in inundation areas of large rivers, and climatic conditions after a flood might influence which species dominates the adult mosquito fauna.
Actinic keratosis, a frequent carcinoma in situ of non-melanoma skin cancer (NMSC), can transform into life-threatening cutaneous squamous cell carcinoma. Current treatment is limited due to low ...complete clearance rates and asks for novel therapeutic concepts; the novel purine nucleotide analogue OxBu may be an option. In order to enhance skin penetration, solid lipid nanoparticles (SLN, 136-156 nm) were produced with an OxBu entrapment efficiency of 96.5 ± 0.1%. For improved preclinical evaluation, we combined tissue engineering with clinically used keratin-18 quantification. Three doses of 10(-3) mol/l OxBu, dissolved in phosphate-buffered saline as well as loaded to SLN, were effective on reconstructed NMSC. Tumour response and apoptosis induction were evaluated by an increase in caspase-cleaved fragment of keratin-18, caspase-7 activation as well as by reduced expression of matrix metallopeptidase-2 and Ki-67. OxBu efficacy was superior to equimolar 5-fluorouracil solution, and thus the drug should be subjected to the next step in preclinical evaluation.
The regular update of the German S3 guidelines on long-term opioid therapy for chronic noncancer pain (CNCP), the"LONTS" (AWMF registration number 145/003), began in November 2013.
The guidelines ...were developed by 26 scientific societies and two patient self-help organisations under the coordination of the Deutsche Schmerzgesellschaft (German Pain Society). A systematic literature search in the Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Scopus databases (up until October 2013) was performed. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. The strength of the recommendations was established by multistep formal procedures, in order to reach a consensus according to German Association of the Medical Scientific Societies ("Arbeitsgemeinschaft der Wissenschaftlich Medizinischen Fachgesellschaften", AWMF) regulations. The guidelines were reviewed by the Drug Commission of the German Medical Association, the Austrian Pain Society and the Swiss Association for the Study of Pain.
Opioids are one drug-based treatment option for short- (4-12 weeks), intermediate- (13-25 weeks) and long-term (≥ 26 weeks) therapy of chronic osteoarthritis, diabetic polyneuropathy, postherpetic neuralgia and low back pain. Contraindications are primary headaches, as well as functional somatic syndromes and mental disorders with the (cardinal) symptom pain. For all other clinical presentations, a short- and long-term therapy with opioid-containing analgesics should be evaluated on an individual basis. Long-term therapy with opioid-containing analgesics is associated with relevant risks (sexual disorders, increased mortality).
Responsible application of opioid-containing analgesics requires consideration of possible indications and contraindications, as well as regular assessment of efficacy and adverse effects. Neither an uncritical increase in opioid application, nor the global rejection of opioid-containing analgesics is justified in patients with CNCP.
Peritonsillar abscesses (PTAs) are encountered routinely in clinical practice. Ultrasound-guided aspiration has been proven both safe and effective in treating this condition. However, to date, there ...are no easily produced, low-cost models that enable the practice of point-of-care ultrasound–guided PTA aspiration and PTA diagnosis.
The objective was to create a low-cost, easy-to-produce, ultrasound phantom to train emergency physicians on ultrasound-guided PTA drainage.
We improved on previous work with ultrasound phantoms by creating a refillable phantom that approximates the oral cavity. This enabled learners to gain the manual dexterity necessary to operate an intraoral ultrasound probe while also aspirating a PTA.
We have created a low-cost ultrasound phantom that is amenable to repeated ultrasound-guided aspirations for the purpose of training both resident- and attending-level physicians.
With minimal lead time and readily available equipment, we successfully created a low-cost ultrasound phantom for the purpose of PTA identification and drainage
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