Pharmakotherapie und intensivmedizinische Aspekte des Status epilepticus: Update 2020/2021

Die Anaesthesiologie - Die gezielte Therapie epileptischer Ereignisse und im Speziellen des Status epilepticus (SE) setzt das sichere Erkennen der Krankheitsbilder voraus, wofür gerade bei...     

Sub-angiographic peripheral emboli in high resolution DWI after endovascular recanalization

Journal of Neurology - To analyze the incidence of peripheral emboli after successful mechanical thrombectomy (MT) of intracranial large vessel occlusions (LVO). We performed a prospective analysis...     

Ischemic stroke and dose adjustment of oral Factor Xa inhibitors in patients with atrial fibrillation

Journal of Neurology - Oral Factor Xa inhibitors for the prevention of stroke in atrial fibrillation require dose adjustment based on certain clinical criteria, but the off-label use of the reduced...     

The wear and tear on health: What is the role of occupation?

Health is well known to show a clear gradient by occupation. Although it may appear evident that occupation can affect health, there are multiple possible sources of selection that can generate a strong association, other than simply a causal effect of occupation on health. We link job characteristics to German panel data spanning 29 years to characterize occupations by their physical and psychosocial burden. Employing a dynamic model to control for factors that simultaneously affect health and selection into occupation, we find that selection into occupation accounts for at least 60% of the association. The effects of occupational characteristics such as physical strain and low job control are negative and increase with age: late‐career exposure to 1 year of high physical strain and low job control is comparable to the average health decline from ageing 16 and 6 months, respectively.     

CFD analysis in an anatomically realistic coronary artery model based on non-invasive 3D imaging: comparison of magnetic resonance imaging with computed tomography

Computational fluid dynamics (CFD) methods based on in vivo three-dimensional vessel reconstructions have recently been shown to provide prognostically relevant hemodynamic data. However, the geometry reconstruction and the assessment of clinically relevant hemodynamic parameters may depend on the used imaging modality. This study compares geometric reconstruction and calculated wall shear stress (WSS) values based on magnetic resonance imaging (MRI) and computed tomography (CT). Both imaging methods were applied to a same 2.5-fold upscale silicon model of the left coronary artery (LCA) main bifurcation. The original model is an optically digitized post mortem vessel cast. This digitized geometry is considered as a “gold standard” or original geometry for the MRI versus CT comparative study. The use of the upscale model allowed generating a high resolution CT raw data set with voxel size of 0.156 × 0.156 × 0.36 mm³ and a high resolution MRI data set with an equivalent voxel size of 0.196 × 0.196 × 0.196 mm³ for corresponding in vivo conditions. MRI based reconstruction achieved a mean Hausdorff surface distance of 0.1 mm to the original geometry. This is 2.5 times better than CT based reconstruction with mean Hausdorff surface distance of 0.252 mm. A comparison of the calculated mean WSS shows good correlation (r = 0.97) and good agreement among the three modalities with a WSS of 0.65 Pa in the original model, of 0.68 Pa in the CT based model and of 0.67 Pa in the MRI based model.     

In Vitro Generation of Atrioventricular Heart Valve Neoscaffolds

Tissue engineering of cardiovascular structures represents a novel approach to improve clinical strategies in heart valve disease treatment. The aim of this study was to engineer decellularized atrioventricular heart valve neoscaffolds with an intact ultrastructure and to reseed them with umbilical cord‐derived endothelial cells under physiological conditions in a bioreactor environment. Mitral (n = 38) and tricuspid (n = 36) valves were harvested from 40 hearts of German Landrace swine from a selected abattoir. Decellularization of atrioventricular heart valves was achieved by a detergent‐based cell extraction protocol. Evaluation of the decellularization method was conducted with light microscopy and quantitative analysis of collagen and elastin content. The presence of residual DNA within the decellularized atrioventricular heart valves was determined with spectrophotometric quantification. The described decellularization regime produced full removal of native cells while maintaining the mechanical stability and the quantitative composition of the atrioventricular heart valve neoscaffolds. The surface of the xenogeneic matrix could be successfully reseeded with in vitro‐expanded human umbilical cord‐derived endothelial cells under physiological flow conditions. After complete decellularization with the detergent‐based protocol described here, physiological reseeding of the xenogeneic neoscaffolds resulted in the formation of a confluent layer of human umbilical cord‐derived endothelial cells. These results warrant further research toward the generation of atrioventricular heart valve neoscaffolds on the basis of decellularized xenogeneic tissue.