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1.
Mohab Omer Jan F. A. Hendrickx Simon De Ridder Alexander De Houwer Rik Carette Sofie De Cooman Andre M. De Wolf 《Journal of clinical monitoring and computing》2018,32(5):799-806
Low fresh gas flows (FGFs) decrease the use of anesthetic gases, but increase CO2 absorbent usage. CO2 absorbent usage remains poorly quantified. The goal of this study is to determine canister life of 8 commercially available CO2 absorbent prepacks with the Zeus®. Pre-packed CO2 canisters of 8 different brands were tested in vitro: Amsorb Plus, Spherasorb, LoFloSorb, LithoLyme, SpiraLith, SpheraSorb, Drägersorb 800+, Drägersorb Free, and CO2ntrol. CO2 (160 mL min??1) flowed into the tip of a 2 L breathing bag that was ventilated with a tidal volume of 500 mL, a respiratory rate of 10/min, and an I:E ratio of 1:1 using the controlled mechanical ventilation mode of the Zeus® (Dräger, Lubeck, Germany). In part I, canister life of 5 canisters each of 2 different lots of each brand was determined with a 350 mL min??1 FGF. Canister life is the time it takes for the inspired CO2 concentration (FICO2) to rise to 0.5%. In part II, canister life was measured accross a FGF range of 0.25 to 4 L min??1 for Drägersorb 800+ (2 lots) and SpiraLith (1 lot). In part III, the calculated canister life per 100 g fresh granule content of the different brands was compared between the Zeus and (previously published data for) the Aisys. In vitro canister life of prefilled CO2 absorber canisters differed between brands, and depended on the amount of CO2 absorbent and chemical composition. Canister life expressed as FCU0.5 (the fraction of the canister used per hour) was proportional to FGF over 0.2–2 L min?1 range only, but was non-linear with higher FGF: FCU0.5 was larger than expected with FGF?>?2 L min?1, and even with FGF?>?minute ventilation FCU0.5 did not become zero, indicating some CO2 was being absorbed. Canister life on a per weight basis of the same brand is higher with the Zeus than the Aisys. Canister life of prefilled CO2 absorber canisters differs between brands. The FCU0.5–FGF relationship is not linear across the entire FGF range. Canister life of prepacks of the same brand for the Zeus and Aisys differs, the exact etiology of which is probably multifactorial, and may include differences in the absolute amount of absorbent and different rebreathing characteristics of the machines. 相似文献
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Introduction
Periadnexal adhesions are known to contribute to subfertility. The restoration of the tubo-ovarian anatomy is one the key principles in reproductive surgery, and this involves adhesiolysis. However, adhesion formation/reformation is very common after periovarian adhesiolysis. It is not known if the application of Hyalobarrier®, an anti-adhesion gel, around the adnexal region postsurgery influences ovulatory status. The study is a pilot randomized controlled trial (RCT) randomizing women into the application of Hyalobarrier® versus no Hyalobarrier® at the time of laparoscopy, where postsurgical ovulatory status and pregnancy rates were evaluated.Methods
This was a pilot RCT where women were recruited from the gynecological and subfertility clinic who were deemed to require an operative laparoscopy. If intraoperatively they were found to have periovarian adhesions, they were randomized into having adhesiolysis with and without usage of Hyalobarrier®. Demographic details and intraoperative details including the severity, extent, and the ease of use of Hyalobarrier® were recorded. Prior to the surgery and postoperatively, the participants had their serum hormonal status (day 2 FSH, LH and day 21 progesterone) evaluated. Postoperatively, they underwent a follicular tracking cycle at 3 months.Results
Fifteen women were randomized into use of Hyalobarrier® (study group) and 15 into the no Hyalobarrier® group (control group) between December 2011 and January 2014. There was no difference in the patient characteristics in terms of age, BMI, the number of previous pregnancies, or the extent, site, and severity of adhesions between the two groups. There was no significant difference between the study versus control groups in terms of the hormonal profile (day 2 FSH and day 21 progesterone) before or after surgery. The 3-month postoperative day 10–12 follicular tracking findings and endometrial thickness were similar between the study and control groups. Four women were pregnant in the study group (24%) and one in the control group (7%) cumulatively over 2 years.Conclusion
The use of Hyalobarrier® post salpingo-ovariolysis did not influence follicular development as inferred from the results of the day 21 progesterone and folliculogram on day 10–12 3-month postsurgery.Trial Registration
ISRCTN number, ISRCTN1833588.Funding
Nordic Pharma.4.
Zhaofei Liu Bing Jia Huiyun Zhao Xiaoyuan Chen Fan Wang 《Molecular imaging and biology》2011,13(1):112-120
Purpose
The cell adhesion molecule integrin αvβ3 is an important player in the process of tumor angiogenesis and metastasis. Abegrin™, a fully humanized anti-integrin αvβ3 monoclonal antibody, was currently in clinical trials for cancer therapy. Herein, we labeled Abegrin™ with 111In, evaluated the in vitro and in vivo characteristics, and investigated whether the expression of integrin αvβ3 in tumors could be imaged with 111In-labeled Abegrin™. 相似文献5.
Peter M. A. Calverley Michael Könen-Bergmann Frank Richard Susan Bell Jens M. Hohlfeld 《Advances in therapy》2016,33(5):786-793
Introduction
The long-acting muscarinic antagonist tiotropium bromide is approved in many countries as maintenance therapy for chronic obstructive pulmonary disease (COPD). Tiotropium is available as a dry-powder formulation delivered via HandiHaler® (18 μg once daily) and is now also approved as an aqueous solution delivered via the Respimat® Soft Mist? Inhaler (5 μg once daily, 2 puffs of 2.5 µg). Several studies have compared the efficacy of tiotropium HandiHaler (18 μg once daily) with different doses of Respimat. We aimed to compare available bronchodilator efficacy data of once-daily Respimat 1.25, 2.5, 5, 10, 20 µg, and HandiHaler 18 µg to investigate which dose of tiotropium delivered by Respimat is the closest match to tiotropium HandiHaler.Methods
Evaluation of six clinical trials (duration from 3 weeks to 2–3 years) that included lung function measures (trough forced expiratory volume in 1 s and trough forced vital capacity) as key outcomes.Results
In the six trials, bronchodilator efficacy of Respimat 5 μg and HandiHaler 18 μg was similar; however, reduced bronchodilator efficacy was observed with lower doses of Respimat (1.25 and 2.5 μg).Conclusion
These findings support the use of the marketed once-daily dose of Respimat 5 μg for the maintenance treatment of patients with COPD.Funding
Boehringer Ingelheim.6.
Maria Cristina Cuerda Antonio Apezetxea Lourdes Carrillo Felipe Casanueva Federico Cuesta Jose Antonio Irles Maria Nuria Virgili Miquel Layola Luis Lizán 《Advances in therapy》2016,33(10):1728-1739
Introduction
NutriQoL® (Nestlé Health Science, Vevay, Switzerland) is a questionnaire developed to assess the health-related quality-of-life (HRQoL) of patients with home enteral nutrition (HEN) irrespective of their underlying condition and route of administration. The aim of this work is assessing the questionnaire’s reliability and responsiveness to change.Methods
Two cohorts of patients with HEN and their primary caregivers were enrolled to assess reliability and responsiveness, respectively. All participants had to be 18 years of age or older, without mental deterioration (≤3 or 4 errors in the Pfeiffer’s test) and with sufficient functional status (>40 points on Karnovsky’s performance status scale). When the patients’ ability to respond to the questionnaire was impaired due to underlying disease, their caregivers answered on their behalf. NutriQoL was administered in two and three visits to reliability and responsiveness cohorts, respectively. Test–retest reliability and internal consistency were assessed by the intra-class correlation coefficient (ICC) and the Cronbach’s α, respectively. Responsiveness was evaluated by standardized effect size and standardized response mean between basal visit and third visit. Finally, the minimal clinically important difference (MCID) was estimated.Results
A total of 54 and 86 participants were recruited to the reliability and responsiveness cohort, respectively. Thirty-five caregivers were selected to assess the inter-observer reliability. ICC values confirmed the good reproducibility level (ICC >0.75) of the questionnaire in both “physical functioning and activities of daily living” and “social life” domains and total score. The assessment of internal consistency in both domains of the questionnaire showed good internal consistency in visit 2. ICC showed the excellent agreement level between caregiver and patient in the global NutriQoL score. Finally, patients classified as having a minimal change in their health reported a mean (standard deviation) MCID in NutriQoL score of 0.63 (11.51).Conclusion
NutriQoL is a reliable and unique instrument to measure the HRQoL in HEN patients. NutriQoL detects changes in the health status of the patient. Nevertheless, further research is needed to determine the full extent of the questionnaire responsiveness.7.
Chorianopoulos E Krumsdorf U Pleger ST Katus HA Bekeredjian R 《Clinical research in cardiology》2012,101(5):349-355
Objectives
Analysis of timing, type, electrocardiographic and patient characteristics of postinterventional bradyarrhythmias after CoreValve implantation. 相似文献8.
Shuanglong Liu Zhaofei Liu Kai Chen Yongjun Yan Petra Watzlowik Hans-Jürgen Wester Frederick T. Chin Xiaoyuan Chen 《Molecular imaging and biology》2010,12(5):530-538
Purpose
In vivo imaging of αvβ3 has important diagnostic and therapeutic applications. 18F-Galacto-arginine–glycine–aspartic acid (RGD) has been developed for positron emission tomography (PET) imaging of integrin αvβ3 expression and is now being tested on humans. Dimerization and multimerization of cyclic RGD peptides have been reported to improve the integrin αvβ3-binding affinity due to the polyvalency effect. Here, we compared a number of new dimeric RGD peptide tracers with the clinically used 18F-galacto-RGD.Procedures
RGD monomers and dimers were coupled with galacto or PEG3 linkers, and labeled with 18F using 4-nitrophenyl 2-18F-fluoropropionate (18F-NFP) or N-succinimidyl 4-18F-fluorobenzoate as a prosthetic group. The newly developed tracers were evaluated by cell-based receptor-binding assay, biodistribution, and small-animal PET studies in a subcutaneous U87MG glioblastoma xenograft model.Results
Starting with 18F-F?, the total reaction time for 18F-FP-SRGD2 and 18F-FP-PRGD2 is about 120 min. The decay-corrected radiochemical yields for 18F-FP-SRGD2 and 18F-FP-PRGD2 are 52?±?9% and 80?±?7% calculated from 18F-NFP. Noninvasive small-animal PET and direct tissue sampling experiments demonstrated that the dimeric RGD peptides had significantly higher tumor uptake as compared to 18F-galacto-RGD.Conclusion
Dimeric RGD peptide tracers with relatively high tumor integrin-specific accumulation and favorable in vivo kinetics may have the potential to be translated into clinic for integrin αvβ3 imaging.9.
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Zhenying Chen Fangmeng Fu Fang Li Zhaohui Zhu Yinghong Yang Xiangjin Chen Bing Jia Shan Zheng Chao Huang Weibing Miao 《Molecular imaging and biology》2018,20(5):846-856
Purpose
This study aimed to investigate the value of 99mtechnetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid ([99mTc]3PRGD2) imaging in diagnosis and staging of breast cancer compared with 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) imaging, and to explore the expression of integrin αvβ3 in tumor vascular endothelial cells.Procedures
Forty-two women with suspected breast cancer underwent both [99mTc]3PRGD2 imaging and [18F]FDG imaging. Visual analysis was used to assess primary breast lesion, axillary lymph node, and distant metastasis. The tumor-blood (T/B) ratios from [99mTc]3PRGD2 imaging and the maximum standardized uptake value (SUVmax) from [18F]FDG imaging were analyzed for breast lesions. Integrin αvβ3 was analyzed through immunohistochemistry.Results
Forty-five breast lesions were found (malignant, n?=?38; benign, n?=?7). The sensitivity, specificity, and accuracy of [99mTc]3PRGD2 and [18F]FDG imaging in visual analysis for the breast lesion were 97.4, 87.5, and 95.6 % and 97.4, 71.4, and 93.3 %, respectively (P?>?0.05). For semi-quantitative analysis, no significant difference of the area under the curves (AUC) was found in the imaging using the two radiopharmaceuticals (0.880 and 0.955; Z?=?0.88, P?>?0.05). The sensitivity, specificity, and accuracy for axillary lymph node metastasis with [99mTc]3PRGD2 and [18F]FDG were 78.05, 99.36, and 94.92 % and 85.37, 98.72, and 95.64 %, respectively (P?>?0.05). Nine patients with distant metastases were all detected with the two radiopharmaceuticals. The expression of integrin αvβ3 was correlated with [99mTc]3PRGD2 uptake (r?=?0.582, P?=?0.001), which were significantly higher in the HER2-positive and stage III–IV patients (P?<?0.05).Conclusions
The prospective study demonstrated that [99mTc]3PRGD2 imaging seems to be valuable for diagnosis of breast cancer and its staging. It may be less sensitive for detecting small lymph node metastatic lesions when compared with [18F]FDG imaging. Integrin αvβ3 in tumor microvessels was associated with the breast cancer subtype and its staging.11.
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Continuous cardiac index (CI) monitoring is frequently used in critically ill patients. Few studies have compared the pulse contour-based device FloTrac/Vigileo® to pulmonary artery thermodilution (PAC) in terms of accuracy for CI monitoring in septic shock. The aim of our study was to compare the third-generation FloTrac/Vigileo® to PAC in septic shock. Eighteen patients with septic shock requiring monitoring by PAC were included in this study. We monitored CI using both FloTrac/Vigileo® and continuous thermodilution (PAC-CI). Hemodynamic data were recorded every hour or every 2 min during fluid challenges. The primary endpoint was the global agreement of all CI-paired measurements determined using the Bland–Altman method adapted to replicated data. We tested the linearity of the bias by regression analysis, and compared the reactivity of the 2 techniques during fluid challenges. A receiver operating characteristic (ROC) curve analysis tested the ability of FloTrac/Vigileo® to detect concordant and significative CI changes, using PAC-CI as the reference method. Overall, 1,201 paired CI measurements were recorded. The Bland–Altman analysis for global agreement of the 2 techniques showed a bias of ?0.1 ± 2.1 L min?1 m?2 and a percentage error of 64 %. The overall correlation coefficient between PAC-CI and FloTrac/Vigileo® CI was 0.47 (p < 0.01), with r2 = 0.22. The area under the curve of the ROC curve for detecting concordant and significant changes in CI was 0.72 (0.53; 0.87). In our study, third-generation Flowtrac-Vigileo® appears to be too inaccurate to be recommended for CI monitoring in septic shock. 相似文献
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Bing Jia Zhaofei Liu Zhaohui Zhu Jiyun Shi Xiaona Jin Huiyun Zhao Fang Li Shuang Liu Fan Wang 《Molecular imaging and biology》2011,13(4):730-736
Purpose
99mTc-3PRGD2 is a 99mTc-labeled dimeric cyclic RGD peptide with increased receptor binding affinity and improved kinetics for in vivo imaging of integrin αvβ3 expression in nude mouse model. To accelerate its clinical translation, we reported here the evaluation of the kit-formulated 99mTc-3PRGD2 in healthy cynomolgus primates for its blood clearance kinetics, biodistribution, and radiation dosimetry. 相似文献14.
Anton Geerinck Olivier Bruyère Médéa Locquet Jean-Yves Reginster Charlotte Beaudart 《Advances in therapy》2018,35(11):1842-1858
Introduction
The Sarcopenia Quality of Life (SarQoL®) questionnaire was developed to provide a patient-reported outcome measure specific to sarcopenia. Its psychometric properties indicate that it is a valid and reliable instrument. However, until now, its ability to detect change over time has not been examined. Therefore, the objective of this study is to evaluate the responsiveness (also known as sensitivity to change) of the SarQoL® questionnaire in a prospective, longitudinal cohort of community-dwelling, older, sarcopenic subjects.Methods
Sarcopenic subjects from the SarcoPhAge (Sarcopenia and Physical impairment with advancing Age) study were included. Responsiveness was evaluated with nine pre-specified hypotheses on the correlation between the evolution of the SarQoL® scores after a 2-year interval and the evolution of the scores on the Short Form-36 (SF-36) and the Euroqol 5-dimension (EQ-5D) questionnaires. This technique considers responsiveness to be a form of longitudinal validity. Additionally, standardized response means were also calculated to compare the quantity of change measured by the different questionnaires.Results
A total of 42 sarcopenic subjects were included. The median age of the sample was 72.9 (68.9–78.8) years, 59.5% were female, and the mean body mass index was 23.3 (20.4–25.7) kg/m2. A good responsiveness was observed, as evidenced by the confirmation of eight out of nine hypotheses, well above the 75% confirmation threshold. The standardized response mean of the Overall SarQoL® score was significantly higher than those of the SF-36 Physical Component Summary (p?=?0.005), the EQ-5D Utility Index (p?<?0.001) and the Euroqol visual analogue scale (p?=?0.003).Conclusion
The first data available on the ability of the SarQoL® questionnaire to detect change over time indicates that the questionnaire has good responsiveness. This, together with the previously established psychometric properties, confirms that the SarQoL® questionnaire is a relevant instrument for the assessment of quality of life in sarcopenic populations.15.
Jochem P. Bremmer Bart N. M. van Berckel Suzanne Persoon L. Jaap Kappelle Adriaan A. Lammertsma Reina Kloet Gert Luurtsema Abraham Rijbroek Catharina J. M. Klijn Ronald Boellaard 《Molecular imaging and biology》2011,13(4):759-768
Purpose
We assessed test–retest variability of cerebral blood flow (CBF), cerebral blood volume (CBV), cerebral metabolic rate of oxygen (CMRO2), and oxygen extraction fraction (OEF) measurements derived from dynamic 15O positron emission tomography (PET) scans. 相似文献16.
Jason B. White Lina Y. Hu David L. Boucher Julie L. Sutcliffe 《Molecular imaging and biology》2018,20(1):103-113
Purpose
Increased expression of the αvβ6 integrin correlates with advanced tumor grade and poor clinical outcome, identifying αvβ6 as a prognostic indicator and an attractive target for molecular imaging. This work investigated the ability of a disulfide-stabilized [64Cu]NOTA-αvβ6 cys-diabody to image αvβ6 expression in vivo using a nu/nu mouse model bearing human melanoma xenografts and positron-emission tomography.Procedures
Small-animal positron emission tomography (PET) imaging, quantitative ROI analysis, and ex vivo biodistribution were conducted to ascertain tumor uptake and organ distribution of the [64Cu]NOTA-αvβ6 cys-diabody. Immunohistochemical staining of tumors and mouse organs and immunoreactivity assays were utilized to correlate in vivo and ex vivo observations.Results
PET imaging of the [64Cu]NOTA-αvβ6 cys-diabody revealed low tumor uptake at 24 h p.i. in DX3Puroβ6 tumors (2.69 ± 0.45 %ID/g) with comparable results found in the DX3Puro tumors (2.24 ± 0.15 %ID/g). Quantitative biodistribution confirmed that DX3Puroβ6 tumor uptake was highest at 24 h p.i. (4.63 ± 0.18 %ID/g); however, uptake was also observed in the stomach (4.84 ± 2.99 %ID/g), small intestines (4.50 ± 1.69 %ID/g), large intestines (4.73 ± 0.97 %ID/g), gallbladder (6.04 ± 1.88 %ID/g), and lungs (3.89 ± 0.69 %ID/g).Conclusions
Small-animal PET imaging was successful in visualizing αvβ6-positive tumor uptake of the [64Cu]NOTA-αvβ6 cys-diabody. Cys-diabody cross-reactivity was observed between human and murine αvβ6 and immunohistochemical staining confirmed the presence of an endogenous αvβ6 antigen sink, which led to suboptimal tumor contrast in this mouse model. Future investigations will focus on dose escalation studies to overcome the endogenous antigen sink while increasing DX3Puroβ6 tumor uptake.17.
Jonathan S. Myers Imran Masood Dana M. Hornbeak Jose I. Belda Gerd Auffarth Anselm Jünemann Jane Ellen Giamporcaro Jose M. Martinez-de-la-Casa Iqbal Ike K. Ahmed Lilit Voskanyan L. Jay Katz 《Advances in therapy》2018,35(3):395-407
Introduction
This study evaluates long-term outcomes of two trabecular micro-bypass stents, one suprachoroidal stent, and postoperative prostaglandin in eyes with refractory open angle glaucoma (OAG).Methods
Prospective ongoing 5-year study of 80 eligible subjects (70 with 4-year follow-up) with OAG and IOP ≥ 18 mmHg after prior trabeculectomy and while taking 1–3 glaucoma medications. Subjects received two iStent® trabecular micro-bypass stents, one iStent Supra® suprachoroidal stent, and postoperative travoprost. Postoperative IOP was measured with medication and annually following medication washouts. Performance was measured by the proportion of eyes with ≥ 20% IOP reduction on one medication (the protocol-specified prostaglandin) versus preoperative medicated IOP (primary outcome); and the proportion of eyes with postoperative IOP ≤ 15 and ≤ 18 mmHg on one medication (secondary outcome). Additional clinical and safety data included medications, visual field, pachymetry, gonioscopy, adverse events, visual acuity, and slit-lamp and fundus examinations.Results
Preoperatively, mean medicated IOP was 22.0 ± 3.1 mmHg on 1.2 ± 0.4 medications, and mean unmedicated IOP was 26.4 ± 2.4 mmHg. Postoperatively, among eyes without later cataract surgery, mean medicated IOP at all visits through 48 months was ≤ 13.7 mmHg (≥ 37% reduction), and annual unmedicated IOP was ≤ 18.4 mmHg (reductions of ≥ 30% vs. preoperative unmedicated IOP and ≥ 16% vs. preoperative medicated IOP). At all postoperative visits among eyes without additional surgery or medication, ≥ 91% of eyes had ≥ 20% IOP reduction on one medication versus preoperative medicated IOP. At month 48, 97 and 98% of eyes achieved IOP ≤ 15 and ≤ 18 mmHg, respectively, on one medication. Six eyes required additional medication, no eyes required additional glaucoma surgery, and safety measurements were favorable throughout follow-up.Conclusion
IOP control was achieved safely with two trabecular micro-bypass stents, one suprachoroidal stent, and postoperative prostaglandin. This microinvasive, ab interno approach introduces a possible new treatment option for refractory disease.Trial Registration
NCT01456390.Funding
Glaukos Corporation.18.
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Weiyi Feng Manojkumar Valiyaveettil Tejasvi Dudiki Ganapati H. Mahabeleshwar Patrick Andre Eugene A. Podrez Tatiana V. Byzova 《Thrombosis journal》2017,15(1):22