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Lung Ultrasound Findings Detected During Inpatient Echocardiography Are Common and Associated With Short‐ and Long‐term Mortality 下载免费PDF全文
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Faik Imeri Karen A. Nolan Andreas M. Bapst Sara Santambrogio Irene Abreu-Rodríguez Patrick Spielmann Svende Pfundstein Silvana Libertini Lisa Crowther Ilaria M.C. Orlando Sophie L. Dahl Anna Keodara Willy Kuo Vartan Kurtcuoglu Carsten C. Scholz Weihong Qi Edith Hummler David Hoogewijs Roland H. Wenger 《Kidney international》2019,95(2):375-387
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David Kessler MD MSc Vartan Pahalyants Joshua Kriger MS Gerald Behr MD Peter Dayan MD MSCE 《Academic emergency medicine》2018,25(9):1027-1034
Background
Our purpose was to determine the potential effect of preprocedural ultrasound (US) to increase lumbar puncture (LP) success compared with standard palpation method. Further, we assessed feasibility of and clinician satisfaction with a standardized US protocol.Methods
This prospective, two‐arm, parallel‐group randomized trial was conducted in a single‐center pediatric emergency department. We compared preprocedural US versus palpation method on success with infant LPs. Infants less than 3 months of age requiring LP were enrolled. Sixteen pediatric emergency medicine physicians with varied US experience were trained to conduct the USs to mark interspace locations. Primary outcome was successful LP, defined as obtaining a cerebrospinal fluid (CSF) sample on first attempt with < 1,000 red blood cells per high‐powered field (clear CSF). Secondary outcomes included clear CSF on any attempt, any CSF on the first attempt, traumatic LP proportion, and LP attempt frequency. Feasibility was assessed by comparing provider number attempting the LP and procedure duration. Clinician satisfaction and sonographer perceptions of US acceptability and impact were assessed.Results
Eighty‐one patients consented and 80 were analyzed (99%): 40 per group. No statistical difference was seen for the primary outcome (p > 0.05) between intervention and control groups (difference 3%; 95% confidence interval = –19% to 24%). There were no statistical differences between intervention and controls groups for secondary outcomes including the rate of traumatic LPs, number of attempts, and the duration of LP procedure. Most sonographers (84%) strongly agreed or agreed that the US protocol was technically easy to perform, well tolerated by the patient (94%), well accepted by the family (100%), and well accepted by the LP procedural clinicians (99%). In the US group, the majority of clinicians who performed the LPs (68.4%) noted that the preprocedural US influenced their behavior, most commonly helping with overall visualization at the selected interspace (28.9%) or prompting a change in interspace (26.3% higher, 5.3% lower). Seventy‐seven percent agreed or strongly agreed that they would like to use the technique again for their next LP. The mean US duration was 4.6 minutes.Conclusions
Preprocedural US by did not improve the rates of first‐attempt success when compared with palpation method. Our results suggest that US is feasible and well accepted, with a perceptible impact on care.16.
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Mehdi Taslimifar Martin Faltys Vartan Kurtcuoglu Franois Verrey Victoria Makrides 《Journal of cerebral blood flow and metabolism》2022,42(1):90
In the CNS, amino acid (AA) neurotransmitters and neurotransmitter precursors are subject to tight homeostatic control mediated by blood-brain barrier (BBB) solute carrier amino acid transporters (AATs). Since the BBB is composed of multiple closely apposed cell types and opportunities for human in vivo studies are limited, we used in vitro and computational approaches to investigate human BBB AAT activity and regulation. Quantitative real-time PCR (qPCR) of the human BBB endothelial cell model hCMEC/D3 (D3) was used to determine expression of selected AAT, tight junction (TJ), and signal transduction (ST) genes under various culture conditions. L-leucine uptake data were interrogated with a computational model developed by our group for calculating AAT activity in complex cell cultures. This approach is potentially applicable to in vitro cell culture drug studies where multiple “receptors” may mediate observed responses. Of 7 Leu AAT genes expressed by D3 only the activity of SLC7A5-SLC3A2/LAT1-4F2HC (LAT1), SLC43A2/LAT4 (LAT4) and sodium-dependent AATs, SLC6A15/B0AT2 (B0AT2), and SLC7A7/y+LAT1 (y+LAT1) were calculated to be required for Leu uptake. Therefore, D3 Leu transport may be mediated by a potentially physiologically relevant functional cooperation between the known BBB AAT, LAT1 and obligatory exchange (y+LAT1), facilitative diffusion (LAT4), and sodium symporter (B0AT2) transporters. 相似文献
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Brennan M. R. Spiegel Marc Kaneshiro Marcia M. Russell Anne Lin Anish Patel Vartan C. Tashjian Vincent Zegarski Digvijay Singh Samuel E. Cohen Mark W. Reid Cynthia B. Whitman Jennifer Talley Bibiana M. Martinez William Kaiser 《Journal of gastrointestinal surgery》2014,18(10):1795-1803