Predictors of an ischemic electrocardiographic response in patients with exercise-induced myocardial ischemia

Background  

The determinants of an ischemic electrocardiographic (ECG) response in patients with exercise-induced ischemia on single-photon emission computed tomography (SPECT) remain poorly defined. Specifically, it is unknown whether the occurrence of an ischemic ECG response is related to the extent and/or severity of SPECT ischemia.     

SPECT myocardial perfusion imaging for the assessment of left ventricular mechanical dyssynchrony

Phase analysis of gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is an evolving technique for measuring LV mechanical dyssynchrony. Since its inception in 2005, it has undergone considerable technical development and clinical evaluation. This article reviews the background, the technical and clinical characteristics, and evolving clinical applications of phase analysis of gated SPECT MPI in patients requiring cardiac resynchronization therapy or implantable cardioverter defibrillator therapy and in assessing LV diastolic dyssynchrony.     

Oxidatively modified nucleic acids in preclinical Alzheimer's disease (PCAD) brain

Previous studies show increased oxidative DNA and RNA damage and diminished 8-oxoguanine glycosylase (OGG1) mediated base excision repair in vulnerable brain regions of mild cognitive impairment and late-stage Alzheimer's disease (LAD) subjects compared to normal control (NC) subjects. Recently, a preclinical stage of AD (PCAD) has been described in which subjects show no overt clinical manifestations of AD but demonstrate significant AD pathology at autopsy. To determine if DNA or RNA oxidation are significantly elevated in PCAD brain we quantified 8-hydroxyguanine (8-OHG) in sections of hippocampus/parahippocamapal gyri in PCAD and NC subjects using immunohistochemistry and confocal microscopy and in superior and middle temporal gyri (SMTG) using gas chromatography/mass spectrometry. To determine if increased DNA oxidation is associated with altered repair capacity, levels of OGG1 protein in HPG were measured by immunohistochemistry and levels of OGG1 mRNA were measured in SMTG using quantitative PCR. Results show significantly increased (p<0.05) 8-OHG immunostaining in DNA and RNA of PCAD HPG and significantly increased 8-OHG in PCAD SMTG. Quantification of OGG1 showed significantly elevated mRNA in PCAD SMTG and a trend toward elevated protein immunostaining in PCAD HPG. Overall, the data suggest oxidative damage to nucleic acids and a compensatory increase in OGG1 expression occur early in the pathogenesis of AD.     

Standardization of fungal polymerase chain reaction for the early diagnosis of invasive fungal infection

Background: An early initiation of antifungal therapy in invasive fungal infections (IFIs) is critical in reducing the high mortality rate. Current diagnosis of fungal infection relies on microscopy, culture, antigen, antibody specific tests and histological diagnosis. However, these tests either lack sensitivity or specificity. There is thus the need for a rapid, specific and accurate diagnostic method. Objective: The aim of our study was to establish PCR for the rapid detection of Candida and Aspergillus species in clinical specimens with improved sensitivity and specificity. Materials and Methods: A total of 71 proven cases of IFI (confirmed by culture) were collected. A total of 15 healthy, 15 patients suffering from bacterial sepsis and 15 patients with HIV, HBV viral infections were included as controls. Clinical specimens were subjected to a standardized nested amplification to produce Round I (504 bp) and Round II (150 bp) amplicons. Restriction digestion was performed on these products for further identification. Results: Analytical sensitivity was determined using 10⁶–10 CFU/ml of cell suspension. The lower detection limit of the assay was 10 CFU/ml of blood. This test was 100% sensitive and specific with a positive predictive value of 100% and a negative predictive value of 96.7%. Conclusion: The assay was found to be effective for the rapid detection of Candida and Aspergillus in clinical specimens.     

How participatory is parental consent in low literacy rural settings in low income countries? Lessons learned from a community based study of infants in South India

Background  

A requisite for ethical human subjects research is that participation should be informed and voluntary. Participation during the informed consent process by way of asking questions is an indicator of the extent to which consent is informed.     

Communication with Patients on Mechanical Ventilation: A Review of Existing Technologies

How to cite this article: Anand A, Nair RR, Kodamanchili S, Panda R, Bhardwaj KK, Gowthaman TB. Communication with Patients on Mechanical Ventilation: A Review of Existing Technologies. Indian J Crit Care Med 2022;26(6):756–757.