313 research outputs found
Advances in Neuroimaging and Monitoring to Defend Cerebral Perfusion in Noncardiac Surgery
No full textNoncardiac surgery conveys a substantial risk of secondary organ dysfunction and injury. Neurocognitive dysfunction and covert stroke are emerging as major forms of perioperative organ dysfunction, but a better understanding of perioperative neurobiology is required to identify effective treatment strategies. The likelihood and severity of perioperative brain injury may be increased by intraoperative hemodynamic dysfunction, tissue hypoperfusion, and a failure to recognize complications early in their development. Advances in neuroimaging and monitoring techniques, including optical, sonographic, and magnetic resonance, have progressed beyond structural imaging and now enable noninvasive assessment of cerebral perfusion, vascular reserve, metabolism, and neurologic function at the bedside. Translation of these imaging methods into the perioperative setting has highlighted several potential avenues to optimize tissue perfusion and deliver neuroprotection. This review introduces the methods, metrics, and evidence underlying emerging optical and magnetic resonance neuroimaging methods and discusses their potential experimental and clinical utility in the setting of noncardiac surgery
Supplementary_material_V2 – Supplemental material for Differential immunological profiles herald magnetic resonance imaging-defined perioperative cerebral infarction
No full textSupplemental material, Supplementary_material_V2 for Differential immunological profiles herald magnetic resonance imaging-defined perioperative cerebral infarction by Jonathon P. Fanning , Louise E. See Hoe, Margaret R. Passmore, Adrian G. Barnett, Barbara E. Rolfe, Jonathan E. Millar, Allan J. Wesley, Jacky Suen and John F. Fraser in Therapeutic Advances in Neurological Disorders</p
Transcatheter Aortic-Valve Replacement in Clinical Practice
No full textThe authors reply: In response to Mahé: the aspect of our results that was unexpected was not the substantial decline in scabies prevalence after mass drug administration, but the further decline (in all three trial groups) between the 3-month and 12-month observation points. To explain this finding, we speculated that the 3-month observation may have been an overestimate of prevalence owing to the persistence of scabetic nodules after successful treatment. We wholeheartedly agree with O’Donnell and colleagues about the importance of improving environmental and living conditions in scabies control, regardless of whether mass drug administration is being considered.No Full Tex
Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: A meta-analysis
No full textImportance: Neurological and neuropsychiatric symptoms that persist or develop three months after the onset of COVID-19 pose a significant threat to the global healthcare system. These symptoms are yet to be synthesized and quantified via meta-analysis. Objective: To determine the prevalence of neurological and neuropsychiatric symptoms reported 12 weeks (3 months) or more after acute COVID-19 onset in adults. Data sources: A systematic search of PubMed, EMBASE, Web of Science, Google Scholar and Scopus was conducted for studies published between January 1st, 2020 and August 1st, 2021. The systematic review was guided by Preferred Reporting Items for Systematic Review and Meta-Analyses. Study selection: Studies were included if the length of follow-up satisfied the National Institute for Healthcare Excellence (NICE) definition of post-COVID-19 syndrome (symptoms that develop or persist ≥3 months after the onset of COVID-19). Additional criteria included the reporting of neurological or neuropsychiatric symptoms in individuals with COVID-19. Data extraction and synthesis: Two authors independently extracted data on patient characteristics, hospital and/or ICU admission, acute-phase COVID-19 symptoms, length of follow-up, and neurological and neuropsychiatric symptoms. Main outcome(s) and measure(s): The primary outcome was the prevalence of neurological and neuropsychiatric symptoms reported ≥3 months post onset of COVID-19. We also compared post-COVID-19 syndrome in hospitalised vs. non-hospitalised patients, with vs. without ICU admission during the acute phase of infection, and with mid-term (3 to 6 months) and long-term (>6 months) follow-up. Results: Of 1458 articles, 19 studies, encompassing a total of 11,324 patients, were analysed. Overall prevalence for neurological post-COVID-19 symptoms were: fatigue (37%, 95% CI: 24%–50%), brain fog (32%, 9%–55%), memory issues (27%, 18%–36%), attention disorder (22%, 10%–34%), myalgia (18%, 4%–32%), anosmia (12%, 7%–17%), dysgeusia (11%, 4%–17%) and headache (10%, 1%–21%). Neuropsychiatric conditions included sleep disturbances (31%, 18%–43%), anxiety (23%, 13%–33%) and depression (12%, 7%–21%). Neuropsychiatric symptoms substantially increased in prevalence between mid- and long-term follow-up. Compared to non-hospitalised patients, patients hospitalised for acute COVID-19 had reduced frequency of anosmia, anxiety, depression, dysgeusia, fatigue, headache, myalgia, and sleep disturbance at three (or more) months post-infection. Conversely, hospital admission was associated with higher frequency of memory issues (OR: 1.9, 95% CI: 1.4–2.3). Cohorts with >20% of patients admitted to the ICU during acute COVID-19 experienced higher prevalence of fatigue, anxiety, depression, and sleep disturbances than cohorts with <20% of ICU admission. Conclusions and relevance: Fatigue, cognitive dysfunction (brain fog, memory issues, attention disorder) and sleep disturbances appear to be key features of post-COVID-19 syndrome. Psychiatric manifestations (sleep disturbances, anxiety, and depression) are common and increase significantly in prevalence over time. Randomised controlled trials are necessary to develop intervention strategy to reduce disease burden.No Full Tex
Neurological Manifestations of Coronavirus Disease 2019: A Comprehensive Review and Meta-Analysis of the First 6 Months of Pandemic Reporting
No full textBackground: There is growing evidence that SARS-Cov-2 infection is associated with severe neurological complications. Understanding the nature and prevalence of these neurologic manifestations is essential for identifying higher-risk patients and projecting demand for ongoing resource utilisation. This review and meta-analysis report the neurologic manifestations identified in hospitalised COVID-19 patients and provide a preliminary estimate of disease prevalence. Methods: MEDLINE, Embase and Scopus were searched for studies reporting the occurrence of neurological complications in hospitalised COVID-19 patients. Results: A total of 2,207 unique entries were identified and screened, among which 14 cohort studies and 53 case reports were included, reporting on a total of 8,577 patients. Central nervous system manifestations included ischemic stroke (n = 226), delirium (n = 79), intracranial haemorrhage (ICH, n = 57), meningoencephalitis (n = 13), seizures (n = 3), and acute demyelinating encephalitis (n = 2). Peripheral nervous system manifestations included Guillain-Barrè Syndrome (n = 21) and other peripheral neuropathies (n = 3). The pooled period prevalence of ischemic stroke from identified studies was 1.3% [95%CI: 0.9–1.8%, 102/7,715] in all hospitalised COVID-19 patients, and 2.8% [95%CI: 1.0–4.6%, 9/318] among COVID-19 patients admitted to ICU. The pooled prevalence of ICH was estimated at 0.4% [95%CI: 0–0.8%, 6/1,006]. Conclusions: The COVID-19 pandemic exerts a substantial neurologic burden which may have residual effects on patients and healthcare systems for years. Low quality evidence impedes the ability to accurately predict the magnitude of this burden. Robust studies with standardised screening and case definitions are required to improve understanding of this disease and optimise treatment of individuals at higher risk for neurologic sequelae.SCOPUS: re.jinfo:eu-repo/semantics/publishe
Characterization of velocity and shear rate distribution in a continuous mixer
No full textComputers simulations have been increasingly used to model mixing for uses in many industries. These simulations have given much insight into the mixing that takes place in different types of mixers. However, most computer simulations are unvalidated. Experiments have not been performed on the same systems to compare the results therefore the accuracy of a simulation is not precisely known. Validation is most important in complex systems or when working with fluids of a non-Newtonian nature. Understanding the mixing that takes place within the mixer allows for changes to be made to the mixer for different materials and aids in mixer design. In order to quantify the mixing taking place in a Readco two inch continuous processor, laser Doppler anemometry was used to measure fluid velocity. This velocity was compared to computer simulation results and was used to calculate the shear rate, length stretch, area stretch and mixing efficiency at different points within the mixer. With this information, the accuracy of the computer simulations was determined. Differences among the mixing of three fluids with different rheology were found. The mixing taking place in different areas of the mixer was assessed. Shear thinning fluids were found to be better mixed with the paddle configuration used. The fluids were mixed best in the intermeshing region and between the tip of the paddle and the barrel wall.M.S.Includes bibliographical references (p. 88-90)by Lindsay M. Fannin
Perioperative stroke and cognitive impairment: Incidence, predictors and outcomes in the transcatheter aortic valve implantation setting
No full textArtful Lives: The Francis Watts Lee Family and their Times
No full textFrancis Watts Lee and his family hold a special place in the history of American photography. F. Holland Day completed a series of remarkable photographs of Lee’s daughter Peggy, and the striking portrait of the child and her mother titled Blessed Art Thou among Women is one of Gertrude Käsebier’s most iconic compositions. In Artful Lives, Patricia J. Fanning uses these and other significant images as guideposts to explore the Lee family and the art and culture of their age.
A social reform advocate, Francis Watts Lee was an artistic photographer and a talented printer, part of the circle of avant-garde artists and intellectuals who formed Boston’s bohemia. He married twice, first Agnes Rand, an award-winning poet and children’s book author, and later, after their divorce, Marion Lewis Chamberlain, a librarian and MIT-trained architect. Francis and Agnes’s eldest daughter, Peggy, who was so integral to the work of pioneer Pictorialists, died at age seven of juvenile diabetes. Her sister, Alice, who lost her hearing in infancy, became a wood carver and sculptor.
Utilizing previously unknown family archives and institutional sources, Fanning traces the Lee family’s story in the context of major artistic, political, social, and religious trends, including the Arts and Crafts movement, Christian Socialism, and Aestheticism, while also showing how their experiences reflected the national culture’s evolving conceptions of family, gender, childhood, medicine, deaf education, and mourning. This richly drawn and gracefully written account of one family informs our understanding of this vibrant era, in Boston and well beyond.https://vc.bridgew.edu/fac_books/1149/thumbnail.jp
Letter by Fanning et al regarding article, "histopathology of embolic debris captured during transcatheter aortic valve replacement"
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