Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 196
Filter
1.
Sci Rep ; 14(1): 13256, 2024 06 10.
Article in English | MEDLINE | ID: mdl-38858516

ABSTRACT

In recent years, pharmaceutical counterfeiting has become an increasingly dangerous situation. A patient who unknowingly consumes a counterfeit drug is at a serious health risk. To address this problem, a low-cost and robust approach for authentication that can be administered at the point-of-care is required. Our proposed solution uses Optical Physical Unclonable Functions (PUFs); patterns formed by a stochastic process that can be used for authentication. We create edible PUFs (ePUFs) using electrospray deposition, which utilizes strong electric fields to atomize a liquid suspension into a plume of micro-scale droplets that are delivered to the target. The ePUFs are electrospray-deposited from an edible ink directly onto the surface of the drug tablets. The process parameters (flow rate, translation speed, and suspension concentration) govern the characteristics of the ePUF to provide highly stochastic patterns. To evaluate our approach, 200 ePUFs were deposited onto tablets at various conditions, followed by imaging and storage of the patterns in a database. For ePUF authentication, a machine vision approach was created using the open source SIFT pattern matching algorithm. Using optimized pattern-matching constraints, our algorithm was shown to be 100% successful in authenticating the cellphone images of the ePUFs to the database. Additionally, the algorithm was found to be robust against changes in illumination and orientation of the cellphone images.


Subject(s)
Counterfeit Drugs , Counterfeit Drugs/analysis , Humans , Tablets
2.
J Math Biol ; 88(6): 69, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38664246

ABSTRACT

Flow in a porous medium can be driven by the deformations of the boundaries of the porous domain. Such boundary deformations locally change the volume fraction accessible by the fluid, creating non-uniform porosity and permeability throughout the medium. In this work, we construct a deformation-driven porous medium transport model with spatially and temporally varying porosity and permeability that are dependent on the boundary deformations imposed on the medium. We use this model to study the transport of interstitial fluid along the basement membranes in the arterial walls of the brain. The basement membrane is modeled as a deforming annular porous channel with the compressible pore space filled with an incompressible, Newtonian fluid. The role of a forward propagating peristaltic heart pulse wave and a reverse smooth muscle contraction wave on the flow within the basement membranes is investigated. Our results identify combinations of wave amplitudes that can induce either forward or reverse transport along these transport pathways in the brain. The magnitude and direction of fluid transport predicted by our model can help in understanding the clearance of fluids and solutes along the Intramural Periarterial Drainage route and the pathology of cerebral amyloid angiopathy.


Subject(s)
Brain , Extracellular Fluid , Extracellular Fluid/metabolism , Extracellular Fluid/physiology , Porosity , Humans , Brain/metabolism , Brain/blood supply , Brain/physiology , Basement Membrane/metabolism , Basement Membrane/physiology , Mathematical Concepts , Biological Transport/physiology , Models, Biological , Computer Simulation , Models, Neurological , Animals , Permeability
3.
Front Pain Res (Lausanne) ; 4: 1145934, 2023.
Article in English | MEDLINE | ID: mdl-37415830

ABSTRACT

Chronic pain is among the most common reasons adults in the U.S. seek medical care. Despite chronic pain's substantial impact on individuals' physical, emotional, and financial wellness, the biologic underpinnings of chronic pain remain incompletely understood. Such deleterious impact on an individuals' wellness is also manifested in the substantial co-occurrence of chronic stress with chronic pain. However, whether chronic stress and adversity and related alcohol and substance misuse increases risk of developing chronic pain, and, if so, what the overlapping psychobiological processes are, is not well understood. Individuals suffering with chronic pain find alleviation through prescription opioids as well as non-prescribed cannabis, alcohol, and other drugs to control pain, and use of these substances have grown significantly. Substance misuse also increases experience of chronic stress. Thus, given the evidence showing a strong correlation between chronic stress and chronic pain, we aim to review and identify overlapping factors and processes. We first explore the predisposing factors and psychologic features common to both conditions. This is followed by examining the overlapping neural circuitry of pain and stress in order to trace a common pathophysiologic processes for the development of chronic pain and its link to substance use. Based on the previous literature and our own findings, we propose a critical role for ventromedial prefrontal cortex dysfunction, an overlapping brain area associated with the regulation of both pain and stress that is also affected by substance use, as key in the risk of developing chronic pain. Finally, we identify the need for future research in exploring the role of medial prefrontal circuits in chronic pain pathology. Critically, in order to alleviate the enormous burden of chronic pain without exacerbating the co-occurring substance misuse crisis, we emphasize the need to find better approaches to treat and prevent chronic pain.

4.
J Eur Acad Dermatol Venereol ; 35(10): 2079-2084, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33988879

ABSTRACT

BACKGROUND: Maculopapular cutaneous mastocytosis (MPCM) in children is classified in two variants: (i) monomorphic variant, presenting with the small macules or papules typically seen in adult patients; and (ii) polymorphic variant with larger lesions of variable size and shape, typically seen in children. The definition of polymorphic and monomorphic variants is mostly intuitive, and a validation of this classification has not been done. OBJECTIVE: To study interobserver variability in the classification of MPCM in two groups of observers: mastocytosis experts and general dermatologists. MATERIALS AND METHODS: Nineteen cases of childhood MPCM were shown blindly, for classification as monomorphic or polymorphic type, to 10 independent observers (eight dermatologists, one allergist and one haematologist) from Europe and North America with a vast experience in the management of paediatric mastocytosis. Also, the same cases were shown on a screen to 129 general dermatologists attending a meeting; their votes were registered by remote controls. The interobserver variability kappa coefficient (with 95% confidence interval) was calculated to measure the reliability of the correlation. RESULTS: The value of kappa interobserver variability coefficient for the group of 10 experts (95% confidence interval) was 0.39 (0.18-0.63), which is considered as 'fair'. The value of kappa interobserver variability coefficient for the group of 129 general dermatologists (95% confidence interval) was 0.17 (0.06-0.39), which is considered as 'slight'. A complete agreement of all 10 experts was achieved in only four of 19 cases (21.1%) The most voted choice was concordant between the two groups in only 11 of the 19 cases. CONCLUSIONS: We failed to validate the classification system of childhood MPCM in monomorphic and polymorphic types. While the rate of agreement was low for mastocytosis experts, it was nearly the agreement expected by chance in general dermatologists.


Subject(s)
Urticaria Pigmentosa , Adult , Child , Europe , Humans , Observer Variation , Reproducibility of Results
5.
Biomicrofluidics ; 13(2): 024103, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30867887

ABSTRACT

The failure to clear amyloid-Beta from an aging brain leads to its accumulation within the walls of arteries and potentially to Alzheimer's disease. However, the clearance mechanism through the intramural periarterial pathway is not well understood. We previously proposed a hydrodynamic reverse transport model for the cerebral arterial basement membrane pathway. In our model, solute transport results from fluidic forcing driven by the superposition of forward and reverse propagating boundary waves. The aim of this study is to experimentally validate this hydrodynamic reverse transport mechanism in a microfluidic device where reverse transport in a rectangular conduit is driven by applying waveforms along its boundaries. Our results support our theory that while the superimposed boundary waves propagate in the forward direction, a reverse flow in the rectangular conduit can be induced by boundary wave reflections. We quantified the fluid transport velocity and direction under various boundary conditions and analyzed numerical simulations that support our experimental findings. We identified a set of boundary wave parameters that achieved reverse transport, which could be responsible for intramural periarterial drainage of cerebral metabolic waste.

6.
J Intern Med ; 284(5): 478-491, 2018 11.
Article in English | MEDLINE | ID: mdl-29331057

ABSTRACT

Environmental and socioeconomic changes over the past thirty years have contributed to a dramatic rise in the worldwide prevalence of obesity. Heart disease is amongst the most serious health risks of obesity, with increases in both atherosclerotic coronary heart disease and heart failure among obese individuals. In this review, we focus on primary myocardial alterations in obesity that include hypertrophic remodelling and diastolic dysfunction. Obesity-associated perturbations in myocardial and systemic lipid metabolism are important contributors to cardiovascular complications of obesity. Accumulation of excess lipid in nonadipose cells of the cardiovascular system can cause cell dysfunction and cell death, a process known as lipotoxicity. Lipotoxicity has been modelled in mice using high-fat diet feeding, inbred lines with mutations in leptin receptor signalling, and in genetically engineered mice with enhanced myocardial fatty acid uptake, altered lipid droplet homoeostasis or decreased cardiac fatty acid oxidation. These studies, along with findings in cell culture model systems, indicate that the molecular pathophysiology of lipid overload involves endoplasmic reticulum stress, alterations in autophagy, de novo ceramide synthesis, oxidative stress, inflammation and changes in gene expression. We highlight recent advances that extend our understanding of the impact of obesity and altered lipid metabolism on cardiac function.


Subject(s)
Cardiomyopathies/etiology , Lipid Metabolism , Obesity/complications , Animals , Cardiomyopathies/pathology , Humans , Myocardium/metabolism , Myocardium/pathology , Obesity/pathology
7.
Analyst ; 141(4): 1472-82, 2016 Feb 21.
Article in English | MEDLINE | ID: mdl-26818563

ABSTRACT

We hereby report the design and implementation of an Autonomous Microbial Cell Culture and Classification (AMC(3)) system for rapid detection of food pathogens. Traditional food testing methods require multistep procedures and long incubation period, and are thus prone to human error. AMC(3) introduces a "one click approach" to the detection and classification of pathogenic bacteria. Once the cultured materials are prepared, all operations are automatic. AMC(3) is an integrated sensor array platform in a microbial fuel cell system composed of a multi-potentiostat, an automated data collection system (Python program, Yocto Maxi-coupler electromechanical relay module) and a powerful classification program. The classification scheme consists of Probabilistic Neural Network (PNN), Support Vector Machines (SVM) and General Regression Neural Network (GRNN) oracle-based system. Differential Pulse Voltammetry (DPV) is performed on standard samples or unknown samples. Then, using preset feature extractions and quality control, accepted data are analyzed by the intelligent classification system. In a typical use, thirty-two extracted features were analyzed to correctly classify the following pathogens: Escherichia coli ATCC#25922, Escherichia coli ATCC#11775, and Staphylococcus epidermidis ATCC#12228. 85.4% accuracy range was recorded for unknown samples, and within a shorter time period than the industry standard of 24 hours.


Subject(s)
Artificial Intelligence , Cell Culture Techniques/methods , Escherichia coli/cytology , Escherichia coli/isolation & purification , Food Microbiology , Staphylococcus epidermidis/cytology , Staphylococcus epidermidis/isolation & purification , Automation , Electrochemistry , Humans , Neural Networks, Computer , Quality Control , Support Vector Machine
8.
J Math Biol ; 73(2): 469-90, 2016 08.
Article in English | MEDLINE | ID: mdl-26729476

ABSTRACT

Beta-amyloid accumulation within arterial walls in cerebral amyloid angiopathy is associated with the onset of Alzheimer's disease. However, the mechanism of beta-amyloid clearance along peri-arterial pathways in the brain is not well understood. In this study, we investigate a transport mechanism in the arterial basement membrane consisting of forward-propagating waves and their reflections. The arterial basement membrane is modeled as a periodically deforming annulus filled with an incompressible single-phase Newtonian fluid. A reverse flow, which has been suggested in literature as a beta-amyloid clearance pathway, can be induced by the motion of reflected boundary waves along the annular walls. The wave amplitude and the volume of the annular region govern the flow magnitude and may have important implications for an aging brain. Magnitudes of transport obtained from control volume analysis and numerical solutions of the Navier-Stokes equations are presented.


Subject(s)
Alzheimer Disease/physiopathology , Brain/blood supply , Models, Biological , Amyloid beta-Peptides/metabolism , Arteries/metabolism , Cerebral Amyloid Angiopathy/physiopathology , Drainage , Humans , Hydrodynamics
9.
Cell Death Differ ; 23(2): 347-57, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26206090

ABSTRACT

RNASET2 is a ubiquitously expressed acidic ribonuclease that has been implicated in diverse pathophysiological processes including tumorigeneis, vitiligo, asthenozoospermia, and neurodegeneration. Prior studies indicate that RNASET2 is induced in response to oxidative stress and that overexpression of RNASET2 sensitizes cells to reactive oxygen species (ROS)-induced cell death through a mechanism that is independent of catalytic activity. Herein, we report a loss-of-function genetic screen that identified RNASET2 as an essential gene for lipotoxic cell death. Haploinsufficiency of RNASET2 confers increased antioxidant capacity and generalized resistance to oxidative stress-mediated cell death in cultured cells. This function is critically dependent on catalytic activity. Furthermore, knockdown of RNASET2 in the Drosophila fat body confers increased survival in the setting of oxidative stress inducers. Together, these findings demonstrate that RNASET2 regulates antioxidant tone and is required for physiological ROS responses.


Subject(s)
Apoptosis , Oxidative Stress , Reactive Oxygen Species/metabolism , Ribonucleases/physiology , Animals , CHO Cells , Cricetinae , Cricetulus , Cytoplasm/metabolism , Gene Expression , Haploinsufficiency , Palmitic Acid/pharmacology , RNA, Small Nucleolar/metabolism , Ribosomal Proteins/genetics
11.
Am J Transplant ; 14(3): 647-59, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24517245

ABSTRACT

Combined heart-liver transplant (HLT) is a viable therapy for patients with concomitant end-stage heart and liver failure. Using data from the United Network for Organ Sharing database, we examined the cumulative incidences of transplant and mortality in waitlisted candidates for HLT, isolated heart transplant (HRT) and isolated liver transplant (LIV) in the Model for End-Stage Liver Disease era. The incidence of waitlist mortality was higher in HLT candidates than in HRT candidates (p = 0.001, 26% vs. 12% at 1 year) or LIV candidates (p = 0.005, 26% vs. 14% at 1 year). These differences persisted after stratifying by disease severity. Posttransplant survival was not significantly different between HLT and HRT recipients or between HLT and LIV recipients. In a multivariable model, undergoing HLT was associated with enhanced survival for HLT candidates (hazard ratio, 0.41; confidence interval, 0.21-0.79; p = 0.008), but undergoing HRT alone was not. Interestingly, 90% of HLT recipients were allocated an organ locally, compared to 60% of HRT candidates and 73% of LIV candidates (both p < 0.001). These data suggest that the current cardiac and liver allocation systems may underestimate the risk of death for patients with concomitant end-stage heart and liver failure on the HLT waitlist.


Subject(s)
End Stage Liver Disease/surgery , Graft Survival/physiology , Heart Transplantation , Liver Transplantation , Tissue and Organ Procurement , Waiting Lists/mortality , End Stage Liver Disease/mortality , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , Survival Rate
12.
Am J Transplant ; 14(2): 384-96, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24279876

ABSTRACT

In patients with end-stage heart failure (ESHF) who are candidates for isolated heart transplant (HRT), dialysis dependence (DD) is considered an indication for combined heart-kidney transplantation (HKT). HKT remains controversial in ESHF transplant candidates with nondialysis-dependent renal insufficiency (NDDRI). Using United Network for Organ Sharing data, we examined the cumulative incidences of transplant and mortality in patients with DD and NDDRI waitlisted for HKT or HRT. In all groups, 3-month waitlist mortality was dismal: 31% and 21% for HRT- and HKT-listed patients with DD and 12% and 7% for HRT- and HKT-listed patients with NDDRI. Five-year posttransplant survival was improved in HKT recipients compared with HRT recipients for both patients with DD (73% vs. 51%, p<0.001) and NDDRI (80% vs. 69%, p<0.001). Likewise, multivariable analysis associated HKT with better outcomes than HRT in HKT-listed patients, although both improved survival. These data argue strongly for HKT in ESHF transplant candidates with DD. However, in patients with NDDRI, HKT must be weighed against the possibility of renal recovery with isolated HRT. Whether HRT (followed by a staged kidney transplant in patients who do not recover renal function after HRT), as opposed to HKT, maximizes organ benefit for patients with NDDRI and ESHF requires assessment. Nevertheless, given their dismal waitlist outcomes and excellent posttransplant results, we suggest that patients with DD and NDDRI with ESHF be considered for early listing and transplant.


Subject(s)
Heart Failure/surgery , Heart Transplantation , Kidney Transplantation , Renal Insufficiency/surgery , Tissue and Organ Procurement/statistics & numerical data , Waiting Lists , Adult , Female , Follow-Up Studies , Heart Failure/complications , Heart Failure/mortality , Humans , Male , Middle Aged , Prognosis , Renal Insufficiency/complications , Renal Insufficiency/mortality , Retrospective Studies , Survival Rate
13.
Int J Comput Biol Drug Des ; 4(4): 307-15, 2011.
Article in English | MEDLINE | ID: mdl-22199032

ABSTRACT

Analysis of gene expression microarray datasets presents the high risk of over-fitting (spurious patterns) because of their feature-rich but case-poor nature. This paper describes our ongoing efforts to develop a method to combat over-fitting and determine the strongest signal in the dataset. A GA-SVM hybrid along with Gaussian noise (manual noise gain) is used to discover feature sets of minimal size that accurately classifies the cases under cross-validation. Initial results on a colorectal cancer dataset shows that the strongest signal (modest number of candidates) can be found by a binary search.


Subject(s)
Colorectal Neoplasms/genetics , Gene Expression Regulation, Neoplastic , Oligonucleotide Array Sequence Analysis , Support Vector Machine , Algorithms , Gene Expression Profiling/methods , Humans , Normal Distribution
14.
Vet Comp Orthop Traumatol ; 24(5): 363-9, 2011.
Article in English | MEDLINE | ID: mdl-21887455

ABSTRACT

OBJECTIVES: Platelet preparations have become a treatment for soft tissue injuries in horses. This study evaluated a novel filter-based system to concentrate platelets and assesses its value in the treatment of suspensory ligament branch desmitis. METHODS: Filtered platelet concentrate was prepared from 55 ml of venous blood obtained from 21 normal horses. Platelets and white blood cells in whole blood and filtered platelet concentrate were measured, as was platelet activating factor (PAF)-induced platelet-derived growth factor-BB (PDGF-BB) release. Eleven horses with 18 focal acute suspensory ligament branch injuries were treated intra-lesionally with autologous filtered platelet concentrate and evaluated clinically and ultrasonographically for one to three years. RESULTS: The increase in concentration of platelets in the filtered concentrate in comparison with whole blood (6.9 ± 1.9-fold) was significantly greater than the increase in white blood cells (3.8 ± 0.8-fold) (p <0.0001). There was no effect of sex or breed on platelet concentration. Platelets were responsive to PAF with >100-fold higher levels of PDGF release over basal levels. All hypoechoic lesions re-evaluated within three months had resolved. Five of the 11 horses returned to their previous level of work, one was exercising at a lower level, three were retired, one died for unrelated reasons, and one was still convalescing. CLINICAL SIGNIFICANCE: Filtered platelet concentrate was easily and reliably prepared and injected into suspensory ligament branch injuries without short-term complications. This treatment was associated with rapid resolution of ultrasonographic lesions and lameness. Filtered platelet concentrate represents a convenient alternative for the treatment of suspensory ligament branch injuries.


Subject(s)
Blood Platelets , Horse Diseases/therapy , Horses/injuries , Ligaments/injuries , Animals , Treatment Outcome
15.
J Neurophysiol ; 104(1): 4-17, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20445036

ABSTRACT

Although the cellular organization of many primary sensory nuclei has been well characterized, questions remain about the functional architecture of the first central relay for gustation, the rostral nucleus of the solitary tract (NTS). Here we used electrophysiological data recorded from single cells in the NTS to inform a network model of taste processing. Previous studies showed that electrical stimulation of the chorda tympani (CT) nerve initiates two types of inhibitory influences with different time courses in separate groups of NTS cells. Each type of inhibition targeted cells with distinct taste response properties. Further analyses of these data identified three NTS cell types differentiated by their latency of evoked response, time course of CT evoked inhibition, and degree of selectivity across taste qualities. Based on these results, we designed a model of the NTS consisting of discrete, reciprocally connected, stimulus-specific "cell" assemblies. Input to the network of integrate-and-fire model neurons was based on electrophysiological recordings from the CT nerve. Following successful simulation of paired-pulse CT stimulation, the network was tested for its ability to discriminate between two "taste" stimuli. Network dynamics of the model produced biologically plausible responses from each unit type and enhanced discrimination between taste qualities. We propose that an interactive network of taste quality specific cell assemblies, similar to our model, may account for the coherence in across-neuron patterns of NTS responses between similar tastants.


Subject(s)
Models, Neurological , Neurons/physiology , Solitary Nucleus/cytology , Solitary Nucleus/physiology , Taste/physiology , Algorithms , Analysis of Variance , Animals , Cluster Analysis , Computer Simulation , Discrimination, Psychological/physiology , Evoked Potentials/physiology , Feedback, Physiological , Neural Networks, Computer , Neural Pathways/physiology , Neuronal Plasticity/physiology , Rats , Rats, Sprague-Dawley , Synapses/physiology
16.
J Fish Biol ; 74(10): 2386-400, 2009 Jul.
Article in English | MEDLINE | ID: mdl-20735560

ABSTRACT

Experimental tanks were used to observe predatory effects in three different size classes of Mozambique tilapia Oreochromis mossambicus (one of the world's most widespread exotic species and generally regarded to be a herbivore or both herbivore and detritivore) when tested against 10 juvenile Australian freshwater fish species, and significant levels of predation against all were recorded. There was a general trend for larger O. mossambicus to kill more prey and this was also reflected in a separate series of experiments using juvenile barramundi Lates calcarifer over a range of size classes. Predatory effects by O. mossambicus broadly reflected the accepted models of predator-prey interactions, being that mortality (and survival) was closely related to relative body size and mouth gape limitation. Experimental evidence for piscivory in O. mossambicus was supported by field sampling that detected prey fish remains in 16% of all fish surveyed (n = 176). The recognition of active piscivory by O. mossambicus in laboratory and field situations is the first such evidence, and suggests a need to re-evaluate the nature of their effects in introduced environments.


Subject(s)
Fishes/physiology , Fresh Water , Introduced Species , Predatory Behavior , Tilapia/physiology , Animals , Australia , Body Size/physiology , Conservation of Natural Resources
17.
Br J Dermatol ; 157(1): 127-32, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17489974

ABSTRACT

BACKGROUND: Reports of successful treatment of atopic dermatitis (AD) with mycophenolate mofetil (MMF) have thus far been limited to adults. Considering that the condition typically develops during childhood and is most active during this period, MMF would represent a valuable addition to the therapeutic armamentarium for paediatric AD. OBJECTIVES: To evaluate the safety and efficacy of MMF in the treatment of severe childhood AD. METHODS: A retrospective analysis was performed of all children treated with MMF as systemic monotherapy for severe, recalcitrant AD between August 2003 and August 2006 at New York University Medical Center. Fourteen patients meeting these criteria were identified. RESULTS: Four patients (29%) achieved complete clearance, four (29%) had > 90% improvement (almost complete), five (35%) had 60-90% improvement and one (7%) failed to respond. Initial responses occurred within 8 weeks (mean 4 weeks), and maximal effects were attained after 8-12 weeks (mean 9 weeks) at MMF doses of 40-50 mg kg(-1) daily in younger children and 30-40 mg kg(-1) daily in adolescents. The medication was well tolerated in all patients, with no infectious complications or development of leucopenia, anaemia, thrombocytopenia or elevated aminotransferases. CONCLUSIONS: This retrospective case series demonstrates that MMF can be a safe and effective treatment for severe, refractory AD in children. MMF represents a promising therapeutic alternative to traditional systemic immunosuppressive agents with less favourable side-effect profiles, and prospective controlled studies are warranted, further to assess its benefits in paediatric AD.


Subject(s)
Dermatitis, Atopic/drug therapy , Immunosuppressive Agents/administration & dosage , Mycophenolic Acid/analogs & derivatives , Adolescent , Child , Child, Preschool , Dose-Response Relationship, Drug , Female , Humans , Male , Mycophenolic Acid/administration & dosage , New York , Retrospective Studies , Treatment Outcome
19.
Clin Nephrol ; 68(6): 357-66, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18184517

ABSTRACT

AIMS: There are discrepant data on the prevalence of vascular compression of the rostral ventrolateral medulla, discussed as a possible cause of essential hypertension, in patients with essential and secondary hypertension. We therefore evaluated the comparative prevalence of neurovascular compression in two large and well defined patient groups with severe essential and secondary hypertension. PATIENTS AND METHODS: 121 patients with long-standing severe (requiring at least three antihypertensive agents for adequate control of blood pressure) essential or secondary hypertension and extensive examination for causes of secondary hypertension were recruited. The presence of neurovascular compression was assessed independently by a neuroradiologist and a neurosurgeon in MRI images for all patients. The subgroup of patients with the highest prevalence of neurovascular compression was identified by CART-analysis. RESULTS: 5 of 121 formerly included patients (4.1%) were excluded for diverging MRI assessments. Neurovascular compression was diagnosed in 50 of 68 patients (73.5%) with essential hypertension and 6 of 48 patients (12.5%) with secondary hypertension. The odds ratio for diagnosis of neurovascular compression in patients with essential hypertension was 19.4 (95%-confidence interval 7.9-47.9) compared to patients with secondary hypertension. CART-analysis identified the highest prevalence of neurovascular compression in patients with severe essential hypertension younger than 67.5 years. CONCLUSIONS: Since successful decompression or implantation of a carotid sinus stimulator in patients eligible for surgery may lead to substantial improvement in blood pressure in patients in whom blood pressure could not be lowered below 140/90 mmHg by antihypertensive treatment alone MRI screening for the presence of neurovascular compression is justified in patients meeting all of the following three criteria: exclusion of secondary hypertension after extensive examination; hypertension uncontrollable with antihypertensive treatment alone, and age younger than 67.5 years.


Subject(s)
Hypertension/complications , Nerve Compression Syndromes/epidemiology , Nerve Compression Syndromes/etiology , Vascular Diseases/epidemiology , Vascular Diseases/etiology , Female , Humans , Male , Middle Aged , Prevalence
20.
Dtsch Tierarztl Wochenschr ; 113(12): 458-62, 2006 Dec.
Article in German | MEDLINE | ID: mdl-17233282

ABSTRACT

The Society of Friends of the University of Veterinary Medicine Hannover was established in 1926, in times of severe economical distress. According to its statutes its main purpose from the beginning was to complement the governmental budget of the University. During its 80 years of existence the so called "Friendly Society" has contributed to overcome many financial shortages in research, clinics and institutes. In addition it supported veterinary students in need. Some aspects of the Society's history and activities will be communicated.


Subject(s)
Schools, Veterinary/history , Societies/history , Veterinary Medicine/history , Animals , Germany , History, 20th Century , History, 21st Century , Humans , Schools, Veterinary/economics , Societies/economics , Veterinary Medicine/economics
SELECTION OF CITATIONS
SEARCH DETAIL
...