El autor reconoce Gentry Anne, Farmacia por su ayuda en la preparación de este manuscrito, Randy Wesnitzer, Farmacia para la recogida y análisis de datos del primer documento de protocolo de insulina intravenosa (IV) y Devy A. Lee, BSc (Pharm), para el CMPP su ayuda en la preparación de la edición y manuscrito.

<ol>
	<li>Umpierrez, G. E., Isaacs, S. D., Bazargan, N., You, X., Thaler, L. M., Ktabchi, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hyperglycemia:+an+independent+marker+of+in-hospital+mortality+in+patients+with+undiagnosed+diabetes.">Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes.</a> J. Clin. Endocrinol. Metab. 87, 978-982 (2002).</li><li>Bochicchio, G. V., Sung, J., Josh, M. I., Bochicchio, K., Johnson, S. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Persistent+hyperglycemia+is+predictive+of+outcome+in+critically+ill+trauma+patients.">Persistent hyperglycemia is predictive of outcome in critically ill trauma patients.</a> J. Trauma. 58, 921-924 (2005).</li><li>Finfer, S., Delaney, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tight+glycemic+control+in+critically+ill+adults.">Tight glycemic control in critically ill adults.</a> JAMA. 300, 963-965 (2008).</li><li>American Diabetes Association. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Standards+of+medical+care+in+diabetes-2008.">Standards of medical care in diabetes-2008.</a> Diabetes Care. 31, S12-S54 (2008).</li><li>Moghissi, E. S., Korytkowski, M. T., DiNardo, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=American+Association+of+Clinical+Endocrinologists+and+American+Diabetes+Association+Consensus+statement+on+inpatient+glycemic+control.">American Association of Clinical Endocrinologists and American Diabetes Association Consensus statement on inpatient glycemic control.</a> Endocr. Pract. 15, 1-17 (2009).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+NICE-SUGAR+Study+Investigators.+Intensive+versus+conventional+glucose+control+in+critically+ill+patients.">The NICE-SUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients.</a> N. Engl. J. Med. 360, 1283-1297 (2009).</li><li>Brunkhorst, F. M., Engel, C., Bloos, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intensive+insulin+therapy+and+pentastarch+resuscitation+in+severe+sepsis.">Intensive insulin therapy and pentastarch resuscitation in severe sepsis.</a> N. Engl. J. Med. 358, 125-139 (2008).</li><li>Griesdale, D. E., de Souza, R. J., van Dam, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intensive+insulin+therapy+and+mortality+among+critically+ill+patients:+a+meta-analysis+including+NICE-SUGAR+study+data.">Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data.</a> CMAJ. 180, 821-827 (2009).</li><li>Van den Berghe, G., Wilmer, A., Hermans, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intensive+insulin+therapy+in+the+medical+ICU.">Intensive insulin therapy in the medical ICU.</a> N. Engl. J. Med. 354, 449-461 (2006).</li><li>Trence, D. L., Kelly, J. L., Hirsch, I. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+rationale+and+management+of+hyperglycemia+for+in-patients+with+cardiovascular+disease:+time+for+change.">The rationale and management of hyperglycemia for in-patients with cardiovascular disease: time for change.</a> J. Clin. Endocrinol Metab. 88, 2430-2437 (2003).</li></ol>

La producción y el libre acceso a este artículo es patrocinado por Hospira, Inc.

Este sistema EndoTool fue elegido debido a sus algoritmos sofisticados y facilidad de uso. El programa es EE.UU. Food and Drug Administration (FDA)-despejado y ayuda a la institución en ser Health Insurance Portability and Accountability Act (HIPAA) compatible. Puede ser cargado en el servidor del hospital y de la intranet, sin necesidad de hardware adicional. El software utiliza modelos matemáticos para el cálculo de un paciente específico de la curva fisiológica de la dosis de insulina sobre la base de la entrada de pacientes específicos de las concentraciones de glucosa en sangre. La base de la dosis de insulina IV es un mecanismo complejo de retroalimentación basado en las matemáticas controladas. El software utiliza algoritmos de 33 para analizar e interpretar de los pacientes anteriores lecturas de glucosa-que incorporan las cuatro lecturas más recientes - para calcular la dosis de insulina IV más apropiado en ese punto en el tiempo. Con la entrada de cada lectura de glucosa en sangre posterior, la curva se ajustó a minimIze extremos en las concentraciones de glucosa en sangre. En sus cálculos iniciales, las cuentas del sistema de factores que afectan las concentraciones de glucosa en sangre, como la presencia / ausencia de la diabetes o el uso de los corticosteroides. Aunque el CGMS ofrece una dosificación precisa y oportuna y la información de la tasa, el pensamiento crítico en la cabecera sigue siendo necesaria para la administración de insulina IV. El software guiado por computadora proporciona una guía para el usuario final respecto a las tasas IV de insulina y la ingesta de hidratos de carbono, información para pacientes nuevos start-ups, y qué hacer durante las interrupciones de ordenador (es decir, el tiempo de inactividad del servidor). Tras la implementación del CGMS, hubo cierta resistencia inicial de los médicos hasta que sintieron que podían entender y confiar en el software. Sin embargo, la resistencia disminuye cuando el personal médico vio lo fácil que era el sistema a utilizar, lo efectivo que era en el control de las concentraciones de glucosa en la sangre, y cómo fueron capaces de anular sus recomendaciones, si clinically necesario. En general, el personal de enfermería estaba ansioso de poner en práctica las CGMS debido a su creciente frustración con los protocolos de papel. Sin embargo, en un principio hubo algunas dudas de las enfermeras en la aceptación de las tasas más altas de insulina de infusión y dosis en bolo que fueron recomendados por los CGMS. En ocasiones, el sistema le recomendaría mucho más altas tasas de infusión y dosis en bolo para mantener al paciente en el rango meta que se recomienda con frecuencia por los protocolos de papel. Las enfermeras se han convertido en cómodos con las recomendaciones del CGMS y rara vez se apartan de las tasas de infusión o sugeridos dosis en bolo. La importancia de un buen control glucémico en pacientes hospitalizados ha sido bien documentada en la literatura. Estos estudios han demostrado una disminución de la morbilidad y la mortalidad cuando la glucosa se controla eficazmente durante la hospitalización. El cambio de uso de protocolos de insulina IV de papel a un sistema informatizado de gestión de la glucosa en Wyoming Medical Center dio lugar a la sustancially mejoró el control glucémico, de acuerdo con las directrices actuales en los pacientes con hiperglucemia y reducir al mínimo el riesgo de hipoglucemia. A pesar de que los beneficios de un buen control glucémico son bien conocidos entre los profesionales de la salud, la aplicación de esa estrategia tuvo una planificación cuidadosa (Tabla 2). A pesar de múltiples revisiones del protocolo de papel, los resultados en términos de lograr normoglucemia tiempo que minimiza la hipoglucemia fueron óptimos. En general, CGMS permite el control de la glucosa más rápido y más fuerte, logrando concentraciones objetivo mayor del 75% de todas las lecturas. Cuando la administración de insulina por vía intravenosa, existe el temor natural de la hipoglucemia. Sin embargo, la prevalencia de hipoglucemia con el uso de GCSM era muy inferior al 1%.

improving iv insulin administration in a community hospital

La diabetes mellitus es un factor importante de riesgo independiente de aumento de la morbilidad y la mortalidad en el paciente hospitalizado, y concentraciones elevadas de glucosa en la sangre, incluso en pacientes no diabéticos, predice malos resultados. 1.4 La declaración de consenso 2008 por la Asociación Americana de Endocrinólogos Clínicos ( AACE) y la Asociación Americana de Diabetes (ADA) establece que &quot;la hiperglucemia en pacientes hospitalizados, independientemente de su causa, está inequívocamente asociada con resultados adversos.&quot; 5 Es importante reconocer que la hiperglucemia se presenta en pacientes con diabetes conocida o no diagnosticada, así como durante la enfermedad aguda en los pacientes con tolerancia a la glucosa previamente normal. La normoglucemia en Cuidados Intensivos de evaluación-la supervivencia utilizando el algoritmo regulación de la glucosa (NICE-SUGAR) estudio incluyó a más de seis mil adultos unidad de cuidados intensivos (UCI) de los pacientes que fueron aleatorizados a un control intensivo de la glucosa o glucosa convencional. de control 6 Sorprendentemente, este estudio encontró que el control intensivo de la glucosa aumenta el riesgo de mortalidad en un 14% (odds ratio, 1,14, p = 0,02). Además, hubo un aumento de la prevalencia de hipoglucemia grave en el grupo de control intensivo de la comparación con el grupo de control convencional (6,8% vs 0,5%, respectivamente, p &lt;0,001). A partir de este ensayo pivotal y otros dos, 7,8 Wyoming Medical Center (WMC), se dio cuenta de la importancia de controlar la hiperglucemia en el paciente hospitalizado, evitando el impacto negativo de la hipoglucemia resultante. A pesar de múltiples revisiones de un protocolo de trabajo IV a la insulina, el análisis de los datos de uso del protocolo de papel en las demostraciones de WMC que, en términos de lograr normoglucemia y reducir al mínimo la hipoglucemia, los resultados fueron óptimos. Por lo tanto, a través de un plan de aplicación sistemática, el seguimiento de los pacientes los niveles de glucosa en la sangre se cambió el uso de un protocolo de trabajo IV de insulina a un managemen glucosa computarizadosistema de t. Al comparar los niveles de glucosa en sangre utilizando el protocolo de papel a la del sistema informatizado, se determinó, que, en general, el sistema informatizado de gestión de la glucosa como resultado más rápido y más estricto control de la glucosa que el protocolo de papel tradicional. Específicamente, un aumento sustancial en el tiempo dedicado dentro del intervalo objetivo concentración de glucosa en sangre, así como una disminución en la prevalencia de hipoglucemia grave (BG &lt;40 mg / dl), hipoglucemia clínica (BG &lt;70 mg / dl), y la hiperglucemia (BG&gt; 180 mg / dl), fue presenciado en los primeros cinco meses después de la implementación del sistema computarizado de gestión de la glucosa. El sistema informático se lograron concentraciones en más del 75% de todas las lecturas y reducir al mínimo el riesgo de hipoglucemia. La prevalencia de hipoglucemia (BG &lt;70 mg / dl) con el uso del sistema informático de gestión de glucosa era muy inferior al 1%.

Watch this Scientific Journal Video about Improving IV Insulin Administration in a Community Hospital at JoVE.com

Improving IV Insulin Administration in a Community Hospital

Cuando se compara con el protocolo de trabajo anterior, la aplicación de los resultados de glucosa de un sistema informatizado de gestión en un aumento sustancial en las mediciones de concentración de glucosa en sangre dentro del rango meta. El uso de un sistema de gestión de la glucosa computarizado para monitorear los niveles de glucosa en sangre, disminución de la hipoglucemia severa (&lt;40 mg / dL), la hipoglucemia clínica (&lt;70 mg / dL), y la hiperglucemia (&gt; 180 mg / dL) también se puede observar.

Mejora de la administración IV de la insulina en un hospital de la comunidad

Diabetes mellitus is a major independent risk factor for increased morbidity and mortality in the hospitalized patient, and elevated blood glucose ...

improving-iv-insulin-administration-in-a-community-hospital

Research

Education

JoVE Core

JoVE Journal

Nursing

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Unit 1

The Nursing Process II

SCIENTISTS IN ACTION

18.4K vistas.  Wyoming Medical Center. Cuando se compara con el protocolo de trabajo anterior, la aplicación de los resultados de glucosa de un sistema informatizado de gestión en un aumento sustancial en las mediciones de concentración de glucosa en sangre dentro del rango meta. El uso de un sistema de gestión de la glucosa computarizado para monitorear los niveles de glucosa en sangre, disminución de la hipoglucemia severa (

Video: Improving IV Insulin Administration in a Community Hospital

Intranasal Administration of CNS Therapeutics to Awake Mice

Intranasal administration is a method of delivering therapeutic agents to the central nervous system (CNS). It is non-invasive and allows large molecules that do not cross the blood-brain barrier access to the CNS. Drugs are directly targeted to the CNS with intranasal delivery, reducing systemic exposure and thus unwanted systemic side effects1. Delivery from the nose to the CNS occurs within minutes along both the olfactory and trigeminal neural pathways via an extracellular route and does not require drug to bind to any receptor or axonal transport2. Intranasal delivery is a widely publicized method and is currently being used in human clinical trials3.
Intranasal delivery of drugs in animal models allows for initial evaluation of pharmacokinetic distribution and efficacy. With mice, it is possible to administer drugs to awake (non-anesthetized) animals on a regular basis using a specialized intranasal grip. Awake delivery is beneficial because it allows for long-term chronic dosing without anesthesia, it takes less time than with anesthesia, and can be learned and done by many people so that teams of technicians can dose large numbers of mice in short periods. Efficacy of therapeutics administered intranasally in this way to mice has been demonstrated in a number of studies including insulin in diabetic mouse models 4-6 and deferoxamine in Alzheimer's mouse models. 7,8
The intranasal grip for mice can be learned, but is not easy and requires practice, skill, and a precise grip to effectively deliver drug to the brain and avoid drainage to the lung and stomach. Mice are restrained by hand using a modified scruff in the non-dominant hand with the neck held parallel to the floor, while drug is delivered with a pipettor using the dominant hand. It usually takes 3-4 weeks of acclimating to handling before mice can be held with this grip without a stress response. We have prepared this JoVE video to make this intranasal delivery technique more accessible.

A method to intranasally administer drugs to awake mice for the purpose of targeting the brain is described. This method allows for repeat dosing over long periods using intranasal administration of drug without anesthesia, and nose-to-brain delivery with minimal systemic exposure.

Administración intranasal de la terapéutica del SNC para Ratones Awake

Intranasal administration is a method of delivering  therapeutic agents to the central nervous system (CNS). It is  non-invasive and allows large ...

Investigación

Medicina

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

We demonstrate: (1) procedures for collection of salivary samples in cognitive impaired older adults by family caregivers in the home setting, (2) procedures for measuring stress activity via salivary cortisol and alpha amylase, and (3) representative profiles. Protocols that allow researchers to study stress-linked processes advance our understanding of biological sensitivity and susceptibility.

Recopilación de la saliva y la medición de cortisol salival y alfa-amilasa en Frail comunitarios residentes adultos mayores a través de Cuidadores de Familia

Salivary measures have emerged in bio-behavioral research  that are easy-to-collect, minimally invasive, and relatively inexpensive  biologic markers of ...

Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples

Despite the public health importance of mucosal pathogens (including HIV), relatively little is known about mucosal immunity, particularly at the female genital tract (FGT). Because heterosexual transmission now represents the dominant mechanism of HIV transmission, and given the continual spread of sexually transmitted infections (STIs), it is critical to understand the interplay between host and pathogen at the genital mucosa. The substantial gaps in knowledge around FGT immunity are partially due to the difficulty in successfully collecting and processing mucosal samples. In order to facilitate studies with sufficient sample size, collection techniques must be minimally invasive and efficient. To this end, a protocol for the collection of cervical cytobrush samples and subsequent isolation of cervical mononuclear cells (CMC) has been optimized. Using ex vivo flow cytometry-based immunophenotyping, it is possible to accurately and reliably quantify CMC lymphocyte/monocyte population frequencies and phenotypes. This technique can be coupled with the collection of cervical-vaginal lavage (CVL), which contains soluble immune mediators including cytokines, chemokines and anti-proteases, all of which can be used to determine the anti- or pro-inflammatory environment in the vagina.

The use of cytobrush sampling to collect lymphocytes and monocytes from the endocervix is a minimally invasive technique that provides samples for analysis of female genital tract immunity. In this protocol, we describe the collection of cytobrush samples and immune cell isolation for flow cytometry assays.

Colección, Aislamiento, y citometría de flujo análisis de las muestras endocervicales Humano

Despite the public health importance of mucosal pathogens (including HIV), relatively little is known about mucosal immunity, particularly at the female ...

A Radio-telemetric System to Monitor Cardiovascular Function in Rats with Spinal Cord Transection and Embryonic Neural Stem Cell Grafts

High thoracic or cervical spinal cord injury (SCI) can lead to cardiovascular dysfunction. To monitor cardiovascular parameters, we implanted a catheter connected to a radio transmitter into the femoral artery of rats that underwent a T4 spinal cord transection with or without grafting of embryonic brainstem-derived neural stem cells expressing green fluorescent protein. Compared to other methods such as cannula insertion or tail-cuff, telemetry is advantageous to continuously monitor blood pressure and heart rate in freely moving animals. It is also capable of long term multiple data acquisitions. In spinal cord injured rats, basal cardiovascular data under unrestrained condition and autonomic dysreflexia in response to colorectal distension were successfully recorded. In addition, cardiovascular parameters before and after SCI can be compared in the same rat if a transmitter is implanted before a spinal cord transection. One limitation of the described telemetry procedure is that implantation in the femoral artery may influence the blood supply to the ipsilateral hindlimb.

We present a protocol for using a radio-telemetric system to record cardiovascular parameters in T4 spinal cord transected rats eight weeks after embryonic brainstem neural stem cell grafting into the lesion site. Telemetry is an advanced technique to accurately evaluate cardiovascular function in conscious freely moving spinal cord injured rats.

Un sistema de radio-telemetría para monitorizar la función cardiovascular en ratas con la médula espinal y transección Embryonic Stem Neural injertos de células

High thoracic or cervical spinal cord injury (SCI) can lead to cardiovascular dysfunction. To monitor cardiovascular parameters, we implanted a catheter ...

Rapid Fractionation and Isolation of Whole Blood Components in Samples Obtained from a Community-based Setting

Collection and processing of whole blood samples in a non-clinical setting offers a unique opportunity to evaluate community-dwelling individuals both with and without preexisting conditions. Rapid processing of these samples is essential to avoid degradation of key cellular components. Included here are methods for simultaneous peripheral blood mononuclear cell (PBMC), DNA, RNA and serum isolation from a single blood draw performed in the homes of consenting participants across a metropolitan area, with processing initiated within 2 hr of collection. We have used these techniques to process over 1,600 blood specimens yielding consistent, high quality material, which has subsequently been used in successful DNA methylation, genotyping, gene expression and flow cytometry analyses. Some of the methods employed are standard; however, when combined in the described manner, they enable efficient processing of samples from participants of population- and/or community-based studies who would not normally be evaluated in a clinical setting. Therefore, this protocol has the potential to obtain samples (and subsequently data) that are more representative of the general population.

We outline a methodology for the processing of whole blood to obtain a variety of components for further analysis. We have optimized a streamlined protocol that enables rapid, high-throughput simultaneous processing of whole blood samples in a non-clinical setting.

Fraccionamiento rápida y aislamiento de componentes de sangre total en las muestras obtenidas a partir de una configuración basada en la comunidad

Collection and processing of whole blood samples in a non-clinical setting offers a unique opportunity to evaluate community-dwelling individuals both ...

A Reproducible Computerized Method for Quantitation of Capillary Density using Nailfold Capillaroscopy

Capillaroscopy is a non-invasive, efficient, relatively inexpensive and easy to learn methodology for directly visualizing the microcirculation. The capillaroscopy technique can provide insight into a patient&#8217;s microvascular health, leading to a variety of potentially valuable dermatologic, ophthalmologic, rheumatologic and cardiovascular clinical applications. In addition, tumor growth may be dependent on angiogenesis, which can be quantitated by measuring microvessel density within the tumor. However, there is currently little to no standardization of techniques, and only one publication to date reports the reliability of a currently available, complex computer based algorithms for quantitating capillaroscopy data.1 This paper describes a new, simpler, reliable, standardized capillary counting algorithm for quantitating nailfold capillaroscopy data. A simple, reproducible computerized capillaroscopy algorithm such as this would facilitate more widespread use of the technique among researchers and clinicians. Many researchers currently analyze capillaroscopy images by hand, promoting user fatigue and subjectivity of the results. This paper describes a novel, easy-to-use automated image processing algorithm in addition to a reproducible, semi-automated counting algorithm. This algorithm enables analysis of images in minutes while reducing subjectivity; only a minimal amount of training time (in our experience, less than 1 hr) is needed to learn the technique.

Capillaroscopy is a non-invasive, efficient, relatively inexpensive and easy-to-learn methodology for directly visualizing capillaries in the microcirculation. However, only one publication to date describes the reliability of a complex software program available for quantitating capillaroscopy data. Here, we present a simple, reliable protocol for quantitating capillaries using a standardized algorithm.

Un método computarizado reproducible para la cuantificación de la densidad capilar utilizando periungueal capilaroscopia

Capillaroscopy is a non-invasive, efficient, relatively inexpensive and easy to learn methodology for directly visualizing the microcirculation. The ...

Transarterial Administration of Oncolytic Viruses for Locoregional Therapy of Orthotopic HCC in Rats

Hepatocellular carcinoma (HCC) is a disease with limited treatment options and poor prognosis. In recent years, oncolytic virotherapies have proven themselves to be potentially powerful tools to fight malignancy. Due to the unique dual blood supply in the liver, it is possible to apply therapies locally to orthotopic liver tumors, which are predominantly fed by arterial blood flow. We have previously demonstrated that hepatic arterial delivery of oncolytic viruses results in safe and efficient transduction efficiency of multifocal HCC lesions, resulting in significant prolongation of survival in immune competent rats. This procedure closely mimics the application of transarterial embolization in patients, which is the standard palliative care provided to many HCC patients. The ability to administer tumor therapies through the hepatic artery in rats allows for a highly sophisticated preclinical model for evaluating novel viral vectors under development. Here we describe the detailed protocol for microdissection of the hepatic artery for infusion of oncolytic virus vectors to treat orthotopic HCC.

Oncolytic virotherapies are under development as novel therapeutics for the treatment of hepatocellular carcinoma (HCC). Here we describe a method for locoregional therapy of HCC via hepatic arterial administration of oncolytic virus.

Administración transarterial de virus oncolíticos para locorregional Terapia de HCC ortotópico en ratas

Hepatocellular carcinoma (HCC) is a disease with limited treatment options and poor prognosis.  In recent years, oncolytic virotherapies have proven ...

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

Murine infection models are critical for understanding disease pathogenesis and testing the efficacy of novel therapeutics designed to combat causative pathogens. Infectious pneumonia is among the most common infections presented by patients in the clinic and thus warrants an appropriate in vivo model. Typical pneumonia models use intranasal inoculation, which deposits excessive organisms outside the lung, causing off-target complications and symptoms, such as sinusitis, gastritis, enteritis, physical trauma, or microparticle misting to mimic aerosol spread more typical of viral, tuberculous, or fungal pneumonia. These models do not accurately reflect the pathogenesis of typical community- or healthcare-acquired bacterial pneumonia. In contrast, this murine model of oropharyngeal aspiration pneumonia mimics the droplet route in healthcare-acquired pneumonia. Inoculating 50 &#181;L of the bacteria suspension into the oropharynx of anesthetized mice causes reflexive aspiration, which results in pneumonia. With this model, one can examine the pathogenesis of pneumonia-causing pathogens and new treatments to combat these diseases.

Infectious pneumonia is among the most common infections in human. An appropriate in vivo model is critical for understanding disease pathogenesis and testing the efficacy of novel therapeutics. With this murine oropharyngeal aspiration pneumonia model, one can examine the pathogenesis and new treatments against these deadly infections.

Modelo murino de aspiración orofaríngea de neumonía bacteriana asociada a la ventilación y adquirida en el Hospital

Murine infection models are critical for understanding disease pathogenesis and testing the efficacy of novel therapeutics designed to combat causative ...

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. The purpose of this study is to report the physical fitness benefits of a training program for independent community-dwelling older adults using an agility ladder. Each training session lasted approximately 30 minutes, and the benefits were achieved with two sessions per week for 14 weeks. Training was timed and involved four different drills and varying levels of difficulty through time. The exercises were performed at the School of Physical Education of the University of Campinas, S&#227;o Paulo state, Brazil. The study participants (n = 16; mean age of 66.9 &#177; 5.0 years) were instructed to perform the exercises as quickly as possible without making mistakes and were assisted by a physical trainer when they made mistakes. Assessments were performed both before and after training using five functional tests (i.e., Illinois agility, five times sit-to-stand, timed up-and-go, walking usual speed, and one-leg stand). Although the study sample was not compared with a control group, the results indicate that training protocols using an agility ladder are easy and practical and improve physical function performance in older adults.

The aim of this study is to present an agility training program for older people. The feasibility of this program is described, and the training protocol demonstrated by video imaging.

Un programa de capacitación que utiliza una escalera de agilidad para adultos mayores que viven en la comunidad

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. ...

Using a Chemical Biopsy for Graft Quality Assessment

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated with an increased survival rate and greater quality of patient&#8217;s life when compared to conventional dialysis. Regrettably, transplantology suffers from a lack of reliable methods for organ quality assessment. Standard diagnostic techniques are limited to macroscopic appearance inspection or invasive tissue biopsy, which do not provide comprehensive information about the graft. The proposed protocol aims to introduce solid phase microextraction (SPME) as an ideal analytical method for comprehensive metabolomics and lipidomic analysis of all low molecular compounds present in kidneys allocated for transplantation. The small size of the SPME probe enables performance of a chemical biopsy, which enables extraction of metabolites directly from the organ without any tissue collection. The minimum invasiveness of the method permits execution of multiple analyses over time: directly after organ harvesting, during its preservation, and immediately after revascularization at the recipient&#8217;s body. It is hypothesized that the combination of this novel sampling method with a high-resolution mass spectrometer will allow for discrimination of a set of characteristic compounds that could serve as biological markers of graft quality and indicators of possible development of organ dysfunction.

The protocol presents utilization of the chemical biopsy approach followed by comprehensive metabolomic and lipidomic analysis for quality assessment of kidney grafts allocated for transplantation.

Uso de una biopsia química para la evaluación de la calidad del injerto

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated ...