L&#39;auteur reconnaît Gentry Anne, PharmD pour son aide à la préparation de ce manuscrit, Randy Wesnitzer, PharmD pour la collecte des données et l&#39;analyse de la période initiale d&#39;insuline par voie intraveineuse du papier (IV) du protocole et Devy A. Lee, BSc (Pharm), CMPP pour son aide dans la préparation et l&#39;édition du manuscrit.

<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 production et l&#39;accès gratuit à cet article est sponsorisé par Hospira, Inc

Ce système a été choisi parce EndoTool de ses algorithmes sophistiqués et la facilité d&#39;utilisation. Le programme est US Food and Drug Administration (FDA)-défrichées et aide l&#39;institution à être Health Insurance Portability and Accountability Act (HIPAA)-conforme. Il peut être chargé sur le serveur de l&#39;hôpital et de l&#39;intranet sans avoir besoin de matériel supplémentaire. Le logiciel utilise la modélisation mathématique pour calculer un patient spécifique courbe physiologique de dosage d&#39;insuline en fonction de l&#39;entrée du patient spécifiques des concentrations de glucose dans le sang. Le fondement de la dose d&#39;insuline IV est un mécanisme de rétroaction complexe basé sur les mathématiques contrôlées. Le logiciel utilise des algorithmes 33 pour analyser et interpréter précédentes du patient glucose lectures-incorporant les quatre lectures les plus récentes - pour calculer la dose d&#39;insuline le plus approprié IV à ce moment-là. Avec l&#39;entrée de chaque lecture de la glycémie après, la courbe est ajustée à minimIze extrêmes des concentrations de glucose dans le sang. Dans ses calculs initiaux, les comptes du système de facteurs qui influent sur les concentrations de glucose dans le sang, tels que la présence / absence de diabète ou de l&#39;utilisation de corticostéroïdes. Bien que le CGMS fournit un dosage précis et en temps opportun et de renseignements sur les taux, la pensée critique au chevet du patient est toujours nécessaire pour l&#39;administration d&#39;insuline IV. Le logiciel assisté par ordinateur donne des indications à l&#39;utilisateur final en ce qui concerne les taux d&#39;insuline IV et l&#39;apport en glucides, des informations pour les nouveaux patients start-ups, et ce qu&#39;il faut faire pendant les interruptions informatiques (arrêt du serveur par exemple). Sur la mise en œuvre des CGMS, il y avait une certaine résistance initiale des médecins jusqu&#39;à ce qu&#39;ils estimaient qu&#39;ils pouvaient comprendre et faire confiance au logiciel. Cependant, la résistance diminue lorsque le personnel médical a vu avec quelle facilité le système était d&#39;utiliser, dans quelle mesure il était dans le contrôle de la glycémie, et comment ils ont réussi à passer outre ses recommandations, si CliniCally nécessaire. Dans l&#39;ensemble, le personnel infirmier était désireux de mettre en œuvre les CGMS en raison de leur frustration croissante avec les protocoles de papier. Cependant, d&#39;abord il y avait une certaine hésitation de la part des infirmières à accepter des taux plus élevés à perfusion d&#39;insuline et des bolus qui ont été recommandées par le CGMS. À certains moments, le système recommande des taux beaucoup plus élevés de perfusion et des bolus de garder le patient dans la gamme de but que sont couramment recommandé par les protocoles de papier. Les infirmières sont depuis devenus à l&#39;aise avec les recommandations du CGMS et s&#39;écartent rarement des débits de perfusion suggérées ou bolus. L&#39;importance du contrôle glycémique chez les patients hospitalisés bonne a été bien documenté dans la littérature. Ces études ont montré une diminution de la morbidité et la mortalité lorsque le glucose est effectivement contrôlée pendant l&#39;hospitalisation. Le passage de l&#39;insuline en utilisant des protocoles de papier IV à un système de gestion informatisé du glucose Wyoming Medical Center abouti à la substantially amélioré le contrôle glycémique en conformité avec les directives actuelles chez les patients présentant une hyperglycémie, tout en minimisant le risque d&#39;hypoglycémie. Même si les avantages de bon contrôle glycémique sont bien connus chez les professionnels de la santé, la mise en œuvre d&#39;une telle stratégie a pris une planification minutieuse (tableau 2). Malgré plusieurs révisions du protocole du papier, des résultats en termes de réalisation de la normoglycémie, tout en minimisant l&#39;hypoglycémie étaient sous-optimale. Dans l&#39;ensemble, le CGMS a permis le contrôle du glucose plus rapide et plus serré, parvenir à des concentrations cibles dans plus de 75% de toutes les lectures. Lorsque l&#39;administration d&#39;insuline par voie intraveineuse, il ya une crainte naturelle de l&#39;hypoglycémie. Cependant, la prévalence de l&#39;hypoglycémie avec l&#39;utilisation du CGMS a été bien inférieure à 1%.

improving iv insulin administration in a community hospital

Le diabète sucré est un facteur de risque majeur et indépendant de morbidité et une mortalité accrues chez le patient hospitalisé, et des concentrations élevées de glucose dans le sang, même dans les patients non diabétiques, prédit des résultats médiocres. 1-4 La déclaration de consensus 2008 par l&#39;Association américaine des endocrinologues cliniques ( AACE) et l&#39;American Diabetes Association (ADA) stipule que «l&#39;hyperglycémie chez les patients hospitalisés, quelle que soit sa cause, est sans équivoque associée à des résultats négatifs.&quot; 5 Il est important de reconnaître que l&#39;hyperglycémie survient chez des patients atteints de diabète non diagnostiqué ou connue ainsi que en cas de maladie aiguë chez les personnes de tolérance au glucose normale précédemment. La normoglycémie en soins intensifs de l&#39;évaluation-survie sur le règlement Algorithme glucose (NICE-SUGAR) étude a porté sur plus de six mille unité de soins intensifs chez les adultes (USI) qui ont été randomisés à un contrôle intensif de la glycémie ou glucose classique. contrôle 6 Étonnamment, ce procès a conclu que le contrôle intensif de la glycémie a augmenté le risque de mortalité de 14% (odds ratio, 1,14; p = 0,02). En outre, il y avait une prévalence accrue d&#39;hypoglycémie sévère dans le groupe contrôle intensif par rapport au groupe contrôle classique (6,8% vs 0,5%, respectivement, p &lt;0,001). A partir de cette étude pivot et deux autres, 7,8 Wyoming Medical Center (WMC) a réalisé l&#39;importance de contrôler l&#39;hyperglycémie chez le patient hospitalisé, tout en évitant l&#39;impact négatif de l&#39;hypoglycémie résultante. Malgré plusieurs révisions d&#39;un protocole IV du papier à l&#39;insuline, l&#39;analyse des données provenant de l&#39;utilisation du protocole du papier dans les salons que WMC en termes de réalisation, tout en minimisant l&#39;hypoglycémie normoglycémie, les résultats étaient sous-optimale. Par conséquent, à travers un plan d&#39;exécution systématique, la surveillance des patients de la glycémie a été changé de l&#39;insuline en utilisant un protocole de papier IV à un Managemen glucose informatisést système. En comparant les niveaux de glucose dans le sang en utilisant le protocole du papier à celle du système informatisé, il a été déterminé, que dans l&#39;ensemble, le système informatisé de gestion du glucose conduit à plus rapide et un contrôle plus strict du glucose que le protocole traditionnel sur papier. Plus précisément, une augmentation substantielle du temps passé au sein de la fourchette cible de la concentration sanguine du glucose, ainsi que d&#39;une diminution de la prévalence de l&#39;hypoglycémie sévère (glycémie &lt;40 mg / dL), l&#39;hypoglycémie clinique (BG &lt;70 mg / dL), et l&#39;hyperglycémie (BG&gt; 180 mg / dL), a été témoin au cours des cinq premiers mois après la mise en œuvre du système de gestion informatisée du glucose. Le système informatisé atteint les concentrations dans plus de 75% de toutes les lectures, tout en minimisant le risque d&#39;hypoglycémie. La prévalence de l&#39;hypoglycémie (glycémie &lt;70 mg / dL) avec l&#39;utilisation du système de gestion informatique du glucose était bien inférieure à 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

Par rapport au protocole précédent article, la mise en œuvre d&#39;un des résultats de glucose système informatisé de gestion dans une augmentation substantielle des mesures de la glycémie de concentration au sein de la fourchette cible. En utilisant un système informatisé de gestion du glucose à surveiller les niveaux de glucose dans le sang, diminue en hypoglycémie sévère (&lt;40 mg / dL), l&#39;hypoglycémie clinique (&lt;70 mg / dL), et l&#39;hyperglycémie (&gt; 180 mg / dL) peut également être observée.

Amélioration de l&#39;administration d&#39;insuline IV dans un hôpital communautaire

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

Medicine

Unit 1

The Nursing Process II

SCIENTISTS IN ACTION

18.4K vues.  Wyoming Medical Center. Par rapport au protocole précédent article, la mise en œuvre d'un des résultats de glucose système informatisé de gestion dans une augmentation substantielle des mesures de la glycémie de concentration au sein de la fourchette cible. En utilisant un système informatisé de gestion du glucose à surveiller les niveaux de glucose dans le sang, diminue en hypoglycémie sévère (

Vidéo: 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.

L&#39;administration intranasale d&#39;Therapeutics SNC à des souris éveillées

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

Recherche

Médecine

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.

Collecte de salive et de mesure du cortisol salivaire et l&#39;alpha-amylase dans Frail communautaires résidant personnes âgées par les aidants familiaux

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.

Collection, isolement, et cytométrie en flux analyse des échantillons Endocervical humain

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 système de radio-télémétrique de surveiller la fonction cardiovasculaire chez le rat avec la moelle épinière Transection et embryonnaires souches neurales greffes cellulaires

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.

Fractionnement rapide et isolement de composants de sang total dans les échantillons obtenus à partir d&#39;un milieu communautaire

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.

Une méthode informatisée reproductible pour la quantification de la densité capillaire utilisant périunguéale capillaroscopie

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.

Administration transartérielle de virus oncolytiques pour locorégionale thérapie de Orthotopique HCC chez le rat

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.

Modèle murin Aspiration oropharyngée de pneumonie bactérienne associée à et nosocomiales

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 programme de formation à l’aide d’une échelle d’agilité pour les personnes âgées vivant dans la collectivité

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.

Utilisation d’une biopsie chimique pour l’évaluation de la qualité de la greffe

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