L&#39;autore riconosce Gentry Anne, PharmD per la sua assistenza con la preparazione di questo manoscritto, Randy Wesnitzer, PharmD per la raccolta dati e l&#39;analisi del periodo iniziale di insulina carta protocollo per via endovenosa (IV) e Devy A. Lee, BSc (Pharm), per CMPP la sua assistenza nella preparazione di editing e manoscritto.

<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>

Produzione e l&#39;accesso gratuito a questo articolo è sponsorizzato da Hospira, Inc.

Questo sistema EndoTool è stato scelto per i suoi sofisticati algoritmi e facilità d&#39;uso. Il programma è di US Food and Drug Administration (FDA)-eliminato e assiste l&#39;istituzione in essere Salute Insurance Portability and Accountability Act (HIPAA)-compliant. Può essere caricati sul server di dell&#39;ospedale intranet e senza la necessità di hardware aggiuntivo. Il software usa modellazione matematica per calcolare un paziente specifico fisiologica curva dosaggio dell&#39;insulina in base all&#39;ingresso delle concentrazioni ematiche specifiche di un paziente glucosio. La Fondazione per la dose di insulina IV è un meccanismo di feedback complessa basata sulla matematica controllate. Il software utilizza 33 algoritmi per analizzare e interpretare il paziente precedenti letture di glucosio-comprendente le quattro letture più recenti - per calcolare la dose di insulina più appropriato IV a quel punto nel tempo. Con l&#39;entrata di ogni successiva lettura di glucosio nel sangue, la curva viene regolato minimaizzare estremi delle concentrazioni di glucosio nel sangue. Nei suoi calcoli iniziali, gli account di sistema per i fattori che influenzano le concentrazioni di glucosio nel sangue, come la presenza / assenza di diabete o l&#39;uso di corticosteroidi. Sebbene il dosaggio CGMS fornisce accurate e tempestive e sulla frequenza, il pensiero critico al letto del paziente è ancora necessario per la somministrazione di insulina IV. Il computer-guidata software fornisce una guida per l&#39;utente finale per quanto riguarda i tassi di insulina IV e assunzione di carboidrati, informazioni per i nuovi pazienti start-up, e cosa fare durante le interruzioni di computer (server ad esempio i tempi di inattività). Al momento l&#39;attuazione delle CGMS, c&#39;era una certa resistenza iniziale da parte dei medici fino a quando ritenevano di poter capire e fidarsi del software. Tuttavia, la resistenza diminuisce quando il personale medico ha visto quanto sia facile il sistema era quello di utilizzare, quanto efficace è stato nel controllare la glicemia, e come sono stati in grado di ignorare le sue raccomandazioni, se clinically necessario. Nel complesso, il personale infermieristico era desideroso di attuare le CGMS a causa della loro crescente frustrazione con i protocolli di carta. Tuttavia, inizialmente c&#39;era qualche esitazione dalle infermiere ad accettare più elevati dei tassi di infusione di insulina e di dosi in bolo che sono stati raccomandati dai CGMS. A volte, il sistema consiglia di velocità di infusione più elevate e dosi bolo per mantenere il paziente nel range obiettivo di quelle comunemente raccomandato dai protocolli di carta. Le infermiere sono diventate agio con le raccomandazioni CGMS e raramente si discostano dalla velocità di infusione / suggerite dosi bolo. L&#39;importanza di un buon controllo glicemico in pazienti ospedalizzati è stato ben documentato in letteratura. Questi studi hanno dimostrato una riduzione della morbilità e mortalità quando il glucosio viene effettivamente controllato durante l&#39;ospedalizzazione. Il passaggio da utilizzare carta protocolli insulina IV ad un sistema computerizzato di gestione del glucosio a Wyoming Medical Center portato substantially migliorato il controllo glicemico in conformità con le attuali linee guida nei pazienti con iperglicemia, riducendo al minimo il rischio di ipoglicemia. Anche se i benefici di un buon controllo glicemico sono ben noti tra i professionisti sanitari, l&#39;attuazione di tale strategia ha avuto un&#39;attenta pianificazione (Tabella 2). Nonostante le revisioni multiple del protocollo di carta, i risultati in termini di raggiungimento normoglicemia, riducendo al minimo l&#39;ipoglicemia era subottimale. Nel complesso, CGMS permesso il controllo del glucosio più rapida e più stretta, raggiungendo concentrazioni target in più del 75% di tutte le letture. Quando la somministrazione di insulina endovenosa, vi è un timore naturale di ipoglicemia. Tuttavia, la prevalenza di ipoglicemia con l&#39;uso di CGMS era ben sotto 1%.

improving iv insulin administration in a community hospital

Il diabete mellito è un fattore importante di rischio indipendente per l&#39;aumento della morbilità e mortalità nel paziente ospedalizzato, ed aumento delle concentrazioni di glucosio nel sangue, anche in pazienti non diabetici, predice esiti negativi. 1-4 del 2008 dichiarazione di consenso da parte dell&#39;Associazione Americana degli endocrinologi clinici ( AACE) e l&#39;American Diabetes Association (ADA) afferma che &quot;l&#39;iperglicemia nei pazienti ospedalizzati, indipendentemente dalla sua causa, è inequivocabilmente associato ad esiti negativi.&quot; 5 E &#39;importante riconoscere che l&#39;iperglicemia si verifica nei pazienti con diabete noto o non diagnosticata così come durante la malattia acuta nei soggetti con normale tolleranza al glucosio in precedenza. La normoglicemia in Terapia Intensiva Valutazione sopravvivenza utilizzando l&#39;algoritmo di regolazione del glucosio (NICE-SUGAR) studio ha coinvolto più di seimila unità di terapie intensive per adulti (ICU) pazienti che sono stati randomizzati a controllo intensivo della glicemia o di glucosio convenzionale. di controllo 6 Sorprendentemente, questo studio ha trovato che il controllo intensivo della glicemia aumenta il rischio di mortalità del 14% (odds ratio 1,14, p = 0,02). Inoltre, c&#39;è stato un aumento della prevalenza di ipoglicemia grave nel gruppo controllo intensivo rispetto al gruppo di controllo convenzionali (6,8% vs 0,5%, rispettivamente, p &lt;0,001). Da questo studio registrativo e altri due, 7,8 Wyoming Medical Center (WMC) realizzato l&#39;importanza del controllo dell&#39;iperglicemia nel paziente ospedalizzato, evitando l&#39;impatto negativo di ipoglicemia risultante. Nonostante le revisioni multiple di un protocollo di carta di insulina IV, l&#39;analisi dei dati di utilizzo del protocollo di carta in mostra WMC che in termini di raggiungimento di normoglicemia, riducendo al minimo l&#39;ipoglicemia, i risultati sono stati ottimali. Pertanto, attraverso un piano di attuazione sistematica, monitoraggio dei livelli di glucosio nel sangue dei pazienti è stato acceso l&#39;uso di un foglio protocollo di insulina IV ad un managemen glucosio computerizzatot sistema. Confrontando i livelli di glucosio nel sangue utilizzando il protocollo di carta a quella del sistema computerizzato, è stato determinato, che nel complesso, il sistema computerizzato di gestione del glucosio comportato più rapida e controllo glicemico più stretto rispetto al protocollo carta tradizionale. In particolare, un aumento sostanziale del tempo trascorso all&#39;interno dell&#39;intervallo di concentrazione di glucosio nel sangue, nonché una diminuzione della prevalenza di ipoglicemia grave (BG &lt;40 mg / dL), ipoglicemia clinica (BG &lt;70 mg / dL), e iperglicemia (BG&gt; 180 mg / dL), si è assistito nei primi cinque mesi dopo l&#39;implementazione del sistema computerizzato di gestione del glucosio. Il sistema computerizzato raggiungevano le concentrazioni in più del 75% di tutte le letture, riducendo al minimo il rischio di ipoglicemia. La prevalenza di ipoglicemia (BG &lt;70 mg / dL) con l&#39;uso del sistema computerizzato di gestione del glucosio era ben al di sotto 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

Rispetto al protocollo precedente articolo, l&#39;attuazione di un sistema computerizzato di gestione dei risultati di glucosio in un sostanziale incremento nelle misurazioni della concentrazione di glucosio nel sangue entro l&#39;intervallo di destinazione. Utilizzando un sistema computerizzato di gestione del glucosio per monitorare i livelli di glucosio nel sangue, diminuisce in ipoglicemia grave (&lt;40 mg / dL), ipoglicemia clinica (&lt;70 mg / dL) e iperglicemia (&gt; 180 mg / dL) può anche essere osservato.

Migliorare La somministrazione di insulina IV in un ospedale di comunità

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

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18.4K Views.  Wyoming Medical Center. Rispetto al protocollo precedente articolo, l'attuazione di un sistema computerizzato di gestione dei risultati di glucosio in un sostanziale incremento nelle misurazioni della concentrazione di glucosio nel sangue entro l'intervallo di destinazione. Utilizzando un sistema computerizzato di gestione del glucosio per monitorare i livelli di glucosio nel sangue, diminuisce in ipoglicemia grave (

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.

Somministrazione intranasale di terapeutica del sistema nervoso centrale di topi Awake

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

Ricerca

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.

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.

Raccolta, isolamento e analisi citofluorimetrica di campioni endocervicali umano

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 radio-telemetria per monitorare la funzionalità cardiovascolare in ratti con midollo spinale e Transection embrionali staminali neurali Innesti cellulari

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.

Frazionamento rapida e isolamento dei componenti sangue intero in campioni ottenuti da una impostazione basata su Comunità

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 metodo computerizzato riproducibile per la quantificazione della densità capillare con letto ungueale Capillaroscopia

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.

Transarteriosa somministrazione di oncolitici virus per locoregionale Terapia delle ortotopico HCC in Rats

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.

Modello murino aspirazione orofaringea di polmonite batterica associata a ventilazione e acquisite in ospedale

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 programma di formazione con una scala di agilità per gli adulti anziani che vivono nella comunità

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.

Utilizzo di una biopsia chimica per la valutazione della qualità dell'innesto

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