This project was supported by Grant Numbers HL96593 from NIH and D56HP20783 from HRSA/ HHS. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or HRSA / HHS.

Nota: O processo de aquisição para a obtenção de imagens capilares foi publicado anteriormente e é realizada usando uma câmera fotográfica digital com um programa de computador de aquisição e análise de imagem correspondente 11 21 Este laboratório utiliza imagens estáticas para análise, não vídeos, simplificando a aquisição de imagens para análise.. O que se segue descreve a nova técnica para a quantificação dos capilares a partir das imagens. 1. Processo de Aperfeiçoamento de Imagem <ol><li> Obter imagens digitais com uma câmera digital monocromática. Calibrar as imagens para um objeto de tamanho conhecido por tirar uma foto de um objeto de comprimento conhecido como um governante com a câmera. Este processo permite que o programa de computador para medir com precisão e contar capilares após o processamento. O ideal para a mais alta precisão, deve ser usada uma retícula (peça cientificamente fabricados de vidro com uma régua gravada nela). Mede o número de pixels em um quadrado de 1 mmcaixa usando um programa de computador. Nota: A chave para a reprodutibilidade ea padronização desse protocolo depende em grande parte a colocação adequada da caixa de um milímetro 2 que é contado. </li><li> Use ferramentas de aprimoramento de contraste para escurecer os capilares e clarear o fundo, que irá maximizar a visualização dos vasos capilares. Diferenciação inicial de capilares a partir do fundo é importante para o recorte da imagem adequada em etapas posteriores. Para fazer isso, o ajuste da imagem usando um Para fazer isso, clique em &quot;melhor ajuste histograma.&quot;: Captura, intensidade, imagem histograma, melhor ajuste. </li><li> Cortar uma região de interesse (ROI) para a contagem capilar como uma nova imagem (selecionar, regiões de interesse). Use uma caixa de um milímetro 2, que foi determinada pela calibração das imagens a 530 pixels igualando 1 mm. verifique se a imagem recortada coloca o ápice das alças capilares no topo da imagem. </li><li> Achatar a imagem para que todos os ajustes de imagem futuras será aplicado uniformementea imagem. Para isso, clique em: guia processo, filtros 2D, alise, BG intensidade &quot;, brilhante&quot; width objeto para &quot;75&quot;, se aplicam. </li><li> Levante o contraste da imagem de forma capilares são maximamente visualizado. Para fazer isso, clique em: ajustar guia, exposição, levantar contraste com 75. </li><li> Despeckle a imagem para suavizar as bordas dos capilares, clicando na guia processo, filtros 2D, despeckle, tamanho do kernel 7 x 7, aplique. </li><li> Finalize o contraste da imagem de forma capilares são o preto eo fundo é branco. Execute esta etapa, ajustando o histograma para o &quot;melhor ajuste&quot; do modelo. Nota: Por favor, consulte a Figura 2 em resultados representativos para um exemplo do que a imagem processada deve ser semelhante a de seguir estes passos. </li></ol> 2. Executando Counts capilares / quantificação de densidade capilar <ol><li> Em cada imagem, selecionar manualmente uma parte de um capilar bem definida usando o featur &quot;target objeto&quot;E para ser reconhecido como objectos a serem contados pelo programa. Em seguida, selecione uma pequena parte do fundo, usando o recurso de &quot;base&quot;, como uma referência para as áreas que precisam ser desconsiderada pelo algoritmo de contagem. Nota: A combinação desses destaques faz com que todos os capilares a ser destacado ignorando o ruído de fundo. A (contagem) protocolo de quantificação utiliza as funções do computador para diferenciar partes da imagem com base na cor e morfologia. </li><li> Use a função de contagem para contar instantaneamente todos os capilares na imagem com o equipamento de imagem. Definir o diâmetro mínimo de objectos contados a 5 pixels, a fim de evitar a contagem de ruído de fundo como capilares. </li><li> Para cada indivíduo, a contagem média de 3 - 4 imagens, a fim de se obter uma avaliação mais fiável. Nota: Por favor, consulte a Figura 3 em resultados representativos para um exemplo do que a imagem deve ser semelhante durante o processo de contagem. </li></ol&gt; 3. Criar e utilizar macros para automatizar Processamento de Imagem Nota: Para economizar tempo, macros podem ser criados a fim de executar automaticamente uma seqüência específica de processos em uma ou várias imagens. Estas sequências podem ser personalizados, a fim de fazer as modificações imagem mais rápido. Em essência, esses macros lembrar de como as imagens são processadas, e executar todas as etapas de forma rápida e sem entrada do usuário. Realizando conta com 12 imagens capilares leva este laboratório entre 20 a 30 minutos com as macros (2 a 3 minutos por imagem), em oposição a cerca de 8 minutos por imagem sem as macros. Por conseguinte, utilizar as macros é 3 a 5 vezes mais eficiente do que o processamento manualmente cada imagem individual. <ol><li> A fim de criar uma macro, selecione &quot;Gravar Macro&quot; e em uma imagem execute as etapas e processos desejado, conforme descrito nas etapas 1 e 2 acima. Nome da macro com base na qual a imagem de processamento etapas foram executadas para referência futura. Quando using a macro sobre as futuras imagens, basta clicar em &quot;Executar macro&quot; eo programa aplicará automaticamente as melhorias registadas para a imagem (s) desejada. Nota: Este laboratório usa uma macro para executar todos, mas um dos passos na Seção 1 dos métodos em poucos segundos. O único passo que requer entrada do usuário é escolher onde cortar a imagem, Passo 1.2. </li></ol>

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The authors have no conflicts of interest.

A capilaroscopia periungueal mostra promessa como uma ferramenta clinicamente útil no futuro para vários oncologia, cardiovascular, e aplicações de doenças reumatológicas. O processo de aquisição de imagem é bastante consistente entre os pesquisadores, ainda existem atualmente vários métodos de processamento e análise de imagem. Os métodos incluem atualmente contagens informatizados e manuais capilares. Contagens manuais são problemáticas como eles são demorados e sujeitos a subjetividade do usuário e f...

Imaging microvascular é um campo de rápido crescimento, com muitos potenciais aplicações clínicas. 2 Por exemplo, os oncologistas estão usando imagens de microvasos para determinar a extensão da angiogénese tumoral, produzindo informações valiosas sobre o estado do tumor e insights sobre possíveis opções de tratamento. 3 4 Contudo, capilaroscopia periungueal é talvez a forma eficiente e amplamente aplicáveis ​​maioria de custo da imagiologia microvascular. Os pesquisadores estão usando o vídeo capilaroscopia periungueal para estudar as taxas de fluxo de sangue e investigar a morfologia capilar. 5 6 Ambos vídeo e de imagem estática capilaroscopia periungueal são adjuntos para cuidar de diagnóstico e tratamento de fenômeno e várias doenças do tecido conjuntivo de Raynaud, como a esclerose sistêmica. 2 A capilaroscopia periungueal tem várias aplicações potenciais cardiovasculares também. A pesquisa atual sugere usando capilaroscopia periunguealque diabetes mellitus tipo 1 e tipo 2 pacientes apresentam uma elevada prevalência de morfologia capilar anormal, ainda têm densidades capilares inalteradas em comparação com indivíduos não-diabéticos. 7-8 Capilaroscopia também tem sido estudada experimentalmente em hipertensão. Rarefação capilar estrutural que conduz a uma reduzida densidade capilar tem sido demonstrada em indivíduos hipertensos quando comparados com indivíduos não-hipertensos. 9-10 Em contraste com estes pacientes hipertensos mais velhos que apresentam rarefação estrutural, a pesquisa mais recente tem demonstrado que (idade 40 e acima de média) pacientes hipertensos mais jovens (idade média de menos de 40 anos de idade) têm rarefação funcional sem rarefação estrutural. 11 Isto sugere que a rarefação funcional ocorre antes e pode evoluir ao longo do tempo a rarefação estrutural. Curiosamente, os pacientes hipertensos tratados com drogas anti-hipertensivas específicas, tais como perindopril / indapamida exibido normaal densidade capilar e função endotelial após o tratamento, enquanto aqueles tratados com ACE (conversora da angiotensina-enzima) inibidores ou diuréticos manteve uma baixa densidade capilar apesar do controle da pressão arterial comparável. 12 Isto sugere que alguns medicamentos anti-hipertensivos podem normalizar a densidade capilar, invertendo o capilar rarefação causada por hipertensão. Além disso, outros pesquisadores demonstraram que uma redução no consumo de sal leva à reversão de ambos rarefação capilar funcional e estrutural em indivíduos hipertensos 13. Apesar das várias aplicações clínicas potenciais desta tecnologia, há pouca padronização da técnica para quantificar imagens densidade capilar. 2 Até o momento, os pesquisadores descobriram que os resultados de densidade capilar são reprodutíveis tanto intra-observador e inter-observador perspectiva apenas se o exato mesma área está sendo contado cada vez que 1,14 15. </sup&gt; De nota, os pesquisadores anteriores já largamente executada contagens capilares manualmente usando a olho nu, 9 16 17 18, que é um processo lento e subjetivo. , Baseados em computador algoritmos padronizados para quantificação de imagens capilares, teoricamente, fornecer uma análise de dados mais eficiente e reprodutível com menos subjetividade, facilitando aplicações clínicas da capilaroscopia. Alguns pesquisadores têm realmente usado programas baseados em computador para quantificar os dados a partir das cutículas imagens capilaroscópicos. 1,6 19 20 No entanto, apenas uma publicação a data descreve a confiabilidade de um programa de software complexo disponíveis para quantificar dados capilaroscópicas, 1 e este programa é complicada como anteriormente mencionado acima pela exigência de contar no mesmo campo visual exata. Aqui, nós apresentamos, um protocolo simples para a quantificação fiável capilares utilizando um algoritmo normalizado que permitea utilização de vários campos visuais. A utilização de vários campos visuais não só simplifica o processo, mas também permite a avaliação da variação biológica normal em contagem capilar. O objetivo deste estudo é descrever um algoritmo baseado em computador reprodutível e eficiente que padroniza o processo de quantificação capilar. Embora estes métodos não são totalmente automatizados que exigem entrada muito pouco do usuário e fornecer a quantificação rápida e confiável das imagens.

<table>
	<tbody>
		<tr>
			<td class="xl65">Image-Pro Premier</td>
			<td class="xl65">Media Cybernetics, Inc</td>
			<td align="right" class="xl63">9.1</td>
			<td class="xl63">Image processing software</td>
		</tr>
	</tbody>
</table>

a reproducible computerized method for quantitation of capillary density using nailfold capillaroscopy

A capilaroscopia é uma metodologia não-invasiva, eficaz, relativamente barata e fácil de aprender para visualizar diretamente a microcirculação. A técnica capilaroscopia pode fornecer insights sobre microvascular saúde de um paciente, levando a uma variedade de dermatológica potencialmente valiosa, oftalmológica, aplicações clínicas reumatológicas e cardiovasculares. Além disso, o crescimento de tumores pode ser dependente da angiogénese, que pode ser quantificada medindo a densidade de microvasos no interior do tumor. No entanto, não há atualmente pouca ou nenhuma padronização de técnicas, e apenas uma publicação a data relata a confiabilidade de um disponíveis atualmente algoritmos complexos baseados computador para quantificar dados capilaroscópicas. 1 Este artigo descreve um algoritmo novo, mais simples, confiável, capilar padronizado contagem para quantificar dados capilaroscópicas das cutículas. Um algoritmo capilaroscopia simples, reprodutível informatizado como este iria facilitar maisuso generalizado da técnica entre pesquisadores e clínicos. Muitos pesquisadores atualmente analisar imagens capilaroscópicas com a mão, promovendo a fadiga do usuário e da subjetividade dos resultados. Este artigo descreve um romance, easy-to-use automatizado algoritmo de processamento de imagem, além de um algoritmo de contagem reprodutível, semi-automatizado. Este algoritmo permite a análise de imagens em minutos, reduzindo a subjetividade; apenas uma quantidade mínima de tempo de treinamento (em nossa experiência, a menos de 1 hora) é necessário para aprender a técnica.

O objetivo deste procedimento de processamento de imagem é diferenciar os capilares a partir da imagem de fundo para que eles possam ser quantificados com precisão. Ambos processamento de imagem incompleta e processamento de imagem excessiva são prejudiciais para a capacidade do programa para quantificar os capilares. Como pode ser visto na Figura 3, o processamento de imagem incompleta faz com que os capilares difícil de distinguir do fundo. É fundamental que o usuário seja capaz...

Watch this Scientific Journal Video about A Reproducible Computerized Method for Quantitation of Capillary Density using Nailfold Capillaroscopy at JoVE.com

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 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.

Um método computadorizado reprodutível para quantificação da densidade capilar usando capilaroscopia periungueal

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

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8.9K visualizações.  Thomas Jefferson University. 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. 

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

Photothrombotic Ischemia: A Minimally Invasive and Reproducible Photochemical Cortical Lesion Model for Mouse Stroke Studies

The photothrombotic stroke model aims to induce an ischemic damage within a given cortical area by means of photo-activation of a previously injected light-sensitive dye. Following illumination, the dye is activated and produces singlet oxygen that damages components of endothelial cell membranes, with subsequent platelet aggregation and thrombi formation, which eventually determines the interruption of local blood flow. This approach, initially proposed by Rosenblum and El-Sabban in 1977, was later improved by Watson in 1985 in rat brain and set the basis of the current model. Also, the increased availability of transgenic mouse lines further contributed to raise the interest on the photothrombosis model. Briefly, a photosensitive dye (Rose Bengal) is injected intraperitoneally and enters the blood stream. When illuminated by a cold light source, the dye becomes activated and induces endothelial damage with platelet activation and thrombosis, resulting in local blood flow interruption. The light source can be applied on the intact skull with no need of craniotomy, which allows targeting of any cortical area of interest in a reproducible and non-invasive way. The mouse is then sutured and allowed to wake up. The evaluation of ischemic damage can be quickly accomplished by triphenyl-tetrazolium chloride or cresyl violet staining. This technique produces infarction of small size and well-delimited boundaries, which is highly advantageous for precise cell characterization or functional studies. Furthermore, it is particularly suitable for studying cellular and molecular responses underlying brain plasticity in transgenic mice.

Photothrombosis is a quick, minimally-invasive technique for inducing small and well-delimited infarction in areas of interest in highly reproducible manner. It is particularly suitable for studying cellular and molecular responses underlying brain plasticity in transgenic mice.

Isquemia Photothrombotic: Um Modelo de lesão cortical fotoquímica Minimamente Invasiva e reprodutível para mouse Estudos curso

The photothrombotic stroke model aims to induce an ischemic damage within a given cortical area by means of photo-activation of a previously injected ...

Medicina

Generation and 3-Dimensional Quantitation of Arterial Lesions in Mice Using Optical Projection Tomography

The generation and analysis of vascular lesions in appropriate animal models is a cornerstone of research into cardiovascular disease, generating important information on the pathogenesis of lesion formation and the action of novel therapies. Use of atherosclerosis-prone mice, surgical methods of lesion induction, and dietary modification has dramatically improved understanding of the mechanisms that contribute to disease development and the potential of new treatments.
Classically, analysis of lesions is performed ex vivo using 2-dimensional histological techniques. This article describes application of optical projection tomography (OPT) to 3-dimensional quantitation of arterial lesions. As this technique is non-destructive, it can be used as an adjunct to standard histological and immunohistochemical analyses.
Neointimal lesions were induced by wire-insertion or ligation of the mouse femoral artery whilst atherosclerotic lesions were generated by administration of an atherogenic diet to apoE-deficient mice.
Lesions were examined using OPT imaging of autofluorescent emission followed by complementary histological and immunohistochemical analysis. OPT clearly distinguished lesions from the underlying vascular wall. Lesion size was calculated in 2-dimensional sections using planimetry, enabling calculation of lesion volume and maximal cross-sectional area. Data generated using OPT were consistent with measurements obtained using histology, confirming the accuracy of the technique and its potential as a complement (rather than alternative) to traditional methods of analysis.
This work demonstrates the potential of OPT for imaging atherosclerotic and neointimal lesions. It provides a rapid, much needed ex vivo technique for the routine 3-dimensional quantification of vascular remodelling.

Ex vivo analysis of arterial lesions from animal models of cardiovascular disease classically relies on histological and immunohistochemical techniques. These provide 2-dimensional measurements in 3-dimensional lesions. This manuscript describes the generation of arterial lesions for quantitative analysis in 3-dimensions using optical projection tomography.

Geração e quantificação 3-Dimensional de Arterial lesões em ratos por meio de tomografia óptica de Projeção

The generation and analysis of vascular lesions in appropriate animal models is a cornerstone of research into cardiovascular disease, generating ...

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic conditions. As part of a diagnostic assessment, the early detection of postural deficits is important so that appropriate and targeted interventions can be prescribed. The Sensory Organization Test (SOT) on the EquiTest determines an individual&#39;s use of the sensory systems (somatosensory, visual, and vestibular) that are responsible for postural control. Somatosensory and visual input are altered by the calibrated sway-referenced support surface and visual surround, which move in the anterior-posterior direction in response to the individual&#39;s postural sway. This creates a conflicting sensory experience. The Motor Control Test (MCT) challenges postural control by creating unexpected postural disturbances in the form of backwards and forwards translations. The translations are graded in magnitude and the time to recover from the perturbation is computed.
Intermittent claudication, the most common symptom of peripheral arterial disease, is characterized by a cramping pain in the lower limbs and caused by muscle ischemia secondary to reduced blood flow to working muscles during physical exertion. Claudicants often display poor balance, making them susceptible to falls and activity avoidance. The Ankle Brachial Pressure Index (ABPI) is a noninvasive method for indicating the presence of peripheral arterial disease and intermittent claudication, a common symptom in the lower extremities. ABPI is measured as the highest systolic pressure from either the dorsalis pedis or posterior tibial artery divided by the highest brachial artery systolic pressure from either arm. This paper will focus on the use of computerized dynamic posturography in the assessment of balance in claudicants.

Individuals with intermittent claudication exhibit poor balance compared to healthy controls. Computerized dynamic posturography is an objective method for measuring an individual's postural responses to balance disturbances. This provides an objective reflection of the person&#x2019;s ability to respond to situations under which sensory stimuli are altered and unexpected perturbations occur.

Posturografia Dinâmica Computadorizada para Avaliação do controle postural em pacientes com claudicação intermitente

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic ...

Quantitation of Intra-peritoneal Ovarian Cancer Metastasis

Epithelial ovarian cancer (EOC) is the leading cause of death from gynecologic malignancy in the United States. Mortality is due to diagnosis of 75% of women with late stage disease, when metastasis is already present. EOC is characterized by diffuse and widely disseminated intra-peritoneal metastasis. Cells shed from the primary tumor anchor in the mesothelium that lines the peritoneal cavity as well as in the omentum, resulting in multi-focal metastasis, often in the presence of peritoneal ascites. Efforts in our laboratory are directed at a more detailed understanding of factors that regulate EOC metastatic success. However, quantifying metastatic tumor burden represents a significant technical challenge due to the large number, small size and broad distribution of lesions throughout the peritoneum. Herein we describe a method for analysis of EOC metastasis using cells labeled with red fluorescent protein (RFP) coupled with in vivo multispectral imaging. Following intra-peritoneal injection of RFP-labelled tumor cells, mice are imaged weekly until time of sacrifice. At this time, the peritoneal cavity is surgically exposed and organs are imaged in situ. Dissected organs are then placed on a labeled transparent template and imaged ex vivo. Removal of tissue auto-fluorescence during image processing using multispectral unmixing enables accurate quantitation of relative tumor burden. This method has utility in a variety of applications including therapeutic studies to evaluate compounds that may inhibit metastasis and thereby improve overall survival.

Ovarian cancer metastasis is characterized by numerous diffuse intra-peritoneal lesions, such that accurate visual quantitation of tumor burden is challenging. Herein we describe a method for in situ and ex vivo quantitation of metastatic tumor burden using red fluorescent protein (RFP)-labeled tumor cells and optical imaging.

A quantificação da Intra-peritoneal Ovarian Cancer Metástase

Epithelial ovarian cancer (EOC) is the leading cause of death from gynecologic malignancy in the United States.  Mortality is due to diagnosis of 75% of ...

Method of Direct Segmental Intra-hepatic Delivery Using a Rat Liver Hilar Clamp Model

Major hepatic surgery with inflow occlusion, and liver transplantation, necessitate a period of warm ischemia, and a period of reperfusion leading to ischemia/reperfusion (I/R) injury with myriad negative consequences. Potential I/R injury in marginal organs destined for liver transplantation contributes to the current donor shortage secondary to a decreased organ utilization rate. A significant need exists to explore hepatic I/R injury in order to mediate its impact on graft function in transplantation. Rat liver hilar clamp models are used to investigate the impact of different molecules on hepatic I/R injury. Depending on the model, these molecules have been delivered using inhalation, epidural infusion, intraperitoneal injection, intravenous administration or injection into the peripheral superior mesenteric vein. A rat liver hilar clamp model has been developed for use in studying the impact of pharmacologic molecules in ameliorating I/R injury. The described model for rat liver hilar clamp includes direct cannulation of the portal supply to the ischemic hepatic segment via a side branch of the portal vein, allowing for direct segmental hepatic delivery. Our approach is to induce ischemia in the left lateral and median lobes for 60 min, during which time the substance under study is infused. In this case, pegylated-superoxide dismutase (PEG-SOD), a free radical scavenger, is infused directly into the ischemic segment. This series of experiments demonstrates that infusion of PEG-SOD is protective against hepatic I/R injury. Advantages of this approach include direct injection of the molecule into the ischemic segment with consequent decrease in volume of distribution and reduction in systemic side effects.

A unique rat liver hilar clamp model was developed for studying the impact of pharmacologic molecules in ameliorating ischemia-reperfusion injury. This model includes direct cannulation of the portal supply to the ischemic liver segment via a branch of the portal vein, allowing for direct hepatic delivery.

Método de entrega directa segmentos intra-hepática Usando um modelo de rato Liver Hilar Grampo

Major hepatic surgery with inflow occlusion, and liver transplantation, necessitate a period of warm ischemia, and a period of reperfusion leading to ...

Reproducible Arterial Denudation Injury by Infrarenal Abdominal Aortic Clamping in a Murine Model

Percutaneous vascular interventions uniformly result in arterial denudation injuries that subsequently lead to thrombosis and restenosis. These complications can be attributed to impairments in re-endothelialization within the wound margins. Yet, the cellular and molecular mechanisms of re-endothelialization remain to be defined. While several animal models to study re-endothelialization after arterial denudation are available, few are performed in the mouse because of surgical limitations. This undermines the opportunity to exploit transgenic mouse lines and investigate the contribution of specific genes to the process of re-endothelialization. Here, we present a step-by-step protocol for creating a highly reproducible murine model of arterial denudation injury in the infrarenal abdominal aorta using external vascular clamping. Immunocytochemical staining of injured aortas for fibrinogen and &#946;-catenin demonstrate the exposure of a pro-thrombotic surface and the border of intact endothelium, respectively. The method presented here has the advantages of speed, excellent overall survival rate, and relative technical ease, creating a uniquely practical tool for imposing arterial denudation injury in transgenic mouse models. Using this method, investigators may elucidate the mechanisms of re-endothelialization under normal or pathological conditions.

Understanding the cellular and molecular mechanisms of re-endothelialization following arterial denudation injury is of paramount importance in preventing thrombosis and restenosis of arteries. Here we describe a protocol for reproducible arterial denudation injury of the infrarenal abdominal aorta. The procedure was developed to investigate the underlying mechanisms that regulate endothelial regeneration using mouse models.

Reprodutível Arterial Desnudamento Lesão por aorta abdominal infrarrenal fixação num modelo murino

Percutaneous vascular interventions uniformly result in arterial denudation injuries that subsequently lead to thrombosis and restenosis. These ...

A Method for Quantifying Upper Limb Performance in Daily Life Using Accelerometers

A key reason for referral to rehabilitation services after stroke and other neurological conditions is to improve one's ability to function in daily life. It has become important to measure a person's activities in daily life, and not just measure their capacity for activity in the structured environment of a clinic or laboratory. A wearable sensor that is now enabling measurement of daily movement is the accelerometer. Accelerometers are commercially-available devices resembling large wrist watches that can be worn throughout the day. Data from accelerometers can quantify how the limbs are engaged to perform activities in peoples' homes and communities. This report describes a methodology to collect accelerometry data and turn it into clinically-relevant information. First, data are collected by having the participant wear two accelerometers (one on each wrist) for 24 h or longer. The accelerometry data are then downloaded and processed to produce four different variables that describe key aspects of upper limb activity in daily life: hours of use, use ratio, magnitude ratio, and the bilateral magnitude. Density plots can be constructed that visually represent the data from the 24 h wearing period. The variables and their resultant density plots are highly consistent in neurologically-intact, community-dwelling adults. This striking consistency makes them a useful tool for determining if upper limb daily performance is different from normal. This methodology is appropriate for research studies investigating upper limb dysfunction and interventions designed to improve upper limb performance in daily life in people with stroke and other patient populations. Because of its relative simplicity, it may not be long before it is also incorporated in clinical neurorehabilitation practice.

This protocol describes a method to quantify upper limb performance in daily life using wrist-worn accelerometers.

Um método para quantificar Desempenho Membro Superior na Vida Diária utilizem acelerómetros

A key reason for referral to rehabilitation services after stroke and other neurological conditions is to improve one's ability to function in daily life. ...

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Ventricular tachycardia (VT) in patients with ischemic cardiomyopathy mainly results from endocardial scars after myocardial infarction; those scars represent zones of slow conduction that allow the occurrence and maintenance of reentrant circuits. Catheter ablation enables substrate modification of those low voltage areas and thus can help to alter the scar tissue in such a way that arrhythmias cannot appear anymore. Hospitalizations of concerned patients decrease, quality of life and outcome rise. Consequently, VT ablation represents a growing field in electrophysiology, especially for patients with endocardial scars in ischemic heart disease after myocardial infarction. However, ablation of ventricular tachycardia remains one of the most challenging procedures in the electrophysiology lab. Precise scar definition and localization of abnormal potentials are critical for ablation success. The following manuscript describes the use of a multipolar mapping catheter and 3-dimensional (3D) mapping system to create a high density electro-anatomical map of the left ventricle including a precise scar representation as well as mapping of fractionated and late potentials in order to allow a highly accurate substrate modification.

With the following protocol, we provide an approach to Ventricular Tachycardia (VT) ablation using high density mapping with a multipolar catheter and 3D mapping system enhancing the success of the procedure.

Ablação de taquicardia Ventricular isquêmica, usando um cateter Multipolar e sistema de mapeamento 3-dimensional para reconstrução de Electro-anatômica de alta densidade

Ventricular tachycardia (VT) in patients with ischemic cardiomyopathy mainly results from endocardial scars after myocardial infarction; those scars ...

A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program.
Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation.
51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p&#60;0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t&#60;1.66, all p&#62;0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t&#60;1.64, all p&#62;0.11).
Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training.

This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.

Um programa informatizado de avaliação e treinamento de habilidades funcionais que visa a tecnologia baseada em habilidades funcionais cotidianas

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a ...

A Reproducible Intensive Care Unit-Oriented Endotoxin Model in Rats

Sepsis and septic shock remain the leading cause of death in intensive care units. Despite significant improvements in sepsis management, mortality still ranges between 20 and 30%. Novel treatment approaches in order to reduce sepsis-related multiorgan failure and death are urgently needed. Robust animal models allow for one or multiple treatment approaches as well as for testing their effect on physiological and molecular parameters. In this article, a simple animal model is presented.
First, general anesthesia is induced in animals either with the use of volatile or by intraperitoneal anesthesia. After placement of an intravenous catheter (tail vein), tracheostomy, and insertion of an intraarterial catheter (tail artery), mechanical ventilation is started. Baseline values of mean arterial blood pressure, arterial blood oxygen saturation, and heart rate are recorded.
The injection of lipopolysaccharides (1 milligram/kilogram body weight) dissolved in phosphate-buffered saline induces a strong and reproducible inflammatory response via the toll-like receptor 4. Fluid corrections as well as the application of norepinephrine are performed based on well-established protocols.
The animal model presented in this article is easy to learn and strongly oriented towards clinical sepsis treatment in an intensive care unit with sedation, mechanical ventilation, continuous blood pressure monitoring, and repetitive blood sampling. Also, the model is reliable, allowing for reproducible data with a limited number of animals in accordance with the 3R (reduce, replace, refine) principles of animal research. While animal experiments in sepsis research cannot easily replaced, repetitive measurements allow for a reduction of animals and keeping septic animals anesthetized diminishes suffering.

Here, we present a reproducible intensive care unit-oriented endotoxin model in rats.

Um modelo de endotoxina de unidade de terapia intensiva reprodutível em ratos

Sepsis and septic shock remain the leading cause of death in intensive care units. Despite significant improvements in sepsis management, mortality still ...