BACKGROUND: Accurate assessment of carotid stenosis severity is important for proper patient management. The present study aimed to compare the evaluation of carotid stenosis severity using four duplex sonography (DUS) measurements, including peak systolic velocity (PSV), PSV ratio in stenosis and distal to stenosis (PSVICA/ICA ratio), end-diastolic velocity (EDV), and B-mode, with computed tomography angiography (CTA), and to evaluate the impact of plaque morphology on correlation between DUS and CTA. METHODS: Consecutive patients with carotid stenosis of ≥40% examined using DUS and CTA were included. Plaque morphology was also determined using magnetic resonance imaging. Spearman's correlation and Kendall's rank correlation were used to evaluate the results. RESULTS: A total of 143 cases of internal carotid artery stenosis of ≥40% based on DUS were analyzed. The PSVICA/ICA ratio showed the highest correlation [Spearman's correlation r = 0.576) with CTA, followed by PSV (r = 0.526), B-mode measurement (r = 0.482), and EDV (r = 0.441; p < 0.001 in all cases]. The worst correlation was found for PSV when the plaque was calcified (r = 0.238), whereas EDV showed a higher correlation (r = 0.523). Correlations of B-mode measurement were superior for plaques with smooth surface (r = 0.677), while the PSVICA/ICA ratio showed the highest correlation in stenoses with irregular (r = 0.373) or ulcerated (r = 0.382) surfaces, as well as lipid (r = 0.406), fibrous (r = 0.461), and mixed (r = 0.403; p < 0.01 in all cases) plaques. Nevertheless, differences between the mentioned correlations were not statistically significant (p > 0.05 in all cases). CONCLUSION: PSV, PSVICA/ICA ratio, EDV, and B-mode measurements showed comparable correlations with CTA in evaluation of carotid artery stenosis based on their correlation with CTA results. Heavy calcifications and plaque surface irregularity or ulceration negatively influenced the measurement accuracy.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Influenza virus causes severe respiratory infection in humans. Current antivirotics target three key proteins in the viral life cycle: neuraminidase, the M2 channel and the endonuclease domain of RNA-dependent-RNA polymerase. Due to the development of novel pandemic strains, additional antiviral drugs targetting different viral proteins are still needed. The protein-protein interaction between polymerase subunits PA and PB1 is one such possible target. We recently identified a modified decapeptide derived from the N-terminus of the PB1 subunit with high affinity for the C-terminal part of the PA subunit. Here, we optimized its amino acid hotspots to maintain the inhibitory potency and greatly increase peptide solubility. This allowed thermodynamic characterization of peptide binding to PA. Solving the X-ray structure of the peptide-PA complex provided structural insights into the interaction. Additionally, we optimized intracellular delivery of the peptide using a bicyclic strategy that led to improved inhibition in cell-based assays.
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- arteria vertebralis diagnostické zobrazování MeSH
- arteriae carotides diagnostické zobrazování MeSH
- arteriae cerebrales diagnostické zobrazování MeSH
- cerebrovaskulární poruchy diagnostické zobrazování MeSH
- diagnostické zobrazování klasifikace metody MeSH
- lidé MeSH
- mozek diagnostické zobrazování MeSH
- neurologické vyšetření klasifikace metody přístrojové vybavení MeSH
- ultrasonografie dopplerovská transkraniální metody MeSH
- ultrasonografie * klasifikace metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
PURPOSE: The aim of the study was to obtain the values of oxygen saturation in retinal vessels and ophthalmic blood flow parameters in a healthy Caucasian population and assess whether the oximetry parameters are affected by the flow rate or the vascular resistance. METHODS: The spectrophotometric retinal oximetry and colour Doppler imaging (CDI) of retinal vessels were successfully performed with 52 healthy subjects (average age 29.7 ± 5.6 years). The retinal oximeter simultaneously measures the wavelength difference of haemoglobin oxygen saturation in retinal arterioles and venules. The arteriolar and venular saturation in both eyes was measured. The peak systolic (PSV) end diastolic (EDV) velocities, resistive (RI) and pulsatility (PI) indices were obtained for both eyes using CDI in the ophthalmic artery. A paired t-test and two sample t-tests were used for statistical analyses. The correlation was assessed using the Pearson coefficient correlation. RESULTS: The mean oxygen saturation level was 96.9 ± 3.0% for the retinal arterioles and 65.0 ± 5.1% for the retinal venules. The A-V difference was 31.8 ± 4.6%. The mean of the measured haemodynamic parameters was PSV 46.6 ± 9.4 cm/s, EDV 12.0 ± 3.5 cm/s, PI 1.68 ± 0.38 and RI 0.74 ± 0.05. No significant difference in oxygen saturation and haemodynamic parameters was found between the left and the right eyes or the dominant and non-dominant eye. The oximetry and ultrasound values were sex independent. The Pearson correlation coefficient demonstrated a significant yet weak negative correlation between A-V difference and RI (r = -0.321, p = 0.020). CONCLUSIONS: A negative correlation between A-V difference and resistance index was observed, suggesting that reduced oxygen consumption may reflect the increased vascular tone of the ophthalmic vessels, which is likely determined by autoregulatory mechanisms.
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- arteria centralis retinae * diagnostické zobrazování fyziologie MeSH
- arteria ophthalmica * MeSH
- dospělí MeSH
- hemodynamika MeSH
- hemoglobiny MeSH
- kyslík MeSH
- lidé MeSH
- mladý dospělý MeSH
- oxymetrie metody MeSH
- retina MeSH
- rychlost toku krve MeSH
- saturace kyslíkem MeSH
- zdraví dobrovolníci pro lékařské studie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Purpose of this prospective uncontrolled single-centre pilot study was to find an association of retinal oxygen saturation (SatO2 ) with acid-base balance (ABB), carboxyhaemoglobin concentration, current plasma glucose concentration (PG), mean PG and PG variability over the last 72 hr, haemoglobin A1c (HbA1c), and other conditions. METHODS: Forty-one adults (17 men) with type 1 (N = 14) or type 2 (N = 27) diabetes mellitus, age 48.6 ± 13.5 years, diabetes duration 9 (0.1-36) years, BMI 29.4 ± 6.3 kg/m2 , and HbA1c 52 ± 12.7 mmol/mol completed the study. The 4-day study comprised two visits (Day l, Day 4) including 72 hr of continuous glucose monitoring (CGM) by iPro® 2 Professional CGM (Medtronic, MiniMed, Inc., Northridge, CA, USA). Retinal oximeter Oxymap T1 (Oxymap ehf., Reykjavik, Iceland) was used to assess SatO2 . RESULTS: Wilcoxon signed-rank test showed no SatO2 difference between eyes and visits. Spearman's correlation analysis revealed a significant correlation between arterial SatO2 and PG variability in type 2 diabetes mellitus, a positive correlation of venous SatO2 with HbA1c and with finger pulse oximetry. However, no correlation of SatO2 with ABB, carboxyhaemoglobin, current PG, mean PG over the 72 hr, age, diabetes duration, BMI, lipoproteinaemia, body temperature, systolic and diastolic blood pressure, heart rate, central retinal thickness and retinal nerve fibre layer thickness was found. CONCLUSION: This study confirmed the association of venous SatO2 with long-term but not with short-term diabetes control, ABB and other conditions. The increased SatO2 and questionable impact of PG variability on retinal SatO2 is a research challenge.
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- časové faktory MeSH
- diabetes mellitus 2. typu krev komplikace MeSH
- glykovaný hemoglobin metabolismus MeSH
- klinické křížové studie MeSH
- kouření škodlivé účinky krev MeSH
- krevní glukóza MeSH
- kyslík krev MeSH
- lidé MeSH
- následné studie MeSH
- nemoci retiny krev etiologie MeSH
- novorozenec MeSH
- oxymetrie MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- retinální cévy metabolismus patofyziologie MeSH
- saturace kyslíkem fyziologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
INTRODUCTION: Supraglottic airway devices represent a less invasive method of airway management than tracheal intubation during general anaesthesia. Their continued development is focused mainly on improvements in the insertion success rate and minimalisation of perioperative and postoperative complications. The i-gel Plus is a novel, anatomically preshaped supraglottic airway device which achieves a perilaryngeal seal due to a non-inflatable cuff made of a soft thermoplastic elastomer. The purpose of this cohort study is to assess the success rate of the i-gel Plus use during elective procedures under general anaesthesia, its intraoperative performance, and the degree of postoperative complications. METHODS AND ANALYSIS: This is a multicentre, prospective, interventional cohort study. The enrolment will take place in seven centres in four European countries. We plan to enrol 2000 adult patients in total, who are scheduled for elective surgery under general anaesthesia, and with an indication for use of a supraglottic airway device for management of their airway. The study is projected to run over a period of 18 months. The primary outcome of the study is the total success rate of the i-gel Plus insertion in terms of successful ventilation and oxygenation through the device. Secondary outcomes include perioperative parameters, such as insertion time, seal/leak pressures, number of insertion attempts and postoperative adverse events and complications. Postoperative follow-up will be performed at 1 hour, 24 hours in all patients, and for selected patients at 3 and 6 months. ETHICS AND DISSEMINATION: The cohort study has received the following ethical approvals: General University Hospital Prague, University Hospital Olomouc, University Military Hospital Prague, University Hospital Barcelona, University Hospital Lodz, Antrim Area Hospital, Craigavon Area Hospital, Office for Research Ethics Committees Northern Ireland. The results will be published in peer-reviewed journals and presented at relevant anaesthesia conferences. TRIAL REGISTRATION NUMBER: ISRCTN86233693;Pre-results.
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- celková anestezie * škodlivé účinky MeSH
- dospělí MeSH
- intratracheální intubace metody MeSH
- kohortové studie MeSH
- laryngální masky * škodlivé účinky MeSH
- lidé MeSH
- multicentrické studie jako téma MeSH
- prospektivní studie MeSH
- zajištění dýchacích cest metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Intravenous thrombolysis (IVT) is a standard treatment for both anterior circulation ischaemic stroke (ACIS) and posterior circulation ischaemic stroke (PCIS). Our aim was to evaluate the predictors for a good clinical outcome and intracerebral haemorrhage (ICH) in patients undergoing posterior circulation IVT based on the initially performed CT or MR imaging. METHODS: The study cohort consisted of 1643 consecutive patients with acute ischaemic stroke (1440 ACIS, 203 PCIS cases) who underwent IVT. ICH was classified according to the European Cooperative Acute Stroke Study (ECASS) I protocol. Clinical outcome was assessed using the modified Rankin scale (mRS). Early ischaemic signs and pre-existing structural signs were assessed. RESULTS: Good clinical outcomes (mRS 0-1) were noted in 45.3% of patients with PCIS, with a mortality rate of 14.8%. ICH was noted in 8.3%, and a large haemorrhage was found in 2.4% of patients. Some early ischaemic signs and pre-existing structural signs on initial CT/MR imaging correlated significantly with the 90-day clinical outcome. CONCLUSIONS: Early ischaemic signs and pre-existing structural signs should be considered during the assessment of patients with PCIS eligible for IVT. Tissue hypoattenuation on initial CT scans correlates with an increased risk of death. Similarly to anterior circulation, atrophy on initial MRI may negatively predict good clinical outcome in posterior circulation.
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- cévní mozková příhoda * diagnostické zobrazování farmakoterapie MeSH
- fibrinolytika terapeutické užití MeSH
- ischemie mozku * diagnostické zobrazování farmakoterapie MeSH
- lidé MeSH
- neurozobrazování MeSH
- tkáňový aktivátor plazminogenu terapeutické užití MeSH
- trombolytická terapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Cíl: Mechanická trombektomie (MT) symptomatického uzávěru mozkové tepny u pacientů s akutní ischemickou cévní mozkovou příhodou (iCMP) se stala standardní léčbou. Na základě analýzy dosud publikovaných výsledků byla navržena v roce 2018 doporučení určená pro centra provádějící MT, která jsou zároveň považována za indikátory kvality péče. Cílem prezentované studie bylo ověřit, zda je naše centrum schopno plnit doporučení navržené mezinárodním multioborovým konsenzem a současně zhodnotit vývoj těchto indikátorů v čase srovnáním výsledků mezi lety 2016 a 2019. Metodika: Do analýzy byli zařazení všichni pacienti s akutní iCMP a prokázanou okluzí velké mozkové tepny jak v předním, tak v zadním povodí, kteří byli léčeni v našem centru v roce 2019. Všechna demografická a klinická data, časové údaje a údaje o výsledcích léčby byly sbírány prospektivně a následně byly srovnány s doporučenými hodnotami jednotlivých parametrů multioborového konsenzu. K posouzení vývoje výkonnosti našeho centra byly výsledky za rok 2019 následně srovnány s výsledky pacientů léčených v našem centru v roce 2016. Výsledky: V roce 2019 bylo na našem pracovišti indikováno k MT celkem 152 pacientů (52 % mužů, průměrný věk: 71,2 ? 13,2 let) s akutní iCMP. U 75 % pacientů indikovaných k MT bylo zobrazení zahájeno do 23 minut od příjezdu do centra, punkce třísla u primárně transportovaných pacientů do centra byla provedena do 62 minut od zahájení zobrazení a u 70 % pacientů byla rekanalizace provedena do 34 minut od punkce třísla. Rekanalizace (mTICI ž 2b) bylo dosaženo celkem u 133 pacientů (87,5 %) a kompletní rekanalizace (mTICI 3) u 102 pacientů (67,2 %). Dobrého klinického výsledku (mRS 0-2) po 3 měsících dosáhlo 80 (52,6 %) pacientů. K SICH po výkonu došlo u pěti (3,4 %) pacientů. Závěr: Výsledky ukazují, že lze splnit doporučované hodnoty parametrů uvedených v mezinárodním multioborovém konsenzu i v podmínkách České republiky, a lze je tak doporučit jako indikátory kvality péče.
Aim: Mechanical thrombectomy (MT) of symptomatic occlusion of cerebral artery has become a standard treatment in acute ischemic stroke (IS) patients. Based on analysis of previously published results, the recommendations for the centers performing MT were introduced in the year 2018 and became accepted as indicators of quality of care. The aim of presented study was to evaluate if our center was able to follow the recommendations established by international multi-society consensus, and furthermore, to assess a trend of recommended indicators during the time using a comparison of our results between years 2016 and 2019. Methods: All consecutive acute IS patients with large vessel occlusion both in anterior and posterior circulation treated in our center in the year 2019 were included in the analysis. All demographic and clinical data, as well as time parameters and treatment results were collected prospectively. Data were subsequently compared with recommended values of indi- vidual parameters of multi-society consensus. The results of the year 2019 were subsequently compared with those from the year 2016 to assess a trend in our center. Results: In total, 152 patients (52% of males, mean age: 71.2 ? 13.2 years) were indicated to MR in our center in the year 2019. In 75% of patients indicated to MT, brain imaging was started within 23 min after patient?s arrival to center, groin puncture was performed within 62 min after patient?s arrival to center (primary transport), and in 70% of patients, recanalization was achieved within 34 min after groin puncture. Recanalization (mTICI ž 2b) was achieved in 133 (87.5%) patients a completed (mTICI 3) in 102 67.2%) patients. Eighty (52.6%) patients reached good 3-month clinical outcome (mRS 0-2). Symptomatic intracerebral hemorrhage after MT occurred in 5 (3.4%) patients. Conclusion: Our results showed that it was possible fulfill the recommended values of parameters stated in the international multi-society consensus also in Czech Republic and thus, the can be recommended as indicators of quality of care.
