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Grinderslev JB, Häussermann U, Jensen TR, Faraone A, Nagao M, Karlsson M, Udovic TJ, Andersson MS. Reorientational Dynamics in Y(BH 4) 3· xNH 3 ( x = 0, 3, and 7): The Impact of NH 3 on BH 4- Dynamics. J Phys Chem C Nanomater Interfaces 2024; 128:4431-4439. [PMID: 38533240 PMCID: PMC10961835 DOI: 10.1021/acs.jpcc.4c00265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024]
Abstract
The reorientational dynamics of Y(BH4)3·xNH3 (x = 0, 3, and 7) was studied using quasielastic neutron scattering (QENS) and neutron spin echo (NSE). The results showed that changing the number of NH3 ligands drastically alters the reorientational mobility of the BH4- anion. From the QENS experiments, it was determined that the BH4- anion performs 2-fold reorientations around the C2 axis in Y(BH4)3, 3-fold reorientations around the C3 axis in Y(BH4)3·3NH3, and either 2-fold reorientations around the C2 axis or 3-fold reorientations around the C3 axis in Y(BH4)3·7NH3. The relaxation time of the BH4- anion at 300 K decreases from 2 × 10-7 s for x = 0 to 1 × 10-12 s for x = 3 and to 7 × 10-13 s for x = 7. In addition to the reorientational dynamics of the BH4- anion, it was shown that the NH3 ligands exhibit 3-fold reorientations around the C3 axis in Y(BH4)3·3NH3 and Y(BH4)3·7NH3 as well as 3-fold quantum mechanical rotational tunneling around the same axis at 5 K. The new insights constitute a significant step toward understanding the relationship between the addition of ligands and the enhanced ionic conductivity observed in systems such as LiBH4·xNH3 and Mg(BH4)2·xCH3NH2.
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Affiliation(s)
- J. B. Grinderslev
- Interdisciplinary
Nanoscience Center (iNANO) and Department of Chemistry, Aarhus University, Aarhus DK-8000, Denmark
| | - U. Häussermann
- Department
of Materials and Environmental Chemistry, Stockholm University, SE-10691 Stockholm, Sweden
| | - T. R. Jensen
- Interdisciplinary
Nanoscience Center (iNANO) and Department of Chemistry, Aarhus University, Aarhus DK-8000, Denmark
| | - A. Faraone
- NIST Center
for Neutron Research, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-6102, United
States
| | - M. Nagao
- NIST Center
for Neutron Research, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-6102, United
States
- Department
of Materials Science and Engineering, University
of Maryland, College Park, Maryland 20742-2115, United States
- Department
of Physics and Astronomy, University of
Delaware, Newark, Delaware 19716, United States
| | - M. Karlsson
- Department
of Chemistry and Chemical Engineering, Chalmers
University of Technology, Göteborg SE-412 96, Sweden
| | - T. J. Udovic
- NIST Center
for Neutron Research, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-6102, United
States
- Department
of Materials Science and Engineering, University
of Maryland, College Park, Maryland 20742-2115, United States
| | - M. S. Andersson
- Ångström
Laboratory, Department of Chemistry, Uppsala
University, Box 538, SE-751 21 Uppsala, Sweden
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2
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Westerlund E, Marelsson SE, Karlsson M, Sjövall F, Chamkha I, Åsander Frostner E, Lundgren J, Fellman V, Eklund EA, Steding-Ehrenborg K, Darin N, Paul G, Hansson MJ, Ehinger JK, Elmér E. Correlation of mitochondrial respiration in platelets, peripheral blood mononuclear cells and muscle fibers. Heliyon 2024; 10:e26745. [PMID: 38439844 PMCID: PMC10909709 DOI: 10.1016/j.heliyon.2024.e26745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024] Open
Abstract
There is a growing interest for the possibility of using peripheral blood cells (including platelets) as markers for mitochondrial function in less accessible tissues. Only a few studies have examined the correlation between respiration in blood and muscle tissue, with small sample sizes and conflicting results. This study investigated the correlation of mitochondrial respiration within and across tissues. Additional analyses were performed to elucidate which blood cell type would be most useful for assessing systemic mitochondrial function. There was a significant but weak within tissue correlation between platelets and peripheral blood mononuclear cells (PBMCs). Neither PBMCs nor platelet respiration correlated significantly with muscle respiration. Muscle fibers from a group of athletes had higher mass-specific respiration, due to higher mitochondrial content than non-athlete controls, but this finding was not replicated in either of the blood cell types. In a group of patients with primary mitochondrial diseases, there were significant differences in blood cell respiration compared to healthy controls, particularly in platelets. Platelet respiration generally correlated better with the citrate synthase activity of each sample, in comparison to PBMCs. In conclusion, this study does not support the theory that blood cells can be used as accurate biomarkers to detect minor alterations in muscle respiration. However, in some instances, pronounced mitochondrial abnormalities might be reflected across tissues and detectable in blood cells, with more promising findings for platelets than PBMCs.
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Affiliation(s)
- Emil Westerlund
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Emergency Department, Kungälv Hospital, Kungälv, Sweden
| | - Sigurður E. Marelsson
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Children's Medical Center, Landspitali-The National University Hospital of Iceland, Reykjavík, Iceland
| | | | - Fredrik Sjövall
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Intensive- and Perioperative Care, Skåne University Hospital, Malmö, Sweden
| | - Imen Chamkha
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Johan Lundgren
- Department of Pediatrics, Skåne University Hospital, Lund University, Lund, Sweden
| | - Vineta Fellman
- Department of Pediatrics, Skåne University Hospital, Lund University, Lund, Sweden
| | - Erik A. Eklund
- Department of Pediatrics, Skåne University Hospital, Lund University, Lund, Sweden
| | - Katarina Steding-Ehrenborg
- Clinical Physiology, Department of Clinical Sciences Lund, Skåne University Hospital, Lund University, Lund, Sweden
| | - Niklas Darin
- Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Gesine Paul
- Translational Neurology Group and Wallenberg Center for Molecular Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Magnus J. Hansson
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Johannes K. Ehinger
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Clinical Sciences Lund, Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, Lund University, Lund, Sweden
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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3
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Ehinger JK, Westerlund E, Frostner EÅ, Karlsson M, Paul G, Sjövall F, Elmér E. Mitochondrial function in peripheral blood cells across the human lifespan. NPJ Aging 2024; 10:10. [PMID: 38326348 PMCID: PMC10850142 DOI: 10.1038/s41514-023-00130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/20/2023] [Indexed: 02/09/2024]
Abstract
Mitochondrial dysfunction is considered a hallmark of aging. Up to now, a gradual decline of mitochondrial respiration with advancing age has mainly been demonstrated in human muscle tissue. A handful of studies have examined age-related mitochondrial dysfunction in human blood cells, and only with small sample sizes and mainly in platelets. In this study, we analyzed mitochondrial respiration in peripheral blood mononuclear cells (PBMCs) and platelets from 308 individuals across the human lifespan (0-86 years). In regression analyses, with adjustment for false discovery rate (FDR), we found age-related changes in respiratory measurements to be either small or absent. The main significant changes were an age-related relative decline in complex I-linked respiration and a corresponding rise of complex II-linked respiration in PBMCs. These results add to the understanding of mitochondrial dysfunction in aging and to its possible role in immune cell and platelet senescence.
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Affiliation(s)
- Johannes K Ehinger
- Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
- Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.
| | - Emil Westerlund
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Emergency Department, Kungälv Hospital, Kungälv, Sweden
| | | | | | - Gesine Paul
- Translational Neurology Group and Wallenberg Center for Molecular Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Fredrik Sjövall
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Intensive- and Perioperative Care, Skåne University Hospital, Malmö, Sweden
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Clinical Neurophysiology, Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
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4
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Piel S, Janowska JI, Ward JL, McManus MJ, Aronowitz DI, Janowski PK, Starr J, Hook JN, Hefti MM, Clayman CL, Elmér E, Hansson MJ, Jang DH, Karlsson M, Ehinger JK, Kilbaugh TJ. Succinate prodrugs as treatment for acute metabolic crisis during fluoroacetate intoxication in the rat. Mol Cell Biochem 2023; 478:1231-1244. [PMID: 36282352 PMCID: PMC10540239 DOI: 10.1007/s11010-022-04589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/12/2022] [Indexed: 10/31/2022]
Abstract
Sodium fluoroacetate (FA) is a metabolic poison that systemically inhibits the tricarboxylic acid (TCA) cycle, causing energy deficiency and ultimately multi-organ failure. It poses a significant threat to society because of its high toxicity, potential use as a chemical weapon and lack of effective antidotal therapy. In this study, we investigated cell-permeable succinate prodrugs as potential treatment for acute FA intoxication. We hypothesized that succinate prodrugs would bypass FA-induced mitochondrial dysfunction, provide metabolic support, and prevent metabolic crisis during acute FA intoxication. To test this hypothesis, rats were exposed to FA (0.75 mg/kg) and treated with the succinate prodrug candidate NV354. Treatment efficacy was evaluated based on cardiac and cerebral mitochondrial respiration, mitochondrial content, metabolic profiles and tissue pathology. In the heart, FA increased concentrations of the TCA metabolite citrate (+ 4.2-fold, p < 0.01) and lowered ATP levels (- 1.9-fold, p < 0.001), confirming the inhibition of the TCA cycle by FA. High-resolution respirometry of cardiac mitochondria further revealed an impairment of mitochondrial complex V (CV)-linked metabolism, as evident by a reduced phosphorylation system control ratio (- 41%, p < 0.05). The inhibition of CV-linked metabolism is a novel mechanism of FA cardiac toxicity, which has implications for drug development and which NV354 was unable to counteract at the given dose. In the brain, FA induced the accumulation of β-hydroxybutyrate (+ 1.4-fold, p < 0.05) and the reduction of mitochondrial complex I (CI)-linked oxidative phosphorylation (OXPHOSCI) (- 20%, p < 0.01), the latter of which was successfully alleviated by NV354. This promising effect of NV354 warrants further investigations to determine its potential neuroprotective effects.
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Affiliation(s)
- Sarah Piel
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA.
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA.
| | - Joanna I Janowska
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - J Laurenson Ward
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Meagan J McManus
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Danielle I Aronowitz
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Piotr K Janowski
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Jonathan Starr
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Jordan N Hook
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, USA
| | - Marco M Hefti
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, USA
| | - Carly L Clayman
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Eskil Elmér
- Abliva AB, Lund, Sweden
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Magnus J Hansson
- Abliva AB, Lund, Sweden
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - David H Jang
- Department of Emergency Medicine, Division of Medical Toxicology, University of Pennsylvania School of Medicine, Philadelphia, USA
| | | | - Johannes K Ehinger
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Todd J Kilbaugh
- Resuscitation Science Center of Emphasis, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, USA
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5
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Bömers JP, Karlsson M, Mathiesen TI, Edvinsson L, Haanes KA. Abstract TP235: Temporal Change Of Brain Mitochondrial Function In A Rodent Model Of Subarachnoid Hemorrhage. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.tp235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction:
Subarachnoid hemorrhage (SAH) is a devastating disease. A third of the patients die and a large percentage of the survivors require support in daily living and suffers from reduced quality of life. As part of clinical practice for these patients, a cerebral microdialysis catheter may be placed to monitor cerebral metabolic function. Using this monitoring technique, the patients often demonstrate an increase in the lactate-pyruvate ratio, despite adequate supply of glucose and oxygen, which may be an indirect marker of mitochondrial dysfunction. We wanted to identify a possible mitochondrial dysfunction in a rat SAH model at different time points by directly measuring mitochondrial function in brain tissue
ex vivo
.
Method:
The pre-chiasmatic single injection model of SAH was used. Oroboros Oxygraph high resolution respirometry was used to evaluate the electron transport chain of the mitochondria. We also analyzed ROS generation simultaneously at the same time points using the Oroboros LED2 module. We measured tissue from the cortex and the hippocampus.
Results:
45 rats at four different timepoints, 6-, 24-, 48- and 96 hours after surgery, were included. We identified a significant reduction in respiration through complexes I and II of the electron transport chain in hippocampal tissue at 96 hours after SAH compared to sham. The respiration of cortical tissue at the same time point was reduced compared to sham but did not reach significance. No differences were identified at other time points and no differences in ROS generation were identified.
Conclusion:
We conclude that the SAH model can be used as a suitable model to identify mitochondrial dysfunction and that the respiratory capacity of the electron transport chain is reduced in the hippocampus at 96 h post insult in this rat model of SAH.
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Affiliation(s)
- Jesper P Bömers
- Neurosurgery, Copenhagen Univ Hosp - Rigshospitalet, Copenhagen, Denmark
| | - Michael Karlsson
- Neurosurgery, Copenhagen Univ Hosp - Rigshospitalet, Copenhagen, Denmark
| | - Tiit I Mathiesen
- Neurosurgery, Copenhagen Univ Hosp - Rigshospitalet, Copenhagen, Denmark
| | - Lars Edvinsson
- Clinical Experimental Rsch, Copenhagen Univ Hosp - Rigshospitalet, Glostrup, Denmark
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6
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Piel S, Janowska JI, Ward JL, McManus MJ, Jose JS, Starr J, Sheldon M, Clayman CL, Elmér E, Hansson MJ, Jang DH, Karlsson M, Ehinger JK, Kilbaugh TJ. Succinate prodrugs in combination with atropine and pralidoxime protect cerebral mitochondrial function in a rodent model of acute organophosphate poisoning. Sci Rep 2022; 12:20329. [PMID: 36434021 PMCID: PMC9700731 DOI: 10.1038/s41598-022-24472-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
Pesticides account for hundreds of millions of cases of acute poisoning worldwide each year, with organophosphates (OPs) being responsible for the majority of all pesticide-related deaths. OPs inhibit the enzyme acetylcholinesterase (AChE), which leads to impairment of the central- and peripheral nervous system. Current standard of care (SOC) alleviates acute neurologic-, cardiovascular- and respiratory symptoms and reduces short term mortality. However, survivors often demonstrate significant neurologic sequelae. This highlights the critical need for further development of adjunctive therapies with novel targets. While the inhibition of AChE is thought to be the main mechanism of injury, mitochondrial dysfunction and resulting metabolic crisis may contribute to the overall toxicity of these agents. We hypothesized that the mitochondrially targeted succinate prodrug NV354 would support mitochondrial function and reduce brain injury during acute intoxication with the OP diisopropylfluorophosphate (DFP). To this end, we developed a rat model of acute DFP intoxication and evaluated the efficacy of NV354 as adjunctive therapy to SOC treatment with atropine and pralidoxime. We demonstrate that NV354, in combination with atropine and pralidoxime therapy, significantly improved cerebral mitochondrial complex IV-linked respiration and reduced signs of brain injury in a rodent model of acute DFP exposure.
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Affiliation(s)
- Sarah Piel
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Joanna I. Janowska
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - J. Laurenson Ward
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Meagan J. McManus
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Joshua S. Jose
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Jonathan Starr
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Malkah Sheldon
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Carly L. Clayman
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Eskil Elmér
- grid.4514.40000 0001 0930 2361Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,Abliva AB, Lund, Sweden
| | - Magnus J. Hansson
- grid.4514.40000 0001 0930 2361Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,Abliva AB, Lund, Sweden
| | - David H. Jang
- grid.25879.310000 0004 1936 8972Division of Medical Toxicology, Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA
| | - Michael Karlsson
- grid.475435.4Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Johannes K. Ehinger
- grid.4514.40000 0001 0930 2361Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,grid.4514.40000 0001 0930 2361Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Todd J. Kilbaugh
- grid.239552.a0000 0001 0680 8770Resuscitation Science Center of Emphasis, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104 USA ,grid.239552.a0000 0001 0680 8770Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, USA
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7
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Mellion M, Widholm P, Karlsson M, Ahlgren A, Dahlqvist-Leinhard O, Tawil R, Wagner K, Statland J, Wang L, Shieh P, van Engelen B, Cadavid D, Ronco L, Odueyungbo A, Han J, Hatch M. IMAGING. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Bjällmark A, Bazzi M, Karlsson M, Krakys E, Kihlberg J. Radiology departmental policy compliance with Swedish guidelines regarding post-contrast acute kidney injury for examinations with iodinated contrast media. Radiography (Lond) 2021; 27:1058-1063. [PMID: 34023227 DOI: 10.1016/j.radi.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Guidelines concerning intravenous iodinated contrast media (CM) during computed tomography (CT) examinations are important to follow to minimize the risk for post-contrast acute kidney injury (PC-AKI). The purpose of this study was to investigate the radiology departmental policy compliance with Swedish guidelines concerning PC-AKI. METHODS In February 2020, an electronic survey was distributed to the responsible radiographer at 41 radiology departments in all university hospitals and medium-sized hospitals in Sweden. The questions focused on routines around renal functional tests, individualized contrast administration and handling of patients with diabetes mellitus taking metformin. RESULTS The response rate was 83%. Seventy-six percent (n = 26) of radiology departments calculated estimated glomerular filtration rate (eGFR) from serum creatinine prior to CM administration, but only 24% (n = 8) followed the recommendation to calculate eGFR from both serum creatinine and cystatin C. For acute/inpatients, 55% (n = 18) followed the recommendation that renal functional tests should be performed within 12 h before CM administration. For elective patients, 97% (n = 33) followed the recommendation to have eGFR newer than three months which is acceptable for patients with no history of disease that may have affected renal function. Approximately 80% of the radiology departments followed the recommendation that CM dose always should be individually adjusted to patient eGFR. Seventy-six percent (n = 26) followed the recommendation to continue with metformin at eGFR ≥ 45 ml/min. CONCLUSION Compliance with the national guidelines was high regarding routines around renal functional tests, dose adjustment of CM and metformin discontinuation. Improvements can be made in using both cystatin C and serum creatinine for eGFR calculations as well as ensuring renal function tests within 12 h for acute/inpatients with acute disease that may affect renal function. IMPLICATIONS FOR PRACTICE This study raises awareness of the importance of adhering to guidelines in healthcare. To have knowledge about the current level of compliance regarding PCI-AKI is important to maintain and develop effective clinical implementation of guidelines. The variation in practice seen in this study emphasizes the need of more effective implementation strategies to ensure adherence with best practice.
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Affiliation(s)
- A Bjällmark
- Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - M Bazzi
- Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - M Karlsson
- Department of Radiology, Höglandssjukhuset, Eksjö, Sweden
| | - E Krakys
- Department of Radiology, Motala Hospital, Motala, Sweden
| | - J Kihlberg
- Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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9
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Wagner K, Boehle A, Pathak P, Kasper M, Arsenault R, Jakob G, Käufl U, Leveratto S, Maire AL, Pantin E, Siebenmorgen R, Zins G, Absil O, Ageorges N, Apai D, Carlotti A, Choquet É, Delacroix C, Dohlen K, Duhoux P, Forsberg P, Fuenteseca E, Gutruf S, Guyon O, Huby E, Kampf D, Karlsson M, Kervella P, Kirchbauer JP, Klupar P, Kolb J, Mawet D, N'Diaye M, de Xivry GO, Quanz SP, Reutlinger A, Ruane G, Riquelme M, Soenke C, Sterzik M, Vigan A, de Zeeuw T. Author Correction: Imaging low-mass planets within the habitable zone of α Centauri. Nat Commun 2021; 12:2651. [PMID: 33953194 PMCID: PMC8099858 DOI: 10.1038/s41467-021-23145-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- K Wagner
- Dept. of Astronomy and Steward Observatory, University of Arizona, Tucson, AZ, USA. .,NASA Nexus for Exoplanet System Science, Earths in Other Solar Systems Team, Tucson, AZ, USA.
| | - A Boehle
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zürich, Switzerland
| | - P Pathak
- European Southern Observatory, Garching bei München, Germany
| | - M Kasper
- European Southern Observatory, Garching bei München, Germany
| | - R Arsenault
- European Southern Observatory, Garching bei München, Germany
| | - G Jakob
- European Southern Observatory, Garching bei München, Germany
| | - U Käufl
- European Southern Observatory, Garching bei München, Germany
| | - S Leveratto
- European Southern Observatory, Garching bei München, Germany
| | - A-L Maire
- STAR Institute, Université de Liège, Liège, Belgium
| | - E Pantin
- AIM, CEA, CNRS, Université Paris-Saclay, Université Paris Diderot, Sorbonne Paris Cité, Gif-sur-Yvette, France
| | - R Siebenmorgen
- European Southern Observatory, Garching bei München, Germany
| | - G Zins
- European Southern Observatory, Garching bei München, Germany
| | - O Absil
- STAR Institute, Université de Liège, Liège, Belgium
| | - N Ageorges
- Kampf Telescope Optics, München, Germany
| | - D Apai
- Dept. of Astronomy and Steward Observatory, University of Arizona, Tucson, AZ, USA.,NASA Nexus for Exoplanet System Science, Earths in Other Solar Systems Team, Tucson, AZ, USA.,Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - A Carlotti
- Univ. Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - É Choquet
- Aix Marseille Univ, CNRS, CNES, LAM, Marseille, France
| | - C Delacroix
- STAR Institute, Université de Liège, Liège, Belgium
| | - K Dohlen
- Aix Marseille Univ, CNRS, CNES, LAM, Marseille, France
| | - P Duhoux
- European Southern Observatory, Garching bei München, Germany
| | - P Forsberg
- Department of Materials Science and Engineering, Ångström Laboratory, Uppsala University, Uppsala, Sweden
| | - E Fuenteseca
- European Southern Observatory, Garching bei München, Germany
| | - S Gutruf
- Kampf Telescope Optics, München, Germany
| | - O Guyon
- Dept. of Astronomy and Steward Observatory, University of Arizona, Tucson, AZ, USA.,Subaru Telescope, National Astronomical Observatory of Japan, National Institutes of Natural Sciences (NINS), Hilo, HI, USA.,The Breakthrough Initiatives, NASA Research Park, Moffett Field, CA, USA.,James C. Wyant College of Optical Sciences, University of Arizona, Tucson, AZ, USA
| | - E Huby
- LESIA, Observatoire de Paris, Meudon, France
| | - D Kampf
- Kampf Telescope Optics, München, Germany
| | - M Karlsson
- Department of Materials Science and Engineering, Ångström Laboratory, Uppsala University, Uppsala, Sweden
| | - P Kervella
- LESIA, Observatoire de Paris, Meudon, France
| | - J-P Kirchbauer
- European Southern Observatory, Garching bei München, Germany
| | - P Klupar
- The Breakthrough Initiatives, NASA Research Park, Moffett Field, CA, USA
| | - J Kolb
- European Southern Observatory, Garching bei München, Germany
| | - D Mawet
- California Institute of Technology, Pasadena, CA, USA
| | - M N'Diaye
- Université Côte d'Azur, Observatoire de la Côte d'Azur, CNRS, Laboratoire Lagrange, Nice, France
| | | | - S P Quanz
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zürich, Switzerland
| | | | - G Ruane
- California Institute of Technology, Pasadena, CA, USA.,Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - M Riquelme
- European Southern Observatory, Garching bei München, Germany
| | - C Soenke
- European Southern Observatory, Garching bei München, Germany
| | - M Sterzik
- European Southern Observatory, Garching bei München, Germany
| | - A Vigan
- Aix Marseille Univ, CNRS, CNES, LAM, Marseille, France
| | - T de Zeeuw
- European Southern Observatory, Garching bei München, Germany.,Sterrewacht Leiden, Leiden University, Leiden, The Netherlands.,Max Planck Institute for Extraterrestrial Physics, Garching, Germany
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10
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Kristjansdottir H, Mellström D, Johansson P, Karlsson M, Vandenput L, Lorentzon M, Herlitz H, Ohlsson C, Lerner U, Lewerin C. High platelet count is associated with low bone mineral density: The MrOS Sweden cohort. Osteoporos Int 2021; 32:865-871. [PMID: 33313993 PMCID: PMC8043867 DOI: 10.1007/s00198-020-05766-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/25/2020] [Indexed: 12/16/2022]
Abstract
UNLABELLED In elderly ambulatory men, high platelet and high neutrophil counts are related to low bone mineral density (BMD), after adjustment for relevant covariates. Low hemoglobin (hgb) is even associated with low BMD, but this relationship seems to be dependent on estradiol and osteocalcin. PURPOSE Blood and bone cells exist in close proximity to each other in the bone marrow. Accumulating evidence, from both preclinical and clinical studies, indicates that these cell types are interconnected. Our hypothesis was that BMD measurements are associated with blood count variables and bone remodeling markers. METHODS We analyzed blood count variables, bone remodeling markers, and BMD, in subjects from the MrOS cohort from Gothenburg, Sweden. Men with at least one blood count variable (hgb, white blood cell count, or platelet count) analyzed were included in the current analysis (n = 1005), median age 75.3 years (range 69-81 years). RESULTS Our results show that high platelet counts were related to low BMD at all sites (total hip BMD; r = - 0.11, P = 0.003). No statistically significant association was seen between platelet counts and bone remodeling markers. Neutrophil counts were negatively associated with total body BMD (r = - 0.09, P = 0.006) and total hip BMD (r = - 0.08, P = 0.010), and positively related to serum ALP (r = 0.15, P < 0.001). Hgb was positively related to total hip BMD (r = 0.16, P < 0.001), and negatively to serum osteocalcin (r = - 0.13, P < 0.001). The association between platelet and neutrophil counts and total hip BMD was statistically significant after adjustments for other covariates, but the association between hgb and total hip BMD was dependent on estradiol and osteocalcin. CONCLUSIONS Our observations support the hypothesis of an interplay between blood and bone components.
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Affiliation(s)
- H.L. Kristjansdottir
- grid.8761.80000 0000 9919 9582Section of Hematology and Coagulation at the Sahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Bruna Stråket 5, 413 45 Gothenburg, Sweden
| | - D. Mellström
- grid.8761.80000 0000 9919 9582Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- grid.8761.80000 0000 9919 9582Department of Geriatric Medicine, Internal Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - P. Johansson
- grid.8761.80000 0000 9919 9582Section of Hematology and Coagulation at the Sahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Bruna Stråket 5, 413 45 Gothenburg, Sweden
| | - M. Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Skåne University Hospital (SUS), Lund University, Malmö, Sweden
| | - L. Vandenput
- grid.8761.80000 0000 9919 9582Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- grid.411958.00000 0001 2194 1270Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria Australia
| | - M. Lorentzon
- grid.8761.80000 0000 9919 9582Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- grid.8761.80000 0000 9919 9582Department of Geriatric Medicine, Internal Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- grid.411958.00000 0001 2194 1270Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria Australia
| | - H. Herlitz
- grid.8761.80000 0000 9919 9582Department of Molecular and Clinical Medicine/Nephrology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C. Ohlsson
- grid.8761.80000 0000 9919 9582Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- grid.1649.a000000009445082XDepartment of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - U.H. Lerner
- grid.8761.80000 0000 9919 9582Center for Bone and Arthritis Research (CBAR) at the Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - C. Lewerin
- grid.8761.80000 0000 9919 9582Section of Hematology and Coagulation at the Sahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Bruna Stråket 5, 413 45 Gothenburg, Sweden
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11
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Senthil K, Morgan RW, Hefti MM, Karlsson M, Lautz AJ, Mavroudis CD, Ko T, Nadkarni VM, Ehinger J, Berg RA, Sutton RM, McGowan FX, Kilbaugh TJ. Haemodynamic-directed cardiopulmonary resuscitation promotes mitochondrial fusion and preservation of mitochondrial mass after successful resuscitation in a pediatric porcine model. Resusc Plus 2021; 6:100124. [PMID: 34223382 PMCID: PMC8244484 DOI: 10.1016/j.resplu.2021.100124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 01/09/2023] Open
Abstract
Objective Cerebral mitochondrial dysfunction is a key mediator of neurologic injury following cardiac arrest (CA) and is regulated by the balance of fusion and fission (mitochondrial dynamics). Under stress, fission can decrease mitochondrial mass and signal apoptosis, while fusion promotes oxidative phosphorylation efficiency. This study evaluates mitochondrial dynamics and content in brain tissue 24 h after CA between two cardiopulmonary resuscitation (CPR) strategies. Interventions Piglets (1 month), previously randomized to three groups: (1) Std-CPR (n = 5); (2) HD-CPR (n = 5; goal systolic blood pressure 90 mmHg, goal coronary perfusion pressure 20 mmHg); (3) Shams (n = 7). Std-CPR and HD-CPR groups underwent 7 min of asphyxia, 10 min of CPR, and standardized post-resuscitation care. Primary outcomes: (1) cerebral cortical mitochondrial protein expression for fusion (OPA1, OPA1 long to short chain ratio, MFN2) and fission (DRP1, FIS1), and (2) mitochondrial mass by citrate synthase activity. Secondary outcomes: (1) intra-arrest haemodynamics and (2) cerebral performance category (CPC) at 24 h. Results HD-CPR subjects had higher total OPA1 expression compared to Std-CPR (1.52; IQR 1.02-1.69 vs 0.67; IQR 0.54-0.88, p = 0.001) and higher OPA1 long to short chain ratio than both Std-CPR (0.63; IQR 0.46-0.92 vs 0.26; IQR 0.26-0.31, p = 0.016) and shams. Citrate synthase activity was lower in Std-CPR than sham (11.0; IQR 10.15-12.29 vs 13.4; IQR 12.28-15.66, p = 0.047), but preserved in HD-CPR. HD-CPR subjects had improved intra-arrest haemodynamics and CPC scores at 24 h compared to Std-CPR. Conclusions Following asphyxia-associated CA, HD-CPR exhibits increased pro-mitochondrial fusion protein expression, preservation of mitochondrial mass, improved haemodynamics and superior neurologic scoring compared to Std-CPR. Institutional protocol number IAC 16-001023.
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Affiliation(s)
- Kumaran Senthil
- Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, United States
| | - Ryan W Morgan
- Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, United States
| | - Marco M Hefti
- University of Iowa, Division of Pathology, United States
| | | | - Andrew J Lautz
- Cincinnati Children's Hospital Medical Center, Division of Critical Care Medicine, United States
| | - Constantine D Mavroudis
- Department of Neurosurgery, Righospitalet, Copenhagen, Denmark.,Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Division of Cardiothoracic Surgery, United States
| | - Tiffany Ko
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Division of Neurology, United States
| | - Vinay M Nadkarni
- Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, United States
| | | | - Robert A Berg
- Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, United States
| | - Robert M Sutton
- Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, United States
| | - Francis X McGowan
- Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, United States
| | - Todd J Kilbaugh
- Children's Hospital of Philadelphia and Perelman School of Medicine at University of Pennsylvania, Department of Anesthesiology and Critical Care Medicine, United States
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12
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Andersson MS, Grinderslev JB, Chen XM, Chen X, Häussermann U, Zhou W, Jensen TR, Karlsson M, Udovic TJ. Interplay between the Reorientational Dynamics of the B 3H 8 - Anion and the Structure in KB 3H 8. J Phys Chem C Nanomater Interfaces 2021; 125:3716-3724. [PMID: 33841604 PMCID: PMC8023716 DOI: 10.1021/acs.jpcc.0c10186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/04/2021] [Indexed: 05/25/2023]
Abstract
The structure and reorientational dynamics of KB3H8 were studied by using quasielastic and inelastic neutron scattering, Raman spectroscopy, first-principles calculations, differential scanning calorimetry, and in situ synchrotron radiation powder X-ray diffraction. The results reveal the existence of a previously unknown polymorph in between the α'- and β-polymorphs. Furthermore, it was found that the [B3H8]- anion undergoes different reorientational motions in the three polymorphs α, α', and β. In α-KB3H8, the [B3H8]- anion performs 3-fold rotations in the plane created by the three boron atoms, which changes to a 2-fold rotation around the C 2 symmetry axis of the [B3H8]- anion upon transitioning to α'-KB3H8. After transitioning to β-KB3H8, the [B3H8]- anion performs 4-fold rotations in the plane created by the three boron atoms, which indicates that the local structure of β-KB3H8 deviates from the global cubic NaCl-type structure. The results also indicate that the high reorientational mobility of the [B3H8]- anion facilitates the K+ cation conductivity, since the 2-orders-of-magnitude increase in the anion reorientational mobility observed between 297 and 311 K coincides with a large increase in K+ conductivity.
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Affiliation(s)
- M. S. Andersson
- Department
of Chemistry and Chemical Engineering, Chalmers
University of Technology, Göteborg SE-412 96, Sweden
- NIST
Center for Neutron Research, National Institute
of Standards and Technology, Gaithersburg, Maryland 20899-6102, United States
| | - J. B. Grinderslev
- Interdisciplinary
Nanoscience Center (iNANO) and Department of Chemistry, Aarhus University, DK-8000 Aarhus, Denmark
| | - X.-M. Chen
- School
of Chemistry and Chemical Engineering, Henan Key Laboratory of Boron
Chemistry and Advanced Energy Materials, Henan Normal University, Xinxiang, Henan 453007, China
| | - X. Chen
- School
of Chemistry and Chemical Engineering, Henan Key Laboratory of Boron
Chemistry and Advanced Energy Materials, Henan Normal University, Xinxiang, Henan 453007, China
- College
of Chemistry and Green Catalysis Center, Zhengzhou University, Zhengzhou, Henan 450001, China
| | - U. Häussermann
- Department
of Materials and Environmental Chemistry, Stockholm University, SE-10691 Stockholm, Sweden
| | - W. Zhou
- NIST
Center for Neutron Research, National Institute
of Standards and Technology, Gaithersburg, Maryland 20899-6102, United States
| | - T. R. Jensen
- Interdisciplinary
Nanoscience Center (iNANO) and Department of Chemistry, Aarhus University, DK-8000 Aarhus, Denmark
| | - M. Karlsson
- Department
of Chemistry and Chemical Engineering, Chalmers
University of Technology, Göteborg SE-412 96, Sweden
| | - T. J. Udovic
- NIST
Center for Neutron Research, National Institute
of Standards and Technology, Gaithersburg, Maryland 20899-6102, United States
- Department
of Materials Science and Engineering, University
of Maryland, College Park, Maryland 20742-2115, United States
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13
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Karlsson M, Yang Z, Chawla S, Delso N, Pukenas B, Elmér E, Hugerth M, Margulies SS, Ehinger J, Hansson MJ, Wang KKW, Kilbaugh TJ. Evaluation of Diffusion Tensor Imaging and Fluid Based Biomarkers in a Large Animal Trial of Cyclosporine in Focal Traumatic Brain Injury. J Neurotrauma 2021; 38:1870-1878. [PMID: 33191835 DOI: 10.1089/neu.2020.7317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
All phase III trials evaluating medical treatments for traumatic brain injury (TBI), performed to date, have failed. To facilitate future success there is a need for novel outcome metrics that can bridge pre-clinical studies to clinical proof of concept trials. Our objective was to assess diffusion tensor imaging (DTI) and biofluid-based biomarkers as efficacy outcome metrics in a large animal study evaluating the efficacy of cyclosporine in TBI. This work builds on our previously published study that demonstrated a reduced volume of injury by 35% with cyclosporine treatment based on magnetic resonance imaging (MRI) results. A focal contusion injury was induced in piglets using a controlled cortical impact (CCI) device. Cyclosporine in a novel Cremophor/Kolliphor EL-free lipid emulsion, NeuroSTAT, was administered by continuous intravenous infusion for 5 days. The animals underwent DTI on day 5. Glial fibrillary acidic protein (GFAP), as a measure of astroglia injury, and neurofilament light (NF-L), as a measure of axonal injury, were measured in blood on days 1, 2, and 5, and in cerebrospinal fluid (CSF) on day 5 post-injury. Normalized fractional anisotropy (FA) was significantly (p = 0.027) higher in in the treatment group, indicating preserved tissue integrity with treatment. For the biomarkers, we observed a statistical trend of a decreased level of NF-L in CSF (p = 0.051), in the treatment group relative to placebo, indicating less axonal injury. Our findings suggest that DTI, and possibly CSF NF-L, may be feasible as translational end-points assessing neuroprotective drugs in TBI.
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Affiliation(s)
- Michael Karlsson
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.,Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, USA
| | - Zhihui Yang
- Program for Neurotrauma, Neuroproteomics, and Biomarkers Research, Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
| | - Sanjeev Chawla
- Department of Radiology, Perelman School of Medicine at University of Pennsylvania, Philadelphia, USA
| | - Nile Delso
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, USA
| | - Bryan Pukenas
- Department of Radiology, Perelman School of Medicine at University of Pennsylvania, Philadelphia, USA
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,Abliva AB, Lund, Sweden
| | | | - Susan S Margulies
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Johannes Ehinger
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Magnus J Hansson
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,Abliva AB, Lund, Sweden
| | - Kevin K W Wang
- Program for Neurotrauma, Neuroproteomics, and Biomarkers Research, Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
| | - Todd J Kilbaugh
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, USA
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14
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Olsen MH, Olesen ND, Karlsson M, Holmlöv T, Søndergaard L, Boutelle M, Mathiesen T, Møller K. Randomized blinded trial of automated REBOA during CPR in a porcine model of cardiac arrest. Resuscitation 2021; 160:39-48. [PMID: 33482264 DOI: 10.1016/j.resuscitation.2021.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Resuscitative endovascular balloon occlusion of the aorta (REBOA) reportedly elevates arterial blood pressure (ABP) during non-traumatic cardiac arrest. OBJECTIVES This randomized, blinded trial of cardiac arrest in pigs evaluated the effect of automated REBOA two minutes after balloon inflation on ABP (primary endpoint) as well as arterial blood gas values and markers of cerebral haemodynamics and metabolism. METHODS Twenty anesthetized pigs were randomized to REBOA inflation or sham-inflation (n = 10 in each group) followed by insertion of invasive monitoring and a novel, automated REBOA catheter (NEURESCUE® Catheter & NEURESCUE® Assistant). Cardiac arrest was induced by ventricular pacing. Cardiopulmonary resuscitation was initiated three min after cardiac arrest, and the automated REBOA was inflated or sham-inflated (blinded to the investigators) five min after cardiac arrest. RESULTS In the inflation compared to the sham group, mean ABP above the REBOA balloon after inflation was higher (inflation: 54 (95%CI: 43-65) mmHg; sham: 44 (33-55) mmHg; P = 0.06), and diastolic ABP was higher (inflation: 38 (29-47) mmHg; sham: 26 (20-33) mmHg; P = 0.02), and the arterial to jugular oxygen content difference was lower (P = 0.04). After return of spontaneous circulation, mean ABP (inflation: 111 (95%CI: 94-128) mmHg; sham: 94 (95%CI: 65-123) mmHg; P = 0.04), diastolic ABP (inflation: 95 (95%CI: 78-113) mmHg; sham: 78 (95%CI: 50-105) mmHg; P = 0.02), CPP (P = 0.01), and brain tissue oxygen tension (inflation: 315 (95%CI: 139-491)% of baseline; sham: 204 (95%CI: 75-333)%; P = 0.04) were higher in the inflation compared to the sham group. CONCLUSION Inflation of REBOA in a porcine model of non-traumatic cardiac arrest improves central diastolic arterial pressure as a surrogate marker of coronary artery pressure, and cerebral perfusion. INSTITUTIONAL PROTOCOL NUMBER 2017-15-0201-01371.
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Affiliation(s)
- Markus Harboe Olsen
- Department of Neurointensive Care and Neuroanaesthesiology, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark.
| | - Niels D Olesen
- Department of Anesthesiology, Centre of Cancer and Organ Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - Michael Karlsson
- Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark
| | - Theodore Holmlöv
- Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Lars Søndergaard
- Department of Cardiology, Centre of Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Martyn Boutelle
- Faculty of Engineering, Department of Bioengineering, Imperial College, London, United Kingdom
| | - Tiit Mathiesen
- Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kirsten Møller
- Department of Neurointensive Care and Neuroanaesthesiology, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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15
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Ehinger JK, Karlsson M, Sjövall F, Leffler M, McCormack SE, Kubis SE, Åkesson A, Falk MJ, Kilbaugh TJ. Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit. Pediatr Res 2021; 90:1221-1227. [PMID: 33627817 PMCID: PMC7903037 DOI: 10.1038/s41390-021-01410-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to identify factors predicting outcome in patients with mitochondrial disease admitted to pediatric intensive care units (PICU). METHODS Retrospective study of 2434 patients (age <21 years) admitted to a PICU from 1 January 2006 through 31 March 2016 and captured in the Virtual Pediatric Systems database with ICD9 diagnosis 277.87, disorders of mitochondrial metabolism. Factors influencing mortality and prolonged length of stay (≥14 days) were analyzed using logistic regression. RESULTS Predictors independently affecting mortality (adjusted odds ratios and 95% confidence intervals, p < 0.05): age 1-23 months 3.4 (1.7-6.6) and mechanical ventilation 4.7 (2.6-8.6) were risk factors; post-operative 0.2 (0.1-0.6), readmission 0.5 (0.3-0.9), and neurologic reason for admittance 0.3 (0.1-0.9) were factors reducing risk. Predictors affecting prolonged length of stay: mechanical ventilation 7.4 (5.2-10.3) and infectious reason for admittance 2.0 (1.3-3.2) were risk factors, post-operative patients 0.3 (0.2-0.5) had lower risk. The utility of PRISM and PIM2 scores in this patient group was evaluated. CONCLUSIONS The single most predictive factor for both mortality and prolonged length of stay is the presence of mechanical ventilation. Age 1-23 months is a risk factor for mortality, and infectious reason for admittance indicates risk for prolonged length of stay. IMPACT Presence of mechanical ventilation is the factor most strongly associated with negative outcome in patients with mitochondrial disease in pediatric intensive care. Age 1-23 months is a risk factor for mortality, and infectious reason for admittance indicates risk for prolonged length of stay PRISM3 and PIM2 are not as accurate in patients with mitochondrial disease as in a mixed patient population.
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Affiliation(s)
- Johannes K. Ehinger
- grid.4514.40000 0001 0930 2361Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,grid.25879.310000 0004 1936 8972Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA ,grid.239552.a0000 0001 0680 8770Center for Mitochondrial and Epigenomic Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.411843.b0000 0004 0623 9987Department of Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden
| | - Michael Karlsson
- grid.4514.40000 0001 0930 2361Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,grid.25879.310000 0004 1936 8972Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA ,grid.239552.a0000 0001 0680 8770Center for Mitochondrial and Epigenomic Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.475435.4Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Fredrik Sjövall
- grid.4514.40000 0001 0930 2361Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,grid.411843.b0000 0004 0623 9987Department of Intensive- and perioperative Care, Skåne University Hospital, Malmö, Sweden
| | - Märta Leffler
- grid.4514.40000 0001 0930 2361Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,grid.411843.b0000 0004 0623 9987Department of Intensive- and perioperative Care, Skåne University Hospital, Malmö, Sweden
| | - Shana E. McCormack
- grid.239552.a0000 0001 0680 8770Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Sherri E. Kubis
- grid.239552.a0000 0001 0680 8770Department of Nursing, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Anna Åkesson
- grid.411843.b0000 0004 0623 9987Clinical Studies Sweden – Forum South, Skåne University Hospital, Lund, Sweden
| | - Marni J. Falk
- grid.239552.a0000 0001 0680 8770Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Todd J. Kilbaugh
- grid.25879.310000 0004 1936 8972Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA ,grid.239552.a0000 0001 0680 8770Center for Mitochondrial and Epigenomic Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
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16
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Nielsen S, Giang K, Karlsson M, Hansson E, Pivodic A, Lindgren M, Jeppsson A. Younger patients have an increased risk for dementia after coronary artery bypass grafting, a population-based cohort study from the SWEDEHEART registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous studies investigating the association between coronary artery bypass grafting (CABG) and risk for dementia show conflicting results.
Purpose
To compare the long-term risk for dementia in CABG patients to matched individuals in the general population, and to identify independent predictors for developing dementia after CABG.
Methods
Data from the SWEDEHEART registry and three other mandatory national registries were merged to compare all patients who underwent isolated CABG in Sweden from 1992 to 2015 (n=111.335) with an age- and sex-matched control individuals from the general population (n=222.396). Cumulative incidence adjusted for the competing risk for death and Cox regression models with Hazard Ratio (HR) and 95% confidence interval (CI) adjusted for age, gender, co-morbidity and socioeconomic variables, were used to calculate the risk of dementia. Median follow-up was 10.1 years (IQR 2.5–14.7) among CABG patients and 10.7 years (5.6–15.7) among the controls. Identified interactions of the excess risk for dementia with sex and age categories (<65, 65-<75, ≥75 years) resulted in analyses being stratified on those sub-cohorts.
Results
The overall cumulative incidence at 20 years follow up of all-cause dementia was 9.6% (95% CI 9.4–9.9) among CABG patients and 9.0 (8.8–9.2) among individuals in the general population. The adjusted relative risk for all-cause dementia was increased among CABG patients <65 years and 65–75 years, (HR 1.29 (95% CI 1.17–1.41) and HR 1.06 (1.01–1.11), respectively (fig 1). The risk for all-cause dementia was higher in CABG women than in CABG men (HR 1.62 (1.30–2.03) vs HR 1.22 (1.10–1.35)). In the oldest age group (75 years and older) the risk for all cause dementia, vascular dementia and Alzheimer's disease was lower for CABG patients compared to controls (HR 0.73 (0.69–0.78). Female CABG patients <65 years had an increased risk for Alzheimer's disease (HR 1.83 (1.06–3.15). Hypertension, diabetes, preoperative stroke, renal failure, heart failure, atrial fibrillation, depression and low income were independent predictors for all-cause dementia in CABG patients.
Conclusion
CABG patients younger than 75 years at the time of surgery have an increased risk of all-cause dementia compared to an age- and sex-matched population. Women younger than 65 years that underwent CABG had also a markedly higher risk for Alzheimer disease. Increased awareness of the higher risk for dementia in younger CABG patients is warranted to avoid delay of diagnosis and treatment.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Swedish Heart and Lung Foundation, Swedish State
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Affiliation(s)
- S Nielsen
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - K.W Giang
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - M Karlsson
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - E.C Hansson
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - A Pivodic
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg, Department of Ophthalmology, Institute of Neuroscience and Physiology, Gothenburg, Sweden
| | - M Lindgren
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - A Jeppsson
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
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17
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Mavroudis CD, Ko TS, Morgan RW, Volk LE, Landis WP, Smood B, Xiao R, Hefti M, Boorady TW, Marquez A, Karlsson M, Licht DJ, Nadkarni VM, Berg RA, Sutton RM, Kilbaugh TJ. Epinephrine's effects on cerebrovascular and systemic hemodynamics during cardiopulmonary resuscitation. Crit Care 2020; 24:583. [PMID: 32993753 PMCID: PMC7522922 DOI: 10.1186/s13054-020-03297-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 09/17/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite controversies, epinephrine remains a mainstay of cardiopulmonary resuscitation (CPR). Recent animal studies have suggested that epinephrine may decrease cerebral blood flow (CBF) and cerebral oxygenation, possibly potentiating neurological injury during CPR. We investigated the cerebrovascular effects of intravenous epinephrine in a swine model of pediatric in-hospital cardiac arrest. The primary objectives of this study were to determine if (1) epinephrine doses have a significant acute effect on CBF and cerebral tissue oxygenation during CPR and (2) if the effect of each subsequent dose of epinephrine differs significantly from that of the first. METHODS One-month-old piglets (n = 20) underwent asphyxia for 7 min, ventricular fibrillation, and CPR for 10-20 min. Epinephrine (20 mcg/kg) was administered at 2, 6, 10, 14, and 18 min of CPR. Invasive (laser Doppler, brain tissue oxygen tension [PbtO2]) and noninvasive (diffuse correlation spectroscopy and diffuse optical spectroscopy) measurements of CBF and cerebral tissue oxygenation were simultaneously recorded. Effects of subsequent epinephrine doses were compared to the first. RESULTS With the first epinephrine dose during CPR, CBF and cerebral tissue oxygenation increased by > 10%, as measured by each of the invasive and noninvasive measures (p < 0.001). The effects of epinephrine on CBF and cerebral tissue oxygenation decreased with subsequent doses. By the fifth dose of epinephrine, there were no demonstrable increases in CBF of cerebral tissue oxygenation. Invasive and noninvasive CBF measurements were highly correlated during asphyxia (slope effect 1.3, p < 0.001) and CPR (slope effect 0.20, p < 0.001). CONCLUSIONS This model suggests that epinephrine increases CBF and cerebral tissue oxygenation, but that effects wane following the third dose. Noninvasive measurements of neurological health parameters hold promise for developing and directing resuscitation strategies.
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Affiliation(s)
- Constantine D Mavroudis
- Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA. .,Division of Cardiovascular Surgery, The University of Pennsylvania, Philadelphia, PA, USA.
| | - Tiffany S Ko
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lindsay E Volk
- Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - William P Landis
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Benjamin Smood
- Division of Cardiovascular Surgery, The University of Pennsylvania, Philadelphia, PA, USA
| | - Rui Xiao
- Department of Pediatrics, Division of Biostatistics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marco Hefti
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Timothy W Boorady
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alexandra Marquez
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Daniel J Licht
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Vinay M Nadkarni
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Robert M Sutton
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Todd J Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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18
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Karlsson M, Steinvall I, Olofsson P, Thorfinn J, Sjöberg F, Åstrand L, Fayiz S, Khalaf A, Divyasree P, El-Serafi A, Elmasry M. Sprayed cultured autologous keratinocytes in the treatment of severe burns: a retrospective matched cohort study. Ann Burns Fire Disasters 2020; 33:134-142. [PMID: 32913435 PMCID: PMC7452605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 02/20/2020] [Indexed: 06/11/2023]
Abstract
The standard treatment of burns is early excision followed by autologous skin grafting. The closure of extensive deep burns poses a considerable challenge. Cultured autologous keratinocytes have been used since 1981 in an effort to improve healing. However, the time required to culture the cells and the lack of a dermal component limit the expectations of outcome. Our aim was to compare the duration of hospital stay between patients who were treated with autologous skin grafts and cultured autologous keratinocytes and those who were treated with autologous skin grafting without cultured autologous keratinocytes. In this retrospective study all patients treated with cultured autologous keratinocytes between 2012 and 2015 were matched by size and depth of burn with patients not treated with cultured autologous keratinocytes. Multivariable regression was used to analyse associations between duration of hospital stay and treatment adjusted for age, mortality, size and depth of the burn. Then, we investigated the possibility of differentiation of human bone marrow stem cell line to keratinocyte- like cells as a future direction. The regression analysis showed a coefficient of 17.36 (95% CI -17.69 to 52.40), p= 0.32, for hospital stay in the treatment group, compared with the matched group. Our results showed no difference in the duration of hospital stay between the two treatments. Autologous stem cells should be considered as a future modality of burn management, although further studies are needed.
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Affiliation(s)
- M. Karlsson
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - I. Steinvall
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - P. Olofsson
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - J. Thorfinn
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - F. Sjöberg
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - L. Åstrand
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - S. Fayiz
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - A. Khalaf
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - P. Divyasree
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - A.T. El-Serafi
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
- Suez Canal University, Ismailia, Egypt
| | - M. Elmasry
- Department of Hand Surgery, Plastic Surgery and Burns in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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19
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Vala CH, Kärrholm J, Kanis JA, Johansson H, Sten S, Sundh V, Karlsson M, Lorentzon M, Mellström D. Risk for hip fracture before and after total knee replacement in Sweden. Osteoporos Int 2020; 31:887-895. [PMID: 31832694 PMCID: PMC7170830 DOI: 10.1007/s00198-019-05241-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/19/2019] [Indexed: 11/29/2022]
Abstract
UNLABELLED We studied the risk for hip fracture before and after total knee replacement (TKR) in the entire population in Sweden. Women and men had a low risk for hip fracture before TKR but an increased risk the first year after TKR. PURPOSE It is known that osteoarthritis is associated with high bone mass. We therefore studied the risk of hip fracture before and after total knee replacement (TKR), risk of different hip fracture types, and risk subdivided in genders and age groups. METHODS We followed the total Swedish population born between 1902 and 1952 (n = 4,258,934) during the period 1987-2002 and identified all patients with TKR due to primary OA (n = 39,291), and all patients with hip fracture (n = 195,860) in the Swedish National Inpatient Register. The risk time analyses were based on Poisson regression models. RESULTS The hazard ratio (HR) for hip fracture the last year before TKR was 0.86 (95% CI 0.74 to 1.00) and the first year after 1.26 (95% CI 1.11 to 1.42) compared to individuals without TKR. The HR for femoral neck fracture 0-10 years after TKR was 0.95 (95% CI 0.89 to 1.01) and for trochanteric fracture was 1.13 (95% CI 1.06 to 1.21). The HR for hip fracture in the age group 50-74 was 1.28 (95% CI 1.14 to 1.43) and in the age group 75-90 years was 0.99 (95% CI 0.94 to 1.04) 0-10 years after TKR, compared to individuals without TKR. CONCLUSION Individuals had a low risk for hip fracture before TKR but an increased risk the first year after TKR. The risk in individuals below age 75 years and for trochanteric fractures was increased after TKR. Possible explanations include changed knee kinematics after a TKR, physical activity level, fall risk, and other unknown factors.
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Affiliation(s)
- C H Vala
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden.
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden.
| | - J Kärrholm
- Department of Orthopedic Surgery, Sahlgrenska Academy, University of Gothenburg, 431 80, Mölndal, Sweden
| | - J A Kanis
- Centre for Metabolic Bone Disease, Medical School, University of Sheffield, S10 2RX, Sheffield, UK
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, VIC, 3000, Australia
| | - H Johansson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
| | - S Sten
- Department of Archaeology and Ancient History, Uppsala University- Campus Gotland, 621 57, Visby, Sweden
| | - V Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
| | - M Karlsson
- Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden
| | - M Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, VIC, 3000, Australia
- Center for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - D Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden
- Center for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
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20
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Marquez AM, Morgan RW, Ko T, Landis WP, Hefti MM, Mavroudis CD, McManus MJ, Karlsson M, Starr J, Roberts AL, Lin Y, Nadkarni V, Licht DJ, Berg RA, Sutton RM, Kilbaugh TJ. Oxygen Exposure During Cardiopulmonary Resuscitation Is Associated With Cerebral Oxidative Injury in a Randomized, Blinded, Controlled, Preclinical Trial. J Am Heart Assoc 2020; 9:e015032. [PMID: 32321350 PMCID: PMC7428577 DOI: 10.1161/jaha.119.015032] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Hyperoxia during cardiopulmonary resuscitation (CPR) may lead to oxidative injury from mitochondrial‐derived reactive oxygen species, despite guidelines recommending 1.0 inspired oxygen during CPR. We hypothesized exposure to 1.0 inspired oxygen during CPR would result in cerebral hyperoxia, higher mitochondrial‐derived reactive oxygen species, increased oxidative injury, and similar survival compared with those exposed to 21% oxygen. Methods and Results Four‐week‐old piglets (n=25) underwent asphyxial cardiac arrest followed by randomization and blinding to CPR with 0.21 (n=10) or 1.0 inspired oxygen (n=10) through 10 minutes post return of spontaneous circulation. Sham was n=5. Survivors received 4 hours of protocolized postarrest care, whereupon brain was obtained for mitochondrial analysis and neuropathology. Groups were compared using Kruskal‐Wallis test, Wilcoxon rank‐sum test, and generalized estimating equations regression models. Both 1.0 and 0.21 groups were similar in systemic hemodynamics and cerebral blood flow, as well as survival (8/10). The 1.0 animals had relative cerebral hyperoxia during CPR and immediately following return of spontaneous circulation (brain tissue oxygen tension, 85% [interquartile range, 72%–120%] baseline in 0.21 animals versus 697% [interquartile range, 515%–721%] baseline in 1.0 animals; P=0.001 at 10 minutes postarrest). Cerebral mitochondrial reactive oxygen species production was higher in animals treated with 1.0 compared with 0.21 (P<0.03). Exposure to 1.0 oxygen led to increased cerebral oxidative injury to proteins and lipids, as evidenced by significantly higher protein carbonyls and 4‐hydroxynoneals compared with 0.21 (P<0.05) and sham (P<0.001). Conclusions Exposure to 1.0 inspired oxygen during CPR caused cerebral hyperoxia during resuscitation, and resultant increased mitochondrial‐derived reactive oxygen species and oxidative injury following cardiac arrest.
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Affiliation(s)
- Alexandra M Marquez
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Ryan W Morgan
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Tiffany Ko
- Division of Neurology Department of Pediatrics Children's Hospital of Philadelphia PA
| | - William P Landis
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Marco M Hefti
- Department of Pathology University of Iowa Iowa City IA
| | - Constantine D Mavroudis
- Division of Cardiothoracic Surgery Department of Surgery Children's Hospital of Philadelphia PA
| | - Meagan J McManus
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | | | - Jonathan Starr
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Anna L Roberts
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Yuxi Lin
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Vinay Nadkarni
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Daniel J Licht
- Division of Neurology Department of Pediatrics Children's Hospital of Philadelphia PA
| | - Robert A Berg
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Robert M Sutton
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
| | - Todd J Kilbaugh
- Division of Critical Care Medicine Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia PA
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21
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Vala CH, Lorentzon M, Sundh V, Johansson H, Lewerin C, Sten S, Karlsson M, Ohlsson C, Johansson B, Kanis JA, Mellström D. Increased risk for hip fracture after death of a spouse-further support for bereavement frailty? Osteoporos Int 2020; 31:485-492. [PMID: 31832693 PMCID: PMC7075824 DOI: 10.1007/s00198-019-05242-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/19/2019] [Indexed: 12/16/2022]
Abstract
UNLABELLED Death of a spouse is associated with poorer physical and mental health. We followed all married individuals, born from 1902 to 1942, during the period from 1987 to 2002, and found that widows and widowers had higher risk for hip fracture, compared with still married women and men. INTRODUCTION Spousal bereavement can lead to poorer physical and mental health. We aimed to determine whether married women and men had an elevated risk of hip fracture after death of a spouse. METHODS In a retrospective cohort study, we followed all Swedish married individuals aged 60 to 100 years (n = 1,783,035), from 1987 to 2002. Data are presented as mean with 95% confidence interval (CI). RESULTS During the follow-up period, 21,305 hip fractures among widows and 6538 hip fractures among widowers were noted. The hazard ratio (HR) for hip fracture in widows compared with married women was 1.34 (95% CI 1.31 to 1.37) and for widowers compared with married men 1.32 (95% CI 1.29 to 1.35). The HR for hip fracture in the first 6 months after death of a spouse was in widows compared with married women 1.62 (95% CI 1.53 to 1.71) and in widowers compared with married men 1.84 (95% CI 1.68 to 2.03). The elevated risk was especially prominent in young widowers in the age range 60-69 years. During the first 6 months they showed a HR of 2.76 (95% CI 1.66 to 4.58) for a hip fractvure compared with age matched married men. Widows aged 60-69 years showed a HR of 1.59 (95% CI 1.26 to 1.99) compared with age matched married women. CONCLUSION Our observation of a higher hip fracture risk in both genders in connection with the death of a spouse indicates a possible effect of bereavement on frailty.
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Affiliation(s)
- C H Vala
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden.
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden.
| | - M Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
| | - V Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
| | - H Johansson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
| | - C Lewerin
- Section of Haematology and Coagulation, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
| | - S Sten
- Department of Archaeology and Ancient History, Uppsala University-Campus Gotland, 621 57, Visby, Sweden
| | - M Karlsson
- Department of Orthopedics and Clinical Sciences, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden
| | - C Ohlsson
- Center for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - B Johansson
- Department of Psychology, University of Gothenburg, 405 30, Gothenburg, Sweden
| | - J A Kanis
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Disease, Medical School, University of Sheffield, Sheffield, S10 2RX, UK
| | - D Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 413 45, Göteborg, Sweden
- Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden
- Center for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
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22
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Gowers SAN, Samper IC, Murray DSRK, Smith GK, Jeyaprakash S, Rogers ML, Karlsson M, Olsen MH, Møller K, Boutelle MG. Real-time neurochemical measurement of dynamic metabolic events during cardiac arrest and resuscitation in a porcine model. Analyst 2020; 145:1894-1902. [DOI: 10.1039/c9an01950b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This work describes a fully-integrated portable microfluidic analysis system for real-time monitoring of dynamic changes in glucose and lactate occurring in the brain as a result of cardiac arrest and resuscitation.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kirsten Møller
- Department of Neuroanaesthesiology
- Rigshospitalet
- Copenhagen
- Denmark
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23
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Nyman E, Karlsson M, Naslund U, Gronlund C. P3430Classification of pronounced subclinical atherosclerosis: deep learning approach of carotid intima media ultrasound images is superior to clinical risk factors. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Carotid ultrasound measurements of subclinical atherosclerosis is extensively used in the research field of cardiovascular disease. Increased intima media thickness (IMT) and plaque detection have predictive value for cardiovascular events when added to traditional risk factors. However, among studies different protocols for measuring IMT (projections, mean or max values and sites) are used and methodological difficulties of plaque detection, together result in conflicting results. Recently, Deep Learning image driven classification methods, has been successfully applied in several medical imaging applications. Here we hypothesize that ultrasound image texture of the intima media complex accurately reflects the disease burden without the need to measure IMT values or detect plaques.
Purpose
To evaluate classification accuracy of ultrasound based deep learning approach of the intima media complex image compared to traditional risk factors for participants with no vs pronounced subclinical atherosclerosis.
Methods
Subjects from the VIPVIZA study (Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention, n: 3532, 40, 50 and 60 year old, 53% women) were selected for analysis. Bilateral carotid ultrasound examinations were performed according to a standardized protocol. Subjects were categorized in two groups as 1) pronounced subclinical atherosclerosis (n: 401) – bilateral plaques and estimated vascular age 10 years older, or 2) No subclinical atherosclerosis (n: 592) – no plaques and estimated ordinary vascular age. Traditional risk factors for the participants were estimated by the SCORE risk chart. A 1-cm wide region of the distal common carotid artery intima media complex was automatically segmented from the original B-mode images. The images were fed to a Deep Learning model, convolution neural network (CNN), trained using transfer learning model with 60% training data set and 40% evaluation data set. Classification performance was quantified using accuracy of ROC analysis.
Results
The mean age was 58 and 56 years in groups 1 and 2, respectively (with 43% and 56% women, respectively). The mean SCORE was 1.74 in group 1 and 1.09 in group 2. Classification based on SCORE had an area under the curve of 0.69 with an accuracy of 38%. The Deep learning approach had an area under the curve of 0.89 with an accuracy of 78%.
Intima media image based classification
Conclusion
The results shows that ultrasound image texture of the intima media with Deep Learning approach can be used to detect pronounced disease without explicit measurement of IMT values or detection of plaques. With hard end-points, the approach could be used for risk stratification of subclinical atherosclerosis.
Acknowledgement/Funding
Västerbotten County Council, Swedish Research Council, Heart and Lung Foundation, Carl Bennet Ltd, Sweden.
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Affiliation(s)
- E Nyman
- Umeå University, Public Health and Clinical Medicine, Umeå, Sweden
| | - M Karlsson
- Umeå University, Radiation Sciences, Biomedical Engineering, Umeå, Sweden
| | - U Naslund
- Umeå University, Public Health and Clinical Medicine, Umeå, Sweden
| | - C Gronlund
- Umeå University, Radiation Sciences, Biomedical Engineering, Umeå, Sweden
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Affiliation(s)
| | - H. Kollberg
- Department of Women's and Children's Health, University Hospital, Uppsala, Sweden
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25
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Kelsen J, Karlsson M, Hansson MJ, Yang Z, Fischer W, Hugerth M, Nordström CH, Åstrand R, Keep MF, Kilbaugh T, Wang KKW, Møller K, Juhler M, Elmér E. Copenhagen Head Injury Ciclosporin Study: A Phase IIa Safety, Pharmacokinetics, and Biomarker Study of Ciclosporin in Severe Traumatic Brain Injury Patients. J Neurotrauma 2019; 36:3253-3263. [PMID: 31210099 PMCID: PMC6857463 DOI: 10.1089/neu.2018.6369] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) contributes to almost one third of all trauma-related deaths, and those that survive often suffer from long-term physical and cognitive deficits. Ciclosporin (cyclosporine, cyclosporin A) has shown promising neuroprotective properties in pre-clinical TBI models. The Copenhagen Head Injury Ciclosporin (CHIC) study was initiated to establish the safety profile and pharmacokinetics of ciclosporin in patients with severe TBI, using a novel parenteral lipid emulsion formulation. Exploratory pharmacodynamic study measures included microdialysis in brain parenchyma and protein biomarkers of brain injury in the cerebrospinal fluid (CSF). Sixteen adult patients with severe TBI (Glasgow Coma Scale 4–8) were included, and all patients received an initial loading dose of 2.5 mg/kg followed by a continuous infusion for 5 days. The first 10 patients received an infusion dosage of 5 mg/kg/day whereas the subsequent 6 patients received 10 mg/kg/day. No mortality was registered within the study duration, and the distribution of adverse events was similar between the two treatment groups. Pharmacokinetic analysis of CSF confirmed dose-dependent brain exposure. Between- and within-patient variability in blood concentrations was limited, whereas CSF concentrations were more variable. The four biomarkers, glial fibrillary acidic protein, neurofilament light, tau, and ubiquitin carboxy-terminal hydrolase L1, showed consistent trends to decrease during the 5-day treatment period, whereas the samples taken on the days after the treatment period showed higher values in the majority of patients. In conclusion, ciclosporin, as administered in this study, is safe and well tolerated. The study confirmed that ciclosporin is able to pass the blood–brain barrier in a TBI population and provided an initial biomarker-based signal of efficacy.
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Affiliation(s)
- Jesper Kelsen
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Michael Karlsson
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.,Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,NeuroVive Pharmaceutical AB, Lund, Sweden
| | - Magnus J Hansson
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,NeuroVive Pharmaceutical AB, Lund, Sweden
| | - Zhihui Yang
- Program for Neurotrauma, Neuroproteomics and Biomarkers Research, Department of Emergency Medicine, University of Florida, Gainesville, Florida
| | - Walter Fischer
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Ramona Åstrand
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Marcus F Keep
- NeuroVive Pharmaceutical AB, Lund, Sweden.,Department of Neurosurgery, Sanford Brain and Spine Institute, Sanford Medical Center, Fargo, North Dakota
| | - Todd Kilbaugh
- Perelman School of Medicine, University of Pennsylvania; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kevin K W Wang
- Program for Neurotrauma, Neuroproteomics and Biomarkers Research, Department of Emergency Medicine, University of Florida, Gainesville, Florida.,Brain Rehabilitation Research Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida
| | - Kirsten Møller
- Department of Neuroanesthesiology, Rigshospitalet, Copenhagen, Denmark
| | - Marianne Juhler
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,NeuroVive Pharmaceutical AB, Lund, Sweden
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Darlison J, Mieli M, Bengtsson T, Hartmann R, Mogren L, Vågsholm I, Karlsson M, Alsanius BW. Plant species affects establishment of Escherichia coli O157:H7 gfp+ on leafy vegetables. J Appl Microbiol 2019; 127:292-305. [PMID: 31054164 DOI: 10.1111/jam.14299] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/18/2019] [Accepted: 04/29/2019] [Indexed: 01/25/2023]
Abstract
AIMS Greenhouse trials were conducted with different cultivars of baby leaf spinach, rocket and Swiss chard and inoculation of Escherichia coli O157:H7 gfp+, to determine whether plant species and cultivar have an impact on the establishment of this strain. METHODS AND RESULTS Three cultivars each of spinach, rocket and Swiss chard were spray inoculated with E. coli O157:H7 gfp+ at doses of log 7 CFU per ml. Due to the different lengths of growing period spinach and Swiss chard were spray inoculated three times and rocket five times, with final inoculation performed 3 days prior to harvest. After a growing period of 26-33 days, E. coli O157:H7 gfp+ was recovered from the leaf surface in mean populations between log 1 and 6 CFU per gram. The lowest occurrence of E. coli O157:H7 gfp+ was found on rocket leaves and the highest on spinach. There was no significant difference in the establishment of E. coli O157:H7 gfp+ between cultivars, but there were differences between plant species. Indigenous phyllosphere bacteria were pure cultured and identified with 16S rRNA gene sequencing. CONCLUSIONS Despite the same high inoculation dose of E. coli O157:H7 gfp+ on leaves, the establishment rate differed between plant species. However, plant cultivar did not affect establishment. Pantoea agglomerans dominated the identified bacterial isolates. SIGNIFICANCE AND IMPACT OF THE STUDY As previous studies are inconclusive on choice of model plant species and cultivar, we studied whether plant species or cultivar determines the fate of E. coli O157:H7 gfp+ on leafy vegetables. The findings indicate that plant species is a key determinant in the establishment of E. coli O157:H7 gfp+.
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Affiliation(s)
- J Darlison
- Department of Biosystems and Technology, Microbial Horticulture Laboratory, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - M Mieli
- Department of Biosystems and Technology, Microbial Horticulture Laboratory, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - T Bengtsson
- Department of Biosystems and Technology, Microbial Horticulture Laboratory, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - R Hartmann
- Department of Biosystems and Technology, Microbial Horticulture Laboratory, Swedish University of Agricultural Sciences, Alnarp, Sweden.,Department of Horticultural Production Systems, Wilhelm Leibniz University, Hannover, Germany
| | - L Mogren
- Department of Biosystems and Technology, Microbial Horticulture Laboratory, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - I Vågsholm
- Department of Biomedical Sciences and Veterinary Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - M Karlsson
- Department of Biosystems and Technology, Microbial Horticulture Laboratory, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - B W Alsanius
- Department of Biosystems and Technology, Microbial Horticulture Laboratory, Swedish University of Agricultural Sciences, Alnarp, Sweden
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Waldén K, Shams Hakimi C, Jeppsson A, Karlsson M. Effects of fibrinogen supplementation on clot formation in blood samples from cardiac surgery patients before and after tranexamic acid administration. Transfus Med 2019; 29:319-324. [DOI: 10.1111/tme.12604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 12/31/2022]
Affiliation(s)
- K. Waldén
- Department of Anaesthesia and Intensive CareEastern Hospital Gothenburg Sweden
- Department of Anaesthesia and Intensive CareInstitute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - C. Shams Hakimi
- Department of Molecular and Clinical MedicineInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - A. Jeppsson
- Department of Molecular and Clinical MedicineInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Cardiothoracic SurgerySahlgrenska University Hospital Gothenburg Sweden
| | - M. Karlsson
- Department of Molecular and Clinical MedicineInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of MedicineSkaraborg Hospital Lidköping Sweden
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Björk A, Ribom E, Johansson G, Scragg R, Mellström D, Grundberg E, Ohlsson C, Karlsson M, Ljunggren Ö, Kindmark A. Variations in the vitamin D receptor gene are not associated with measures of muscle strength, physical performance, or falls in elderly men. Data from MrOS Sweden. J Steroid Biochem Mol Biol 2019; 187:160-165. [PMID: 30476589 DOI: 10.1016/j.jsbmb.2018.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 11/17/2018] [Accepted: 11/23/2018] [Indexed: 01/07/2023]
Abstract
The vitamin D receptor (VDR) has been proposed as a candidate gene for several musculoskeletal phenotypes. However, previous results on the associations between genetic variants of the VDR with muscle strength and falls have been contradictory. The MrOS Sweden survey, a prospective population-based cohort study of 3014 elderly men (mean age 75 years, range 69-81) offered the opportunity to further investigate these associations. At baseline, data were collected on muscle strength and also the prevalence of falls during the previous 12 months. Genetic association analysis was performed for 7 Single Nucleotide Polymorphisms (SNPs), covering the genetic region surrounding the VDR gene in 2924 men with available samples of DNA. Genetic variations in the VDR were not associated with five different measurements of muscle strength or physical performance (hand grip strength right and left, 6 m walking test (easy and narrow) and timed-stands test). However, one of the 7 SNPs of the gene for the VDR receptor, rs7136534, was associated with prevalence of falls (33.6% of the AA, 14.6% of the AG and 16.5% of the GG allele). In conclusion, VDR genetic variants are not related to muscle strength or physical performance in elderly Swedish men. The role of the rs7136534 SNP for the occurrence of falls is not clear.
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Affiliation(s)
- A Björk
- Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, Sweden.
| | - E Ribom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - G Johansson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - R Scragg
- Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - D Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical, Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - E Grundberg
- Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, McGill University, Montreal, Quebec, Canada
| | - C Ohlsson
- Center for Bone and Arthritis Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - M Karlsson
- Department of Clinical Sciences and Orthopedic Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ö Ljunggren
- Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, Sweden
| | - A Kindmark
- Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, Sweden
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Lautz AJ, Morgan RW, Karlsson M, Mavroudis CD, Ko TS, Licht DJ, Nadkarni VM, Berg RA, Sutton RM, Kilbaugh TJ. Hemodynamic-Directed Cardiopulmonary Resuscitation Improves Neurologic Outcomes and Mitochondrial Function in the Heart and Brain. Crit Care Med 2019; 47:e241-e249. [PMID: 30779720 PMCID: PMC6561502 DOI: 10.1097/ccm.0000000000003620] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Less than half of the thousands of children who suffer in-hospital cardiac arrests annually survive, and neurologic injury is common among survivors. Hemodynamic-directed cardiopulmonary resuscitation improves short-term survival, but its impact on longer term survival and mitochondrial respiration-a potential neurotherapeutic target-remains unknown. The primary objectives of this study were to compare rates of 24-hour survival with favorable neurologic outcome after cardiac arrest treated with hemodynamic-directed cardiopulmonary resuscitation versus standard depth-guided cardiopulmonary resuscitation and to compare brain and heart mitochondrial respiration between groups 24 hours after resuscitation. DESIGN Randomized preclinical large animal trial. SETTING A large animal resuscitation laboratory at a large academic children's hospital. SUBJECTS Twenty-eight 4-week-old female piglets (8-11 kg). INTERVENTIONS Twenty-two swine underwent 7 minutes of asphyxia followed by ventricular fibrillation and randomized treatment with either hemodynamic-directed cardiopulmonary resuscitation (n = 10; compression depth titrated to aortic systolic pressure of 90 mm Hg, vasopressors titrated to coronary perfusion pressure ≥ 20 mm Hg) or depth-guided cardiopulmonary resuscitation (n = 12; depth 1/3 chest diameter, epinephrine every 4 min). Six animals (sham group) underwent anesthesia and instrumentation without cardiac arrest. The primary outcomes were favorable neurologic outcome (swine Cerebral Performance Category ≤ 2) and mitochondrial maximal oxidative phosphorylation utilizing substrate for complex I and complex II (OXPHOSCI+CII) in the cerebral cortex and hippocampus. MEASUREMENTS AND MAIN RESULTS Favorable neurologic outcome was more likely with hemodynamic-directed cardiopulmonary resuscitation (7/10) than depth-guided cardiopulmonary resuscitation (1/12; p = 0.006). Hemodynamic-directed cardiopulmonary resuscitation resulted in higher intra-arrest coronary perfusion pressure, aortic pressures, and brain tissue oxygenation. Hemodynamic-directed cardiopulmonary resuscitation resulted in higher OXPHOSCI+CII (pmol oxygen/s × mg/citrate synthase) in the cortex (6.00 ± 0.28 vs 3.88 ± 0.43; p < 0.05) and hippocampus (6.26 ± 0.67 vs 3.55 ± 0.65; p < 0.05) and higher complex I respiration (pmol oxygen/s × mg) in the right (20.62 ± 1.06 vs 15.88 ± 0.81; p < 0.05) and left ventricles (20.14 ± 1.40 vs 14.17 ± 1.53; p < 0.05). CONCLUSIONS In a model of asphyxia-associated pediatric cardiac arrest, hemodynamic-directed cardiopulmonary resuscitation increases rates of 24-hour survival with favorable neurologic outcome, intra-arrest hemodynamics, and cerebral and myocardial mitochondrial respiration.
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Affiliation(s)
- Andrew J. Lautz
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Anesthesiology and Critical Care Medicine
- Cincinnati Children’s Hospital Medical Center; Division of Critical Care Medicine
| | - Ryan W. Morgan
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Anesthesiology and Critical Care Medicine
| | - Michael Karlsson
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Anesthesiology and Critical Care Medicine
| | - Constantine D. Mavroudis
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Cardiothoracic Surgery
| | - Tiffany S. Ko
- University of Pennsylvania, Department of Bioengineering
| | - Daniel J. Licht
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Pediatrics, Division of Neurology
| | - Vinay M. Nadkarni
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Anesthesiology and Critical Care Medicine
| | - Robert A. Berg
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Anesthesiology and Critical Care Medicine
| | - Robert M. Sutton
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Anesthesiology and Critical Care Medicine
| | - Todd J. Kilbaugh
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine; Department of Anesthesiology and Critical Care Medicine
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30
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Karlsson M, Becker W, Cederholm T, Sjogren P. Adherence to dietary patterns at age 71 and prevalence of sarcopenia 16 years later. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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31
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Nielsen S, Jeppsson A, Giang KW, Rosengren A, Karlsson M. 2394Socioeconomic status and mortality risk among 110,756 men and women in sweden after coronary artery bypass grafting. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Nielsen
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - A Jeppsson
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
| | - K W Giang
- Sahlgrenska University Hospital At Ostra Department of Medicine Goteborg University Ostra Sjukhuset, Gothenburg, Sweden
| | - A Rosengren
- Sahlgrenska University Hospital At Ostra Department of Medicine Goteborg University Ostra Sjukhuset, Gothenburg, Sweden
| | - M Karlsson
- Sahlgrenska Academy, Department of Molecular and Clinical Medicine, Gothenburg, Sweden
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Karlsson M, Pukenas B, Chawla S, Ehinger JK, Plyler R, Stolow M, Gabello M, Hugerth M, Elmér E, Hansson MJ, Margulies S, Kilbaugh T. Neuroprotective Effects of Cyclosporine in a Porcine Pre-Clinical Trial of Focal Traumatic Brain Injury. J Neurotrauma 2018; 36:14-24. [PMID: 29929438 PMCID: PMC6306685 DOI: 10.1089/neu.2018.5706] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Mitochondrial dysfunction is thought to be a hallmark of traumatic brain injury (TBI) and plays a pivotal role in the resulting cellular injury. Cyclophilin D-mediated activation of the mitochondrial permeability transition pore has been suggested to contribute to this secondary injury cascade. Cyclosporine possesses neuroprotective properties that have been attributed to the desensitization of mitochondrial permeability transition pore activation. In vivo animal experiments have demonstrated neuroprotective effects of cyclosporine in more than 20 independent experimental studies in a multitude of different experimental models. However, the majority of these studies have been carried out in rodents. The aim of the present study was to evaluate the efficacy of a novel and cremophor/kolliphor EL-free lipid emulsion formulation of cyclosporine in a translational large animal model of TBI. A mild-to-moderate focal contusion injury was induced in piglets using a controlled cortical impact device. After initial step-wise analyses of pharmacokinetics and comparing with exposure of cyclosporine in clinical TBI trials, a 5-day dosing regimen with continuous intravenous cyclosporine infusion (20 mg/kg/day) was evaluated in a randomized and blinded placebo-controlled setting. Cyclosporine reduced the volume of parenchymal injury by 35%, as well as improved markers of neuronal injury, as measured with magnetic resonance spectroscopic imaging. Further, a consistent trend toward positive improvements in brain metabolism and mitochondrial function was observed in the pericontusional tissue. In this study, we have demonstrated efficacy using a novel cyclosporine formulation in clinically relevant and translatable outcome metrics in a large animal model of focal TBI.
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Affiliation(s)
- Michael Karlsson
- 1 Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
- 2 Mitochondrial Medicine, Department of Clinical Sciences, Lund University , Lund, Sweden
- 3 Department of Neurosurgery, Rigshospitalet , Copenhagen, Denmark
- 4 NeuroVive Pharmaceutical AB , Lund, Sweden
| | - Bryan Pukenas
- 5 Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Sanjeev Chawla
- 5 Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Johannes K Ehinger
- 1 Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
- 2 Mitochondrial Medicine, Department of Clinical Sciences, Lund University , Lund, Sweden
- 4 NeuroVive Pharmaceutical AB , Lund, Sweden
| | - Ross Plyler
- 6 Department of Bioengineering, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Madeline Stolow
- 6 Department of Bioengineering, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Melissa Gabello
- 1 Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
| | | | - Eskil Elmér
- 2 Mitochondrial Medicine, Department of Clinical Sciences, Lund University , Lund, Sweden
- 4 NeuroVive Pharmaceutical AB , Lund, Sweden
| | - Magnus J Hansson
- 2 Mitochondrial Medicine, Department of Clinical Sciences, Lund University , Lund, Sweden
- 4 NeuroVive Pharmaceutical AB , Lund, Sweden
| | - Susan Margulies
- 6 Department of Bioengineering, University of Pennsylvania , Philadelphia, Pennsylvania
| | - Todd Kilbaugh
- 1 Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania
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33
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Mavroudis CD, Karlsson M, Ko T, Hefti M, Gentile JI, Morgan RW, Plyler R, Mensah-Brown KG, Boorady TW, Melchior RW, Rosenthal TM, Shade BC, Schiavo KL, Nicolson SC, Spray TL, Sutton RM, Berg RA, Licht DJ, Gaynor JW, Kilbaugh TJ. Cerebral mitochondrial dysfunction associated with deep hypothermic circulatory arrest in neonatal swine. Eur J Cardiothorac Surg 2018; 54:162-168. [PMID: 29346537 PMCID: PMC7448940 DOI: 10.1093/ejcts/ezx467] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 11/15/2017] [Accepted: 12/02/2017] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES Controversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations in cerebral mitochondrial bioenergetics are thought to contribute to ischaemia-reperfusion injury in DHCA. The purpose of this study was to compare cerebral mitochondrial bioenergetics for DHCA with deep hypothermic continuous perfusion using a neonatal swine model. METHODS Twenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling to 18°C, 10 underwent 40 min DHCA and 10 remained at deep hypothermia for 40 min; animals were subsequently rewarmed to normothermia. 4 remained on normothermic CPB throughout. Fresh brain tissue was harvested while on CPB and assessed for mitochondrial respiration and reactive oxygen species generation. Cerebral microdialysis samples were collected throughout the analysis. RESULTS DHCA animals had significantly decreased mitochondrial complex I respiration, maximal oxidative phosphorylation, respiratory control ratio and significantly increased mitochondrial reactive oxygen species (P < 0.05 for all). DHCA animals also had significantly increased cerebral microdialysis indicators of cerebral ischaemia (lactate/pyruvate ratio) and neuronal death (glycerol) during and after rewarming. CONCLUSIONS DHCA is associated with disruption of mitochondrial bioenergetics compared with deep hypothermic continuous perfusion. Preserving mitochondrial health may mitigate brain injury in cardiac surgical patients. Further studies are needed to better understand the mechanisms of neurological injury in neonatal cardiac surgery and correlate mitochondrial dysfunction with neurological outcomes.
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Affiliation(s)
- Constantine D Mavroudis
- Department of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael Karlsson
- Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Tiffany Ko
- Department of Neurology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marco Hefti
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Javier I Gentile
- Department of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ryan W Morgan
- Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ross Plyler
- Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kobina G Mensah-Brown
- Department of Neurology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Timothy W Boorady
- Department of Neurology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Richard W Melchior
- Department of Perfusion Services, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Tami M Rosenthal
- Department of Perfusion Services, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Brandon C Shade
- Department of Perfusion Services, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kellie L Schiavo
- Department of Perfusion Services, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Susan C Nicolson
- Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Thomas L Spray
- Department of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Robert M Sutton
- Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Robert A Berg
- Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Daniel J Licht
- Department of Neurology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - J William Gaynor
- Department of Cardiothoracic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Todd J Kilbaugh
- Department of Anesthesia and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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Morgan RW, Sutton RM, Karlsson M, Lautz AJ, Mavroudis CD, Landis WP, Lin Y, Jeong S, Craig N, Nadkarni VM, Kilbaugh TJ, Berg RA. Pulmonary Vasodilator Therapy in Shock-associated Cardiac Arrest. Am J Respir Crit Care Med 2018; 197:905-912. [PMID: 29244522 PMCID: PMC6020403 DOI: 10.1164/rccm.201709-1818oc] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 12/15/2017] [Indexed: 12/24/2022] Open
Abstract
RATIONALE Many in-hospital cardiac arrests are precipitated by hypotension, often associated with systemic inflammation. These patients are less likely to be successfully resuscitated, and novel approaches to their treatment are needed. OBJECTIVES To determine if the addition of inhaled nitric oxide (iNO) to hemodynamic-directed cardiopulmonary resuscitation (HD-CPR) would improve short-term survival from cardiac arrest associated with shock and systemic inflammation. METHODS In 3-month-old swine (n = 21), LPS was intravenously infused, inducing systemic hypotension. Ventricular fibrillation was induced, and animals were randomized to blinded treatment with either: 1) HD-CPR with iNO, or 2) HD-CPR without iNO. During HD-CPR, chest compression depth was titrated to peak aortic compression pressure of 100 mm Hg, and vasopressor administration was titrated to coronary perfusion pressure greater than or equal to 20 mm Hg. Defibrillation attempts began after 10 minutes of resuscitation. The primary outcome was 45-minute survival. MEASUREMENTS AND MAIN RESULTS The iNO group had higher rates of 45-minute survival (10 of 10 vs. 3 of 11; P = 0.001). During cardiopulmonary resuscitation, the iNO group had lower pulmonary artery relaxation pressure (mean ± SEM, 10.9 ± 2.4 vs. 18.4 ± 2.4 mm Hg; P = 0.03), higher coronary perfusion pressure (21.1 ± 1.5 vs. 16.9 ± 1.0 mm Hg; P = 0.005), and higher aortic relaxation pressure (36.6 ± 1.6 vs. 30.4 ± 1.1 mm Hg; P < 0.001) despite shallower chest compressions (5.88 ± 0.25 vs. 6.46 ± 0.40 cm; P = 0.02) and fewer vasopressor doses in the first 10 minutes (median, 4 [interquartile range, 3-4] vs. 5 [interquartile range, 5-6], P = 0.03). CONCLUSIONS The addition of iNO to HD-CPR in LPS-induced shock-associated cardiac arrest improved short-term survival and intraarrest hemodynamics.
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Affiliation(s)
- Ryan W. Morgan
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Robert M. Sutton
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Michael Karlsson
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Andrew J. Lautz
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
- Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Constantine D. Mavroudis
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - William P. Landis
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Yuxi Lin
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Sejin Jeong
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Nancy Craig
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Vinay M. Nadkarni
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Todd J. Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Robert A. Berg
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
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La Fleur L, Boura V, Berglund A, Mattsson J, Djureinovic D, Persson J, Brunnström H, Isaksson J, Branden E, Koyi H, Micke P, Karlsson M, Botling J. MA 05.13 Scavenger Receptor MARCO Defines a Targetable Tumor-Associated Macrophage Subset in Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Karlsson M, Cederholm T, Becker W, Sjogren P. PT01.4: Energy and Macronutrient Intake at Age 70 is not Associated with Prevalence of Sarcopenia at Age 88. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30715-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Karlsson M, Ardenkjær-Larsen JH, Lerche MH. Hyperpolarized 133Cs is a sensitive probe for real-time monitoring of biophysical environments. Chem Commun (Camb) 2017; 53:6625-6628. [PMID: 28585639 DOI: 10.1039/c7cc02943h] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
133Cs NMR is a valuable tool for non-invasive analysis of biological systems, where chemical shift and relaxation properties report on changes in the physical environment. Hyperpolarization can increase the liquid-state 133Cs NMR signal by several orders of magnitude and allow real-time monitoring of physical changes in cell based systems.
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Affiliation(s)
- M Karlsson
- Technical University of Denmark, Department of Electrical Engineering, Center for Hyperpolarization in Magnetic Resonance, Building 349, DK-2800 Kgs Lyngby, Denmark.
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McCormack SE, Xiao R, Kilbaugh TJ, Karlsson M, Ganetzky RD, Cunningham ZZ, Goldstein A, Falk MJ, Damrauer SM. Hospitalizations for mitochondrial disease across the lifespan in the U.S. Mol Genet Metab 2017; 121:119-126. [PMID: 28442181 PMCID: PMC5492979 DOI: 10.1016/j.ymgme.2017.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/17/2017] [Accepted: 04/17/2017] [Indexed: 01/04/2023]
Abstract
IMPORTANCE Mitochondrial disease is being diagnosed with increasing frequency. Although children with mitochondrial disease often have severe, life-limiting illnesses, many survive into adulthood. There is, however, limited information about the impact of mitochondrial disease on healthcare utilization in the U.S. across the lifespan. OBJECTIVES To describe the characteristics of inpatient hospitalizations related to mitochondrial disease in the U.S., to identify patient-level clinical factors associated with in-hospital mortality, and to estimate the burden of hospitalizations on individual patients. DESIGN Cross-sectional and longitudinal observational studies. SETTING U.S. hospitals. PARTICIPANTS Individuals with hospital discharges included in the triennial Healthcare Cost and Utilization Project (HCUP) Kids Inpatient Database (KID) and the National Inpatient Sample (NIS) in 2012 (cross-sectional analysis); individuals with hospital discharges included in the HCUP California State Inpatient Database from 2007 to 2011, inclusive (longitudinal analysis). EXPOSURE Hospital discharge associated with a diagnosis of mitochondrial disease. MAIN OUTCOME MEASURES Total number and rate of hospitalizations for individuals with mitochondrial disease (International Classification of Diseases, 9th revision, Clinical Modification code 277.87, disorder of mitochondrial metabolism); in-hospital mortality. RESULTS In the 2012, there were approximately 3200 inpatient pediatric hospitalizations (1.9 per 100,000 population) and 2000 inpatient adult hospitalizations (0.8 per 100,000 population) for mitochondrial disease in the U.S., with associated direct medical costs of $113million. In-hospital mortality rates were 2.4% for children and 3.0% for adults, far exceeding population averages. Higher socioeconomic status was associated with both having a diagnosis of mitochondrial disease and with higher in-hospital mortality. From 2007 to 2011 in California, 495 individuals had at least one admission with a diagnosis of mitochondrial disease. Patients had a median of 1.1 hospitalizations (IQI, 0.6-2.2) per calendar year of follow-up; infants under 2y were hospitalized more frequently than other age groups. Over up to five years of follow up, 9.9% of participants with any hospitalization for mitochondrial disease were noted to have an in-hospital death. CONCLUSIONS AND RELEVANCE Hospitalizations for pediatric and adult mitochondrial diseases are associated with serious illnesses, substantial costs, and significant patient time. Identification of opportunities to prevent or shorten such hospitalizations should be the focus of future studies.
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Affiliation(s)
- Shana E McCormack
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
| | - Rui Xiao
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Todd J Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Michael Karlsson
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Rebecca D Ganetzky
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | | | - Amy Goldstein
- Division of Neurology, Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Marni J Falk
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Scott M Damrauer
- Division of Vascular Surgery, Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia PA & Department of Surgery, Corporal Michael Crescenz VA, Philadelphia, PA, United States
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Jeppsson A, Karlsson M. Preoperative supplementation with fibrinogen concentrate in cardiac surgery: Reply. Br J Anaesth 2017; 118:273-274. [DOI: 10.1093/bja/aew452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Banerjee I, Salih T, Ramachandraiah H, Erlandsson J, Pettersson T, Araújo AC, Karlsson M, Russom A. Slipdisc: a versatile sample preparation platform for point of care diagnostics. RSC Adv 2017. [DOI: 10.1039/c7ra05209j] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A novel POC sample preparation technology, “Slipdisc”, based rotational slipchip technology is presented. In operation, the hand-winded slipdisc platform uses a unique clockwork mechanism to manipulate minute amount of liquids.
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Affiliation(s)
- I. Banerjee
- Division of Proteomics and Nanobiotechnology
- Science for Life Laboratory
- KTH Royal Institute of Technology
- Stockholm
- Sweden
| | - T. Salih
- Division of Proteomics and Nanobiotechnology
- Science for Life Laboratory
- KTH Royal Institute of Technology
- Stockholm
- Sweden
| | - H. Ramachandraiah
- Division of Proteomics and Nanobiotechnology
- Science for Life Laboratory
- KTH Royal Institute of Technology
- Stockholm
- Sweden
| | - J. Erlandsson
- Fibre and Polymer Technology
- Wallenberg Wood Science Centre
- KTH Royal Institute of Technology
- Stockholm
- Sweden
| | - T. Pettersson
- Fibre and Polymer Technology
- Wallenberg Wood Science Centre
- KTH Royal Institute of Technology
- Stockholm
- Sweden
| | | | | | - A. Russom
- Division of Proteomics and Nanobiotechnology
- Science for Life Laboratory
- KTH Royal Institute of Technology
- Stockholm
- Sweden
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Vala CH, Odén A, Lorentzon M, Sundh V, Johansson H, Karlsson M, Rosengren B, Ohlsson C, Johansson B, Kanis J, Mellström D. Increased risk of hip fracture among spouses-evidence of a homogamy effect. Osteoporos Int 2017; 28:95-102. [PMID: 27585578 PMCID: PMC5206252 DOI: 10.1007/s00198-016-3738-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 08/10/2016] [Indexed: 12/22/2022]
Abstract
UNLABELLED Spouses tend to share habits and therefore have an increased risk of same diseases. We followed all married couples in Sweden, born 1902 to 1942, in hospital records from 1987 to 2002, and found that individuals whose spouse had a hip fracture had an increased risk of hip fracture. INTRODUCTION The purpose of this study was to determine whether spouses of hip fracture patients have an elevated risk of hip fracture. METHODS We performed a retrospective cohort study of all couples married for at least 5 years in Sweden and born between 1902 and 1942 (n = 904,451) and all patients registered with a hip fracture (n = 218,285) in the National Inpatients Register in Sweden from 1987 to 2002. RESULTS During the period 1987 to 2002 hip fractures occurred among spouses in 4212 married couples. The hazard ratio (HR) for hip fracture in a married woman following hip fracture in the husband was 1.11 (95 % confidence interval 1.07 to 1.16) compared to a woman whose husband did not have hip fracture. The corresponding HR for a married man was 1.20 (1.15 to 1.26) compared to a man whose wife did not have hip fracture. The risk was significantly elevated over the age range 60 to 90 years. The increased risk for hip fracture among spouses remained after adjustments for income, education, geographical latitude and urbanisation. In a common model with spouses and their siblings, the HR for spousal effect were 1.63 (1.01 to 2.64) and for sibling effect 2.18 (1.55 to 3.06) compared to married with spouse and sibling respectively without hip fracture. CONCLUSION The novel finding of an increased risk for hip fracture among spouses provides evidence indicating that there is a homogamy effect due to common social and lifestyle factors but could also be due to assortative mating.
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Affiliation(s)
- C H Vala
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 431 80, Mölndal, Sweden
| | - A Odén
- Department of Biostatics, Chalmers University, 412 58, Gothenburg, Sweden
| | - M Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 431 80, Mölndal, Sweden
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - V Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 431 80, Mölndal, Sweden
| | - H Johansson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 431 80, Mölndal, Sweden
| | - M Karlsson
- Department of Orthopedics and Clinical Sciences, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden
| | - B Rosengren
- Department of Orthopedics and Clinical Sciences, Skåne University Hospital, Lund University, 205 02, Malmö, Sweden
| | - C Ohlsson
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
| | - B Johansson
- Department of Psychology, University of Gothenburg, 405 30, Gothenburg, Sweden
| | - J Kanis
- Centre for Metabolic Bone Disease, Medical School, University of Sheffield, Sheffield, S10 2RX, UK
| | - D Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 431 80, Mölndal, Sweden.
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden.
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Bale SD, Goetz K, Harvey PR, Turin P, Bonnell JW, de Wit TD, Ergun RE, MacDowall RJ, Pulupa M, Andre M, Bolton M, Bougeret JL, Bowen TA, Burgess D, Cattell CA, Chandran BDG, Chaston CC, Chen CHK, Choi MK, Connerney JE, Cranmer S, Diaz-Aguado M, Donakowski W, Drake JF, Farrell WM, Fergeau P, Fermin J, Fischer J, Fox N, Glaser D, Goldstein M, Gordon D, Hanson E, Harris SE, Hayes LM, Hinze JJ, Hollweg JV, Horbury TS, Howard RA, Hoxie V, Jannet G, Karlsson M, Kasper JC, Kellogg PJ, Kien M, Klimchuk JA, Krasnoselskikh VV, Krucker S, Lynch JJ, Maksimovic M, Malaspina DM, Marker S, Martin P, Martinez-Oliveros J, McCauley J, McComas DJ, McDonald T, Meyer-Vernet N, Moncuquet M, Monson SJ, Mozer FS, Murphy SD, Odom J, Oliverson R, Olson J, Parker EN, Pankow D, Phan T, Quataert E, Quinn T, Ruplin SW, Salem C, Seitz D, Sheppard DA, Siy A, Stevens K, Summers D, Szabo A, Timofeeva M, Vaivads A, Velli M, Yehle A, Werthimer D, Wygant JR. The FIELDS Instrument Suite for Solar Probe Plus: Measuring the Coronal Plasma and Magnetic Field, Plasma Waves and Turbulence, and Radio Signatures of Solar Transients. Space Sci Rev 2016; 204:49-82. [PMID: 29755144 PMCID: PMC5942226 DOI: 10.1007/s11214-016-0244-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
NASA's Solar Probe Plus (SPP) mission will make the first in situ measurements of the solar corona and the birthplace of the solar wind. The FIELDS instrument suite on SPP will make direct measurements of electric and magnetic fields, the properties of in situ plasma waves, electron density and temperature profiles, and interplanetary radio emissions, amongst other things. Here, we describe the scientific objectives targeted by the SPP/FIELDS instrument, the instrument design itself, and the instrument concept of operations and planned data products.
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Affiliation(s)
- S D Bale
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - K Goetz
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - P R Harvey
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - P Turin
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J W Bonnell
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - T Dudok de Wit
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - R E Ergun
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - R J MacDowall
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Pulupa
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - M Andre
- Swedish Institute of Space Physics (IRF), Uppsala, Sweden
| | - M Bolton
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | | | - T A Bowen
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - D Burgess
- Astronomy Unit, Queen Mary, University of London, London, UK
| | - C A Cattell
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - B D G Chandran
- Department of Physics, University of New Hampshire, Durham, NH, USA
| | - C C Chaston
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - C H K Chen
- Department of Physics, Imperial College, London, UK
| | - M K Choi
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J E Connerney
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Cranmer
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - M Diaz-Aguado
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - W Donakowski
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J F Drake
- Department of Physics, University of Maryland, College Park, MD, USA
| | - W M Farrell
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - P Fergeau
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - J Fermin
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J Fischer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - N Fox
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - D Glaser
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - M Goldstein
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - D Gordon
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E Hanson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
- Physics Department, University of California, Berkeley, CA, USA
| | - S E Harris
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - L M Hayes
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J J Hinze
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - J V Hollweg
- Department of Physics, University of New Hampshire, Durham, NH, USA
| | - T S Horbury
- Department of Physics, Imperial College, London, UK
| | - R A Howard
- Space Science Division, Naval Research Laboratory, Washington, DC, USA
| | - V Hoxie
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - G Jannet
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - M Karlsson
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - J C Kasper
- University of Michigan, Ann Arbor, MI, USA
| | - P J Kellogg
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - M Kien
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - J A Klimchuk
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - S Krucker
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J J Lynch
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | | | - D M Malaspina
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - S Marker
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - P Martin
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | | | - J McCauley
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D J McComas
- Southwest Research Institute, San Antonio, TX, USA
| | - T McDonald
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | | | - M Moncuquet
- LESIA, Observatoire de Paris, Meudon, France
| | - S J Monson
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
| | - F S Mozer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - S D Murphy
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Odom
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - R Oliverson
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Olson
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E N Parker
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | - D Pankow
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - T Phan
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - E Quataert
- Astronomy Department, University of California, Berkeley, CA, USA
| | - T Quinn
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | | | - C Salem
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D Seitz
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - D A Sheppard
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - A Siy
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - K Stevens
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - D Summers
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - A Szabo
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Timofeeva
- LPC2E, CNRS, 3A avenue de la Recherche Scientifique, Orléans, France
| | - A Vaivads
- Swedish Institute of Space Physics (IRF), Uppsala, Sweden
| | - M Velli
- Earth, Planetary, and Space Sciences, UCLA, Los Angelos, CA, USA
| | - A Yehle
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - D Werthimer
- Space Sciences Laboratory, University of California, Berkeley, CA, USA
| | - J R Wygant
- School of Physics and Astronomy, University of Minnesota, Minneapolis, MN, USA
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Karlsson M, Ehinger JK, Piel S, Sjövall F, Henriksnäs J, Höglund U, Hansson MJ, Elmér E. Changes in energy metabolism due to acute rotenone-induced mitochondrial complex I dysfunction – An in vivo large animal model. Mitochondrion 2016; 31:56-62. [DOI: 10.1016/j.mito.2016.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 10/06/2016] [Accepted: 10/13/2016] [Indexed: 12/30/2022]
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Ehinger JK, Piel S, Ford R, Karlsson M, Sjövall F, Frostner EÅ, Morota S, Taylor RW, Turnbull DM, Cornell C, Moss SJ, Metzsch C, Hansson MJ, Fliri H, Elmér E. Cell-permeable succinate prodrugs bypass mitochondrial complex I deficiency. Nat Commun 2016; 7:12317. [PMID: 27502960 PMCID: PMC4980488 DOI: 10.1038/ncomms12317] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 06/21/2016] [Indexed: 12/22/2022] Open
Abstract
Mitochondrial complex I (CI) deficiency is the most prevalent defect in the respiratory chain in paediatric mitochondrial disease. This heterogeneous group of diseases includes serious or fatal neurological presentations such as Leigh syndrome and there are very limited evidence-based treatment options available. Here we describe that cell membrane-permeable prodrugs of the complex II substrate succinate increase ATP-linked mitochondrial respiration in CI-deficient human blood cells, fibroblasts and heart fibres. Lactate accumulation in platelets due to rotenone-induced CI inhibition is reversed and rotenone-induced increase in lactate:pyruvate ratio in white blood cells is alleviated. Metabolomic analyses demonstrate delivery and metabolism of [(13)C]succinate. In Leigh syndrome patient fibroblasts, with a recessive NDUFS2 mutation, respiration and spare respiratory capacity are increased by prodrug administration. We conclude that prodrug-delivered succinate bypasses CI and supports electron transport, membrane potential and ATP production. This strategy offers a potential future therapy for metabolic decompensation due to mitochondrial CI dysfunction.
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Affiliation(s)
- Johannes K Ehinger
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden.,NeuroVive Pharmaceutical AB, Medicon Village, 223 81 Lund, Sweden.,Department of Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, 221 85 Lund, Sweden
| | - Sarah Piel
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden.,NeuroVive Pharmaceutical AB, Medicon Village, 223 81 Lund, Sweden
| | - Rhonan Ford
- Selcia Ltd, Fyfield Business and Research Park, Fyfield Road, Ongar CM5 0GS, Essex, UK
| | - Michael Karlsson
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden.,NeuroVive Pharmaceutical AB, Medicon Village, 223 81 Lund, Sweden
| | - Fredrik Sjövall
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden.,Department of Intensive Care and Perioperative Medicine, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Eleonor Åsander Frostner
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden.,NeuroVive Pharmaceutical AB, Medicon Village, 223 81 Lund, Sweden
| | - Saori Morota
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden
| | - Robert W Taylor
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Doug M Turnbull
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Clive Cornell
- Selcia Ltd, Fyfield Business and Research Park, Fyfield Road, Ongar CM5 0GS, Essex, UK
| | - Steven J Moss
- Isomerase Therapeutics Ltd, Chesterford Research Park, Cambridge CB10 1XL, UK
| | - Carsten Metzsch
- Anaesthesiology and Intensive Care, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, 221 85 Lund, Sweden
| | - Magnus J Hansson
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden.,NeuroVive Pharmaceutical AB, Medicon Village, 223 81 Lund, Sweden
| | - Hans Fliri
- Mitopharm Ltd, Fyfield Business and Research Park, Fyfield Road, Ongar CM5 0GS, Essex, UK
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, BMC A13, 221 84 Lund, Sweden.,NeuroVive Pharmaceutical AB, Medicon Village, 223 81 Lund, Sweden.,Clinical Neurophysiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, 221 85 Lund, Sweden
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Pedersen PJ, Karlsson M, Flethøj M, Trachsel DS, Kanters JK, Klaerke DA, Buhl R. Differences in the electrocardiographic QT interval of various breeds of athletic horses during rest and exercise. J Vet Cardiol 2016; 18:255-264. [PMID: 27068842 DOI: 10.1016/j.jvc.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 01/07/2016] [Accepted: 02/08/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Quantitative measurements of cardiac repolarization, defined as the electrocardiographic QT interval, have important diagnostic implications in humans, as irregularities can trigger potentially fatal ventricular tachyarrhythmia. In both humans and horses, cardiac repolarization is influenced to some extent by heart rate, age, body weight (BW), sex, autonomic tone, and environment. In horses, there is substantial inter-breed variation in size and training, and the aims of this study were therefore to determine the best model describing the QT to RR relationship in breeds of various athletic horses and to test for differences in the QT interval. ANIMALS Ten Icelandic horses, 10 Arabian horses, 10 Thoroughbreds, 10 Standardbreds, six Coldblood trotters, 10 Warmbloods (dressage) and 10 Warmbloods (show jumping). All horses were geldings. METHODS QT intervals were measured from resting to peak exercise level and plotted against RR intervals. Data points were fitted with relevant regression models, and the effect of breed, BW, and estimated exercise intensity was examined. RESULTS For all breeds in this study, the QT interval was best described as a function of RR by the piecewise linear regression model. The breed of horse had a significant effect on the model. There was no systematic effect of BW or estimated exercise intensity, but a high inter-horse variability was observed. CONCLUSIONS The equine QT interval should preferably be corrected for heart rate according to breed. In addition, the results indicate that equine studies of the QT interval must be designed to eliminate the influence of a large inter-horse variation.
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Affiliation(s)
- P J Pedersen
- Department of Veterinary Clinical and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 100, 1870 Frederiksberg C, Denmark
| | - M Karlsson
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark
| | - M Flethøj
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark
| | - D S Trachsel
- Department of Veterinary Clinical and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 100, 1870 Frederiksberg C, Denmark; Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark.
| | - J K Kanters
- Laboratory of Experimental Cardiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Koebenhavn N, Denmark; Department of Cardiology, Herlev and Gentofte University Hospitals, Niels Andersens Vej, 2900 Hellerup, Denmark
| | - D A Klaerke
- Department of Veterinary Clinical and Animal Science, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 100, 1870 Frederiksberg C, Denmark
| | - R Buhl
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark
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Ferguson MA, Sutton RM, Karlsson M, Sjövall F, Becker LB, Berg RA, Margulies SS, Kilbaugh TJ. Increased platelet mitochondrial respiration after cardiac arrest and resuscitation as a potential peripheral biosignature of cerebral bioenergetic dysfunction. J Bioenerg Biomembr 2016; 48:269-79. [PMID: 27020568 DOI: 10.1007/s10863-016-9657-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/15/2016] [Indexed: 02/02/2023]
Abstract
UNLABELLED Cardiac arrest (CA) results in a sepsis-like syndrome with activation of the innate immune system and increased mitochondrial bioenergetics. OBJECTIVE To determine if platelet mitochondrial respiration increases following CA in a porcine pediatric model of asphyxia-associated ventricular fibrillation (VF) CA, and if this readily obtained biomarker is associated with decreased brain mitochondrial respiration. CA protocol: 7 min of asphyxia, followed by VF, protocolized titration of compression depth to systolic blood pressure of 90 mmHg and vasopressor administration to a coronary perfusion pressure greater than 20 mmHg. PRIMARY OUTCOME platelet integrated mitochondrial electron transport system (ETS) function evaluated pre- and post-CA/ROSC four hours after return of spontaneous circulation (ROSC). Secondary outcome: correlation of platelet mitochondrial bioenergetics to cerebral bioenergetic function. Platelet maximal oxidative phosphorylation (OXPHOSCI+CII), P < 0.02, and maximal respiratory capacity (ETSCI+CII), P < 0.04, were both significantly increased compared to pre-arrest values. This was primarily due to a significant increase in succinate-supported respiration through Complex II (OXPHOSCII, P < 0.02 and ETSCII, P < 0.03). Higher respiration was not due to uncoupling, as the LEAKCI + CII respiration (mitochondrial respiration independent of ATP-production) was unchanged after CA/ROSC. Larger increases in platelet mitochondrial respiratory control ratio (RCR) compared to pre-CA RCR were significantly correlated with lower RCRs in the cortex (P < 0.03) and hippocampus (P < 0.04) compared to sham respiration. Platelet mitochondrial respiration is significantly increased four hours after ROSC. Future studies will identify mechanistic relationships between this serum biomarker and altered cerebral bioenergetics function following cardiac arrest.
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Affiliation(s)
- Michael A Ferguson
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th & Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Robert M Sutton
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th & Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Michael Karlsson
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, BMC A13, SE-221 84, Lund, Sweden
| | - Fredrik Sjövall
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, BMC A13, SE-221 84, Lund, Sweden
| | - Lance B Becker
- Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, The Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Robert A Berg
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th & Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Susan S Margulies
- School of Engineering and Applied Science, Department of Bioengineering, University of Pennsylvania, 210 South 33rd Street, Philadelphia, PA, 19104, USA
| | - Todd J Kilbaugh
- Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th & Civic Center Blvd., Philadelphia, PA, 19104, USA.
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47
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Candela-Juan C, Karlsson M, Lundell M, Ballester F, Tedgren ÅC. Dosimetric characterization of two radium sources for retrospective dosimetry studies. Med Phys 2016; 42:2132-42. [PMID: 25979008 DOI: 10.1118/1.4916685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE During the first part of the 20th century, (226)Ra was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long-term radiation effects. The purpose of this work was to dosimetrically characterize two (226)Ra sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose-effect studies. METHODS An 8 mg (226)Ra tube and a 10 mg (226)Ra needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiation transport codes: geant4 and mcnp5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG-43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG-43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a (226)Ra point-like-source placed in the center of 1 m radius water sphere was calculated with geant4. RESULTS TG-43 parameters [including gL(r), F(r, θ), Λ, and sK] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG-43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been estimated that the uncertainty associated to the absorbed dose within the treatment volume is 10%-15%, whereas uncertainty of absorbed dose to distant organs is roughly 20%-25%. CONCLUSIONS The results provided here facilitate retrospective dosimetry studies of (226)Ra using modern treatment planning systems, which may be used to improve knowledge on long term radiation effects. It is surely important for the epidemiologic studies to be aware of the estimated uncertainty provided here before extracting their conclusions.
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Affiliation(s)
- C Candela-Juan
- Radiation Oncology Department, La Fe University and Polytechnic Hospital, Valencia 46026, Spain and Department of Atomic, Molecular and Nuclear Physics, University of Valencia, Burjassot 46100, Spain
| | - M Karlsson
- Division of Radiological Sciences, Department of Medical and Health Sciences, Linköping University, Linköping SE 581 85, Sweden
| | - M Lundell
- Department of Medical Physics and Oncology, Karolinska University Hospital and Karolinska Institute, Stockholm SE 171 76, Sweden
| | - F Ballester
- Department of Atomic, Molecular and Nuclear Physics, University of Valencia, Burjassot 46100, Spain
| | - Å Carlsson Tedgren
- Division of Radiological Sciences, Department of Medical and Health Sciences, Linköping University, Linköping SE 581 85, Sweden and Swedish Radiation Safety Authority, Stockholm SE 171 16, Sweden
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48
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Jeppsson A, Waldén K, Roman-Emanuel C, Thimour-Bergström L, Karlsson M. Preoperative supplementation with fibrinogen concentrate in cardiac surgery: A randomized controlled study. Br J Anaesth 2016; 116:208-14. [DOI: 10.1093/bja/aev367] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2015] [Indexed: 01/24/2023] Open
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49
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Kilbaugh TJ, Karlsson M, Duhaime AC, Hansson MJ, Elmer E, Margulies SS. Mitochondrial response in a toddler-aged swine model following diffuse non-impact traumatic brain injury. Mitochondrion 2016; 26:19-25. [PMID: 26549476 PMCID: PMC4752861 DOI: 10.1016/j.mito.2015.11.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 01/19/2023]
Abstract
Traumatic brain injury (TBI) is an important health problem, and a leading cause of death in children worldwide. Mitochondrial dysfunction is a critical component of the secondary TBI cascades. Mitochondrial response in the pediatric brain has limited investigation, despite evidence that the developing brain's response differs from that of the adult, especially in diffuse non-impact TBI. We performed a detailed evaluation of mitochondrial bioenergetics using high-resolution respirometry in a swine model of diffuse TBI (rapid non-impact rotational injury: RNR), and examined the cortex and hippocampus. A substrate-uncoupler-inhibitor-titration protocol examined the role of the individual complexes as well as the uncoupled maximal respiration. Respiration per mg of tissue was also related to citrate synthase activity (CS) as an attempt to control for variability in mitochondrial content following injury. Diffuse RNR stimulated increased complex II-driven respiration relative to mitochondrial content in the hippocampus compared to shams. LEAK (State 4o) respiration increased in both regions, with decreased respiratory ratios of convergent oxidative phosphorylation through complex I and II, compared to sham animals, indicating uncoupling of oxidative phosphorylation at 24h. The study suggests that proportionately, complex I contribution to convergent mitochondrial respiration was reduced in the hippocampus after RNR, with a simultaneous increase in complex-II driven respiration. Mitochondrial respiration 24h after diffuse TBI varies by location within the brain. We concluded that significant uncoupling of oxidative phosphorylation and alterations in convergent respiration through complex I- and complex II-driven respiration reveals therapeutic opportunities for the injured at-risk pediatric brain.
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Affiliation(s)
- Todd J Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA.
| | - Michael Karlsson
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, BMC A13, SE-221 84 Lund, Sweden.
| | - Ann-Christine Duhaime
- Department of Bioengineering, University of Pennsylvania, 210 South 33rd Street, Philadelphia, PA 19104, USA.
| | - Magnus J Hansson
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, BMC A13, SE-221 84 Lund, Sweden.
| | - Eskil Elmer
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, BMC A13, SE-221 84 Lund, Sweden.
| | - Susan S Margulies
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street, Boston, MA 02114, USA.
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50
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Kilbaugh TJ, Sutton RM, Karlsson M, Hansson MJ, Naim MY, Morgan RW, Bratinov G, Lampe JW, Nadkarni VM, Becker LB, Margulies SS, Berg RA. Persistently Altered Brain Mitochondrial Bioenergetics After Apparently Successful Resuscitation From Cardiac Arrest. J Am Heart Assoc 2015; 4:e002232. [PMID: 26370446 PMCID: PMC4599507 DOI: 10.1161/jaha.115.002232] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although advances in cardiopulmonary resuscitation have improved survival from cardiac arrest (CA), neurologic injury persists and impaired mitochondrial bioenergetics may be critical for targeted neuroresuscitation. The authors sought to determine if excellent cardiopulmonary resuscitation and postresuscitation care and good traditional survival rates result in persistently disordered cerebral mitochondrial bioenergetics in a porcine pediatric model of asphyxia-associated ventricular fibrillation CA. METHODS AND RESULTS After 7 minutes of asphyxia, followed by ventricular fibrillation, 5 female 1-month-old swine (4 sham) received blood pressure-targeted care: titration of compression depth to systolic blood pressure of 90 mm Hg and vasopressor administration to a coronary perfusion pressure >20 mm Hg. All animals received protocol-based vasopressor support after return of spontaneous circulation for 4 hours before they were killed. The primary outcome was integrated mitochondrial electron transport system (ETS) function. CA animals displayed significantly decreased maximal, coupled oxidative phosphorylating respiration (OXPHOSCI + CII) in cortex (P<0.02) and hippocampus (P<0.02), as well as decreased phosphorylation and coupling efficiency (cortex, P<0.05; hippocampus, P<0.05). Complex I- and complex II-driven respiration were both significantly decreased after CA (cortex: OXPHOSCI P<0.01, ETSCII P<0.05; hippocampus: OXPHOSCI P<0.03, ETSCII P<0.01). In the hippocampus, there was a significant decrease in maximal uncoupled, nonphosphorylating respiration (ETSCI + CII), as well as a 30% reduction in citrate synthase activity (P<0.04). CONCLUSIONS Mitochondria in both the cortex and hippocampus displayed significant alterations in respiratory function after CA despite excellent cardiopulmonary resuscitation and postresuscitation care in asphyxia-associated ventricular fibrillation CA. Analysis of integrated ETS function identifies mitochondrial bioenergetic failure as a target for goal-directed neuroresuscitation after CA. IACUC Protocol: IAC 13-001023.
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Affiliation(s)
- Todd J Kilbaugh
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (T.J.K., R.M.S., M.Y.N., R.W.M., G.B., V.M.N., R.A.B.)
| | - Robert M Sutton
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (T.J.K., R.M.S., M.Y.N., R.W.M., G.B., V.M.N., R.A.B.)
| | - Michael Karlsson
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden (M.K., M.J.H.)
| | - Magnus J Hansson
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden (M.K., M.J.H.)
| | - Maryam Y Naim
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (T.J.K., R.M.S., M.Y.N., R.W.M., G.B., V.M.N., R.A.B.)
| | - Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (T.J.K., R.M.S., M.Y.N., R.W.M., G.B., V.M.N., R.A.B.)
| | - George Bratinov
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (T.J.K., R.M.S., M.Y.N., R.W.M., G.B., V.M.N., R.A.B.)
| | - Joshua W Lampe
- Department of Emergency Medicine, The Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (J.W.L., L.B.B.)
| | - Vinay M Nadkarni
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (T.J.K., R.M.S., M.Y.N., R.W.M., G.B., V.M.N., R.A.B.)
| | - Lance B Becker
- Department of Emergency Medicine, The Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (J.W.L., L.B.B.)
| | - Susan S Margulies
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA (S.S.M.)
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (T.J.K., R.M.S., M.Y.N., R.W.M., G.B., V.M.N., R.A.B.)
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