Article
Neurosciences
Huichao You, Wenqi Li, Qianxue Chen
Summary: This study aimed to establish the reference value range of cerebrospinal fluid (CSF) in the pathological state following spontaneous subarachnoid hemorrhage (SAH). The results showed that in 95% of patients after SAH, the leukocyte count in CSF was less than 880 x 10(6)/L. Additionally, the proportions of neutrophils, lymphocytes, and monocytes did not exceed 75%, 75%, and 15% respectively in 95% of the population. Furthermore, the concentration of chloride, glucose, and protein in the CSF were within specific ranges in 95% of the specimens. The CSF indexes after spontaneous SAH showed significant changes compared to normal reference values, particularly in leukocyte count, chloride concentration, and glucose concentration. Using specific reference values for leukocyte count, glucose, and chloride levels can be more meaningful for assessing the pathological status of SAH.
Article
Biochemistry & Molecular Biology
Sara Diana Lolansen, Nina Rostgaard, Tenna Capion, Nicolas H. Norager, Markus Harboe Olsen, Marianne Juhler, Tiit Illimar Mathiesen, Nanna MacAulay
Summary: The molecular mechanisms underlying the development of posthemorrhagic hydrocephalus (PHH) remain unclear, but elevated cerebrospinal fluid (CSF) osmolality is not the cause of PHH. The pathological CSF accumulation observed in these patients is instead attributed to other pathological alterations associated with the abnormal presence of blood within the CSF compartments following subarachnoid hemorrhage (SAH).
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Nanoscience & Nanotechnology
Jingyi Sun, Yanan Song, Mengyue Wang, Peng Zhao, Feng Gao, Junqi Li, Mingfeng Yang, Hui Yuan, Baoliang Sun, Ying Wang
Summary: This paper presents a novel surface-enhanced Raman scattering (SERS) strategy for quantitative detection and monitoring of miRNA using hairpin DNA-conjugated gold nanostars probes and acupuncture-based technology. The developed strategy offers high sensitivity and accuracy, making it a promising method for analyzing multiple biomolecules in single cells and living bodies.
ACS APPLIED MATERIALS & INTERFACES
(2022)
Article
Pharmacology & Pharmacy
Xue Wang, Hong-Ji Deng, Sheng-Qing Gao, Tao Li, Chao-Chao Gao, Yan-Ling Han, Yun-Song Zhuang, Jia-Yin Qiu, Shu-Hao Miao, Meng-Liang Zhou
Summary: The administration of dobutamine can promote the drainage of red blood cells and their degradation products from the subarachnoid space, leading to the improvement of neurological deficits in the early stage after subarachnoid hemorrhage.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Neurosciences
Fan Liu, Yun Bao, Binghui Qiu, Jian Mao, Xixian Liao, Haorun Huang, An Zhang, Guozhong Zhang, Songtao Qi, Fen Mei
Summary: In this study, we identified and validated five cerebrospinal fluid (CSF) biomarkers for cognitive impairment in patients with aneurysmal subarachnoid hemorrhage (aSAH). These biomarkers have important predictive and discriminative potential for cognitive impairment in aSAH and could be potential targets for early disease intervention.
FRONTIERS IN CELLULAR NEUROSCIENCE
(2022)
Article
Biochemistry & Molecular Biology
Nina Rostgaard, Markus Harboe Olsen, Tenna Capion, Nanna MacAulay, Marianne Juhler
Summary: This study aimed to identify inflammatory biomarkers in cerebrospinal fluid (CSF) that can predict the development of post-hemorrhagic hydrocephalus (PHH) and shunt-dependency, as well as functional outcome in patients with subarachnoid hemorrhage (SAH). Proximity extension assay (PEA) was used to analyze CSF samples from 31 SAH patients, and 7 markers were identified as predictors of shunt dependency and 4 markers as predictors of functional outcome. These inflammatory biomarkers hold potential as predictive tools in the clinic.
Review
Critical Care Medicine
Carlos A. Santacruz, Jean-Louis Vincent, Andres Bader, Luis A. Rincon-Gutierrez, Claudia Dominguez-Curell, David Communi, Fabio S. Taccone
Summary: Studies suggest that altered CSF concentrations of protein biomarkers related to cytoskeletal damage, inflammation, apoptosis, and oxidative stress may predict worse neurological outcomes in patients with acute brain injuries.
Review
Cell Biology
Lintao Wang, Guangping Geng, Tao Zhu, Wenwu Chen, Xiaohui Li, Jianjun Gu, Enshe Jiang
Summary: Subarachnoid hemorrhage (SAH) is a common clinical neurological emergency with a relatively high incidence and often leads to severe adverse prognoses. Inflammatory response plays an important role in early nerve injury in SAH, with Toll-like receptor 4 (TLR4) playing a vital role in the inflammatory transduction pathway.
Review
Clinical Neurology
Cheng Yang, Yuhong Li
Summary: This article reviews the interventions before and after the formation of hydrocephalus following aneurysmal subarachnoid hemorrhage. It focuses on the relationships between treatment options and the incidence of postoperative hydrocephalus, management of cerebrospinal fluid drainage and shunt dependent hydrocephalus, and advocates for a combination of prevention and treatment to develop individualized treatment plans for patients.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Jane Y. Yuan, Yasheng Chen, Atul Kumar, Zach Zlepper, Keshav Jayaraman, Wint Y. Aung, Julian Clarke, Michelle Allen, Umeshkumar Athiraman, Joshua Osbun, Gregory J. Zipfel, Rajat Dhar
Summary: Through quantitative biomarker SSV, it was found that early brain injury after aSAH can be objectively evaluated, with reduced early SSV being an independent predictor of poor outcomes, especially in younger patients. This suggests that GCE may have a greater impact on younger patients with SAH.
Review
Clinical Neurology
Hussein A. Zeineddine, Pedram Honarpisheh, Devin McBride, Peeyush Kumar Thankamani Pandit, Ari Dienel, Sung-Ha Hong, James Grotta, Spiros Blackburn
Summary: Delayed cerebral ischemia (DCI) is a serious complication of aneurysmal subarachnoid hemorrhage (aSAH) that can lead to severe morbidity and mortality. Current treatment options are limited, with nimodipine being the only available therapeutic agent. Accumulating evidence suggests that factors such as microvessel vasoconstriction, microthrombosis, oxidative tissue damage, and cortical spreading depolarization, as well as large vessel vasospasm, contribute to the development of DCI. Red blood cell leakage and subsequent hemoglobin release have been identified as central triggers in these processes, leading to the hypothesis that early blood removal could improve clinical outcomes and reduce DCI. This article provides a narrative review of the evidence supporting hemoglobin as an instigator of DCI and discusses the use of blood clearance and cerebrospinal fluid (CSF) drainage as a treatment for DCI. Additionally, it introduces a novel device called the Neurapheresis CSF Management System (TM), which is currently being tested and offers automated dual-lumen lumbar drainage with CSF filtration and reinfusion capabilities.
TRANSLATIONAL STROKE RESEARCH
(2022)
Article
Clinical Neurology
Julian Zimmermann, Johannes Weller, Sven Grub, Sied Kebir, Felix Lehmann, Hartmut Vatter, Patrick Schuss, Erdem Gueresir, Marcus Mueller
Summary: In aneurysmal subarachnoid hemorrhage (SAH), the enzyme arginase-1 is released into cerebrospinal fluid, leading to dysregulated metabolism of L-arginine. The levels of arginase-1 and the Arg/Orn ratio are associated with the occurrence of cerebral vasospasm syndrome (CVS), providing a novel prognostic biomarker for SAH.
TRANSLATIONAL STROKE RESEARCH
(2022)
Article
Clinical Neurology
Jianquan Zhao, Heng Jiang, Huan Jiang, Yicheng Meng, Rui Gao, Jun Ma, Ce Wang, Xuhui Zhou
Summary: This retrospective study analyzed the occurrence of acute SAH after spinal surgery and identified hypertension, intraoperative CSF leakage, and postoperative CSF continuous drainage speed as risk factors for SAH.
WORLD NEUROSURGERY
(2022)
Article
Chemistry, Analytical
Hui-Tzung Luh, Yi-Wei Chung, Po-Yi Cho, Yu-Cheng Hsiao
Summary: A novel device for detecting HO-1 in cerebrospinal fluid (CSF) was invented using cholesteric liquid crystal (LC; CLC). The LC reorientation was influenced by the alignment layer and adjacent LCs, enabling the detection of HO-1. This label-free CLC immunoassay offers a low detection limit and a wide linear range for HO-1 concentration measurement in CSF.
Article
Clinical Neurology
Fei Tian, Jin Liang, Gang Liu, Xue Zhang, Zengyan Cai, Hongzhi Huo, Erqing Chai
Summary: This study investigated the association between post-infectious inflammation in cerebrospinal fluid and nonconvulsive seizures (NCS) in patients with subarachnoid hemorrhage (SAH). The results showed that a high level of CSF interleukin-6 (IL-6) was an independent risk factor for NCS, and NCS patients were more likely to have poor neurological prognosis at 3 months after discharge.
Article
Medicine, General & Internal
Madeleine Otto, Aidan J. C. Burrell, Ary S. Neto, Patricia Alliegro, Tony Trapani, Allen Cheng, Andrew A. Udy
Summary: This study compared the clinical characteristics and outcomes of vaccinated and unvaccinated patients with SARS-CoV-2 infection admitted to the ICU on a nationwide scale. The study found that vaccination did not show a significant association with inhospital or ICU mortality after adjusting for age, gender, and comorbid status. However, COVID-19 infection can still cause severe disease and death in vaccine recipients, with comorbid status and older age playing significant roles in mortality. Organ support requirements and the number of deaths were highest in the unvaccinated cohort.
INTERNAL MEDICINE JOURNAL
(2023)
Article
Pharmacology & Pharmacy
Amy Legg, Niamh Meagher, Sandra A. Johnson, Matthew A. Roberts, Alan Cass, Marc H. Scheetz, Jane Davies, Jason A. Roberts, Joshua S. Davis, Steven Y. C. Tong
Summary: The clinical risk factors for nephrotoxicity in Staphylococcus aureus bacteraemia are still unclear. In a clinical trial comparing standard therapy to combination therapy, it was found that the combination therapy group had a significantly higher incidence of acute kidney injury.
CLINICAL DRUG INVESTIGATION
(2023)
Article
Medical Laboratory Technology
Lucy Sharrock, Melissa J. Ankravs, Adam M. Deane, Thomas Rechnitzer, Steven C. Wallis, Jason A. Roberts, Rinaldo Bellomo
Summary: This study measured the clearance of piperacillin-tazobactam and vancomycin in patients receiving CVVHDF with regional citrate anticoagulation, and found that both drugs have high clearance, providing key information for optimal dosing.
THERAPEUTIC DRUG MONITORING
(2023)
Review
Virology
Chuan Kok Lim, Jason Roberts, Michael Moso, Kwee Chin Liew, Mona L. Taouk, Eloise Williams, Thomas Tran, Eike Steinig, Leon Caly, Deborah Ann Williamson
Summary: This review discusses the changes in the epidemiology of monkeypox and the advancements in the understanding of its virology and viral dynamics relevant to diagnostics. It outlines the traditional and emerging laboratory technologies useful for monkeypox virus detection and in guiding elimination strategies. Importantly, the development in MPXV genomics has rapidly advanced our understanding of viral evolution and adaptation in the current outbreak.
JOURNAL OF MEDICAL VIROLOGY
(2023)
Article
Pharmacology & Pharmacy
Paul Williams, Menino Osbert Cotta, Mohd H. H. Abdul-Aziz, Kathryn Wilks, Andras Farkas, Jason A. A. Roberts
Summary: This study aimed to compare the achievement of therapeutic PK-PD exposure targets for beta-lactam antibiotics using product information dosing or guideline-based dosing for serious infections. In silico simulations were performed, and the results showed that guideline-based dosing had significantly higher probability of target attainment at 48 and 96 hours compared to product information dosing. The study also found that eGFR was significantly associated with the %PTA by guideline-based dosing.
Article
Urology & Nephrology
Carla E. Scuderi, Suzanne L. Parker, Margaret Jacks, George T. John, Brett McWhinney, Jacobus Ungerer, Andrew J. Mallett, Helen G. Healy, Jason A. Roberts, Christine E. Staatz
Summary: This study aimed to assess the diagnostic accuracy of using volumetric absorptive microsamplers (VAMS) to measure tacrolimus and creatinine in kidney transplant recipients. The results showed that VAMS can reliably measure tacrolimus and creatinine, providing a less invasive and more frequent sampling method for patients.
Article
Microbiology
Pier Giorgio Cojutti, Aaron J. Heffernan, Thomas Tangden, Paola Della Siega, Carlo Tascini, Jason A. Roberts, Federico Pea
Summary: This study aimed to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model of valganciclovir for preemptive therapy of cytomegalovirus (CMV) infection in kidney transplant patients. Ganciclovir concentrations and CMV viral loads were retrospectively obtained from kidney transplant patients. Monte Carlo simulations were conducted to assess the probability of attaining viral load targets, and a PK/PD model was devised.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2023)
Article
Pharmacology & Pharmacy
Eko Setiawan, Menino Osbert Cotta, Mohd-Hafiz Abdul-Aziz, Doddy Widjanarko, Hernycane Sosilya, Dwi Lily Lukas, Steven C. Wallis, Suzanne Parker, Jason A. Roberts
Summary: This study investigated the pharmacokinetics of ampicillin-sulbactam in patients with a wide range of renal functions and found that serum creatinine was closely associated with drug clearance. Furthermore, a 4-hour infusion was found to enhance the probability of target attainment and fractional target attainment, especially at higher minimum inhibitory concentrations.
CLINICAL PHARMACOKINETICS
(2023)
Review
Pharmacology & Pharmacy
Haifa Lyster, Kiran Shekar, Kevin Watt, Anna Reed, Jason A. A. Roberts, Mohd-Hafiz Abdul-Aziz
Summary: Extracorporeal membrane oxygenation (ECMO) is an advanced life support system that provides temporary cardiac and/or respiratory support for critically ill patients. Fungal infections are associated with higher mortality rates in patients on ECMO. The pharmacokinetics of antifungal drugs can be affected by critical illness and ECMO, making dosing challenging. Current literature on antifungal dosing in critically ill patients on ECMO is limited and inconsistent, making it necessary to consider therapeutic drug monitoring.
CLINICAL PHARMACOKINETICS
(2023)
Review
Infectious Diseases
Jason A. Roberts, Katherine Croom, Nicholas Adomakoh
Summary: Continuous infusion of beta-lactam antibiotics may be beneficial in some patients, especially those with severe infections. However, the existing studies have been small-scale and have yielded conflicting results. The best evidence on the clinical outcomes of beta-lactam continuous infusion comes from systematic reviews/meta-analyses.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2023)
Review
Pharmacology & Pharmacy
Gavin Matthew Joynt, Lowell Ling, Wai Tat Wong, Jeffrey Lipman
Summary: The importance of antibiotic treatment for sepsis in critically ill septic patients is well known. However, achieving the correct dosage of antibiotics is a challenge. Understanding the pharmacokinetic and pharmacodynamic characteristics of antibiotics in critically ill patients is reshaping how they are dosed.
EXPERT REVIEW OF CLINICAL PHARMACOLOGY
(2023)
Review
Infectious Diseases
Eko Setiawan, Menino Osbert Cotta, Jason A. Roberts, Mohd Hafiz Abdul-Aziz
Summary: While inter-ethnic differences in the pharmacokinetic variabilities of antimicrobials have been studied among healthy subjects, further investigation is needed to understand the differences in antimicrobial pharmacokinetics between Asian and non-Asian patients with severe pathologic conditions. A systematic review was conducted to explore the potential variations in antimicrobial pharmacokinetics between Asian and non-Asian populations, with the inclusion of thirty studies on different antimicrobial agents. Inconsistent differences in pharmacokinetic parameters were observed between Asian and non-Asian patients, suggesting that ethnicity may not be a significant predictor in characterizing these differences, and dosing regimens should be adjusted based on demographic or clinical characteristics.
Review
Infectious Diseases
Amy Legg, Sinead Carmichael, Ming G. Chai, Jason A. Roberts, Menino O. Cotta
Summary: Beta-lactam antibiotics are commonly used in critically ill patients to treat infections, but the optimal exposure targets for these drugs are still debated. Overcoming pharmacokinetic and pharmacodynamic challenges in the intensive care unit is necessary to achieve desired exposures. Therapeutic drug monitoring has shown promise for determining if the desired exposures are reached, but more research is needed to determine its impact on infection-related outcomes. Improving the efficiency of sampling and reporting results in at-risk patients is important for an ideal beta-lactam TDM service.
Article
Infectious Diseases
Francisco Beraldi-Magalhaes, Suzanne L. L. Parker, Cristina Sanches, Leandro Sousa Garcia, Brenda Karoline Souza Carvalho, Amanda Araujo Costa, Mariana Millan Fachi, Marcus Vinicius de Liz, Alexandra Brito de Souza, Izabella Picinin Safe, Roberto Pontarolo, Steven Wallis, Jeffrey Lipman, Jason A. A. Roberts, Marcelo Cordeiro-Santos
Summary: This study compared the pharmacokinetics of oral rifampin, isoniazid, pyrazinamide, and ethambutol in tuberculosis patients in intensive care units (ICU) and outpatients, and evaluated drug serum concentrations as a potential cause of mortality. The results showed that ICU patients had a lower clearance and volume of distribution for these drugs, and the 30-day mortality rate was 77% compared to an 89% cure rate in outpatients. These differences may reflect changes in organ function, absorption, and distribution to the site of infection in ICU patients, which could impact clinical outcomes.
TROPICAL MEDICINE AND INFECTIOUS DISEASE
(2023)
Article
Anesthesiology
Ming G. Chai, Jason A. Roberts, Christina F. Kelly, Jacobus P. J. Ungerer, Brett C. Mcwhinney, Jeffrey Lipman, Andras Farkas, Menino O. Cotta
Summary: This study aimed to evaluate the efficiency of dosing software for achieving target antibiotic exposures in critically ill patients. The results showed that the use of therapeutic drug monitoring combined with Bayesian forecasting dosing software increased the chances of achieving target exposures in patients, and no antibiotic exposure-related adverse events were reported.
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2023)