Comparative examination of telemetric intracranial pressure measurement in a prospective pilot study

Zielsetzung: Die Messung des intrakraniellen Druckes (ICP) spielt eine wichtige Rolle in verschiedenen neurointensivmedizinischen Situationen und in der langfristigen Betreuung und Behandlung der Patienten mit einem Liquorshunt. Derzeit sind weltweit nur zwei telemetrische Vollimplantate zur ICP-Messung verfügbar. Diese arbeiten nach verschiedenen technischen Prinzipien. In der vorliegenden prospektiven klinischen Pilotstudie sollen Patienten untersucht werden, bei denen aus klinischen Gründen beide Messsonden mit zeitlicher Überschneidung implantiert waren. Die Arbeit stellt den ersten In-vivo-Vergleich beider Messmethoden dar. Ziel der Untersuchung ist es, eine Grundlage der Vergleichbarkeit der Messdaten beider Methoden herzustellen. Material und Methodik: Das Studienvorhaben wurde der zuständigen Ethikkommission vorgelegt und die Durchführung genehmigt (Charité, EA1/278/12). Patienten mit primärer Subarachnoidalblutung (SAB) oder spontaner intrazerebraler Blutung (ICB) mit ventrikulärer Blutung, die aus klinischer Indikation eine telemetrische intraparenchymatöse ICP-Sonde (Raumedic NEUROVENT P-tel) erhalten hatten, wurden nach entsprechender Aufklärung und Einwilligung in die Studie eingeschlossen. Bei den Patienten, die im weiteren Verlauf aufgrund eines Hydrozephalus die Indikation zur Liquordrainage entwickelten, wurden je nach klinischer Indikation externe Ventrikeldrainagen und ggf. später ventrikuloperitoneale Shunts implantiert, die einen telemetrischen ICP-Sensor (Miethke Sensor-Reservoir) enthielten. Über alle Systeme wurden ICP-Werte gemessen. Aufgrund von einander überschneidenden Implantationszeiten, konnten zeitweise parallele Messungen der ICP-Werte über beide Geräte durchgeführt werden. Nach Explantation der telemetrischen intraparenchymatösen ICP-Sonde nach 3 Monaten führten wir ICP-Messungen nach drei und sechs Monaten über das Sensor-Reservoir durch. Die Unterschiede zwischen den mit der NEUROVENT-P-tel-Sonde, dem Miethke-Sensor-Reservoir und den teilweise implantierten EVD-Sonden gemessenen ICP-Werten wurden bewertet. Ergebnisse: Zwischen Februar 2016 und Oktober 2018 wurden 16 Patienten eingeschlossen, 6 weibliche und 10 männliche. Ein paralleles Messintervall von 3 Monaten wurde bei 11 Patienten erreicht. Die über das Sensor-Reservoir gemessenen ICP-Werte zeigten in 9 Fällen eine durchgehend übereinstimmende Tendenz im Vergleich zu den mit der Telemetrie-Sonde oder EVD gemessenen ICP-Werten. Die ICP-Differenz lag maximal bei 14,5 mmHg und minimal bei 0,0 mmHg. Die durchschnittliche ICP-Differenz lag bei 8 Fällen ≤ 3,5 mmHg. Schlussfolgerung: Die absoluten ICP-Werte der Messungen mit den verschiedenen Systemen stimmen nicht überein aber alle Systeme zeigen durchgehend eine synchrone ICP-Dynamik.Objectives: The measurement of intracranial pressure (ICP) plays an important role in the neurointensive care management, the long-term care, and in treatment of patients with a cerebral shunt. Currently, only two complete telemetric Implants, with different technical principles, are available worldwide. This prospective pilot study aims to investigate patients who, for clinical reasons, had temporally overlapping both probes implanted and presents the first in-vivo comparison of both measurement methods. Material and Methods: Patients with primary subarachnoid hemorrhage or spontaneous intracerebral hemorrhage with ventricular hemorrhage who had received a telemetric ICP probe (Raumedic NEUROVENT P-tel) were included in the study. External ventricular drainage and ventriculoperitoneal shunts containing a telemetric ICP (Miethke Sensor Reservoir) sensor were implanted in the patients with hydrocephalus requiring CSF drainage. ICP values were measured with all systems. Due to overlapping implant times, it was possible to perform interim measurements of the ICP values with both devices at same times. ICP measurements at the sensor reservoir were performed at three and six months. The differences between the ICP values measured with the NEUROVENT P-tel probe, the Miethke sensor reservoir and the partially implanted EVD probes were evaluated. Results: From 2016 through 2018, 16 patients were enrolled and 63% were male. A parallel measurement interval of 3 months was achieved in 11 patients. The ICP values measured by the sensor reserve showed a consistent trend in 9 cases compared to the ICP values measured with the telemetry probe or EVD. The ICP difference was a maximum of 14.5 mmHg and a minimum of 0.0 mmHg. The average ICP difference was in 8 cases ≤ 3.5 mmHg. Conclusion: Both systems have shown continuous synchronous ICP dynamics however, the absolute ICP values of the measurements with the different systems did not match

Repurposing Potential of the Antiparasitic Agent Ivermectin for the Treatment and/or Prophylaxis of COVID-19

Due to the rapid, vast, and emerging global spread of the Coronavirus Disease 2019 (COVID-19) pandemic, many drugs were quickly repurposed in a desperate attempt to unveil a miracle drug. Ivermectin (IVM), an antiparasitic macrocyclic lactone, was tested and confirmed for its in vitro antiviral activity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in early 2020. Along with its potential antiviral activity, the affordability and availability of IVM resulted in a wide public interest. Across the world, trials have put IVM to test for both the treatment and prophylaxis of COVID-19, as well as its potential role in combination therapy. Additionally, the targeted delivery of IVM was studied in animals and COVID-19 patients. Through this conducted literature review, the potential value and effectiveness of the repurposed antiparasitic agent in the ongoing global emergency were summarized. The reviewed trials suggested a value of IVM as a treatment in mild COVID-19 cases, though the benefit was not extensive. On the other hand, IVM efficacy as a prophylactic agent was more evident and widely reported. In the most recent trials, novel nasal formulations of IVM were explored with the hope of an improved optimized effect

CAROTENOID EXTRACTION OF ORANGE-FLESHED SWEET POTATO AND ITS APPLICATION AS NATURAL FOOD COLORANT [Ekstraksi Karotenoid Ubi Jalar Jingga dan Aplikasinya sebagai Pewarna Makanan Alami]

The orange-fleshed sweet potato is rich in carotenoids, which can potentially be used as a natural food colorant. However, effective and safe extraction techniques are needed. The carotenoid extraction of deep orange-fleshed cultivar (Beta 1) at different moisture contents of fresh tubers using combined solvents was studied. The research design was a factorial randomized complete design with two factors and three replicates. The first factor was moisture content of the grated tubers. The second factor was the ratios of ethanol and acetone. The extract obtained from the most effective extraction process was stored for 1 month at room temperature and also applied as a topping colorant for steamed cakes (bolu kukus) which was compared to bolu kukus treated with no colorant and with artificial yellow colorant. The results showed that the fresh tubers contained high moisture (79.28%) and beta-carotene (12,169 µg/100 g wb) with the lightness value (L*) of 44.77. Extraction of reduced-water grated-tubers (m.c. 60.63%) using ethanol-acetone at ratio of 5:5 v/v gave the highest content of beta-carotene in the extract (235.94 µg/ml) with L* value of 52.48. Meanwhile, fresh grated tuber extracted with ethanol-acetone (9:1 v/v) had the lowest beta-carotene content (12.49 µg/ml). The extract stored in a dark bottle for 1 month showed better color stability with higher beta-carotene content (92.18 µg/ml) than that of transparent bottle (20.12 µg/ml). The color, odor and taste of steamed cakes with the extract as a topping colorant were slightly liked by panelists and were similarly scored to those of the counterparts, yet had better odor acceptance