Inventarisatiestudie naar de behoefte aan assistentie door het Mobiel Medisch Team in de avond en nacht

Samenvatting Inleiding: Tot 2005 kon men uitsluitend gedurende de dag een beroep doen op professionele aanvullende prehospitale hulpverlening. In 2005 ontstond een voor Nederland unieke situatie waarbij het Mobiel Medisch Team (MMT) ook ’s nacht paraat inzetbaar was. Het doel van deze studie was inzicht te krijgen in de kwantitatieve en kwalitatieve aspecten van grondgebonden MMT inzetten in de nacht, tussen 19.00 en 7.00 uur. Methode: In een beschrijvend cohortonderzoek werden alle patiënten waarvoor in 2005 tussen 19.00 en 7.00 uur MMT-assistentie werd gevraagd in de regio Zuid West Nederland geïncludeerd. Van de geïncludeerde patiënten werden prospectief (pre)hospitale data gedocumenteerd, en na 1 jaar geanalyseerd. Resultaten: Gedurende de studieperiode werd in de avond en nacht 235 keer om assistentie gevraagd, waarvan 69 aanvragen werden geannuleerd. Zevenenzestig procent van deze nachtelijke inzetten vond plaats op basis van de inzetcriteria die gebaseerd zijn op de aard van het ongeval, en 33% op basis van de toestand van de patiënt. Drieënzestig procent van de inzetten vond plaats tussen 19.00 uur en middernacht. De mediane Injury Severity Score was 10 (4-25) met een mortaliteit van 16 %. Drieëntwintig procent van de patiënten werd geïntubeerd. Conclusie: Deze studie laat zien dat er ook gedurende de avond en nacht aanzienlijke behoefte is aan gespecialiseerde medische hulp ter aanvulling op de ambulancezorg. De kwalitatieve behoefte aan zorg is vergelijkbaar met de zorgvraag overdag. Het handelen van het nachtelijk grondgebonden MMT was potentieel levensreddend. Extrapolatie van deze regionale resultaten levert een behoefteraming op van jaarlijks 505 daadwerkelijke MMT assistenties in heel Nederland tussen 19.00 uur en 7.00 uur

Quantification of Dynamic 11C-Phenytoin PET Studies

The overexpression of P-glycoprotein (Pgp) is thought to be an important mechanism of pharmacoresistance in epilepsy. Recently, 11C-phenytoin has been evaluated preclinically as a tracer for Pgp. The aim of the present study was to assess the optimal plasma kinetic model for quantification of 11C-phenytoin studies in humans. Methods: Dynamic 11C-phenytoin PET scans of 6 healthy volunteers with arterial sampling were acquired twice on the same day and analyzed using single- and 2-tissue-compartment models with and without a blood volume parameter. Global and regional test– retest (TRT) variability was determined for both plasma to tissue rate constant (K1) and volume of distribution (VT). Results: According to the Akaike information criterion, the reversible single-tissue-compartment model with blood volume parameter was the preferred plasma input model. Mean TRT variability ranged from 1.5% to 16.9% for K1 and from 0.5% to 5.8% for VT. Larger volumes of interest showed better repeatabilities than smaller regions. A 45-min scan provided essentially the same K1 and VT values as a 60-min scan. Conclusion: A reversible single-tissue-compartment model with blood volume seems to be a good candidate model for quantification of dynamic 11C-phenytoin studies. Scan duration may be reduced to 45 min without notable loss of accuracy and precision of both K1 and VT, although this still needs to be confirmed under pathologic conditions

[11C]Flumazenil brain uptake is influenced by the blood-brain barrier efflux transporter P-glycoprotein

Background:

AVNP2 protects against cognitive impairments induced by C6 glioma by suppressing tumour associated inflammation in rats

© 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).Glioblastoma is a kind of malignant tumour and originates from the central nervous system. In the last century, some researchers and clinician have noticed that the psychosocial and neurocognitive functioning of patients with malignant gliomas can be impaired. Many clinical studies have demonstrated that part of patients, adults or children, diagnosed with glioblastoma will suffer from cognitive deficiency during their clinical course, especially in long-term survivors. Many nanoparticles (NPs) can inhibit the biological functions of tumours by modulating tumour-associated inflammation, which provokes angiogenesis and tumour growth. As one of the best antiviral nanoparticles (AVNPs), AVNP2 is the 2nd generation of AVNP2 that have been conjugated to graphite-graphene for improving physiochemical performance and reducing toxicity. AVNP2 inactivates viruses, such as the H1N1 and H5N1influenza viruses and even the SARS coronavirus, while it inhibits bacteria, such as MRSA and E. coli. As antimicrobials, nanoparticles are considered to be one of the vectors for the administration of therapeutic compounds. Yet, little is known about their potential functionalities and toxicities to the neurotoxic effects of cancer. Herein, we explored the functionality of AVNP2 on inhibiting C6 in glioma-bearing rats. The novel object-recognition test and open-field test showed that AVNP2 significantly improved the neuro-behaviour affected by C6 glioma. AVNP2 also alleviated the decline of long-term potentiation (LTP) and the decreased density of dendritic spines in the CA1 region induced by C6. Western blot assay and immunofluorescence staining showed that the expressions of synaptic-related proteins (PSD-95 and SYP) were increased, and these findings were in accordance with the results mentioned above. It revealed that the sizes of tumours in C6 glioma-bearing rats were smaller after treatment with AVNP2. The decreased expression of inflammatory factors (IL-1β, IL-6 and TNF-α) by Western blotting assay and ELISA, angiogenesis protein (VEGF) by Western blotting assay and other related proteins (BDNF, NF-ĸB, iNOS and COX-2) by Western blotting assay in peri-tumour tissue indicated that AVNP2 could control tumour-associated inflammation, thus efficiently ameliorating the local inflammatory condition and, to some extent, inhibiting angiogenesis in C6-bearing rats. In conclusion, our results suggested that AVNP2 could have an effect on the peri-tumor environment, obviously restraining the growth progress of gliomas, and eventually improving cognitive levels in C6-bearing rats.Peer reviewedProo

An aCGH classifier derived from BRCA1-mutated breast cancer and benefit of high-dose platinum-based chemotherapy in HER2-negative breast cancer patients

Background: Breast cancer cells deficient for BRCA1 are hypersensitive to agents inducing DNA double-strand breaks (DSB), such as bifunctional alkylators and platinum agents. Earlier, we had developed a comparative genomic hybridisation (CGH) classifier based on BRCA1-mutated breast cancers. We hypothesised that this BRCA1-likeCGH classifier could also detect loss of function of BRCA1 due to other causes besides mutations and, consequently, might predict sensitivity to DSB-inducing agents