Optimal operating MR contrast for brain ventricle parcellation

Development of MR harmonization has enabled different contrast MRIs to be synthesized while preserving the underlying anatomy. In this paper, we use image harmonization to explore the impact of different T1-w MR contrasts on a state-of-the-art ventricle parcellation algorithm VParNet. We identify an optimal operating contrast (OOC) for ventricle parcellation; by showing that the performance of a pretrained VParNet can be boosted by adjusting contrast to the OOC

An experimental in-vivo canine model for adult shunt infection

<p>Abstract</p> <p>Background</p> <p>Detailed human studies of the mechanisms and development of shunt infection in real time are not possible, and we have developed a canine hydrocephalus model to overcome this. The intention of this pilot study was to show that the canine hydrocephalus model could be shunted using conventional "human" shunts, and that a shunt infection could be established so that further studies could then be planned.</p> <p>Methods</p> <p>Hydrocephalus was induced in seven dogs (<it>Canis familiaris</it>) by fourth ventricle obstruction. Four weeks later they were shunted using a Hakim Precision valve. Four of the dogs received shunts whose ventricular catheter had been inoculated with <it>Staphylococcus epidermidis</it>, and three were uninoculated controls. Four weeks after shunting the dogs were sacrificed and necropsy was performed. Removed shunts and tissue samples were examined microbiologically and isolates were subjected to detailed identification and genomic comparison.</p> <p>Results</p> <p>All the dogs remained well after shunting. Examination of removed shunt components revealed <it>S. epidermidis </it>in the brain and throughout the shunt system in the four inoculated animals, but in two of these <it>Staphylococcus intermedius </it>was also found. <it>S. intermedius </it>was also isolated from all three "negative" controls. There were slight differences between <it>S. intermedius </it>strains suggesting endogenous infection rather than cross- infection from a point source.</p> <p>Conclusion</p> <p>Shunt infection was established in the canine model, and had the experiment been extended beyond four weeks the typical microbiological, pathological and clinical features might have appeared. The occurrence of unplanned shunt infections in control animals due to canine normal skin flora reflects human clinical experience and underlines the usual source of bacteria causing shunt infection.</p

Hydrodynamics of the Certas™ programmable valve for the treatment of hydrocephalus

<p>Abstract</p> <p>Background</p> <p>The new Certas™ shunt for the treatment of hydrocephalus has seven standard pressure settings that according to the manufacturer range from 36 to 238 mmH₂O, and an additional “Virtual Off” setting with an opening pressure >400 mmH₂O. Information on actual pressure response and reliability of shunt performance is important in clinical application, especially the “Virtual Off” setting as a non-surgical replacement for shunt ligation. The objective of this study was to evaluate the <it>in-vitro</it> hydrodynamic performance of the Certas™ shunt.</p> <p>Methods</p> <p>Six new Certas™ shunts with proximal and distal catheters were tested with an automated, computerized test system that raised the pressure from zero to a maximum pressure and back to zero at each valve setting. Opening pressure and flow resistance were determined.</p> <p>Results</p> <p>For settings 1–7 the measured opening pressure range was 26 to 247 mmH₂O, and the mean change in opening pressure for a one-step adjustment was between 33 and 38 mmH₂O. For setting 8 (“Virtual Off”) the measured mean opening pressure was 494 ± 34 mmH₂O (range 451 to 556 mmH₂O). The mean outflow resistance was 7.0 mmHg/ml/min (outflow conductance 17.9 μl/s/kPa).</p> <p>Conclusions</p> <p>The six shunts had similar characteristics and closely matched the manufacturer’s specifications for opening pressure at settings 1–7. The opening pressure for the “Virtual Off” setting was nearly 500 mmH₂O, which is 100 mmH₂O higher than the manufacturer’s specification of “>400” and should be functionally off for most patients with communicating hydrocephalus. Clinical studies are needed to evaluate if the CSF dynamic profile persists after implantation in patients.</p

Control of edema in hypertensive subjects treated with calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitors with Pycnogenol.

The presence of edema in different phases and stages of essential hypertension may be due to antihypertensive treatment. Some drugs may cause edema by inducing vasodilatation, increasing the capillary exchange surface and capillary filtration. Pycnogenol has an important anti-edema effect in diabetic microangiopathy and chronic venous insufficiency. This 8-week study evaluated capillary filtration in 2 comparable treatment groups with hypertension treated with a calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitor to define its efficacy in preventing edema caused by antihypertensives. A significant decrease in filtration was observed in the Pycnogenol groups. Pycnogenol controls this type of edema, it helps to prevent and limit long-term damage in the microcirculation in hypertensive patients, and allows the dose of anti-hypertensive drugs to be reduced in most patients

The Epidemiologic Study in San Valentino

The efficacy of a 2-month treatment with oral colostrum in the prevention of flu episodes compared with antiinfluenza vaccination was evaluated. Groups included healthy subjects without prophylaxis and those receiving both vaccination and colostrum. After 3 months of follow-up, the number of days with flu was 3 times higher in the non-colostrum subjects. The colostrum group had 13 episodes versus 14 in the colostrum + vaccination group, 41 in the group without prophylaxis, and 57 in nontreated subjects. Part 2 of the study had a similar protocol with 65 very high-risk cardiovascular subjects, all of whom had prophylaxis. The incidence of complications and hospital admission was higher in the group that received only a vaccination compared with the colostrum groups. Colostrum, both in healthy subjects and high-risk cardiovascular patients, is at least 3 times more effective than vaccination to prevent flu and is very cost-effective

Cauchy-perturbative matching and outer boundary conditions: computational studies

We present results from a new technique which allows extraction of gravitational radiation information from a generic three-dimensional numerical relativity code and provides stable outer boundary conditions. In our approach we match the solution of a Cauchy evolution of the nonlinear Einstein field equations to a set of one-dimensional linear equations obtained through perturbation techniques over a curved background. We discuss the validity of this approach in the case of linear and mildly nonlinear gravitational waves and show how a numerical module developed for this purpose is able to provide an accurate and numerically convergent description of the gravitational wave propagation and a stable numerical evolution.Comment: 20 pages, RevTe