Interventional Neuroradiology: Henry Ford Hospital Experience with Nonembolization Procedures

Innovative technical developments over the past two decades have resulted in the development of a variety of useful interventional procedures for minimally invasive treatment of a variety of head and neck lesions. We have had experience with four different types of nonembolization interventional neuroradiologic procedures at Henry Ford Hospital from 1981 through 1985. Percutaneous transluminal angioplasty of six external carotid artery stenoses has been performed in five patients. Five were successful, and the artery became occluded in one patient. Intracarotid BCNU infusion was performed successfully in five patients with recurrent astrocytoma. Intraarterial streptokinase infusion was performed in one patient with acute thrombosis of an ectatic basilar artery. A traumatic carotid cavernous fistula was successfully closed by detachable silicone balloon technique

Interventional Neuroradiology: Henry Ford Hospital Experience with Transcatheter Embolization of Vascular Lesions in the Head, Neck, and Spine

Innovative developments over the past 15 years have resulted in increased sophistication and effectiveness of therapeutic neuroembolization procedures. As a result, percutaneous transcatheter embolization has assumed an increasingly important role in the management of patients with vascular lesions of the head, neck, and spine. By reducing bleeding during surgery, this technique can markedly facilitate the surgical approach to difficult vascular lesions. The technique may also be applied in cases where surgery is contraindicated. Therapeutic neuroembolization has been performed in 23 patients with vascular lesions of the head, neck, or spine at Henry Ford Hospital. Devascularization of the extraaxial blood supply was achieved in all cases, and no neurologic complications were encountered. Eighteen patients with vascular tumors of the head, neck, or spine and three patients with arteriovenous malformations (AVM) were embolized preoperatively, resulting in marked facilitation of the surgical procedures. One patient with a dural AVM and one with a spinal metastasis were embolized without surger

A Novel Classification of Lung Cancer into Molecular Subtypes

The remarkably heterogeneous nature of lung cancer has become more apparent over the last decade. In general, advanced lung cancer is an aggressive malignancy with a poor prognosis. The discovery of multiple molecular mechanisms underlying the development, progression, and prognosis of lung cancer, however, has created new opportunities for targeted therapy and improved outcome. In this paper, we define “molecular subtypes” of lung cancer based on specific actionable genetic aberrations. Each subtype is associated with molecular tests that define the subtype and drugs that may potentially treat it. We hope this paper will be a useful guide to clinicians and researchers alike by assisting in therapy decision making and acting as a platform for further study. In this new era of cancer treatment, the ‘one-size-fits-all’ paradigm is being forcibly pushed aside—allowing for more effective, personalized oncologic care to emerge

Global impact of COVID-19 on stroke care and IV thrombolysis

Objective To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.Paroxysmal Cerebral Disorder

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Effect of Dangling Bonds on De-Poling Time for Polymeric Electric Field Optical Sensors

This paper investigates the possible chemical changes in polydimethylsiloxane (PDMS) caused by two different techniques of fabrication for ultra-sensitive electric field optical sensors. The sensing element is a micro-sphere made from 60:1 PDMS (60 parts base silicon elastomer to one part polymer curing agent by volume). The measurement principle is based on the morphology dependent resonances (MDR) shifts of the micro-sphere. We present the effects of curing and poling of polymer micro-spheres used as optical sensors. The degree of curing leads to changes in the de-poling time which results from dangling bonds in the polymeric chains. Consequently, the longevity of the sensitivity of the sensor can extended by two orders of magnitude. An analysis is carried out along with preliminary experiments to investigate that behavior

Impact of lactation stage on milk composition and blood biochemical and hematological parameters of dairy Baladi goats

The objective of this study was to elucidate the impact of lactation stage on milk composition, hematological and biochemical parameters of dairy Baladi goats under Egyptian conditions. Forty-eight Baladi goats (32.8 ± 2.9 kg of BW) were enrolled in the current study. The lactation period has been divided into three stages; early (DIM less than 80 days), Mid (DIM 80–140 days), and Late (DIM over 140 days). Baladi goats had decreased daily-MY at a rate of 18.4% and 31.9% at mid and late stages of lactation, compared with early stage, respectively (p = 0.001). Furthermore, lactose% decreased significantly with progress of lactation (p = 0.017). Total solids%, however, decreased significantly at early stage of lactation in comparison with mid and late stages (p = 0.022). On the contrary, no significant differences were found in protein, fat and SNF percentages at different stages of lactation (p = 0.836, 0.625 and 0.281, respectively). Serum glucose and total protein were significantly reduced at late stage of lactation in comparison with early and mid stages (p = 0.001 and 0.001, respectively). On the contrary, no significant differences were found for erythrocytes count, hemoglobin, serum cholesterol, catalase and triiodothyronine at different stages of lactation. There were high and positive correlations between daily-MY and serum total protein (r = 0.87, P < 0.01) and triiodothyronine (r = 0.41, P < 0.01). However, negative estimates were reported between daily-MY and triglycerides (r = −0.55, P < 0.01) and cholesterol (r = −0.33, P < 0.05). Our results indicate that dairy Baladi goats produce milk with relatively stable protein, fat and solid not fat (SNF) contents at the different stages of lactation, encouraging the continuous utilization of their milk in processing. Also, dairy Baladi goats seem able to maintain the most vital biochemical parameters. Keywords: Dairy goat, Lactation stage, Biochemical trait

Detection of SNPs in growth hormone and insulin like growth factor -1 genes in two divergently selected lines of Japanese quail

The Japanese quail (Coturnix japonica) is used for producing both meat and egg in many countries and as a model for animal research purposes. Two lines of Japanese quail that were differentiated by high body weight (HBW) and low body weight (LBW) had been improved by selection for body weight at four weeks of age. The objective of this study was to detect single nucleotide polymorphism (SNP) in Growth hormone (GH) and Insulin like Growth Factor -1 (IGF-1) genes in the two Japanese quails selected lines which based on the weight of the body at four weeks of age. DNA has been extracted from fifty blood samples by commercial kits and amplified by polymerase chain reaction (PCR). DNA sequencing revealed nucleotide polymorphisms between the two Japanese quails selected lines. The results of this investigation revealed that, one nucleotide change (T/C) in the intron 2 of GH gene. However, there were no nucleotide differences in IGF-1gene between the two selected lines. It concluded that, the SNP discovered in the GH gene may provide appropriate markers for associating researches of candidate genes with imperative economic measurements in Japanese quail. However, further studies are necessitating detecting mutation in another region of IGF-1

Identification of Mx gene nucleotide dimorphism (G/A) as genetic marker for antiviral activity in Egyptian chickens

Egyptian chickens, representing 2 breeds and 7 strains, were genotyped using the PCR-RFLP and sequencing techniques for detection of a non-synonymous dimorphism (G/A) in exon 14 of chicken Myxovirus resistance (Mx) gene. This dimorphic position is responsible for altering Mx protein’s antiviral activity. Polymerase Chain reactions were performed using Egyptian chickens DNA and specific primer set to amplify Mx DNA fragments of 299 or 301 bp, containing the dimorphic position. Amplicons were cut with restriction enzyme Hpy81. Genotype and allele frequencies for the resistant allele A and sensitive allele G were calculated in all the tested chickens. Results of PCR-RFLP were confirmed by sequencing. The three genotypes AA, AG, GG at the target nucleotide position in Mx gene were represented in all the studied Egyptian chicken breeds and strains except Baladi strain which showed only one genotype AA. The average allele frequency of the resistant A allele in the tested birds (0.67) was higher than the sensitive G allele average frequency in the same birds (0.33). Appling PCR-RFLP technique in the breeding program can be used to select chickens carrying the A allele with high frequencies. This will help in improving poultry breeding in Egypt by producing infectious disease-resistant chickens. Keywords: Egyptian chickens, Antiviral activity, Mx gene, Genotyping, PCR-RFL