Non-invasive Monitoring Method Research Articles

Non-invasively accuracy enhanced blood glucose sensor using shallow dense neural networks with NIR monitoring and medical features

Non-invasive and accurate method for continuous blood glucose monitoring, the self-testing of blood glucose is in quest for better diagnosis, control and the management of diabetes mellitus (DM). Therefore, this study reports a multiple photonic band near-infrared (mbNIR) sensor augmented with personalized medical features (PMF) in Shallow Dense Neural Networks (SDNN) for the precise, inexpensive and pain free blood glucose determination. Datasets collected from 401 blood samples were randomized and trained with ten-fold validation. Additionally, a cohort of 234 individuals not included in the model training set were investigated to evaluate the performance of the model. The model achieved the accuracy of 97.8% along with 96.0% precision, 94.8% sensitivity and 98.7% specificity for DM classification based on a diagnosis threshold of 126 mg/dL for diabetes in fasting blood glucose. For non-invasive real-time blood glucose monitoring, the model exhibited ± 15% error with 95% confidence interval and the detection limit of 60–400 mg/dL, as validated with the standard hexokinase enzymatic method for glucose estimation. In conclusion, this proposed mbNIR based SDNN model with PMF is highly accurate and computationally cheaper compared to similar previous works using complex neural network. Some groups proposed using complicated mixed types of sensors to improve noninvasive glucose prediction accuracy; however, the accuracy gain over the complexity and costs of the systems harvested is still in questioned (Geng et al. in Sci Rep 7:12650, 2017). None of previous works report on accuracy enhancement of NIR/NN using PMF. Therefore, the proposed SDNN over PMF/mbNIR is an extremely promising candidate for the non-invasive real-time blood glucose monitoring with less complexity and pain-free.

Phase II trial of organ preservation program using short-course radiation and folfoxiri for rectal cancer (SHORT-FOX).

TPS218 Background: Locally advanced rectal cancer is treated with preoperative chemoradiotherapy followed by total mesorectal excision (TME). While this trimodal approach achieves low rates of local recurrences, distant metastasis rates can exceed 25%. Total neoadjuvant therapy (TNT) has been shown in OPRA, RAPIDO, and PRODIGE23 to reduce risk of distant metastasis and improve rates of pathological complete response compared to standard preoperative chemoradiotherapy. Thus, TNT not only addresses distant disease, but gives opportunity to reduce locoregional morbidity through organ preservation. We propose a treatment approach that incorporates TNT with FOLFOXIRI and up-front short-course radiation with the goal of increasing clinical complete response (cCR) rates and thereby eligibility for organ preservation. Currently, clinical response following neoadjuvant therapy is best assessed by a multidisciplinary team and includes flexible endoscopy and MRI. Circulating tumor DNA (ctDNA) analysis can be used as a noninvasive method for tumor monitoring. Biomarker development is essential to better select patients for treatment de-escalation and monitor for recurrence in order not to jeopardize the excellent cure rates following standard of care therapy. Methods: This is a single-arm, open-label, non-randomized study of an organ preservation approach using short-course radiation followed by FOLFOXIRI for patients with > T2N0 or low T2N0, M0 rectal adenocarcinoma (NCT04380337). Patients undergo radiation (25 Gy/5 fractions + 5 Gy/1 fraction boost) followed by 8 cycles of FOLFOXIRI. Patients are assessed for response at 8 weeks following chemotherapy completion using pelvic MRI (MRI Tumor Regression Grading), flexible sigmoidoscopy, and digital rectal exam. Those who achieve a cCR can defer TME and be surveilled. The primary objective is to assess cCR, with the hypothesis that this approach will achieve higher cCR rates than historical controls (40 versus 20%). Secondary objectives include assessing toxicity, local regrowth rate, disease-free survival, colostomy-free survival, overall survival, and longitudinal health-related quality of life. ctDNA will be collected throughout treatment and surveillance, and correlative studies will assess the association between ctDNA levels and cCR, local regrowth, and disease-free survival. A Simon 2-stage design addressed our primary objective. Assuming a one-sided type 1 error of 0.1, power of 0.9, a null cCR of 0.2 versus an alternate cCR of 0.4, we plan to enroll 37 patients. The null hypothesis will be rejected if > = 11 patients have cCR. Seventeen patients have been enrolled and the trial is currently on hold for planned interim analysis for futility and safety. If < = 3 patients have cCR or if > = 7 patients have non-hematologic grade 4+ toxicity, the study will be stopped. Otherwise, we will continue to enroll 20 more patients. Clinical trial information: NCT04380337.

Reconstruction of central arterial pressure waveform based on CNN-BILSTM

Central arterial pressure is an important physiological indicator of the human cardiovascular system. Its noninvasive, continuous and accurate reconstruction and monitoring are essential to the evaluation, prevention and treatment of cardiovascular system diseases. However, it is difficult to improve the accuracy of noninvasive central arterial pressure reconstruction by traditional methods, which limits its clinical application and promotion. In this study, a model for reconstructing central artery pressure from radial arterial pressure waveforms based on a convolutional neural network and bi-directional long short-term memory (CNN-BiLSTM) was proposed. Central aortic pressure waveforms and radial arterial pressure waveforms were measured invasively before and after medication in 62 patients to evaluate the CNN-BiLSTM model for reconstructing central artery pressure. The CNN-BiLSTM model was compared with two traditional methods (autoregressive exogenous (ARX) and N-point moving average method (NPMA)) and four deep learning models (LSTM, BiLSTM, LSTM-BiLSTM and CNN-LSTM) in the mean absolute error (MAE), root mean square error (RMSE) and Spearman correlation coefficient (SCC). Experimental results showed that the proposed model achieved the best results on waveform reconstruction (MAE: 2.18 ± 0.13 mmHg, RMSE: 2.95 ± 0.16 mmHg). At the same time, a good reconstruction effect was obtained in the central arterial systolic pressure (RMSE: 3.34 ± 0.91 mmHg) and diastolic blood pressure (RMSE: 2.41 ± 0.18 mmHg). Therefore, the reconstruction model based on CNN-BILSTM is a potential method for noninvasive continuous monitoring of central arterial pressure.

Engineered Protein-Iron Oxide Hybrid Biomaterial for MRI-traceable Drug Encapsulation.

Labeled protein-based biomaterials have become a popular for various biomedical applications such as tissue-engineered, therapeutic, or diagnostic scaffolds. Labeling of protein biomaterials, including with ultrasmall super-paramagnetic iron oxide (USPIO) nanoparticles, has enabled a wide variety of imaging techniques. These USPIO-based biomaterials are widely studied in magnetic resonance imaging (MRI), thermotherapy, and magnetically-driven drug delivery which provide a method for direct and non-invasive monitoring of implants or drug delivery agents. Where most developments have been made using polymers or collagen hydrogels, shown here is the use of a rationally designed protein as the building block for a meso-scale fiber. While USPIOs have been chemically conjugated to antibodies, glycoproteins, and tissue-engineered scaffolds for targeting or improved biocompatibility and stability, these constructs have predominantly served as diagnostic agents and often involve harsh conditions for USPIO synthesis. Here, we present an engineered protein-iron oxide hybrid material comprised of an azide-functionalized coiled-coil protein with small molecule binding capacity conjugated via bioorthogonal azide-alkyne cycloaddition to an alkyne-bearing iron oxide templating peptide, CMms6, for USPIO biomineralization under mild conditions. The coiled-coil protein, dubbed Q, has been previously shown to form nanofibers and, upon small molecule binding, further assembles into mesofibers via encapsulation and aggregation. The resulting hybrid material is capable of doxorubicin encapsulation as well as sensitive T2*-weighted MRI darkening for strong imaging capability that is uniquely derived from a coiled-coil protein.

Sweat-Based Glucose Sensor Based on a Graphene/Au Composite Electrode

In the present study, an integrated and flexible device was designed for the electrochemical analysis of biomarkers in human sweat, providing a new method for non-invasive glucose monitoring. At present, sweat-based glucose monitoring still faces many challenges. For example, changes in the environmental temperature can cause changes in glucose oxidase activity. This device uses multiple sensors for glucose sensing based on the real-time correction of pH and temperature measurement values, which can improve the accuracy of the detection results. Moreover, the efficiency of the sweat sensing process can be improved through the miniaturization of the sensor. This device provides a novel solution for the non-invasive sweat-based and real-time monitoring of glucose.

Laparoscopy in diagnosis and complex treatm ent of malignant ovarian tumors

To study the possibilities of laparoscopy in diagnosis of malignant ovarian tumors 635 patients at different stages of the disease were examined. High informing characteristics make it possible to recommend laparoscopy as a method of improved diagnostics of tumors in smallpelvic with the aim of early revealingof malignant tumors, morphologic verification and evaluation of tumor extensiveness, diagnosis of preclinical recurrent tumors in case of diverse results of non-invasive monitoring methods.

Monitoring Blinks And Eyelid Twitches In Horses To Assess Stress During The Samples Collection Process

ABSTRACT To assess stress in horses, a method of monitoring eye blinks (full and half) and eyelid twitches while collecting saliva and blood samples before and after annual intensive police training was carried out. This noninvasive monitoring method was used to determine whether blood collection, which is considered invasive, is more stressful for horses than saliva collection. We discovered no significant difference in stress related manifestations between saliva sampling and blood collection in our study. In both cases, sampling (blood and saliva) reduced the number of full and half eye blinks. Based on our hypothesis, we expected a statistically significant changes in the number of eye blinks and eyelid twitches as the number of potential stressors increased (in our case, we considered police training and sampling). Saliva cortisol levels, on the other hand, revealed that police training for horses was not stressful. The method of measuring eye blinks and eyelid twitches appears to be an appropriate alternative method for monitoring stress factors in horses.

Monitoring Bevacizumab-Induced Tumor Vascular Normalization by Intravoxel Incoherent Motion Diffusion-Weighted MRI.

Accurate monitoring of tumor blood vessel normalization progression is beneficial to accurate treatment of patients. At present, there is a lack of safe and noninvasive monitoring methods. To serial monitor the vascular normalization time window of tumor antiangiogenesis treatment through intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and histopathological methods. Exploratory animal study. Sixty rat C6 glioma models were randomly and equally divided into the control groups (N=30) and bevacizumab treatment groups (N=30). Twenty-five for magnetic resonance imaging (MRI) and five for electron microscope testing in each group. T1-weighted imaging (T1WI), T2WI with a fast spin echo sequence and IVIM-DWI with a spin-echo echo-planar imaging sequence at 3T. IVIM-DWI quantitative parameters (f, D, D*, and fD*) were obtained on days 0, 2, 4, 6, and 8 after bevacizumab treatment. After MRI, the microvessel density (MVD), pericyte coverage, and hypoxia-inducible factor-1α (HIF-1α) were assessed. Electron microscope observation was performed at each time point. One-way analysis of variance and Student's t-tests were used to compare differences within and between groups. Spearman's correlation coefficient (r) assess the correlation between IVIM and pathological parameters. The intragroup correlation coefficient was determined to assess the repeatability of each IVIM parameter. The IVIM-DWI perfusion parameters (f and fD*) of the treated group were higher than the control group on days 2 and 4. Compared to the control group, MVD decreased on days 2 and pericyte coverage increased on days 4 in the treatment group. Electron microscopy showed that the tight junctions of the treatment group were prolonged on days 2-4. In the control group, f had the highest correlation with MVD (r=0.689). In the treated group, f had a good correlation with pericyte coverage (r=0.557), HIF-1α had a moderately positive correlation with f (r=0.480) and fD*(r=0.447). The vascular normalization time window of bevacizumab treatment of glioma was days 2-4 after antiangiogenesis treatment, which could be monitored noninvasively by IVIM-DWI. 2 TECHNICAL EFFICACY: Stage 3.

Evaluation of fingertip pulse oximeters for monitoring haemoglobin oxygen saturation in arterial blood and pulse rate in isoflurane‐anaesthetised horses breathing greater than 90 percent oxygen

SummaryBackgroundPulse oximetry is a noninvasive method for continuous monitoring of oxygen saturation (SpO2) and pulse rate (PR) used in equine anaesthesia. Despite species differences in the oxyhaemoglobin dissociation curve, pulse oximeters validated for humans are commonly used in veterinary medicine. These devices are expensive and at an increased risk for damage when used for equine anaesthesia. Human fingertip pulse oximeters (FPO) may be useful as an inexpensive alternative to standard devices.ObjectivesEvaluate accuracy and repeatability of FPOs applied to tongues of anaesthetised horses breathing >90% oxygen.Study designProspective clinical study.MethodsDuplicate SpO2 and PR measurements from eight pulse oximeters (PO; seven FPOs and reference PO) placed in random order on tongues of horses under inhalational anaesthesia were recorded. A standard portable PO (RPO) was used as reference SpO2 and invasive blood pressure trace or manual pulse palpation as reference PR. Nonparametric Bland‐Altman analysis was performed. Acceptable coefficient of repeatability (CR) value was ≤6% SpO2. Agreements were accepted if limits of agreement were ≤ ±3% difference in SpO2 and ≤ ±10% relative difference in PR. Only PR values between 25 and 50 beats per minute and their corresponding SpO2 measurements were used for agreement analysis.ResultsSpO2 repeatability and agreement were unacceptable for all devices. The agreement of PR measurements was acceptable for one FPO and the RPO.Main limitationsUtilisation of devices designed for the human oxyhaemoglobin dissociation curve, high number of absent or erroneous readings, use of healthy horses, small sample size, unavailability of co‐oximetry, lack of a desaturation protocol and difficulty with proper placement of FPOs on horse tongues are all considered limitations in this study.ConclusionsAccuracy of FPOs used in anaesthetised horses was poor. Their use in equine anaesthesia for SpO2 monitoring is not recommended, but some models may be considered for continuous PR monitoring in conjunction with intermittent manual confirmation.

The Platform A novel non-invasive fish monitoring method

The Platform A novel non-invasive fish monitoring method

Take a good catch at the scat: carboxylic and sulfonic acid profiles as a non-invasive tool for species identification and sex determination in neotropical carnivores

ABSTRACT There is an increasing interest in the use of noninvasive monitoring methods, such as the use of chemical profiles obtained from noninvasive samples. Here, we propose the use of carboxylic and sulfonic acids profiles obtained from scats as a noninvasive tool to identify mammalian carnivoran species and for sex determination. We used High-Performance Liquid Chromatography (HPLC) coupled to a Laser-Induced Fluorescence (LIF) detection system (HPLC-LIF) to retrieve carboxylic and sulfonic acids profiles from scats of five mammalian carnivores: Puma concolor, Herpailurus yagouaroundi, Leopardus pardalis and Felis catus (all Felidae) and Nasua nasua (Procyonidae). We were able to unambiguously identify the species and determinate the sex for all fecal samples through the pattern of presence-absence of carboxylic and sulfonic acids (digital coding). The method allowed the discrimination of the evaluated species of the Carnivora, even between closely related and ecologically similar felids. Moreover, our method is low cost and can be executed in a short period of time. Further investigation is necessary to evaluate if the method’s discriminatory power is applicable to other mammalian species. Additionally, the method’s potential to ascertain other intraspecific traits such as age, identity, reproductive and health status is yet to be determined.

Extracellular vesicles-derived microRNAs expression as biomarkers for neurological radiation injury: Risk assessment for space exploration

Space missions pose threats to the health of the astronauts due to long-term exposure to galactic cosmic rays and solar particle events comprised predominantly of medium to high energy protons, energetic helium ions, and energetic high atomic number particles (HZEs). While the tissue-specific effects of radiation have been studied extensively, the changes in exosomal miRNA expression levels in response to acute radiation exposure have not been assessed. Extracellular vesicles (EVs) originate from the host cells and contain nucleic acid and proteins that can modify the physiology of the receiving cells via the transfer of genomic, proteomic, and lipids cargo. Detection and analysis of miRNA cargo of circulating EVs is an emerging method for non-invasive diagnosis and monitoring of neurological disorders. This study characterizes the EV-derived miRNA expression profiles of human astrocytes to identify those that are altered after treatment with 3 Gy proton radiation as biomarkers of neurological radiation injury. The relationship between radiation and miRNA extracellular vesicles expression levels was investigated in human astrocytes after treatment with 3 Gy proton radiation at Willis-Knighton Cancer Center. Microarray analysis was performed using miRNA from the EVs enriched fraction in the cell culture medium collected from sham-control and radiation-treated cells. The exosomal levels of 13 miRNAs were significantly (FDR p < 0.05) down-regulated after exposure to high-energy radiation. The computational analysis identified hsa-miR-762, hsa-let-7c-5p, and has-let-7b-5p regulate the highest number of genes being associated with cognitive, mental, and motor delay. These miRNAs target the same subset of genes (Amd1, CCNF, COX6B, PLXND1) that are associated with epileptic encephalopathy; frontotemporal dementia; mitochondrial complex iv deficiency, and a rare neurological condition (Moebius syndrome) respectively. GO enrichment analysis of the biological processes identified overrepresentation in mRNA polyadenylation and regulation of glutamine and long fatty acids transport. Gene expression analysis confirmed the upregulation of the glutamine synthetase after irradiation. Significant fold enrichment of GO l-glutamine transmembrane transporter activity was identified in the molecular function category as well indicating exosome-mediated regulation of this important pathway after proton radiation exposure.

Noninvasive detection of elevated ICP using spontaneous tympanic membrane pulsation

Neurological conditions such as traumatic brain injury (TBI) and hydrocephalus may lead to intracranial pressure (ICP) elevation. Current diagnosis methods rely on direct pressure measurement, while CT, MRI and other expensive imaging may be used. However, these invasive or expensive testing methods are often delayed because symptoms of elevated ICP are non-specific. Invasive methods, such as intraventricular catheter, subdural screw, epidural sensor, lumbar puncture, are associated with an increased risk of infection and hemorrhage. On the other hand, noninvasive, low-cost, accurate methods of ICP monitoring can help avoid risks and reduce costs while expediting diagnosis and treatment. The current study proposes and evaluates a novel method for noninvasive ICP monitoring using tympanic membrane pulsation (TMp). These signals are believed to be transmitted from ICP to the auditory system through the cochlear aqueduct. Fifteen healthy subjects were recruited and TMp signals were acquired noninvasively while the subjects performed maneuvers that are known to change ICP. A custom made system utilizing a stethoscope headset and a pressure transducer was used to perform these measurements. Maneuvers included head-up-tilt, head-down-tilt and hyperventilation. When elevated ICP was induced, significant TMp waveform morphological changes were observed in each subject (p < 0.01). These changes include certain waveform slopes and high frequency wave features. The observed changes were reversed by the maneuvers that decreased ICP (p < .01). The study results suggest that TMp waveform measurement and analysis may offer an inexpensive, noninvasive, accurate tool for detection and monitoring of ICP elevations. Further studies are warranted to validate this technique in patients with pathologically elevated ICP.

Multispectral Imaging for Hemoglobin Estimation by PCA.

Tissular blood perfusion is helpful to assess the health condition of a subject and even monitor superficial lesions. Current state of the art is focused on developing non-invasive, quantitative and accessible methods for blood flow monitoring in large areas. This paper presents an approach based on multispectral images on the VIS-NIR range to quantify blood perfusion. Our goal is to estimate the changes in deoxygenated hemoglobin. To do so, we employ principal component analysis followed by a linear regression model. The proposal was evaluated using in-vivo data from a vascular occlusion protocol, and the results were validated against photoplethysmography measurements. Although the number of subjects in the protocol was limited, our model made a prediction with an average similarity of 91.53% with a mean R-squared adjusted of 0.8104.

Squirrel Cage Induction Motor Defects Diagnosis Using Lissajous Curve of an Auxiliary Winding Voltage

Developing a non-invasive condition monitoring method for a squirrel cage induction machine and its fault diagnosis is the objective of this paper. Several signals can be used to monitor the Induction Machines (IMs) such as power input, stator voltage, and stator current. In this research a new processing signal is developed as an auxiliary winding voltage. The auxiliary winding is considered as a small coil inserting between the stator phases. This approach is based on a Lissajous curve of the auxiliary winding voltage Park component. First, the squirrel cage induction motor is mathematically modeled by considering the real geometry of the rotor structure. After that, the auxiliary winding voltage expression and its Park component are presented. In order to verify the proposed approach effectiveness, the simulation has been carried out in MATLAB for non-defected motor and motor with different load level. The results have confirmed the capability of this method to detect failures.

Non-invasive monitoring of arthritis treatment response via targeting of tyrosine-phosphorylated annexin A2 in chondrocytes

BackgroundThe development and optimization of therapies for rheumatoid arthritis (RA) is currently hindered by a lack of methods for early non-invasive monitoring of treatment response. Annexin A2, an inflammation-associated protein whose presence and phosphorylation levels are upregulated in RA, represents a potential molecular target for tracking RA treatment response.MethodsLS301, a near-infrared dye-peptide conjugate that selectively targets tyrosine 23-phosphorylated annexin A2 (pANXA2), was evaluated for its utility in monitoring disease progression, remission, and early response to drug treatment in mouse models of RA by fluorescence imaging. The intraarticular distribution and localization of LS301 relative to pANXA2 was determined by histological and immunohistochemical methods.ResultsIn mouse models of spontaneous and serum transfer-induced inflammatory arthritis, intravenously administered LS301 showed selective accumulation in regions of joint pathology including paws, ankles, and knees with positive correlation between fluorescent signal and disease severity by clinical scoring. Whole-body near-infrared imaging with LS301 allowed tracking of spontaneous disease remission and the therapeutic response after dexamethasone treatment. Histological analysis showed preferential accumulation of LS301 within the chondrocytes and articular cartilage in arthritic mice, and colocalization was observed between LS301 and pANXA2 in the joint tissue.ConclusionsWe demonstrate that fluorescence imaging with LS301 can be used to monitor the progression, remission, and early response to drug treatment in mouse models of RA. Given the ease of detecting LS301 with portable optical imaging devices, the agent may become a useful early treatment response reporter for arthritis diagnosis and drug evaluation.

Fluorescent Sensor Array for Quantitative Determination of Saccharides.

Accurate monitoring of sugar levels is essential for many fields from food industry to human health. Here, we developed FRET-based dual chromophore sensors for saccharides that form oxazolidine boronate and may be employed as a noninvasive method for monitoring of sugar levels in biological fluids, namely, urine. The saccharide-binding properties of the sensors were studied using fluorescence spectroscopy and utilized in the determination of saccharides in a high-throughput manner. Here, two fluorescent sensors were successful in the classification of nine different monosaccharides and disaccharides with 100% correct classification. Furthermore, the dual chromophore self-assembled sensors were successfully utilized for the quantitative determination of important carbohydrates such as glucose in the presence of competitive saccharides (fructose) and in complex media (urine) without sample pretreatment. The present fluorescent sensors allow for quantification of glucose in a concentration range of 0-60 mM, which matches the concentration range of frequently used urinalysis test strips.

Liquid Biopsy-Based Biosensors for MRD Detection and Treatment Monitoring in Non-Small Cell Lung Cancer (NSCLC).

Globally, non-small cell lung cancer (NSCLC) is the leading cause of cancer deaths. Despite advancements in chemotherapy and targeted therapies, the 5-year survival rate has remained at 16% for the past forty years. Minimal residual disease (MRD) is described as the existence of either isolated tumour cells or circulating tumour cells in biological liquid of patients after removal of the primary tumour without any clinical signs of cancer. Recently, liquid biopsy has been promising as a non-invasive method of disease monitoring and treatment guidelines as an MRD marker. Liquid biopsy could be used to detect and assess earlier stages of NSCLC, post-treatment MRD, resistance to targeted therapies, immune checkpoint inhibitors (ICIs) and tumour mutational burden. MRD surveillance has been proposed as a potential marker for lung cancer relapse. Principally, biosensors provide the quantitative analysis of various materials by converting biological functions into quantifiable signals. Biosensors are usually operated to detect antibodies, enzymes, DNA, RNA, extracellular vesicles (EVs) and whole cells. Here, we present a category of biosensors based on the signal transduction method for identifying biosensor-based biomarkers in liquid biopsy specimens to monitor lung cancer treatment.

18F-FDG PET imaging-monitored anti-inflammatory therapy for acute myocardial infarction: Exploring the role of MCC950 in murine model

BackgroundMCC950 is a novel NLRP3 inflammasome inhibitor that possesses potent anti-inflammatory properties in acute myocardial infarction (AMI). However, the lack of noninvasive monitoring methods limits its potential clinical translation. Thus, we sought to investigate whether 18F-FDG PET imaging can monitor the therapeutic effects of MCC950 in an AMI murine model. MethodsC57BL/6 mice were used to generate an AMI model. MCC950 or sterile saline was intraperitoneally administered 1 hour after surgery and then daily for 7 consecutive days. 18F-FDG PET (inflammation) imaging was used to monitor inflammatory changes on days 3 and 5. Immunohistochemistry and Western blot were used to detect inflammatory markers and to confirm the PET imaging results. 18F-FDG PET (viability) imaging was used to quantitate the viability defect expansion on days 7 and 28. Cardiac ultrasound and survival analyses were performed to evaluate the cardiac function and survival rate. Adverse remodeling was determined by Wheat Germ Agglutinin (WGA) and Masson trichrome staining. ResultsThe FDG-PET (inflammation) imaging revealed that MCC950 treatment led to lower 18F-FDG inflammatory uptakes, at the infarct region, on days 3 and 5 when compared to the MI group. The decreased M1 macrophages and neutrophils infiltration and the remission of the NLRP3/IL-1β pathway, confirmed the FDG-PET (inflammation) imaging results. The FDG-PET (viability) imaging revealed that MCC950 significantly decreased the expansion of the viability defect, demonstrating its myocardial preservation effects. The acute FDG-PET (inflammation) signal positively correlated with the late viability defect and with the reduction in the left ventricular ejection fraction (LVEF). Additionally, the alleviated adverse remodeling and the improved survival rate further support the anti-inflammatory efficiency of MCC950 in AMI. ConclusionUsing 18F-FDG PET imaging, we noninvasively demonstrated the therapeutic effects of MCC950 in AMI and showed that 18F-FDG PET imaging holds promising application potentials in MCC950’s clinical translation.

Неинвазивный мониторинг сердечного выброса у пациентов с политравмой

Актуальность. Стандартом оценки параметров центральной гемодинамики и ответа на инфузионную терапию принято считать мониторинг сердечного выброса. Инновационная технология неинвазивного расчетного непрерывного измерения сердечного выброса (Estimated Continuous Cardiac Output — esCCO) позволяет измерять его в online-режиме и может обеспечивать улучшенный мониторинг гемодинамического статуса пациентов с политравмой. Цель: оценить эффективность и целесообразность неинвазивного непрерывного мониторинга сердечного выброса с помощью технологии esCCO у пациентов в остром периоде политравмы. Материалы и методы. Приведены данные клинического обследования и лечения 40 пациентов с политравмой, доставленных в отделение анестезиологии и интенсивной терапии КНП «Клиническая больница скорой медицинской помощи г. Львова». У 20 пациентов 1-й группы, кроме определения рутинных параметров, проводили мониторинг показателей центральной гемодинамики с помощью модуля esCCO, интегрированного в монитор Life Scope (Nihon Kohden, Япония). Во 2-й (контрольной) группе (n = 20) для сравнительного анализа регистрировали только традиционные показатели — артериальное давление (АД), электрокардиограмму, сатурацию крови (SpO2) — с помощью многофункциональных мониторов Philips IntelliVue (MP20), выполняли стандартные лабораторные анализы. Результаты. С первых по вторые сутки в обеих группах пациентов наблюдались статистически значимые изменения лабораторных показателей: уровень гематокрита снижался с 32,0 ± 1,0 % до 29,0 ± 0,8 % (р &lt; 0,01); содержание гемоглобина крови снижалось в среднем с 91,5 ± 2,1 г/л до 87,0 ± 1,9 г/л (р &lt; 0,05); уровень лейкоцитов возрастал в среднем с (9,8 ± 0,4) • 106 до (12,0 ± 0,5) • 106 (р &lt; 0,001). Эти изменения свидетельствуют о развитии анемии и системной воспалительной реакции в остром периоде после травмы, что оказывает существенное влияние на реологические свойства крови и гемодинамику. У пациентов 1-й группы отмечались стабильные показатели АД (систолическое АД — 122,9 ± 6,2 мм рт.ст., диастолическое АД — 69,7 ± 2,3 мм рт.ст.) по сравнению с контрольной группой (систолическое АД — 112,2 ± 5,9 мм рт.ст., диастолическое АД — 67,5 ± 2,1 мм рт.ст.). У больных 1-й группы наблюдалось уменьшение объема инфузионной терапии на 13,5 % и снижение на 11,5 % ранних осложнений по сравнению с пациентами контрольной группы. Выводы. Мы установили, что в условиях острого периода политравмы на фоне системного воспалительного ответа организма развиваются реологические изменения, которые потенцируют недостаточность кровообращения. Неинвазивный мониторинг показателей центральной гемодинамики с помощью модуля esCCO является простым и информативным методом, позволяющим эффективно ускорить оптимизацию гемодинамического статуса пациентов при политравме.