Machine Learning-Based Perivascular Space Volumetry in Alzheimer Disease.

Objectives: Impaired perivascular clearance has been suggested as a contributing factor to the pathogenesis of Alzheimer disease (AD). However, it remains unresolved when the anatomy of the perivascular space (PVS) is altered during AD progression. Therefore, this study investigates the association between PVS volume and AD progression in cognitively unimpaired (CU) individuals, both with and without subjective cognitive decline (SCD), and in those clinically diagnosed with mild cognitive impairment (MCI) or mild AD.

Stairway to heaven or a placebo: the impact of lean leadership, through job demands, on hospital workers' engagement and performance.

Purpose: This study aims to examine to what extent the relationships between hospital workers' perceptions of lean leadership behaviour, their engagement and the hospital unit's perceived performance are mediated by job demands.

Design/methodology/approach: The data ( = 1,624) come from a lean implementation study in a Dutch hospital and are analysed using structural equation modelling in Mplus (v8.4).

The relation between acute changes in the systemic inflammatory response and circulating thiamine and magnesium concentrations after elective knee arthroplasty.

Thiamine diphosphate (TDP) and magnesium are co-factors for key enzymes in human intermediary metabolism. However, their role in the systemic inflammatory response (SIR) is not clear. Therefore, the aim of the present study was to examine the relation between acute changes in the SIR and thiamine and magnesium dependent enzyme activity in patients undergoing elective knee arthroplasty (a standard reproducible surgical injury in apparently healthy individuals).

Dealing with a changing work environment: hospital job type contingencies.

Purpose The purpose of this paper is twofold: first, to examine whether workers in various hospital job groups differ in their perceptions of the provision of managerial support, and of their up-to-date expertise (UDE), willingness to change (WTC) and employment opportunities (EO). Second, to examine whether and how the relationships between managerial support, workers' UDE, WTC and their EO are moderated by hospital job type. Design/methodology/approach Survey data were collected from 1,764 employees of three Dutch hospitals.

The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty.

Background: Studies indicate that low plasma 25-hydroxyvitamin D [25(OH)D] is associated with a range of disease processes, many of which are inflammatory. However, other lipid-soluble vitamins decrease during the systemic inflammatory response, and this response may confound the interpretation of plasma 25(OH)D.

Objective: The objective was to examine whether plasma 25(OH)D concentrations change during evolution of the systemic inflammatory response.

Pre-oxygenation in healthy volunteers: a comparison of the supine and 45° seated positions*.

Pre-oxygenation in the seated (sitting) position has been associated with better oxygenation. This randomised, cross over study compared oxygenation in the supine position with that in the 45° seated position in 40 young, healthy volunteers. Oxygen was administered through a circle system and tight fitting facemask.

The cardiovascular effects of normobaric hyperoxia in patients with heart rate fixed by permanent pacemaker.

To investigate whether the established reductions in heart rate and cardiac output with hyperoxia in humans are primary effects or secondary to increases in systemic vascular resistance, we paced the hearts of nine patients with permanent pacemakers at a fixed rate when breathing either medical air (inspired O(2) fraction 0.21) or oxygen (inspired O(2) fraction 0.80) in a randomised, double-blind fashion.

Effect of intraoperative fluid optimisation on renal function in patients undergoing emergency abdominal surgery: a randomised controlled pilot study (ISRCTN 11799696).

Background: Emergency abdominal surgery carries a high risk of postoperative morbidity and mortality. Goal directed therapy has been advocated to improve outcome in high-risk surgery. The aim of the present pilot study was to examine the effect of goal directed therapy using fluid alone on postoperative renal function and organ failure score in patients undergoing emergency abdominal surgery.

Cardiovascular changes after achieving constant effect site concentration of propofol.

Target controlled infusions of propofol use a pharmacokinetic/pharmacodynamic model to calculate an effect site concentration of the drug. We assessed the cardiovascular stability of 10 healthy patients using non-invasive thoracic bioimpedance and their 'depth' of anaesthesia using the Bispectral index after they had been anaesthetised to a constant effect site concentration of propofol (6.5 min from starting).

Effects of normobaric hyperoxia on haemodynamic parameters of healthy full-term parturients.

Fifteen healthy, full-term women with singleton pregnancies were exposed to an increased F(I)o(2) of 0.4 and their haemodynamic responses measured with a non-invasive transthoracic bio-impedance monitor. There was a mean reduction in cardiac index from 3.

Postoperative serum urea is associated with 30-day mortality in patients undergoing emergency abdominal surgery.

Background: Emergency abdominal surgery carries considerable postoperative morbidity and mortality. Hypovolaemia is considered to be a cause of renal hypoperfusion, which is associated with a decreased clearance of serum urea and creatinine. This study examines whether the perioperative serum urea and creatinine concentrations are predictors of mortality in patients undergoing emergency abdominal surgery.

The effect of gender on postoperative mortality after emergency abdominal surgery.

Background: The factors contributing to the high mortality after emergency abdominal surgery are unclear. Recent studies have revealed gender differences in immune function after trauma and in the presence of sepsis.

Objective: This study tested the hypothesis that factors determining survival after emergency abdominal surgery differ in males and females.

The cardiovascular effects of inspired oxygen fraction in anaesthetized patients.

Background And Objective: Increased inspired oxygen fractions (FiO2) have significant haemodynamic effects in awake volunteers. We sought to establish whether these effects are also present in anaesthetized patients.

Methods: We prospectively studied 30 ASA I-II patients, 15 in each of a propofol and sevoflurane group.

Normobaric hyperoxia reduces cardiac index in patients after coronary artery bypass surgery.

Objective: The purpose of this study was to assess the hemodynamic changes in response to normobaric hyperoxia in patients immediately after coronary artery bypass surgery.

Design: Observational study.

Setting: Single-center university hospital.

Effects of a height and weight adjusted dose of local anaesthetic for spinal anaesthesia for elective Caesarean section.

In this prospective, randomised, double-blind study, we compared the effects of two dosage regimens. Pregnant patients at term were randomly assigned to two groups to be given diamorphine 0.4 mg in hyperbaric bupivacaine 0.

Post partum pneumothorax: two case reports and discussion.

Pneumothorax is a rare event during pregnancy. We present two cases of pneumothorax occurring after caesarean section under general anaesthesia, including one tension pneumothorax. We summarise risk factors for developing a pneumothorax during pregnancy and discuss differential diagnosis and the anaesthetic management in the labour ward.

The effect of normobaric hyperoxia on cardiac index in healthy awake volunteers.

Fifteen healthy volunteers were exposed to a stepwise increase in FIO2 between 0.21 and 1.0, and their haemodynamic responses were measured with a non-invasive transthoracic bio-impedance monitor.

Is enalapril adequate for the prevention of renal tissue damage caused by unilateral ureteral obstruction and/or hyperoxaluria?

Unilateral ureteral obstruction (UUO) and hyperoxaluria (HOX) can lead to end-stage renal disease with tubulointerstitial fibrosis. We investigated the effects of enalapril (E), an ACE-inhibitor, on rat kidneys with either UUO or HOX. Sham-operated, UUO, HOX, UUO+HOX, UUO+E and HOX+E rats were killed 14 days after UUO and/or HOX was initiated.

Interleukin-18 expression and modulation in human corneal epithelial cells.

Purpose: The interferon-gamma-inducing factor Interleukin-18 (IL-18) is a recently described cytokine that appears to have multiple important pro-inflammatory effects including the induction of interferon-gamma (IFN-gamma) by activated T-cells. The expression of IL-18 by human cornea has not been previously reported. In the present study, we examine the possibility that human corneal epithelial cells are capable of producing this leukocyte-activating factor which may play an important role in IFN-gamma-dependent inflammation responses in the cornea.

Subependymal nodular heterotopia in patients with encephalocele.

Only incidental mention has been made to date of the combined occurrence of subependymal heterotopia and posterior encephalocele. We evaluated the presence of disseminated nodular subependymal heterotopia in two series of patients with posterior encephalocele. The first series consisted of all six patients who were treated in our hospital for encephalocele during the last 11 years and who underwent magnetic resonance imaging (MRI).