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Cortical hemodynamics of electrographic status epilepticus in the critically ill.
Epilepsia
December 2024
Department of Neurosciences, Université de Montréal, Montréal, Québec, Canada.
Objectives: The pathophysiological mechanisms of status epilepticus (SE) underlying potential brain injury remain largely unclear. This study aims to employ functional near-infrared spectroscopy (fNIRS) combined with video-electroencephalography (vEEG) to monitor brain hemodynamics continuously and non-invasively in critically ill adult patients experiencing electrographic SE. Our primary focus is to investigate neurovascular coupling and cerebrovascular changes associated with seizures, particularly during recurring and/or prolonged episodes.
View Article and Find Full Text PDFPilot Study of Cerebral Hemodynamics in Depressive Patient Under Electroconvulsive Therapy.
Neuropsychiatr Dis Treat
December 2024
Research Center of Educational Neuroscience, School of Educational Science, Huazhong University of Science and Technology, Wuhan City, Hubei Province, People's Republic of China.
Article Synopsis
- Major depressive disorder (MDD) is a complex condition that can be hard to treat, and Electroconvulsive therapy (ECT) shows promise but its workings are not fully understood.
- This study used functional Near-Infrared Spectroscopy (fNIRS) to compare the brain activity of a male MDD patient to that of 26 healthy controls before and after ECT, focusing on how ECT affects cerebral blood flow and brain networks.
- Results indicated that the MDD patient had lower brain activity and connectivity at the start, but after ECT, these measures improved significantly, suggesting that ECT can effectively alter brain function in depressed patients and that fNIRS is a valuable tool for studying these changes.
Fetal-to-Neonatal Transition of an Infant with Transposition of the Great Arteries and Intact Ventricular Septum: A Case Report.
Biomed Hub
December 2024
Division of Paediatric Cardiology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre (LUMC), Leiden, The Netherlands.
Introduction: Transposition of the great arteries (TGA), especially with intact ventricular septum (TGA-IVS), presents unique challenges during fetal-to-neonatal transition, which can contribute to developing persistent pulmonary hypertension of the newborn (PPHN).
Case Presentation: A male newborn with TGA-IVS, delivered via caesarean section, presented with hypoxemia and tachycardia immediately after birth (preductal SpO: 50-60%, post-ductal SpO: 70-75%). Echocardiography revealed a floppy interatrial septum and two interatrial connections with bidirectional shunting.
Highly sensitive ultra-high-performance liquid chromatography coupled with tandem mass spectrometry method for the multiplex analysis of levosimendan and its metabolites OR-1855 and OR-1896 in human plasma.
J Pharm Biomed Anal
December 2024
Service of Clinical Pharmacology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Levosimendan is a positive inotrope and vasodilator used in patients with acute and chronic decompensated heart failure. It is metabolized into OR-1855 (inactive metabolite), which is further acetylated into OR-1896 (active metabolite having a prolonged half-life, hence a sustained effect). Levosimendan represents a valuable alternative to traditional inotropes with broad clinical applications in critically ill patients with cardiogenic shock, advanced heart failure and post-cardiac surgery.
View Article and Find Full Text PDFMixed Cardiogenic-Vasodilatory Shock: Current Insights and Future Directions.
JACC Adv
January 2025
Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, and Lifespan Cardiovascular Institute, Providence, Rhode Island, USA.
This state-of-the-art review describes the potential etiologies, pathophysiology, and management of mixed shock in the context of a proposed novel classification system. Cardiogenic-vasodilatory shock occurs when cardiogenic shock is complicated by inappropriate vasodilation, impairing compensatory mechanisms, and contributing to worsening shock. Vasodilatory-cardiogenic shock occurs when vasodilatory shock is complicated by myocardial dysfunction, resulting in low cardiac output.
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