-
1دورية أكاديمية
المؤلفون: Filippo Annoni, Elisa Gouvea Bogossian, Lorenzo Peluso, Fuhong Su, Anthony Moreau, Leda Nobile, Stefano Giuseppe Casu, Elda Diletta Sterchele, Lorenzo Calabro, Michele Salvagno, Mauro Oddo, Fabio Silvio Taccone
المصدر: Cells, Vol 13, Iss 9, p 784 (2024)
مصطلحات موضوعية: ketone bodies, ischemia–reperfusion, cerebral metabolism, anoxic brain injury, heart arrest, Cytology, QH573-671
الوصف: Cardiac arrest survivors suffer the repercussions of anoxic brain injury, a critical factor influencing long-term prognosis. This injury is characterised by profound and enduring metabolic impairment. Ketone bodies, an alternative energetic resource in physiological states such as exercise, fasting, and extended starvation, are avidly taken up and used by the brain. Both the ketogenic diet and exogenous ketone supplementation have been associated with neuroprotective effects across a spectrum of conditions. These include refractory epilepsy, neurodegenerative disorders, cognitive impairment, focal cerebral ischemia, and traumatic brain injuries. Beyond this, ketone bodies possess a plethora of attributes that appear to be particularly favourable after cardiac arrest. These encompass anti-inflammatory effects, the attenuation of oxidative stress, the improvement of mitochondrial function, a glucose-sparing effect, and the enhancement of cardiac function. The aim of this manuscript is to appraise pertinent scientific literature on the topic through a narrative review. We aim to encapsulate the existing evidence and underscore the potential therapeutic value of ketone bodies in the context of cardiac arrest to provide a rationale for their use in forthcoming translational research efforts.
وصف الملف: electronic resource
-
2دورية أكاديمية
المؤلفون: Federico Romagnosi, Adriano Bernini, Filippo Bongiovanni, Carolina Iaquaniello, John-Paul Miroz, Giuseppe Citerio, Fabio Silvio Taccone, Mauro Oddo
المصدر: Brain Sciences, Vol 12, Iss 5, p 609 (2022)
مصطلحات موضوعية: Neurological Pupil index, acute brain injury, quantitative pupillometry, neurological prognosis, midline shift, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
الوصف: In this study, we examined the early value of automated quantitative pupillary examination, using the Neurological Pupil index (NPi), to predict the long-term outcome of acute brain injured (ABI) patients. We performed a single-centre retrospective study (October 2016–March 2019) in ABI patients who underwent NPi measurement during the first 3 days following brain insult. We examined the performance of NPi—alone or in combination with other baseline demographic (age) and radiologic (CT midline shift) predictors—to prognosticate unfavourable 6-month outcome (Glasgow Outcome Scale 1–3). A total of 145 severely brain-injured subjects (65 traumatic brain injury, TBI; 80 non-TBI) were studied. At each time point tested, NPi p = 0.008; DeLong test) for 6-month neurological outcome prediction. NPi, assessed at the early post-injury phase, has a superior ability to predict unfavourable long-term neurological outcomes in severely brain-injured patients. The added prognostic value of NPi was most significant when complemented with baseline demographic and radiologic information.
وصف الملف: electronic resource
-
3دورية أكاديميةMultimodal Approach to Predict Neurological Outcome after Cardiac Arrest: A Single-Center Experience
المؤلفون: Lorenzo Peluso, Thomas Boisdenghien, Laila Attanasio, Filippo Annoni, Lili Mateus Sanabria, Paolo Severgnini, Benjamin Legros, Elisa Gouvêa Bogossian, Jean-Louis Vincent, Jacques Creteur, Mauro Oddo, Nicolas Gaspard, Fabio Silvio Taccone
المصدر: Brain Sciences, Vol 11, Iss 7, p 888 (2021)
مصطلحات موضوعية: electroencephalography, post-anoxic, pupillometry, evoked potentials, neuroprognostication, NSE, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
الوصف: Introduction: The aims of this study were to assess the concordance of different tools and to describe the accuracy of a multimodal approach to predict unfavorable neurological outcome (UO) in cardiac arrest patients. Methods: Retrospective study of adult (>18 years) cardiac arrest patients who underwent multimodal monitoring; UO was defined as cerebral performance category 3–5 at 3 months. Predictors of UO were neurological pupillary index (NPi) ≤ 2 at 24 h; highly malignant patterns on EEG (HMp) within 48 h; bilateral absence of N20 waves on somato-sensory evoked potentials; and neuron-specific enolase (NSE) > 75 μg/L. Time-dependent decisional tree (i.e., NPi on day 1; HMp on day 1–2; absent N20 on day 2–3; highest NSE) and classification and regression tree (CART) analysis were used to assess the prediction of UO. Results: Of 137 patients, 104 (73%) had UO. Abnormal NPi, HMp on day 1 or 2, the bilateral absence of N20 or NSE >75 mcg/L had a specificity of 100% to predict UO. The presence of abnormal NPi was highly concordant with HMp and high NSE, and absence of N20 or high NSE with HMp. However, HMp had weak to moderate concordance with other predictors. The time-dependent decisional tree approach identified 73/103 patients (70%) with UO, showing a sensitivity of 71% and a specificity of 100%. Using the CART approach, HMp on EEG was the only variable significantly associated with UO. Conclusions: This study suggests that patients with UO had often at least two predictors of UO, except for HMp. A multimodal time-dependent approach may be helpful in the prediction of UO after CA. EEG should be included in all multimodal prognostic models.
وصف الملف: electronic resource
-
4دورية أكاديمية
المؤلفون: Sabina Berezowska, Karine Lefort, Kalliopi Ioannidou, Daba-Rokhya Ndiaye, Damien Maison, Constantinos Petrovas, Samuel Rotman, Nathalie Piazzon, Dina Milowich, Nathalie Sala, Chun-Yi Tsai, Eleonore Multone, Pierre-Yves Bochud, Mauro Oddo, Bettina Bisig, Laurence de Leval
المصدر: Diagnostics, Vol 11, Iss 8, p 1357 (2021)
مصطلحات موضوعية: SARS-CoV-2, COVID-19, diffuse alveolar damage, immunohistochemistry, RNAscope, reverse transcriptase quantitative PCR, Medicine (General), R5-920
الوصف: We report postmortem cardio-pulmonary findings including detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in formalin-fixed paraffin embedded tissue in 12 patients with COVID-19. The 5 women and 7 men (median age: 73 years; range 35–96) died 6–38 days after onset of symptoms (median: 14.5 days). Eight patients received mechanical ventilation. Ten patients showed diffuse alveolar damage (DAD), 7 as exudative and 3 as proliferative/organizing DAD. One case presented as acute fibrinous and organizing pneumonia. Seven patients (58%) had acute bronchopneumonia, 1/7 without associated DAD and 1/7 with aspergillosis and necrotic bronchitis. Microthrombi were present in 5 patients, only in exudative DAD. Reverse transcriptase quantitative PCR detected high virus amounts in 6 patients (50%) with exudative DAD and symptom-duration ≤14 days, supported by immunohistochemistry and in-situ RNA hybridization (RNAscope). The 6 patients with low viral copy levels were symptomatic for ≥15 days, comprising all cases with organizing DAD, the patient without DAD and one exudative DAD. We show the high prevalence of DAD as a reaction pattern in COVID-19, the high number of overlying acute bronchopneumonia, and high-level pulmonary virus detection limited to patients who died ≤2 weeks after onset of symptoms, correlating with exudative phase of DAD.
وصف الملف: electronic resource
النص الكامل