Matthiesenterkelsen3484

Lastly, an experimental protocol was suggested, and a freely available graphical user interface was presented to facilitate easy use of the theoretical expression.Epilepsy is the noncommunicable and chronic central nervous system disorder characterized by frequent, unprovoked seizures, or electrical disturbances in the brain. Topiramate is used as an antiepileptic drug for the treatment of partial onset seizures, generalized seizures and Lennox-Gastaut Syndrome. Topiramate, a BCS class II drug, has a relatively low bioavailability. It is also a substrate of P-glycoprotein and Blood Brain Barrier restricts its entry into the brain. This investigation was aimed to prepare O/W nanoemulsion delivery system of topiramate to improve its brain bioavailability. Topiramate loaded nanoemulsion was prepared by phase titration method. It was consisting of 2% w/w Capmul MCM C8, 32% w/w Tween 20Carbitol (21) and 66% w/w water. It was characterized for globule size, viscosity, polydispersibility index, zeta potential, pH, conductivity values, transmittance and TEM. Pharmacodynamic, pharmacokinetic and brain drug uptake study was carried out using wistar albino rats post intranasal and oral administration. Topiramate loaded nanoemulsion was having a globule size of 4.73 ± 0.52 nm. It was stable for six months. Brain uptake of topiramate post intranasal administration of topiramate loaded nanoemulsion was significantly (P less then 1.86 × 10-8) higher when it was compared with oral administration of topiramate loaded nanoemulsion. This study indicates that intranasal administration of topiramate containing nanoemulsion could be an encouraging approach for the treatment of epilepsy to minimize the dose of topiramate in direction to avoid dose related adverse events.Image 1In this study, the main influence factors of combined UV/O3 process in practical industrial application were explored through laboratory trials and industrial pilot tests. Dimethyl phthalate (DMP) was analyzed as the research subject through different experiments in laboratory. The degradation effect of organic compounds by O3 and UV/O3 processes in different air distribution methods was compared independently, and the mechanism of free radical generation by the two processes was analyzed. This study found that the combined UV/O3 process for organic matter mineralization is clearly better than that of independent effect of O3 process as mixed gas-liquid distribution method was superior to the bubble aeration method. The experimental conditions included inlet O3 concentration between 70 and 75 mg/L, reactor internal relative pressure at 0.3 MPa, contact reaction time of 12 min, DMP mineralization efficiency reaching 63.07%. The calculated dosing ratio of O3 in the dynamic experiment was around 0.74 mg CODCr/mg O3. The results showed that the best effect in wastewater treatment was achieved when the conditions of ultraviolet lamp irradiation intensity and the O3 dosage reached 822.88 W/m2 15 mg/L and utilized in conjunction with biochemical reactions. The resulting CODCr concentration of effluent reached 39.8 mg/L. Finally, it is determined that the main influence factors affecting the economically efficient operation of UV/O3 process were the efficient O3 distribution mode, control of the relative pressure within the reactor, proportion of ozone addition and light source configuration.Background Patients undergoing carotid endarterectomy (CEA) often experience post-operative hemodynamic changes that require intravenous medications for hypo- and hypertension. Prior studies have found these changes to be associated with increased risks of 30-day mortality, stroke, myocardial infarction (MI), and length of stay (LOS). Our aim was to investigate pre-operative risk factors associated with the need for post-operative intravenous medications for blood pressure control. Material and methods A retrospective review of an internally maintained prospective database of patients undergoing carotid interventions between January 2014 to March 2019 was performed. Demographic data, clinical history and peri-operative data were recorded. Carotid artery stents and re-interventions were excluded. Our primary endpoints were the need to intervene with intravenous medication for either post-operative hypotension (systolic blood pressure (SBP) 160 mmHg), RESULTS A total of 221 patients were included in the study aatients (2.0[± 1.6] vs. 1.8[± 2.4] vs. 1.3[± 0.8], P=.002). Multivariable logistic regression demonstrated that non-Caucasian patients (OR, 2.72; 95% CI, 1.26-5.86; P=0.01), and those with a history of MI (OR, 2.98; 95% CI,1.33-6.67) were more likely to have post-operative hypertension compared to patients who were Caucasian or had no history of MI. Conclusion Post-operative hypertension is associated with non-Caucasian race and a history of MI. Given the potential implications for adverse peri-operative outcomes including MI, mortality, and LOS, it is important to continue to elucidate potential risk factors in order to further tailor the peri-operative management of patients undergoing CEA.Carotid artery stent thrombosis is a relatively rare yet devastating complication of endovascular carotid interventions, and manifests as ipsilateral neurological aberrancies such as transient ischemic attack or cerebrovascular accident. Prompt evaluation is necessary and appropriate imaging is warranted to ascertain the urgency for intervention. Traditionally, anticoagulation with stent explantation and associated thrombectomy is performed. With patients presenting with more high-risk criteria and medical comorbidities, we describe the successful use TCAR flow reversal with the Penumbra mechanical thrombectomy device to extirpate thrombus.We present a case of abdominal aortic aneurysm open repair planned with temporary left ventricular support (Impella®) in a patient suffering of severe chronic heart failure. Only one single similar case was reported in the literature from 1974.Background Management of uncomplicated type B aortic dissection (TBAD) has traditionally been aggressive medical therapy. Recent studies brought about a paradigm shift with evidence to suggest benefits from early endovascular intervention to a high risk subgroup of acute uncomplicated TBAD patients. Aims We aim to review the effects of aortic remodeling in Asian patients with TBAD with and without endovascular intervention, including maximal aortic diameter, true lumen diameter, and false lumen thrombosis. Methods This is a single-center retrospective study of a prospective database. Patients who presented to our institution with acute TBAD from January 2008 to December 2015 (n=44) were evaluated. 18% (8 patients) presented with complicated TBAD and underwent emergency TEVAR while the remaining 82% (36 patients) were treated with optimal medical therapy (OMT). Results 6 patients under the conservative arm crossed over to elective TEVAR after 6 weeks because of interval radiological progression of disease. There was no significant difference in the baseline demographics of TEVAR group and OMT group. At 24-month, mean maximal aortic diameter difference was -7.7mm and +1.9mm (p value=0.077), mean true lumen diameter difference was +10.0mm and +2.6mm (p value=0.049), and false lumen thrombosis was 100% and 20% (p value=0.012) for TEVAR and OMT respectively. Kaplan Meier analysis showed no significant difference in mortality between the two groups at 30-day and 2-year. Conclusion Within an Asian population with TBAD, TEVAR with OMT has a significant positive effect on aortic remodeling, as compared with OMT-only management.Objective The purpose of this study is to record our institution's experience in the management of extracranial carotid artery aneurysms (ECCAs) over the past 15 years. Methods A retrospective chart review was performed on consecutive ECCA patients from April 2003 to December 2017. Outpatient and inpatient clinic charts were reviewed. All the patients were treated by open surgery between 2003 and 2008. For other patients, the treatment methods included open surgery, endovascular surgery, and hybrid operations which were dependent on the aneurysm anatomy, as well as conservative management. In open series, carotid shunt was applied and Transcranial Color Doppler (TCD) was selectively used for intraoperative monitoring of cerebral blood flow. The resected aneurysm sacs were tested with hematoxylin and eosin (HE) stains. Each case was reexamined one month after the patients were discharged from the hospital. A questionnaire survey, a clinical examination, and duplex ultrasonography or computed tomography angiogrology of the carotid artery and properties of aneurysms. Open surgical repair is a suitable and safe procedure for Type I ECCAs when they concomitant with kinking in the internal carotid artery. Endovascular treatment is an effective alternative to open surgery for false ECCA repair.Objectives Acute limb ischemia (ALI) is challenging to treat due to high morbidity and mortality. Endovascular-first options beginning with thrombolysis are technically feasible with similar results to open surgery. We examined our experience with thrombolysis to identify patients and target conduits that are predictive of improved outcomes. Methods We performed a retrospective review of our institutional database of thrombolysis cases for arterial lower extremity disease. Thrombolysis was the index procedure and any subsequent treatment was a reintervention. Conversion to open surgery perioperatively such as thromboembolectomy or bypass was considered a technical failure. Primary outcomes included primary patency, secondary patency, amputation free survival (AFS), and survival. Secondary outcomes included conversion to open, reintervention less then 30d, and amputation less then 30d. Descriptive statistics and analysis of variance were performed for preoperative and intraoperative risk factors. Kaplan meieining primary patency (P less then 0.05), secondary patency (P less then 0.05), and AFS (P less then 0.05). Patients who had adjunctive procedures at the time of thrombolysis had a significantly greater primary patency (P less then 0.05) and secondary patency (P less then 0.05) but not greater AFS. Conclusions Outcomes in thrombolysis for ALI have not significantly improved 20 years after the STILE trial. Technical success and mid-term patency rates are modest at best. Thrombolysis of vein bypasses and prosthetic grafts have poor technical success and primary patency compared to native arteries. However, aggressive adjunctive interventions during thrombolysis appear to improve primary and secondary patency.Background Carotid Body Tumors (CBTs) are rare highly vascularized and slow enlarging tumors arising from paraganglionic tissue at the carotid bifurcation(1). Main treatment options for CBTs are surgical resection or 'wait and scan' strategy. The choice for either strategy may be equally good medically in many patients. A structured 'Shared Decision Making' (SDM) might be helpful for guiding patients. Aim In order to develop a SDM strategy for the surgical treatment we aim to 1) identify considerations and factors involved in the decision-making of patients with CBTs; 2) evaluating the current practice in our clinic and explore the opinions of patients on their treatment. Methods This exploratory study was conducted in patients of the Leiden University Medical Centre (LUMC), The Netherlands. Patients who met the inclusion criteria were invited for a semi-structured interview. All conversations were fully audiotaped and transcripted. Results Fifteen patients were included and interviewed. Phenformin Ten of these patients underwent previously surgical resection of at least one tumor.