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Sideri IK, Stangel C, Stergiou A, Liapi A, Ojeda-Galván HJ, Quintana M, Tagmatarchis N. Covalently Modified MoS 2 Bearing a Hamilton-Type Receptor for Recognizing a Redox-Active Ferrocene-Barbiturate Guest via Multiple H-Bonds. Chemistry 2023; 29:e202301474. [PMID: 37249239 DOI: 10.1002/chem.202301474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 05/31/2023]
Abstract
The covalent modification of the metallic phase of MoS2 with a Hamilton-type ligand is presented, transforming MoS2 to a recognition platform which is able to embrace barbiturate moieties via hydrogen bonding. The successful hydrogen bonding formation is easily monitored by simple electrochemical assessments, if a ferrocene-labeled barbiturate analogue is utilized as a proof of concept. Full spectroscopic, thermal, and electron microscopy imaging characterization is provided for the newly formed recognition system, along with valuable insights concerning the electrochemical sensing. The given methodology expands beyond the sensing applications, confidently entering the territory of supramolecular interactions on the surface of 2D transition metal dichalcogenides. The well-designed host-guest chemistry presented herein, constitutes a guide and an inspiration for hosting customized-structured functional building blocks on MoS2 and its relatives via hydrogen bonding, opening up new opportunities regarding potential applications.
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Affiliation(s)
- Ioanna K Sideri
- Theoretical and Physical Chemistry Institute, National Hellenic Research Foundation, 48 Vassileos Constantinou Avenue, 11635, Athens, Greece
| | - Christina Stangel
- Theoretical and Physical Chemistry Institute, National Hellenic Research Foundation, 48 Vassileos Constantinou Avenue, 11635, Athens, Greece
| | - Anastasios Stergiou
- Theoretical and Physical Chemistry Institute, National Hellenic Research Foundation, 48 Vassileos Constantinou Avenue, 11635, Athens, Greece
| | - Alexandra Liapi
- Theoretical and Physical Chemistry Institute, National Hellenic Research Foundation, 48 Vassileos Constantinou Avenue, 11635, Athens, Greece
| | - Hiram Joazet Ojeda-Galván
- High Resolution Microscopy-CICSaB and Faculty of Science, Universidad Autonóma de San Luis Potosi, Av. Sierra Leona 550, 78210, Lomas de San Luis Potosi, SLP, Mexico
| | - Mildred Quintana
- High Resolution Microscopy-CICSaB and Faculty of Science, Universidad Autonóma de San Luis Potosi, Av. Sierra Leona 550, 78210, Lomas de San Luis Potosi, SLP, Mexico
| | - Nikos Tagmatarchis
- Theoretical and Physical Chemistry Institute, National Hellenic Research Foundation, 48 Vassileos Constantinou Avenue, 11635, Athens, Greece
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Choo YH, Seo Y, Oh HJ. Deep Sedation in Traumatic Brain Injury Patients. Korean J Neurotrauma 2023; 19:185-194. [PMID: 37431376 PMCID: PMC10329893 DOI: 10.13004/kjnt.2023.19.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 07/12/2023] Open
Abstract
Traumatic brain injury (TBI) is one of the leading causes of mortality and disability in adults. In cases of severe TBI, preventing secondary brain injury by managing intracranial hypertension during the acute phase is a critical treatment challenge. Among surgical and medical interventions to control intracranial pressure (ICP), deep sedation can provide comfort to patients and directly control ICP by regulating cerebral metabolism. However, insufficient sedation does not achieve the intended treatment goals, and excessive sedation can lead to fatal sedative-related complications. Therefore, it is important to continuously monitor and titrate sedatives by measuring the appropriate depth of sedation. In this review, we discuss the effectiveness of deep sedation, techniques to monitor the depth of sedation, and the clinical use of recommended sedatives, barbiturates, and propofol in TBI.
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Affiliation(s)
- Yoon-Hee Choo
- Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youngbeom Seo
- Department of Neurosurgery, Yeungnam University Hospital, Yeungnam Universtiy College of Medicine, Daegu, Korea
| | - Hyuk-Jin Oh
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
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The surgical management of intraoperative intracranial internal carotid artery injury in open skull base surgery-a systematic review. Neurosurg Rev 2021; 45:1263-1273. [PMID: 34802074 DOI: 10.1007/s10143-021-01692-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 01/25/2023]
Abstract
Intraoperative internal carotid artery (ICA) injury during open skull base surgery is a catastrophic complication. Multiple techniques and management strategies have been reported for endoscopic skull base surgery; however, the literature on managing this complication in open skull base surgery is limited. To perform a systematic review and give an overview of the different techniques described to manage this complication intraoperatively, a systematic review was conducted in PubMed, Ovid Medline, Ovid Embase and Scopus for literature published until July 2021. Titles and abstracts were screened. Studies meeting prespecified inclusion criteria were reviewed in full. PRISMA guidelines were strictly adhered to. Out of 4492 articles, only 12 articles could be included, reflecting an underreporting of open skull base ICA injuries. Multiple techniques can be used depending on the location and size of the injury as well as the surgeon's experience. Described techniques include the following: a primary repair via a micro-suture or nonpenetrating clips; wrapping or plugging; coating; occlusion of the parent artery with or without a bypass; packing with further endovascular management. A treatment algorithm is proposed.
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Kajiwara S, Hasegawa Y, Negoto T, Orito K, Kawano T, Yoshitomi M, Sakata K, Takeshige N, Yamakawa Y, Jono H, Saito H, Hirayu N, Takasu O, Hirohata M, Morioka M. Efficacy of a Novel Prophylactic Barbiturate Therapy for Severe Traumatic Brain Injuries: Step-down Infusion of a Barbiturate with Normothermia. Neurol Med Chir (Tokyo) 2021; 61:528-535. [PMID: 34078830 PMCID: PMC8443969 DOI: 10.2176/nmc.oa.2021-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study aimed to examine the beneficial effects of a novel prophylactic barbiturate therapy, step-down infusion of barbiturates, using thiamylal with normothermia (NOR+sdB), on the poor outcome in the patients with severe traumatic brain injuries (sTBI), in comparison with mild hypothermia (MD-HYPO). From January 2000 to March 2019, 4133 patients with TBI were admitted to our hospital. The inclusion criteria were: a Glasgow coma scale (GCS) score of ≤8 on admission, age between 20 and 80 years, intracranial hematoma requiring surgical evacuation of the hematoma with craniotomy and/or external decompression, and patients who underwent management of body temperature and assessed their outcome at 6-12 months. Finally, 43 patients were included in the MD-HYPO (n = 29) and NOR+sdB (n = 14) groups. sdB was initiated intraoperatively or immediately after the surgical treatment. There were no significant differences in patient characteristics, including age, sex, past medical history, GCS on admission, type of intracranial hematoma, and length of hospitalization between the two groups. Although NOR+sdB could not improve the patient's poor outcome either at discharge from the intensive care unit (ICU) or at 6-12 months after admission, the treatment inhibited composite death at discharge from the ICU. The mean value of the maximum intracranial pressure (ICP) in the NOR+sdB group was <20 mmHg throughout the first 120 h. NOR+sdB prevented composite death in the ICU in patients with sTBI, and we may obtain novel insights into the beneficial role of prophylactic barbiturate therapy from suppression of the elevated ICP during the first 120 h.
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Affiliation(s)
- Sosho Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine
| | - Yu Hasegawa
- Department of Neurosurgery, Kurume University School of Medicine.,Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Kimihiko Orito
- Department of Neurosurgery, Kurume University School of Medicine
| | - Takayuki Kawano
- Department of Neurosurgery, Kurume University School of Medicine
| | | | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine
| | | | | | - Hirofumi Jono
- Department of Pharmacy, Kumamoto University Hospital
| | | | - Nobuhisa Hirayu
- Department of Emergency and Critical Care Medicine, Kurume University School of Medicine
| | - Osamu Takasu
- Department of Emergency and Critical Care Medicine, Kurume University School of Medicine
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine
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Velle F, Lewén A, Howells T, Nilsson P, Enblad P. Temporal effects of barbiturate coma on intracranial pressure and compensatory reserve in children with traumatic brain injury. Acta Neurochir (Wien) 2021; 163:489-498. [PMID: 33341913 PMCID: PMC7815615 DOI: 10.1007/s00701-020-04677-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/07/2020] [Indexed: 01/18/2023]
Abstract
Background The aim was to study the effects of barbiturate coma treatment (BCT) on intracranial pressure (ICP) and intracranial compensatory reserve (RAP index) in children (< 17 years of age) with traumatic brain injury (TBI) and refractory intracranial hypertension (RICH). Methods High-resolution monitoring data were used to study the effects of BCT on ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP), and RAP index. Four half hour long periods were studied: before bolus injection and at 5, 10, and 24 hours thereafter, respectively, and a fifth tapering period with S-thiopental between < 100 and < 30 μmol/L. S-thiopental concentrations and administered doses were registered. Results Seventeen children treated with BCT 2007–2017 with high-resolution data were included; median age 15 (range 6–17) and median Glasgow coma score 7 (range 3–8). Median time from trauma to start of BCT was 44.5 h (range 2.5–197.5) and from start to stop 99.0 h (range 21.0–329.0). Median ICP was 22 (IQR 20–25) in the half hour period before onset of BCT and 16 (IQR 11–20) in the half hour period 5 h later (p = 0.011). The corresponding figures for CPP were 65 (IQR 62–71) and 63 (57–71) (p > 0.05). The RAP index was in the half hour period before onset of BCT 0.6 (IQR 0.1–0.7), in the half hour period 5 h later 0.3 (IQR 0.1–0.7) (p = 0.331), and in the whole BCT period 0.3 (IQR 0.2–0.4) (p = 0.004). Eighty-two percent (14/17) had favorable outcome (good recovery = 8 patients and moderate disability = 6 patients). Conclusion BCT significantly reduced ICP and RAP index with preserved CPP. BCT should be considered in case of RICH.
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Affiliation(s)
- Fartein Velle
- Department of Neuroscience, Section of Neurosurgery, Uppsala University, SE 751 85, Uppsala, Sweden.
| | - Anders Lewén
- Department of Neuroscience, Section of Neurosurgery, Uppsala University, SE 751 85, Uppsala, Sweden
| | - Timothy Howells
- Department of Neuroscience, Section of Neurosurgery, Uppsala University, SE 751 85, Uppsala, Sweden
| | - Pelle Nilsson
- Department of Neuroscience, Section of Neurosurgery, Uppsala University, SE 751 85, Uppsala, Sweden
| | - Per Enblad
- Department of Neuroscience, Section of Neurosurgery, Uppsala University, SE 751 85, Uppsala, Sweden
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Wang C, Liu H, Zhao W, Li P, Ji L, Liu R, Lei K, Xu X. Synthesis and Herbicidal Activity of 5-(1-Amino-2-phenoxyethylidene)barbituric Acid Derivatives. CHINESE J ORG CHEM 2021. [DOI: 10.6023/cjoc202010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wu S, Zhu R, Dong Y, Huang C, Shen X. Electromembrane extraction of barbiturates using tributyl phosphate as an efficient supported liquid membrane. Anal Chim Acta 2020; 1129:118-125. [DOI: 10.1016/j.aca.2020.07.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 01/17/2023]
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Malviya J, Singh RKP. One‐pot three‐component synthesis of chromeno [2,3‐
d
] pyrimidine derivatives: Novel, simple, and efficient electrochemical approach. J Heterocycl Chem 2020. [DOI: 10.1002/jhet.3741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jyoti Malviya
- Electrochemical Laboratory of Green Synthesis, Department of ChemistryUniversity of Allahabad Allahabad 211002 Uttar Pradesh India
| | - Rana Krishna Pal Singh
- Electrochemical Laboratory of Green Synthesis, Department of ChemistryUniversity of Allahabad Allahabad 211002 Uttar Pradesh India
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Zhang X, Lin Z, Li J, Huang Z, Rao Y, Liang H, Yan J, Zheng F. Rapid determination of nine barbiturates in human whole blood by liquid chromatography-tandem mass spectrometry. Drug Test Anal 2016; 9:588-595. [DOI: 10.1002/dta.2002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 04/26/2016] [Accepted: 05/08/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Xinyu Zhang
- Department of Pharmaceutical Analysis; China Pharmaceutical University; Nanjing Jiangsu PR China
- Department of Forensic Medicine, School of Basic Medical Sciences; Fudan University; Shanghai PR China
| | - Zebin Lin
- Department of Forensic Medicine, School of Basic Medical Sciences; Fudan University; Shanghai PR China
| | - Jiaolun Li
- Department of Chemistry; Fudan University; Shanghai PR China
| | - Zhibin Huang
- Department of Forensic Medicine, School of Basic Medical Sciences; Fudan University; Shanghai PR China
| | - Yulan Rao
- Department of Forensic Medicine, School of Basic Medical Sciences; Fudan University; Shanghai PR China
| | - Hao Liang
- Department of Forensic Medicine, School of Basic Medical Sciences; Fudan University; Shanghai PR China
| | - Jie Yan
- Department of Forensic Science, School of Basic Medical Sciences; Central South University; Changsha Hunan PR China
| | - Feng Zheng
- Department of Pharmaceutical Analysis; China Pharmaceutical University; Nanjing Jiangsu PR China
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Falsely elevated sodium levels during thiopental treatment in the ICU: technical interference on a laboratory device with important clinical relevance. Neurocrit Care 2013; 18:64-9. [PMID: 23104171 DOI: 10.1007/s12028-012-9794-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Thiopental is a cornerstone in the treatment of refractory status epilepticus and intractable intracranial hypertension. In our center we observed that thiopental might cause falsely elevated serum sodium levels. METHODS Triggered by a recent case experience of extremely elevated serum sodium levels during thiopental treatment, we retrospectively identified 53 patients treated with thiopental in our intensive care unit between 2007 and 2011 and evaluated electrolyte changes. We differentiated the analysis before and after introduction of a new device for sodium assays (Dimension Vista, Siemens) in the central laboratory in April 2010. Standardized in vitro laboratory tests were performed to study the effect of thiopental on sodium analysis. RESULTS Before April 2010, serum sodium levels determined in the central laboratory showed a good agreement with the bedside point-of-care (POC) device during thiopental therapy with [sodium](laboratory) - [sodium](POC) of only 1.08 mmol/L (P = .0517). After April 2010, a strong discrepancy between laboratory values and POC values was observed with [sodium](laboratory) - [sodium](POC) = 11.57 mmol/L (P < .0001). Standardized in vitro testing confirmed that thiopental induced a dose-dependent false hypernatremia (P = .002). CONCLUSIONS Thiopental treatment can result in falsely elevated serum sodium. This is a critical finding since high sodium levels preclude administrating mannitol or hypertonic saline for the treatment of elevated intracranial pressure. Moreover, a false high sodium level might lead to the inappropriate administration of hypotonic fluids potentially resulting in increased brain edema and even higher intracranial pressure. To our knowledge, this is the first paper describing this clinically relevant phenomenon.
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Mak CHK, Lu YY, Wong GKC. Review and recommendations on management of refractory raised intracranial pressure in aneurysmal subarachnoid hemorrhage. Vasc Health Risk Manag 2013; 9:353-9. [PMID: 23874101 PMCID: PMC3714000 DOI: 10.2147/vhrm.s34046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Intracranial hypertension is commonly encountered in poor-grade aneurysmal subarachnoid hemorrhage patients. Refractory raised intracranial pressure is associated with poor prognosis. The management of raised intracranial pressure is commonly referenced to experiences in traumatic brain injury. However, pathophysiologically, aneurysmal subarachnoid hemorrhage is different from traumatic brain injury. Currently, there is a paucity of consensus on the management of refractory raised intracranial pressure in spontaneous subarachnoid hemorrhage. We discuss in this paper the role of hyperosmolar agents, hypothermia, barbiturates, and decompressive craniectomy in managing raised intracranial pressure refractory to first-line treatment, in which preliminary data supported the use of hypertonic saline and secondary decompressive craniectomy. Future clinical trials should be carried out to delineate better their roles in management of raised intracranial pressure in aneurysmal subarachnoid hemorrhage patients.
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Puri KDS, Sood S, Muthuraman A. Synthesis and evaluation of substituted 5-(3-chloro-2-oxo-4-phenylazetidin-1-ylamino)pyrimidine-2,4,6(1H,3H,5H)-triones against pentylenetetrazole-induced convulsant in mice. Med Chem Res 2011. [DOI: 10.1007/s00044-011-9760-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Roberts DM, Buckley NA. Enhanced elimination in acute barbiturate poisoning - a systematic review. Clin Toxicol (Phila) 2011; 49:2-12. [PMID: 21288146 DOI: 10.3109/15563650.2010.550582] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Despite a worldwide decline in barbiturate use, cases of acute poisoning with severe toxicity are still noted, particularly in developing countries. Severe poisonings often require prolonged admission to an intensive care unit, so enhanced elimination might be useful to hasten recovery. Information regarding the efficacy of these techniques for individual barbiturates is not available in standard textbooks. OBJECTIVE To determine the evidence supporting the effect of enhanced elimination and its role in the management of acute barbiturate poisoning. METHODS A systematic review was conducted using broad search criteria in three databases. All potentially relevant articles were obtained, and reference lists were manually reviewed. Ninety-four publications fulfilling inclusion criteria were located. Studies were classified as controlled or uncontrolled, and clinical and pharmacokinetic end points were manually extracted. If not directly stated, standard pharmacokinetic methods were used to calculate the clearance and efficiency of enhanced elimination techniques for each barbiturate and tabulated for direct comparison. PROSPECTIVE CONTROLLED CLINICAL TRIALS: Two of the 94 publications were prospective controlled studies (only one stated that allocation was via blinded randomisation), and both assessed the effect of multiple-dose activated charcoal for acute phenobarbital poisoning. These studies demonstrated enhanced elimination with a decrease in elimination of half-life from approximately 80 to 40?h, but only one study reported clinical benefits. UNCONTROLLED SERIES AND SINGLE CASE REPORTS: Sufficient data to determine the clearance due to enhanced elimination were available in only 52 of these papers. Barbiturate clearances by enhanced elimination varied markedly among studies. While extracorporeal modalities appeared to increase the direct clearance of many barbiturates, there was insufficient information to confirm a clinical benefit. CONCLUSIONS There is limited evidence to support the use of enhanced elimination in the treatment of poisoning with most barbiturates. There is no role for urine alkalinisation, while multiple-dose activated charcoal may be useful for most phenobarbital and possibly primidone poisonings. Extracorporeal techniques appear to enhance elimination, but the clinical benefits, relative to the potential complications and cost, are poorly defined. Extracorporeal techniques such as haemodialysis and haemoperfusion can be considered for patients with life-threatening barbiturate toxicity such as refractory hypotension.
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Affiliation(s)
- Darren M Roberts
- Burns, Trauma and Critical Care Research Unit, Royal Brisbane and Women's Hospital, School of Medicine, University of Queensland, Australia.
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Wang B, He J, Shamsi SA. A high-throughput multivariate optimization for the simultaneous enantioseparation and detection of barbiturates in micellar electrokinetic chromatography-mass spectrometry. J Chromatogr Sci 2010; 48:572-83. [PMID: 20819283 PMCID: PMC3098000 DOI: 10.1093/chromsci/48.7.572] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The R- and S-configurations of barbiturates display differences in potency and biological activity. In this study, multivariate micellar electrokinetic chromatography-mass spectrometry (MEKC-MS) approach for the simultaneous analysis of three chiral barbiturates (mephobarbital, pentobarbital, and secobarbital) is developed using a polymeric chiral surfactant. After screening 11 amino acid polymeric surfactants, polysodium N-undecenoxycarbonyl-L-isoleucinate (poly-L-SUCIL) was found to be the best chiral selector. The multivariate central composite design (CCD) is used to optimize the chiral resolution, decrease the total analysis time, and improve the ESI-MS signal-to-noise (S/N) ratio. In the preliminary set of experiments, the ranges of the factors investigated in the multivariate approaches are determined. Next, the CCD design is conducted to determine the best overall chiral resolution with shortest possible run times. This optimization resulted in simultaneous enantioseparation in less than 32 min of all three barbiturates with 3-5 fold higher sensitivity by MS compared to UV detection. The adequacy of the multivariate model is validated by three replicate experimental runs at the predicted optimum conditions. The predicted results of MEKC-MS are found to be in good agreement with the experimental data for migration times, resolution, and S/N ratio. The optimized method provided good results in terms of linearity and recovery values of chiral barbiturates spiked in human serum after solid-phase extraction procedure.
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Affiliation(s)
- Bin Wang
- Department of Chemistry, Center of Biotechnology and Drug Design, Georgia State University, Atlanta, GA 30303, USA
| | - Jun He
- Department of Chemistry, Center of Biotechnology and Drug Design, Georgia State University, Atlanta, GA 30303, USA
| | - Shahab A. Shamsi
- Department of Chemistry, Center of Biotechnology and Drug Design, Georgia State University, Atlanta, GA 30303, USA
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Barbarawi M, Smith SF, Jamous MA, Haboub H, Suhair Q, Abdullah S. Therapeutic approaches to cerebral vasospasm complicating ruptured aneurysm. Neurol Int 2009; 1:e13. [PMID: 21577350 PMCID: PMC3093235 DOI: 10.4081/ni.2009.e13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2009] [Revised: 06/20/2009] [Accepted: 09/23/2009] [Indexed: 12/02/2022] Open
Abstract
Cerebral vasospasm is a serious complication of ruptured aneurysm. In order to avoid short- and long-term effects of cerebral vasospasm, and as there is no single or optimal treatment modality employed, we have instituted a protocol for the prevention and treatment of vasospasm in patients suffering aneurysmal sub-arachnoid hemorrhage (SAH). We then reviewed the effectiveness of this protocol in reducing the mortality and morbidity rate in our institution. In this study we present a retrospective analysis of 52 cases. Between March 2004 and December 2008 52 patients were admitted to our service with aneurysmal SAH. All patients commenced nimodipine, magnesium sulphate (MgSO4) and triple H therapy. Patients with significant reduction in conscious level were intubated, ventilated and sedated. Intracranial pressure (ICP) monitoring was used for intubated patients. Sodium thiopental coma was induced for patients with refractory high ICP; angiography was performed for diagnosis and treatment. Balloon angioplasty was performed if considered necessary. Using this protocol, only 13 patients (25%) developed clinical vasospasm. Ten of them were given barbiturates to induce coma. Three patients underwent transluminal balloon angioplasty. Four out of 52 patients (7.7%) died from severe vasospasm, 3 patients (5.8%) became severely disabled, and 39 patients (75%) were discharged in a condition considered as either normal or near to their pre-hemorrhage status. Our results confirm that the aforementioned protocol for treatment of cerebral vasospasm is effective and can be used safely.
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Bhalla A, Hargroves D. Does early medical intervention have a role in the management of intracerebral haemorrhage? Int J Clin Pract 2008; 62:633-41. [PMID: 18205794 DOI: 10.1111/j.1742-1241.2007.01691.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION An increasing amount of research is now being directed towards the medical treatment of patients who have suffered an intracerebral haemorrhage (ICH). Despite this, no routine drug treatment to date has been shown to be unequivocally effective in unselected patients. TREATMENTS/DISCUSSION Approaches to treatment are based upon our understanding of the pathophysiological sequelae following ICH. Strategies to reduce haematoma growth, subsequent oedema formation and perihaematoma ischaemia are key targets for further research. Whether these therapies become valuable tools for the future is as yet unclear. Until then, the mainstay of the medical management of ICH remains individualised care. CONCLUSIONS There is now a pressing need for large prospective randomised controlled trials to determine the effectiveness of pharmacological therapies for this condition.
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Affiliation(s)
- A Bhalla
- St Helier Stroke Service, Epsom and St Helier University Hospitals NHS Trust, Surrey, UK.
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Bouchard PM, Frenette AJ, Williamson DR, Perreault MM. Thiopental-associated dyskalemia in severe head trauma. THE JOURNAL OF TRAUMA 2008; 64:838-842. [PMID: 18332833 DOI: 10.1097/ta.0b013e3180341f65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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