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Spataru A, Eiben P, Pluddemann A. Performance of closed-loop systems for intravenous drug administration: a systematic review and meta-analysis of randomised controlled trials. J Clin Monit Comput 2024; 38:5-18. [PMID: 37695449 DOI: 10.1007/s10877-023-01069-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/13/2023] [Indexed: 09/12/2023]
Abstract
Closed-loop drug delivery systems are autonomous computers able to administer medication in response to changes in physiological parameters (controlled variables). While limited evidence suggested that closed-loop systems can perform better than manual drug administration in certain settings, this technology remains a research tool with an uncertain risk/benefit profile. Our aim was comparing the performance of closed-loop systems with manual intravenous drug administration in adults. We searched MEDLINE, CENTRAL, and Embase from inception until November 2022, without restriction to language. We assessed for inclusion randomised controlled trials comparing closed-loop and manual administration of intravenous drugs in adults, intraoperatively or in the Intensive Care Unit. We identified 32 studies on closed-loop administration of propofol, noradrenaline, phenylephrine, insulin, neuromuscular blockers, and vasodilators. Most studies were at moderate or high risk of bias. The results showed that closed-loop systems reduced the duration of blood pressure outside prespecified targets during noradrenaline (MD 14.9%, 95% CI 9.6-20.2%, I2 = 66.6%) and vasodilators administration (MD 7.4%, 95% CI 5.2-9.7%, I2 = 62.3%). Closed-loop systems also decreased the duration of recovery after propofol (MD 1.3 min, 95% CI 0.4-2.1 min, I2 = 58.6%) and neuromuscular blockers (MD 9.0 min, 95% CI 7.9-10.0 min, I2 = 0%). The certainty of the evidence was low or very low for most outcomes. Automatic technology may be used to improve the hemodynamic profile during noradrenaline and vasodilators administration and reduce the duration of postanaesthetic recovery.Registration: This systematic review was registered with PROSPERO (CRD42022336950) on the 7th of June 2022.
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Affiliation(s)
- Ana Spataru
- Department of Neurocritical Care, Southampton General Hospital, Hampshire, SO164YO, UK.
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX26GG, UK.
| | - Paola Eiben
- Department of Anaesthesia, St. Bartholomew's Hospital, Barts Health NHS Trust, London, EC1A7BE, UK
| | - Annette Pluddemann
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX26GG, UK
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2
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Randhawa VK, Spataru A, Jory L, Moussa F, Bhardwaj A, Rajapreyar I. Effects of Inhaled Pulmonary Vasodilators on Perioperative Right Ventricular Hemodynamics: Are These "Nebs" Simply Nebulous? Can J Cardiol 2023; 39:483-486. [PMID: 36746371 DOI: 10.1016/j.cjca.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Affiliation(s)
- Varinder K Randhawa
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Ana Spataru
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Jory
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Fuad Moussa
- Department of Cardiac Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anju Bhardwaj
- Department of Advanced Cardiopulmonary Therapies and Transplantation, University of Texas/McGovern Medical School, Houston, Texas, USA
| | - Indranee Rajapreyar
- Division of Cardiology, Jefferson Heart Institute, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Pavel B, Moroti R, Spataru A, Popescu MR, Panaitescu AM, Zagrean AM. Neurological Manifestations of SARS-CoV2 Infection: A Narrative Review. Brain Sci 2022; 12:1531. [PMID: 36421855 PMCID: PMC9688734 DOI: 10.3390/brainsci12111531] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 08/30/2023] Open
Abstract
The COVID-19 virus frequently causes neurological complications. These have been described in various forms in adults and children. Headache, seizures, coma, and encephalitis are some of the manifestations of SARS-CoV-2-induced neurological impairment. Recent publications have revealed important aspects of viral pathophysiology and its involvement in nervous-system impairment in humans. We evaluated the latest literature describing the relationship between COVID-19 infection and the central nervous system. We searched three databases for observational and interventional studies in adults published between December 2019 and September 2022. We discussed in narrative form the neurological impairment associated with COVID-19, including clinical signs and symptoms, imaging abnormalities, and the pathophysiology of SARS-CoV2-induced neurological damage.
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Affiliation(s)
- Bogdan Pavel
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Clinical Emergency Hospital of Plastic, Reconstructive Surgery and Burns, 010713 Bucharest, Romania
| | - Ruxandra Moroti
- Clinical Department 2, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Matei Bals National Institute of Infectious Diseases, 021105 Bucharest, Romania
| | - Ana Spataru
- Department of Critical Care, King’s College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Mihaela Roxana Popescu
- Cardiothoracic Medicine Department, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania
- Department of Cardiology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Anca Maria Panaitescu
- Department of Obstetrics and Gynecology Filantropia Clinical Hospital Bucharest, 011171 Bucharest, Romania
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ana-Maria Zagrean
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Sandru S, Buzescu D, Zahiu CDM, Spataru A, Panaitescu AM, Isac S, Balan CI, Zagrean AM, Pavel B. Near-Infrared Spectroscopy Usefulness in Validation of Hyperventilation Test. Medicina (Kaunas) 2022; 58:medicina58101396. [PMID: 36295560 PMCID: PMC9607377 DOI: 10.3390/medicina58101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022]
Abstract
Background: The hyperventilation test is used in clinical practice for diagnosis and therapeutic purposes; however, in the absence of a standardized protocol, the procedure varies significantly, predisposing tested subjects to risks such as cerebral hypoxia and ischemia. Near-infrared spectroscopy (NIRS), a noninvasive technique performed for cerebral oximetry monitoring, was used in the present study to identify the minimum decrease in the end-tidal CO2 (ETCO2) during hyperventilation necessary to induce changes on NIRS. Materials and Methods: We recruited 46 volunteers with no preexisting medical conditions. Each subject was asked to breathe at a baseline rate (8−14 breaths/min) for 2 min and then to hyperventilate at a double respiratory rate for the next 4 min. The parameters recorded during the procedure were the regional cerebral oxyhemoglobin and deoxyhemoglobin concentrations via NIRS, ETCO2, and the respiratory rate. Results: During hyperventilation, ETCO2 values dropped (31.4 ± 12.2%) vs. baseline in all subjects. Changes in cerebral oximetry were observed only in those subjects (n = 30) who registered a decrease (%) in ETCO2 of 37.58 ± 10.34%, but not in the subjects (n = 16) for which the decrease in ETCO2 was 20.31 ± 5.6%. According to AUC-ROC analysis, a cutoff value of ETCO2 decrease >26% was found to predict changes in oximetry (AUC-ROC = 0.93, p < 0.0001). Seven subjects reported symptoms, such as dizziness, vertigo, and numbness, throughout the procedure. Conclusions: The rise in the respiratory rate alone cannot effectively predict the occurrence of a cerebral vasoconstrictor response induced by hyperventilation, and synchronous ETCO2 and cerebral oximetry monitoring could be used to validate this clinical test. NIRS seems to be a useful tool in predicting vasoconstriction following hyperventilation.
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Affiliation(s)
- Stefan Sandru
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Dan Buzescu
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Carmen Denise Mihaela Zahiu
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (C.D.M.Z.); (B.P.)
| | - Ana Spataru
- Department of Critical Care, King’s College Hospital Denmark Hill, London SE5 9RS, UK
| | - Anca Maria Panaitescu
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital Bucharest, 011171 Bucharest, Romania
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Sebastian Isac
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cosmin Ion Balan
- Department I of Cardiovascular Anesthesiology and Intensive Care, “Prof. C. C Iliescu” Emergency Institute for Cardiovascular Diseases, 050474 Bucharest, Romania
| | - Ana-Maria Zagrean
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Pavel
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (C.D.M.Z.); (B.P.)
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Rodríguez-Villar S, Kraut JA, Arévalo-Serrano J, Sakka SG, Harris C, Awad I, Toolan M, Vanapalli S, Collins A, Spataru A, Eiben P, Recea V, Brathwaite-Shirley C, Thompson L, Gurung B, Reece-Anthony R. Systemic acidemia impairs cardiac function in critically Ill patients. EClinicalMedicine 2021; 37:100956. [PMID: 34258569 PMCID: PMC8255172 DOI: 10.1016/j.eclinm.2021.100956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/29/2021] [Accepted: 05/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Acidemia, is associated with reduced cardiac function in animals, but no studies showing an effect of acidemia on cardiac function in humans are reported. In the present study, we examined the effect of acidemia on cardiac function assessed with transpulmonary thermodilution technique with integrated pulse contour analysis (Pulse Contour Cardiac Output, PiCCO™) in a large cohort of critically ill patients. METHODS This was a prospective multicenter observational cross-sectional study of 297 patients from 6 intensive care units in London, England selected from all patients admitted consecutively between May 2018 and March 2019. Measurements of lowest plasma pH and concurrent assessment of cardiac function were obtained. FINDINGS There was a significant difference between two pH categories (pH ≤ 7.28 vs. pH > 7.28) for the following variables of cardiac function: SVI (difference in means 32.7; 95% CI: 21 to 45 mL/m2; p < 0.001); GEF (18; 95% CI: 11 to 26%; p < 0.001), dPmax (-331; 95% CI: -510 to -153 mmHg/s; p = 0.001), CFI (0.7; 95% CI: 0.2 to 1.3 1/min; p = 0.01) and CPI (0.09; 95% CI: 0.03 to 0.15 W/m2; p < 0.001). However, there was no significant difference in CI (0.13; 95% CI: -0.20 to 0.47 L/min/m2; p = 0.12) between the pH categories. Also, a significant relationship was found between the quantitative pH and the following variables: SVI (132; 95% CI: 77 to 188 mL/m2; p < 0.001), GEF (74.7; 95% CI: 37.1 to 112.4%; p < 0.001), dPmax (-1587; 95% CI: -2361 to -815 mmHg/s; p < 0.001), CFI (3.5; 95% CI: 0.9 to 6.1 /min; p = 0.009), CPI (0.62; 95% CI: 0.36 to 0.88 W/m2; p < 0.001) and CI (regression coefficient 1.96; 95% CI:0.45 to 3.47 L/min/m2; p = 0.01). INTERPRETATION Acidemia is associated with impaired cardiac function in seriously ill patients hospitalized in the intensive care unit supporting the potential value of early diagnosis and improvement of arterial pH in these patients. FUNDING The study was partially supported by unrestricted funds from the UCLA School of Medicine.
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Affiliation(s)
- S Rodríguez-Villar
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
- Corresponding author.
| | - JA Kraut
- Division of Nephrology and Department of Medicine Veterans Administration Greater Los Angeles Healthcare System and UCLA School Of Medicine, California, United States
| | - J Arévalo-Serrano
- Internal Medicine Department, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - SG Sakka
- Critical Care Department. Gemeinschaftsklinikum Mittelrhein gGmbH, Kemperhof und Ev, Stift St. Martin. Academic Teaching Hospital of the Johannes Gutenberg University Mainz. Germany
| | - C Harris
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
| | - I Awad
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
| | - M Toolan
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
| | - S Vanapalli
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
| | - A Collins
- Critical Care Department. Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, United Kingdom
| | - A Spataru
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
| | - P Eiben
- Critical Care Department. Princess Royal University Hospital, King´s College Hospital NHS Trust Foundation, London, United Kingdom
| | - V Recea
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
| | - C Brathwaite-Shirley
- Critical Care Department. Princess Royal University Hospital, King´s College Hospital NHS Trust Foundation, London, United Kingdom
| | - L Thompson
- Critical Care Department, King´s College Hospital NHS Trust Foundation. London, United Kingdom
| | - B Gurung
- Critical Care Department. Lewisham University Hospital, Lewisham and Greenwich NHS Trust, United Kingdom
| | - R Reece-Anthony
- Critical Care Department. Lewisham University Hospital, Lewisham and Greenwich NHS Trust, United Kingdom
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Spataru A, Hurst TP, Loveridge RW, Auzinger G. Persistent left superior vena cava in a patient requiring cannulation for extracorporeal membrane oxygenation. Artif Organs 2019; 43:1042-1043. [PMID: 31119746 DOI: 10.1111/aor.13472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/06/2019] [Accepted: 04/11/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Ana Spataru
- Department of Critical Care, King's College Hospital, London, United Kingdom
| | - Thomas P Hurst
- Department of Critical Care, King's College Hospital, London, United Kingdom
| | - Robert W Loveridge
- Department of Critical Care, King's College Hospital, London, United Kingdom
| | - Georg Auzinger
- Department of Critical Care, King's College Hospital, London, United Kingdom
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7
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Spataru A, Le Duc D, Zagrean L, Zagrean AM. Ethanol exposed maturing rat cerebellar granule cells show impaired energy metabolism and increased cell death after oxygen-glucose deprivation. Neural Regen Res 2019; 14:485-490. [PMID: 30539817 PMCID: PMC6334607 DOI: 10.4103/1673-5374.245474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Alcohol, a widely abused drug, has deleterious effects on the immature nervous system. This study investigates the effect of chronic in vitro ethanol exposure on the metabolism of immature rat cerebellar granular cells (CGCs) and on their response to oxygen-glucose deprivation (OGD). Primary CGC cultures were exposed to ethanol (100 mM in culture medium) or to control ethanol-free medium starting day one in vitro (DIV1). At DIV8, the expression of ATP synthase gene ATP5g3 was quantified using real-time PCR, then cultures were exposed to 3 hours of OGD or normoxic conditions. Subsequently, cellular metabolism was assessed by a resazurin assay and by ATP level measurement. ATP5g3 expression was reduced by 12-fold (P = 0.03) and resazurin metabolism and ATP level were decreased to 74.4 ± 4.6% and 55.5 ± 6.9%, respectively after chronic ethanol treatment compared to control values (P < 0.01). Additionally, after OGD exposure of ethanol-treated cultures, resazurin metabolism and ATP level were decreased to 12.7 ± 1.0% and 9.0 ± 2.0% from control values (P < 0.01). These results suggest that chronic ethanol exposure reduces the cellular ATP level, possibly through a gene expression down-regulation mechanism, and increases the vulnerability to oxygen-glucose deprivation. Thus, interventions which improve metabolic function and sustain ATP-levels could attenuate ethanol-induced neuronal dysfunction and should be addressed in future studies.
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Affiliation(s)
- Ana Spataru
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; King's College Hospital, London, UK
| | - Diana Le Duc
- Institute of Human Genetics, University of Leipzig Hospitals and Clinics, Leipzig, Germany; Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Leon Zagrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ana-Maria Zagrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Isac S, Panaitescu AM, Spataru A, Iesanu M, Totan A, Udriste A, Cucu N, Peltecu G, Zagrean L, Zagrean AM. Trans-resveratrol enriched maternal diet protects the immature hippocampus from perinatal asphyxia in rats. Neurosci Lett 2017; 653:308-313. [PMID: 28595952 DOI: 10.1016/j.neulet.2017.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/10/2017] [Accepted: 06/04/2017] [Indexed: 01/20/2023]
Abstract
Trans-resveratrol (tRESV), a polyphenol with antioxidant properties, is common in many food sources, hence easily accessible for study as a maternal dietary supplement in perinatal asphyxia (PA). Hypoxic-ischemic encephalopathy secondary to PA affects especially vulnerable brain areas such as hippocampus and is a leading cause of neonatal morbidity. The purpose of this study is to identify new epigenetic mechanisms of brain inflammation and injury related to PA and to explore the benefit of tRESV enriched maternal diet. The hippocampal interleukin 1 beta (IL-1b), tumour necrosis factor alpha (TNFα) and S-100B protein, at 24-48h after 90min of asphyxia were assessed in postnatal day 6 rats whose mothers received either standard or tRESV enriched diet. The expression of non-coding microRNAs miR124, miR132, miR134, miR146 and miR15a as epigenetic markers of hippocampus response to PA was determined 24h post-asphyxia. Our results indicate that neural response to PA could be epigenetically controlled and that tRESV reduces asphyxia-related neuroinflammation and neural injury. Moreover, tRESV could increase, through epigenetic mechanisms, the tolerance to asphyxia, with possible impact on the neuronal maturation. Our data support the neuroprotective quality of tRESV when used as a supplement in the maternal diet on the offspring's outcome in PA.
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Affiliation(s)
- Sebastian Isac
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Anca Maria Panaitescu
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Ana Spataru
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mara Iesanu
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Alexandra Totan
- Division of Biochemistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Amalia Udriste
- Association for Epigenetics and Metabolomics, Bucharest, Romania; Research Center for Studies of Food Quality and Agricultural Products, Bucharest, Romania
| | - Natalia Cucu
- Association for Epigenetics and Metabolomics, Bucharest, Romania
| | | | - Leon Zagrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ana-Maria Zagrean
- Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
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Spataru A, Jain R, Chung JW, Gerner G, Krebs R, Lens PN. Enhanced adsorption of orthophosphate and copper onto hydrochar derived from sewage sludge by KOH activation. RSC Adv 2016. [DOI: 10.1039/c6ra22327c] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hydrochar, produced by hydrothermal carbonization of sewage sludge, adsorbs orthophosphate to improve effluent quality, recover & reutilize phosphorous and positively impact sewage sludge management.
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Affiliation(s)
| | - Rohan Jain
- UNESCO-IHE
- 2611 AX Delft
- The Netherlands
- Department of Chemistry and Bioengineering
- Tampere University of Technology
| | | | - Gabriel Gerner
- Institute of Natural Resource Sciences
- Zurich University of Applied Sciences
- 8820 Wädenswil
- Switzerland
| | - Rolf Krebs
- Institute of Natural Resource Sciences
- Zurich University of Applied Sciences
- 8820 Wädenswil
- Switzerland
| | - Piet N. L. Lens
- UNESCO-IHE
- 2611 AX Delft
- The Netherlands
- Department of Chemistry and Bioengineering
- Tampere University of Technology
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10
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Le Duc D, Spataru A, Ceanga M, Zagrean L, Schöneberg T, Toescu EC, Zagrean AM. Developmental exposure to ethanol increases the neuronal vulnerability to oxygen-glucose deprivation in cerebellar granule cell cultures. Brain Res 2015; 1614:1-13. [PMID: 25881894 DOI: 10.1016/j.brainres.2015.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 03/18/2015] [Accepted: 04/04/2015] [Indexed: 01/01/2023]
Abstract
Prenatal alcohol exposure is associated with microencephaly, cognitive and behavioral deficits, and growth retardation. Some of the mechanisms of ethanol-induced injury, such as high level oxidative stress and overexpression of pro-apoptotic genes, can increase the sensitivity of fetal neurons towards hypoxic/ischemic stress associated with normal labor. Thus, alcohol-induced sequelae may be the cumulative result of direct ethanol toxicity and increased neuronal vulnerability towards metabolic stressors, including hypoxia. We examined the effects of ethanol exposure on the fetal cerebellar granular neurons' susceptibility to hypoxic/hypoglycemic damage. A chronic ethanol exposure covered the entire prenatal period and 5 days postpartum through breastfeeding, a time interval partially extending into the third-trimester equivalent in humans. After a binge-like alcohol exposure at postnatal day 5, glutamatergic cerebellar granule neurons were cultured and grown for 7 days in vitro, then exposed to a 3-h oxygen-glucose deprivation to mimic a hypoxic/ischemic condition. Cellular viability was monitored by dynamic recording of propidium iodide fluorescence over 20 h reoxygenation. We explored differentially expressed genes on microarray data from a mouse embryonic ethanol-exposure model and validated these by real-time PCR on the present model. In the ethanol-treated cerebellar granule neurons we find an increased expression of genes related to apoptosis (Mapk8 and Bax), but also of genes previously described as neuroprotective (Dhcr24 and Bdnf), which might suggest an actively maintained viability. Our data suggest that neurons exposed to ethanol during development are more vulnerable to in vitro hypoxia/hypoglycemia and have higher intrinsic death susceptibility than unexposed neurons.
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Affiliation(s)
- Diana Le Duc
- Division of Physiology and Fundamental Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; Molecular Biochemistry, Institute of Biochemistry, Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany.
| | - Ana Spataru
- Division of Physiology and Fundamental Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihai Ceanga
- Division of Physiology and Fundamental Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Leon Zagrean
- Division of Physiology and Fundamental Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Torsten Schöneberg
- Molecular Biochemistry, Institute of Biochemistry, Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Emil C Toescu
- Translational Neuroscience, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Ana-Maria Zagrean
- Division of Physiology and Fundamental Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
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Zăgrean AM, Spataru A, Ceangă M, Zăgrean L. The single versus combinatorial effects of MK-801, CNQX, Nifedipine and AP-3 on primary cultures of cerebellar granule cells in an oxygen-glucose deprivation model. Rom J Morphol Embryol 2014; 55:811-816. [PMID: 25329107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The excitotoxicity cascade associated with energetic failure during and after cerebral ischemia involves the overactivation of glutamate receptors and intracellular calcium loading. We searched for synergistic neuroprotective effects of various drugs designed to prevent intracellular calcium influx in a model of oxygen-glucose deprivation (OGD) in cerebellar granule cells primary cultures. (5S,10R)-(-)-5-Methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine hydrogen maleate (MK-801), D,L-2-Amino-3-phosphonopropionic acid (AP-3), 6-Cyano-7-nitroquinoxaline-2,3-dione disodium salt (CNQX) and Nifedipine were tested alone or in combinations. Treatments were applied during a two-hour OGD exposure and cellular outcome was assessed throughout 20-hour reoxygenation by the measurement of Propidium Iodide (PI) fluorescence. All treatments were able to prevent neuronal damage. OGD resulted in a mortality of 36.3±2.3% and 61.3±3.1% after 10 and 20 hours of reoxygenation, respectively. The most effective single treatment was AP-3 (3.3±1.4%; 17.9±2.6% mortality after 10 and 20 hours), followed in order by Nifedipine (7.2±1.6%; 20.1±3.0%), CNQX (8.5±2.5%; 20.0±3.5%), and MK-801 (14.9±2.6%; 39.3±6.4%). The combination of AP-3 with MK-801 showed a moderate synergistic effect (11.8±2.0% mortality at 20 hours), while the combinations of CNQX with Nifedipine and CNQX with MK-801, as well as the triple mix CNQX, Nifedipine and MK-801 failed to show a further improvement in the reduction of cellular death. In conclusion, targeting two mechanisms of cellular demise (ionotropic receptors and metabotropic glutamate receptors) provided an advantage against several unimodal strategies (blocking calcium entry through ionotropic glutamate receptors and L-type calcium channels). Our results suggest that a multimodal combinatorial treatment strategy in cerebral ischemia may increase neuroprotective efficacy and call for further research.
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Affiliation(s)
- Ana Maria Zăgrean
- Division of Physiology and Fundamental Neuroscience, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; ,
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