Methods: We have developed algorithms incorporating continuous, automated, digital ICP and CPP monitoring data into a pressure times time “”dose”" function. In this study, we calculated cumulative doses using thresholds of Entinostat ICP > 20 mm Hg and CPP < 60 mm Hg and graphed these as a Brain Trauma Index (BTI or CPP/ICP). Using receiver operator characteristics analysis, we examined BTI < 3 and BTI < 2 and various threshold levels of pressure times time doses of ICP and CPP as predictors of 30-day mortality and Extended Glasgow Outcome Scale (GOSE) < 5 at 6 months and 12 months. Using the data processing and analysis tools underlying
this work, we are also piloting a real-time bedside and telemetric display system as a means of indentifying and monitoring critical changes in physiologic metrics, including BTI, CPP, and ICP.
Results: Sixty subjects yielded 8678.1 hours of data (5,206,860 data points). BTI < 2 was better than CPP < 60 mm Hg in predicting unfavorable Extended Glasgow Outcome Scale at 6
months (p < 0.05). An example of linear and graphically processed BTI, CPP, and ICP data from a representative TBI patient is provided.
Conclusion: Calculation of a BTI from continuous digital data predicts outcome in severe TBI and has potential for the design of real-time bedside early warning systems.”
“Background: Patients with type 2 diabetes find more have increased stiffness of central elastic arteries. However, whether peripheral muscular artery stiffness is equally affected by the disease remains sparsely examined.
Moreover, the association between pulse wave velocity (PWV) and augmentation index (AIx) in diabetes is poorly understood.
Hypothesis: Type 2 diabetes is associated with the alterations in arterial stiffness (PWV and AIx) in a community-based population.
Methods: A total of 79 Chinese patients with type 2 diabetes and 79 sex-, age- (+/- 3 years), and body mass index- (+/- 2 kg/m(2)) matched healthy controls were studied. Carotid-femoral pulse wave velocity (CF-PWV), carotid-radial pulse wave velocity (CR-PWV), and carotid-ankle pulse wave velocity (CA-PWV) were calculated from tonometry waveforms and body surface measurements, whereas AIx was assessed using pulse wave analyses.
Results: In univariate analysis, patients with type 2 diabetes showed increased CF-PWV (P < 0.001), selleckchem CR-PWV (P = 0.012), and CA-PWV (P = 0.016), and lower AIx (P = 0.017) than the control group. In multiple linear regression models adjusting for covariates, type 2 diabetes remained a significant determinant of CF-PWV. Fasting glucose was associated with CR-PWV but was not related to CA-PWV or AIx.
Conclusions: Our findings suggest that patients with type 2 diabetes have increased central and peripheral artery stiffness, but preserved AIx compared to controls. Diabetes was a predictor of central artery stiffness, and glucose was a determinant of peripheral artery stiffness.”
“Objective.