1
40
2
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10.1016/j.resuscitation.2023.109735
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Title
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Preclinical evaluation of triiodothyronine nanoparticles as a novel therapeutic intervention for resuscitation from cardiac arrest
Creator
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Brian R Weil
Shannon E Allen
Thomas Barbaccia
Kimberly Wong
Abigail M Beaver
Elizabeth A Slabinski
Jeffrey G Mellott
Peter C Taylor Dickinson
Shaker A Mousa
Date
A point or period of time associated with an event in the lifecycle of the resource
2023
Description
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Background: Given emerging evidence of rapid non-genomic cytoprotective effects of triiodothyronine (T3), we evaluated the resuscitative efficacy of two nanoparticle formulations of T3 (T3np) designed to prolong cell membrane receptor-mediated signaling.
Methods: Swine (n = 40) were randomized to intravenous vehicle (empty np), EPI (0.015 mg/kg), T3np (0.125 mg/kg), or T3np loaded with phosphocreatine (T3np + PCr; 0.125 mg/kg) during CPR following 7-min cardiac arrest (n = 10/group). Hemodynamics and biomarkers of heart (cardiac troponin I; cTnI) and brain (neuron-specific enolase; NSE) injury were assessed for up to 4-hours post-ROSC, at which time the heart and brain were collected for post-mortem analysis.
Results: Compared with vehicle (4/10), the rate of ROSC was higher in swine receiving T3np (10/10; p < 0.01), T3np + PCr (8/10; p = 0.08) or EPI (10/10; p < 0.01) during CPR. Although time to ROSC and survival duration were comparable between groups, EPI was associated with a ∼2-fold higher post-ROSC concentration of cTnI vs T3np and T3np + PCr and the early post-ROSC rise in NSE and neuronal injury were attenuated in T3np-treated vs EPI-treated animals. Analysis of hippocampal ultrastructure revealed deterioration of mitochondrial integrity, reduced active zone length, and increased axonal vacuolization in EPI-treated animals vs controls. However, the frequency of these abnormalities was diminished in animals resuscitated with T3np.
Conclusions: T3np achieved a ROSC rate and post-ROSC survival that was superior to vehicle and comparable to EPI. The attenuation of selected biomarkers of cardiac and neurologic injury at individual early post-ROSC timepoints in T3np-treated vs EPI-treated animals suggests that T3np administration during CPR may lead to more favorable outcomes in cardiac arrest.
Source
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Resuscitation
. 2023 Feb 16;109735. doi: 10.1016/j.resuscitation.2023.109735. Online ahead of print.
Language
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English
2023
cardiac arrest
Ischemic Injury
Nanoparticles
Phosphocreatine
Thyroid hormone
triiodothyronine
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<a href="http://doi.org/10.1016/j.jemermed.2019.09.037" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jemermed.2019.09.037</a>
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ISSN
0736-4679
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<a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.jemermed.2019.09.037" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.jemermed.2019.09.037</a>
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Update Year & Number
January 2020 Update
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine; Department of Internal Medicine; NEOMED College of Medicine Student Publications
Affiliated Hospital
Cleveland Clinic Akron General Hospital; Summa Health System Akron City Hospital; Summa Health Akron;
Dublin Core
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Title
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Throws of Death: Traumatic Coronary Artery Dissection Resulting From Jiu Jitsu Training
Publisher
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The Journal of Emergency Medicine
Date
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2019
2019-11-16
Subject
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cardiac arrest; coronary dissection; myocardial infarction; myocardial injury; sports medicine; trauma
Creator
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Haywood Steven T; Patel Kush; Gallo Douglas; Silver Kevin; Jouriles Nicolas
Description
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BACKGROUND: The risk of cardiac injury in blunt thoracic trauma is quite rare, occurring in only 0.1% of patients. The least common cardiac injury is coronary artery dissection. Most cardiac injuries result from high-energy mechanisms such as motor vehicle collisions. Even low-mechanism injuries that have been reported involved rapid deceleration. CASE REPORT: We present a case of traumatic coronary artery dissection that resulted from a low-energy blunt thoracic injury with no rapid deceleration. This patient had no other associated thoracic injuries, such as rib fractures or sternal fracture. Following presentation, our patient twice deteriorated into ventricular fibrillation and was successfully resuscitated each time. The coronary lesion was successfully stented and the patient was eventually discharged home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case underscores the importance of maintaining a high level of suspicion for coronary artery dissection even in low-energy mechanisms. An electrocardiogram should be obtained early, even in low-energy mechanisms. While patients with traumatic cardiac injuries will commonly present with other injuries, such as rib fractures, the absence of these injuries does not rule out cardiac injury.
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<a href="http://doi.org/10.1016/j.jemermed.2019.09.037" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2019.09.037</a>
PMID: 31744712
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Journal Article
2019
cardiac arrest
Cleveland Clinic Akron General Hospital
coronary dissection
Department of Emergency Medicine
Department of Internal Medicine
Gallo Douglas
Haywood Steven T
January 2020 Update
Jouriles Nicolas
Journal Article
myocardial infarction
myocardial injury
NEOMED College of Medicine
NEOMED College of Medicine Student
NEOMED Student Publications
Patel Kush
Silver Kevin
Sports Medicine
Summa Health Akron
Summa Health System Akron City Hospital
The Journal of emergency medicine
trauma