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Nanotechnology for Brain Targeting
Published in Raj K. Keservani, Anil K. Sharma, Rajesh K. Kesharwani, Nanocarriers for Brain Targeting, 2019
Debjani Banerjee, Huma Shamshad, Nidhi Mishra
Due to the given widely changing premises, most of the pharmacological therapies for neurological diseases render useless. As a consequence, many different types of strategies and methods are currently in quest for increasing the efficacy of drug delivery across the BBB. Most of the current strategies involve invasive techniques, for example, from osmotic and chemical opening of BBB, transporter/carrier, to chemical modifications of drugs (Kaur et al., 2008). By passing the BBB through alternative routes of delivery such as transnasal route may be considered. Alternative methods of drug delivery can also be used for crossing the cerebrospinal fluid also be considered or direct delivery of the drugs into the cerebrospinal fluid through lumbar puncture can also be adopted if targeted delivery is not required (Fig. 3.2). Invasive methods for bypassing the BBB involve direct introduction of drugs into the brain by surgical procedures (Sousa et al., 2010; He et al., 2011).
Central nervous system
Published in David A Lisle, Imaging for Students, 2012
CT is the primary imaging investigation of choice in suspected SAH. CT that is positive for SAH is usually followed by CT angiography (CTA) to diagnose and define the cause. A negative CT does not exclude a small SAH; up to 5 per cent of patients with a proven SAH have a normal CT at initial presentation. In cases where there is strong clinical suspicion for SAH and CT is negative, CTA may be performed to try to demonstrate a berry aneurysm. Alternatively, in such cases, diagnostic lumbar puncture may be performed to look for blood in the CSF or xanthochromia. Potential problems with lumbar puncture include:False positive due to blood-stained (‘traumatic’) tapProblems with interpretation of xanthochromiaPost-lumbar puncture headache.
Radiopharmaceuticals for Diagnostics
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Jim Ballinger, Jacek Koziorowski
There are several applications of 111In in nuclear medicine. 111In-chloride can be used to label transferrin in whole blood as a blood pool marker or for diagnosis of protein-losing enteropathy. 111In-oxine or -tropolonate have been used for in vitro labelling of white blood cells or platelets (see section 2.3.8). 111In-pentetate (DTPA) is the preferred agent for cisternography, which requires injection into the cerebrospinal fluid via lumbar puncture. 111In-pentetate is also used as a liquid phase marker in gastric emptying studies (see section 2.3.6.1). 111In-pentetreotide is a ligand for the somatostatin receptor, which is overexpressed in neuroendocrine tumours (see section 2.3.10.3).
Mechanical filtration of the cerebrospinal fluid: procedures, systems, and applications
Published in Expert Review of Medical Devices, 2023
The CSF is a highly informative source to inquire about CNS. Under normal conditions, the composition of CSF remains roughly constant within certain ranges of normality. However, various neurological diseases can alter the composition, quantity, and pressure. Lumbar puncture for CSF analysis is a routine test in clinical neurology diagnostic workouts. Also, CSF is an extremely useful matrix for biomarker research for several purposes, such as diagnosis, prognosis, monitoring, and identification of prominent leads in pathways of neurologic diseases [2]. In contrast, CSF has not been extensively regarded as a target biological fluid for therapies for CNS conditions. Today, few drugs are delivered in the CSF, mainly because it is an invasive procedure not without risks. However, in the last decades, therapies addressed at the CSF have gained some momentum as a result of advanced treatments such as gene therapies and replacement enzymatic therapies which need intrathecal (IT) or intraventricular (IVT) delivery. In addition, methods aimed at filtration CSF are a group of therapeutic procedures that have been proposed to treat neurological conditions where pathogens are present in the CSF. This includes microorganisms, antibodies, inflammatory mediators, or abnormal peptides that are the cause or play an important role in the pathogenesis of the disease [3,4].
Early revision events among patients with a three dimensional (3D) printed cellular titanium or PEEK (polyetheretherketone) spinal cage for single-level lumbar spinal fusion
Published in Expert Review of Medical Devices, 2022
Katherine A Corso, Prerna Kothari, Kristin Corrado, Annalisa Michielli, Jill Ruppenkamp, Dawn Bowden
The ICD-10 diagnoses associated with reoperation and the number of patients with the diagnosis in the PEEK group were infection and inflammatory reaction due to internal fixation device of spine (one patient); infection following a procedure, superficial incisional surgical site (two patients); infection following a procedure, other surgical site (one patient); osteomyelitis of vertebra, lumbar region (three patients); other reaction to spinal and lumbar puncture (one patient); infection following a procedure, deep incisional surgical site (one patient); osteomyelitis of vertebra, lumbosacral region (one patient). Patients may have had more than one diagnosis and thus the counts will not add up to a total of nine patients. Diagnoses associated with reoperation for the single patient in the 3D-printed-titanium group were infection following a procedure, deep incisional surgical site and intraspinal abscess and granuloma.
Spinal dura mater: biophysical characteristics relevant to medical device development
Published in Journal of Medical Engineering & Technology, 2018
Sean J. Nagel, Chandan G. Reddy, Leonardo A. Frizon, Matthieu K. Chardon, Marshall Holland, Andre G. Machado, George T. Gillies, Matthew A. Howard, Saul Wilson
Fibrin sealants can be applied directly to a durotomy suture line, be used to seal suture holes, or fix dural patches. They consist essentially of fibrinogen and thrombin that form a fibrin clot when mixed. These products can be used as a type of liquid glue or as a dry patch, and are safe and beneficial in providing a water-tight closure of the dura [40]. Intraoperative use of one of these products is shown in Figure 3. Epidural blood patch is an effective treatment for dural tears after lumbar puncture resulting in post-dural puncture headache. Using a needle, about 15–20 ml of venous blood is injected slowly into the epidural space near the site of original puncture, with subsequent clotting to patch the CSF leak [41].