Biochemical and Molecular Biological Assessments of Subarachnoid Hemorrhage - Animal Models of Acute Neurological Injuries: Injury and Mechanistic Assessments - page 410

The state of the art in diagnostic and assessment technologies
especially associated with protein and genetic technologies requires
extensive sample handling and substantial delays in producing
information of hours to days. For example, if a family of genes were
to be required for evaluating subarachnoid hemorrhage and this
evaluation required amplifi cation, the results would require skilled
personal and substantial time to obtain results. Costs and time
could make the results prohibitive and impractical. However, cur-
rent technology of a lab on a chip and point of care is making it
such that some results can be achieved relatively quickly. When this
state of the art is applied to the subarachnoid hemorrhage patient
improvements in care can follow. Unfortunately, there are still sig-
nal resolution issues that mean detecting low levels of analytes is
diffi cult and not yet achievable. What is exciting is that there is cut-
ting edge technology called metal enhance fl orescence that would
produce a paradigm shifting way business is done with assessing
subarachnoid hemorrhage patients. Metal-enhanced fl orescence
( 43-45 ) can be coupled to almost any fl uorescent assay methodol-
ogy to enhance the fl orescence signal. The result is 10,000-fold
increase in signal. So the tests discussed above that might take
hours or days could be coupled with lab on a chip technology and/
or metal-enhanced fl orescence to provide a quick, easy, and quan-
titative result in minutes. As cutting edge technology, it will take
time to become state of the art and now is the time to direct molec-
ular and biochemical assessments that will eventually adopt and
apply these technologies.
4. Pathos
Concerning the three prongs of a compelling argument, what is
left from pathos, logos, and ethos is pathos. Pathos refers to the
emotional side of the argument. The usual arguments for evaluat-
ing subarachnoid hemorrhage generally focus on the devastating
outcomes that patients have postsubarachnoid hemorrhage and
the secondary damage that can occur because of cerebral vasos-
pasm and delayed neurologic decline. These patients suffer enor-
mously because they frequently require constant and intense care
should they survive. The result is that their lives are permanently
impacted plus at least one caregiver must adjust his or her lifestyle
to care for the debilitated subarachnoid hemorrhage patient. These
new poststroke dynamics can remain for many years with little
improvement. Because time is brain, it is the early time point when
chemical changes are occurring that need to be better managed to
improve outcome for these patients.
What is sometimes insidious for the loved ones of patients
postsubarachnoid hemorrhage is that there is a window of opportunity