Κυριακή 21 Ιανουαρίου 2018
Luigi Porta’s contribution to anesthesia in Europe in the 1800s
Abstract
Luigi Porta (1800–1875), an Italian physician who was well known in the field of surgery, played an important role in spreading ethereal anesthesia in Europe. Moreover, he proposed an original method to administer ethereal anesthesia, the Italian method "of the bladder of pig". This paper reminds us of the important role that this physician played in Anesthesiology.
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Toward a reliable, automated method of individual alpha frequency (IAF) quantification
Abstract
Individual alpha frequency (IAF) is a promising electrophysiological marker of interindividual differences in cognitive function. IAF has been linked with trait-like differences in information processing and general intelligence, and provides an empirical basis for the definition of individualized frequency bands. Despite its widespread application, however, there is little consensus on the optimal method for estimating IAF, and many common approaches are prone to bias and inconsistency. Here, we describe an automated strategy for deriving two of the most prevalent IAF estimators in the literature: peak alpha frequency (PAF) and center of gravity (CoG). These indices are calculated from resting-state power spectra that have been smoothed using a Savitzky-Golay filter (SGF). We evaluate the performance characteristics of this analysis procedure in both empirical and simulated EEG data sets. Applying the SGF technique to resting-state data from n = 63 healthy adults furnished 61 PAF and 62 CoG estimates. The statistical properties of these estimates were consistent with previous reports. Simulation analyses revealed that the SGF routine was able to reliably extract target alpha components, even under relatively noisy spectral conditions. The routine consistently outperformed a simpler method of automated peak detection that did not involve spectral smoothing. The SGF technique is fast, open source, and available in two popular programming languages (MATLAB, Python), and thus can easily be integrated within the most popular M/EEG toolsets (EEGLAB, FieldTrip, MNE-Python). As such, it affords a convenient tool for improving the reliability and replicability of future IAF-related research.
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Treatment of Post Anoxic Action Myoclonus with Intrathecal Baclofen: A Case Report
A case of severe action myoclonus following pulmonary arrest is described. Although there was benefit from oral pharmacotherapy, action myoclonus remained disabling. A favorable response to baclofen during an intrathecal trial led to eventual placement of an intrathecal baclofen pump. The present case illustrates the potential utility of intrathecal baclofen for treating this condition.
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Impaction durability of porous PEEK and titanium-coated PEEK interbody fusion devices
Various surface modifications, often incorporating roughened or porous surfaces, have recently been introduced to enhance osseointegration of interbody fusion devices. However, these topographical features can be vulnerable to damage during clinical impaction. Despite the potential negative impact of surface damage on clinical outcomes, current testing standards do not replicate clinically relevant impaction loading conditions.
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Resting-state quantitative EEG characteristics of insomniac patients with depression
Source:International Journal of Psychophysiology, Volume 124
Author(s): Yunna Kwan, Chorom Baek, Sunhye Chung, Tae Hui Kim, Sungwon Choi
Insomnia is known to show hyperarousal in the central nervous system. However, depression that often coexists with insomnia exhibits hypo-activity in the frontal lobe, which is very different from insomnia. In the present study, we examined wake resting state EEG of insomniac patients with depression to investigate whether they could be conceptualized as spectrum of insomnia or significantly different from insomnia. We compared the absolute power values of EEG spectra of three groups: 15 insomniacs with comorbid depression (CD), age- and sex-matched 15 comorbid-free insomniacs (CFI), and 15 good sleep controls (GSC). As a result, CD and CFI showed no significant difference in the EEG power spectrum analysis. Compared with GSC, however, both CD and CFI groups showed increased high frequency EEG amplitude. From these results, we have confirmed that CD shows cortical hyperarousal similar to insomnia in the daytime resting state. In conclusion, it would be reasonable to understood insomniac patients experiencing depression as a continuum of insomnia patients.
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Cue and context conditioning to respiratory threat: Effects of suffocation fear and implications for the etiology of panic disorder
Source:International Journal of Psychophysiology, Volume 124
Author(s): Christoph Benke, Manuela G. Alius, Alfons O. Hamm, Christiane A. Pané-Farré
Interoceptive threats play a crucial role in the etiology of panic disorder (PD). While body sensations may become conditioned stimuli (CS) when paired with such interoceptive threats (cue conditioning), the environment in which such interoceptive threats occur may also be learned as a predictor of threat (context conditioning). Suffocation fear (SF) might facilitate these associative learning processes if threats of suffocation become relevant as unconditioned stimuli (US). To investigate whether SF affects associative learning during such respiratory threat, we used mild dyspnea as CS that predicted the occurrence of strong dyspnea (US) in one context (predictable), was not related to the occurrence of the US in another context (unpredictable) or was presented in a different context (safe) in which no US was delivered. Startle eyeblink responses and subjective reports were assessed in 34 participants during learning. Individuals reporting high SF showed a clear potentiation of the startle response during the interoceptive CS predicting the occurrence of interoceptive threat (US). Such startle potentiation was not observed when the CS remained unpaired (safe or unpredictable context). Moreover, high SF persons also showed a significant startle potentiation to the threatening context, when the CS did not predict the onset of the US. No such learning effects were observed for low SF individuals. The data support the view that defensive response mobilization can be triggered by cues but also by contexts that predict the occurrence of interoceptive threats if these threats are relevant for the individuals, supporting learning accounts for the development of PD.
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Developmental changes in the feedback related negativity from 8 to 14 years
Source:International Journal of Psychophysiology
Author(s): Yael Arbel, Kayleigh N. McCarty, Mark Goldman, Emanuel Donchin, Ty Brumback
The study examined age related changes in the magnitude of the Feedback Related Negativity (FRN) in 8–14 year old children performing a variation of a Go/No-Go task. Participants were presented with four stimuli and tasked with mapping each of them either to a response or to a "no response" by trial and error guided by feedback. Feedback was valid for two stimuli (Go and No-Go) and invalid (.5 positive; .5 negative feedback) for the other two stimuli. The amplitude of the FRN was evaluated as a function of age separately for Go and No-Go trials. The results indicated that while performance on valid Go trials improved with age, accuracy on valid No-Go trials remained stable with age. FRN amplitude was found to be inversely related to age such that smaller FRN amplitudes were observed in older children even after controlling for variance in learning. Additionally, the FRN was found as a predictor of post-learning performance on Go trials but not on No-Go trials, regardless of age. These results do not provide support to the link between the FRN and inhibition control as measured by No-Go performance, but do suggest a link with other executive control abilities called for by the Go condition.
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Electrophysiological brain indices of risk behavior modification induced by contingent feedback
Source:International Journal of Psychophysiology
Author(s): Alberto Megías, Miguel Angel Torres, Andrés Catena, Antonio Cándido, Antonio Maldonado
The main aim of this research was to study the effects of response feedback on risk behavior and the neural and cognitive mechanisms involved, as a function of the feedback contingency. Sixty drivers were randomly assigned to one of three feedback groups: contingent, non-contingent and no feedback. The participants' task consisted of braking or not when confronted with a set of risky driving situations, while their electroencephalographic activity was continuously recorded. We observed that contingent feedback, as opposed to non-contingent feedback, promoted changes in the response bias towards safer decisions. This behavioral modification implied a higher demand on cognitive control, reflected in a larger amplitude of the N400 component. Moreover, the contingent feedback, being predictable and entailing more informative value, gave rise to smaller SPN and larger FRN scores when compared with non-contingent feedback. Taken together, these findings provide a new and complex insight into the neurophysiological basis of the influence of feedback contingency on the processing of decision-making under risk. We suggest that response feedback, when contingent upon the risky behavior, appears to improve the functionality of the brain mechanism involved in decision-making and can be a powerful tool for reducing the tendency to choose risky options in risk-prone individuals.
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Lost connections: Oxytocin and the neural, physiological and behavioral consequences of disrupted relationships
Publication date: Available online 9 January 2018
Source:International Journal of Psychophysiology
Author(s): Tobias T. Pohl, Larry J. Young, Oliver J. Bosch
In humans and rodent animal models, the brain oxytocin system is paramount for facilitating social bonds, from the formation and consequences of early-life parent-infant bonds to adult pair bond relationships. In social species, oxytocin also mediates the positive effects of healthy social bonds on the partners' well-being. However, new evidence suggests that the negative consequences of early neglect or partner loss may be mediated by disruptions in the oxytocin system as well. With a focus on oxytocin and its receptor, we review studies from humans and animal models, i.e. mainly from the biparental, socially monogamous prairie vole (Microtus ochrogaster), on the beneficial effects of positive social relationships both between offspring and parents and in adult partners. The abundance of social bonds and benevolent social relationships, in general, are associated with protective effects against psycho- and physiopathology not only in the developing infant, but also during adulthood. Furthermore, we discuss the negative effects on well-being, emotionality and behaviour, when these bonds are diminished in quality or are disrupted, for example through parental neglect of the young or the loss of the partner in adulthood. Strikingly, in prairie voles, oxytocinergic signalling plays an important developmental role in the ability to form bonds later in life in the face of early-life neglect, while disruption of oxytocin signalling following partner loss results in the emergence of depressive-like behaviour and physiology. This review demonstrates the translational value of animal models for investigating the oxytocinergic mechanisms that underlie the detrimental effects of developmental parental neglect and pair bond disruption, encouraging future translationally relevant studies on this topic that is so central to our daily lives.
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The role of the rehabilitation in subjects with Progressive Supranuclear Palsy: a narrative review
Progressive Supranuclear Palsy (PSP) is a progressive neurodegenerative disorder due to the deposition of abnormal proteins in neurons of the basal ganglia that limit motor ability producing disability and reduced quality of life. So far, no pharmacologic therapy has been developed and the treatment remains symptomatic. The aim of the present study was to investigate systematically literature, and to determine the types and effects of rehabilitative interventions. A search of all studies was conducted in MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials, CINAHL and EMBASE.
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The patient health questionnaire (PHQ-9): an aid to assessment of patient-reported functional outcomes after spinal surgery
Preoperative depression is increasingly understood as an important predictor of patient outcomes after spinal surgery. In this study, we examine the relationship between depression and patient-reported functional outcomes (PRFO), including disability and pain, at various time-points postoperatively.
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Effect of palpable vs. impalpable cricothyroid membranes in a simulated emergency front-of-neck access scenario.
| Related Articles |
Effect of palpable vs. impalpable cricothyroid membranes in a simulated emergency front-of-neck access scenario.
Anaesthesia. 2018 Jan 19;:
Authors: Pairaudeau CF, Mendonca C, Hillermann C, Qazi I, Baker PA, Hodgson RE, Radhakrishna S
Abstract
The Difficult Airway Society 2015 guidelines recommend and describe in detail a surgical cricothyroidotomy technique for the can't intubate, can't oxygenate (CICO) scenario, but this can be technically challenging for anaesthetists with no surgical training. Following a structured training session, 104 anaesthetists took part individually in a simulated can't intubate, can't oxygenate event using simulation and airway models to evaluate how well they could perform these front-of-neck access techniques. Main outcomes measures were: ability to correctly perform the technical steps; procedural time; and success rate. Outcomes were compared between palpable and impalpable cricothyroid membrane scenarios. Anaesthetists' technical abilities were good, as assessed by a video analysis checklist score. Mean (SD) procedural time was 44 (16) s and 65 (17) s for the palpable and impalpable cricothyroid membrane models, respectively (p ≤ 0.001). First-pass tracheal tube placement was obtained in 103 out of the 104 palpable cricothyroidotomies and in 101 out of the 104 impalpable cricothyroidotomies (p = 0.31). We conclude that anaesthetists can be trained to perform surgical front-of-neck access to an acceptable level of competence and speed when assessed using a simulator.
PMID: 29349776 [PubMed - as supplied by publisher]
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