Σάββατο, 14 Ιανουαρίου 2017

A simple method to control the distal tip of nasotracheal tube using the surgical suture

With great interest, we read the recent article by Hung et al. [1] describing a novel method to control the distal tip of nasotracheal tube. In clinical practice, we had used this technique to achieve the successful nasotracheal intubation [2]. We completely agree with the authors that this method may be used as a back-up technique if the cuff inflation technique fails for controlling the tube tip location during nasotracheal intubation. However, one of main concerns on this method is possible injury of the nasal mucosa by removing the surgical suture along the tube placed in the nasal passage immediately after intubation.

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Evaluating LMA-ProSeal insertion techniques: A call for methodological clarification

In the recent article by Ishio et al. [1] evaluating the insertion efficacy of the LMA-ProSeal by novice doctors with or without a 90° bend created by an intubating stylet in anesthetized patients, they demonstrate that a 90° bend re-figuration facilitates LMA-ProSeal insertion, as shown by a higher successful insertion rate, a higher sealing pressure, and a lower subjective difficulty of insertion. To rightly compare effect of insertion techniques on performance of the studied device in a randomized controlled trial, however, standardization of equipment and rational design of study are crucial.

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IOP-details

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Publication date: February 2017
Source:International Journal of Psychophysiology, Volume 112





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Editorial Board

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Publication date: February 2017
Source:International Journal of Psychophysiology, Volume 112





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Instructions to Authors

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Publication date: February 2017
Source:International Journal of Psychophysiology, Volume 112





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Δ14CO2 from dark respiration in plants and its impact on the estimation of atmospheric fossil fuel CO2

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Publication date: April 2017
Source:Journal of Environmental Radioactivity, Volumes 169–170
Author(s): Xiaohu Xiong, Weijian Zhou, Peng Cheng, Shugang Wu, Zhenchuan Niu, Hua Du, Xuefeng Lu, Yunchong Fu, George S. Burr
Radiocarbon (14C) has been widely used for quantification of fossil fuel CO2 (CO2ff) in the atmosphere and for ecosystem source partitioning studies. The strength of the technique lies in the intrinsic differences between the 14C signature of fossil fuels and other sources. In past studies, the 14C content of CO2 derived from plants has been equated with the 14C content of the atmosphere. Carbon isotopic fractionation mechanisms vary among plants however, and experimental study on fractionation associated with dark respiration is lacking. Here we present accelerator mass spectrometry (AMS) radiocarbon results of CO2 respired from 21 plants using a lab-incubation method and associated bulk organic matter. From the respired CO2 we determine Δ14Cres values, and from the bulk organic matter we determine Δ14Cbom values. A significant difference between Δ14Cres and Δ14Cbom (P < 0.01) was observed for all investigated plants, ranging from −42.3‰ to 10.1‰. The results show that Δ14Cres values are in agreement with mean atmospheric Δ14CO2 for several days leading up to the sampling date, but are significantly different from corresponding bulk organic Δ14C values. We find that although dark respiration is unlikely to significantly influence the estimation of CO2ff, an additional bias associated with the respiration rate during a plant's growth period should be considered when using Δ14C in plants to quantify atmospheric CO2ff.



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A Comparison of Locomotor Therapy Interventions: Partial Body Weight Supported Treadmill, Lokomat® and G-EO® Training in Persons with Traumatic Brain Injury

Literature in the application of gait training techniques in persons with traumatic brain injury is limited. Current techniques require of multiple staff and are physically demanding. The use of a robotic locomotor training may provide improved training capacity for this population.

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Rehabilitation of the Pontine Ataxia-Dysmetria Syndrome: A Case Presentation

We present a case of a patient with significant ataxia and dysmetria following a lacunar pontine infarction and review the literature on this uncommon syndrome. The patient had an excellent clinical course with near resolution of symptoms and signs in less than three weeks. We characterize and illustrate with videos of the ataxia and dysmetria. Interestingly, the characteristics of the dysmetria appear to be different than that seen in patients with dysmetria arising from a cerebellar or thalamic lesion.

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Improved Arousal and Motor Function Using Zolpidem in a Patient with Space-Occupying Intracranial Lesions: a case report

Patients with disorders of consciousness (DOC) have profound functional limitations with few treatment options for improving arousal and quality of life. Zolpidem is a non-benzodiazepine hypnotic used to treat insomnia that has also been observed to paradoxically improve arousal in those with DOC, such as the vegetative or minimally conscious states (MCS). There is little information on its use in DOC patients with intracranial space occupying lesions. We present a case of a 24year old man in a MCS due to CNS lymphoma who was observed to have increased arousal and improved motor function following administration of zolpidem.

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Predictors of Pharmacological Intervention in Adolescents with Protracted Symptoms after Sports-related Concussion

Though recovery after concussion is spontaneous and typically occurs within two to three weeks, a subset of adolescents develop persistent symptoms after a sports-related concussion. Medications are frequently prescribed as part of a comprehensive treatment approach to alleviate these symptoms; however, there are no guidelines for prescription of pharmacologic therapy after concussion.

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Does Trainee Involvement in Fluoroscopic Injections affect Fluoroscopic Time, Immediate Pain Reduction, and Complication Rate?

Patients have expressed concern about undergoing procedures involving trainees, even with direct attending physician supervision. Little literature examines the effect of trainee involvement on patient outcomes.

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Sonographically Guided Knee Meniscus Injections: Feasibility, Techniques and Validation

There is a growing interest in the use of biologic agents such as platelet-rich plasma and mesenchymal stem/stromal cells to treat musculoskeletal injuries, including meniscal tears. Although prior research has documented the role of diagnostic ultrasound to evaluate meniscal tears, sonographically guided (SG) techniques to specifically deliver therapeutic agents into the meniscus have not been described.

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Evaluation of lip pulling method efficacy for direct laryngoscopy: A prospective crossover clinical pilot trial

A lip pulling method is usually used to prevent lip or tooth injuries [1]. We previously suggested that this method may provide a better laryngoscopy [2]. We hypothesized that lip pulling could also improve laryngoscopy, since the lips sometimes impede sufficient laryngoscopy with the Macintosh laryngoscope (McL). To test our hypothesis, we conducted a prospective randomized crossover study to compare laryngoscopy with or without lip pulling. The primary outcome was the efficiency of laryngoscopy (Fig.

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Comparing direct and indirect laryngoscopy: Study design is crucial

In a randomized, controlled clinical trial by Kurnaz and Sarıtaş [1]. comparing intubation performance of the Truview PCD™ and Macintosh laryngoscopes and their effects on intubation hemodynamic responses in geriatric patients, they show that compared to Macintosh laryngoscope, Truview PCD™ laryngoscope (TPL) does not provide significant hemodynamic response sparing or a shorten intubation time. Besides the limitations described in the discussion, there are the several issues in this study that need to be clarified.

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Reply to the correspondence in relation to the article “Randomized study of post-cesarean analgesia with intrathecal morphine alone or combined with clonidine”

Firstly I would like to thank the opportunity to respond Dr. Bhakta.

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Anaesthetic management of a patient with Michels syndrome

Michels Syndrome, which was first defined in 1978, is an uncommon syndrome seen with craniosynostosis, blepharophimosis, ptosis, epicanthus inversus, cleft lip/palate, abnormal supra umbilical abdominal wall defect and mental deficit, hearing loss, spina bifida occulta, abnormalities in the kidneys, bladder and genital system [1].

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Lip injury associated with i-gel placement during general anesthesia

Although the i-gel® (i-gel: Intersurgical, U.K.) supraglottic airway device is useful for airway management during general anesthesia [1,2], there are reports of nerve and tongue injuries associated with i-gel use [3,4]. Here, we report a case of lip injury associated with i-gel use during general anesthesia.

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Dose ranging effects of pregabalin on pain in patients undergoing laparoscopic hysterectomy: A randomized, double blinded, placebo controlled, clinical trial

The study aimed to investigate the preemptive analgesia efficacy of different concentrations (75, 150 and 300mg) of preemptive pregabalin for the postoperative pain management after laparoscopic hysterectomy.

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Use of local anesthetic a key tenet in multimodal analgesia to modulate chronic post-mastectomy pain

Steyaert et al. performed a cross-sectional survey of women undergoing mastectomy with axillary lymph node dissection to determine risk factors, including anesthetic and analgesic regimen, for the development of chronic post-mastectomy pain [1]. They found that of the many anesthetic and analgesic variables studied, only the use of halogenated agents was associated with a decreased incidence of chronic pain. We appreciate the diligence of this investigation into how our anesthetic care can affect our patients, particularly given the frequent incidence of chronic post-mastectomy pain in this population.

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Airtraq® videolaryngoscope for assessing vocal cord mobility at the end of thyroidectomy

Voice impairment due to recurrent laryngeal nerve (RLN) palsy is one of the common and serious complications caused by thyroid surgery and a leading reason for medicolegal litigation. RLN palsy rates depend not only on the type of thyroid disease and the extent of resection but also on the surgeon's training. Routine RLN recognition is considered the gold standard of care for the prevention of nerve injury during thyroid surgery [1]; however, despite meticulous anatomical identification, the reported incidence of RLN palsy ranges from 0 to 12% [2,3].

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Intraoperative anaphylaxis, cardiac arrest and hypertrophic cardiomyopathy: Implications for Kounis syndrome

Anaphylactic reactions occurring during general anesthesia constitute the most severe and frequent forms of drug-induced hypersensitivity reactions. Although bronchospasm, cutaneous and mucus signs and symptoms are easily recognized, signs and symptoms that mainly involve the cardiovascular system constitute diagnostic and therapeutic problems. In the very interesting report published recently [1], a 75-year-old woman, hypertensive, smoker and allergic to penicillin and cephalosporin with vancomycin spacer placement, developed twice hypotensive cardiac arrest with pulseless electrical activity during preoperative general anesthesia for left total hip re-implantation.

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Postoperative foreign language syndrome

Foreign language syndrome (FLS), a substitution of native language (first language, L1) with person's later learned language (second language, L2) may rarely occur after serious injury to the brain which renders victims unconscious. There have been few reported cases of the FLS since it was first reported in the 1940s. The most famous case was a Norwegian woman, hit by shrapnel (World War II), who subsequently developed a German accent. Other cases include two British woman, one developed a Chinese accent following a migraine, and another had a stroke and gained a French accent (Foreign accent syndrome).(http://ift.tt/1QrW1FS).

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Selective attentional impairment in chronic tinnitus: evidence from an event-related potentials study

Tinnitus is an auditory phantom sensation experienced in the absence of a sound source (Eggermont and Roberts, 2004; Eggermont and Roberts, 2012). Tinnitus is a common symptom that is perceived as chronic by 10-15% of adults (Heller, 2003; Henry et al., 2005), 10-20% of whom report that it interferes with their everyday life (Leske, 1981; Quaranta et al., 1996). It is usually described as a ringing noise, though some patients experience a high-pitched whining, hissing or steady tone.

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Intermittent bilateral coherence in physiological and essential hand tremor

Physiological tremor and many of the pathological tremors typically occur in limbs on both the sides of the body, with similar fundamental frequency of the oscillation. This raises the possibility that the contralateral tremors may have a common source or are otherwise coupled. To confirm such coupling, however, it is necessary to systematically assess the dependence of the two tremor oscillations. This is commonly done by coherence analysis, which has been used in the previous literature to quantify kinematic (Marsden et al.

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Identification of Fhit as a post-transcriptional effector of Thymidine Kinase 1 expression

Publication date: Available online 14 January 2017
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Daniel L. Kiss, Catherine E. Waters, Iman M. Ouda, Joshua C. Saldivar, Jenna R. Karras, Zaynab A. Amin, Seham Mahrous, Teresa Druck, Ralf A. Bundschuh, Daniel R. Schoenberg, Kay Huebner
FHIT is a genome caretaker gene that is silenced in >50% of cancers. Loss of Fhit protein expression promotes accumulation of DNA damage, affects apoptosis and epithelial-mesenchymal transition, though molecular mechanisms underlying these alterations have not been fully elucidated. Initiation of genome instability directly follows Fhit loss and the associated reduced Thymidine Kinase 1 (TK1) protein expression. The effects on TK1 of Fhit knockdown and Fhit induction in the current study confirmed the role of Fhit in regulating TK1 expression. Changes in Fhit expression did not impact TK1 protein turnover or transcription from the TK1 promoter, nor steady-state levels of TK1 mRNA or turnover. Polysome profile analysis showed that up-regulated Fhit expression resulted in decreased TK1 RNA in non-translating messenger ribonucleoproteins and increased ribosome density on TK1 mRNA. Fhit does not bind RNA but its expression increased luciferase expression from a transgene bearing the TK1 5′-UTR. Fhit has been reported to act as a scavenger decapping enzyme, and a similar result with a mutant (H96) that binds but does not cleave nucleoside 5′,5′-triphosphates suggests the impact on TK1 translation is due to its ability to modulate the intracellular level of cap-like molecules. Consistent with this, cells expressing Fhit mutants with reduced activity toward cap-like dinucleotides exhibit DNA damage resulting from TK1 deficiency, whereas cells expressing wild-type Fhit or the H96N mutant do not. The results have implications for the mechanism by which Fhit regulates TK1 mRNA, and more broadly, for its modulation of multiple functions as tumor suppressor/genome caretaker.

Graphical abstract

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Intermittent bilateral coherence in physiological and essential hand tremor

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Publication date: Available online 14 January 2017
Source:Clinical Neurophysiology
Author(s): Soma Chakraborty, Jana Kopecká, Otakar Šprdlík, Martina Hoskovcová, Olga Ulmanová, Evžen Růžička, Martin Zapotocky
[Objective]To investigate the prevalence and the temporal structure of bilateral coherence in physiological (PT) and essential (ET) hand tremor.[Methods]Triaxial accelerometric recordings from both hands in 30 healthy subjects and 34 ET patients were analyzed using spectral coherence and wavelet coherence methods. In 12 additional healthy subjects, the relation between the hand tremor and the chest wall acceleration was evaluated using partial coherence analysis.[Results]The majority of both PT and ET subjects displayed significant bilateral coherence. While in PT, bilateral coherence was most frequently found in resting hand position (97% of subjects), in ET the prevalence was comparable for resting (54%) and postural (49%-57%) positions. In both PT and ET, epochs of strong coherence lasting several to a dozen seconds were separated by intervals of insignificant coherence. In PT, bilateral coherence at the main tremor frequency (8-12 Hz) was coupled with the ballistocardiac rhythm.[Conclusion]The oscillations of the two hands are intermittently synchronized in both PT and ET. We propose that in postural PT, bilateral coherence at the main tremor frequency arises from transient simultaneous entrainment of the left and right hand oscillations to ballistocardiac forcing.[Significance]Bilateral coherence of hand kinematics provides a sensitive measure of synchronizing influences on the left and right tremor oscillators.



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Lateralization of Language Function in Epilepsy Patients: A High-Density Scalp-Derived Event-Related Potentials (ERP) Study

Epilepsy surgery offers an effective and safe treatment option for patients with medically refractory seizure disorders and leads to seizure freedom in 60-80% of patients. The goals of epilepsy surgery are on one hand to remove the epileptogenic zone, giving seizure freedom, but also to avoid causing neuropsychological deficits such as language or memory dysfunction (Binder et al., 2008; Sabsevitz et al., 2003). Thus, the accurate localization of essential brain regions, which are responsible for language and memory, as well as vision and motor function, is of the utmost importance.

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Hemotherapy algorithm for the management of trauma-induced coagulopathy: the German and European perspective.

Purpose of review: This review presents a synopsis of best current knowledge with reference to the updated German and European guidelines and recommendations on the management of severe trauma hemorrhage and trauma-induced coagulopathy as well as a viscoelastic-based treatment algorithm based upon international expert consensus to trigger the administration of hemostatic agents and blood products. Recent findings: Uncontrolled hemorrhage and trauma-induced coagulopathy are the major causes for preventable death after trauma and early detection and aggressive management have been associated with improved outcomes. However, best practice to treat this newly defined entity is still under debate. In the acute phase, the clinical management usually follows the 'Damage Control Resuscitation' concept, which advocates the empiric administration of blood products in predefined and fixed ratios. As an alternative, several European but also a few US trauma centers have instituted the concept of 'Goal-directed Coagulation Therapy' based upon results obtained from early point-of-care viscoelastic testing. Summary: Current guidelines urge for the implementation of evidence-based local protocols and algorithms including clinical quality and safety management systems together with parameters to assess key measures of bleeding control and outcome. Copyright (C) 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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