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Mackenzie Graham, Colin P Doherty, Lorina Naci
Robust prognostic indicators of neurological recovery are urgently needed for acutely comatose patients. Functional neuroimaging is a highly sensitive tool for uncovering covert cognition and awareness in behaviorally nonresponsive patients with prolonged disorders of consciousness, and may be applicable to acutely comatose patients. Establishing a link between early detection of covert awareness in acutely comatose patients and eventual recovery of function could have significant implications for patient prognosis, treatment, and end-of-life decisions...
October 2018: Seminars in Neurology
Spencer Septien, Michael A Rubin
Consciousness defines our humanity more than any other biologic phenomena that a clinician might be called upon to examine, diagnose, or treat. When family comes to the bedside of a patient, they hope to find them talking, thinking, and feeling. The complexity of consciousness allows an expansive gradation of dysfunction such that we must consider numerous potential insults, possible interventions, and often an unknown likelihood of recovery. As value-laden questions are more often in the hands of surrogate decision makers, the neurologist is given the herculean task of not only diagnosing and treating alterations of consciousness but also predicting the likely course of the disease to empower surrogates to make a choice most consistent with the preferences of the patient...
October 2018: Seminars in Neurology
Emmanuel Bugarin-Estrada, Andrés Gómez-De León, Yadith Karina López-García, Erik Alejandro Díaz-Chuc, José Manuel Priesca-Marín, Guillermo J Ruiz-Argüelles, José Carlos Jaime-Pérez, David Gómez-Almaguer
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a hematologic disease that can be fatal if not treated early. We aimed to describe the clinical characteristics of Mexican patients with idiopathic TTP. STUDY DESIGN AND METHODS: We conducted a retrospective study, including all adult patients diagnosed with idiopathic TTP from 2011 to 2017 in two Mexican centers. We further compared our results with the published literature. RESULTS: Twenty patients were included; 70% were female, with a median age of 38...
October 15, 2018: Journal of Clinical Apheresis
Mora A Reinka, Colin Wayne Leach
As race acts as a social frame of reference, it should guide individual's appraisal of visual representations of social events and issues. Thus, grounded in Scherer's (2009) model of appraisal as a sequential process, in 2 experiments (N = 133, 166) we used early event-related potentials (ERPs) of brain activity (the N100, P200, P300) to examine Black and White participants' appraisals of the novelty of images of police force against Black (and White) targets, as well as of Black-led protest. We used a later ERP (the late positive potential, LPP) as well as blood pressure to assess their appraisal of motivational relevance, and self-reported affect and emotion to assess conscious experience...
November 2018: Journal of Personality and Social Psychology
Trung P Nguyen, Jeff Schaffert, Christian LoBue, Kyle B Womack, John Hart, C Munro Cullum
BACKGROUND: Traumatic brain injury (TBI) with loss of consciousness (LOC) has been associated with earlier onset of mild cognitive impairment, frontotemporal dementia, Parkinson's disease, and Alzheimer's disease (AD), but has not been examined as a risk factor for earlier onset of dementia with Lewy bodies (DLB). OBJECTIVE: The purpose of this study was to assess the association between a history of TBI and the age of onset of DLB. METHOD: Data from 576 subjects with a clinical diagnosis of DLB were obtained from the National Alzheimer's Coordinating Center (NACC)...
October 6, 2018: Journal of Alzheimer's Disease: JAD
Richard K J Brown, Sean Petty, Stephanie O'Malley, Jadranka Stojanovska, Matthew S Davenport, Ella A Kazerooni, Daniel Fessahazion
Magnetic resonance imaging (MRI) is an extremely useful tool for the detection and characterization of numerous pathologic processes. Although patients can benefit from the use of MRI, claustrophobia is a major issue in some cases. This fear alone can lead to cancellation of the scanning procedure in some cases and the need for conscious sedation in others. Patient anxiety during the scan can also lead to increased motion-related artifacts on the images with associated degradation of the diagnostic quality of the study...
September 2018: Tomography: a Journal for Imaging Research
Wen-Chin Weng, Jung-Chih Chen, Chia-Yen Lee, Chia-Wei Lin, Wang-Tso Lee, Jeng-Yi Shieh, Chia-Chen Wang, Ching-Cheng Chuang
Duchenne muscular dystrophy (DMD) is an X-linked debilitating muscular disease that may decrease nitric oxide (NO) production and lead to functional muscular ischemia. Currently, the 6-minute walk test (6-MWT) and the North Star Ambulatory Assessment (NSAA) are the primary outcome measures in clinical trials, but they are severely limited by the subjective consciousness and mood of patients, and can only be used in older and ambulatory boys. This study proposed using functional near-infrared spectroscopy (fNIRS) to evaluate the dynamic changes in muscle hemodynamic responses (gastrocnemius and forearm muscle) during a 6-MWT and a venous occlusion test (VOT), respectively...
October 1, 2018: Biomedical Optics Express
Lucía Jáñez-García, Enrique Mencía-Gutiérrez, Esperanza Gutiérrez-Díaz, Luis F Moreno-García-Rubio, Laura Zarratea-Herreros, Álvaro Bengoa-González, Silvia Pérez-Trigo
Penetrating injuries of the cranium are relatively uncommon, only 0.4% of all head injuries. In patients with disturbed conscious level, an extensive examination should be performed in the emergency unit to rule out transorbital penetrating brain injury. A 25-year-old male was attacked with a dagger. He presented with ethylic intoxication and the physical examination demonstrated a small skin injury on the lateral canthus of the left eye with a large periocular hematoma which prevented eyelid opening. Cranial CT scan showed a metallic intraorbital foreign body consisting of a fragment of a dagger which perforated the eyeball, and penetrated through the superomedial wall of the orbit into the anterior cranial fossa...
2018: Case Reports in Ophthalmological Medicine
Daniel Kondziella, Anne Marie Jensen, Thomas Hjuler, Michael Bille, Jesper Kjaergaard
Background: Non-invasive, easy-to-use bedside tools to estimate prognosis in unresponsive patients with postanoxic brain injury are needed. We assessed the usefulness of otoacoustic emissions as outcome markers after cardiac arrest. Methods: Distortion product otoacoustic emissions (DPOAE) and transient evoked otoacoustic emissions (TEOAE) were measured in cardiac arrest patients whose prognosis was deemed to be poor following standard neurological assessment ( n = 10). Ten patients with myocardial infarction without prior loss of consciousness served as controls...
2018: Frontiers in Neurology
Michał Bola, Paweł Orłowski, Karolina Baranowska, Michael Schartner, Artur Marchewka
Brain signal diversity constitutes a robust neuronal marker of the global states of consciousness. It has been demonstrated that, in comparison to the resting wakefulness, signal diversity is lower during unconscious states, and higher during psychedelic states. A plausible interpretation of these findings is that the neuronal diversity corresponds to the diversity of subjective conscious experiences. Therefore, in the present study we varied an information rate processed by the subjects and hypothesized that greater information rate will be related to richer and more differentiated phenomenology and, consequently, to greater signal diversity...
2018: Frontiers in Psychology
Matthew John Mellor
With the publication of Wilfred Bion's text 'Learning from Experience,' psychoanalysis was afforded a new schema for understanding the processes and implications involved in an infant's contact with their caregivers. As a result, our conception of some of the most fundamental phenomena of psychic life was significantly enriched. By proposing his theory of alpha-functioning, Bion mapped out how meaningful connexions to the internal and external worlds become established in the mind. In contrast, and through working clinically with psychotic patients, Bion revealed how these ties can catastrophically come undone...
2018: Frontiers in Psychology
Boban Simonovic, Edward J N Stupple, Maggie Gale, David Sheffield
Stress pervades everyday life and impedes risky decision making. The following experiment is the first to examine effects of stress on risky decision making in the Iowa Gambling Task (IGT), while measuring inspection time and conscious awareness of deck contingencies. This was original as it allowed a fine grained rigorous analysis of the way that stress impedes awareness of, and attention to maladaptive financial choices. The extended Cognitive Reflection Task (CRT) further afforded examination of the impact of impaired reflective thinking on risky decision making...
2018: Frontiers in Behavioral Neuroscience
Dileep P Chandrasekhar, Mohan L Noone, S P Harish Babu, V T Chandra Bose
We report a case of high-voltage electrical injury to scalp, focusing on the magnetic resonance imaging (MRI) findings in brain. A 51-year-old male suffered burns to the right side of scalp and loss of consciousness following electric shock. Brain abnormalities were detected on MRI taken 4 days after the insult. Right parietal lobe neuroparenchyma beneath the scalp burn defect demonstrated homogeneous hypointensity on T1-weighted MR images, while T2-weighted images depicted hyperintensity mainly in white matter forming finger-like projections...
July 2018: Indian Journal of Radiology & Imaging
Eunice Ho, Stephanie Hc Cheung, Michael Denton, Brian Dh Kim, Fraser Stephenson, Joyce Ching, Karl Boyle, Sandy Lyeo, Nancy M Salbach
BACKGROUND: Early mobilization (EM) post-stroke is recommended; however, the ideal timing and nature of EM, and factors that may influence EM practice are unclear. OBJECTIVES: The primary objective was to describe the type and extent of mobilization 0-48 h post-stroke admission to acute hospital care. A secondary objective was to evaluate whether pre-stroke functional level, stroke severity, tissue plasminogen activator (tPA) administration, and level of consciousness (LOC) predicted any passive, any active, and out-of-bed mobilization (i...
October 15, 2018: Topics in Stroke Rehabilitation
Tarandeep Oberai, Maggie Killington, Kate Laver, Maria Crotty, Ruurd Jaarsma
ABSTRACTBackground:Delirium is a complex clinical syndrome characterized by disturbed consciousness, cognitive function, or perception and associated with serious adverse outcomes such as death, dementia, and the need for long-term care. However, recognition and management of delirium is poorly prioritized even though it is the most frequent complication among patients undergoing surgery following hip fracture. The aim of this study was to understand clinicians' from orthopedic speciality perceptions in relation to recognition, diagnosis, and management of delirium...
October 15, 2018: International Psychogeriatrics
Ming Y Lim, Charles S Greenberg
Over the next decade, there is a predicted shortage of nonmalignant hematologist to maintain the workforce in the United States. To address this, the American Society of Hematology described the creation of the healthcare systems-based hematologist (SBH). The role of SBH has the potential to provide high-value, cost-conscious care to the healthcare system. In 2011, an Anticoagulation and Bleeding Management Medical Directorship position for a SBH was created at our healthcare system. We described our 6-year experience as SBH at a 750-bed tertiary academic medical center to improve clinical outcomes while reducing costs...
October 13, 2018: Journal of Thrombosis and Thrombolysis
Hakimeh Abdoli, Tabandeh Sadeghi, Majid Kazemi
Background Poisoning with methadone is considered dangerous and fatal, which can lead to decreased consciousness, coma, apnea and eventually death. Aims The present study was conducted to evaluate the effect of educating the clients of rehabilitation (rehab) centers on the frequency of methadone poisoning among children. Methods In the present semi-experimental study, the study population included all of the clients referred to the rehab centers in an urban area of Iran who received treatment with methadone...
October 15, 2018: International Journal of Adolescent Medicine and Health
Jean-Marie Berthelot, Julien Nizard, Yves Maugars
In medicine, the positive Hawthorne effect is defined as decreased symptom expression due to being observed. This effect occurs in addition to the decrease in symptom experience due to the placebo effect. Symptom overexpression, in contrast, whether related to conscious or to unconscious factors, defines the negative Hawthorne effect, which should be distinguished from the nocebo effect, defined as an increase in symptom experience. For instance, the negative Hawthorne effect can result in patients who seem fully relaxed evaluating their pain intensity at 11 on a 10-point scale...
October 11, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Ignacio Niizawa, Brenda Y Espinaco, Susana E Zorrilla, Guillermo A Sihufe
Nowadays, consumers are more conscious about healthier products consumption benefits. Astaxanthin obtained from the microalgae Haematococcus pluvialis represents a natural ingredient for the nutraceutical and functional food industries. It is claimed that astaxanthin has much stronger antioxidant activity than vitamin E and β-carotene, providing different health benefits. However, the unstable structure of the molecule limits its application in functional foods development. Therefore, the present study evaluates the effect of five independent formulation and process variables for natural astaxanthin oleoresin encapsulation using an external ionic gelation technique...
October 11, 2018: International Journal of Biological Macromolecules
Susan L Prescott, Alan C Logan
The term planetary health - denoting the interconnections between the health of person and place at all scales - emerged from the environmental and holistic health movements of the 1970-80s; in 1980, Friends of the Earth expanded the World Health Organization definition of health, stating: "health is a state of complete physical, mental, social and ecological well-being and not merely the absence of disease - personal health involves planetary health". By the 1990s, the concept of planetary health was part of the fabric of integrative medicine; more recently, after the 2015 Lancet Commission on Planetary Health report, the concept has penetrated mainstream academic and medical discourse...
September 11, 2018: Explore: the Journal of Science and Healing
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