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Ching-Chang Chen, Chi-Tung Cheng, Po-Chuan Hsieh, Chun-Ting Chen, Yi-Ming Wu, Chien-Hung Chang, Alvin Yi-Chou Wang
BACKGROUND: A ruptured vertebral artery dissecting aneurysm (VADA) with a high clinical grade (Hunt and Hess [H&H] grade V) has a devastating prognosis. Because of the high rebleeding nature and location, the rapid mortality can occur in patients due to brainstem compression. Adjuvant decompression of the posterior fossa (PF) after aneurysm secured might improve the outcomes of these patients. METHODS: Between January 2011 and December 2016, 22 patients who presented with H&H Gr...
August 7, 2018: World Neurosurgery
Lihong Chen, Congying Qiao, Ying Wang, Yi Jiang
Visual size perception is highly context-dependent. In a series of experiments reported here, we demonstrated that the contextual modulation of visual size processing could occur independent of conscious awareness. Specifically, the Ebbinghaus illusion, which is mediated by lateral connections within the early visual processing stream, persisted even when the surrounding inducers were rendered invisible. Moreover, when the central target was initially interocularly suppressed, the identical target emerged from suppression faster when surrounded by small relative to large inducers, with the suppression time difference well predicted by the strength of the illusion...
August 7, 2018: Cognition
Seon-Young Kim, Jae-Min Kim, Sung-Wan Kim, Eun-Song Kim, Hee-Ju Kang, Ju-Yeon Lee, Kyung-Yeol Bae, Il-Seon Shin, Jin-Sang Yoon
OBJECTIVE: This study compared phenotypes of diurnal fluctuation among different delirium subtypes using a prospective design. METHODS: The motor subtypes of delirium patients were determined using the Delirium Motor Subtype Scale (DMSS), fluctuations in consciousness levels were monitored with the Richmond Agitation-Sedation Scale (RASS), and symptom severity was assessed with the Nursing Delirium Screening Scale (Nu-DESC). All scales were administered at three timepoints over 24 h; fluctuations in and phenotypes of symptoms were compared according to subtype of delirium using repeated-measures analysis of variance after adjustment for covariates...
August 7, 2018: Journal of Pain and Symptom Management
Nader Rajaei, Naoya Aoki, Haruka K Takahashi, Tetsu Miyaoka, Takanori Kochiyama, Masahiro Ohka, Norihiro Sadato, Ryo Kitada
Humans are adept at perceiving textures through touch. Previous neuroimaging studies have identified a distributed network of brain regions involved in the tactile perception of texture. However, it remains unclear how nodes in this network contribute to the tactile awareness of texture. To examine the hypothesis that such awareness involves the interaction of the primary somatosensory cortex with higher order cortices, we conducted a functional magnetic resonance imaging (fMRI) study utilizing the velvet hand illusion, in which an illusory velvet-like surface is perceived between the hands...
August 10, 2018: Human Brain Mapping
Justin M Gregory, Margaret Lautz, L Merkle Moore, Phillip E Williams, Praveen Reddy, Alan D Cherrington
AIMS: Current therapy fails to emulate rapid (first-phase) insulin release in relation with a meal, a key defect in types 1 and 2 diabetes. We aimed to quantify the pharmacokinetic (PK) and pharmacodynamic (PD) profile of insulin tregopil, an enterically-absorbed insulin analog that restores the normal distribution of insulin between the hepatic portal and peripheral circulations. MATERIALS AND METHODS: The PK and PD profile of insulin tregopil were studied in in overnight-fasted, catheterized, conscious canines using four approaches: 1) equimolar intraportal infusions of tregopil vs...
August 10, 2018: Diabetes, Obesity & Metabolism
Laura D Lewis, Giovanni Piantoni, Robert A Peterfreund, Emad N Eskandar, Priscilla Grace Harrell, Oluwaseun Akeju, Linda S Aglio, Sydney S Cash, Emery N Brown, Eran A Mukamel, Patrick L Purdon
During awake consciousness, the brain intrinsically maintains a dynamical state in which it can coordinate complex responses to sensory input. How the brain reaches this state spontaneously is not known. General anesthesia provides a unique opportunity to examine how the human brain recovers its functional capabilities after profound unconsciousness. We used intracranial electrocorticography and scalp EEG in humans to track neural dynamics during emergence from propofol general anesthesia. We identify a distinct transient brain state that occurs immediately prior to recovery of behavioral responsiveness...
August 10, 2018: ELife
Moujan Mirdamadi
This paper is divided into two parts. First I argue for the existence of a death-conscious culture in Iran, traceable in religious and literary texts, and manifested strongly in the discourse following the Iran-Iraq war. I then look at how this culture influences articulations and experiences of depression as felt by Iranian patients. Adopting a phenomenological perspective and drawing on empirical data, I show how death-consciousness, as a point of cultural divergence between the UK and Iran, can be used to account for some of the phenomenologically significant cultural variations in the experience of depression...
August 9, 2018: Culture, Medicine and Psychiatry
Ben Wisner, Douglas Paton, Eva Alisic, Oliver Eastwood, Cheney Shreve, Maureen Fordham
PURPOSE OF REVIEW: To identify strategies for communicating with youth and children pre- and post-disaster in the context of a broader survey of child participation in disaster risk reduction as well as methods for communication with children. RECENT FINDINGS: Youth and children are capable of peer and community education and activism concerning disaster issues and such participation benefits the young actors. Family and sibling support are important in easing the impact of trauma on children...
August 9, 2018: Current Psychiatry Reports
Akiko Miki, Masashi Fujihara, Akiko Yoshida, Makoto Nakamura, Atsushi Azumi
Purpose: To report a rare case of bilateral periphlebitis associated with a pineal germinoma. Observations: A 17-year-old male teenager presented at a local clinic complaining of blurred vision in both eyes. The treating physician identified bilateral uveitis, and prescribed the patient with a local steroid treatment. However, the inflammatory findings did not improve with the treatment, and the patient was referred to our hospital for further examination. At the first visit, his best-corrected visual acuities were 0...
September 2018: American Journal of Ophthalmology Case Reports
Stefanos Karamaroudis, Aliki Stamou, Stamatia C Vorri, Paraskevas Gkolfakis, Vasilios Papadopoulos, Georgios Tziatzios, Aikaterini Karagouni, Panagiota Katsouli, George D Dimitriadis, Konstantinos Triantafyllou
Background: We monitor colonoscopy service quality biannually, by measuring sedation administration, colonoscopy completion, adenoma detection and early complications rates (CR). We herein present our audit results for the years 2013 and 2015. Methods: In our endoscopy facility, five rotating senior gastroenterologists perform colonoscopies, on a daily basis. We measured the quality indicators in three cohorts: A, intention for total colonoscopy cases; B, cohort A excluding bowel obstruction cases; C, colorectal cancer (CRC) screening cases...
July 2018: Annals of Translational Medicine
Yue Cui, Ming Song, Darren M Lipnicki, Yi Yang, Chuyang Ye, Lingzhong Fan, Jing Sui, Tianzi Jiang, Jianghong He
Evidence suggests that disruptions of the posteromedial cortex (PMC) and posteromedial corticothalamic connectivity contribute to disorders of consciousness (DOCs). While most previous studies treated the PMC as a whole, this structure is functionally heterogeneous. The present study investigated whether particular subdivisions of the PMC are specifically associated with DOCs. Participants were DOC patients, 21 vegetative state/unresponsive wakefulness syndrome (VS/UWS), 12 minimally conscious state (MCS), and 29 healthy controls...
2018: NeuroImage: Clinical
María Del Rocío Cantero, Cecilia Villa Etchegoyen, Paula L Perez, Noelia Scarinci, Horacio F Cantiello
Microtubules (MTs) are long cylindrical structures of the cytoskeleton that control cell division, intracellular transport, and the shape of cells. MTs also form bundles, which are particularly prominent in neurons, where they help define axons and dendrites. MTs are bio-electrochemical transistors that form nonlinear electrical transmission lines. However, the electrical properties of most MT structures remain largely unknown. Here we show that bundles of brain MTs spontaneously generate electrical oscillations and bursts of electrical activity similar to action potentials...
August 9, 2018: Scientific Reports
Lili Aslostovar, Allison L Boyd, Mohammed Almakadi, Tony J Collins, Darryl P Leong, Rommel G Tirona, Richard B Kim, Jim A Julian, Anargyros Xenocostas, Brian Leber, Mark N Levine, Ronan Foley, Mickie Bhatia
We completed a phase 1 dose-escalation trial to evaluate the safety of a dopamine receptor D2 (DRD2) antagonist thioridazine (TDZ), in combination with cytarabine. Thirteen patients 55 years and older with relapsed or refractory acute myeloid leukemia (AML) were enrolled. Oral TDZ was administered at 3 dose levels: 25 mg (n = 6), 50 mg (n = 4), or 100 mg (n = 3) every 6 hours for 21 days. Intermediate-dose cytarabine was administered on days 6 to 10. Dose-limiting toxicities (DLTs) included grade 3 QTc interval prolongation in 1 patient at 25 mg TDZ and neurological events in 2 patients at 100 mg TDZ (gait disturbance, depressed consciousness, and dizziness)...
August 14, 2018: Blood Advances
Mila C Kundu, Liz R Gore, Sean Maguire, Aidan G Gilmartin
Hydroxyurea induces production of fetal hemoglobin (HbF), a tetramer of α and γ globin proteins and corresponding hememolecules, normally found in less than 1% of adult RBC. Increases in circulating HbF are correlated with clinical improvementof patients with hemoglobinopathies, and hydroxyurea, as a daily medication, is the standard treatment for sickle cell anemia.Although olive baboons (Papio anubis) are considered a key model species for HbF induction, cynomolgus macaques (Macacafasicularis) are another species that conserves the ability to produce HbF into maturity...
August 9, 2018: Comparative Medicine
Arnaud Pellerin, Clémence Marois, Nicolas Mezouar, Karima Mokhtari, Delphine Leclercq, Bruno Law-Ye
Background Magnetic resonance imaging abnormalities in hemiplegic migraine have been described previously but were limited to a cortical thickening and biphasic alternation of hypoperfusion and hyperperfusion. Our report reveals possible blood-brain barrier disruption during migraine. Case We present the first demonstrated case of regressive diffuse hemispheric cortical enhancement in sporadic hemiplegic migraine, with histological correlation revealing neuronal lesions similar to ischemic lesions. This is probably due to the severity of the attack as indicated by the left hemiplegia and transient altered consciousness in our 43-year-old male patient...
August 9, 2018: Cephalalgia: An International Journal of Headache
Matthew J Miller, Brian TaeHyuk Keum, Christina J Thai, Yun Lu, Nancy N Truong, Gloria A Huh, Xu Li, Jeffrey G Yeung, Lydia HaRim Ahn
Although racism persists as a significant public health issue that adversely impacts the mental health of people of color (U.S. Department of Health and Human Service, 2001), there has been very little systematic guidance for mental health professionals to address racism through practice (S. Harrell, 2000). Therefore, we conducted a content analysis of the peer reviewed counseling psychology literature-the first of its kind-to provide a summary and critique of the extant practice recommendations and facilitate the development and enhancement of practice efforts aimed at addressing racism...
August 9, 2018: Journal of Counseling Psychology
Heath Sl Adams, Srikkumar Ashokkumar, Andrew Newcomb, Andrew I MacIsaac, Robert J Whitbourn, Sonny Palmer
Severe aortic stenosis (AS) is the most common form of valvular heart disease in the developed world with a rising prevalence due to an ageing Australian population. Transcatheter aortic valve implantation (TAVI) offers a less invasive option for the treatment of severe AS with evidence supporting of TAVI compared to medical therapy in inoperable patients, and superior to surgical aortic valve replacement (SAVR) in high-risk patients. Equal outcomes have been observed in all-comer intermediate risk populations...
August 8, 2018: Internal Medicine Journal
James R Riehl, Ben J Palanca, ShiNung Ching
Characterizing anesthesia-induced alterations to brain network dynamics provides a powerful framework to understand the neural mechanisms of unconsciousness. To this end, increased attention has been directed at how anesthetic drugs alter the functional connectivity between brain regions as defined through neuroimaging. However, the effects of anesthesia on temporal dynamics at functional network scales is less well understood. Here, we examine such dynamics in view of the free-energy principle, which postulates that brain dynamics tend to promote lower energy (more organized) states...
2018: Network neuroscience
Joseph J Fins, James L Bernat
This essay complements the scientific and practice scope of the American Academy of Neurology Guideline on Disorders of Consciousness by providing a discussion of the ethical, palliative, and policy aspects of the management of this group of patients. We endorse the renaming of "permanent" vegetative state to "chronic" vegetative state given the increased frequency of reports of late improvements but suggest that further refinement of this class of patients is necessary to distinguish late recoveries from patients who were misdiagnosed or in cognitive-motor dissociation...
August 8, 2018: Neurology
Joseph T Giacino, Douglas I Katz, Nicholas D Schiff, John Whyte, Eric J Ashman, Stephen Ashwal, Richard Barbano, Flora M Hammond, Steven Laureys, Geoffrey S F Ling, Risa Nakase-Richardson, Ronald T Seel, Stuart Yablon, Thomas S D Getchius, Gary S Gronseth, Melissa J Armstrong
OBJECTIVE: To update the 1995 American Academy of Neurology (AAN) practice parameter on persistent vegetative state and the 2002 case definition on minimally conscious state (MCS) and provide care recommendations for patients with prolonged disorders of consciousness (DoC). METHODS: Recommendations were based on systematic review evidence, related evidence, care principles, and inferences using a modified Delphi consensus process according to the AAN 2011 process manual, as amended...
August 8, 2018: Neurology
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