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https://www.readbyqxmd.com/read/27896706/anesthetics-and-outcome-in-status-epilepticus-a-matched-two-center-cohort-study
#1
Raoul Sutter, Gian Marco De Marchis, Saskia Semmlack, Peter Fuhr, Stephan Rüegg, Stephan Marsch, Wendy C Ziai, Peter W Kaplan
BACKGROUND: The use of anesthetics has been linked to poor outcome in patients with status epilepticus (SE). This association, however, may be confounded, as anesthetics are mostly administered in patients with more severe SE and critical illnesses. OBJECTIVE: To minimize treatment-selection bias, we assessed the association between continuously administered intravenous anesthetic drugs (IVADs) and outcome in SE patients by a matched two-center study design. METHODS: This cohort study was performed at the Johns Hopkins Bayview Medical Center, Baltimore, MD, USA and the University Hospital Basel, Basel, Switzerland...
November 29, 2016: CNS Drugs
https://www.readbyqxmd.com/read/27879519/use-of-the-wattbike-cycle-ergometer-for-attenuation-of-bilateral-pedaling-asymmetry-in-trained-cyclists
#2
David T Kell, Beau Kjerulf Greer
Experienced cyclists typically pedal with a 5-20% bilateral asymmetry in regards to power output. The aim of this study was to determine if visual feedback via the Wattbike cycle ergometer is an effective tool in reducing bilateral pedaling asymmetry in trained cyclists. Twelve subjects completed three 10-minute cycling trials on the Wattbike at a power output consistent with 60% VO2 peak. The three trials consisted of a baseline (BASE) trial in which cyclists pedaled without instruction, a conscious control (CC) trial during which cyclists attempted to pedal symmetrically, and another trial in which cyclists attempted to pedal symmetrically while utilizing visual feedback (VF) of their bilateral power outputs (%) via the Wattbike...
May 19, 2016: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/27857682/functional-connectivity-substrates-for-tdcs-response-in-minimally-conscious-state-patients
#3
Carlo Cavaliere, Marco Aiello, Carol Di Perri, Enrico Amico, Charlotte Martial, Aurore Thibaut, Steven Laureys, Andrea Soddu
Transcranial direct current stimulation (tDCS) is a non-invasive technique recently employed in disorders of consciousness, and determining a transitory recovery of signs of consciousness in almost half of minimally conscious state (MCS) patients. Although the rising evidences about its possible role in the treatment of many neurological and psychiatric conditions exist, no evidences exist about brain functional connectivity substrates underlying tDCS response. We retrospectively evaluated resting state functional Magnetic Resonance Imaging (fMRI) of 16 sub-acute and chronic MCS patients (6 tDCS responders) who successively received a single left dorsolateral prefrontal cortex (DLPFC) tDCS in a double-blind randomized cross-over trial...
2016: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/27829654/minimally-conscious-state-evolution-of-concept-diagnosis-and-treatment
#4
Ricardo Hodelín-Tablada
The study of consciousness disorders is a scientific challenge, and clinical differentiation among the various sorts of alterations in consciousness is difficult. Persistent vegetative state was defined in 1972, but years later cases appeared in which diagnosed patients showed signs of cognitive activity, and therefore could not be considered vegetative. Minimally conscious state was defined in 2002. This article discusses minimally conscious state based on a literature review and the author's clinical experience...
October 2016: MEDICC Review
https://www.readbyqxmd.com/read/27812319/evaluating-the-effect-of-repetitive-transcranial-magnetic-stimulation-on-disorders-of-consciousness-by-using-tms-eeg
#5
Yang Bai, Xiaoyu Xia, Jiannan Kang, Xiaoxiao Yin, Yi Yang, Jianghong He, Xiaoli Li
Background: The modulation efficacy of Transcranial magnetic stimulation (TMS) on consciousness improvement of patient with disorder of consciousness (DOC) has not been definitely confirmed. Objective: This study proposes TMS-EEG to assess effects of repetitive TMS (rTMS) on brain modulation of DOC. Methods: Twenty sessions of 10 Hz rTMS were applied over the dorsolateral prefrontal cortex for a patient with DOC. Measures of Coma Recovery Scale-Revised (CRS-R) score, TMS-evoked potential (TEP), perturbation complexity index (PCI), and global mean field power (GMFP) were used to evaluate the consciousness level of the patient at three intervals: before the rTMS protocol (T0), immediately after one session rTMS (T1), and immediately after 20 sessions (T2)...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27810793/testing-the-significance-of-connectivity-networks-comparison-of-different-assessing-procedures
#6
Jlenia Toppi, Donatella Mattia, Monica Risetti, Rita Formisano, Fabio Babiloni, Laura Astolfi
: Despite the well-established use of partial directed coherence (PDC) to estimate interactions between brain signals, the assessment of its statistical significance still remains controversial. Commonly used approaches are based on the generation of empirical distributions of the null case, implying a considerable computational time, which may become a serious limitation in practical applications. Recently, rigorous asymptotic distributions for PDC were proposed. The aim of this work is to compare the performances of the asymptotic statistics with those of an empirical approach, in terms of both accuracy and computational time...
December 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27794486/changes-in-standard-eeg-parallel-consciousness-improvement-in-patients-with-unresponsive-wakefulness-syndrome
#7
Sergio Bagnato, Cristina Boccagni, Caterina Prestandrea, Alexander A Fingelkurts, Andrew A Fingelkurts, Giuseppe Galardi
OBJECTIVE: To identify changes in the standard electroencephalograms (EEGs) of patients with unresponsive wakefulness syndrome (UWS) who did or did not recover consciousness 6 months after admission to a rehabilitation department. DESIGN: Prospective cohort study. SETTING: Unit for Severe Acquired Brain Injuries. PARTICIPANTS: Twenty-eight consecutive patients with UWS. INTERVENTIONS: Not applicable...
October 26, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27793075/does-modafinil-improve-the-level-of-consciousness-for-people-with-a-prolonged-disorder-of-consciousness-a-retrospective-pilot-study
#8
Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose, Peter Watson, Agnes Shiel
BACKGROUND AND AIM: Modafinil is best known as a sleep regulator among healthy individuals, but studies suggest that it reduces excessive daytime sleepiness in patients with brain injury. This retrospective pilot study evaluated the effectiveness of Modafinil for people with a prolonged disorder of consciousness and whether those with a traumatic brain injury did better than those with a non-traumatic brain injury. METHOD: Twenty four prolonged disorder of consciousness patients who were prescribed Modafinil, were assessed at least four times both before and during treatment...
October 28, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27791428/cpr-induced-consciousness-during-out-of-hospital-cardiac-arrest-a-case-report-on-an-emerging-phenomenon
#9
Joshua Pound, P Richard Verbeek, Sheldon Cheskes
BACKGROUND: High quality cardiopulmonary resuscitation (CPR) has produced a relatively new phenomenon of consciousness in patients with vital signs absent. Further research is necessary to produce a viable treatment strategy during and post resuscitation. OBJECTIVE: To provide a case study done by paramedics in the field illustrating the need for sedation in a patient whose presentation was consistent with CPR induced consciousness. Resuscitative challenges are provided as well as potential future treatment options to minimize harm to both patients and prehospital providers...
October 28, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27788615/the-impact-of-prolonged-disorders-of-consciousness-on-the-occupational-life-of-family-members
#10
Karen Elliott, Andrew McVicar
The impact of vegetative state (VS) and minimally conscious states (MCSs) on an individual is devastating. VS and MCSs may be transitional towards recovery, but may become permanent. Although devastating for the individual the nature of these conditions also has a profound effect on the family. This study examined the impact on the family member and the changes in the individuals' occupation. Six participants (spouses, partners or parents) were recruited to the study. Mixed methods were adopted to meet the requirements of the research and participants...
October 27, 2016: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/27780215/return-to-work-a-cut-off-of-fim-gain-with-montebello-rehabilitation-factor-score-in-order-to-identify-predictive-factors-in-subjects-with-acquired-brain-injury
#11
Marco Franceschini, Maria Pia Massimiani, Stefano Paravati, Maurizio Agosti
Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients...
2016: PloS One
https://www.readbyqxmd.com/read/27773729/do-you-see-me-the-role-of-visual-fixation-in-chronic-disorders-of-consciousness-differential-diagnosis
#12
Antonino Naro, Antonino Leo, Antonio Buda, Alfredo Manuli, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Visual fixation (VF) of a target is a possible, although atypical, feature of the Unresponsive Wakefulness Syndrome (UWS). Whether VF may indicate residual awareness in these patients is debatable, since it may simply subtend a series of reflex processes. Objective tools should therefore be used to identify aware VF, which depends on the integrity of visuomotor networks encompassing frontal-parietal-occipital areas. The aim of our study was to detect residual visuomotor network functionality potentially sustaining aware VF...
October 20, 2016: Brain Research
https://www.readbyqxmd.com/read/27770300/cultivating-medical-intentionality-the-phenomenology-of-diagnostic-virtuosity-in-east-asian-medicine
#13
Taewoo Kim
This study examines the perceptual basis of diagnostic virtuosity in East Asian medicine, combining Merleau-Ponty's phenomenology and an ethnographic investigation of Korean medicine in South Korea. A novice, being exposed to numerous clinical transactions during apprenticeship, organizes perceptual experience that occurs between him or herself and patients. In the process, the fledgling practitioner's body begins to set up a medically-tinged "intentionality" interconnecting his or her consciousness and medically significant qualities in patients...
October 21, 2016: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/27770069/electromyographic-decoding-of-response-to-command-in-disorders-of-consciousness
#14
Damien Lesenfants, Dina Habbal, Camille Chatelle, Caroline Schnakers, Steven Laureys, Quentin Noirhomme
OBJECTIVE: To propose a new methodology based on single-trial analysis for detecting residual response to command with EMG in patients with disorders of consciousness (DOC), overcoming the issue of trial dependency and decreasing the influence of a patient's fluctuation of vigilance or arousal over time on diagnostic accuracy. METHODS: Forty-five patients with DOC (18 with vegetative/unresponsive wakefulness syndrome [VS/UWS], 22 in a minimally conscious state [MCS], 3 who emerged from MCS [EMCS], and 2 with locked-in syndrome [LIS]) and 20 healthy controls were included in the study...
October 21, 2016: Neurology
https://www.readbyqxmd.com/read/27765304/transcarotid-transcatheter-aortic%C3%A2-valve%C3%A2-replacement-general-or-local-anesthesia
#15
Nicolas Debry, Cédric Delhaye, Alexandre Azmoun, Ramzi Ramadan, Sahbi Fradi, Philippe Brenot, Arnaud Sudre, Mouhamed Djahoum Moussa, Didier Tchetche, Said Ghostine, Darren Mylotte, Thomas Modine
OBJECTIVES: The study sought to assess the safety and efficacy of a minimally invasive strategy (MIS) (local anesthesia and conscious sedation) compared to general anesthesia (GA) among the largest published cohort of patients undergoing transcarotid transcatheter aortic valve replacement (TAVR). BACKGROUND: Transcarotid TAVR has been shown to be feasible and safe. There is, however, no information pertaining to the mode anesthesia in these procedures. METHODS: Between 2009 and 2014, 174 patients underwent transcarotid TAVR at 2 French centers...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27753928/os-05-03-decreased-rho-kinase-based-calcium-sensitization-in-hypertensive-ren-2-transgenic-rats-tgr
#16
Josef Zicha, Michal Behuliak, Ivana Vaneckova
OBJECTIVE: Comparing BP response to Ca channel opener BAY K8644 prior and after Rho kinase inhibition we demonstrated lowered calcium sensitization in spontaneously hypertensive rats (SHR), although BP response of intact SHR to Rho kinase inhibitor fasudil was enhanced (Behuliak et al. J Hypertens 31:2025,2013). The aim of the present study was to evaluate calcium sensitization in hypertensive TGR and their normotensive HanSD controls using the same methods. We also tried to elucidate the interference of baroreflex-activated sympathetic activity with BP response to fasudil...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27752623/patients-who-leave-the-emergency-department-against-medical-advice
#17
Choung Ah Lee, Joon Pil Cho, Sang Cheon Choi, Hyuk Hoon Kim, Ju Ok Park
OBJECTIVE: Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients. METHODS: We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group...
June 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27748687/update-on-pharmacotherapy-for-stroke-and-traumatic-brain-injury-recovery-during-rehabilitation
#18
Joachim Liepert
PURPOSE OF REVIEW: This article evaluates whether specific drugs are able to facilitate motor recovery after stroke or improve the level of consciousness, cognitive, or behavioral symptoms after traumatic brain injury. RECENT FINDINGS: After stroke, serotonin reuptake inhibitors can enhance restitution of motor functions in depressed as well as in nondepressed patients. Erythropoietin and progesterone administered within hours after moderate to severe traumatic brain injury failed to improve the outcome...
December 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27740600/disorders-of-consciousness-painless-or-painful-conditions-evidence-from-neuroimaging-studies
#19
Francesca Pistoia, Simona Sacco, Janet Stewart, Marco Sarà, Antonio Carolei
The experience of pain in disorders of consciousness is still debated. Neuroimaging studies, using functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), multichannel electroencephalography (EEG) and laser-evoked potentials, suggest that the perception of pain increases with the level of consciousness. Brain activation in response to noxious stimuli has been observed in patients with unresponsive wakefulness syndrome (UWS), which is also referred to as a vegetative state (VS), as well as those in a minimally conscious state (MCS)...
October 8, 2016: Brain Sciences
https://www.readbyqxmd.com/read/27739612/structural-and-functional-connectivity-of-the-precuneus-and-thalamus-to-the-default-mode-network
#20
Samantha I Cunningham, Dardo Tomasi, Nora D Volkow
Neuroimaging studies have identified functional interactions between the thalamus, precuneus, and default mode network (DMN) in studies of consciousness. However, less is known about the structural connectivity of the precuneus and thalamus to regions within the DMN. We used diffusion tensor imaging (DTI) to parcellate the precuneus and thalamus based on their probabilistic white matter connectivity to each other and DMN regions of interest (ROIs) in 37 healthy subjects from the Human Connectome Database. We further assessed resting-state functional connectivity (RSFC) among the precuneus, thalamus, and DMN ROIs...
October 14, 2016: Human Brain Mapping
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