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Heather M O'Leary, Walter E Kaufmann, Katherine V Barnes, Kshitiz Rakesh, Kush Kapur, Daniel C Tarquinio, Nicole G Cantwell, Katherine J Roche, Suzanne A Rose, Alexandra C Walco, Natalie M Bruck, Grace A Bazin, Ingrid A Holm, Mark E Alexander, Lindsay C Swanson, Lauren M Baczewski, Juan M Mayor Torres, Charles A Nelson, Mustafa Sahin
Objective: To measure the efficacy of mecasermin (recombinant human insulin-like growth factor 1, rhIGF-1), for treating symptoms of Rett syndrome (RTT) in a pediatric population using a double-blind crossover study design. Methods: Thirty girls with classic RTT in postregression stage were randomly assigned to placebo or rhIGF-1 in treatment period 1 and crossed over to the opposite assignment for period 2 (both 20 weeks), separated by a 28-week washout period...
March 2018: Annals of Clinical and Translational Neurology
Xinyue Zhang, Lichao Sun, Li Cui, Weihong Lin
Background Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in people with epilepsy. The pathogenesis of SUDEP is still unclear. The majority of SUDEP cases occur in intractable epilepsy, especially in the aftermath of a generalized tonic-clonic seizure. We report an atypical SUDEP case with infrequent seizures in frontal lobe epilepsy. Case Report A 14-year-old girl presented with a 13-year history of paroxysmal convulsions. She experienced three episodes within 6-10 months after birth...
January 1, 2018: Journal of International Medical Research
Valentina Cettolo, Maria Pia Francescato
PURPOSE: A new algorithm is illustrated for the determination of breath-by-breath alveolar gas exchange that neglects the contiguity in time of breaths, i.e. it allows the breaths to be partially superimposed or disjoined in time. METHODS: Traces of oxygen, carbon dioxide fractions, and ventilatory flow were recorded continuously over 20 min in 15 healthy subjects in resting conditions; at 5-min intervals, subjects voluntarily hyperventilated for ~ 30 s to induce abrupt changes in lung gas stores...
March 15, 2018: European Journal of Applied Physiology
Nobuhisa Ishii, Kazuhide Tomita, Shinsuke Suetake, Yukako Okuno, Kenta Kawamura, Reiko Takeshima, Hirotaka Ohse, Shigeyuki Imura
[Purpose] It is unclear whether diaphragmatic breathing (DB) results in lower respiratory muscle oxygen consumption during dynamic exercise. The purpose of this study was to compare oxygen consumption in the respiratory muscles (VO2 rm) with thoracic breathing (TB) and with DB, in healthy males during hyperventilation. [Subjects and Methods] Ten healthy men participated in this study. The subjects sat on a chair with the backrest reclined at an angle of 60 degrees. Respiratory parameters were measured breath by breath, using an expired gas analyzer...
February 2018: Journal of Physical Therapy Science
Michael D Kennedy, Jessie M S Gill, Alastair N H Hodges
Background: Diagnosing Airway hyper-responsiveness (AHR) requires bronchial provocation tests that are performed at rest and after exercise or hyperventilation in either a lab or field setting. Presently, it is unclear whether the proposed AHR field test for swimming induces sufficient provocation due to lack of intensity. Thus we aimed to examine how the 8 minute field swim test compared to all out racing and a lower intensity practice exposure affected AHR. We hypothesized that the race would affect AHR the most thereby highlighting the importance of maximal effort in swim AHR...
June 2017: Journal of Exercise Science and Fitness
Chun-Ting Chen, Hung-Yi Lai, Ting-Wei Chang, Ching-Yi Lee
BACKGROUND: Spontaneous epidural hemorrhage (EDH) is a rare occurrence that may be caused by vascular anomalies, infections, coagulopathies, or tumors. Spontaneous EDH occurring in patients without specific underlying disease has been reported only as intraspinal lesion but has never been demonstrated in the intracranial area. This study presents a 19-year-old patient with repeated spontaneous intracranial EDH caused twice by hysterical crying. CASE DESCRIPTION: The patient had spontaneous left frontal EDH after hysterical crying...
March 9, 2018: World Neurosurgery
S D Yang, P Q Li, Y G Huang, W Li, L Z Ma, L Wu, N Wang, J M Lu, W Q Chen, Guang-Ming Liu, Y M Xiong, Y L Chen, Ying Zhang
Enterovirus A-71 (EV-A71) may be fatal, but the natural history, symptoms, and signs are poorly understood. This study aimed to examine the natural history of fatal EV-A71 infection and to identify the symptoms and signs of early warning of deterioration. This was a clinical observational study of fatal cases of EV-A71 infection treated at five Chinese hospitals between 1 January 2010 and 31 December 2012. We recorded and analysed 91 manifestations of EV-A71 infection in order to identify early prognosis indicators...
March 12, 2018: Epidemiology and Infection
Baraa K Al-Khazraji, Leena N Shoemaker, Joseph S Gati, Trevor Szekeres, J Kevin Shoemaker
The larger intracranial conduit vessels contribute to the total cerebral vascular resistance, and understanding their vasoreactivity to physiological stimuli is required when attempting to understand regional brain perfusion. Reactivity of the larger cerebral conduit arteries remains understudied due to a need for improved imaging methods to simultaneously assess these vessels in a single stimulus. We characterized reactivity of basal intracranial conduit arteries (basilar, right and left posterior, middle and anterior cerebral arteries) and the right and left internal carotid arteries, to manipulations in end-tidal CO2 (PetCO2 )...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
M K Fehrenbach, U Nestler, J Meixensberger, M K Bernhard, A Merkenschlager, S Weise, M Krause
INTRODUCTION: The ciliopathy "Joubert syndrome" was first described in 1969 by Dr. Marie Joubert and most subtypes follow an autosomal recessive inheritance. The complex disorder shows typical clinical features, such as hyperventilation, abnormal eye movements, and retardation. A pathognomonic midbrain-hindbrain malformation, the molar tooth sign, can be found on magnetic resonance imaging of the brainstem. There are a little more than 200 reports of Joubert syndrome in the literature...
March 5, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Dan A Oh, Hyeyun Kim, Eun Kee Bae
BACKGROUND AND PURPOSE: Electroencephalography (EEG) is often used as a screening tool for selecting pilots despite controversy regarding its contribution to aviation safety. We investigated EEG abnormalities in Korean commercial pilot applicants in order to identify the usefulness of EEG screening in this population. METHODS: We retrospectively analyzed the EEG results of 740 unselected pilot applicants who underwent waking EEG at Inha University Hospital from January 2013 to May 2017...
February 28, 2018: Journal of Clinical Neurology
Eline J Vinke, Jens Eyding, Chris de Korte, Cornelis H Slump, Johannes G van der Hoeven, Cornelia W E Hoedemaekers
OBJECTIVE: The aim of this study was to investigate the feasibility of simultaneous visualization of the cerebral macrocirculation and microcirculation, using ultrasound perfusion imaging (UPI). In addition, we studied the sensitivity of this technique for detecting changes in cerebral blood flow (CBF). MATERIALS AND METHODS: We performed an observational study in ten healthy volunteers. Ultrasound contrast was used for UPI measurements during normoventilation and hyperventilation...
2018: Acta Neurochirurgica. Supplement
Adam M Hyde, Robert G McMurray, Frank A Chavoya, Daniela A Rubin
PURPOSE: Prader-Willi syndrome (PWS) is a genetic neurobehavioral disorder presenting hypothalamic dysfunction and adiposity. At rest, PWS exhibits hypoventilation with hypercapnia. We characterized ventilatory responses in children with PWS during exercise. METHODS: Participants were children aged 7-12 years with PWS (n = 8) and without PWS with normal weight (NW; n = 9, body mass index ≤ 85th percentile) or obesity (n = 9, body mass index ≥ 95th percentile)...
February 27, 2018: Pediatric Exercise Science
Daniel A Keir, Michael Pollock, Piramilan Thuraisingam, Donald H Paterson, George J F Heigenhauser, Harry B Rossiter, John M Kowalchuk
We examined whether slower pulmonary O2 uptake (V̇O2p ) kinetics in hypoxia is a consequence of: a) hypoxia alone (lowered arterial O2 pressure), b) hyperventilation-induced hypocapnia (lowered arterial CO2 pressure), or c) a combination of both. Eleven participants performed 3-5 repetitions of step-changes in cycle ergometer power output from 20W to 80% lactate threshold in the following conditions: i) normoxia (CON; room air); ii) hypoxia (HX, inspired O2  = 12%; lowered end-tidal O2 pressure [PET O2 ] and end-tidal CO2 pressure [PET CO2 ]); iii) hyperventilation (HV; increased PET O2 and lowered PET CO2 ); and iv) normocapnic hypoxia (NC-HX; lowered PET O2 and PET CO2 matched to CON)...
February 22, 2018: Respiratory Physiology & Neurobiology
A F Macchione, F Anunziata, B O Haymal, P Abate, J C Molina
RATIONALE: The effects of early ethanol exposure upon neonatal respiratory plasticity have received progressive attention given a multifactorial perspective related with sudden infant death syndrome or hypoxia-associated syndromes. The present preclinical study was performed in 3-9-day-old pups, a stage in development characterized by a brain growth spurt that partially overlaps with the 3rd human gestational trimester. METHODS: Breathing frequencies and apneas were examined in pups receiving vehicle or a relatively moderate ethanol dose (2...
February 21, 2018: Psychopharmacology
Eila Sonkajärvi, Seppo Rytky, Seppo Alahuhta, Kalervo Suominen, Timo Kumpulainen, Pasi Ohtonen, Elina Karvonen, Ville Jäntti
OBJECTIVES: The aim of the study was to compare the EEG findings and haemodynamic parameters of adult male patients while undergoing mask induction with sevoflurane anaesthesia with either controlled hyperventilation (CH) or spontaneous breathing (SB). METHODS: Twenty male patients, aged 23-52 (mean 42) years were anaesthetized randomly with either spontaneous breathing or mild controlled hyperventilation via mask. EEG was recorded using a full 10-20 electrode set...
January 11, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
AbdAllah Gad, Sajjad Ali, Talal Zahoor, Nick Azarov
Malarial infections are uncommon in the United States and almost all reported cases stem from recent travelers coming from endemic countries. Cerebral malaria (CM) is a severe form of the disease usually affecting children and individuals with limited immunity. Despite proper management, mortality from CM can reach up to 25%, especially when it is associated with brain edema. Inefficient management of the edema may result in brain herniation and death. Uniform guidelines for management of CM-associated brain edema are lacking...
February 5, 2018: American Journal of Tropical Medicine and Hygiene
Federica N Vigotti, Germana Daidola, Antonio Marciello, Francesco Berruto, Antonietta Rizzuto, Ernesto Reina, Paolo M Perosa, Marco Saltarelli
BACKGROUND: Lactic acidosis (LA) is the most common form of metabolic acidosis, defined by lactate values greater than 5 mmol/L and pH<7.34. The pathogenesis of LA involves hypoxic causes (type A) and non-hypoxic (type B), often coexisting. Identification and removal of the trigger are mandatory in the therapeutic management of LA. The case: A 38 years-old male patient entered the Emergency Ward for dyspnea, fever, vomiting and hyporexia. An important respiratory distress with hyperventilation due to severe LA was found, together with severe hypoglicemia, without renal impairment...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Anthony J Hudson, Geir Strandenes, Christopher K Bjerkvig, Marius Svanevik, Elon Glassberg
Many standard trauma management guidelines advocate the early use of endotracheal intubation and positive pressure ventilation as key treatment interventions in haemorrhagic shock. The evidence for using these airway and ventilation strategies to manage a circulation problem is unclear. The potentially harmful effects of drug assisted intubation and positive pressure ventilation include reduced cardiac output, apnoea, hypoxia, hypocapnoea (due to inadvertent hyperventilation) and unnecessarily prolonged on-scene times...
January 31, 2018: Journal of Trauma and Acute Care Surgery
Shinpei Sato, Daigo Kojima, Yasuyoshi Shimada, Jun Yoshida, Kentaro Fujimato, Shunrou Fujiwara, Masakazu Kobayashi, Yoshitaka Kubo, Kenji Yoshida, Kazunori Terasaki, Shouta Tsutsui, Kenya Miyoshi, Kuniaki Ogasawara
The present study examined whether preoperatively reduced cerebrovascular contractile reactivity to hypocapnia by hyperventilation is associated with development of cerebral hyperperfusion syndrome after arterial bypass surgery for adult patients with cerebral misery perfusion due to ischemic moyamoya disease. Among 65 adult patients with ischemic moyamoya disease, 19 had misery perfusion in the precentral region on preoperative15 O positron emission tomography and underwent arterial bypass surgery for that region...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
José López-Barneo
The carotid body (CB) is the major arterial chemoreceptor responsible for the detection of acute decreases in O2 tension (hypoxia) in arterial blood that trigger hyperventilation and sympathetic activation. The CB contains O2-sensitive glomus (chief) cells, which respond to hypoxia with the release of transmitters to activate sensory nerve fibers impinging upon the brain respiratory and autonomic centers. During exposure to sustained hypoxia (for weeks or months), the CB grows several-fold in size, a response associated with acclimatization to high altitude or to medical conditions presenting hypoxemia...
January 24, 2018: Cell and Tissue Research
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