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Stephan Malherbe

Gustavo Moraga-Cid, Ludovic Sauguet, Christèle Huon, Laurie Malherbe, Christine Girard-Blanc, Stéphane Petres, Samuel Murail, Antoine Taly, Marc Baaden, Marc Delarue, Pierre-Jean Corringer
The glycine receptor (GlyR) is a pentameric ligand-gated ion channel (pLGIC) mediating inhibitory transmission in the nervous system. Its transmembrane domain (TMD) is the target of allosteric modulators such as general anesthetics and ethanol and is a major locus for hyperekplexic congenital mutations altering the allosteric transitions of activation or desensitization. We previously showed that the TMD of the human α1GlyR could be fused to the extracellular domain of GLIC, a bacterial pLGIC, to form a functional chimera called Lily...
March 3, 2015: Proceedings of the National Academy of Sciences of the United States of America
Caroline Malherbe, Arnaud Messé, Eric Bardinet, Mélanie Pélégrini-Issac, Vincent Perlbarg, Guillaume Marrelec, Yulia Worbe, Jérôme Yelnik, Stéphane Lehéricy, Habib Benali
Functional brain networks are sets of cortical, subcortical, and cerebellar regions whose neuronal activities are synchronous over multiple time scales. Spatial independent component analysis (sICA) is a widespread approach that is used to identify functional networks in the human brain from functional magnetic resonance imaging (fMRI) resting-state data, and there is now a general agreement regarding the cortical regions involved in each network. It is well known that these cortical regions are preferentially connected with specific subcortical functional territories; however, subcortical components (SC) have not been observed whether in a robust or in a reproducible manner using sICA...
April 2014: Brain Connectivity
Simon D Whyte, Erin Cooke, Stephan Malherbe
PURPOSE: The air-Q® intubating laryngeal airway (ILA) is a supraglottic device (SGD) designed specifically to function as both a primary airway and a bridging device and conduit for fibreoptic intubation in difficult airway scenarios. This observational study evaluated the usability and performance characteristics of pediatric air-Q ILA sizes 1.0, 1.5, 2.0, and 2.5 when used as a primary airway. METHODS: One hundred ten children, American Society of Anesthesiologists physical status I-III and undergoing elective surgery, received a weight-appropriate air-Q ILA following induction of anesthesia...
June 2013: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Yulia Worbe, Caroline Malherbe, Andreas Hartmann, Mélanie Pélégrini-Issac, Arnaud Messé, Marie Vidailhet, Stéphane Lehéricy, Habib Benali
Gilles de la Tourette syndrome is a clinically heterogeneous disorder with poor known pathophysiology. Recent neuropathological and structural neuroimaging data pointed to the dysfunction of cortico-basal ganglia networks. Nonetheless, it is not clear how these structural changes alter the functional activity of the brain and lead to heterogeneous clinical expressions of the syndrome. The objective of this study was to evaluate global integrative state and organization of functional connections of sensori-motor, associative and limbic cortico-basal ganglia networks, which are likely involved in tics and behavioural expressions of Gilles de la Tourette syndrome...
June 2012: Brain: a Journal of Neurology
Frederick K Kozak, Marcela Fandiño, Luthiana F Carpes, Kawshala Peiris, Stephan Malherbe, Robert Purdy
Craniopagus conjoined twins have long been the subject of interest because of the rarity and peculiarity of their juxtaposition. We present the surgical, airway and anesthetic challenges in craniopagus conjoined twins, in which one of the twins underwent adenoidectomy for obstructive sleep breathing disorder. The surgical procedure required a special setting from an anesthetic perspective whereby both children needed anesthesia due to the complex physiology of their brains and cardiovascular systems. As well, we took the opportunity to do bilateral ear examinations of both twins...
March 2011: International Journal of Pediatric Otorhinolaryngology
Stephan Malherbe, Simon Whyte, Permendra Singh, Erica Amari, Ashlee King, J Mark Ansermino
INTRODUCTION: Inhalational anesthesia with spontaneous respiration is traditionally used to facilitate airway endoscopy in children. The potential difficulties in maintaining adequate depth of anesthesia using inhalational anesthesia and the anesthetic pollution of the surgical environment are significant disadvantages of this technique. We report our institutional experience using total intravenous anesthesia (TIVA) and spontaneous respiration. METHODS: We prospectively studied 41 pediatric patients undergoing 52 airway endoscopies and airway surgeries...
May 2010: Paediatric Anaesthesia
Helen Hume-Smith, Jon McCormack, Carolyne Montgomery, Rollin Brant, Stephan Malherbe, Disha Mehta, J Mark Ansermino
INTRODUCTION: This study aimed to determine the age-specific bolus dose of remifentanil (ED(50)) to facilitate tracheal intubation without the use of neuromuscular blocking agents. METHODS: ASA 1-2 subjects were recruited into three groups of 0-3 months (group I), 4-12 months (group II), and 1-3 years (group III) of age. A sequential up-and-down design determined the remifentanil bolus dose, which was initially started at 3 mcg x kg(-1) and adjusted in 1 mcg x kg(-1) increments (range 1-6 mcg x kg(-1))...
January 2010: Paediatric Anaesthesia
Nigel Barker, Joanne Lim, Erica Amari, Stephan Malherbe, J Mark Ansermino
BACKGROUND: Maintaining spontaneous ventilation in children, using total intravenous anesthesia (TIVA), is often desirable, particularly for airway endoscopy. The aim of this study was to evaluate the effect of age on the dose of remifentanil tolerated during spontaneous ventilation under anesthesia maintained with infusions of propofol and remifentanil and to provide guidelines for the administration of remifentanil and propofol to maintain spontaneous ventilation in children. METHODS: Forty-five children scheduled for strabismus surgery were divided by age into three groups (group I: 6 months-3 years, group II: 3 years-6 years, and group III: 6 years-9 years)...
October 2007: Paediatric Anaesthesia
Nao Nakatsuka, Sean C Minogue, Joanne Lim, Carolyne J Montgomery, Colleen A Court, Stephan Malherbe, Yvonne Csanyi-Fritz, Ramona A Kearney, Leeann Phillips, Kathy Reid, Justin Kingsley, J Mark Ansermino
PURPOSE: This investigation evaluated the efficacy of nalbuphine in treating postoperative opioid-induced pruritus (Pr) in pediatric patients. METHODS: After Ethics Board approval, the dual site, tertiary care teaching centre study recruited 212 subjects, age > or = seven years, who received opioid analgesia postoperatively. A modified, self-report colour analogue scale (CAS) scored pruritus intensity (PrI). Subjects who reported PrI score > or = 5/10 were randomized to treatment with nalbuphine 50 microg x kg(-1) iv (max 5 mg) or saline placebo...
November 2006: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Ban C H Tsui, Dawn Davies, Sunil Desai, Stephan Malherbe
A 2.8-year-old female patient (11.6 kg) was admitted to the hospital for uncontrolled pain and swelling in the left leg relating to a metastatic neuroblastoma. Initially, her pain was managed with oral morphine 2 mg (approx. 0.2 mg/kg) every 4 hours. Because she was quite somnolent but still in significant pain, analgesia was then changed to methadone 1 mg orally every 6 hours (approximately 0.1 mg/kg/dose) and was eventually increased over 36 hours to 2 mg every 6 hours (approximately 0.2 mg/kg/dose). She received oral methadone 0...
October 2004: Journal of Pediatric Hematology/oncology
Ban C H Tsui, Stephan Malherbe
Inadvertent placement of an epidural catheter in the cervical region via the caudal route is described in an infant who underwent revision of a fundoplication. We attempted electrical stimulation (the Tsui test) via the epidural catheter to confirm correct placement and positioning of the catheter tip. In this case, the epidural catheter was inadvertently advanced to the cervical region, resulting in stimulation of the phrenic nerve. These diaphragmatic twitches were misinterpreted as chest wall twitches, and it was incorrectly assumed that the catheter was in the thoracic region...
July 2004: Anesthesia and Analgesia
Ban C H Tsui, Stephan Malherbe, John Koller, Keith Aronyk
UNLABELLED: In this case report, we describe the use of cerebrospinal fluid lavage as a successful treatment of an inadvertent intrathecally placed epidural catheter in a 14-yr-old girl who underwent a combination of epidural anesthesia and general anesthesia for orthopedic surgery. In this case, a large amount of local anesthetic was injected (the total possible intrathecal injection was 200 mg of lidocaine and 61 mg of bupivacaine), resulting in apnea and fixed dilated pupils in the patient at the end of surgery...
February 2004: Anesthesia and Analgesia
Ban C H Tsui, Alese Wagner, Dominic Cave, Clark Elliott, Hamdy El-Hakim, Stephan Malherbe
UNLABELLED: In this case series, we evaluated the incidence of laryngospasm using a clearly defined awake tracheal extubation technique in 20 children undergoing elective tonsillectomy with or without adenoidectomy. This technique required patients to be turned to the recovery position at the end of the procedure before discontinuing the volatile anesthetics. No further stimulation, besides continuous oximetry monitoring, was allowed until the patients spontaneously woke up ("no touch" technique)...
February 2004: Anesthesia and Analgesia
Stephan Malherbe, Ban C H Tsui, Kent Stobart, John Koller
No abstract text is available yet for this article.
February 2004: Anesthesiology
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