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Neuromuscular monitoring

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https://www.readbyqxmd.com/read/28227967/a-stimulation-driven-exoskeleton-for-walking-after-paraplegia
#1
Sarah R Chang, Mark J Nandor, Lu Li, Kevin M Foglyano, John R Schnellenberger, Rudi Kobetic, Roger D Quinn, Ronald J Triolo, Sarah R Chang, Mark J Nandor, Lu Li, Kevin M Foglyano, John R Schnellenberger, Rudi Kobetic, Roger D Quinn, Ronald J Triolo, Mark J Nandor, Rudi Kobetic, Roger D Quinn, John R Schnellenberger, Sarah R Chang, Kevin M Foglyano, Lu Li, Ronald J Triolo
An untethered version of a stimulation-driven exoskeleton was evaluated for its ability to restore walking after paralysis from spinal cord injury. The hybrid neuroprosthesis (HNP) combined a passive variable-constraint exoskeleton for stability and support with functional neuromuscular stimulation (FNS) to contract the paralyzed muscles to drive limb movement. This self-contained HNP was operated by an onboard controller that sampled sensor signals, generated appropriate commands to both the exoskeletal constraints and integrated stimulator, and transmitted data wirelessly via Bluetooth to an off-board computer for real-time monitoring and recording for offline analysis...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28216703/effects-of-avoiding-neuromuscular-blocking-agents-during-maintenance-of-anaesthesia-on-recovery-characteristics-in-patients-undergoing-craniotomy-for-supratentorial-lesions-a-randomised-controlled-study
#2
Ruchi A Jain, Anita N Shetty, Shrikanta P Oak, Anjana S Wajekar, Madhu B Garasia
BACKGROUND AND AIMS: Neuromuscular blocking agents have been one of the cornerstones of anaesthesia. With the advent of newer surgical, anaesthetic and neurological monitoring techniques, their utility in neuroanaesthesia practice seems dispensable. The aim of this prospective, comparative, randomised study was to determine whether neuromuscular blocking agents are required in patients undergoing supratentorial surgery when balanced anaesthesia with desflurane, dexmedetomidine and scalp block is used...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28183581/chemotherapy-alters-cisatracurium-induced-neuromuscular-blockade-characteristics-a-prospective-cohort-study
#3
Amir Poya Zanjani, Maziar Maghsoudloo, Jalil Makarem, Fahimeh Farokhnia, Morteza Fazli, Zahid Hussain Khan
STUDY OBJECTIVE: To compare the characteristics of NMDR induced muscle paralysis in breast cancer patients with and without a history of recent chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) regimen. DESIGN: This is a non-randomized prospective cohort study. SETTING: Operating room of a university-affiliated teaching hospital. PATIENTS: Out of a total of 50 patients who had undergone mastectomy, 22 patients were allocated to the "Chemo group" and 28 patients to the "Non-Chemo group", based on a valid history of recent chemotherapy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#4
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#5
C Tacquard, O Collange, P Gomis, J-M Malinovsky, N Petitpain, P Demoly, S Nicoll, P M Mertes
BACKGROUND: Immediate hypersensitivity reactions during anaesthesia are rare but potentially life-threatening. The epidemiology changes with time and evolving professional practice, and hence needs to be monitored. Our objective was to follow this epidemiology. METHODS: This was a retrospective, observational study in French hospital clinics, conducted by GERAP members (Groupe d'Étude des Réactions Anaphylactoïdes Périopératoires). Consecutive patients seen in allergo-anaesthesia outpatient clinics, who had experienced a hypersensitivity reaction during anaesthesia between 1 January 2011 and 31 December 2012, were included...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28123712/asymptomatic-hyperckemia-during-a-two-year-monitoring-period-a-case-report-and-literature-overview
#6
Spyridon Klinis, Athanasios Symeonidis, Dimitrios Karanasios, Emmanouil K Symvoulakis
High creatine kinase (CK) levels can be associated with many disorders, including neuromuscular, cardiac, metabolic, endocrine and traumatic. Idiopathic hyperCKemia is a diagnostic dilemma for physicians even though its long-term prognosis is usually benign. We report a case of a Caucasian 61-year-old woman who presented as completely asymptomatic to her general practitioner with a serum CK (sCK) level at 6,122 IU/l. A complete diagnostic evaluation, including physical and laboratory examinations, electromyogram and muscle biopsy were negative for any neuromuscular or other disorder...
January 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28119879/influence-of-the-proprioceptive-neuromuscular-facilitation-exercise-programs-on-idiopathic-scoliosis-patient-in-the-early-20s-in-terms-of-curves-and-balancing-abilities-single-case-study
#7
Byung-Ki Lee
The purpose of this study was to determine the influence of the proprioceptive neuromuscular facilitation (PNF) exercise programs for idiopathic scoliosis with a female patient in the early 20s in terms of her spinal curve and balancing abilities. The study subject was selected among 21-year-old female college students. There were no particular activities that the subject could not perform, but patient complained of difficulty in maintaining the standing position for a prolonged time. Patient chest X-ray results showed S-shaped curves tilted towards the left or right in the lumbar spine, thoracic spine, and cervical spine areas...
December 2016: Journal of Exercise Rehabilitation
https://www.readbyqxmd.com/read/28113221/a-subspace-approach-to-the-structural-decomposition-and-identification-of-ankle-joint-dynamic-stiffness
#8
Seyed Kian Jalaleddini, Ehsan Sobhani Tehrani, Robert Kearney
OBJECTIVE: The purpose of this paper is to present a Structural Decomposition SubSpace (SDSS) method for decomposition of the joint torque to intrinsic, reflexive and voluntary torques and identification of joint dynamic stiffness. METHODS: Firstly, it formulates a novel state-space representation for the joint dynamic stiffness modelled by a parallel-cascade structure with a concise parameter set that provides a direct link between the state-space representation matrices and the parallel-cascade parameters...
August 31, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28111148/a-gradient-in-synaptic-strength-and-plasticity-among-motoneurons-provides-a-peripheral-mechanism-for-locomotor-control
#9
Wei-Chun Wang, Paul Brehm
The recruitment of motoneurons during force generation follows a general pattern that has been confirmed across diverse species [1-3]. Motoneurons are recruited systematically according to synaptic inputs and intrinsic cellular properties and corresponding to movements of different intensities. However, much less is known about the output properties of individual motoneurons and how they affect the translation of motoneuron recruitment to the strength of muscle contractions. In larval zebrafish, spinal motoneurons are recruited in a topographic gradient according to their input resistance (Rin) at different swimming strengths and speeds...
February 6, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28102521/clinical-assessment-and-train-of-four-measurements-in-critically-ill-patients-treated-with-recommended-doses-of-cisatracurium-or-atracurium-for-neuromuscular-blockade-a-prospective-descriptive-study
#10
Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo, Arnaud Gacouin
BACKGROUND: Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measurements with an overall clinical assessment for neuromuscular blockade in ICU patients treated with recommended doses of atracurium or cisatracurium, including patients with acute respiratory disease syndrome (ARDS). METHODS: We prospectively included in two ICUs 119 patients, 94 with ARDS, who required a neuromuscular blockade for more than 24 h...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28088340/the-role-of-magnetic-resonance-imaging-techniques-in-evaluation-and-management-of-the-idiopathic-inflammatory-myopathies
#11
REVIEW
Jessica Day, Sandy Patel, Vidya Limaye
Magnetic resonance imaging (MRI) is an important tool in the evaluation of neuromuscular disorders. MRI accurately demonstrates muscle oedema, atrophy, subcutaneous pathology and fatty infiltration and also highlights the distribution of muscle involvement. This review examines the role of MRI in evaluation of the idiopathic inflammatory myopathies (IIMs), a heterogeneous group of autoimmune conditions characterised by muscle inflammation and a variety of extra-muscular manifestations. MRI has a clear role in aiding diagnosis of these conditions, guiding muscle biopsy, differentiating subtypes of IIM using a pattern-based approach, and monitoring disease activity in a longitudinal fashion...
November 5, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28077717/complexin-mutants-reveal-partial-segregation-between-recycling-pathways-that-drive-evoked-and-spontaneous-neurotransmission
#12
Nadezhda Sabeva, Richard W Cho, Alexander Vasin, Agustin Gonzalez, J Troy Littleton, Maria Bykhovskaia
: Synaptic vesicles fuse at morphological specializations in the presynaptic terminal termed active zones (AZs). Vesicle fusion can occur spontaneously or in response to an action potential. Following fusion, vesicles are retrieved and recycled within nerve terminals. It is still unclear whether vesicles that fuse spontaneously or following evoked release share similar recycling mechanisms. Genetic deletion of the SNARE-binding protein complexin dramatically increases spontaneous fusion, with the protein serving as the synaptic vesicle fusion clamp at Drosophila synapses...
January 11, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28070484/deep-learning-predictions-of-survival-based-on-mri-in-amyotrophic-lateral-sclerosis
#13
Hannelore K van der Burgh, Ruben Schmidt, Henk-Jan Westeneng, Marcel A de Reus, Leonard H van den Berg, Martijn P van den Heuvel
Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease, with large variation in survival between patients. Currently, it remains rather difficult to predict survival based on clinical parameters alone. Here, we set out to use clinical characteristics in combination with MRI data to predict survival of ALS patients using deep learning, a machine learning technique highly effective in a broad range of big-data analyses. A group of 135 ALS patients was included from whom high-resolution diffusion-weighted and T1-weighted images were acquired at the first visit to the outpatient clinic...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28064412/journal-of-clinical-monitoring-and-computing-2016-end-of-year-summary-anesthesia
#14
REVIEW
Jan F A Hendrickx, Andre M De Wolf
Clinical monitoring and computing are essential during general anesthesia. As a result it would be impossible to review all the articles published in the Journal of Clinical Monitoring and Computing that are relevant to anesthesia. We therefore will limit this summary to those articles that are uniquely related to anesthesia. The topics include: anesthesia machines; ensuring the airway; anesthetic depth; neuromuscular transmission monitoring; locoregional anesthesia; ultrasound; and pain.
February 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28052716/tripartite-stratification-of-the-glasgow-coma-scale-in-children-with-severe-traumatic-brain-injury-and-mortality-an-analysis-from-a-multicenter-comparative-effectiveness-study
#15
Sarah Murphy, Neal J Thomas, Shira Gertz, John Beca, James F Luther, Michael J Bell, Steven R Wisniewski, Adam Hartman, Robert Tasker
The Glasgow Coma Scale (GCS) score has not been validated in children < 5y and the clinical circumstances at the time of assignment can limit its applicability. This study describes the distribution of GCS scores in the population, the relationship between injury characteristics with the GCS score and the association between the tripartite stratification of the GCS on mortality in children with severe traumatic brain injury (TBI). The first 200 children from a multicenter, comparative effectiveness study in severe TBI (inclusion criteria [age 0 - 18 y, GCS ≤ 8 at the time of ICP monitoring] were analyzed...
January 4, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28045856/a-multiparametric-alarm-criterion-for-motor-evoked-potential-monitoring-during-spine-deformity-surgery
#16
Martín J Segura, María E Talarico, Mariano A Noel
PURPOSE: This is a pilot study to compare changes in the amplitude, area below the curve, number of phases, duration, and latency of the intraoperative transcranial motor evoked potentials (TcMEP) for early detection of impending spinal cord injury. An empirical ratio calculated by a combination of the above-mentioned parameters was also assessed. METHODS: Intraoperative TcMEP recordings from five patients presenting with neuromuscular kyphoscoliosis, idiopathic scoliosis, achondroplasia and lumbar kyphosis, congenital kyphosis, and achondroplasia with cervical instability were reviewed...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28044330/conceptual-and-technical-insights-into-the-basis-of-neuromuscular-monitoring
#17
REVIEW
M Naguib, S J Brull, K B Johnson
Unrecognised postoperative residual neuromuscular block remains a frequent occurrence in recovery rooms. Evidence indicates that current practice continues to perpetuate the status quo, in which 10-40% of patients experience postoperative residual weakness. A departure from the current practice requires small efforts on the clinicians' part. This review addresses several selected core questions regarding neuromuscular blockade monitoring and provides a framework to rationally discuss and develop basic guidelines for the use of neuromuscular blocking agents in patient care...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28043867/bont-ab-hybrid-maintains-similar-duration-of-paresis-as-bont-a-wild-type-in-murine-running-wheel-assay
#18
Anna Kutschenko, Marie-Christine Reinert, Nadja Krez, David Liebetanz, Andreas Rummel
The highly potent Botulinum neurotoxins (BoNT) are successful drugs to treat neuromuscular disorders. Efforts are being made to further reduce the injected BoNT dose and to lengthen the interval between treatments. Detailed knowledge of the BoNT structure-activity relationship (SAR) allows combining the best features of the different BoNT serotypes. Of all seven BoNT serotypes A-G, BoNT/A displays the highest potency despite low neuronal binding affinity, while BoNT/B exhibits much higher affinity. Recently, a new BoNT/AB hybrid (AABB) was constructed comprising the catalytic and translocation domain of BoNT/A and the 50kDa cell binding domain of BoNT/B...
December 30, 2016: Neurotoxicology
https://www.readbyqxmd.com/read/28036088/current-concepts-of-ards-a-narrative-review
#19
REVIEW
Michele Umbrello, Paolo Formenti, Luca Bolgiaghi, Davide Chiumello
Acute respiratory distress syndrome (ARDS) is characterized by the acute onset of pulmonary edema of non-cardiogenic origin, along with bilateral pulmonary infiltrates and reduction in respiratory system compliance. The hallmark of the syndrome is refractory hypoxemia. Despite its first description dates back in the late 1970s, a new definition has recently been proposed. However, the definition remains based on clinical characteristic. In the present review, the diagnostic workup and the pathophysiology of the syndrome will be presented...
December 29, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28032343/tracking-motor-units-longitudinally-across-experimental-sessions-with-high-density-surface-electromyography
#20
E Martinez-Valdes, F Negro, C M Laine, D Falla, F Mayer, D Farina
A new method is proposed for tracking individual motor units (MUs) across multiple experimental sessions on different days. The technique is based on a novel decomposition approach for high-density surface electromyography and was tested with two experimental studies for reliability and sensitivity. Experiment I (reliability): ten participants performed isometric knee extensions at 10, 30, 50 and 70% of their maximum voluntary contraction (MVC) force in three sessions, each separated by 1 week. Experiment II (sensitivity): seven participants performed 2 weeks of endurance training (cycling) and were tested pre-post intervention during isometric knee extensions at 10 and 30% MVC...
December 28, 2016: Journal of Physiology
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