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pupillary reactivity

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https://www.readbyqxmd.com/read/28107273/influence-of-depth-of-hypnosis-on-pupillary-reactivity-to-a-standardized-tetanic-stimulus-in-patients-under-propofol-remifentanil-target-controlled-infusion-a-crossover-randomized-pilot-study
#1
Nada Sabourdin, Jean-Baptiste Peretout, Eliane Khalil, Marie-Laurence Guye, Nicolas Louvet, Isabelle Constant
BACKGROUND: Pupillometry allows the measurement of pupillary diameter variations in response to nociceptive stimuli. This technique has been used to monitor the balance between analgesia and nociception. Under general anesthesia, the amplitude of pupillary dilation is related to the amount of administered opioids. The objective of this study was to determine whether at a constant infusion rate of opioids, the pupillary response was influenced by depth of hypnosis assessed by the bispectral index (BIS)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28008074/increased-neural-and-pupillary-reactivity-to-emotional-faces-in-adolescents-with-current-and-remitted-major-depressive-disorder
#2
Katie L Burkhouse, Max Owens, Cope Feurer, Effua Sosoo, Anastacia Kudinova, Brandon E Gibb
The current study combined multiple levels of analysis to examine whether disrupted neural and pupillary reactivity to emotional faces serves as a state- or trait-like marker of adolescent major depressive disorder (MDD). The study examined differences in pupil dilation and the event-related potential (ERP) late positive potential (LPP) component to emotional faces before and after a negative mood induction between 71 adolescents (age 11-18 years) with (i) a current diagnosis of MDD, (ii) a past episode of MDD currently in full remission, and (iii) no lifetime history of any Axis I disorder...
December 21, 2016: Social Cognitive and Affective Neuroscience
https://www.readbyqxmd.com/read/27982219/nonarteritic-anterior-ischemic-optic-neuropathy-following-pars-plana-vitrectomy-for-macular-hole-treatment-case-report
#3
Leonardo Provetti Cunha, Luciana Virgínia Ferreira Costa Cunha, Carolina Ferreira Costa, Mário Luiz Ribeiro Monteiro
Herein, we report a case of nonarteritic anterior ischemic optic neuropathy (NAION) following uneventful pars plana vitrectomy for macular hole treatment. A 56-year-old previously healthy woman presented with a full-thickness macular hole in right eye (OD) and small cup-to-disc ratios in both eyes. Five days after surgery, she noticed sudden painless loss of vision in OD and was found to have an afferent pupillary defect and intraocular pressure of 29 mmHg. Fundus examination showed right optic disc edema and the resolution of a macular hole with an inferior altitudinal visual field defect...
September 2016: Arquivos Brasileiros de Oftalmologia
https://www.readbyqxmd.com/read/27796652/prognostic-value-of-corpus-callosum-injuries-in-severe-head-trauma
#4
Marta Cicuendez, Ana Castaño-León, Ana Ramos, Amaya Hilario, Pedro A Gómez, Alfonso Lagares
BACKGROUND: This study was performed to investigate the relationship between corpus callosum (CC) injury and prognosis in traumatic axonal injury (TAI). METHOD: We retrospectively reviewed 264 patients with severe head trauma who underwent a conventional MR imaging in the first 60 days after injury. They were selected from a prospectively collected database of 1048 patients with severe head trauma admitted in our hospital. TAI lesions were defined as areas of increased signal intensity on T2 and FLAIR or areas of decreased signal on gradient-echo T2...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27784772/predicting-survival-after-acute-civilian-penetrating-brain-injuries-the-spin-score
#5
Susanne Muehlschlegel, Didem Ayturk, Aditi Ahlawat, Saef Izzy, Thomas M Scalea, Deborah M Stein, Timothy Emhoff, Kevin N Sheth
OBJECTIVE: To identify predictors associated with survival in civilian penetrating traumatic brain injury (pTBI) utilizing a contemporary, large, diverse 2-center cohort, and to develop a parsimonious survival prediction score for pTBI. METHODS: Our cohort comprised 413 pTBI patients retrospectively identified from the local trauma registries at 2 US level 1 trauma centers, of which one was predominantly urban and the other predominantly rural. Predictors of in-hospital and 6-month survival identified in univariate and multivariable logistic regression were used to develop the simple Surviving Penetrating Injury to the Brain (SPIN) score...
November 22, 2016: Neurology
https://www.readbyqxmd.com/read/27779091/pupillary-and-affective-responses-to-maternal-feedback-and-the-development-of-borderline-personality-disorder-symptoms
#6
Lori N Scott, Maureen Zalewski, Joseph E Beeney, Neil P Jones, Stephanie D Stepp
Etiological models propose that a biological vulnerability to emotional reactivity plays an important role in the development of borderline personality disorder (BPD). However, the physiological and phenomenological components of emotional reactivity that predict the course of BPD symptoms in adolescence are poorly understood. This prospective study examines pupillary and affective responses to maternal feedback as predictors of BPD symptom development in adolescent girls over 18 months. Fifty-seven 16-year-old girls completed a laboratory task in which they heard recorded clips of their own mothers making critical or praising statements about them, as well as neutral statements that did not pertain to them...
October 25, 2016: Development and Psychopathology
https://www.readbyqxmd.com/read/27720997/autonomic-nervous-system-reactivity-within-the-valence-arousal-affective-space-modulation-by-sex-and-age
#7
Patrick Gomez, Armin von Gunten, Brigitta Danuser
In the present study, we examined how sex and age shape cardiovascular, electrodermal, and pupillary reactivity to picture series within the valence-arousal affective space in a sample of 176 healthy younger, middle-aged, and older men and women. Across participants, heart rate (HR) decelerated with increasing self-reported unpleasantness, whereas skin conductance level (SCL) and pupil size (PS) increased with increasing self-rated arousal. Systolic (SBP) and diastolic (DBP) blood pressure increased with increasing self-rated arousal when valence was pleasant but much less when valence was unpleasant...
November 2016: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/27671353/pupillary-reactivity-to-negative-stimuli-prospectively-predicts-recurrence-of-major-depressive-disorder-in-women
#8
Anastacia Y Kudinova, Katie L Burkhouse, Greg Siegle, Max Owens, Mary L Woody, Brandon E Gibb
There is a large body of research supporting the association between disrupted physiological reactivity to negative stimuli and depression. The present study aimed to examine whether physiological reactivity to emotional stimuli, assessed via pupil dilation, served as a biological marker of risk for depression recurrence among individuals who are known to be at a higher risk due to having previous history of depression. Participants were 57 women with a history of major depressive disorder (MDD). Pupil dilation to angry, happy, sad, and neutral faces was recorded...
December 2016: Psychophysiology
https://www.readbyqxmd.com/read/27669329/ciliary-body-iris-appositioning-producing-mechanical-pupillary-defects-in-carotid-cavernous-sinus-fistula-an-overlooked-pathophysiologic-mechanism
#9
Margarita G Todorova, Cameron F Parsa
BACKGROUND: Variable pupillary responses have been described with carotid-cavernous sinus fistulas. These often are associated with a decrease in visual acuity and attributed to retinal ischemia. We propose a novel pathophysiologic mechanism for changes in pupillary reactivity involving anatomic changes secondary to choroidal effusion. METHODS: To demonstrate proof-of-concept, we investigated 2 consecutive patients with carotid-cavernous sinus fistulas and pupillary disturbances using repeated refractions and anterior segment ultrasound biomicroscopy...
March 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27553436/early-prediction-of-outcome-after-severe-traumatic-brain-injury-a-simple-and-practical-model
#10
Sandro Rizoli, Ashley Petersen, Eileen Bulger, Raul Coimbra, Jeffrey D Kerby, Joseph Minei, Laurie Morrison, Avery Nathens, Martin Schreiber, Airton Leonardo de Oliveira Manoel
BACKGROUND: Traumatic brain injury (TBI) is a heterogeneous syndrome with a broad range of outcome. We developed a simple model for long-term outcome prognostication after severe TBI. METHODS: Secondary data analysis of a large multicenter randomized trial. Patients were grouped according to 6-month extended Glasgow outcome scale (eGOS): poor-outcome (eGOS ≤ 4; severe disability or death) and acceptable outcome (eGOS > 4; no or moderate disability)...
August 24, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27422586/inter-device-reliability-of-the-npi-100-pupillometer
#11
Weidan Zhao, Sonja Stutzman, Olson DaiWai, Ciji Saju, Margaret Wilson, Venkatesh Aiyagari
The purpose of this study was to explore the inter-device reliability of NPi-100 pupillometers (NeuroOptics, Inc.). The pupillary examination is a fundamental element of the neurological exam. Current evidence suggests that the traditional examination of the pupil with a hand held flashlight has limited inter-rater reliability. Automated pupillometers were developed to provide an objective scoring of pupil size and reactivity. However, there are no data examining inter-device reliability of automated pupil assessments...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27274213/safety-and-efficacy-of-phacoemulsification-and-intraocular-lens-implantation-through-a-small-pupil-using-minimal-iris-manipulation
#12
RANDOMIZED CONTROLLED TRIAL
Dimitris Papaconstantinou, George Kalantzis, Dimitris Brouzas, Anastasios Kontaxakis, Chryssanthi Koutsandrea, Andreas Diagourtas, Ilias Georgalas
PURPOSE: The aim of this study was to compare the results of phacoemulsification through a small pupil using minimal iris manipulation versus phacoemulsification through a well-dilated pupil. METHODS: This prospective randomized control (comparative) study comprised 78 patients (group I) with a maximally dilated pupil size of ≤4.00 mm and 45 patients (group II) with dilated pupil size of ≥7.00 mm. In group I patients, only viscodilation and minimal push-and-pull iris stretching with two collar-button iris-retractor hooks were utilized without iris manipulation...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27135180/early-absent-pupillary-light-reflexes-after-cardiac-arrest-in-patients-treated-with-therapeutic-hypothermia
#13
Laxmi P Dhakal, Ayan Sen, Carlene M Stanko, Bhupendra Rawal, Michael G Heckman, Jonathan B Hoyne, Elliot L Dimberg, Michelle L Freeman, Lauren K Ng, Alejandro A Rabinstein, William D Freeman
Loss of pupillary light reactivity is one recognized indicator of poor prognosis after cardiopulmonary resuscitation (CPR). However, drug overdose, low cardiac output, and/or resuscitation drugs can lead to impaired pupillary light reflex. To investigate pupillary light reflex status before therapeutic hypothermia (TH) in relation to neurological outcome, we retrospectively reviewed the data of a prospectively implemented TH protocol in patients with cardiac arrest (CA) at Mayo Clinic in Jacksonville, Florida (January 2006-January 2012), and Mayo Clinic in Scottsdale, Arizona (August 2010-March 2014)...
August 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27134226/underestimation-of-pupil-size-by-critical-care-and-neurosurgical-nurses
#14
Robert G Kerr, Andrea M Bacon, Laura L Baker, Janelle S Gehrke, K Danielle Hahn, Cheryl L Lillegraven, Catherine Hackett Renner, Sarah K Spilman
BACKGROUND: Early detection of pupillary changes in patients with head injuries can alert the care team to increasing intracranial pressure. Previous research has shown inconsistencies in pupil measurement that are most likely due to the subjective nature of measuring pupils without the assistance of technology. OBJECTIVES: To evaluate nurses' abilities to assess pupil diameter accurately and detect unequal pupils. METHODS: In a 3-part study, the accuracy of critical care and neurosurgical nurses' assessments of pupils was determined...
May 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27072310/reliability-of-standard-pupillometry-practice-in-neurocritical-care-an-observational-double-blinded-study
#15
David Couret, Delphine Boumaza, Coline Grisotto, Thibaut Triglia, Lionel Pellegrini, Philippe Ocquidant, Nicolas J Bruder, Lionel J Velly
BACKGROUND: In critical care units, pupil examination is an important clinical parameter for patient monitoring. Current practice is to use a penlight to observe the pupillary light reflex. The result seems to be a subjective measurement, with low precision and reproducibility. Several quantitative pupillometer devices are now available, although their use is primarily restricted to the research setting. To assess whether adoption of these technologies would benefit the clinic, we compared automated quantitative pupillometry with the standard clinical pupillary examination currently used for brain-injured patients...
March 13, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27022058/a-practical-concussion-physical-examination-toolbox
#16
REVIEW
Jason M Matuszak, Jennifer McVige, Jacob McPherson, Barry Willer, John Leddy
CONTEXT: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. EVIDENCE ACQUISITION: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor...
May 2016: Sports Health
https://www.readbyqxmd.com/read/27003280/prognostic-models-for-prediction-of-outcomes-after-traumatic-brain-injury-based-on-patients-admission-characteristics
#17
Vineet Kumar Kamal, Deepak Agrawal, Ravindra Mohan Pandey
OBJECTIVE: To identify the best performing prognostic model using admission characteristics to predict mortality at 30 days and functioning outcome at 6-months post-admission in patients with moderate or severe brain injury. METHODS: Using a retrospective database (n = 1466 patients) of a tertiary trauma care centre, three different models were developed using logistic regression methods for predicting mortality and functioning outcome. The performance of the models was assessed in terms of discrimination and calibration...
March 22, 2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/26987507/modern-modeling-techniques-had-limited-external-validity-in-predicting-mortality-from-traumatic-brain-injury
#18
Tjeerd van der Ploeg, Daan Nieboer, Ewout W Steyerberg
BACKGROUND AND OBJECTIVE: Prediction of medical outcomes may potentially benefit from using modern statistical modeling techniques. We aimed to externally validate modeling strategies for prediction of 6-month mortality of patients suffering from traumatic brain injury (TBI) with predictor sets of increasing complexity. METHODS: We analyzed individual patient data from 15 different studies including 11,026 TBI patients. We consecutively considered a core set of predictors (age, motor score, and pupillary reactivity), an extended set with computed tomography scan characteristics, and a further extension with two laboratory measurements (glucose and hemoglobin)...
March 14, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/26889604/a-physiological-signature-of-sound-meaning-in-dementia
#19
Phillip D Fletcher, Jennifer M Nicholas, Laura E Downey, Hannah L Golden, Camilla N Clark, Carolina Pires, Jennifer L Agustus, Catherine J Mummery, Jonathan M Schott, Jonathan D Rohrer, Sebastian J Crutch, Jason D Warren
The meaning of sensory objects is often behaviourally and biologically salient and decoding of semantic salience is potentially vulnerable in dementia. However, it remains unclear how sensory semantic processing is linked to physiological mechanisms for coding object salience and how that linkage is affected by neurodegenerative diseases. Here we addressed this issue using the paradigm of complex sounds. We used pupillometry to compare physiological responses to real versus synthetic nonverbal sounds in patients with canonical dementia syndromes (behavioural variant frontotemporal dementia - bvFTD, semantic dementia - SD; progressive nonfluent aphasia - PNFA; typical Alzheimer's disease - AD) relative to healthy older individuals...
April 2016: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
https://www.readbyqxmd.com/read/26882061/upper-eyelid-and-pupillary-effects-of-topical-dilute-epinephrine
#20
Giancarlo A Garcia, Philip Ngai, Swapna Vemuri, Jeremiah P Tao
PURPOSE: Adrenergic medications may elevate the upper eyelid and dilate the pupil. The effects of topical phenylephrine on Müller's muscle have been well described. Dilute epinephrine (DE) is a sympathomimetic agent commonly administered in blepharoptosis surgery, and has been shown to elevate the upper eyelid margin when injected subcutaneously. The effects of DE applied topically to the eye, whether intentional or inadvertent during surgery have not been characterized. The purpose of this investigation was to quantify and compare the effects of topical DE and phenylephrine on upper eyelid position and pupil size...
February 12, 2016: Ophthalmic Plastic and Reconstructive Surgery
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