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Margaret J Livingstone, Cornelius B Groenewald, Jennifer A Rabbitts, Tonya M Palermo
BACKGROUND: Concerns regarding the safety of codeine have been raised. Cases of life-threatening respiratory depression and death in children have been attributed to codeine's polymorphic metabolic pathway. International health agencies recommend restricted use of codeine in children. Despite these recommendations, the epidemiology of codeine use among children remains unknown. AIMS: Our objective was to examine patterns of codeine use in the US among children. METHODS: A cross-sectional analysis of children of age 0-17 years from 1996 to 2013 in the US was performed...
October 25, 2016: Paediatric Anaesthesia
Chao-Ying Chen, Tonya L Rich, Jessica M Cassidy, Bernadette T Gillick
Transcranial magnetic stimulation (TMS) can be used as an assessment or intervention to evaluate or influence brain activity in children with hemiparetic cerebral palsy (CP) commonly caused by perinatal stroke. This communication report analyzed data from two clinical trials using TMS to assess corticospinal excitability in children and young adults with hemiparetic CP. The results of this communication revealed a higher probability of finding a motor evoked potential (MEP) on the non-lesioned hemisphere compared to the lesioned hemisphere (p = 0...
October 20, 2016: Brain Sciences
Zafer Iscan, Maria Nazarova, Tommaso Fedele, Evgeny Blagovechtchenski, Vadim V Nikulin
Inter- and intra-subject variability of the motor evoked potentials (MEPs) to TMS is a well-known phenomenon. Although a possible link between this variability and ongoing brain oscillations was demonstrated, the results of the studies are not consistent with each other. Exploring this topic further is important since the modulation of MEPs provides unique possibility to relate oscillatory cortical phenomena to the state of the motor cortex probed with TMS. Given that alpha oscillations were shown to reflect cortical excitability, we hypothesized that their power and variability might explain the modulation of subject-specific MEPs to single- and paired-pulse TMS (spTMS, ppTMS, respectively)...
2016: Frontiers in Human Neuroscience
Nathan D Nuzum, Ashlee M Hendy, Aaron P Russell, Wei-Peng Teo
Individual responses to transcranial direct current stimulation (tDCS) are varied and therefore potentially limit its application. There is evidence that this variability is related to the contributions of Indirect waves (I-waves) recruited in the cortex. The latency of motor-evoked potentials (MEPs) can be measured through transcranial magnetic stimulation (TMS), allowing an individual's responsiveness to tDCS to be determined. However, this single-pulse method requires several different orientations of the TMS coil, potentially affecting its reliability...
2016: Frontiers in Human Neuroscience
Matthew Sykes, Natalie A Matheson, Philip W Brownjohn, Alexander D Tang, Jennifer Rodger, Jonathan B H Shemmell, John N J Reynolds
Repetitive transcranial magnetic stimulation (rTMS) is primarily used in humans to change the state of corticospinal excitability. To assess the efficacy of different rTMS stimulation protocols, motor evoked potentials (MEPs) are used as a readout due to their non-invasive nature. Stimulation of the motor cortex produces a response in a targeted muscle, and the amplitude of this twitch provides an indirect measure of the current state of the cortex. When applied to the motor cortex, rTMS can alter MEP amplitude, however, results are variable between participants and across studies...
2016: Frontiers in Neural Circuits
Michael Pickell, Stephen M Mann, Rajesh Chakravertty, Daniel P Borschneck
BACKGROUND: This is a prospective observational study examining the use of a surgeon-driven intraoperative neurophysiologic monitoring system. Intraoperative neurophysiologic monitoring is becoming the standard of care for spinal surgeries with potential post-operative neurologic deficits. This standard applies to both adult and pediatric spinal surgery, but a shortage of appropriately trained and certified technologists and physiologists can compromise monitoring capabilities in some centers...
September 2016: J Spine Surg
Marc Jubeau, Thomas Rupp, John Temesi, Stéphane Perrey, Bernard Wuyam, Guillaume Y Millet, Samuel Verges
PURPOSE: Prolonged cycling exercise performance in normoxia is limited due to both peripheral and central neuromuscular impairments. It has been reported that cerebral perturbations are greater during short-duration exercise in hypoxia compared to normoxia. The purpose of this study was to test the hypothesis that central deficits are accentuated in hypoxia compared to normoxia during prolonged (3 bouts of 80 min separated by 25 min) whole-body exercise at the same relative intensity...
October 6, 2016: Medicine and Science in Sports and Exercise
Yasuaki Imajo, Tsukasa Kanchiku, Hidenori Suzuki, Masahiro Funaba, Norihiro Nishida, Kazuhiro Fujimoto, Toshihiko Taguchi
INTRODUCTION: Lumbar spinal stenosis (LSS) typically presents with neurogenic intermittent claudication (NIC). The aim is to investigate cauda equina conduction time (CECT) in patients with NIC caused by LSS and its relationship with age and body height in normal subjects. METHODS: The study included 172 normal subjects (mean age 44.1 ± 16.6 years; mean height 163.7 ± 8.9 cm). (Group C) 47 patients (mean age 71.3 ± 8.7 years; mean height 158.8 ± 11.2 cm) underwent surgery due to NIC in cauda equina type for LSS...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
L Angius, B Pageaux, J Hopker, S M Marcora, A R Mauger
Transcranial direct current stimulation (tDCS) can increase cortical excitability of a targeted brain area, which may affect endurance exercise performance. However, optimal electrode placement for tDCS remains unclear. We tested the effect of two different tDCS electrode montages for improving exercise performance. Nine subjects underwent a control (CON), placebo (SHAM) and two different tDCS montage sessions in a randomised design. In one tDCS session, the anodal electrode was placed over the left motor cortex and the cathodal on contralateral forehead (HEAD), while for the other montage the anodal electrode was placed over the left motor cortex and cathodal electrode above the shoulder (SHOULDER)...
October 14, 2016: Neuroscience
Susana Pinto, Pedro Alves, Michael Swash, Mamede de Carvalho
AIMS OF THE STUDY: To compare the assessment of respiratory decline with conventional tests, measurement of diaphragm compound muscle action potential (CMAP) to phrenic nerve stimulation and diaphragm thickness to ultrasound (US) investigation in amyotrophic lateral sclerosis (ALS) patients followed for a short period of time. PATIENTS AND METHODS: We evaluated in 40 consecutive ALS patients, the clinical functional scale (ALSFRS-R), forced vital capacity (FVC), maximal voluntary ventilation (MVV), maximal inspiratory (MIP) and expiratory (MEP) pressures, sniff nasal inspiratory pressure (SNIP), Diaphragm-CMAP (latency and amplitude) and diaphragm US (maximal and minimal diaphragm thickness during full inspiration and expiration, respectively)...
October 14, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
Andreia Alves, Gudrun Koppen, Guido Vanermen, Adrian Covaci, Stefan Voorspoels
Phthalate esters (PEs) are easily metabolized and commonly excreted via urine within 24h, therefore their bioaccumulation potential is thought to be rather low. In the present study, we developed a sample preparation combined with a new microextraction method to measure seven PE metabolites in nails. The use of whole nails did not result in significantly different levels compared to powdered nails, which makes the method very fast and user friendly. The method was validated using whole nails showing good accuracy, satisfactory precision and low limits of quantification (2-14ng/g)...
September 28, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
David M Levine, Jeffrey A Linder, Bruce E Landon
Importance: Widespread deficits in the quality of US health care were described over a decade ago. Since then, local, regional, and national efforts have sought to improve quality and patient experience, but there is incomplete information about whether such efforts have been successful. Objective: To measure changes in outpatient quality and patient experience in the United States from 2002 to 2013. Design, Setting, and Participants: We analyzed temporal trends from 2002 to 2013 using quality measures constructed from the Medical Expenditure Panel Survey (MEPS), a nationally representative annual survey of the US population that collects data from individual respondents as well as respondents' clinicians, hospitals, pharmacies, and employers...
October 17, 2016: JAMA Internal Medicine
Mei-Yun Liaw, Lin-Yi Wang, Ya-Ping Pong, Yu-Chin Tsai, Yu-Chi Huang, Tsung-Hsun Yang, Meng-Chih Lin
The aim of this study was to investigate the relationships between pulmonary function, respiratory muscle strength, perceived dyspnea, degree of fatigue, and activity of daily living with motor function and neurological status in stroke patients with stable congestive heart failure (CHF).This was a cohort study in a tertiary care medical center. Stroke patients with CHF and exertional dyspnea (New York Heart Association class I-III) were recruited. The baseline characteristics included duration of disease, Brunnstrom stage, spirometry, resting heart rate, resting oxyhemoglobin saturation (SpO2), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Borg scale, fatigue scale, and Barthel index...
October 2016: Medicine (Baltimore)
Drishti Shah, Vamshi Ruthwik Anupindi, Varun Vaidya
Chronic back pain is an extremely common health problem. The largest category for pain therapy costs includes nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. However, there has been limited evidence outlining their effectiveness in terms of quality of life for the treatment of chronic back pain. The authors performed a comparative pharmacoeconomic analysis of chronic back pain patients using NSAIDs versus those using opioids alone or combination opioid analgesics. This pharmacoeconomic evaluation was conducted using the Medical Expenditure Panel Survey (MEPS)...
October 17, 2016: Journal of Pain & Palliative Care Pharmacotherapy
Suliman Alghnam, Glen H Tinkoff, Renan Castillo
BACKGROUND: Repeated injuries, as known as injury recidivism, pose a significant burden on population health and healthcare settings. Therefore, identifying those at risk of recidivism can highlight targeted populations for primary prevention in order to improve health and reduce healthcare expenditures. There has been limited research on factors associated with recidivism in the U.S. Using a population-based sample, we aim to: 1) identify the prevalence and risk factors for injury recidivism among non-institutionalized adults; 2) investigate the trend in nationwide recidivism rates over time...
December 2016: Injury Epidemiology
Chih-Cheng Lai, Chin-Ming Chen, Shyh-Ren Chiang, Wei-Lun Liu, Shih-Feng Weng, Mei-I Sung, Shu-Chen Hsing, Kuo-Chen Cheng
The aim of this study was to establish predictors for successfully planned extubation, which can be followed by medical personnel. The patients who were admitted to the adult intensive care unit of a tertiary hospital and met the following criteria between January 2005 and December 2014 were collected retrospectively: intubation > 48 hours; and candidate for extubation. The patient characteristics, including disease severity, rapid shallow breath index (RSBI), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), cuff leak test (CLT) before extubation, and outcome, were recorded...
October 2016: Medicine (Baltimore)
Renata Spósito Roxo, Vivian Bertoni Xavier, Luiz Antônio Miorin, Andrea Olivares Magalhães, Yvoty Alves Dos Santos Sens, Vera Lúcia Dos Santos Alves
Introduction: Literature shows that patients undergoing hemodialysis present poor physical conditioning and low tolerance to exercise. They may also suffer from respiratory dysfunctions. The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation on pulmonary function and functional capacity of patients with chronic kidney disease on hemodialysis. Methods: Forty adult patients with chronic kidney disease on hemodialysis were prospectively studied and randomized into two groups (control n = 20 and treatment n = 20)...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Mads Jochumsen, Imran K Niazi, Nada Signal, Rasmus W Nedergaard, Kelly Holt, Heidi Haavik, Denise Taylor
Learning new motor skills has been correlated with increased cortical excitability. In this study, different location of electrical stimulation (ES), nerve, or muscle, was paired with voluntary movement to investigate if ES paired with voluntary movement (a) would increase the excitability of cortical projections to tibialis anterior and (b) if stimulation location mattered. Cortical excitability changes were quantified using motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) at varying intensities during four conditions...
2016: Frontiers in Human Neuroscience
Arijita Deb, Usha Sambamoorthi
OBJECTIVE: To estimate rates and the patterns of depression treatment among adults with Chronic Obstructive Pulmonary Disease (COPD) and depression. METHODS: We used a retrospective, cross-sectional study design, pooling data from 2010 and 2012 Medical Expenditure Panel Survey (MEPS). The study sample consisted of 527 individuals aged 21 years or older, diagnosed with COPD and depression. Depression treatment was grouped into 3 categories based on those who received: 1) neither antidepressant nor psychotherapy; 2) antidepressants only; and 3) psychotherapy combined with antidepressants (combination therapy)...
October 13, 2016: Current Medical Research and Opinion
Chengqian Yuan, Haiming Wu, Meiye Jia, Peifeng Su, Zhixun Luo, Jiannian Yao
Weak intermolecular interactions in phenylenediamine dimer (pdd) clusters are studied by dispersion-corrected density functional theory (DFT) calculations. Along with the optimization of geometric structures and the calculation of interaction energies, we employ molecular electrostatic potential (MEP) mapping, natural bond orbital (NBO) analysis and quantum theory of atoms in molecule (AIM) to analyze the origin and relative energetic contributions of the weak interactions in these pdd systems. It is revealed that the most stable o-phenylenediamine dimer (opdd) cluster is dominated by N-HN hydrogen bonds, the p-phenylenediamine dimer (ppdd) cluster is largely stabilized by N-Hπ and ππ stacking interactions, while the m-phenylenediamine dimer (mpdd) cluster is mainly held by a combination of n → π*, C-Hπ and C-HN interactions...
October 12, 2016: Physical Chemistry Chemical Physics: PCCP
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