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Stefaan Six, Steven Laureys, Jan Poelaert, Johan Bilsen, Peter Theuns, Reginald Deschepper
BACKGROUND: In case of untreatable suffering at the end of life, palliative sedation may be chosen to assure comfort by reducing the patient's level of consciousness. An important question here is whether such sedated patients are completely free of pain. Because these patients cannot communicate anymore, caregivers have to rely on observation to assess the patient's comfort. Recently however, more sophisticated techniques from the neurosciences have shown that sometimes consciousness and pain are undetectable with these traditional behavioral methods...
April 18, 2018: BMC Palliative Care
Nicholas West, Paul B McBeth, Sonia M Brodie, Klaske van Heusden, Sarah Sunderland, Guy A Dumont, Donald E G Griesdale, J Mark Ansermino, Matthias Görges
Sedation in the intensive care unit (ICU) is challenging, as both over- and under-sedation are detrimental. Current methods of assessment, such as the Richmond Agitation Sedation Scale (RASS), are measured intermittently and rely on patients' behavioral response to stimulation, which may interrupt sleep/rest. A non-stimulating method for continuous sedation monitoring may be beneficial and allow more frequent assessment. Processed electroencephalography (EEG) monitors have not been routinely adopted in the ICU...
February 20, 2018: Journal of Clinical Monitoring and Computing
Nicholas West, Klaske van Heusden, Matthias Görges, Sonia Brodie, Aryannah Rollinson, Christian L Petersen, Guy A Dumont, J Mark Ansermino, Richard N Merchant
BACKGROUND: Closed-loop control of anesthesia involves continual adjustment of drug infusion rates according to measured clinical effect. The NeuroSENSE monitor provides an electroencephalographic measure of depth of hypnosis (wavelet-based anesthetic value for central nervous system monitoring [WAVCNS]). It has previously been used as feedback for closed-loop control of propofol, in a system designed using robust control engineering principles, which implements features specifically designed to ensure patient safety...
November 22, 2017: Anesthesia and Analgesia
Christian Leth Petersen, Matthias Görges, Roslyn Massey, Guy Albert Dumont, J Mark Ansermino
BACKGROUND: Recent research and advances in the automation of anesthesia are driving the need to better understand electroencephalogram (EEG)-based anesthesia end points and to test the performance of anesthesia monitors. This effort is currently limited by the need to collect raw EEG data directly from patients. METHODS: A procedural method to synthesize EEG signals was implemented in a mobile software application. The application is capable of sending the simulated signal to an anesthesia depth of hypnosis monitor...
November 2016: Anesthesia and Analgesia
Kevin Humblet, Marie-Agnès Docquier, Jean Rubay, Mona Momeni
No abstract text is available yet for this article.
February 2017: Journal of Cardiothoracic and Vascular Anesthesia
Julie Bresson, Etienne Gayat, Gracee Agrawal, Thierry Chazot, Ngai Liu, Chantal Hausser-Haw, Marc Fischler
BACKGROUND: NeuroSENSE is a depth of anesthesia monitor that uses automated electroencephalogram quantification. The Wavelet-based Anesthetic Value for Central Nervous System (WAVCNS) index calculated by this monitor is based on wavelet analysis of a normalized electroencephalogram signal in the γ-frequency band. The aim of this study was to determine the extent of disagreement between the Bispectral Index (BIS) and the WAVCNS index during propofol-based and sevoflurane-based maintenance of general anesthesia in a routine surgical population...
November 2015: Anesthesia and Analgesia
Jian Xu, Menglian Zhao, Xiaobo Wu, Md Kafiul Islam, Zhi Yang
Recorded neural data are frequently corrupted by large amplitude artifacts that are triggered by a variety of sources, such as subject movements, organ motions, electromagnetic interferences and discharges at the electrode surface. To prevent the system from saturating and the electronics from malfunctioning due to these large artifacts, a wide dynamic range for data acquisition is demanded, which is quite challenging to achieve and would require excessive circuit area and power for implementation. In this paper, we present a high performance Delta-Sigma modulator along with several design techniques and enabling blocks to reduce circuit area and power...
2015: Sensors
Mona Momeni, Philippe Baele, Luc-Marie Jacquet, André Peeters, Philippe Noirhomme, Jean Rubay, Marie-Agnès Docquier
No abstract text is available yet for this article.
August 2015: Journal of Cardiothoracic and Vascular Anesthesia
Ming Yin, David A Borton, Juan Aceros, William R Patterson, Arto V Nurmikko
A 100-channel fully implantable wireless broadband neural recording system was developed. It features 100 parallel broadband (0.1 Hz-7.8 kHz) neural recording channels, a medical grade 200 mAh Li-ion battery recharged inductively at 150 kHz , and data telemetry using 3.2 GHz to 3.8 GHz FSK modulated wireless link for 48 Mbps Manchester encoded data. All active electronics are hermetically sealed in a titanium enclosure with a sapphire window for electromagnetic transparency. A custom, high-density configuration of 100 individual hermetic feedthrough pins enable connection to an intracortical neural recording microelectrode array...
April 2013: IEEE Transactions on Biomedical Circuits and Systems
Suw Young Ly, Dal woong Choi
Neurotransmitter assay of epinephrine (EP) was sought using a modified carbon nanotube paste electrode (PE). Using optimum conditions, cyclic voltammetry (CV) and the square wave (SW) stripping voltammetric working ranges were attained to 10-100 mgL(-1) (CV) and 20-140 ngL(-1) (SW). The relative standard deviation of 0.0549 (n=15) was obtained at 20.0 mgL(-1) EP constant. Here, the analytical detection limit (S/N) was reached with 4.60 ngL(-1) (2.5×10(-11) molL(-1)) EP. The hand-made electrode was implanted into the in-vivo brain core of the animals and was used in chronoamperometric neurodetection...
August 2013: Current Neurovascular Research
Nicholas West, Guy A Dumont, Klaske van Heusden, Christian L Petersen, Sara Khosravi, Kristian Soltesz, Aryannah Umedaly, Eleanor Reimer, J Mark Ansermino
BACKGROUND: During closed-loop control, a drug infusion is continually adjusted according to a measure of clinical effect (e.g., an electroencephalographic depth of hypnosis (DoH) index). Inconsistency in population-derived pediatric pharmacokinetic/pharmacodynamic models and the large interpatient variability observed in children suggest a role for closed-loop control in optimizing the administration of intravenous anesthesia. OBJECTIVE: To clinically evaluate a robustly tuned system for closed-loop control of the induction and maintenance of propofol anesthesia in children undergoing gastrointestinal endoscopy...
August 2013: Paediatric Anaesthesia
Meining Zhang, Ping Yu, Lanqun Mao
To understand the molecular basis of brain functions, researchers would like to be able to quantitatively monitor the levels of neurochemicals in the extracellular fluid in vivo. However, the chemical and physiological complexity of the central nervous system (CNS) presents challenges for the development of these analytical methods. This Account describes the rational design and careful construction of electrodes and nanoparticles with specific surface/interface chemistry for quantitative in vivo monitoring of brain chemistry...
April 17, 2012: Accounts of Chemical Research
Gracee Agrawal, Mohammad Modarres, Tatjana Zikov, Stephane Bibian
OBJECTIVE: Visual scoring of 30-s epochs of sleep data is not always adequate to show the dynamic structure of sleep in sufficient details. It is also prone to considerable inter- and intra-rater variability. Moreover, it involves considerable training and experience, and is very tedious, time-consuming, labor-intensive and costly. Hence, automatic sleep staging is needed to overcome these limitations. Since naturally occurring NREM sleep and anesthesia have been reported to possess various underlying neurophysiological similarities, EEG-based depth-of-anesthesia monitors have started to penetrate into sleep research...
April 2011: Journal of Clinical Monitoring and Computing
Stéphane Bibian, Guy A Dumont, Tatjana Zikov
OBJECTIVES: The objective of this paper is to assess the suitability of brain function monitors for use in closed-loop anesthesia or sedation delivery. In such systems, monitors used as feedback sensors should preferably be Linear and Time Invariant (LTI) in order to limit sensor-induced uncertainty which can cause degraded performance. In this paper, we evaluate the suitability of the BIS A2000 (Aspect Medical Systems, MA), the M-Entropy Monitor (GE HealthCare), and the NeuroSENSE Monitor (NeuroWave Systems Inc, OH), by verifying whether their dynamic behavior conforms to the LTI hypothesis...
February 2011: Journal of Clinical Monitoring and Computing
Masoud Roham, Charles D Blaha, Paul A Garris, Kendall H Lee, Pedram Mohseni
A 16-channel chip for wireless in vivo recording of chemical and electrical neural activity is described. The 7.83-mm2 IC is fabricated using a 0.5-microm CMOS process and incorporates a 71-microW, 3rd-order, configurable, DeltaSigma modulator per channel, achieving an input-referred noise of 4.69 microVrms in 4-kHz BW and 94.1 pArms in 5-kHz BW for electrical and fastscan voltammetric chemical neurosensing, respectively. Brain extracellular levels of dopamine elicited by electrical stimulation of the medial forebrain bundle have been recorded wirelessly on multiple channels using 300-V/s fast-scan cyclic voltammetry in the anesthetized rat...
2009: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Ricardo Horta, Rui Barbosa, Isabel Oliveira, José Manuel Amarante, Marisa Marques, Jorge Cruz Reis, Marco Rebelo
Coverage of a soft tissue defect of the thumb that cannot be replanted or without bone shortening is difficult to achieve, but it is essential to preserve key-pinch and to restore a sensible and painless pulp.We reviewed retrospectively 107 cases of thumb reconstruction in an emergency situation using the following flaps: Moberg, radial innervated cross-finger, Venkataswami-Subramanian, Foucher, Tezcan, and Littler.The choice of the flap was determined by the extension and location of the injury; Foucher flap (56 cases) was the most used one, and it proved to be the best choice as shown by the results...
June 2009: Techniques in Hand & Upper Extremity Surgery
T Soldati, E C Schwarz, H Geissler
The cytoplasm of eukaryotic cells is a complex milieu and unraveling how its unique cytoarchitecture is achieved and maintained is a central theme in modern cell biology. The actin cytoskeleton is essential for the maintenance of cell shape and locomotion, and also provides tracks for active intracellular transport. Myosins, the actin-dependent motor proteins form a superfamily of at least 15 structural classes and have been identified in a wide variety of organisms, making the presence of actin and myosins a hallmark feature of eukaryotes...
1999: Protoplasma
H Leonhardt, D Meinecke, T Mustafa, K L Gerlach
Measuring devices for the quantitative assessment of thermal and pain thresholds are either simple and only suited for inexact tests or accurate and objective but expensive. The aim was there for to develop a cost effective device to enable a short and practical test of neurosensibility under clinical conditions. The result of this development is a new thermosensibility-measuring device (TSM) consisting of the measuring unit itself and a thermal probe. The data are registered and analysed through direct data transfer to a connected PC...
September 2005: Biomedizinische Technik. Biomedical Engineering
K Ando, M S Wallace, J Braun, G Schulteis
BACKGROUND AND OBJECTIVES: Mexiletine is a sodium channel blocker that has been used for the treatment of a variety of neuropathic pain syndromes. A recent double-blinded placebo-controlled study concluded that it was ineffective in the treatment of allodynia associated with neuropathic pain. However, this study failed to achieve adequate plasma levels of mexiletine. This was a study in healthy volunteers that sought to push the drug to dose-limiting side effects and then evaluate the effects on human experimental pain...
September 2000: Regional Anesthesia and Pain Medicine
M S Wallace, S Magnuson, B Ridgeway
BACKGROUND AND OBJECTIVES: Mexiletine is an oral sodium channel antagonist that has been reported to be effective in a variety of neuropathic pain syndromes. However, recent reports question the efficacy of oral mexiletine in neuropathic pain. The objectives of this study were to examine the effect of oral mexiletine on pain, neurosensation, allodynia, and quality of life. METHODS: Twenty subjects suffering from neuropathic pain with prominent allodynia were enrolled in a randomized placebo-controlled crossover study...
September 2000: Regional Anesthesia and Pain Medicine
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