Autonomous precision resuscitation during ground and air transport of an animal hemorrhagic shock model.

We tested the ability of a physiologically driven minimally invasive closed-loop algorithm, called Resuscitation based on Functional Hemodynamic Monitoring (ReFit), to stabilize for up to 3 h a porcine model of noncompressible hemorrhage induced by severe liver injury and do so during both ground and air transport. Twelve animals were resuscitated using ReFit to drive fluid and vasopressor infusion to a mean arterial pressure (MAP) > 60 mmHg and heart rate < 110 min 30 min after MAP < 40 mmHg following liver injury. ReFit was initially validated in 8 animals in the laboratory, then in 4 animals during air (23nm and 35nm) and ground (9 mi) to air (9.

[Epilepsy surgery seems underutilized in Sweden].

Epilepsy surgery should be considered for individuals with drug-resistant focal epilepsy. The pre-surgical evaluation is highly multi-disciplinary and performed by a team consisting of neurologists, neurophysiologists, neurosurgeons, neuroradiologists, neuropsychologists, biomedical scientists, speech-language pathologists and nursing staff. The evaluation comprises of a meticulous medical history with focus on seizure semiology, a 3 Tesla MRI, ictal video-EEG, neuropsychological evaluation and sometimes also MEG, nTMS, fMRI, PET or SISCOM/ictal SPECT.

The Microcirculatory Response to Endotoxemia and Resuscitation Is a Marker of Regional Renal Perfusion, Renal Metabolic Stress, and Tubular Injury.

We sought to investigate the relationship between macrohemodynamic resuscitation and microcirculatory parameters with the response of microcirculatory flow, tissue-specific parameters of metabolic stress and injury. We hypothesized that early resuscitation based on macrohemodynamic parameters does not prevent the development of organ dysfunction in a porcine model of endotoxemic shock, and that sublingual microcirculatory parameters are associated with markers of tissue metabolic stress and injury. Both resuscitation groups had significant increases in creatinine and neutrophil gelatinase-associated lipocalin as compared with baseline.

POLG-Associated Ataxia Presenting as a Fragile X Tremor/Ataxia Phenocopy Syndrome.

Hyperintensities in the middle cerebellar peduncles (MCP), known as the MCP sign, and progressive late-onset ataxia constitute major characteristics of the fragile X tremor/ataxia syndrome (FXTAS). Here, we describe a 60-year-old male affected by ataxia due to biallelic mutations in the mitochondrial polymerase gamma (POLG) gene in which hyperintensities of the middle cerebellar peduncles (MCP) were found. The initial suspicion of FXTAS was however ruled out by a normal CGG expansion size in the FMR1 gene.

Inhaled, nebulized sodium nitrite protects in murine and porcine experimental models of hemorrhagic shock and resuscitation by limiting mitochondrial injury.

Objective: The cellular injury that occurs in the setting of hemorrhagic shock and resuscitation (HS/R) affects all tissue types and can drive altered inflammatory responses. Resuscitative adjuncts hold the promise of decreasing such injury. Here we test the hypothesis that sodium nitrite (NaNO2), delivered as a nebulized solution via an inhalational route, protects against injury and inflammation from HS/R.

Inhaled Carbon Monoxide Protects against the Development of Shock and Mitochondrial Injury following Hemorrhage and Resuscitation.

Aims: Currently, there is no effective resuscitative adjunct to fluid and blood products to limit tissue injury for traumatic hemorrhagic shock. The objective of this study was to investigate the role of inhaled carbon monoxide (CO) to limit inflammation and tissue injury, and specifically mitochondrial damage, in experimental models of hemorrhage and resuscitation.

Results: Inhaled CO (250 ppm for 30 minutes) protected against mortality in severe murine hemorrhagic shock and resuscitation (HS/R) (20% vs.

An adequately robust early TNF-alpha response is a hallmark of survival following trauma/hemorrhage.

Background: Trauma/hemorrhagic shock (T/HS) results in cytokine-mediated acute inflammation that is generally considered detrimental.

Methodology/principal Findings: Paradoxically, plasma levels of the early inflammatory cytokine TNF-alpha (but not IL-6, IL-10, or NO(2) (-)/NO(3) (-)) were significantly elevated within 6 h post-admission in 19 human trauma survivors vs. 4 non-survivors.

Analysis of acuity trends using Resource Intensity Weights via the CIHI Portal.

One key to revolutionizing health care with informatics is the ability of decision-makers to access and analyze relevant data in a timely and efficient manner. Inspired by the demand for timely access to hospitalization data in Canada, CIHI Portal is an innovative web-based analytical tool which combines leading technology and data for decision support analysis. Hospitals, regional health authorities and ministries of health can use CIHI Portal to access comparable, pan-Canadian healthcare data for health data analysis, collaboration and dissemination.

Self-efficacy and academic achievement in Australian high school students: the mediating effects of academic aspirations and delinquency.

Studies have shown that self-efficacy, aspirational, and other psychosocial influences account for considerable variance in academic achievement through a range of mediational pathways, although no research to date has tested the mediational relationships identified. The present research investigated the structural relations among self-efficacy, academic aspirations, and delinquency, on the academic achievement of 935 students aged 11-18 years from ten schools in two Australian cities. The Children's Self-Efficacy Scale, Adapted Self-Report Delinquency Scale (Revised), and Children's Academic Aspirations Scale were administered to participants prior to academic achievement being assessed using mid-year school grades.

Evaluation of a community health promotion resource for primary care practices.

Background: Primary care physicians' ability to provide effective health behavior change advice might be leveraged by linking to available community resources. This study evaluates tools to facilitate such a link.

Design: A mixed methods longitudinal pre-post-test study was conducted in 2004.

Ethical parameters of challenge studies inducing psychosis with ketamine.

Researchers routinely induce psychosis in healthy volunteers via ketamine infusion to expand their knowledge of schizophrenia. We question the ethics of the nature and procedures of such studies. We also address safeguards for ethically conducting and reporting such pursuits, including recruitment, screening, available treatment, and follow-up.