A prospective controlled study on the impact of anterior temporal lobectomy on dream content.

Objective: Changes of dream ability and content in patients with brain lesions have been addressed in only about 100 case reports. All of these reports lack data regarding prelesional baseline dream content. Therefore, it was the objective of this study to prospectively assess dream content before and after anterior temporal lobectomy.

Endovascular selective hypothermia facilitates giant aneurysm clipping: illustrative case.

Background: The authors present a case of selective hypothermia used for neuroprotection during clipping of a giant partially thrombosed middle cerebral artery (MCA) aneurysm. Although these cases have traditionally required deep hypothermic cardiac arrest, this case illustrates a novel and entirely endovascular solution that avoids cardiac standstill and whole-body cooling.

Observations: This is, to the authors' knowledge, the first case in human surgery of a catheter-based selective hypothermic circuit used to facilitate MCA trapping for almost 30 minutes.

Adequate vegetative cover decreases nitrous oxide emissions from cattle urine deposited in grazed pastures under rainy season conditions.

A decline in pasture productivity is often associated with a reduction in vegetative cover. We hypothesize that nitrogen (N) in urine deposited by grazing cattle on degraded pastures, with low vegetative cover, is highly susceptible to losses. Here, we quantified the magnitude of urine-based nitrous oxide (NO) lost from soil under paired degraded (low vegetative cover) and non-degraded (adequate vegetative cover) pastures across five countries of the Latin America and the Caribbean (LAC) region and estimated urine-N emission factors.

Dexmedetomidine for craniotomy under general anesthesia: A systematic review and meta-analysis of randomized clinical trials.

Study Objective: To assess the efficacy and safety of dexmedetomidine as an adjunct to general anesthesia for craniotomy.

Design: A meta-analysis after systematically searching PubMed, Medline, EMBASE, and Cochrane library for randomized trials (RCTs). Relative risk (RR) and weighted mean difference (WMD) were calculated using random-effects meta-analysis.

Functional diversity of brain networks supports consciousness and verbal intelligence.

How are the myriad stimuli arriving at our senses transformed into conscious thought? To address this question, in a series of studies, we asked whether a common mechanism underlies loss of information processing in unconscious states across different conditions, which could shed light on the brain mechanisms of conscious cognition. With a novel approach, we brought together for the first time, data from the same paradigm-a highly engaging auditory-only narrative-in three independent domains: anesthesia-induced unconsciousness, unconsciousness after brain injury, and individual differences in intellectual abilities during conscious cognition. During external stimulation in the unconscious state, the functional differentiation between the auditory and fronto-parietal systems decreased significantly relatively to the conscious state.

Establishment of epilepsy surgery in Peru.

Epilepsy surgery is a well-established treatment for certain types of intractable epilepsy. While there is a relatively high number of epilepsy surgery centers in Canada and the United States, the same cannot be said about many other parts of the world, such as South America. Although there are notable exceptions, such as Brazil and Colombia, formal epilepsy surgery centers have been lacking in many South American countries, including Peru.

Multilevel, ultra-large-volume epidural blood patch for the treatment of neurocognitive decline associated with spontaneous intracranial hypotension: case report.

Spontaneous intracranial hypotension (SIH) is a progressive clinical syndrome characterized by orthostatic headaches, nausea, emesis, and occasionally focal neurological deficits. Rarely, SIH is associated with neurocognitive changes. An epidural blood patch (EBP) is commonly used to treat SIH when conservative measures are inadequate, although some patients require multiple EBP procedures or do not respond at all.

Comparison of Registered and Reported Outcomes in Randomized Clinical Trials Published in Anesthesiology Journals.

Background: Randomized clinical trials (RCTs) provide high-quality evidence for clinical decision-making. Trial registration is one of the many tools used to improve the reporting of RCTs by reducing publication bias and selective outcome reporting bias. The purpose of our study is to examine whether RCTs published in the top 6 general anesthesiology journals were adequately registered and whether the reported primary and secondary outcomes corresponded to the originally registered outcomes.

Ultra-High Field Template-Assisted Target Selection for Deep Brain Stimulation Surgery.

Background: Template and atlas guidance are fundamental aspects of stereotactic neurosurgery. The recent availability of ultra-high field (7 Tesla) magnetic resonance imaging has enabled in vivo visualization at the submillimeter scale. In this Doing More with Less article, we describe our experiences with integrating ultra-high field template data into the clinical workflow to assist with target selection in deep brain stimulation (DBS) surgical planning.

Outcomes of General Anesthesia and Conscious Sedation in Endovascular Treatment for Stroke.

Background Recent studies have strongly indicated the benefits of endovascular therapy for acute ischemic stroke, but what remains a continued debate is the role for general anaesthesia versus conscious sedation (CS) for such procedures. Retrospective studies have found poorer neurological outcomes in patients who underwent general anesthesia (GA); however, some have revealed worse baseline stroke severity in these patients. Methods This study is a retrospective cohort study aimed at comparing mortality and morbidity of GA versus CS in patients treated with endovascular intervention in acute ischemic stroke.

Reduced Endotracheal Tube Cuff Pressure to Assess Dysphagia After Anterior Cervical Spine Surgery.

Study Design: This was a prospective, randomized control pilot study.

Objective: The aim of this study was to determine whether continuous monitoring and adjustment of the endotracheal tube cuff pressure (ETTCP) to 15 mm Hg during ACSS would alter the incidence of postoperative dysphagia.

Summary Of Background Data: Postoperative dysphagia is a recognized potential complication of anterior cervical spine surgery (ACSS).

Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis.

Background: The magnitude of risk of death related to surgery and anaesthesia is not well understood. We aimed to assess whether the risk of perioperative and anaesthetic-related mortality has decreased over the past five decades and whether rates of decline have been comparable in developed and developing countries.

Methods: We did a systematic review to identify all studies published up to February, 2011, in any language, with a sample size of over 3000 that reported perioperative mortality across a mixed surgical population who had undergone general anaesthesia.

Continuous monitoring of absolute cerebral blood flow by near-infrared spectroscopy during global and focal temporary vessel occlusion.

Treatment of intracranial aneurysms by surgical clipping carries a risk of intraoperative ischemia, caused mainly by prolonged temporary occlusion of cerebral arteries. The objective of this study was to develop a near-infrared spectroscopy (NIRS) technique for continuous monitoring of cerebral blood flow (CBF) during surgery. With this approach, cerebral hemodynamics prior to clipping are measured by a bolus-tracking method that uses indocyanine green as an intravascular contrast agent.

Magnesium for acute traumatic brain injury.

Background: Acute traumatic brain injury is a leading cause of death and disability in young adults. Numerous pharmacological and non-pharmacological tools have been investigated and considered as potential mechanisms for improving neurological outcome. Magnesium has been considered as one of these potential therapeutic tools because of its activity on NMDA-receptors, calcium channels and neuron membranes.

Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients.

Objective: To develop and validate practical prognostic models for death at 14 days and for death or severe disability six months after traumatic brain injury.

Design: Multivariable logistic regression to select variables that were independently associated with two patient outcomes. Two models designed: "basic" model (demographic and clinical variables only) and "CT" model (basic model plus results of computed tomography).

Neurosurgery for the treatment of epilepsy.

Purpose Of Review: Epilepsy is a common condition that is estimated to afflict 0.5-1.0% of the world's population.

Identification of a Nicotiana plumbaginifolia plasma membrane H(+)-ATPase gene expressed in the pollen tube.

In Nicotiana plumbaginifolia, plasma membrane H(+)-ATPases (PMAs) are encoded by a gene family of nine members. Here, we report on the characterization of a new isogene, NpPMA5 (belonging to subfamily IV), and the determination of its expression pattern using the beta-glucuronidase (gusA) reporter gene. pNpPMA5-gusA was expressed in cotyledons, in vascular tissues of the stem (mainly in nodal zones), and in the flower and fruit.

Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months.

MRC CRASH is a randomised controlled trial (ISRCTN74459797) of the effect of corticosteroids on death and disability after head injury. We randomly allocated 10,008 adults with head injury and a Glasgow Coma Scale score of 14 or less, within 8 h of injury, to a 48-h infusion of corticosteroid (methylprednisolone) or placebo. Data at 6 months were obtained for 9673 (96.

Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial.

Background: Corticosteroids have been used to treat head injuries for more than 30 years. In 1997, findings of a systematic review suggested that these drugs reduce risk of death by 1-2%. The CRASH trial--a multicentre international collaboration--aimed to confirm or refute such an effect by recruiting 20000 patients.

The plasma membrane proton pump ATPase: the significance of gene subfamilies.

The plasma membrane proton pump ATPase (H(+)-ATPase) plays a central role in transport across the plasma membrane. As a primary transporter, it mediates ATP-dependent H(+) extrusion to the extracellular space, thus creating pH and potential differences across the plasma membrane that activate a large set of secondary transporters. In several species, the H(+)-ATPase is encoded by a family of approximately 10 genes, classified into 5 gene subfamilies and we might ask what can this tell us about the concept, and the evolution, of gene families in plants.