Comparison of Propofol-Based Total Intravenous Anesthesia versus Volatile Anesthesia with Sevoflurane for Postoperative Delirium in Adult Coronary Artery Bypass Grafting Surgery: A Prospective Randomized Single-Blinded Study.

Objectives: To compare the incidence of delirium and early (at 1 week) postoperative cognitive dysfunction (POCD) between propofol-based total intravenous anesthesia (TIVA) and volatile anesthesia with sevoflurane in adult patients undergoing elective coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB).

Design: This was a prospective randomized single-blinded study.

Setting: The study was conducted at a single institution, the Sree Chitra Tirunal Institute for Medical Sciences and Technology, a tertiary care institution and university-level teaching hospital.

Need for cross-level iterative re-entry in models of visual processing.

Two main hypotheses regarding the directional flow of visual information processing in the brain have been proposed: feed-forward (bottom-up) and re-entrant (top-down). Early theories espoused feed-forward principles in which processing was said to advance from simple to increasingly complex attributes terminating at a higher area where conscious perceptions occur. That view is disconfirmed by advances in neuroanatomy and neurophysiology, which implicate re-entrant two-way signaling as the predominant form of communication between brain regions.

Using Temporal Data Mining on Patient Data for Clinical Decision Making in the Care of the Sick Newborn.

Background: In a neonatal intensive care unit, streaming healthcare data comes from many sources, but humans are unable to understand relationships between data variables. Data mining and analysis are just beginning to get utilized in critical care. We present a case study using electronic medical record data in the neonatal intensive care unit and explore possible avenues of advancement using temporal data analytics.

Preoperative screening for obstructive sleep apnea in cardiovascular patients - How useful is STOP-BANG questionnaire in the Indian context?

Background: Obstructive sleep apnea (OSA) is reported in a high proportion of cardiac surgical patients, up to 73%. STOP-BANG is a validated questionnaire for screening of outpatients for OSA with high sensitivity. There is sparse literature from India regarding the prevalence of OSA in preoperative cardiovascular patients and the utility of screening tools.

A comparison of sevoflurane versus sevoflurane-propofol combination on renal function in patients undergoing valvular heart surgery-A prospective randomized controlled pilot study.

Aim: The objective of the present study was to compare the effect of sevoflurane with the sevoflurane-propofol combination on renal function in patients undergoing valvular heart surgery. The renal protective effect was assessed using a novel marker called neutrophil gelatinase-associated lipocalin (NGAL).

Materials And Methods: This was a prospective randomized controlled pilot study conducted at a tertiary care center in India.

Congenital long QT syndrome and patent ductus arteriosus: A rare surgical scenario.

Congenital long QT syndrome (LQTS) is a rare cardiac condition characterized by abnormality of either sodium or potassium ion channels resulting in prolongation of QT interval and thereby predisposing to life-threatening arrhythmia. Once the syndrome is diagnosed, measures should be taken to avoid sudden cardiac death. We present a rare case of LQTS associated with patent ductus arteriosus in a child, and a unique approach was used in managing both conditions.

Intraoperative Three-dimensional Imaging of Ventricular Septal Defects in Children Using Epicardial Echocardiography: A Novel Approach.

Objective: To assess the feasibility and accuracy of intraoperative three-dimensional (3D) epicardial en face images of ventricular septal defects (VSD) in children using the 3D transesophageal echocardiography (TEE) probe as an epicardial probe.

Design: This was a prospective nonrandomized blinded observational study.

Setting: The study was conducted at a single tertiary cardiac care center.

Intraoperative assessment of transient and persistent regional left ventricular wall motion abnormalities in patients undergoing coronary revascularization surgery using real time three-dimensional transesophageal echocardiography: A prospective observational study.

Objective: To evaluate the feasibility of intraoperative real time three-dimensional echocardiography (RT3DE) for identification and quantification of transient and persistent regional wall motion abnormalities (RWMAs) in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting (CABG).

Design: A prospective observational study SETTING: Single-center study in an academic tertiary care hospital PARTICIPANTS: A series of 42 patients undergoing elective CABG over a 2-year period were included.

Intervention: After induction of anesthesia, a comprehensive transesophageal echocardiography (TEE) examination was performed to evaluate regional wall motion using two-dimensional wall motion score index (WMSI) and RT3D echocardiographic parameters at three specific time points during the operative phase.

Discovering functional neuronal connectivity from serial patterns in spike train data.

Repeating patterns of precisely timed activity across a group of neurons (called frequent episodes) are indicative of networks in the underlying neural tissue. This letter develops statistical methods to determine functional connectivity among neurons based on nonoverlapping occurrences of episodes. We study the distribution of episode counts and develop a two-phase strategy for identifying functional connections.

Revenue, relationships and routines: the social organization of acute myocardial infarction patient transfers in the United States.

Heart attack, or acute myocardial infarction (AMI), is a leading cause of death in the United States (U.S.).

Spatio-temporal Structure of US Critical Care Transfer Network.

Most Americans are in Intensive Care Units (ICUs) at some point during their lives. There is wide variation in the outcome quality of ICUs and so, thousands of patients who die each year in ICUs may have survived if they were at the appropriate hospital. In spite of a policy agenda from IOM calling for effective transfer of patients to more capable hospitals to improve outcomes, there appear to be substantial inefficiencies in the existing system.

Conditional probability-based significance tests for sequential patterns in multineuronal spike trains.

We consider the problem of detecting statistically significant sequential patterns in multineuronal spike trains. These patterns are characterized by ordered sequences of spikes from different neurons with specific delays between spikes. We have previously proposed a data-mining scheme to efficiently discover such patterns, which occur often enough in the data.

Statistical significance of sequential firing patterns in multi-neuronal spike trains.

Sequential firings with fixed time delays are frequently observed in simultaneous recordings from multiple neurons. Such temporal patterns are potentially indicative of underlying microcircuits and it is important to know when a repeatedly occurring pattern is statistically significant. These sequences are typically identified through correlation counts.

Economic evaluation of public-private mix for tuberculosis care and control, India. Part II. Cost and cost-effectiveness.

Setting: Bangalore City, India.

Objectives: To assess the cost and cost-effectiveness of public-private mix (PPM) for tuberculosis (TB) care and control when implemented on a large scale.

Design: DOTS implementation under the Revised National TB Control Programme (RNTCP) began in 1999, PPM was introduced in mid-2001 and a second phase of intensified PPM began in 2003.

Economic evaluation of public-private mix for tuberculosis care and control, India. Part I. Socio-economic profile and costs among tuberculosis patients.

Setting: Bangalore City, India.

Objectives: To assess the socio-economic profile, health-seeking behaviour and costs related to tuberculosis (TB) diagnosis and treatment among patients treated under the Revised National TB Control Programme (RNTCP).

Design: All 1106 new TB patients registered for treatment under the RNTCP in the second quarter of 2005 participated.

Oxygraphy: an unexplored perioperative monitoring modality.

Capnography waveforms and capnometry are useful perioperative monitoring tools. The paramagnetic oxygen analyzers incorporated in many clinical monitoring systems estimate oxygen concentration in the breathing circuit during various phases of ventilation. The oxygen concentration is plotted as a real-time waveform and displayed as an oxygraph.

Surgical retrieval of embolised atrial septal occluder device from pulmonary artery: pathophysiology and role of the intraoperative transoesophageal echocardiography.

Atrial septal defect is usually closed in the cardiac catheterisation laboratory using atrial septal occluder (ASO) device. One of the complications associated with the procedure is embolisation of the device into the pulmonary artery. We are reporting two cases wherein the pulmonary embolisation of ASO device occurred during the procedure in one patient and in the early post-procedure period in another; both were retrieved surgically.