Impact of aging on spreading depolarizations induced by focal brain ischemia in rats

Spreading depolarization (SD) contributes to the ischemic damage of the penumbra. Although age is the largest predictor of stroke, no studies have examined age dependence of SD appearance. We characterized the electrophysiological and hemodynamic changes in young (6 weeks old, n = 7), middle-aged (9 months old, n = 6), and old (2 years old, n = 7) male Wistar rats during 30 minutes of middle cerebral artery occlusion (MCAO), utilizing multimodal imaging through a closed cranial window over the ischemic cortex: membrane potential changes (with a voltage-sensitive dye), cerebral blood volume (green light reflectance), and cerebral blood flow (CBF, laser-speckle imaging) were observed. The initial CBF drop was similar in all groups, with a significant further reduction during ischemia in old rats (p < 0.01). Age reduced the total number of SDs (p < 0.05) but increased the size of ischemic area displaying prolonged SD (p < 0.01). The growth of area undergoing prolonged SDs positively correlated with the growth of ischemic core area (p < 0.01) during MCAO. Prolonged SDs and associated hypoperfusion likely compromise cortical tissue exposed to even a short focal ischemia in aged rats.     

多模态超声检查对甲状腺弥漫性病变合并结节的诊断分析

目的:探讨分析多模态超声检查对甲状腺弥漫性病变合并结节的诊断价值。方法:选取2017年5月-2019年5月我院收治的甲状腺弥漫性病变合并结节患者400例,所有患者均在我院接受超声检查。并且全部患者均通过穿刺活检或者手术病理检查确诊。观察比较与病理诊断结果相比超声检查的准确性;良性结节与恶性结节在不同超声特征方面的差异。结果:所有400例患者的病理诊断结果提示,共检查出甲状腺结节:418个,其中,良性结节:148个,恶性结节:270个;超声检查共检查出甲状腺结节408个,其中,良性结节:144个,恶性结节:264个,与病理诊断相比,超声检查在甲状腺结节方面的检出率并无显著差异(P>0.05)。恶性结节与良性结节在不同超声特征:形态、纵横比、边界、边缘、声晕、内部回声、钙化灶、后方回声、相对运动、血流分布、阻力指数、硬度等方面均存在显著差异(P<0.05)。结论:甲状腺弥漫性病变合并结节使用多模态超声检查诊断的准确率较高,且通过多模态超声检查也能够有效地区分良性结节与恶性结节,值得应用。     

多模式综合训练对改善脑梗死患者认知功能及抑郁症状的效果分析

目的 探讨多模式综合训练对改善脑梗死患者认知功能及抑郁症状的效果。方法 选取 2017年11月-2018年11月我科收治的223例脑梗死患者,采用随机数字表法将其分为对照组(113例)和观察组(110例)。对照组采用常规护理方法,观察组采用多模式综合训练法,干预前及干预1个月后比较2组蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)和抑郁自评量表(self-rating depression scale,SDS)评分情况。结果 干预后,观察组MoCA评分高于对照组(t=6.732,P=0.004),SDS评分低于对照组(t= 23.221,P=0.005)。结论 多模式综合训练法应用于脑梗死患者,可有效改善患者的认知功能状态、缓解患者抑郁症状,具有积极的现实意义,值得临床推广。     

A method for recording behavior and multineuronal CNS activity from tethered insects flying in virtual space

We describe a low cost, novel virtual reality-based insect flight simulator that combines visual, olfactory and mechanosensory stimuli with multichannel neurophysiological recording techniques. Three-dimensional visual environments were created using customized modifications of a first person flight simulator computer game. Experiments could be performed in open-loop, where the flying insect's movement through the environment is ‘driven’ by the human operator, or in closed-loop where the movement of the environment is controlled by optically sensed movements of the insect's abdomen. During flight, we recorded multineuronal activity from the ventral nerve cord between the brain and thoracic ganglia. Results show that in open-loop conditions, induced turns of the environment evoked characteristic compensatory optomotor responses. Coordination of wing and body kinematics was similar to that observed in free flight. In closed-loop conditions, the insect was able to navigate through the simulated environment and produce flight tracks in response to presentation of pheromone that resemble those observed in free flight. We discuss the effectiveness of this preparation and its utility for addressing specific questions of insect flight as well as general questions in neuroethology.     

Adult Cancer Pain: An Evidence-Based Update

Cancer often produces excruciating pain, which sends waves reverberating through the person's body, mind, spirit, and social interactions diminishing their quality of life and that of those closest to them. This updated review will summarize the latest research exploring the biologic mechanisms, psychosocial impact, and evidence-based approaches to treating cancer pain. Persons with cancer should not live or die with needless pain because of the detrimental effects it has on longevity and quality of life. This review intends to inform nurses of evidence-informed best practices they can use to prevent avoidable suffering that results from cancer pain.     

Imagen multimodal en la maculopatía fototóxica: descripción de hallazgos en una serie de 12 pacientes

ObjectiveTo study the differences between solar retinopathy (SR) and the maculopathy produced by laser pointer (LPM) using multimodal imaging.MethodA retrospective series is presented of 20 eyes of 12 patients with injuries associated with light, 7 with SR-compatible injuries, and 5 with LPM. At diagnosis, a complete ophthalmological examination was performed, including visual acuity (VA), retinography, and spectral domain optical coherence tomography (OCT). The patients were followed-up for a mean period of 20 months.ResultsLPM is common in paediatrics (mean age 15.60 ± 1.5 years), and SR affects patients of all ages (mean age 47.56 ± 1.51 years). VA at diagnosis in LPM is greater, and recovery is more complete than in solar retinopathy. In conventional retinography, SR is shown as a single lesion in the macular area (100% of cases), while LPM usually presents as multifocal lesions (86% of cases). Infrared reflectance makes this difference clearer. The main sign in OCT is the disruption of the ellipsoid layer and interdigitation zone. This sign is maintained over time, and its size is greater in the SR than in the LPM. Hyper-reflective columns and hyper-reflective reaction of the retinal pigment epithelium are associated with the acute phase.ConclusionsLPM and SR show significant differences in the type of patient affected, as well as in the signs in multimodal imaging, as well as in functional impairment and their evolution.     

Neonatal whisker removal in rats stabilizes a transient projection from the auditory thalamus to the primary somatosensory cortex

A normally transient cross-modal thalamocortical projection from the magnocellular subdivision of the medial geniculate nucleus (MGm) to the primary somatosensory (SI) cortex of rats was found to remain unchanged throughout adulthood following unilateral removal of whiskers in newborn animals. The normal MGm projection to the auditory cortex is not lost in these neonatally whisker-deprived adults rats but some of the MGm neurons send collaterals to both primary auditory and SI cortices. Parallel electrophysiological experiments demonstrated the multimodal character of some MGm neurons, since they responded to both auditory and cutaneous stimulation. These results suggest that the areal distribution in the cortex of thalamocortical projections arising from a multimodal thalamic nucleus, such as the MGm, may be determined during early postnatal development by the normal flow of sensory information from the periphery to the thalamus and that an early postnatal somatosensory deprivation may prevent the normal withdrawal of a cross-modal projection from the MGm to the SI.     

Importancia de la monitorización bilateral de la oxigenación cerebral: caso clínico de asimetría durante el bypass cardiopulmonar secundaria a infarto cerebral previo

Cerebral oximetry based on near infrared spectroscopy (NIRS) technology is used to determine cerebral tissue oxygenation. We hereby present the clinical case of a 12-month old child with right hemiparesis secondary to prior left middle cerebral artery stroke 8 months ago. The child underwent surgical enlargement of the right ventricular outflow tract (RVOT) with cardiopulmonary bypass. During cardiopulmonary bypass, asymmetric NIRS results were detected between both hemispheres. The utilization of multimodal neuromonitoring (NIRS-BIS) allowed acting on both perfusion pressure and anesthetic depth to balance out the supply and demand of cerebral oxygen consumption. No new neurological sequelae were observed postoperatively. We consider bilateral NIRS monitoring necessary in order to detect asymmetries between cerebral hemispheres. Although asymmetries were not present at baseline, they can arise intraoperatively and its monitoring thus allows the detection and treatment of cerebral ischemia-hypoxia in the healthy hemisphere, which if undetected and untreated would lead to additional neurological damage.