Prophylactic control of post‐operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery

Background: The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post‐operative nausea and vomiting (PONV) associated with patient‐controlled analgesia (PCA) after cardiac surgery. Methods: A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2). Results: The incidence of PONV during the 48‐h post‐operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24‐h post‐operative period, whereas the incidence and severity of nausea during 24–48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%). Conclusion: The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.     

Esclerosis hipocampal: evaluación volumétrica de las subestructuras del hipocampo utilizando resonancia magnética

Objective

The pathological classification of hippocampal sclerosis is based on the loss of neurons in the substructures of the hippocampus. This study aimed to evaluate these substructures in patients with hippocampal sclerosis by magnetic resonance imaging and to compare the usefulness of this morphological analysis compared to that of volumetric analysis of the entire hippocampus.

Fijación lumbar posterior empleando el sistema de imagen quirúrgica O-arm: experiencia inicial

ObjectThe use of transpedicular screw fixation has been widely accepted for the treatment of degenerative and traumatic pathology of the lumbar spine. Complications of spinal instrumentation can be serious. Screw misplacement can result in unintended durotomy, nerve root and/or cauda equina injury. In comparison to fluoroscopy-assisted screw placement, computer-assisted image guidance has been shown to achieve overall higher rates of accuracy. The O-arm is able to obtain computed tomography (CT)-type images with multiplanar reconstruction. In this study we evaluated a cohort of patients who underwent posterior lumbar fusion with pedicle screws utilizing the O-arm imaging system.MethodsA retrospective review of 40 consecutive patients who underwent posterior lumbar fusion surgery with O-arm utilization, was performed. The study population included 14 males and 26 females. Age range was 39-85 years with an average of 63.8 years. Twenty one patients had degenerative lumbar stenosis (52.5%) and 19 had spondylolisthesis (47.5%). Intraoperative CT-images were obtained. The mean time for surgery and screw placement was assessed.ResultsA total of 252 pedicle screws were sited using O-arm navigation system, with a mean of 6.3 screws per patient (range 4-10). On the basis of intraoperative CT, 3 screws were redirected, representing a 98.81% accuracy rate.The mean duration of surgery was 157.2 (90-240) minutes and the mean time for screw placement was 7.13 (3.08-15) minutes per screw.Three patients (7.5%) developed superficial wound infections which were treated conservatively. No patients required a return to the operating room because of screw malposition.ConclusionThe use of intraoperative O-arm imaging system with computer-assisted navigation significantly increases the surgical accuracy and safety of pedicle screw placement in lumbar fusion surgery.     

Evidence for a role of corrective eye movements during gaze fixation in saccade planning

In a three‐dimensional (3D) world most saccades are made towards visual targets that are located at different distances. We previously demonstrated that gaze shifts within 3D space consist of two stages: a target saccade followed by a corrective saccade during gaze fixation that directs the eyes to the physical target location. We proposed that, by accurately positioning the eyes on the visual object, the visual system maintains an orderly representation of the visual world. In this study we used a double saccade experiment to assess the function of corrective saccades in humans. We found that, when a corrective eye movement occurred during fixation on the first target point, the direction of the second saccade towards the next target point was accurate. When a corrective saccade was absent, a directional error of the second target saccade was observed. This finding, which cannot be explained by current models of eye movement control, supports the idea of a two‐step model in saccade programming. We suggest that the motor system sends a corollary discharge when programming a corrective saccade for maintaining an orderly representation of the visual world. In conclusion, our results indicate that corrective saccades have a role in programming target saccades within 3D space.     

Progressive behavioral deficits in DJ-1-deficient mice are associated with normal nigrostriatal function

Loss-of-function mutations in the DJ-1 gene account for an autosomal recessive form of Parkinson's disease (PD). To investigate the physiological functions of DJ-1 in vivo, we generated DJ-1 knockout (DJ-1^−/−) mice. Younger (< 1 year) DJ-1^−/− mice were hypoactive and had mild gait abnormalities. Older DJ-1^−/−, however, showed decreased body weight and grip strength and more severe gait irregularities compared to wild-type littermates. The basal level of extracellular dopamine, evoked dopamine release and dopamine receptor D2 sensitivity appeared normal in the striatum of DJ-1^−/− mice, which was consistent with similar results between DJ-1^−/− and controls in behavioral paradigms specific for the dopaminergic system. An examination of spinal cord, nerve and muscle tissues failed to identify any pathological changes that were consistent with the noted motor deficits. Taken together, our findings suggest that loss of DJ-1 leads to progressive behavioral changes without significant alterations in nigrostriatal dopaminergic and spinal motor systems.     

Acne Knowledge of Hispanic Parents of Teenagers with Mild to Moderate Acne

We performed a cross‐sectional study of Hispanic and non‐Hispanic parents of children with acne using a survey designed to determine their level of awareness of acne and its treatment; 82% of Hispanic parents and 40% of non‐Hispanic parents agreed that a health care provider should treat mild acne (p < 0.001). Hispanic parents of adolescents with acne agreed more frequently than non‐Hispanic parents that children with mild and moderate acne should be taken to a health care provider for treatment, but they tended not to visit health care providers. Future studies should aim to determine the reasons for this discrepancy, after which culturally sensitive educational programs can be developed to address this disparity.     

Dopamine inhibits ATP-induced responses in the cat petrosal ganglion in vitro

The petrosal ganglion (PG) provides sensory innervation to the carotid sinus and carotid body through the carotid (sinus) nerve (CN). Application of either acetylcholine (ACh) or adenosine 5'-triphosphate (ATP) to the PG superfused in vitro activates CN fibers. Dopamine (DA) modulates the effects of ACh. We have previously shown that DA when applied to the PG modulates the effects of ACh on carotid sinus nerve fibers. We currently report the effects of DA on the ATP-induced responses in the isolated PG in vitro. While DA had no effect on the basal activity recorded from the CN, it reduced ATP-induced responses in a dose-dependent manner, when preceding ATP applications by 30 s. Our results suggest that DA-a transmitter present in a group of PG neurons and in carotid body cells-may act as an inhibitory modulator of ATP-evoked responses in PG neurons.     

角膜内植入物并发基质内上皮混浊

目的：报告应用角膜内植入物矫正远视眼后发生角膜周边部上皮性混浊的新的并发症。设计：前瞻性观察研究。参加者：7例患者的11只眼行角膜内植入矫正远视。方法：应用显微角膜板层刀制作一个蒂在下方的角膜瓣，将角膜内移植物植入角膜基质床中。     

Thermal dependence of chemosensory activity in the carotid body superfused in vitro

We studied the relationship between chemosensory activity and temperature in carotid bodies excised from pentobarbitone-anesthetized cats, and superfused in vitro at flows between 0.4 and 2.0 ml/min with modified Tyrode's solution buffered with HEPES at pH 7.43. The basal frequencies of chemosensory discharges were recorded from the entire carotid nerve at different steady thermal conditions. For preparations superfused with saline equilibrated with 100% O₂, thermally dependent increases in frequency were observed, with significant differences between all nearby thermal stages separated by 0.5°C steps between 36.0 and 38.5°C. The larger gains were recorded between higher temperatures at high flows, between mid temperatures at intermediate flows, and between lower temperatures at low flows. The critical temperature for the calculated maximal gain was directly correlated to superfusion flow. The basal frequencies were consistently elevated when switching to saline equilibrated with 20% O₂ and no significant differences in mean ranks were recorded between 36 and 37°C, as between 38 and 39°C, but frequencies at 36–37°C were significantly higher than those at 38–39°C. Brief rises in chemosensory discharges were evoked by injections of NaCN applied to carotid bodies superfused with saline equilibrated with 100% O₂. The least effective dose was lower at 40°C than at 37.5° or 35.0°C, but the reactivity and slope were not significantly different. It is concluded that the carotid body chemoreceptors fulfill the criteria for being considered as thermosensors, and that their frequency of discharges is thermally modulated within a range close to physiological body temperature.