Reciprocal modulation of eye-blink and pinna-flexion components of startle during reward anticipation

Because expectancies play a central role in current theories of dopaminergic neuron function, it is important to develop measures of reward anticipation processes. In the present study, reflexogenic bursts of white noise were presented to 39 healthy young adults as they awaited rewards and punishments in a gambling-like task. The rewards were small pieces of chocolate; the punishments, segments of bitter-tasting banana peel. Consistent with prior research on affective valence, postauricular reflexes were larger prior to rewards than punishments, whereas the reverse was true for acoustic blink reflexes. We theorized that potentiation of the postauricular reflex prior to consuming appetizing food is related to the priming of ear-retraction musculature during nursing in our remote ancestors.     

Endoscopic Treatment of Persistent Alveolar-Pleural Air Leaks With a Unidirectional Endobronchial Valve

The persistent air leaks due to alveolopleural fistula is not an uncommon complication of pneumothorax, particularly secondary ones. Unidirectional flow endobronchial valves initially designed for lung volume reduction are the latest tool in the therapeutic armamentarium.We present a patient with chronic obstructive pulmonary disease (COPD) with a persistent pneumothorax in spite of three pleurodesis, which was able to be resolved with the placement of two IBV? valves.     

Abordaje laparoscópico en el tratamiento de las tumoraciones adrenales malignas

BackgroundMalignant primary or secondary adrenal tumours are uncommon. For most of them early surgery with adrenalectomy is the only means of cure. Although controversy exists on this issue, the increasing experience in laparoscopic surgery extends the indication for laparoscopic adrenalectomy to potentially malignant and to metastatic adrenal tumours. Our aim was to evaluate the technical feasibility of laparoscopic adrenalectomy for malignant neoplasias, describing the results of our consecutive series of patients.Material and methodsWe retrospectively analysed 13 patients who underwent laparoscopic adrenalectomy for malignant neoplasia between March 1999 and June 2009, at the Hospital de Clínicas of the Universidad of Buenos Aires and at the Hospital Alemán of Buenos Aires. A transperitoneal laparoscopic approach was used in all patients. The mean follow up was 37.9 months (2–84).ResultsThirteen laparoscopic adrenalectomies were performed due to malignant neoplasia. Mean age was 55.2+12 years. The relationship between male and female was 10/3. Five patients had an adrenal carcinoma, 1 patient a malignant phaeochromocytoma, and 7 patients had metastatic tumours. Three patients required conversion to laparotomy. Average operation time was 146.4 min. There were two perioperative complications and no mortality. Average length of hospital stay was 4.6 days (1–35). The survival at 3 years was 46%. The cause of death was the underlying disease in all cases.ConclusionLaparoscopic adrenalectomy is a reasonable technique for malignant adrenal tumours, when the open oncological resection can be reproduced by the laparoscopic approach.     

Stent or surgery for incurable obstructive colorectal cancer: an individualized decisión

Introduction  

In the setting of stage-IV obstructive colorectal cancer, self-expanding metallic stents (SEMS) placement and palliative surgery may be appropriate options. The aim of the present study is to evaluate the long-term results of surgery compared with stent implantation and to identify patients in whom one of these options can provide more benefit.