Effect of cognitive load on postural control

The present study reports findings from two experiments on the relation between a mental task (silent backward counting) and posture. The first experiment included 30 normal subjects and the second experiment 20 normal subjects. In Experiment 1 postural sway and performance of the mental task were measured in a 2 x 2 dual-task design (with or without mental task and calf stimulation). In Experiment 2 a similar design was used, the only difference being that during trials without the mental task, subjects were instructed to focus on their balance and provide a rating of body sway. Results showed that balance perturbation led to decreased performance on the cognitive task in Experiment 1, but not in Experiment 2. The mental task led to less body sway, while focused attention attenuated the effect. In conclusion, control of body sway and cognitive functioning are to some extent related.     

Functional performance study of an adapted design of the woman’s condom: a crossover,noninferiority, randomized clinical trial

Objectives: We aimed to assess the functional performance and safety of a modified Woman’s Condom (WC2) against the existing FC2 female condom.

Study design: This randomized clinical trial enrolled 287 women in one South African site. The primary outcome of the study was the rate of female condom failure. Participants were asked to use five of each female condom type and to collect information on use in a condom log at home and were interviewed after use of each FC type.

Results: Noninferiority was demonstrated for the WC2 with respect to the reference condom FC2 for all condom functions. The WC2 was found to be superior to the FC2 reference condom for clinical failure (p?=?.000), total female condom failure (p?=?.001), misdirection (p?=?.000) and slippage (p?=?.004).

Conclusion: The WC2 female condom performs as well as the FC2 female condom and offers good stability during use.

Implications: Results from this study will inform further refinement of this female condom design, resulting in a new and potentially less expensive Woman’s Condom.     

Acute aneurysm with prerupture of the left ventricle following inferior infarct

A large infero-posterior aneurysm of the left ventricle following myocardial infarction is reported, which still showed the echo- and angiocardiographic criteria of a true aneurysm. Because of concomitant pericardial effusion a prerupture was suspected. A resection showed that the wall of the aneurysm was composed of epicardium and thrombi only.     

Cost-effectiveness of routine intraoperative transesophageal echocardiography in pediatric cardiac surgery: a 10-year experience

The beneficial effect of transesophageal echocardiography (TEE) on medical and surgical treatment of children with congenital heart disease has been established. Its cost-effectiveness, however, has not been extensively studied. We analyzed reports of 580 routine TEE examinations performed in our institution between January 1994 and December 2003 in patients younger than 17 yr who required congenital cardiac surgery. After excluding patients who died immediately postoperatively, we identified 33 patients (5.7%) who required a second bypass run on clear-cut indication, i.e., surgical reoperation, and who clearly benefited from TEE findings. An estimate of both fixed and variable costs revealed a savings of 850 to 2655 Swiss francs (CHF) ($690 to $2130 US) per child. This figure undoubtedly underestimates the true cost-effectiveness of routine intraoperative TEE in this setting because we used mostly conservative estimates of the benefits and liberal estimates of the costs. The potential benefits of TEE in hemodynamic monitoring and medical management, in reduction of postoperative morbidity, and in improvement in the quality of life are intangible and were not considered. Although benefits and costs vary according to market conditions, patient populations, surgical practice, and technical expertise with TEE, our analysis demonstrates substantial cost-effectiveness in the use of routine TEE during pediatric cardiac surgery.     

Regional differences of the sleep electroencephalogram in adolescents

The sleep electroencephalogram (EEG) was recorded from anterior (Fz/Cz) and posterior (Pz/Oz) bipolar derivations in two developmental groups: 20 pre- or early pubertal (Tanner 1/2, mean age 11.4 +/- 1.1 years, 11 boys) and 20 late pubertal or mature adolescents (Tanner 4/5, 14.1 +/- 1.3 years, 8 boys). A sleep-state independent reduction of EEG power over almost the entire frequency range was present in Tanner 4/5 compared with Tanner 1/2 adolescents. Spectral characteristics of the sleep EEG yielded state- and frequency-dependent regional differences that were similar in both developmental groups. Anterior predominance of power in delta and sigma ranges occurred in non-rapid eye movement sleep. Rapid eye movement sleep EEG power was greater in low delta, alpha, and sigma ranges for the posterior derivation and in theta and beta ranges for the anterior derivation. The decay rate of the sleep homeostatic process--reflected by the exponential decline of the 2-Hz EEG power band across the sleep episode--did not differ for derivations or groups. These results indicate that the nocturnal dynamics of sleep homeostasis are independent of derivation and remain stable across puberty.