Current Issue : July - September Volume : 2018 Issue Number : 3 Articles : 5 Articles
Extracorporeal membrane oxygenation (ECMO) is a life-saving technique that is widely being used in centers throughout the\nworld. However, there is a paucity of literature surrounding the mechanisms affecting cerebral physiology while on ECMO.\nStudies have shown alterations in cerebral blood flow characteristics and subsequently autoregulation. Furthermore, the mechanical\naspects of the ECMO circuit itself may affect cerebral circulation. The nature of these physiological/pathophysiological\nchanges can lead to profound neurological complications. This review aims at describing the changes to normal cerebral\nautoregulation during ECMO, illustrating the various neuromonitoring tools available to assess markers of cerebral autoregulation,\nand finally discussing potential neurological complications that are associated with ECMO....
This study was a retrospective analysis of the epidemiologic profile of severe\ntraumatic brain injuries managed at the surgical intensive care unit of the\nUniversity Hospital Center of Yaound�©, Cameroon, between January 2011\nand December 2015. All the patients admitted at the surgical intensive care\nunit for a traumatic brain injury with an initial Glasgow coma scale score â�¤ 8\nwere included. One hundred and thirty-five cases were enrolled. One hundred\nand fourteen were males and 21 were females. Their mean age was 32.75 years.\nForty-four patients were aged between 16 to 30 years. Road traffic accidents\nrepresented the first mode of injury with 101 cases and most of the patients\nwere pedestrians hit by a car. Pupils and students were the most involved.\nTwenty-three patients had additional extracranial injury. On admission, 97\n(71.85%) patients had GCS 7-8. A brain CT scan was done for 115 patients. Intracranial\nand intracerebral hemorrhages were the most frequent radiological\nfindings with 57 cases. The overall mortality was 32.59% with 44 deaths. Thirty-\ntwo of the deaths occurred in patients with GCS 7 - 8 on admission. Ninety-\none (67.40%) patients survived, 74 (54.81%) had persisting disabilities, while\nonly 17 (12.59%) recovered fully. The following factors had an impact on the\noutcome: GCS at admission, pupillary anomalies, length of hospital stay, endotracheal\nintubation and surgery. Severe TBI remains a heavy socio-economic\nburden worldwide. In Cameroon where the health system is poorly organized,\nthe outcome of individuals who sustained a severe TBI was dismal....
This article reviews selected neuroscientific and psychoanalytic writings with\na focus on dynamic variability, unconscious processes and their presence in\nclinical venues. Two objects are pursued. First is the development of neuron\ncircuity, leading up to higher thought processes and thinking. Second is to\nelucidate the neuron circuitry of unconscious processes. The goal is to describe\nthe stated objectives and the theme of variability represented in clinical\npresentations and venues...
Objective: We compared stigma experienced by psychiatric patients and controls\nin various social domains and hypothesized higher levels of stigma and\nhigher rates of non-disclosure by psychiatric patients. Methods: Psychiatric\noutpatients and a control group of medical outpatients were assessed for experienced\ndiscrimination through a structured questionnaire that included adapted\nitems from the Discrimination and Stigma Scale (DISC-12). Controls were assessed\non discrimination related to physical, rather than mental health issues.\nStatistical analyses were conducted with Pearson�s chi-squared tests and one-way\nAnalyses of Variance (ANOVA). Results: In total, 202 patients comprising 99\npsychiatric patients and 103 controls gave consent to the study. Psychiatric\npatients experienced higher levels of discrimination (F (1, 196) = 24.4, p < 0.001),\nand in more areas of life (F (1, 196) = 22.5, p < 0.001) than controls. Compared\nto controls, a higher proportion of psychiatric patients practised non-disclosure\nof their illness. Conclusion: Our study confirmed that psychiatric patients\nexperienced considerable stigma and coped by non-disclosure of their condition....
This review seeks to describe the use and effects of the drug modafinil. Specifically,\nit presents the research of the impact of modafinil for people with diagnosis\nand experience of schizophrenia. Recent reviews have shown that modafinil\ncan positively impact on cognitive function in people with a diagnosis of\nschizophrenia. There is emerging evidence for the positive impact of modafinil\non negative symptoms, functioning, quality of life, wellbeing, and body mass\nindex (BMI) for people with schizophrenia. Compared to other central nerve\nstimulant (CNS) drugs, modafinil has a low risk of dependency and few negative\nside effects; but there are risks of triggering positive symptoms in schizophrenia.\nA well designed and sufficiently large randomised control trial is\nrequired to test the potential of the impact of modafinil in the lives of people\nwith a diagnosis of schizophrenia. Future research should report participant�s\nperspective of the value of modafinil connected to what concerns them and\nwhat they want to achieve in their lives....
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