Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 5 Articles
One of the challenges of managing athletes with sport-related concussion (SRC) is guiding\nthem to a safe return to play. A potential biomarker for use in the clinical assessment of recovery is\nthe analysis of brain activation patterns during task-related functional Magnetic Resonance Imaging\n(fMRI). However, fMRI studies have provided conflicting results regarding what is pathological.\nAn element that can contribute to this disagreement are hemodynamic impairments of the brain\nthat follow a concussion. A functional neuroimaging technique based on the optical properties of\nbrain tissueââ?¬â?called functional near-infrared spectroscopy (fNIRS)ââ?¬â?can be used to evaluate SRC\nathletes, partially taking into consideration these brain hemodynamic impairments. However, so\nfar, fNIRS has not been extensively used in concussion. In this critical review, there is a description\nof the main fMRI results involving the neocortex in acutely concussed patients, the influences of\nhemodynamic impairments on fMRI and fNIRS and the advantages and disadvantages of fNIRS to\nlimit this influence....
The aim of this work is to evaluate the role of Ultrasound-Doppler in the hemodynamic\nstudy of hepatic vessels during the liver cirrhosis in Togo. Method:\nThis was an analytic cross-sectional study that measured the velocimetric\nparameters of hepatic vessels in cirrhotic patients and in non-cirrhotic patients.\nResults: The velocimetric parameters of the hepatic artery, the portal\nvein, and the hepatic veins were measured in 50 cirrhotic patients and 50\nnon-cirrhotic The caliber of the portal vein was significantly increased in\ncirrhotic patients compared to non-cirrhotic patients with 13.11 �± 2.16 mm\nversus 11.45 �± 1.02 (p < 0.00006). The systolic velocity and the hepatic artery\nresistance index were significantly raised in the cirrhotic patients compared to\nthe non-cirrhotic with 67.32 �± 22.77 versus 49.97 �± 17.24 (p-value < 0.00004)\nrespectively, and 0.78 �± 0.07 against 0.72 �± 0.08 (p < 0.00006). The caliber of\nthe hepatic veins was significantly decreased in the cirrhotic patients compared\nto the non-cirrhotic patients (p < 0.0003). There was no correlation\nbetween the gender of the patients and the change in the hemodynamics of\nthe hepatic vessels. Conclusion: The hemodynamic study of the hepatic vessels\ncan and must rightly be a diagnostic argument for liver cirrhosis....
Object: Functional MRI is frequently applied to lateralize language in\npre-surgical planning, with potential to localize functionally important cortex\ntoo. Here we present BOLD signal activation maps and related functional\nconnectivity, in response to three commonly administered fMRI language\ntasks. Methods: Datasets from 55 pre-surgical fMRI studies were analyzed.\nVerbal response naming, covert word generation and passive listening tasks\nwere administered in all studies. Single-subject analyses, group analyses and\nregion-of-interest analyses were conducted, and a multi-subject functional\nconnectivity analysis was performed. Results: Single-subject analyses revealed\nthat clinically important language regions were activated in all but three patients\nusing the panel of tasks. Group analyses revealed significant bilateral\nBOLD signal increases in anterior and posterior language regions in response\nto verbal response naming and bilateral signal increase in posterior language\nregions only in response to passive listening. Covert word generation activated\nanterior language regions bilaterally and posterior language cortex in\nthe dominant hemisphere. Functional connectivity analyses confirmed that\nactivated regions were significantly correlated in all tasks. Conclusion: The\nfindings of single-subject and group analyses add to the evidence supporting\nthe use of a panel of fMRI tasks to map the language network for pre-surgical\nplanning. Our findings support the additional use of functional connectivity\nanalysis in routine language mapping to add to the localization value to fMRI.\nIn addition, the results of our investigation demonstrate these three commonly\napplied tasks reliably activate unique aspects of the language network,\nwhich advocates closer individual inspection, guided by the surgical intervention\nplanned....
Objectives: The purpose of this pilot study was to obtain an Australian perspective\non evaluating the utility of plain film radiography and computed tomography\n(CT) to rule out fish bone impaction in the upper aerodigestive\ntract in the emergency department (ED) setting. Methods: A retrospective\nmulticentre cohort study was conducted. A total of 73 patients met the inclusion\ncriteria. A subgroup of patients underwent CT. We studied the sensitivity\nand specificity of x-ray and CT along with other demographic variables to determine\nthe likelihood of true fish bone impaction. Results: Out of the 73 patients,\n28 patients had true bone impaction. The sensitivity for x-ray was\n42.9% and specificity was 73.3%. The sensitivity of CT was 87.5% and specificity\nwas 71.4%. We found a significant difference in the mean age of presentation\nfor true bone and false bone impaction, P = 0.02. Conclusion: Due to\nthe low sensitivity of x-ray we do not recommend the utilisation of plain film\nradiography to rule out bone impaction Advances in low dose radiation multidetector\nCT scanners may replace plain film radiography as a screening tool....
Recurrent Ventricular Tachycardia, or Electrical Storm, is a relatively common\ncause of mortality and morbidity after myocardial infarction. We present\na case in which left stellate ganglion blocks were performed under ultrasound\nguidance in order to alleviate recurrent ventricular tachycardia in a patient\nrequiring extracorpeal membrane oxygenation after myocardial infarction. A\nmedically complex 54-year-old male after two weeks removed from an acute\nST elevation myocardial infarction status post stenting and intra-aortic balloon\npump placement presented in the cardiovascular intensive care unit with\nrecurrent unstable ventricular tachycardia while on extracorporeal membrane\noxygenation and multiple vasoactive infusions. Our acute pain service was\nconsulted by the cardiac electrophysiology service to provide left stellate ganglion\nblocks in attempt to attenuate electrical storm. Multiple single shot left\nstellate ganglion blocks were performed on subsequent days with increasing\nlocal anesthetic concentrations and volumes successfully providing temporary\nrelief of electrical storm. A left stellate ganglion catheter was eventually\nplaced, and a continuous infusion of local anesthesia was started. The patient\nexperienced complete relief from unstable ventricular tachycardia and no\nfurther defibrillations were required. The catheter remained in place for 14\ndays allowing for extracorporeal membrane oxygenation decannulation\nwithout the return of electrical storm. We believe ultrasound guided left stellate\nganglion blocks to be a relatively safe means to provide temporary relief\nof recurrent ventricular tachycardia....
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