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Randomized Sequence (randomized + sequence)
Selected AbstractsStress experienced in utero reduces sexual dichotomies in neurogenesis, microenvironment, and cell death in the adult rat hippocampusDEVELOPMENTAL NEUROBIOLOGY, Issue 5 2008Chitra D. Mandyam Abstract Hippocampal function and plasticity differ with gender, but the regulatory mechanisms underlying sex differences remain elusive and may be established early in life. The present study sought to elucidate sex differences in hippocampal plasticity under normal developmental conditions and in response to repetitive, predictable versus varied, unpredictable prenatal stress (PS). Adult male and diestrous female offspring of pregnant rats exposed to no stress (control), repetitive stress (PS-restraint), or a randomized sequence of varied stressors (PS-random) during the last week of pregnancy were examined for hippocampal proliferation, neurogenesis, cell death, and local microenvironment using endogenous markers. Regional volume was also estimated by stereology. Control animals had comparable proliferation and regional volume regardless of sex, but females had lower neurogenesis compared to males. Increased cell death and differential hippocampal precursor kinetics both appear to contribute to reduced neurogenesis in females. Reduced local interleukin-1beta (IL-1,) immunoreactivity (IR) in females argues for a mechanistic role for the anti-apoptotic cytokine in driving sex differences in cell death. Prenatal stress significantly impacted the hippocampus, with both stress paradigms causing robust decreases in actively proliferating cells in males and females. Several other hippocampal measures were feminized in males such as precursor kinetics, IL-1,-IR density, and cell death, reducing or abolishing some sex differences. The findings expand our understanding of the mechanisms underlying sex differences and highlight the critical role early stress can play on the balance between proliferation, neurogenesis, cell death, and hippocampal microenvironment in adulthood. © 2008 Wiley Periodicals, Inc. Develop Neurobiol, 2008. [source] Randomized comparison of the SLIPA (Streamlined Liner of the Pharynx Airway) and the SS-LM (Soft Seal Laryngeal Mask) by medical studentsEMERGENCY MEDICINE AUSTRALASIA, Issue 5-6 2006Cindy Hein Abstract Objective:, The aim of the study was to compare the Streamlined Liner of the Pharynx Airway (SLIPA; Hudson RCI), a new supraglottic airway device, with the Soft Seal Laryngeal Mask (SS-LM; Portex) when used by novices. Methods:, Thirty-six medical students with no previous airway experience, received manikin training in the use of the SLIPA and the SS-LM. Once proficient, the students inserted each device in randomized sequence, in two separate patients in the operating theatre. Only two insertion attempts per patient were allowed. Students were assessed in terms of: device preference; success or failure; success at first attempt and time to ventilation. Results:, Sixty-seven per cent of the students preferred to use the SLIPA (95% confidence interval 49,81%). The SLIPA was successfully inserted (one or two attempts) in 94% of patients (34/36) and the SS-LM in 89% (32/36) (P = 0.39). First attempt success rates were 83% (30/36) and 67% (24/36) in the SLIPA and SS-LM, respectively (P = 0.10). Median time to ventilation was shorter with the SLIPA (40.6 s) than with the SS-LM (66.9 s) when it was the first device used (P = 0.004), but times were similar when inserting the second device (43.8 s vs 42.9 s) (P = 0.75). Conclusions:, In the present study novice users demonstrated high success rates with both devices. The SLIPA group achieved shorter times to ventilation when it was the first device they inserted, which might prove to be of clinical significance, particularly in resuscitation attempts. Although the Laryngeal Mask has gained wide recognition for use by both novice users and as a rescue airway in failed intubation, the data presented here suggest that the SLIPA might also prove useful in these areas. [source] Catheter Ablation of Long-Lasting Persistent Atrial Fibrillation: Critical Structures for TerminationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 11 2005MICHEL HAÏSSAGUERRE M.D. Background: The relative contributions of different atrial regions to the maintenance of persistent atrial fibrillation (AF) are not known. Methods: Sixty patients (53 ± 9 years) undergoing catheter ablation of persistent AF (17 ± 27 months) were studied. Ablation was performed in a randomized sequence at different left atrial (LA) regions and comprised isolation of the pulmonary veins (PV), isolation of other thoracic veins, and atrial tissue ablation targeting all regions with rapid or heterogeneous activation or guided by activation mapping. Finally, linear ablation at the roof and mitral isthmus was performed if sinus rhythm was not restored after addressing the above-mentioned areas. The impact of ablation was evaluated by the effect on the fibrillatory cycle length in the coronary sinus and appendages at each step. Activation mapping and entrainment maneuvers were used to define the mechanisms and locations of intermediate focal or macroreentrant atrial tachycardias. Results: AF terminated in 52 patients (87%), directly to sinus rhythm in 7 or via the ablation of 1,6 intermediate atrial tachycardias (total 87) in 45 patients. This conversion was preceded by prolongation of fibrillatory cycle length by 39 ± 9 msec, with the greatest magnitude occurring during ablation at the anterior LA, coronary sinus and PV-LA junction. Thirty-eight atrial tachycardias were focal (originating dominantly from these same sites), while 49 were macroreentrant (involving the mitral or cavotricuspid isthmus or LA roof). Patients without AF termination displayed shorter fibrillatory cycles at baseline: 130 ± 14 vs 156 ± 23 msec; P = 0.002. Conclusion: Termination of persistent AF can be achieved in 87% of patients by catheter ablation. Ablation of the structures annexed to the left atrium,the left atrial appendage, coronary sinus, and PVs,have the greatest impact on the prolongation of AF cycle length, the conversion of AF to atrial tachycardia, and the termination of focal atrial tachycardias. [source] Palatal plate of different designs for the suppression of masseter muscle activity during sleep.JOURNAL OF ORAL REHABILITATION, Issue 9 2002A challenge to the concept of placebo splint Several designs of palatal appliance have been reported for the treatment of craniomandibular disorders. However, the effect of these appliances has not yet been fully clarified. This study aimed to reveal the effect of palatal appliances of different design on masseter muscle activity during sleep. Four volunteers (three women and one man, mean age 36·0 years) were used in this study. For each subject, four different types of palatal appliances were used. The palatal appliances were (1) horse shoe type (1 mm thick), (2) thin appliance which covered the whole palate (1 mm thick), (3) thick appliance which filled the palatal concavity and (4) appliance with half the thickness of the third appliance. These appliances were worn for 1 week in a randomized sequence with 1-week interval between each appliance. Right masseter muscle EMG was recorded three nights per week at home. The EMG signal longer than 0·25 s was classified as a burst and a signal shorter than 0·25 s was classified as a brief burst of fragmentary myoclonus (FM). Mean number of burst per hour for four subjects were 7·99 ± 7·32, 3·52 ± 1·95, 5·90 ± 3·99, 2·87 ± 2·87 and 9·96 ± 6·02 for base line, appliance 1, 2, 3 and 4, respectively. Mean number of FM per hour were 136·86 ± 69·88, 90·53 ± 41·19, 99·49 ± 39·29, 71·66 ± 24·66 and 144·39 ± 42·97, respectively. From these results, it was suggested that the thick palatal appliance suppressed the masseter muscle activity during sleep most effectively. Also, the results for appliance 4 questioned the concept of placebo effect for non-occlusal appliances. [source] A double blind randomized placebo control trial of levetiracetam in tourette syndromeMOVEMENT DISORDERS, Issue 12 2007Constance L. Smith-Hicks MD Abstract The objective of this study was to investigate the effectiveness of levetiracetam for the treatment of tics in children with Tourette syndrome (TS). Levetiracetam, an atypical anticonvulsant, has been suggested in open-label protocols to be an effective tic-suppressing agent in individuals with TS. A double blind, randomized, placebo-controlled, cross-over trial was performed to investigate this medication in children with moderate to moderately-severe tics. Subjects received, in a randomized sequence, 4-weeks of levetiracetam (maximum dose 30 mg/kg/day) or placebo, with a 2-week intervening washout period between cycles. Primary outcome measures included two separate scales from the Yale Global Tic Severity Scale; the Total Tic score and the Total overall score. Measures were assessed at baseline, prior to randomization, on Day 28 (end of Phase 1), on Day 42 (baseline for second phase) and on Day 70 (end of Phase 2). Twenty-two subjects (21 boys and 1 girl) with TS, mean age 12.2 ± 2.3 years, range 8 to 16 years, participated. A mild reduction in tics occurred during both the levetiracetam and placebo treatment phases. There was no significant difference between treatments and no evidence of sequence or cross-over effects. In conclusion, Levetiracetam is not more beneficial than placebo in suppressing tics in children with TS. © 2007 Movement Disorder Society [source] Day-to-day reproducibility of anorectal sensorimotor assessments in healthy subjectsNEUROGASTROENTEROLOGY & MOTILITY, Issue 2 2004A. E. Bharucha Abstract, The reproducibility of tests widely utilized to assess anorectal sensorimotor functions is not well established. Our aims were to assess the intra-individual day-to-day reproducibility of these parameters in healthy subjects. Anal sphincter pressures were assessed by perfusion manometry on two separate days in 19 healthy subjects. Rectal pressure,volume (p,v) curves and sensory thresholds were assessed in 12/19 subjects by inflating a highly compliant polyethylene balloon from 0 to 32 mmHg in 4 mmHg steps. Subjects also rated intensity of perception by visual analogue scale (VAS) during phasic distentions 8, 16 and 24 mmHg above operating pressure, in randomized sequence. Resting and squeeze anal pressures and rectal compliance were highly reproducible (rs , 0.7) in the same subject on separate days. Pressure thresholds for urgency appeared less reproducible than thresholds for initial perception and the desire to defecate. VAS scores were highly reproducible only during the 24-mmHg distention. Thus, anal pressures and rectal compliance are highly reproducible within healthy subjects on separate days, while sensory thresholds are reproducible to a variable degree, dependent on the intensity of stimulation and the perception being assessed. [source] | ||||||||||