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Response Monitoring (response + monitoring)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

International survey on esophageal cancer: part II staging and neoadjuvant therapy

DISEASES OF THE ESOPHAGUS, Issue 3 2009
J. Boone
SUMMARY The outcome of esophagectomy could be improved by optimal diagnostic strategies leading to adequate preoperative patient selection. Neoadjuvant therapy could improve outcome by increasing the number of radical resections and by controlling metastatic disease. The purposes of this study were to gain insight into the current worldwide practice of staging modalities and neoadjuvant therapy in esophageal cancer, and to detect intercontinental differences. Surgeons with particular interest in esophageal surgery, including members of the International Society for Diseases of the Esophagus, the European Society of Esophagology , Group d'Etude Européen des Maladies de l'Oesophage, and the OESO, were invited to participate in an online questionnaire. Questions were asked regarding staging modalities, neoadjuvant therapy, and response evaluation applied in esophageal cancer patients. Of 567 invited surgeons, 269 participated resulting in a response rate of 47%. The responders currently performing esophagectomies (n= 250; 44%) represented 41 countries across the six continents. Esophagogastroscopy with biopsy and computed tomography (CT) scanning were routinely performed by 98% of responders for diagnosing and staging esophageal cancer, while endoscopic ultrasound (EUS) and barium esophagography were routinely applied by 58% and 51%, respectively. Neoadjuvant therapy is routinely administered by 33% and occasionally by 63% of responders. Of the responders that administer identical neoadjuvant regimens to esophageal adenocarcinoma (AC) and squamous cell carcinoma, 54% favor chemoradiotherapy. For AC, chemotherapy is preferred by 31% of the responders that administer neoadjuvant therapy, whereas for squamous cell carcinoma, the majority of responders (38%) prefer chemoradiotherapy. Response to neoadjuvant therapy is predominantly assessed by CT scanning of the chest and abdomen (86%). Barium esophagography, EUS, and combined CT/PET scan are requested for response monitoring in equal frequency (25%). Substantial differences in applied staging modalities and neoadjuvant regimens were detected between surgeons from different continents. In conclusion, currently the most commonly applied diagnostic modalities for staging and restaging esophageal cancer are CT scanning of the chest and abdomen, gastroscopy, barium esophagography and EUS. Neoadjuvant therapy is routinely applied by one third of the responders. Intercontinental differences have been detected in the diagnostic modalities applied in esophageal cancer staging and in the administration of neoadjuvant therapy. The results of this survey provide baseline data for future research and for the development of international guidelines. [source]

On the positive side of error processing: error-awareness positivity revisited

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 7 2009
Shani Shalgi
Abstract Performance errors are indexed in the brain even if they are not consciously registered, as demonstrated by the error-related negativity (ERN or Ne) event-related potential. It has recently been shown that another response-locked potential, the error positivity (Pe), follows the Ne, but only in those trials in which the participants consciously detect making the error (,Aware Errors'). In the present study we generalize these findings to an auditory task and investigate possible caveats in the interpretation of the Pe as an index of error awareness. In an auditory Go/No-Go error-awareness task (auditory EAT) participants pressed an additional ,fix error' button after noticing that they had made an error. As in visual tasks, the Ne was similar for aware (,fixed') and unaware (,unfixed') errors, while the Pe was enhanced only for Aware Errors. Within subjects, the Ne and Pe behaved in similar fashions for auditory and visual errors. A control condition confirmed that the awareness effect was not due to the requirement to report error awareness. These results reinforce the evidence in favor of the Pe as a correlate of conscious error processing, and imply that this process is not modality-specific. Nevertheless, single-trial analysis suggested that the Pe may be a delayed P3b related to stimulus processing rather than to response monitoring. [source]

Living without aprotinin: the results of a 5-year blood saving program in cardiac surgery

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009
M. RANUCCI
Background: After 20 years of regular use in cardiac surgery patients, aprotinin has recently been withdrawn from the market due to many concerns about its safety. For a number of reasons aprotinin has not been available in Italy since 1998. The present study presents an aprotinin-free treatment protocol applied at our institution during the last 5 years, and aims to verify the results of this protocol in terms of allogeneic blood product transfusions, postoperative blood loss and surgical re-exploration rate. Methods: Retrospective study on 7988 consecutive patients who underwent cardiac surgery during the years 2003,2007. All the patients received specific hemostasis/coagulation management based on (a) routine use of tranexamic acid, (b) heparin dose,response monitoring, thromboelastography, platelet (PLT) function analysis in a select population of patients, and (c) use of fresh frozen plasma (FFP), PLTs, and desmopressin according to the hemostasis/coagulation profile. Data retrieved from the institutional database were quantity of packed red cells (PRCs), FFP, PLT transfusion rate, blood loss in the first 12 postoperative hours, and surgical re-exploration rate. Results: PRCs were transfused in 40.4% of patients (with higher rates for selected high-risk subpopulations), FFP in 12.9% and PLTs in 2.6%. Surgical re-exploration rate was 3.7%. With respect to historical controls, a significant reduction of PRCs and FFP transfusions was obtained using closed circuits, point of care coagulation tests, and combination of the two. Conclusion: This aprotinin-free blood saving program is an effective strategy for allogeneic blood products transfusion containment. [source]

Increased error-related negativity (ERN) in childhood anxiety disorders: ERP and source localization

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 10 2006
Cecile D. Ladouceur
Background:, In this study we used event-related potentials (ERPs) and source localization analyses to track the time course of neural activity underlying response monitoring in children diagnosed with an anxiety disorder compared to age-matched low-risk normal controls. Methods:, High-density ERPs were examined following errors on a flanker task from 12 children between 8 and 14 years old diagnosed with an anxiety disorder (ANX) and 13 age-matched low-risk normal controls (LRNC). Results:, Children diagnosed with an anxiety disorder had increased error-related negativity (ERN) amplitude. The neural generators of the ERN in the ANX group were estimated to be localized in the anterior cingulate cortex (ACC). There were no significant group differences in PE amplitude. Conclusions:, These data provide evidence for increased ERN amplitude localized to the ACC in children diagnosed with an anxiety disorder, suggesting altered maturational patterns of the ACC circuitry early in the course of this illness. [source]