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Second Session (second + session)
Selected AbstractsVastus lateralis surface and single motor unit electromyography during shortening, lengthening and isometric contractions corrected for mode-dependent differences in force-generating capacityACTA PHYSIOLOGICA, Issue 3 2009T. M. Altenburg Abstract Aim:, Knee extensor neuromuscular activity, rectified surface electromyography (rsEMG) and single motor unit EMG was investigated during isometric (60° knee angle), shortening and lengthening contractions (50,70°, 10° s,1) corrected for force,velocity-related differences in force-generating capacity. However, during dynamic contractions additional factors such as shortening-induced force losses and lengthening-induced force gains may also affect force capacity and thereby neuromuscular activity. Therefore, even after correction for force,velocity-related differences in force capacity we expected neuromuscular activity to be higher and lower during shortening and lengthening, respectively, compared to isometric contractions. Methods:, rsEMG of the three superficial muscle heads was obtained in a first session [10 and 50% maximal voluntary contraction (MVC)] and additionally EMG of (46) vastus lateralis motor units was recorded during a second session (4,76% MVC). Using superimposed electrical stimulation, force-generating capacity for shortening and lengthening contractions was found to be 0.96 and 1.16 times isometric (Iso) force capacity respectively. Therefore, neuromuscular activity during submaximal shortening and lengthening was compared with isometric contractions of respectively 1.04Iso (=1/0.96) and 0.86Iso (=1/1.16). rsEMG and discharge rates were normalized to isometric values. Results:, rsEMG behaviour was similar (P > 0.05) during both sessions. Shortening rsEMG (1.30 ± 0.11) and discharge rate (1.22 ± 0.13) were higher (P < 0.05) than 1.04Iso values (1.05 ± 0.05 and 1.03 ± 0.04 respectively), but lengthening rsEMG (1.05 ± 0.12) and discharge rate (0.90 ± 0.08) were not lower (P > 0.05) than 0.86Iso values (0.76 ± 0.04 and 0.91 ± 0.07 respectively). Conclusion:, When force,velocity-related differences in force capacity were taken into account, neuromuscular activity was not lower during lengthening but was still higher during shortening compared with isometric contractions. [source] Conjugate limb coordination after experience with an interlimb yoke: Evidence for motor learning in the rat fetusDEVELOPMENTAL PSYCHOBIOLOGY, Issue 4 2005Scott R. Robinson Abstract This study investigated the capacity of the E20 rat fetus to adaptively alter patterns of interlimb coordination in a prenatal model of motor learning. Fetal limb movement was manipulated with an interlimb yoke, consisting of a fine thread attached at the ankles, which created a physical linkage between two limbs. Exposure to the yoke resulted in a gradual increase in conjugate movements of the yoked limbs during a 30-min training period, which persisted after removal of the yoke. Training effects were evident when the yoke was applied to two hindlimbs, two forelimbs, or a homolateral forelimb,hindlimb pair. A savings in the rate of acquisition also was observed when fetuses experienced yoke training in a second session. These data argue that the rat fetus can respond to kinesthetic feedback resulting from variation in motor performance, which suggests that experience contributes to the development of coordinated motor behavior before birth. © 2005 Wiley Periodicals, Inc. Dev Psychobiol 47: 328,344, 2005. [source] The novel nootropic compound DM232 (UNIFIRAM) ameliorates memory impairment in mice and ratsDRUG DEVELOPMENT RESEARCH, Issue 1 2002Carla Ghelardini Abstract The favorable pharmacological profile exhibited by piracetam stimulated the synthesis of related compounds potentially endowed with a higher nootropic potency. The antiamnesic and procognitive activity of DM232 (unifiram), a new compound structurally related to piracetam, was investigated. Mouse passive avoidance and rat Morris water maze and Social learning tests were employed. DM232 (0.001,1 mg kg,1 i.p. , 0.01,0.1 1 mg kg,1 p.o.) prevented amnesia induced by scopolamine (1.5 mg kg,1 i.p.), mecamylamine (20 mg kg,1 i.p.), baclofen (2 mg kg,1 i.p.), and clonidine (0.125 mg kg,1 i.p.). Furthermore, The antiamnesic effect of the investigated compound was comparable to that exerted by well-known nootropic drugs such as piracetam (30,100 mg kg,1 i.p.), aniracetam (100 mg kg,1 p.o.), rolipram (30 mg kg,1 p.o.), and nicotine (5 mg kg,1 i.p). DM232 (0.1 mg kg,1 i.p.) was also able to prevent amnesia induced by scopolamine (0.8 mg kg,1 i.p.) in the rat Morris watermaze test. In the rat social learning test, DM232 (0.1 mg kg,1 i.p.) injected in adults rats reduced the duration of active exploration of the familiar partner in the second session of the test. DM232, similarly to piracetam, reduced the duration of hypnosis induced by pentobarbital. At the highest effective doses, the investigated compound did not impair motor coordination (rota rod test), nor modified spontaneous (Animex). These results indicate DM232 (unifiram) as a novel cognition enhancer, strictly related to piracetam-like compounds, able to ameliorate memory impairment at doses about 1,000 times lower than the most active available nootropic compounds. Drug Dev. Res. 56:23,32, 2002. © 2002 Wiley-Liss, Inc. [source] Effects of group work programs on community-dwelling elderly people with age-associated cognitive decline and/or mild depressive moods: A Kahoku Longitudinal Aging StudyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2005Kiyohito Okumiya Background: Age-associated cognitive decline (AACD) is a predictor of dementia and highly prevalent among elderly people. Many elderly people with AACD also suffer from depressive moods. We studied, the effect of group work programs on the cognitive function and quality of life (QOL) of community-dwelling elderly people with AACD and/or mild depressive moods. Methods: Thirty-six subjects, with a mean age of 79.8 years, were included in this study. Twenty-one suffered from both AACD and mild depressive moods, nine suffered from mild depressive moods and six from AACD. Subjects were required to participate in a number of group work programs, such as music therapy, handicrafts and so on. They were assigned to one of two groups, and each participated in two 4-month sessions. In the first session, group 1 participated in the group work programs, while group 2 did not (control). In the second session, group 2 participated while group 1 did not. The effect of group work on elderly people with AACD (n = 27) and depressive moods (n = 31), was evaluated separately. Results: Improvement was observed in depressive moods and QOL (visual analogue scale of family relation, friendship and happiness, life satisfaction index) in subjects with cognitive impairment and depressive moods. The effect on cognitive function was shown only in elderly individuals suffering from depressive moods. The improvement in depressive moods and QOL seemed to be accompanied by an improvement in cognitive function but did not continue after completion of the group work program. Conclusion: Group work was shown to improve depressive moods, QOL and cognitive function; however, long-term effects require further examination. [source] James I, Gondomar and the Dissolution of the Parliament of 1621HISTORY, Issue 279 2000Brennan C. Pursell Letters written by Count Gondomar reveal that King James I devised a secret plan to dissolve the parliament of 1621 before it was recalled for a second session. Because of the escalating war in the Holy Roman Empire, James faced a belligerent parliament in England which pressured him to mount an effective defence of the Lower Palatinate against Spanish and imperial forces. James resisted and decided instead to maintain his rapport with Spain, and therefore it became necessary to sacrifice the parliament of 1621. Motivated by a genuine desire for peace, the king provoked a confrontation with the House of Commons in order to give him a pretext for dissolving parliament. [source] Acyclovir-induced neuropsychosis successfully recovered after immediate hemodialysis in an end-stage renal disease patientINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2007Hung-Hsu Yang MD A 70-year-old man developed herpes zoster over the right L5,S2 region for 3 days and was admitted for acyclovir therapy. He had a medical history of rectal cancer status post-colostomy and end-stage renal disease undergoing thrice weekly hemodialysis. Without a prior loading dose, acyclovir 500 mg (7.7 mg/kg) daily was given intravenously in two divided doses. On the third dosage, the patient became confused and agitated and developed insomnia. Within the following 24 h, delirium, visual and auditory hallucinations, disorientation to place and time, as well as impaired recent memory occurred. At the same time, a transient low grade fever (38 °C) was noted but resolved spontaneously after ice pillow (Fig. 1). Figure 1. The clinical and treatment course of the patient The etiology was vigorously explored. He had no history of any neurological or psychiatric disorders. Drug history was reviewed, but no other medications besides acyclovir were currently being used. Physical examination revealed neither meningeal signs nor focal neurological deficits. Serum blood urea nitrogen, glucose, and electrolytes were within normal limits except for an elevated creatinine level at 6.2 and 5.7 mg/dl (before and after neuropsychotic symptoms, respectively). Complete blood count with differentiation was also unremarkable. Cerebrospinal fluid examination was not possible as the patient's family refused the lumbar puncture. Moreover, an electroencephalograph study and head computed tomography scan disclosed no abnormalities. Acyclovir-induced neurotoxicity was suspected. Therefore, acyclovir was discontinued. Subsequently, serum acyclovir and CMMG were checked by enzyme-linked immunosorbent assay. Serum acyclovir level was 1.6 mg/l (normal therapeutic level, 0.12,10.8 mg/l) and CMMG level was 5 mg/l. Emergent hemodialysis (4-h/session) was given; the neuropsychotic symptoms, including agitation, delirium, and visual and auditory hallucinations, greatly abated after the second session. The patient fully recovered after three consecutive days of hemodialysis; the serum was rechecked and revealed that the acyclovir level was below 0.5 mg/l and the CMMG level was undetectable. At the same time, his herpetic skin lesions resolved well. [source] Single-session, graded esophageal dilation without fluoroscopy in outpatients with lower esophageal (Schatzki's) rings: A prospective, long-term follow-up studyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2007Spiros N Sgouros Abstract Background:, Distal esophageal (Schatzki's) ring is a frequent cause of dysphagia. Bougienage is generally effective but relapses are common. The aim of this study was to evaluate the safety and long-term efficacy of single-session graded esophageal dilation with Savary dilators, without fluoroscopic guidance, in outpatients who presented with Schatzki's ring. Methods:, The study was performed on 44 consecutive patients with symptomatic Schatzki's ring, detected endoscopically and/or radiologically. Graded esophageal dilation was performed as an outpatient procedure in a single session with Savary dilators, without fluoroscopic guidance. After appropriate assessment with esophageal manometry and 24 h ambulatory pHmetry, patients with documented gastroesophageal reflux disease (GERD) were treated with omeprazole continuously. All results, including clinical follow up and technical aspects of bougienage, were recorded prospectively. The necessity for re-dilation after documentation of the ring with endoscopy and/or radiology was considered as a relapse of the ring. Results:, In four (9%) patients a second session was necessary to ensure complete symptom relief. Two (4.5%) patients developed post-dilation bacteremia and were managed with antibiotics as outpatients. Patients with (n = 14) or without (n = 30) GERD were comparable with respect to sex, age, body mass index, smoke and ethanol consumption, diameter of the esophageal lumen at the level of the ring, resting lower esophageal sphincter pressure, duration of dysphagia, need for taking antacids during the follow-up period, and duration of follow-up. There was no recurrence of the ring in patients with GERD during a mean follow-up period of 43.8 ± 9.3 months (range 27,62 months); however, in patients without GERD, during a mean follow-up period of 40.6 ± 12.2 months (range 10,58 months), 32% of patients relapsed after a mean 19.9 ± 10.6 months (P = 0.04). Conclusions:, Single-session graded esophageal dilation with large caliber Savary dilators without fluoroscopic guidance can be safely used for the symptomatic relief in patients with lower esophageal (Schatzki's) rings. GERD should be treated if present in order to prevent a symptomatic recurrence of the ring. [source] Reproducibility of jaw movements in patients with craniomandibular disordersJOURNAL OF ORAL REHABILITATION, Issue 11 2006M. STIESCH-SCHOLZ summary, It has never been investigated, if mandibular movements of patients with craniomandibular disorders (CMD) result in a lower reproducibility of dynamic functional parameters which are used for the individual articulator setting. The aim of the present study was to compare the reproducibility of electronically registered functional parameters in patients with CMD and in a control group. Dynamic functional parameters were recorded in 30 patients and 30 volunteers with a computerized ultrasound system (ARCUSdigma). The whole registration was performed three times during one session and three times at a second session 1 week later. The horizontal condylar inclination in the patient group gave a standard deviation of 2·17° ± 0·95°, indicating poorer reproducibility than in the volunteer group, for which the standard deviation was 1·37° ± 0·42°. The reproducibility of measurements of the Bennett angle was also poorer in the patient group than in the volunteer group, with standard deviations of 1·70° ± 0·62° and 1·22° ± 0·40°, respectively. The standard deviations calculated for determination of incisal inclination during laterotrusion was 3·02° ± 1·49° for patients and 2·30° ± 1·17° for volunteers. The standard deviations for incisal inclination during protrusion was 2·02° ± 0·95° for patients and 2·06° ± 1·82° for volunteers. The reproducibility of measurement of horizontal condylar inclination, Bennett angle and incisal inclination during laterotrusion therefore showed significantly lower reproducibility in the patient group than in the volunteer group (P < 0·05). The overall reproducibility of the measurements was nevertheless good in both groups, with standard deviations under 3·1°, so that an individual setting of an articulator seems useful even in patients with CMD. [source] Evaluation of maximal bite force in temporomandibular disorders patientsJOURNAL OF ORAL REHABILITATION, Issue 8 2006E. M. KOGAWA summary, The aim of this study was to evaluate the maximum bite force in temporomandibular disorders (TMD) patients. Two hundred women were equally divided into four groups: myogenic TMD, articular TMD, mixed TMD and control. The maximum bite force was measured in the first molar area, on both sides, in two sessions, using an IDDK (Kratos) Model digital dynamometer, adapted to oral conditions. Three-way anova, Tukey and Pearson correlation tests were used for the statistical analysis. The level of statistical significance was given when P , 0·05. The maximal bite force values were significantly higher in the control group than in the experimental ones (P = 0·00), with no significant differences between sides. Higher values were obtained in the second session (P = 0·001). Indeed, moderate negative correlation was found between age and bite force, when articular, mixed groups and all groups together were evaluated. A moderate negative correlation was also detected between TMD severity and the maximal bite force values for myogenic, mixed and all groups together. Authors concluded that the presence of masticatory muscle pain and/or TMJ inflammation can play a role in maximum bite force. The mechanisms involved in this process, however, are not well understood and deserve further investigation. [source] Intravenous Ethanol Infusions Can Mimic the Time Course of Breath Alcohol Concentrations Following Oral Alcohol Administration in Healthy VolunteersALCOHOLISM, Issue 5 2009Vijay A. Ramchandani Background:, Our previous studies have used intravenous (IV) clamping methods to demonstrate that family history positive (FHP) subjects exhibit a greater initial response to alcohol than family history negative (FHN) subjects. These results differ from other studies of family history of alcoholism (FHA) influences, most of which have used an oral alcohol challenge, suggesting that the route of administration may influence both the response to alcohol and FHA-related differences in response. To examine this possibility, one approach would be to directly compare responses following oral and IV alcohol administration in the same subjects. There is, however, a 3- to 4-fold variance, between- and within-subjects, in the breath alcohol concentrations (BrACs) following oral alcohol administration. Thus, our objective was to characterize the between-subject variability in the time course of BrACs following oral alcohol administration in healthy volunteers and to develop an IV infusion method to mimic the BrAC-time course attained following oral alcohol in the same subject. Methods:, This was a 2-session study in young adult, healthy, nondependent drinkers. In the first session, subjects ingested an oral dose of alcohol, based on total body water, to achieve a target peak BrAC of 80 mg%. In the second session, subjects received an IV infusion of ethanol designed to achieve the same BrAC time course as that achieved in the first session. The individualized infusion-rate profile was precomputed using a physiologically-based pharmacokinetic (PBPK) model for alcohol with model parameters adjusted to the individual's physiology. The peak BrACs (Cmax), times of peak BrAC (Tmax), and the areas under the BrAC vs. time curve (AUC) were compared between sessions to assess how closely the BrAC exposure during the IV infusion session mimicked the exposure following oral alcohol. Results:, The time course of BrACs following oral alcohol administration showed a high degree of between-subject variability. Mean Cmax, Tmax, and AUC did not differ by gender, indicating that calculation of oral doses based on total body water results in comparable BrAC-time courses, on average, for females and males. The IV infusion driven BrAC-time profiles demonstrated good fidelity to the BrAC-time curves resulting from oral alcohol: the mean %difference in Cmax and AUC were both 11%, while the mean %difference for Tmax was 27%. This degree of variability is less than half that seen across individuals following oral alcohol administration, which was substantial [coefficient of variation (%CV) ranging from 22 to 52%]. Conclusions:, Despite the use of standardized doses and controlled experimental conditions, there was substantial between-subject variability in the BrAC time course following oral administration of alcohol. The PBPK-model-based infusion method can mimic the BrACs attained with oral alcohol for individual subjects. This method provides a platform to evaluate effects attributable to the route of administration on the response to alcohol, as well as the influence of determinants such as family history of alcoholism on the alcohol response. [source] Effect of Kava and Valerian on human physiological and psychological responses to mental stress assessed under laboratory conditionsPHYTOTHERAPY RESEARCH, Issue 1 2002M. Cropley Abstract This study investigated whether kava or valerian could moderate the effects of psychological stress induced under laboratory conditions in a group of healthy volunteers. Fifty-four participants performed a standardized colour/word mental stress task on two occasions 1 week apart. Blood pressure (BP), heart rate (HR) and subjective ratings of pressure were assessed at rest and during the mental stress task. Following the first session (time 1,=,T1), individuals took a standard dose of kava (n,=,18), or valerian (n,=,18) for 7 days, while the remainder acted as controls (n,=,18). Differences in BP and HR from resting levels were calculated as reactions to the stress task at both time points. At the second session (time 2,=,T2) there was a significant decrease in systolic BP responsivity in both the kava and valerian groups relative to T1, but there were no significant reductions in diastolic BP. Between T1 and T2, the HR reaction to mental stress was found to decline in the valerian group but not in the kava group. Individuals taking kava or valerian reported less pressure during the task at T2 relative to T1. There were no significant differences in BP, HR or subjective reports of pressure between T1 and T2 in the controls. Behavioural performance on the colour/word task did not change between the groups over the two time points. The results suggest that kava and valerian may be beneficial to health by reducing physiological reactivity during stressful situations. Copyright © 2002 John Wiley & Sons, Ltd. [source] High prevalence information from different sources affects the development of false beliefsAPPLIED COGNITIVE PSYCHOLOGY, Issue 2 2010Celine van Golde To examine the effects of high and low false prevalence information from different sources on false beliefs, subjects took part in two sessions. In the first session, subjects rated the plausibility of different childhood events, how confident they were that they had experienced those events and their memories of those events. In the second session, 2,weeks later, subjects received high prevalence information about one target event and low prevalence information about another. Subjects received the information in a third-person description, a newspaper article, or cohort data about previous students' experiences, or they received no information. High prevalence newspaper and cohort information increased subjects' plausibility ratings compared to no information and third-person descriptions. High prevalence newspaper information also increased subjects' belief ratings. Our findings contribute to the growing literature demonstrating the role of false high prevalence information in the development of false beliefs. Copyright © 2009 John Wiley & Sons, Ltd. [source] Use of an Embalming Machine to Create a Central Venous Access Model in Human CadaversACADEMIC EMERGENCY MEDICINE, Issue 2009Lee Wilbur Background:, Human cadavers provide an effective model for procedural training; however, inconsistent blood return during central venous cannulation compromises the overall reliability of this procedure. Objective:, To create and quantitatively assess a human cadaver central venous access model using a continuously-run embalming machine. Curriculum:, Emergency medicine (EM) faculty at Indiana University created this model for a procedure lab designed for EM residents. The right femoral artery was identified by superficial dissection and cannulated distally towards the lower leg. This cannula was connected to a Duotronic embalming machine with a solution composed of 16 oz of 24-index fluid and 3 gallons of tap water at a fixed output of 13 pounds per square inch (psi). Next, the left subclavian vein and artery were identified by dissection and each was cannulated with an 18 gauge angiocath connected to a continuous pressure monitor. Pressures (mmHg) in the subclavian vein and artery were measured continuously while study personnel cannulated the left femoral, right subclavian, right supraclavicular, and right internal jugular veins. This model was assessed for dual sessions lasting two hours each with a two hour break in-between. Results:, During the first session, subclavian pressures were measured at 3 mmHg venous and 22 mmHg arterial, increasing to 11 mmHg venous and 27 mmHg arterial during the second session. Residents were able to withdraw at least 5 milliliters at each central venous site in the embalmed cadaver. Conclusions:, We created a reliable and measurable central venous access model in a fresh-frozen human cadaver using a standard embalming machine. [source] Effects of prior access and environmental enrichment on stereotypyBEHAVIORAL INTERVENTIONS, Issue 4 2004John T. Rapp A young boy's stereotypy was first evaluated in two daily 30,min sessions (one in the morning and one in the afternoon) during a free operant (FO) condition. Results from the two daily sessions during FO showed that stereotypy was lower during the second session of the day, suggesting that prior access had affected later engagement in stereotypy. The effects of environmental enrichment (EE) with music, EE music plus a guitar, and EE music plus a guitar plus contingent music loss on stereotypy were also evaluated. Unexpectedly, the results showed that the presence of music increased stereotypy during both daily sessions; however, contingent music loss decreased stereotypy and simultaneously increased untargeted guitar play. Increases in stereotypy during both daily sessions suggest that music may have increased the reinforcing value of stereotypy. Copyright © 2004 John Wiley & Sons, Ltd. [source] Determination of the Rh factor: A practical illustrating the use of the polymerase chain reactionBIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION, Issue 1 2005Santiago Imperial Abstract A practical experiment on the PCR is described that has been used over several years as part of an undergraduate biochemistry and molecular biology course for chemistry students. In the first experimental session, students prepare their own DNA samples from epithelial cells of the mouth and use them as templates in the PCR. In the second session, they analyze the amplified DNA by electrophoresis and determine their Rh factor. [source] Virtual reality simulation training can improve technical skills during laparoscopic salpingectomy for ectopic pregnancyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2006R Aggarwal Objectives, To assess the first commercially available virtual reality (VR) simulator to incorporate procedural modules for training of inexperienced gynaecological surgeons to perform laparoscopic salpingectomy for ectopic pregnancy. Design, Prospective cohort study. Setting, Departments of surgery and gynaecology in central London teaching hospitals. Sample, Thirty gynaecological surgeons were recruited to the study, and were divided into novice (<10 laparoscopic procedures), intermediate (20,50) and experienced (>100) groups. Methods, All subjects were orientated to the VR simulator with a basic skills task, followed by performing ten repetitions of the virtual ectopic pregnancy module, in a distributed manner. Main outcome measures, Operative performance was assessed by the time taken to perform surgery, blood loss and total instrument path length. Results, There were significant differences between the groups at the second repetition of the ectopic module for time taken (median 551.1 versus 401.2 versus 249.2 seconds, P= 0.001), total blood loss (median 304.2 versus 187.4 versus 123.3 ml, P= 0.031) and total instrument path length (median 17.8 versus 8.3 versus 6.8 m, P= 0.023). The learning curves of the experienced operators plateaued at the second session, although greater numbers of sessions were necessary for intermediate (seven) and novice (nine) surgeons to achieve similar levels of skill. Conclusions, Gynaecological surgeons with minimal laparoscopic experience can improve their skills during short-phase training on a VR procedural module. In contrast, experienced operators showed nonsignificant improvements. Thus, VR simulation may be useful for the early part of the learning curve for surgeons who wish to learn to perform laparoscopic salpingectomy for ectopic pregnancy. [source] Simultaneous bilateral percutaneous nephrolithotomy in childrenBJU INTERNATIONAL, Issue 1 2005Morshed A. Salah In the paediatric section, two papers relating to the upper urinary tract are presented. The first, from Hungary, describes simultaneous bilateral percutaneous nephrolithotomy in 13 patients, where it was deemed feasible; this is the first such report. Authors from London report on unilateral nephrectomy in patients with nephrogenic hypertension, and found that it was successful in normalising blood pressure in patients with renal hypertension with a normal contralateral kidney. OBJECTIVE To evaluate the efficacy of removing bilateral kidney stones simultaneously from children, in one session. PATIENTS AND METHODS Thirteen patients (three girls and 10 boys, 26 kidneys; mean age 8 years, range 3,14) underwent simultaneous bilateral percutaneous nephrolithotomy (PCNL) in the same session, under general anaesthesia, starting with ureteric catheter insertion into both kidneys and using a 26 F adult nephroscope. The mean (range) stone diameter was 2 (1,3.5) cm. Three patients had staghorn stones in one of their kidneys. Ultrasonic disintegration was used; two patients had bilateral and two others unilateral endopylotomy, and one patient had percutaneous suprapubic cystolithotomy in the same session. The mean (range) operative duration was 65 (55,90) min. RESULTS All patients were rendered stone-free; there was no severe bleeding or any other complication. On one side in one of the patients, a second session was needed because of residual stone. The nephrostomy tubes were removed 3 and 4 days after PCNL and the hospital stay was 6 (1,11) days. CONCLUSION The advantages of simultaneous bilateral PCNL are reduced psychological stress, one cystoscopy and anaesthesia, less medication and a shorter hospital stay and convalescence, with considerable savings in cost. In experienced hands this method can be used not only in adults but also in children. To our knowledge this is the only report of this technique in children. [source] Exploring therapeutic alliance in brief inpatient psychotherapy: a preliminary studyCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 5 2010Mark A. Blais Abstract Background: Therapeutic alliance is one of the most widely investigated variables in psychotherapy research but few studies have explored its role in inpatient psychotherapy. Many factors likely contribute to the lack of inpatient alliance research including the short length of hospital stays, complexity of patient psychopathology and the burdensome quality of most alliance scales. This paper reports on the development and initial application of two comparable brief scales designed to capture patient and therapist alliance ratings. Method: Participants were 20 patients receiving supportive,expressive inpatient psychotherapy. The patients were predominantly depressed women. Baseline measures of distress, symptom severity and functioning were obtained at the first and third sessions. Measures of alliance were obtained at the second session. Results: The brief alliance scales demonstrated adequate internal consistency and the individual items had good adjusted item-to-scale correlations. Consistent with the broad alliance literature, we found that patients rated alliance higher than therapists, patient and therapist alliance ratings were not significantly correlated, and level of functioning was significantly associated with both patients and therapists' alliance ratings. The perceived depth of psychotherapy was also significantly associated with alliance. Unexpectedly, alliance ratings were also negatively associated with improvement during hospitalization. Conclusions: Overall, the study demonstrates both the feasibility and potential benefit of conducting inpatient psychotherapy research.,Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: This paper shows that inpatient psychotherapy can be studied and potentially improved through the application of brief targeted instruments. [source] | ||||||||||||||||