Hypotension during kidney transplantation can be common. Vasopressor use during these procedures is often avoided, with a fear of decreasing renal perfusion in the transplanted kidney. However, ...adequate perfusion for the rest of the body is also necessary, and given that these patients often have underlying hypertension or other comorbid conditions, an appropriate mean arterial pressure (MAP) has to be maintained. Intramuscular injections of ephedrine have been studied in the anesthesiology literature in a variety of case types, and it is seen as a safe and effective method to boost MAP. We present a case series of three patients who underwent renal transplantation and who received an intramuscular injection of ephedrine for hypotension control. The medication worked well for increasing blood pressures without apparent side effects. All three patients were followed for more than one year, and all patients had good graft function at the end of that time period. This series shows that while further research is necessary in this arena, intramuscular ephedrine may have a place in the management of persistent hypotension in the operating room during kidney transplantation.
Topographic organization of macaque area LIP Patel, Gaurav H; Shulman, Gordon L; Baker, Justin T ...
Proceedings of the National Academy of Sciences - PNAS,
03/2010, Letnik:
107, Številka:
10
Journal Article
Recenzirano
Odprti dostop
Despite several attempts to define retinotopic maps in the macaque lateral intraparietal area (LIP) using histological, electrophysiological, and neuroimaging methods, the degree to which this area ...is topographically organized remains controversial. We recorded blood oxygenation level-dependent signals with functional MRI from two macaques performing a difficult visual search task on stimuli presented at the fovea or in the periphery of the visual field. The results revealed the presence of a single topographic representation of the contralateral hemifield in the ventral subdivision of the LIP (LIPv) in both hemispheres of both monkeys. Also, a foveal representation was localized in rostral LIPv rather than in dorsal LIP (LIPd) as previous experiments had suggested. Finally, both LIPd and LIPv responded only to contralateral stimuli. In contrast, human studies have reported multiple topographic maps in intraparietal cortex and robust responses to ipsilateral stimuli. These blood oxygenation level-dependent functional MRI results provide clear evidence for the topographic organization of macaque LIP that complements the results of previous electrophysiology studies, and also reveal some unexpected characteristics of this organization that have eluded these previous studies. The results also delineate organizational differences between LIPv and LIPd, providing support for these two histologically defined areas may subserve different visuospatial functions. Finally, these findings point to potential evolutionary differences in functional organization with human posterior parietal cortex.
Refractory hypotension is a known entity in liver transplantation. Catecholamine and vasopressin infusions are first-line therapies. There has been recent interest in angiotensin II (Ang-2) as an ...alternative vasopressor; however, liver failure patients were excluded from the original trials. Ang-2 has potential in this patient population. This case discusses a patient who received an infusion of Ang-2 during a liver transplant for combined liver failure-induced distributive shock and septic shock. It is the first known successful use of intraoperative Ang-2 in this situation, and it shows that Ang-2 may be safe in liver transplantation when traditional therapies fail.
The use of an anesthesiology rotation in the realm of surgical education is not very well studied. Several studies show the importance of an anesthesiology rotation in the grand scheme of ...undergraduate medical education. However, its importance in perioperative medicine and surgical education is not very well understood. This study attempts to look at this relationship and determine whether or not a temporal relationship between this anesthesiology rotation and a surgical rotation is important.
I used an online survey tool to survey medical students who took the anesthesiology rotation (required rotation) in 2014 and 2015 (when rotation was coupled to surgical rotation) and compared those data to the data of students who took the rotation in 2016 (when the rotation was not coupled to surgery). I asked several questions looking at the importance of the anesthesiology rotation to surgical education and to perioperative medicine.
Having a required anesthesiology rotation appears to add value to the general surgery rotation in undergraduate medical education. Furthermore, when this rotation is paired with the general surgery rotation, it appears that the students learn more about perioperative medicine than when the rotation is paired with other "advanced" rotation.
The pairing of anesthesiology with a general surgery rotation does indeed improve the perioperative medicine education and knowledge of students. Students appreciate having a week of anesthesiology with the surgical rotation, and they note that it adds value to the general surgery rotation.
In the central Indian context, there are some pictograms used in almost all pesticide packaging. These pictograms depict the nature of pesticides, their correct dosage and handling. The objective of ...this study was to investigate the effect of different colors (black, red, yellow, green, blue, and pink) on the comprehensibility of pesticide pictograms. Thirty farmers were selected as the participants of this study. Two tests were conducted in this study, a Comprehension test and a Ranking test. In the Comprehension test, comprehensibility for different colors of pesticide pictograms was evaluated. In the Ranking test, the participant's preference for colors was checked for the pesticide pictograms. Maximum comprehension level was observed for the pictogram of 'Wash after using pesticide' (100%) for all the colors. A minimum comprehension level was observed for the pictogram of 'How to handle liquid' (65%) for red color. Results indicated no significant variations (p > 0.05) in comprehension levels for changes in different colors of pesticide pictograms. Results of the ranking test indicated that the users preferred Red color (mean rank 1.37) for pesticide pictograms, while Yellow (mean rank 4.54) and Pink (mean rank 4.57) colors were the least preferred colors for pesticide pictograms. The results we mentioned are for comprehension level though no significant difference was noticed, but for the ranking test red color was preferred over other colors.
To examine the distribution of visual and oculomotor activity across the macaque brain, we performed functional magnetic resonance imaging (fMRI) on awake, behaving monkeys trained to perform ...visually guided saccades. Two subjects alternated between periods of making saccades and central fixations while blood oxygen level dependent (BOLD) images were collected 3 T, (1.5 mm)3 spatial resolution. BOLD activations from each of four cerebral hemispheres were projected onto the subjects' cortical surfaces and aligned to a surface-based atlas for comparison across hemispheres and subjects. This surface-based analysis revealed patterns of visuo-oculomotor activity across much of the cerebral cortex, including activations in the posterior parietal cortex, superior temporal cortex and frontal lobe. For each cortical domain, we show the anatomical position and extent of visuo-oculomotor activity, including evidence that the dorsolateral frontal activation, which includes the frontal eye field (on the anterior bank of the arcuate sulcus), extends anteriorly into posterior principal sulcus (area 46) and posteriorly into part of dorsal premotor cortex (area 6). Our results also suggest that subcortical BOLD activity in the pulvinar thalamus may be lateralized during voluntary eye movements. These findings provide new neuroanatomical information as to the complex neural substrates that underlie even simple goal-directed behaviors.
People visiting different Government Hospitals at Jabalpur in central India, were facing problems in comprehending different symbols. One of such hospital authority approached the research team for ...developing new symbols which could be easily comprehended by the users. Based on this, the current study was conducted, which included two experiments. The first experiment dealt with the ergonomic evaluation and identification of problems associated with the existing symbols. New concepts were then developed based on Ergonomic principles and users’ feedback. The second experiment focused upon testing of the new concepts on the target users.
Results of Experiment 1 indicated that the mean comprehension level was 22.3% for all the existing symbols (n = 41). Low scores (on a scale of 1–10) were found for the existing symbol for ergonomic principles (mean value was 1.9 for Compatibility, 2.1 for Familiarity, and 2.0 for Standardisation). Redesigned concepts of the symbols were tested on the target users, the result indicated an improvement in comprehensibility of newly designed symbols. The mean comprehension level for 53 new/redesigned symbols was 70.2%, which included redesign of 41 orignal and inclusion of 12 new symbols. High scores (on a scale of 1–10) were received for all the new symbols for ergonomic principles (the mean value was 8.4 for Compatibility, 8.5 for Familiarity, and 8.5 for Standardisation). Findings of this study may be helpful for the researchers working in the domain of information ergonomics in space related to healthcare sector or similar areas.
•Evaluation of hospital symbols in terms of comprehensibility and ergonomic principles.•Adherence of comprehensibility with compatibility, familiarity and standardisation.•Development of new symbols based of users' feedbacks and ergonomic principles.
In the central Indian context, there are some pictograms used in almost all the pesticides packages. The objective of this study was to evaluate the existing pictograms used on pesticide packaging in ...the Indian context and redesign the same in tandem with the ergonomic attributes of the local users. Twelve frequently used pictograms were selected for ergonomic analysis and redesign in tandem with the local context. Two experiments were conducted. Experiment 1 focused on the evaluation of the existing pictograms for comprehensibility and their adherence with different ergonomic principles of familiarity, compatibility and standardization. Experiment 2 focused on the redesigning of these pictograms and further evaluation of the redesigned pictograms similar to that of experiment 1. Experiment 1 indicated that the mean Comprehension level for the existing pictograms was at 52.2% (SD ± 30.8). The mean score of the existing pictograms for Familiarity was at 6.4 (SD ± 1.8), Compatibility at 6.2 (SD ± 1.8) and Standardization at 6.1 (SD ± 1.9). Correlation between the Comprehension level and the ergonomic principles were significant (p < 0.05 for all), r = 0.85 between the Comprehension level and Familiarity, r = 0.84 between the Comprehension level and Compatibility, r = 0.84 between the Comprehension level and Standardization. Experiment 2indicated that the mean Comprehension level of the redesigned pictograms was 82.2% (SD ± 11.9). The mean score of the redesigned pictograms for Familiarity was at 8.0 (SD ± 0.3), Compatibility at 8.2 (SD ± 0.3) and Standardization at 8.2 (SD ± 0.3). Correlation between the Comprehension level and the ergonomic principles were significant (for p < 0.05 for all) and r = 0.62 between the Comprehension level and Familiarity, r = 0.74 between the Comprehension level and Compatibility, r = 0.8 between the Comprehension level and Standardization). Results indicated a significant improvement in the comprehensibility of the redesigned pictograms. The findings of this study might be helpful to the researchers working in the visual ergonomics of pictograms in the agriculture sector.
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