-
Ball McCarty posted an update 2 months ago
The ‘1-3-5 presentation’ has been added to our neurology Grand Rounds series in a recent update. Within the allotted five-minute timeframe, a presentation on a single topic is required, using no more than three slides. This approach is suitable for effectively covering isolated, simple subjects, facilitating an introduction to and engaging debate on more complex matters. Within our department, 1-3-5 presentations have demonstrated widespread appeal, leading to the creation of a dedicated YouTube channel hosting a library of these presentations. This format’s strengths and prospects are analyzed in this article, advocating for similar learning opportunities for all clinical students in other departments.
Continued progress in precision medicine necessitates the extensive sharing of data relating human genetic variation to disease presentations. Nonetheless, the accessibility of data is severely hampered by legal, regulatory, and ethical safeguards intended to maintain patient privacy. By transferring the code, rather than the data, federated analysis empowers data providers with the technical and legal means to analyze their own data within a secure framework, addressing the problem. Data that cannot be moved provides researchers with fresh insights, all while safeguarding patient privacy and respecting the legal obligations of data managers. The technical solution of federated analysis to the legal hurdles of data sharing necessitates a joint assessment of its technology and policy ramifications. A technical overview of federated analysis procedures is given, which is then supplemented by a legal analysis of resulting policy implications. The Annual Review of Genomics and Human Genetics, Volume 24, is anticipated to be published online in August 2023. Please review the publication dates at http//www.annualreviews.org/page/journal/pubdates for the correct information. Revised estimations require this return.
Among the innovative flow-diverting devices, the Pipeline Embolization Device is showing promising results in tackling difficult posterior circulation aneurysms. A paucity of prior investigations has examined the use of FDDs in treating aneurysms of the basilar quadrifurcation.
A retrospective evaluation of FDD treatment for basilar quadrifurcation aneurysms was performed. Patient evaluations included aneurysm type, prior aneurysm treatments, technical success metrics, perioperative complications, and long-term aneurysm occlusion.
A review of 34 patients revealed various intracranial aneurysms, including 23 cases involving the basilar apex, 7 cases of superior cerebellar artery (SCA) aneurysms, one case with both basilar apex and SCA aneurysms, and 3 cases of posterior cerebral artery (PCA) aneurysms. The average largest aneurysm dimension, calculated as 87 mm (standard deviation 61 mm), fell within a range of 19 mm to 308 mm. Fourteen previously existing aneurysms were surgically clipped or endovascularly coiled. Aneurysms, without exception, displayed a saccular morphology. Sixty-six months (SD 54) postoperatively, on average (range 0-19 months), the final angiographic follow-up showed complete or near-complete occlusion in 30 of the 34 patients (88%). No postoperative symptomatic occlusion of the SCA or PCA was observed in any patient; however, four patients did experience asymptomatic posterior communicating artery occlusions; 82% of the 28 patients experienced no complications; 3 patients (9%) suffered major complications, and another 3 (9%) suffered minor complications; and one patient succumbed to subarachnoid hemorrhage.
Basilar quadrifurcation aneurysms can potentially be addressed safely and effectively through flow diversion. Recurrence or persistent lesions in previously treated basilar quadrifurcation aneurysms may respond favorably to additional treatment employing an FDD. Future research endeavors should be focused on confirming these observations.
In the treatment of basilar quadrifurcation aneurysms, flow diversion stands as a potentially safe and effective choice. Additional treatment with an FDD could prove beneficial for basilar quadrifurcation aneurysms that have experienced recurrence or residual lesions following prior treatment. Future research endeavors must prioritize validating these discoveries.
Twilight sleep’s history, while crucial to British obstetric pain relief, has unfortunately been overlooked. This article reconstructs the largely untold story of twilight sleep in Britain, drawing from both digitized newspapers (like the Weekly Dispatch) and medical journals. Scopolamine and morphine, the essential components of twilight sleep, functioned together to ease the pain of childbirth and prevent subsequent recollection. 1915 saw the ascendance of twilight sleep in Britain, a phenomenon that occurred one year after its initial acceptance in America, a topic meticulously explored by scholarship. Hanna Rion, a prominent advocate for twilight sleep in Britain, penned a series of weekly articles in 1916, diligently championing its implementation. From Rion’s writings and the subsequent discourse, the relationship between the growing acceptance of twilight sleep and the anxieties surrounding declining birth rates during World War I becomes clear. Through the case study of twilight sleep, we can observe women asserting their influence on medical treatment, preceding the natural childbirth movement. Twilight sleep, in this context, fulfills the function of the missing link in the history of obstetric anesthetics, bridging the gap between chloroform’s 1847 discovery and the 1930s natural childbirth movement.
Television programs in the contemporary era often showcase anxieties about surveillance and intimate self-revelation when portraying psychotherapy in clinical and therapeutic settings. This analysis of two 21st-century television series focuses on therapy sessions which observe and track mental states for predictive purposes, illustrating Alan Westin’s notion of psychological surveillance. Specifically, this study includes Peter Morgan’s The Crown (2016-2023) and Phoebe Waller-Bridge’s Fleabag (2016-2019). tgf-beta inhibitor These shows, showcasing psychotherapy, depict contrasting ways of admitting personal truths—confessions and post-confessions—that manifest in the therapeutic setting. The confessional mode prioritizes honesty and the quest for therapeutic repair. Postconfessions, employing a parodic style of revelation, reject the authenticity and closeness traditionally associated with therapy and the confessional tradition. Discourses in The Crown, concerning confessions, demonstrate how state power benefits from psychological surveillance, further reinforced by genetic authentication. While other approaches differ, Fleabag’s post-confessional discourse draws the audience into the therapeutic interaction, taking advantage of the increasingly decentralized self-care methods prevalent in social media, television, and audience-centric media.
The ventrolateral periaqueductal gray (vlPAG) region of the midbrain’s periaqueductal gray (PAG) is a component of a key descending pathway, influencing nociception, fear responses, and anxiety in both human and rodent models. Prior research has established the crucial role of inhibitory GABAergic neurons located in the vlPAG in modulating nociceptive responses. Although the PAG demonstrates a substantial diversity of neuronal subtypes, the contribution of specific inhibitory neuronal subtypes to the regulation of nociception is still uninvestigated. Employing a chemogenetic strategy in GlyT2cre mice, we targeted and modified a specific subset of glycinergic neurons residing in the ventral periaqueductal gray (vlPAG), aiming to unveil their role in controlling nociception. We demonstrate that activating GlyT2-PAG neurons results in amplified reactions to cold and noxious heat, as well as an increase in locomotor activity (LMA), in both male and female mice. Unlike the control group, inhibiting GlyT2-PAG neurons resulted in diminished nociceptive responses, leaving locomotor activity unaffected. Findings from our research show that GlyT2-expressing neurons in the ventrolateral periaqueductal gray (vlPAG) affect nociceptive signaling, suggesting that strategies directed at GlyT2-lacking neurons in the periaqueductal gray may provide a basis for creating new analgesic medicines.
The increased availability of electronic nicotine devices (vaping) and nicotine e-liquids, rich in sensory-enhancing additives, has unfortunately contributed to a surge in nicotine use, specifically among adolescents, who are vulnerable to this drug’s addictive qualities. While some research on the function of these additives in relation to nicotine reward suggests a heightened sense of reward and reinforcement, the sensory properties of these additives, especially in their vaporized state, have not been thoroughly examined. We sought to comprehend the effect of a fruit-flavored (strawberry, in this case) additive on nicotine reward and aversion. A conditioned place preference (CPP) procedure was employed, delivering nicotine and strawberry-flavored vapor to male and female adolescent mice. Using a biased experimental setup, we observed that nicotine vapor alone could induce a dose-dependent conditioned place preference. Although the strawberry additive was included, CPP was not elicited, and no discernible effect was observed on nicotine vapor-induced reward. Although mice exposed to nicotine and strawberry-flavored vapor showed higher plasma cotinine levels, this did not appear to correlate with any alterations in nicotine’s metabolic rate. Respiratory monitoring, along with direct vapor sampling techniques, exposed a notable escalation in sniffing responses towards strawberry-laced nicotine vapor when contrasted with plain nicotine vapor. These data imply that the enrichment of e-liquids with chemosensory elements may intensify the perceived sensory aspect of nicotine vapor, contributing to higher nicotine exposure, while potentially not directly affecting the reward value.